2014-11-17T20:45:38-08:00 2013-12-31 990 2013-01-01 930429015 Portland Adventist Medical Center PORT 5032572500 10123 SE Market St Portland OR 97216 Joyce Newmyer President & CEO 2014-11-17 2013 2015-11-30 17:44:51Z Joyce Newmyer 317892351 false false 1071 X www.adventisthealth.org/nw X 1900 OR Our mission is to demonstrate the human expression of the healing ministry of Jesus Christ 13 8 2473 285 4736657 -94795 542898 702222 280416450 313657996 3585154 3018833 -60305 -169361 284484197 317209690 8600 0 0 157261458 163752605 0 299859 120652827 150444382 277922885 314196987 6561312 3012703 284394569 289450544 91018326 93061598 193376243 196388946 Our mission is to demonstrate the human expression of the healing ministry of Jesus Christ. false false 250555798 302739396 Portland Adventist Medical CenterProgram Service Accomplishments2013Portland Adventist Medical Center (AMC) provides quality medical health care regardless of race,creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Portland Adventist Medical Center (AMC), the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Portland Adventist Medical Center (PAMC) provide low cost care to individuals covered by government programs and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. PAMC recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2013 was $13,973,603.The following Inpatient services that were provided to all our patients. These services included:1,089 Babies delivered2,984 Surgeries performed19,886 Radiology procedures performed1,253 Cardiac Catheterizations and other procedures267,768 Laboratory tests14,402 Patient days (Psychiatric Services)The following Outpatient services that were provided to all our patients. These services included:49,880 Emergency department visits3,894 Outpatient Surgeries performed91,681 Radiology procedures performed1,717 Cardiac Catheterizations and other procedures374,129 Laboratory tests217,200 Medical clinic visits67,960 Rehab visitsHome Health Care services in 2013 that were provided to all our Home Health patients. These services included:32,289 Home Health visits34,437 Hospice patient days17,710 Home Medical Equipment deliveries7,278 Home Infusion Therapy daysPAMC recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2013 was $7,431,295.Community Health Improvements ServicesHospice presentationDavid Douglas High SchoolOregon SDA Conference Healthy Heart ProgramOregon Board Of Medical ImagingAHA Heart and Stroke WalkAnswering Medication questionsPower Food for the BrainVegfest 20139 Ways to Prevent DiabetesNational Alliance for the Mentally IllA Delicious Fair of the HeartSmoke Free Support GroupEat more, Weigh lessRemembrance ServiceNorthwest Parish Nursing MinistriesFuneral ServicesWomen's Health FairGrief ClassesSharon SDA Church- Community Health FairNational Cancer Survivor's DayPrepare Childbirth ClassesCancer Care CoordinatorAHA Heart and Stroke WalkCancer Support GroupBetter Living ShowCommunity Based Clinical Services:Compassion SandyStroke AlertSalud! Wellness ClinicsMedicationsCompassion DowntownCHIP Blood Draw- Meadow Glade #1, #2, #3CHIP Blood Draw- Beaverton #1Stroke AlertHealth Care Support Services:Emergent transportation needs of discharging patientsCancer patient transportationEnrollment assistance in government funded health programsCoupons for homeless sheltersCancer Survivor EventCancer Support GroupGrief ClassesHealth Professionals EducationPhysiciansAdvanced Life Support for ObstetricsVarious health lecturesMedical StudentsNurses/Nursing students:Student nurses- 36,327 hours 285 studentsNursing School subsidyOregon Center for NursingOther Health Professionals Education:All City Palliative Care ConferencePlant Based Nutritional ConferenceAll City Palliative Care ConferenceMedical LibraryRehab StudentsSubsidized Health Services:Hospital Outpatient Services:Cardiopulmonary RehabSubsidized Continuing CareHome HealthBehavioral Health ServicesPsych and Psych Services PhysiciansFinancial and In-Kind DonationsCash Donations:Medical Teams InternationalIn-Kind Donations:Northwest Adventist Federal Credit UnionSt Vincent de PaulMeeting Room OverheadPACS Awards Dinner and AuctionPACS Board Meals on WheelsOAHHS Public Policy MeetingFundraising for PACSColumbia Adventist Academy BoardDonation of Medication-Home InfusionCelebration of ThanksgivingDonation of equipmentChildren's Center Healing Garden GalaSupplies Donated to PACSAmerican Cancer Society Relay for LifeAmerican Red Cross Blood drivesCommunity Building ActivitiesEconomic Development:Various Local Chamber of Commerce timeEast Metro Economic AllianceMicro Enterprise Services of OregonRockwood Business CoalitionLeadership developmentOregon MentorsCoalition Building:Annual Clark County Mayors' and Civic Leaders'Workforce DevelopmentLocal High School students mentoringCommunity Benefits OperationAssigned Staff:1928 total hoursCBISA software 250555798 true true false true false false false false false true true false false true true false false true false false false false false false true false true true false false true false false false false false false false false false false false false false false false true true true false false false true 350 0 true 2473 true true false false false false true true false 0 false false false false false false false false false false X 13 8 false false false false true false true true true false false true true true true true true true true true false X Ron Benfield 5032516150 10123 SE Market St Portland OR 97216 X CAVINESS LARRY Director 0.00 2.00 X 0 2263 0 DICKINSON CHARLES Director 0.00 2.00 X 0 5021 0 FIKE RUTHITA Director 0.00 2.00 X 0 576 0 FRIESTAD CHRISTINE Director 0.00 2.00 X 0 1783 0 GABRIEL MELODY Director 0.00 2.00 X 0 1443 0 GRAHAM RICARDO Director 0.00 2.00 X 0 3020 0 INNOCENT LARRY Director 0.00 2.00 X 0 1410 0 JONES HELMUTH Director 0.00 2.00 X 0 85460 0 REIMCHE ALLAN Director 0.00 2.00 X 0 2070 0 RIPPEY WESLEY Director 9.00 2.00 X 95370 1559 0 TORKELSEN MAX Director 0.00 2.00 X 0 2799 0 CARMEN ROBERT Dir/Chair 0.00 50.00 X X 0 1469005 44835 REINER SCOTT Dir/V Chair/Sec 0.00 50.00 X X 0 1075867 198380 REBOK DOUGLAS Asst Secretary 0.00 50.00 X 0 787365 162365 WEHTJE RODNEY Asst Treasurer 0.00 50.00 X 0 508359 105863 WING BILL Asst Secretary 0.00 50.00 X 0 782125 172894 RUSSELL THOMAS President & CEO 50.00 0.00 X 0 510895 120714 PERRY MARK Treas/VPFin/CFO 50.00 0.00 X 0 317479 77885 BENFIELD RONALD Sr VP/COO 50.00 0.00 X 0 318096 76106 HEISER PAMELA VP 50.00 0.00 X 0 1013764 61240 KINZER STEVEN CEO PAMG 50.00 0.00 X 0 294161 71989 RUSSELL DAVID VP Mkt/Bus Dev 50.00 0.00 X 0 234650 59437 TRYON ELLEN VP Pat Care Serv/CNO 50.00 0.00 X 0 251722 29029 Molloy Thomas Physician 40.00 0.00 X 776587 0 24628 Drake Brian Physician 40.00 0.00 X 681807 0 12340 Joo Elliot Physician 40.00 0.00 X 636114 0 28548 Patillo Dominic Physician 40.00 0.00 X 552105 0 24045 Dawson Lynne Physician 40.00 0.00 X 500153 0 22298 DODDS LARRY Former Dir/V Chair/Sec 0.00 0.00 X 0 216120 3969 3242136 7887012 1296565 207 true true false Portland Psyc Assoc Inc 9955 SE Washington Portland OR 97216 Psyc Physician Serv 1789993 Oregon Anesthesiology Grp 120 NW 14th Ave Portland OR 97209 Medical Services 1247973 Northwest Cardiovacular Inst 2222 NW Lovejoy St Portland OR 97210 Medical Services 1232219 AmHlthcareServ 10126 E Cherry Bend Dr Traverse City MI 49685 Temp EE staffing 519939 Accountable Healthcare Staffing 4755 Technology Way Raton FL 33431 Temp EE staffing 498972 21 254830 447392 8825 702222 Patient Service Revenue 900099 291007547 291007547 Other Revenue 900099 8591905 8591905 Rental Revenue - MOBs/Oth 531120 5385200 5385200 Reference Lab Services 621500 3839773 3839773 EHR Incentive 900099 2893668 2893668 1939903 -62420 1047028 955295 313657996 3018833 84446 2934387 0 0 0 0 94203 254830 211684 -117481 -117481 0 320833 470977 -150144 -150144 Medical Staff Funds 900099 98264 98264 98264 317209690 302515146 4736657 9255665 0 0 0 0 95370 42570 52800 0 122476641 110076708 12158070 241863 4787887 4777392 10495 27066643 23002462 4007987 56194 9326064 8353046 955724 17294 0 555138 555138 426227 426227 0 0 0 12572196 8709960 3862236 1733615 1733264 351 4262318 3491660 763766 6892 10805758 10776123 29635 0 10776359 10098947 652583 24829 889749 552588 332435 4726 0 349441 240230 107586 1625 2805194 2805194 0 11039647 10929546 110101 2211321 2172237 39084 Purchased Services 38869463 15136726 23791917 -59180 Pt Care Supplies 37492068 37492068 All other expense 13799287 41740 13752282 5265 Rent/Lease of Equipment 1856601 1856601 0 314196987 250555798 63341330 299859 4438985 3435697 87272856 97946111 0 39042113 36101099 0 0 0 3365793 3906033 2159482 2189134 290548083 168776128 123736391 121771955 569540 1044823 1607193 208932 0 1984618 2546839 20217598 20299921 284394569 289450544 20560785 20982235 1225805 1058735 466667 200000 68765069 70820628 91018326 93061598 X 189297500 192063747 1573794 1819095 2504949 2506104 193376243 196388946 284394569 289450544 3012703 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true false false false false true 28155 false true 13638 41793 false false Part II-B, Line 1i - Other Activities Description A portion of the dues paid to the following organizations has been determined to be related to lobbying: Oregon Association of Hospitals and Health Systems--lobbying portion $13,216. Portland Business Alliance $422.00 7811345 865954 87233 549905 8214627 7464264 828866 53507 535292 7811345 7253658 673090 116350 578834 7464264 8356126 -836081 250744 517131 7253658 10533617 -1374425 189918 992984 8356126 0.47350 0.30510 0.22140 false false false 6643572 6643572 195109904 98107063 97002841 3493761 1398134 2095627 85300846 69270931 16029915 121771955 Receivables from related entities 12492847 Other receivables 3785728 Receivables from third-party payors 4021346 20299921 Workers' comp liability 1959343 Payable to related entities 66535000 Payable to third parties 303620 Other liabilities 2022665 70820628 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. X X X X false Heroes of the Heart Gala 177910 151465 26445 34617 22204 51498 Golf Tournament 171123 103365 67758 2560 1779 22400 19034 57592 349033 254830 94203 2560 1779 22400 53651 22204 109090 211684 -117481 true true X true X true X true true false false true true 1 12037 6032214 6032214 0.01920 1 38771 47329397 39388008 7941389 0.02530 2 50808 53361611 39388008 13973603 0.04450 15128 810676 16032 794644 0.00250 17 1313 601052 103191 497861 0.00160 6 7752 26013518 20191179 5822339 0.01850 1 46945 46945 0.00010 15 6797 313771 44265 269506 0.00090 39 30990 27785962 20354667 7431295 0.02360 41 81798 81147573 59742675 21404898 0.06810 1 1666 1666 5 200 57591 57591 0.00020 1 1460 1460 1 887 887 731 731 8 200 62335 62335 0.00020 true 7808547 3357675 36519613 34620295 1899318 X true true Gresham Family Medical Ctr Physician Services 0.74500 0.12000 0.13500 ASSN-Unit Owners Plaza Cond Condo association mgmt 0.81000 0.19000 1 1 Portland Adventist Medical Ctr 10123 SE Market St Portland OR 97216 X X X X true X X X X X X X X 13 true false true X See Schedule O for url X X X X X X X false false false true true 200.0000 true 399.0000 true X X X X true true X X X X true false X true X false false Part V, Line 3 - Account Input from Person Who Represent the Community Surveys, listening sessions, Association with Healthy Columbia Willamette Colaborate Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why Illicit Drugs- Adventist Health will not focus on this health need due to lack of professional expertise and resources. There are other groups within our community addressing this important need. Please see our community resources section for some of these groups. Poverty- Adventist Health addresses part of the growing poverty problem in our community with our access to health care initiatives. . Besides some limited annual programs like our Holiday Food basket and Warm Winter Clothing programs that are supported generously by employees and directed to those in need, the greater challenges in this area are being served by community groups better suited to address those needs. Adventist Health does not have the resources or expertise to make a greater impact in this area. Hunger- This area of concern is directly related to the issue of poverty. The same reasons for Adventist Health not directing resources to this area in a substantial matter is as for poverty. Adventist Health will continue to sponsor an annual Celebration of Thanksgiving free community concert in the fall where donations to the Oregon Food Bank are collected at the door for admission. Thousands of pounds of non-perishable food has been collected. Part V, Line 12h - Other Factors Used in Determing Amounts Charged Patients Income level and family size are considered. Individuals eligible for Medicaid also qualify for financial assistance Part V, Line 20d - Other Billing Determination of Individuals Without Insurance The hospital's financial assistance policy has three income ranges for patients who received emergency, obsteric, and other medical care, which provides a discount based on Federal Poverty Guidelines. 50 Adventist Health Gresham Station Imaging Center 831 NW Council Dr Suite 100 Gresham OR 97030 Imaging Center Adventist Health Home Health Agency 5835 NE 122nd Ave 155 Portland OR 97230 Home Health Services- Portland Adventist Health Hospice Portland 5835 NE 122nd Ave 155 Portland OR 97230 Hospice Services Adventist Health Home Medical Equipment 5835 NE 122nd Ave 155 Portland OR 97230 Home Medical Equipment Service Adventist Health Physical Therapy Medical Center Outpt 10101 SE Main Street LL Portland OR 97216 Physical Therapy Services Adventist Health Oregon Hand Specialists 10000 SE Main St Suite 327 Portland OR 97216 Physician Speciality Clinic Adventist Health Medical Clinic- NW Orthopedic Specialists 10101 SE Main STreet Suite 3012 Portland OR 97216 Physician Speciality Clinic Adventist Health Medical Clinic- Rockwood Urgent Care 18750 SE Stark Street Portland OR 97233 Physician Clinic/ Urgent Care Adventist Health Wound Healing and Hyperbaric Medicine 10201 SE Main St Suite 29 Portland OR 97216 Wound Care Service Adventist Health Medical Clinic- Gresham Station 831 NW Council Drive Suite 101 Gresham OR 97030 Physician Clinic Adventist Health Medical Clinic-Sandy Family Practice & Urge 17055 Ruben Lane Sandy OR 97055 Physician Clinic and Urgent Care Adventist Health- Womens Center- Happy Valley 9300 SE 91st Avenue Suite 300 Happy Valley OR 97086 Physician Speciality Clinic Adventist Health Physical Therapy Gresham 831 NW Council Dr Suite 200 Gresham OR 97030 Physical Therapy Clinic Adventist Health Medical Clinic Gresham Station IM FP 831 NW Council Drive Suite 125 Gresham OR 97030 Physician Clinic Adventist Health Medical Clinic- Cherry Park FP 10201 SE Main Suite 20 Portland OR 97216 Physician Clinic Adventist Health Medical Clinic-Ventura Park 11510 SE Stark Street Portland OR 97216 Physician Clinic Adventist Health Medical Clinic-Internal Medicine Assoc 10201 SE Main St Suite 12 Portland OR 97216 Physician Clinic Adventist Health Medical Clinic- NW Regional Heart Center 10123 SE Main Street Portland OR 97216 Physician Speciality Clinic Adventist Health Medical Clinic-Portland Lung Clinic 10201 SE Main St Suite 11 Portland OR 97216 Physician Clinic Advenstist Health Medical Clinic- Clackamas 11211 SE Sunnyside Road Clackamas OR 97015 Physician Clinic Adventist Health Physical Therapy Sandy 37095 SE Hwy 26 Suite 102 Sandy OR 97055 Physical Therapy Clinic Adventist Health Medical Clinic-Arthritis and Bone Care 10201 SE Main St Suite 25 Portland OR 97216 Physician Clinic Adventist Health Medical Clinic-Hazelwood 12615 NE Halsey Street Portland OR 97230 Physician Clinic Tillamook Home Health 1015 Third Street Tillamook OR 97141 Home Health Services- Tillamook Adventist Health Medical Clinic-Eastside Internal Med 10000 SE Main St Suite 128 Portland OR 97216 Physician Clinic Adventist Health Occupational Therapy- Fishers Landing 417 SE 164th Avenue Suite 300 Vancouver WA 986848944 Occupational Therapy Services Adventist Health Medical Clinic- Fishers Landing 417 SE 164th Ave Suite 300 Vancouver WA 98684 Physician Clinic Adventist Health Medical Clinic- Creekside Family Medicine 9200 SE 91st Ave 220 Happy Valley OR 97086 Physician Clinic Adventist Health Medical Clinic-Occupational Medicine 10201 SE Main St Suite 29 Portland OR 97216 Physician Clinic and Corporate Services Adventist Health Medical Clinic- Damascus 14450 SE Royer Road Damascus OR 97089 Physician Clinic Adventist Health Medical Clinic-Hoodland 24461 East Welches Road Welches OR 97067 Physician Clinic Adventist Health Physical Therapy Clackamas 13435 SE 97th LL101 Clackamas OR 970157787 Physical Therapy Clinc Adventist Health Medical Clinic- Diabetes & Endo Ctr 10101 SE Main Street Suite 1001 Portland OR 97216 Physician Clinic Adventist Health Medical Clinic- Radiation Oncology Center 10123 SE Market St Portland OR 97216 Physician Speciality Clinic Adventist Health Medical Clinic-Mt Scott Internal Med 9200 SE 91st Ave Suite 300 Portland OR 97286 Physician Clinic Adventist Health Medical Clinic-Camas 411 NE 6th Avenue Camas WA 98607 Physician Clinic Adventist Health Physical Therapy Vancouver 6069 SE 15th Street Vancouver WA 98683 Physical Therapy Clinic Adventist Health Medical Clinic-Gladstone Family Med 1105 Portland Ave Suite 2 Gladstone OR 97027 Physician Clinic Adventist Health Hospice-Tillamook 1015 Third St Tillamook OR 97141 Hospice Services- Tillamook Adventist Health Home Infusion Therapy 5835 NE 122nd Ave 155 Portland OR 97230 Home Infusion Therapy Service Adventist Health Speciality Rehab 10101 SE Main Street LL Portland OR 97216 Speciality Rehab Therapy Clinic Adventist Health Speech Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Speech Theraphy Services Adventist Health West Side Occupational Medicine 1200 NE 48th Avenue Suite 1000 Hillsboro OR 97214 Occupational Therapy Services Adventist Health Outpatient Palliative Care 5835 NE 122nd Ave Suite 135 Portalnd OR 97230 Palliative Care Adventist Health Audiology 10201 SE Main Street Suite 1 Portland OR 97216 Audiology Services Adventist Health Medical Clinic- Rose City Family Medicine 7420 NE Sandy Blvd Portland OR 97213 Physician Clinic Adventist Health Medical Clinic- Diabetes & Endo Ctr 19255 SW 65th Ave Suite 110 Tualatin OR 97062 Physician Speciality Clinic Gresham Station Lab 831 NW Council Drivw Suite 120 Gresham OR 97030 Lab and Draw Station Adventist HealthGresham Surgery Center 831 NW Council Drive Gresham OR 97030 Outpatient surgery center Adventist Health- Willamette View Clinic 13021 SE River Road Suite 3000 Portland OR 97222 Physician Clinic Part I, Line 7g - Costs Associated With Physicans Clinics Specific ratios of cost to charges were use for each department.Departments: Hospice Home Health Cardiopulmonary Rehab Psych and Psych Physicians No Physician clinics are counted as subsidized Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information, those accounts would have been reclassified from bad debt expense to charity care.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit he Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL Revenue. *Medicare Cost Report Revenue 46,806,788 Prior Year Settlements (639,686) Cost Report Reimbursable Bad Debts 670,081 Estimates and Accrual Variances (47,337) Other (69,987) Subtotal - Amount reported in Pt III, line 5 46,719,859 Amounts include in Part I, line g and f (10,200,246) Total Medicare Revenue 35,519,613*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts.Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI - Needs Assessment Every three years, PAMC partners with other local entities to conduct a community health needs assessment that helps to identify the health care gaps that exist within the hospitals service areas. That data and other key sources of information- such as the hospital's situation assessment, discharge data and pertinent healthcare trends- plays a prominent role in the hospital's annual strategic planning. Initiatives to achieve those goals are based on community demographics and the expressed and implied health care needs of the area's residents, communicated through the triennial community health needs assessment and other vehicles. Part VI - Patient Education of Eligibility for Assistance Financial assistance is a part of the community service provided by this hospital and is available to those individuals using our services.For those who are unable to pay, reasonable efforts will be made to assist the patient in obtaining help for payment of their medical bills from public agencies. If a patient indicates they cannot pay the bill, they are offered a charity care application. We contact an external firm to screen patients for eligibility for government assistance. The discussion of whether they can pay the bill may come up at any point (before admission, during the stay, after discharge or after the account is sent to a collection agency).Those who do not qualify for public funding will be considered for financial assistance under the hospital's financial assistance guidelines. Identifying a potential charity discount will begin as soon as information is provided that a patient may be receiving service. Part VI - Community Information PAMCs primary service area is East Multnomah County. This area's lower income population as a percentage of the total population is growing as this population shifts from North Portland to East Portland. In addition the organization provides services to residents of Clackamas and Washington Counties in Oregon and Clark County in Washington. Portland, Vancouver (WA), and the suburbs surrounding these two cities lay within this four county area. Part VI - Community Building Activities Activities in this area focus on the root causes of health problems such as poverty and homelessness. By addressing the root causes of health problems, we help improve access to health care to individuals who might not be able to do so if these issues are ignored. While there are public health agencies that deal with these problems, they are limited to what they can do by budget limitations. Activities we were involved in 2012 include the following:1)Chempacs for state 2)Civic involvement and support of local Chambers of Commerce beyond normal business needs. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose We do not wait until a community member needs our services through our clinics or Emergency Department. We are active in the community we serve. By involving ourselves in various activities, groups, and outreaches, we communicate our willingness to serve our community and our commitment to our mission. Our community health needs assessment keeps us current with changes in the health of our community. By working with other groups and agencies we are better able to assess the needs of the community than if we relied only on our own resources. The hospital uses all available financial resources to improve the quality of the health care we provide and to better serve the needs of the community. Part VI - Affilated Health Care System Roles and Promotion The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served Part VI - States Where Community Benefit Report Filed OR Part V - Explanation of Number of Facility Type Hospice (2), Home Medical Equipment (1), Home Infusion Therapy (1),Home Health Services (2) Physician Clinics (31), Lab (1), Imaging (1), Pt/OT Clinics (10), Wound Care (1) Part VI - Additional Information Supplemental for Part I, Line 7 The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows for 7a-c: (Total expenses - (Provision for bad debts + Other revenue + Interest income)) divided by Gross patient charges7e,f,h,i are calculated based on specific expenses and revenues.7g uses specific cost to charge ratios for those departments X true true X X X X X false true false false false false false false false false DODDS LARRY Former Dir/V Chair/Sec 216120 3969 220089 216120 Molloy Thomas Physician 765325 11262 24628 801215 Drake Brian Physician 654031 10000 17776 12340 694147 Joo Elliot Physician 594470 41644 15576 12972 664662 Patillo Dominic Physician 510437 41668 15576 8469 576150 Dawson Lynne Physician 477752 22401 15576 6722 522451 CARMEN ROBERT Dir/Chair 989976 126046 352983 17787 27048 1513840 REINER SCOTT Dir/V Chair/Sec 688994 84288 302585 169989 28391 1274247 277913 REBOK DOUGLAS Asst Secretary 572416 72192 142757 137764 24601 949730 121472 WEHTJE RODNEY Asst Treasurer 369816 37102 101441 83680 22183 614222 65921 WING BILL Asst Secretary 593788 71552 116785 144195 28699 955019 63725 RUSSELL THOMAS President & CEO 419723 91172 95464 25250 631609 73850 PERRY MARK Treas/VPFin/CFO 265803 51676 55353 22532 395364 44880 BENFIELD RONALD Sr VP/COO 257236 60860 53660 22446 394202 47581 HEISER PAMELA VP 201914 811850 38948 22292 1075004 799214 KINZER STEVEN CEO PAMG 242929 51232 49552 22437 366150 35139 RUSSELL DAVID VP Mkt/Bus Dev 200772 33878 37446 21991 294087 23034 TRYON ELLEN VP Pat Care Serv/CNO 243864 7858 15141 13888 280751 Part I, Line 1a: Relevant information in regards to selections on 1a. Any items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. Wes Rippey MD Director 96929 Physician services false WGW LLC Gabriel JV LLC JV Ownership false Schedule L, Part V Supplemental Information Melody Gabriel, an AH director, and her husband are owners and officers of businesses that engage in a joint venture with the hospital. Other family members with ownership and officer positions in these businesses include her parents, her brother and his wife, and trusts established on behalf of her children. The businesses are organized as LLCs. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.Part VI, Line 7bThe sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 11b: Form 990 Review Process The completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy publicly available. The hospital files monthly/quarterly summary financial reports with the state health planning agency. Form 990, Sch H, Part V, Section B, Line 5a - Hospital Website CHNA adventisthealth.org/nw/pages/about-us/community-benefits/needs-assessment.aspx Healthcare Resources Northwest LLC 2625 SE 98th Ave Portland OR 97266 461719208 Managed Care Mgmt OR 22277768 5438720 Portland Adventist Medical Center Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 NA false Adventist Health Clearlake Hospital Inc 15630 Ave 18th Ave Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Central Valley General Hospital 1025 N Douty Street Hanford CA 93230 770324630 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Road Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Glendale Adventist Medical Center 1509 Wilson Ter Glendale CA 91206 951816017 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Hanford Community Hospital 450 Mall Dr Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Willits Hospital Inc 1 Madrone St Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilities CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Rd St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Ave Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Selma Community Hospital Inc 1141 Rose Ave Selma CA 93662 770509133 Supporting Hanford Community Hospital CA 501(c)(3) 11, Typ 3 func integ Adventist Health SystemWest false Simi Valley Hospital & Hlth Care Svcs 2975 N Sycamore Dr Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Foundn of Tillamook 1000 Third St Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Dr Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital WA 501(c)(3) 1 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Reedley Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Physicians Network 2100 Douglas Blvd Roseville CA 95661 680357690 Medical Foundation CA 501(c)(3) 11b,II Adventist Health SystemWest false PAR LLC 10610 SE Clay Street Portland OR 97216 931262371 Sr Living OR N/A 6751650 11819542 true 39 false 0.50000 Gresham Family Medical Center 1700 SW 257th Ave Troutdale OR 97060 911768081 Physician Office OR N/A C Corp 2015701 455595 1.00000 true Healthcare Resources Northwest 2625 SE 98th Ave Portland OR 97266 931166731 Medical Mgnt Services OR N/A C corp 22277768 5438720 1.00000 false Assn Unit Owners Portland Adv Condo 10101 SE Main St Portland OR 97216 930887521 Condo Assn-MOB OR N/A C corp 167885 143838 0.81000 false Gastroenterlogy Associates PC 10000 SE Main St 112 Portland OR 97216 930583031 Physician Office OR N/A C Corp 224424 1041773 1.00000 false South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C Corp false true false false false false false false false false true false true false true true true true true true PAR LLC s 780000 Gresham Family Medical Center a 143819 Gresham Family Medical Center j 15778 Gresham Family Medical Center n 30959 Gresham Family Medical Center o 1479425 Gresham Family Medical Center q 2191337 Healthcare Resources Northwest a 121456 Healthcare Resources Northwest j 57584 Healthcare Resources Northwest o 2543537 Healthcare Resources Northwest q 3438301 Healthcare Resources Northwest r 618435 Healthcare Resources Northwest s 508029 Assn Unit Owners Portland Adv Condo o 25704 Assn Unit Owners Portland Adv Condo q 122015 Assn Unit Owners Portland Adv Condo r 394587 Gastroenterlogy Associates PC a 72139 Gastroenterlogy Associates PC j 247 Gastroenterlogy Associates PC o 2088511 Gastroenterlogy Associates PC q 2005000