GOOD SHEPHERD HEALTH CARE SYSTEM: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SHEPHERD HEALTH CARE SYSTEM (EIN 93-0425580)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349301404
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T08:48:03-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 877 W MAIN ST STE 800 | AddressLine1 |
| City | BOISE | City |
| State | ID | State |
| ZIP Code | 83702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930425580 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Health Care System | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOOD | NameControl |
| Phone | 5416673400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis Burke | Name |
| Title | President/CEO | Title |
| Phone | 5416673400 | Phone |
| Date Signed | 2013-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kim Hunwardsen CPA | Name |
| PTIN | P00484560 | PTIN |
| Phone | 2083447150 | Phone |
| Date Prepared | 2013-05-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dennis Burke | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 80671946 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.gshealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1953 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | Hospital and health care services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 607 | TotalNbrEmployees |
| Total Nbr Volunteers | 81 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 142973 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 161990 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 77991866 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 78701390 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3036209 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1477660 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 133024 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 81171048 | TotalRevenuePriorYear |
| Total Revenue Current Year | 80474064 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 306894 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 322510 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 34097339 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 36831076 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 33218762 | OtherExpensePriorYear |
| Other Expenses Current Year | 33615294 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 67622995 | TotalExpensesPriorYear |
| Total Expenses Current Year | 70768880 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 13548053 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9705184 | RevenuesLessExpensesCY |
| Total Assets BOY | 116270116 | TotalAssetsBOY |
| Total Assets EOY | 120122697 | TotalAssetsEOY |
| Total Liabilities BOY | 21352430 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 17715512 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 94917686 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 102407185 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide compassionate, high quality, and accessible health care and to promote a healthy community | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 66479600 | Expense |
| Grants | 322510 | Grants |
| Revenue | 78002453 | Revenue |
| Description | Good Shepherd Health Care System (GSHCS) served 1,753 inpatients over 4,988 patient-days and 44,765 outpatients in fiscal year 2011-12, as well as 18,903 patients in our Emergency Center. Although reimbursement for services rendered is critical to the operations and stability of GSHCS, not all individuals have the ability to purchase essential medical services. In recognition of this, during FY 2011-12 GSHCS wrote off to collection $6,745,109 valued at charges foregone as bad debt. Direct charity care to our community amounted to an additional $7,157,230, valued at charges foregone. GSHCS provides care to persons covered by governmental programs at deeply discounted rates. Recognizing its mission to the community, services were provided to both Medicare and Medicaid patients. The unreimbursed value of providing care to these patients during fiscal year 2011-12 was $29,705,117 valued at charges foregone.Our Emergency Center is open around-the-clock to all community members, visitors, and travelers, without regard to one's ability to pay. | Description |
| Total Program Service Expense | 66479600 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 188 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 607 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jan Peter | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5416673416 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Steve Eldrige | ||||||||
| Chair | 2.00 | X | X | 0 | 0 | 0 | ||
| Nancy Mabry | ||||||||
| Vice Chair | 2.00 | X | X | 0 | 0 | 0 | ||
| Barbara Place | ||||||||
| Secretary | 2.00 | X | X | 0 | 0 | 0 | ||
| Bill Elfering | ||||||||
| Treasurer | 2.00 | X | X | 0 | 0 | 0 | ||
| Bob Carlson | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Richard Lindner | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Tricia Fenley | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Dr Derek Earl | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Sue Daggett | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Tom Wamsley | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Janet Cooley | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Glenn Chowning Jul-Dec | ||||||||
| Director | 2.00 | X | 0 | 0 | 0 | |||
| Dennis E Burke | ||||||||
| President/CEO | 40.00 | X | 339481 | 0 | 55358 | |||
| Jan D Peter | ||||||||
| VP/CFO | 40.00 | X | 179196 | 0 | 32056 | |||
| David T Hughes | ||||||||
| VP/COO | 40.00 | 182300 | 0 | 31980 | X | |||
| Dr Gary V Trupp | ||||||||
| Physician | 40.00 | 260539 | 0 | 12250 | X | |||
| Dr Laura K Maskell | ||||||||
| Physician | 40.00 | 235258 | 0 | 0 | X | |||
| Dr Thomas L Farney | ||||||||
| Physician | 40.00 | 285849 | 0 | 18930 | X | |||
| Dr Thomas J Holt | ||||||||
| Physician | 40.00 | 325197 | 0 | 12533 | X | |||
| Josh S Jackson | ||||||||
| CRNA | 40.00 | 228749 | 0 | 8136 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2036569 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 171243 | TotalOtherCompensation |
| Number Individuals GT100 K | 41 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Rick Burrill | |||||
| 610 NW 11th Street | Hermiston | OR | 97838 | Physical Therapy | 1151363 |
| Tualitin Imaging | |||||
| 6464 SW Boreland Rd | Tualitin | OR | 97062 | Imaging Services | 1071183 |
| Medical Doctor Assoc Inc | |||||
| PO Box 277185 | Atlanta | GA | 30384 | Physician Services | 948788 |
| Staff Care Inc | |||||
| PO Box 281923 | Atlanta | GA | 30384 | Physician Services | 522428 |
| Credits Inc | |||||
| 461 E Main | Hermiston | OR | 97838 | Collection Services | 478215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
| All Other Contributions | 161990 | AllOtherContributions |
| Total Contributions | 161990 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Net patient services | 622110 | 77635505 | 77635505 | |
| Other revenue | 900099 | 654239 | 654239 | |
| Cafeteria | 900099 | 464848 | $464,848 | |
| Daycare | 900099 | 234089 | $234,089 | |
| Loss on Subsidiary | 446110 | -287291 | -287291 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 78701390 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1589462 | TotalRevenueColumn |
| Exclusion | $1,589,462 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 133024 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 133024 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 133024 | TotalRevenueColumn |
| Exclusion | $133,024 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 86080 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 173595 | Securities |
| Other | 24287 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -173595 | Securities |
| Other | 61793 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -111802 | TotalRevenueColumn |
| Exclusion | -$111,802 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 80474064 | TotalRevenueColumn |
| Related Or Exempt Function Income | 78002453 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,309,621 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322510 | Total |
| Program Services | 322510 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 842589 | Total |
| Management And General | 842589 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28552885 | Total |
| Program Services | 27023016 | ProgramServices |
| Management And General | 1529869 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1190982 | Total |
| Program Services | 1127145 | ProgramServices |
| Management And General | 63837 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4520731 | Total |
| Program Services | 4278420 | ProgramServices |
| Management And General | 242311 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1723889 | Total |
| Program Services | 1591494 | ProgramServices |
| Management And General | 132395 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14732 | Total |
| Management And General | 14732 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46942 | Total |
| Management And General | 46942 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276234 | Total |
| Management And General | 276234 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9897221 | Total |
| Program Services | 9004048 | ProgramServices |
| Management And General | 893173 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119117 | Total |
| Program Services | 110878 | ProgramServices |
| Management And General | 8239 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8309996 | Total |
| Program Services | 8124508 | ProgramServices |
| Management And General | 185488 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 637173 | Total |
| Program Services | 637173 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 292880 | Total |
| Program Services | 239409 | ProgramServices |
| Management And General | 53471 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129415 | Total |
| Program Services | 129415 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 463555 | Total |
| Program Services | 463555 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4790921 | Total |
| Program Services | 4790921 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 581540 | Total |
| Program Services | 581540 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Bad Debts | 5020156 | 5020156 |
| Medical Supplies | 2786156 | 2786156 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249256 | Total |
| Program Services | 249256 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70768880 | Total |
| Program Services | 66479600 | ProgramServices |
| Management And General | 4289280 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4162250 | BOY |
| EOY | 4198077 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11000597 | BOY |
| EOY | 11207147 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6177119 | BOY |
| EOY | 12883234 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1512595 | BOY |
| EOY | 1591960 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 709516 | BOY |
| EOY | 788546 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 84856026 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 39486403 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44137953 | BOY |
| EOY | 45369623 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50555989 | BOY |
| EOY | 44143587 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -6112733 | BOY |
| EOY | -6400024 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4126830 | BOY |
| EOY | 6340547 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116270116 | BOY |
| EOY | 120122697 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6734044 | BOY |
| EOY | 6920810 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13927302 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500000 | BOY |
| EOY | 10794702 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191084 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21352430 | BOY |
| EOY | 17715512 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94560726 | BOY |
| EOY | 102030950 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 356960 | BOY |
| EOY | 376235 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94917686 | BOY |
| EOY | 102407185 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116270116 | BOY |
| EOY | 120122697 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9705184 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2215685 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 2730126 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 741457 | OtherCostOrOtherBasis |
| Book Value | 3471583 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43200442 | OtherCostOrOtherBasis |
| Depreciation | 15773902 | Depreciation |
| Book Value | 27426540 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36475440 | OtherCostOrOtherBasis |
| Depreciation | 22629205 | Depreciation |
| Book Value | 13846235 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1708561 | OtherCostOrOtherBasis |
| Depreciation | 1083296 | Depreciation |
| Book Value | 625265 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45369623 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Interest Receivable - Intercompany | 3103921 |
| Estimated Third-Party Payor Settlements | 3129936 |
| Financial Aid Receivable | 42171 |
| Student Loan Reserve Fund | 64519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6340547 | TotalBookValueOtherAssets |
| Total Revenue | 80474064 | TotalRevenue |
| Total Expenses | 70768880 | TotalExpenses |
| Excess Or Deficit For Year | 9705184 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -2215685 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -2215685 | TotalAdjustments |
| Excess Or Deficit Per FS | 7489499 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 77640360 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -2215685 | NetUnrealizedGainsInvestments |
| Other Revenues | -293550 | OtherRevenues |
| Revenue Not Rptd F990 | -2509235 | RevenueNotRptdF990 |
| Revenue Subtotal | 80149595 | RevenueSubtotal |
| Investment Expenses Not Included | 276234 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 48235 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 324469 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 80474064 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 70170136 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 70170136 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 276234 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 322510 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 598744 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 70768880 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The Hospital is organized as an Oregon nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 50l(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated fmancial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Hospital's federal Form 990 filings are no longer subject to federal tax examinations by tax authorities for years before 2009. |
| Part XII, Line 2d - Other Adjustments: | Charitable donations reclass from revenue to expenses -322,510. Net assets released from restrictions included in revenue for audit 28,960. | |
| Part XII, Line 4b - Other Adjustments: | Contributions recorded in fund balance for audit 48,235. | |
| Part XIII, Line 4b - Other Adjustments: | Charitable donations reclass from revenue to expenses 322,510. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3916000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3916000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06010 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13031295 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11805886 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1225409 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01880 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16947295 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11805886 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5141409 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07890 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 305112 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 39836 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 265276 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00400 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 227848 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13813 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 214035 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6379012 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4217260 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2161752 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03290 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 322510 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 322510 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7234482 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4270909 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2963573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04510 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24181777 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16076795 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8104982 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12400 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $5,020,156 | BadDebtExpenseAmount |
| Amount Attributable To | 179010 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 14373141 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14230833 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 142308 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Health Care System | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Health Care System | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 150.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 1 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Good Shepherd Medical Group | ||||
| 610 NW 11th Street | Hermiston | OR | 97838 | Clinic |
| Vange John Memorial Hospice | ||||
| 610 NW 11th Street | Hermiston | OR | 97838 | Hospice |
| TLC Home Health | ||||
| 610 NW 11th Street | Hermiston | OR | 97838 | Home Health |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 3c: Patients become eligible for financial assistance once they are at 150% of the federal poverty level. Once eligible the Health Care System provides discounts on a sliding fee scale from 10% to 100% based on an individual's income level and household size. | ||
| Part I, Line 6a: The state posts the community benefit report online. | ||
| Part I, Line 7: The charity care included in Part I, Line 7a is calculated by multiplying the ratio of cost to gross charges for the hospital by the gross uncompensated charges associated with providing charity care to its patients. The unreimbursed Medicaid in Part I, Line 7b is based on gross charges and claims from the Medicaid Cost Report.The community health services, education and contributions in Part I, Lines 7e, 7f and 7i are based on actual expenses. Subsidized health services on Line 7g are reported according to costs allocated to the relevant cost centers on the Medicare cost report. | ||
| Part I, Line 7g: There are $7,150,002 in costs attributable to physician clinics included in subsidized health services. | ||
| Part I, L7 Col(f): The amount of bad debt expense removed from the denominator of the calculation on Part 1, Line 7, column f was $5,020,156. | ||
| Part III, Line 4: Footnote to the organization's financial statements that describes bad debt expense:Patient receivables are uncollateralized customer and third-party payor obligations. Payments of patient receivables are allocated to the specific claims identified on the remittance advice or, if unspecified, are applied to the earliest unpaid claim.The carrying amount of patient receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients and third-party payors. Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts.Management considers historical write off and recovery information in determining the estimated bad debt provision.The organization estimates the amount of bad debt attributable to charity patients to be $179,010. This estimate is based on an overall charity care percentage of gross revenue. | ||
| Part III, Line 8: Medicare allowable cost is based on the Medicare cost report. The Medicare cost report is completed based on the rules & regulations set forth by CMS. | ||
| Part III, Line 9b: The organization's collection procedures requires a financial advisor to work with any patient who is identified as potentially being eligible for financial assistance prior to sending the account to collection. If during the course of the collection process the collection agency determines an account may be eligible for financial assistance, it is referred back to the hospital for further discussion with the patient or for write off. All further collection action is ceased. | ||
| Part V, Section B, Line 11h: The policy indicates other factors beyond income level can be considered to determine free or discounted care. The hospital also uses household size to determine free or discounted care. | Good Shepherd Health Care System | |
| Part V, Section B, Line 19d: The maximum amount charged to a patient under the financial assistance policy for emergency and medically necessary care is 90% of the gross charges This is based on the lowest discount under the charity care policy of 10%. | Good Shepherd Health Care System | |
| Part V, Section B, Line 20: The hospital provides a reduction to gross charges under the their financial assistance policy. The hospital has not determined the amount generally billed under the various proposed methods of calculation. Therefore, it is possible a patient under the financial assistance policy could have paid more than the amount generally billed. The hospital will review the various methods to determine amounts generally billed to ensure it is in compliance with Section 501(r). | Good Shepherd Health Care System | |
| Part V, Section B, Line 21: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. FAP-eligible patients without insurance may be charged gross charges on elective procedures. | Good Shepherd Health Care System | |
| Part VI, Line 2: Our community healthcare needs assessment process has five components that are conducted every other year:1. The ongoing collection and evaluation of community feedback from patient surveys and comment forms.2. Patient and community-member healthcare needs focus groups.3. A healthcare needs survey completed by employers and other community leaders.4. A formal telephone survey.5. A demographic study conducted by the Oregon Office of Rural Health. | ||
| Part VI, Line 3: Our financial counselors inform and educate the people we serve with respect to charity care and governmental assistance programs. All patients and responsible parties, where possible, are apprised of the availability of financial counseling services at the time and point of service. We have arranged our patient flow to maximize the convenience of visiting our financial counselors as part of the Good Shepherd treatment regime.In addition, the financial assistance policy is provided in writing to the patients upon request, and when the Hospital is able to identify a potential FAP-eligible individual upon admissions. | ||
| Part VI, Line 4: Good Shepherd Health Care System (GSHCS) is the corporate name for an organization made up of several entities, including Good Shepherd Medical Center, Vange John Memorial Hospice, TLC Home Health, Good Shepherd Medical Group, Good Shepherd Clinic Pharmacy, Good Shepherd Medical Foundation, and Good Shepherd Community Health Foundation. Good Shepherd serves a core population of almost 50,000 people in the city of Hermiston, Oregon and in 14 outlying smaller towns within a rough 50-mile radius. This population is largely rural, with agriculture dominating industrial enterprises.The average household income in Hermiston is $35,865.17.1% of residents have incomes below federal poverty guidelines.31.3% of residents identify as non-white Hispanic ethnicity, with a sizable number of Spanish-primary speakers. | ||
| Part VI, Line 5: Good Shepherd maintains open active, affiliate, and courtesy medical staffs, with privileges available to all qualified and interested physicians in the communities we serve. GSHCS is governed by a twelve-member board of trustees. The board is comprised of independent representatives of the community, with an emphasis on maintaining a true cross-section of core population communities within its membership.Our surplus funds are used to fund community health education classes, as well as funding building and equipment upgrades to maintain the highest quality healthcare for our community. Surplus funds are also applied to ongoing professional education among our clinical staff to remain current in the best practices of modern healthcare. We operate a fully-staffed 24-hour emergency room, available to the public regardless of ability to pay. Good Shepherd operates two foundations that provide funds to appropriate community groups and activities, as well as providing scholarship funds to local residents establishing or furthering healthcare-related education. We live our mission to promote a healthy community. Good Shepherd is the host and driving force behind the Good Shepherd Wellness Coalition, a grass-roots group of community leaders that identify, analyze, and address pressing healthcare issues in the community.We maintain a dialogue with the people we serve through a biweekly radio show, with an emphasis on wellness and preventative care.Good Shepherd hosts an annual Family Health and Fitness Day, with free access to healthcare professionals, free screenings, and a wealth of health and wellness information available to the public.We are active in community health-related activities, including the American Cancer Society's Relay for Life, the March of Dimes' March for Babies, and the Umatilla County Fair, where we provide health information and healthcare-related giveaways. | ||
| OR | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Community Health Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 931170546 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 250000 | AmountOfCashGrant |
| Purpose Of Grant | Community Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: Grants are awarded to Good Shepherd Community Health Foundation, a related organization which is tax exempt under Section 501(c)(3). | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dennis E Burke | |||||||||||||
| 315481 | 0 | 24000 | 0 | 0 | 0 | 26950 | 0 | 29070 | 0 | 395501 | 0 | 0 | 0 |
| Jan D Peter | |||||||||||||
| 166915 | 0 | 12281 | 0 | 0 | 0 | 11105 | 0 | 21496 | 0 | 211797 | 0 | 0 | 0 |
| David T Hughes | |||||||||||||
| 166631 | 0 | 15669 | 0 | 0 | 0 | 11209 | 0 | 21434 | 0 | 214943 | 0 | 0 | 0 |
| Dr Gary V Trupp | |||||||||||||
| 253727 | 0 | 6812 | 0 | 0 | 0 | 12250 | 0 | 0 | 0 | 272789 | 0 | 0 | 0 |
| Dr Laura K Maskell | |||||||||||||
| 234258 | 0 | 1000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 235258 | 0 | 0 | 0 |
| Dr Thomas L Farney | |||||||||||||
| 279325 | 0 | 6524 | 0 | 0 | 0 | 18930 | 0 | 0 | 0 | 304779 | 0 | 0 | 0 |
| Dr Thomas J Holt | |||||||||||||
| 318972 | 0 | 6225 | 0 | 0 | 0 | 12533 | 0 | 0 | 0 | 337730 | 0 | 0 | 0 |
| Josh S Jackson | |||||||||||||
| 227749 | 0 | 1000 | 0 | 0 | 0 | 8136 | 0 | 0 | 0 | 236885 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Credits Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Company is owned 100% by board member Nancy Mabry | Relationship |
| Amount Of Transaction | 494702 | AmountOfTransaction |
| Description Of Transaction | Charges for collection services | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| New Program Services | Form 990, Part III, line 2 | Cardio pulmonary rehab services are now being offered which falls under our exempt purpose to provide health care services. |
| Form 990, Part VI, Section A, line 8b | There are no committees with the authority to act on behalf of the governing body. | |
| Form 990, Part VI, Section B, line 11 | The return is reviewed by the CFO and Controller and presented on a high level to the Board of Directors. A final copy is provided to the Board before filing. | |
| Form 990, Part VI, Section B, line 12c | All officers, directors, and key employees with conflicts are expected to disclose conflicts of interest on a voluntary basis and refrain from discussion and/or voting on related matters as necessary. These disclosures are reviewed and determined to exist or not to exist by the Board of Directors. | |
| Form 990, Part VI, Section B, line 15a | The CEO's compensation is approved by the compensation committee of the Board of Directors based on survey information. This process is completed annually in the month of October. The compensation of other officers or key employees is determined by the CEO based on survey information. This process is completed annually on the anniversary date of the individual's hire date. | |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are available upon request. | |
| Form 990, Part VII, Column (b) | In addition to the hours reported on Form 990, Part VII, the following individuals devoted time to Good Shepherd Community Health Foundation, a related organization, each week. Tricia Fenley - 1 hour Richard Lindner - 2 hours Tom Wamsley - 2 hours | |
| Changes in Net Assets or Fund Balances: | Form 990, Part XI, line 5: | Net unrealized losses on investments: -2,215,685. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Good Shepherd Community Health Foundation | ||||||||||
| 610 NW 11th Street | Hermiston | OR | 97838 | 931170546 | fundraising | OR | 501(c)(3) | Line 11a, I | Good Shepherd Health Care System | 1 |
| Good Shepherd Medical Foundation | ||||||||||
| 610 NW 11th Street | Hermiston | OR | 97838 | 930844485 | fundraising | OR | 501(c)(3) | Line 7 | Good Shepherd Health Care System | 1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Shepherd Medical Service Corp | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 NW 11th Street | AddressLine1 |
| City | Hermiston | City |
| State | OR | State |
| ZIP Code | 97838 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930688940 | EIN |
| Primary Activity | retail pharmacy | PrimaryActivity |
| Legal Domicile State | OR | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 2580619 | ShareOfTotalIncome |
| Share Of EOY Assets | 9856605 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Good Shepherd Medical Service Corp | ||
| A | 349006 | book value |
| Good Shepherd Medical Service Corp | ||
| N | 448177 | book value |
| Good Shepherd Community Health Foundation | ||
| B | 250000 | book value |
| Good Shepherd Community Health Foundation | ||
| C | 0 | |
| Good Shepherd Community Health Foundation | ||
| M | 0 | |
| Good Shepherd Community Health Foundation | ||
| O | 0 | |