SKY LAKES MEDICAL CENTER INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SKY LAKES MEDICAL CENTER INC (EIN 93-0508781)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-15
- IRS object ID
- 201222289349302467
- Schema version
- 2010v3.4
- 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 B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-15T12:13:22-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW BROADWAY 1200 | AddressLine1 |
| City | PORTLAND | City |
| State | OR | State |
| ZIP Code | 97205 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930508781 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKY LAKES MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SKYL | NameControl |
| Phone | 5412746311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD RICO | Name |
| Title | VP/CFO | Title |
| Phone | 5412746311 | Phone |
| Date Signed | 2012-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WENDY CAMPOS | Name |
| Phone | 5032421447 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PAUL STEWART | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 357497651 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SKYLAKES.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1979 | YearFormation |
| State Legal Domicile | OR | StateLegalDomicile |
| Activity Or Mission Description | SKY LAKES MEDICAL CENTER WILL CONTINUALLY STRIVE TO REDUCE THE BURDEN OF ILLNESS, INJURY AND DISABILITY, AND TO IMPROVE THE HEALTH, SELF-RELIANCE AND WELL-BEING OF THE PEOPLE WE SERVE. WE WILL DEMONSTRATE THAT WE ARE COMPETENT AND CARING IN ALL WE DO. WE SHALL ENDEAVOR TO BE SO SUCCESSFUL IN THIS EFFORT THAT WE WILL BECOME A PREEMINENT HEALTHCARE CENTER. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1209 | TotalNbrEmployees |
| Total Nbr Volunteers | 347 | TotalNbrVolunteers |
| Total Gross UBI | 7215 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 5199 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 640948 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 583985 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 321053289 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 354932861 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 609910 | InvestmentIncomePriorYear |
| Investment Income Current Year | 634469 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 461533 | OtherRevenuePriorYear |
| Other Revenue Current Year | 352404 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 322765680 | TotalRevenuePriorYear |
| Total Revenue Current Year | 356503719 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 327147 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 334466 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 65459152 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 72952593 | 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 | 239866341 | OtherExpensePriorYear |
| Other Expenses Current Year | 268370292 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 305652640 | TotalExpensesPriorYear |
| Total Expenses Current Year | 341657351 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 17113040 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 14846368 | RevenuesLessExpensesCY |
| Total Assets BOY | 158047175 | TotalAssetsBOY |
| Total Assets EOY | 175539803 | TotalAssetsEOY |
| Total Liabilities BOY | 64829606 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 67929677 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 93217569 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 107610126 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SKY LAKES MEDICAL CENTER WILL CONTINUALLY STRIVE TO REDUCE THE BURDEN OF ILLNESS, INJURY AND DISABILITY, AND TO IMPROVE THE HEALTH, SELF-RELIANCE AND WELL-BEING OF THE PEOPLE WE SERVE. WE WILL DEMONSTRATE THAT WE ARE COMPETENT AND CARING IN ALL WE DO. WE SHALL ENDEAVOR TO BE SO SUCCESSFUL IN THIS EFFORT THAT WE WILL BECOME A PREEMINENT HEALTHCARE CENTER. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 276513512 | Expense |
| Grants | 10329 | Grants |
| Revenue | 351368851 | Revenue |
| Description | PATIENT CARE EXPENSES - ACUTE INPATIENT CARE FOR ADULT AND PEDIATRIC PATIENTS; A LEVEL III TRAUMA EMERGENCY DEPARTMENT; SERVICES RELATED TO CHILD ABUSE, HOME CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES; A CANCER TREATMENT CENTER WITH BOTH MEDICAL AND RADIATION ONCOLOGY; AND DIAGNOSTIC TESTING (LABORATORY AND DIAGNOSTIC IMAGING) AVAILABILITY IN SETTINGS AROUND THE COMMUNITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 23564681 | Expense |
| Description | UNCOMPENSATED CARE - DURING FISCAL YEAR 2011, SKY LAKES MEDICAL CENTER CONTINUED TO SEE AN INCREASE IN WRITE OFFS FOR BAD DEBT. BY WAY OF COMPARISON, THE ECONOMY IN KLAMATH COUNTY IS POORER THAN THE STATE OF OREGON, INCLUDING HIGHER UNEMPLOYMENT RATES AND MEDICAL INDIGENCY. CHARGES WRITTEN OFF AS BAD DEBT TOTALED $11,696,879. AS A PERCENTAGE OF CHARGES, THESE REPRESENT 3.3%. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 5856878 | Expense |
| Grants | 267187 | Grants |
| Revenue | 1859777 | Revenue |
| Description | EDUCATIONAL SUPPORT - SKY LAKES MEDICAL CENTER COMMITS SIGNIFICANT DOLLARS AND MAN-HOURS TO BENEFIT EDUCATIONAL EFFORTS IN AND FOR THE COMMUNITY. AMONG THOSE COMMITMENTS ARE THE FOLLOWING: OREGON HEALTH SCIENCE UNIVERSITY AFFILIATED FAMILY PRACTICE RESIDENCY PROGRAM AND CLINIC; AN RN I TRAINING PROGRAM TO INCLUDE 6 MONTHS OF ONE-ON-ONE SUPERVISED ORIENTATION TO THE INPATIENT CARE AREAS; AWARDING OF SCHOLARSHIPS TO COMMUNITY MEMBERS AND/OR EMPLOYEES IN HEALTHCARE- RELATED PROGRAMS; A HOSPITAL DEPARTMENT, LEARNING RESOURCES, DEDICATED TO THE EDUCATION OF PHYSICIANS, EMPLOYEES AND COMMUNITY MEMBERS; COMMITTMENT TO EMPLOYEES ACTING, EITHER FULL-TIME OR PART-TIME, AS INSTRUCTORS IN ACCREDITED COURSES AT THE HIGH SCHOOL, COMMUNITY COLLEGE OR UNIVERSITY LEVEL; STIPEND PAYMENTS TO STUDENTS PERFORMING WORK AND/OR ON-THE-JOB TRAINING WITHIN THE HOSPITAL SETTING; TUITION REIMBURSEMENTS PAID TO EMPLOYEES ENROLLED IN COLLEGE-LEVEL COURSEWORK; JOINT PARTICIPATION IN A SIMULATION LABORATORY WITH OIT; FREE OR MINIMAL COST COMMUNITY EDUCATIONAL OPPORTUNITIES SUCH AS DIABETES EDUCATION, NUTRITION AND OTHER EDUCATION PROGRAMS IN OR FOR THE SCHOOLS; AND HEALTH FAIRS. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 11269093 | Expense |
| Grants | 32725 | Grants |
| Revenue | 2267917 | Revenue |
| Description | EXPENSES RELATED TO MEDICAL CENTER SUPPORTING SERVICES SUCH AS ADMINISTRATION, INFORMATION SYSTEMS, FINANCIAL SERVICES, REVENUE CYCLE PROCESSES, HUMAN RESOURCES, ENGINEERING, ENVIRONMENTAL SERVICES, RISK MANAGEMENT, AND SAFETY AND SECURITY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 11269093 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 32725 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 2267917 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 317204164 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | 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 | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 224 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1209 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | 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 | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | 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 | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RICHARD RICO CFO | NamePerson |
| Telephone Number | 5412746150 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JOHN BELL | |||||||
| CHAIRMAN | 3.00 | X | X | 0 | 0 | 0 | |
| ROD WENDT | |||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| KERMIT HOUSER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CLARK PEDERSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| BERNARD SIMONSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WENDY WARREN MD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DOUGLAS MCINNIS DVM | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GREGORY SINDMACK MD | |||||||
| BOARD MEMBER | 1.00 | X | 26000 | 0 | 0 | ||
| GRANT NISKANEN MD | |||||||
| BOARD MEMBER | 40.00 | X | 259750 | 0 | 12250 | ||
| PAUL R STEWART | |||||||
| PRESIDENT/CEO/SECRETARY/TREASURER | 50.00 | X | X | 492525 | 0 | 26074 | |
| RICHARD RICO | |||||||
| VP/CFO | 50.00 | X | 248409 | 0 | 31066 | ||
| PATRICK MAVEETY MD | |||||||
| MEDICAL PROVIDER | 40.00 | 406375 | 0 | 17351 | X | ||
| TZANN T FANG MD | |||||||
| MEDICAL PROVIDER | 40.00 | 393703 | 0 | 30234 | X | ||
| NASSER G ABU-ERREISH MD | |||||||
| MEDICAL PROVIDER | 40.00 | 290654 | 0 | 21422 | X | ||
| KURT J SLATER DO | |||||||
| MEDICAL PROVIDER | 40.00 | 216870 | 0 | 17417 | X | ||
| W CLAY MCCORD MD | |||||||
| MEDICAL PROVIDER | 40.00 | 201769 | 0 | 25337 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2536055 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 181151 | TotalOtherCompensation |
| Number Individuals GT100 K | 51 | 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 |
|---|---|---|---|---|---|
| HEALTH FUTURE | |||||
| 777 MURPHY ROAD | MEDFORD | OR | 97504 | THIRD PARTY ADMIN SERVICES | 1173348 |
| SOUTHERN OREGON LINEN SERVICES INC | |||||
| 635 AVENUE C | WHITE CITY | OR | 97503 | LINEN SERVICES | 456300 |
| ASD HEALTHCARE | |||||
| PO BOX 848104 | DALLAS | TX | 75284 | CONTRACT LABOR | 384302 |
| REVENUE CYCLE PARTNERS LLC | |||||
| 1643 LEWIS AVENUE 203 | BILLINGS | MT | 59102 | SELF PAY COLLECTION SERVICES | 344767 |
| THE MANDALA AGENCY | |||||
| 2855 NW CROSSING DRIVE SUITE 201 | BEND | OR | 97701 | MARKETING SERVICES | 329641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Related Organizations | 583985 | RelatedOrganizations |
| Total Contributions | 583985 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 621990 | 351368851 | 351368851 |
| OTHER PROGRAM REVENUE | 621990 | 3564010 | 3564010 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 354932861 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 759690 | TotalRevenueColumn |
| Exclusion | $759,690 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 801250 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 692693 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 108557 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 108557 | TotalRevenueColumn |
| Exclusion | $108,557 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3990 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 129211 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -125221 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -125221 | TotalRevenueColumn |
| Exclusion | -$125,221 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 119729 | GrossSalesOfInventory |
| Cost Of Goods Sold | 172028 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -52299 | TotalRevenueColumn |
| Exclusion | -$52,299 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| SUB/PASSTHROUGH INCOME | 621990 | 570899 | 563684 | 7215 | |
| OTHER INCOME | 900099 | -274753 | -$274,753 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 296146 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 356503719 | TotalRevenueColumn |
| Related Or Exempt Function Income | 355496545 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 7215 | UnrelatedBusinessRevenue |
| Exclusion | $415,974 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56950 | Total |
| Program Services | 56950 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 277516 | Total |
| Program Services | 277516 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1182415 | Total |
| Management And General | 1182415 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55385441 | Total |
| Program Services | 51090350 | ProgramServices |
| Management And General | 4295091 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2181807 | Total |
| Program Services | 1990306 | ProgramServices |
| Management And General | 191501 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8877499 | Total |
| Program Services | 8090346 | ProgramServices |
| Management And General | 787153 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5325431 | Total |
| Program Services | 3603825 | ProgramServices |
| Management And General | 1721606 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 234558 | Total |
| Program Services | 33895 | ProgramServices |
| Management And General | 200663 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150289 | Total |
| Management And General | 150289 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6316982 | Total |
| Program Services | 5867636 | ProgramServices |
| Management And General | 449346 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 706661 | Total |
| Program Services | 86713 | ProgramServices |
| Management And General | 619948 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1994701 | Total |
| Program Services | 1325812 | ProgramServices |
| Management And General | 668889 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1716216 | Total |
| Program Services | 37434 | ProgramServices |
| Management And General | 1678782 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2400587 | Total |
| Program Services | 2115654 | ProgramServices |
| Management And General | 284933 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130355 | Total |
| Program Services | 112824 | ProgramServices |
| Management And General | 17531 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419520 | Total |
| Program Services | 335852 | ProgramServices |
| Management And General | 83668 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3026796 | Total |
| Program Services | 2005 | ProgramServices |
| Management And General | 3024791 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7505469 | Total |
| Program Services | 2476791 | ProgramServices |
| Management And General | 5028678 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2620761 | Total |
| Program Services | 576714 | ProgramServices |
| Management And General | 2044047 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACTUAL ALLOWANCE | 178497907 | 178497907 | |
| SUPPLIES | 26507717 | 26354669 | 153048 |
| CHARITY CARE | 11867802 | 11867802 | |
| BAD DEBT EXPENSE | 11696879 | 11696879 | |
| TAXES PAID ON UBI | 650 | 650 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12576442 | Total |
| Program Services | 10706284 | ProgramServices |
| Management And General | 1870158 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 341657351 | Total |
| Program Services | 317204164 | ProgramServices |
| Management And General | 24453187 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 467564 | BOY |
| EOY | 388095 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25715056 | BOY |
| EOY | 37710047 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21702325 | BOY |
| EOY | 20664948 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2699898 | BOY |
| EOY | 2487606 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2191378 | BOY |
| EOY | 2890033 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 166196429 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 80604779 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87326153 | BOY |
| EOY | 85591650 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1134829 | BOY |
| EOY | 4745469 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2368682 | BOY |
| EOY | 2959246 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14441290 | BOY |
| EOY | 18102709 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158047175 | BOY |
| EOY | 175539803 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4705771 | BOY |
| EOY | 4669107 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2622197 | BOY |
| EOY | 2608182 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52122247 | BOY |
| EOY | 51137164 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1247993 | BOY |
| EOY | 1171848 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4131398 | BOY |
| EOY | 8343376 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64829606 | BOY |
| EOY | 67929677 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93217569 | BOY |
| EOY | 107610126 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93217569 | BOY |
| EOY | 107610126 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158047175 | BOY |
| EOY | 175539803 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 14846368 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -453811 | 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 B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1325402 | OtherCostOrOtherBasis |
| Book Value | 1325402 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 106834107 | OtherCostOrOtherBasis |
| Depreciation | 45000639 | Depreciation |
| Book Value | 61833468 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4172451 | OtherCostOrOtherBasis |
| Depreciation | 2095067 | Depreciation |
| Book Value | 2077384 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 38111114 | OtherCostOrOtherBasis |
| Depreciation | 26892814 | Depreciation |
| Book Value | 11218300 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15753355 | OtherCostOrOtherBasis |
| Depreciation | 6616259 | Depreciation |
| Book Value | 9137096 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 85591650 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ASSETS LIMITED AS TO USE | 4910133 |
| OTHER ASSETS | 1638862 |
| RISK-POOL WITHHOLD RECEIVABLE | 1693168 |
| DEFERRED FINANCING COSTS | 1575692 |
| CONSTRUCTION IN PROCESS | 2224839 |
| OTHER RECEIVABLES | 6060015 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 18102709 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $5,857,035 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $2,486,341 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8343376 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | FIN 48 (ASC 740) FOOTNOTE - THE MEDICAL CENTER HAD NO UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2011 OR AT SEPTEMBER 30, 2010. THE MEDICAL CENTER RECOGNIZES INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010, THE MEDICAL CENTER RECOGNIZED NO INTEREST AND PENALTIES. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6640 | PersonsServed |
| Total Community Benefit Expense | 9212930 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9212930 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02790 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 37542 | PersonsServed |
| Total Community Benefit Expense | 26075924 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24642775 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1433149 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 44182 | PersonsServed |
| Total Community Benefit Expense | 35288854 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 24642775 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10646079 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03220 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 528362 | PersonsServed |
| Total Community Benefit Expense | 111408 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21887 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 89521 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 5855 | PersonsServed |
| Total Community Benefit Expense | 4796732 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1617322 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3179410 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00960 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 205267 | PersonsServed |
| Total Community Benefit Expense | 9758269 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6569904 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3188365 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00970 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 260 | PersonsServed |
| Total Community Benefit Expense | 1031 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1031 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 739744 | PersonsServed |
| Total Community Benefit Expense | 14667440 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8209113 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6458327 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01960 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 783926 | PersonsServed |
| Total Community Benefit Expense | 49956294 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 32851888 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17104406 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05180 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 12 | NumberOfActivitiesOrPrograms |
| Persons Served | 258081 | PersonsServed |
| Total Community Building Expense | 863706 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 457006 | DirectOffsettingRevenue |
| Net Community Building Expense | 406700 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 2077 | PersonsServed |
| Total Community Building Expense | 7022 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7022 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 229 | PersonsServed |
| Total Community Building Expense | 3688 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3688 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 150065 | PersonsServed |
| Total Community Building Expense | 364739 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 364739 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 23 | PersonsServed |
| Total Community Building Expense | 412867 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 412867 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 100 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 100 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 37 | NumberOfActivitiesOrPrograms |
| Persons Served | 410475 | PersonsServed |
| Total Community Building Expense | 1652122 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 457006 | DirectOffsettingRevenue |
| Net Community Building Expense | 1195116 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $4,576,859 | BadDebtExpenseAmount |
| Amount Attributable To | 869603 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 44192724 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 44863006 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -670282 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| 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 | SKY LAKES MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| 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 | SKY LAKES MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (9 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CANCER TREATMENT CENTER | ||||
| 2610 URHMAN | KLAMATH FALLS | OR | 97601 | MEDICAL CLINIC |
| OUTPATIENT IMAGING | ||||
| 2900 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | OUTPATIENT DIAGNOSTIC IMAGING CENTER |
| FAMILY MEDICINE RESIDENCY | ||||
| 2801 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | MEDICAL CLINIC |
| CENTER FOR OCCUPATIONAL HEALTH | ||||
| 2621 CROSBY AVENUE | KLAMATH FALLS | OR | 97603 | REHABILITIATION SERVICES, HOME HEALTH SERVICES |
| ENT CLINIC | ||||
| 2617 ALMOND STREET | KLAMATH FALLS | OR | 97601 | MEDICAL CLINIC |
| MOB I | ||||
| 2200 BRYANT WILLIAMS DRIVE | KLAMATH FALLS | OR | 97601 | MEDICAL CLINIC |
| MOB II | ||||
| 3000 BRYANT WILLIAMS DRIVE | KLAMATH FALLS | OR | 97601 | MEDICAL CLINIC |
| COMMUNITY HEALTHEDUCATION | ||||
| 2200 NORTH ELDORADO AVENUE | KLAMATH FALLS | OR | 97601 | COMMUNITY EDUCATION FACILITY |
| HUGH CURRIN HOUSE | ||||
| 2601 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | RESIDENTIAL FACILITY FOR FAMILIES UNDERGOING CARE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 11696879. | ||
| PART II: COMMUNITY BUILDING ACTIVITIES:COMMUNITY SUPPORT: ACTIVITIES INCLUDE KLAMATH-LAKE CHILD ABUSE RESPONSE AND EVALUATION SERVICES (CARES). CARES IS DEDICATED TO PROVIDING SAFE, COMPREHENSIVE, OBJECTIVE MEDICAL ASSESSMENTS, AND TO RAISING AWARENESS ABOUT CHILD ABUSE THROUGH COORDINATED, COLLABORATIVE EDUCATIONAL PROGRAMS. FOUR TIMES PER YEAR, DISCOUNTED AND FREE PRESCRIPTION DRUGS, ALONG WITH EDUCATIONAL SUPPORT BY LICENSED PHARMACISTS, ARE PROVIDED TO LOW INCOME ELDERLY THROUGH LOCAL SENIOR CENTERS. THE NO ONE DIES ALONE PROGRAM IS A VOLUNTEER PROGRAM THAT PROVIDES THE REASSURING PRESENCE OF A VOLUNTEER COMPANION TO DYING PATIENTS WHO WOULD OTHERWISE BE ALONE. IN ADDITION TO PARTICIPATION IN RELAY FOR LIFE, UNITED WAY AND OTHER LOCAL FUNDRAISING AND AWARENESS INITIATIVES, SKY LAKES BEGAN PARTICIPATION IN THE PERIOD OF PURPLE CRYING COMMUNITY EDUCATION CAMPAIGN THIS YEAR. THERE ARE A NUMBER OF OTHER COMMUNITY SUPPORT ACTIVITIES THAT ARE PROVIDED, INCLUDING BUT NOT LIMITED TO SPONSORSHIP OF SUPPORT GROUPS FOR CANCER, ADOPTING FAMILIES AT CHRISTMAS, TRANSPORTATION ASSISTANCE TO INDIGENT PATIENTS, STAFF VOLUNTEER PARTICIPATION IN COMMUNITY EVENTS, AND ACCESS TO FREE MEETING ROOMS.LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: SKY LAKES AND SKY LAKES EMPLOYEES WORK IN CONJUNCTION WITH THE KLAMATH COUNTY HIGH SCHOOLS AND OREGON INSTITUTE OF TECHNOLOGY TO DEVELOP AN AWARENESS OF HEALTH CARE, HEALTH CARE CAREERS, AND SUPPORT FOR HEALTH PROFESSIONS EDUCATION SUPPORT AND TRAINING. SENIORS IN THE OREGON HEALTH AND SCIENCES UNIVERSITY NURSING PROGRAM IN KLAMATH FALLS CONDUCT QUALITATIVE SURVEILLANCE OF THE PERCEIVED HEALTH STATUS OF PEOPLE IN NEARBY COMMUNITIES AND REPORT ON BARRIERS TO ACCESS TO HEALTHCARE IDENTIFIED BY THOSE COMMUNITIES. THE STUDENTS USE TOOLS INCLUDING ONE-ON-ONE INTERVIEWS, FOCUS GROUPS, PUBLIC MEETINGS, AND PHONE SURVEYS. THEIR DATA ARE SHARED WITH COMMUNITY LEADERS AND COMPARED WITH OTHER DATA TO DEVELOP COMPREHENSIVE IMPROVEMENT STRATEGIES.COALITION BUILDING: THE LOCAL HEALTH DEPARTMENT, IN CONJUNCTION WITH THE OREGON HEALTH DEPARTMENT, PERIODICALLY PERFORMS HEALTH ASSESSMENTS OF THE PEOPLE IN THE COMMUNITIES SERVED BY SKY LAKES. THE MEDICAL CENTER WORKS WITH LOCAL HEALTH AUTHORITIES TO DETERMINE THE HEALTH INITIATIVES THAT CAN BE JOINTLY ADDRESSED BY COMMUNITY LEADERS, WITH SKY LAKES MEDICAL CENTER SERVING A SIGNIFICANT LEADERSHIP ROLE. SKY LAKES MEDICAL CENTER ACTIVELY PARTNERS WITH AGENCIES SUCH AS THE KLAMATH COUNTY HEALTH DEPARTMENT, OREGON HEALTH & SCIENCES UNIVERSITY, AND THE UNITED WAY OF THE KLAMATH BASIN IN HEALTH-IMPROVEMENT INITIATIVES. EMPLOYEES VOLUNTEER THEIR TIME FOR LEADERSHIP KLAMATH, KLAMATH HOSPICE AND MANY OTHER COMMUNITY SERVICE ORGANIZATIONS WHERE LEADERS COME TOGETHER.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: SKY LAKES ALSO SUPPORTS COMMUNITY HEALTH IMPROVEMENT ADVOCACY VIA THE SOUTHERN OREGON METH PROJECT. SOMP IS MADE UP OF COMMUNITY BUSINESSES THAT HOPE TO HAVE AN IMPACT ON THE 75% OF CHILDREN IN FOSTER CARE THAT ARE THERE BECAUSE OF METH AND ON THE 8 OUT OF 10 ARRESTS BEING RELATED TO METH. OVERWHELMED COURTS AND JAILS IN OUR COMMUNITY HELP DRIVE THE SOMP PARTNERS TO COME TOGETHER TO STOP THE NEXT GENERATION FROM WORSENING THE PROBLEM. OTHER HEALTH IMPROVEMENT ADVOCACY TAKES PLACE VIA AN ANNUAL HEALTH FAIR AND ONGOING EDUCATIONAL OFFERINGS FOR HEART DISEASE, CHOLESTEROL SCREENING, WEIGHT MANAGEMENT, NUTRITION, DUII, EATING ON A BUDGET, BREASTFEEDING, SMOKING CESSATION, CAR SEAT SAFETY, AIDS/HIV, AND DIABETES. IN ADDITIONAL TO COMMUNITY MEMBERS, EDUCATIONAL OFFERINGS INCLUDE NURSING STUDENTS, ELEMENTARY, MIDDLE, HIGH SCHOOLS AND LOCAL COLLEGES. EMPLOYEE SUPPORT - TIME AND MONETARY DONATIONS - OF LOCAL FOOD BANKS IS ALSO ENCOURAGED.WORKFORCE DEVELOPMENT: SKY LAKES UNDERWRITES THE WAGES AND BENEFITS OF SELECTED NEW GRADUATES FROM THE LOCAL BACCALAUREATE NURSING PROGRAM. THESE NURSES SPEND 6 MONTHS ORIENTING TO VARIOUS INPATIENT UNITS BY SHADOWING EXPERIENCED REGISTERED NURSES IN ORDER TO DETERMINE THE BEST EMPLOYMENT "FIT" FOR THEM AND FOR SKY LAKES.OTHER: EMPLOYEE SUPPORT FOR FUTURE FARMERS OF AMERICA (FFA) AND 4-H PROGRAMS. | ||
| PART III, LINE 4: IN THE NORMAL COURSE OF BUSINESS, THE MEDICAL CENTER PROVIDES CREDIT TERMS TO ITS PATIENTS, INCLUDING BILLING TO THIRD-PARTY INSURANCE CARRIERS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE MEDICAL CENTER PERFORMS ONGOING CREDIT EVALUATIONS OF ITS PATIENTS, BUT TYPICALLY DOES NOT REQUIRE COLLATERAL. THE MEDICAL CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS THROUGH A CHARGE TO CURRENT EARNINGS FOR SPECIFIC RECEIVABLES JUDGED UNLIKELY TO BE COLLECTED BASED ON THE AGE OF THE RECEIVABLE, THE MEDICAL CENTER'S EXPERIENCE WITH THE DEBTOR, POTENTIAL OFFSETS TO THE AMOUNT OWED, AND ECONOMIC CONDITIONS. THE MEDICAL CENTER'S ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND BAD DEBT TOTALED $45,513,505 AND $41,023,358 AT SEPTEMBER 30, 2011 AND 2010, RESPECTIVELY. THE MIX OF GROSS RECEIVABLES FROM PATIENTS AND THIRD-PARTY PAYORS WAS A FOLLOWS AT SEPTEMBER 30: 2011: MEDICARE 32%; MEDICAID 15%; OTHER GOVERNMENTAL 3%; OTHER THIRD-PARTY PAYORS 32%; SELF PAY 18%. 2010: MEDICARE 33%; MEDICAID 19%; OTHER GOVERNMENTAL 4%; OTHER THIRD-PARTY PAYORS 24%; SELF PAY 20%. | ||
| PART III, LINE 8: MEDICARE REIMBURSEMENTS DO NOT COVER THE COSTS OF DELIVERING CARE TO THE COMMUNITY. IN ADDITION, SKY LAKES IS A TEACHING HOSPITAL THAT PROVIDES ACCESS TO PRIMARY CARE IN A RURAL COMMUNITY THAT HAS A PHYSICIAN SHORTAGE.SERVICES PROVIDED AND PAID ON THE MEDICARE FEE SCHEDULE (E.G. OP LAB TESTS, OP THERAPY SERVICES, OR PROVIDER BASED PHYSICIAN SERVICES) ARE NOT INCLUDED IN THE MEDICARE AMOUNTS INCLUDED IN PART III, SECTION B.SKY LAKES DOES NOT UTILIZE A COST ACCOUNTING SYSTEM. VENDORS AND SURVEYING AGENCIES (GOVERNMENTAL AND NON-GOVERNMENTAL) ARE PROVIDED WITH THE MEDICARE COST REPORT COST-TO-CHARGE RATIO WHEN THEY REQUEST IT.COSTS OF ROUTINE AND ICU NURSING SERVICES ARE CALCULATED ON A PER DIEM. ANCILLARY SERVICE COSTS ARE CALCULATED BASED ON TOTAL COSTS INCLUDING OVERHEAD TO TOTAL CHARGES BY ANCILLARY SERVICE TO DEVELOP AN RCC, WITH MEDICARE'S APPORTIONMENT CALCULATED BY TAKING MEDICARE CHARGES MULTIPLIED BY THE RCC DEVELOPED ON THE COST REPORT. | ||
| PART III, LINE 9B: SKY LAKES PLACES ALL ACCOUNTS IDENTIFIED AS ELIGIBLE FOR FINANCIAL ASSISTANCE ON HOLD AND THEN MAKES ANY NECESSARY ADJUSTMENTS BEFORE STATEMENTS ARE SENT. MANY OF THESE ACCOUNTS ARE ADJUSTED OFF COMPLETELY AND NO STATEMENTS ARE SENT. SKY LAKES ALSO CALLS PAST DUE ACCOUNTS (THIRD STATEMENT) AND REVIEWS TO SEE IF FINANCIAL ASSISTANCE IS AVAILABLE. LARGER ACCOUNTS ARE REVIEWED BY FINANCIAL COUNSELORS AND CHAMBERLIN EDMONDS FOR FINANCIAL ASSISTANCE ELIGIBILITY OR MEDICAID ELIGIBILITY. BOTH GROUPS MAKE PROACTIVE CALLS AND FOLLOW UP WITH PATIENTS TO GET THE NECESSARY INFORMATION TURNED IN. | ||
| PART VI, LINE 2: BESIDES FORMAL CONVERSATIONS WITH COMMUNITY PARTNERS AND MEDICAL COLLABORATORS, SKY LAKES MEDICAL CENTER ACTIVELY PARTNERS WITH AGENCIES SUCH AS THE KLAMATH COUNTY HEALTH DEPARTMENT AND THE UNITED WAY OF THE KLAMATH BASIN IN HEALTH-IMPROVEMENT INITIATIVES. THE HEALTH DEPARTMENT, IN CONJUNCTION WITH THE OREGON HEALTH DEPARTMENT, PERIODICALLY PERFORMS HEALTH ASSESSMENTS OF THE PEOPLE IN THE COMMUNITIES SERVED BY SKY LAKES. THE MEDICAL CENTER WORKS WITH LOCAL HEALTH AUTHORITIES TO DETERMINE THE HEALTH INITIATIVES THAT CAN BE JOINTLY ADDRESSED BY COMMUNITY LEADERS, WITH SKY LAKES MEDICAL CENTER SERVING A SIGNIFICANT LEADERSHIP ROLE. FURTHER, MEDICAL CENTER LEADERS USE INFORMATION AND DATA TRENDING FROM THE ROBERT WOOD JOHNSON FOUNDATION-SPONSORED UNIVERSITY OF WISCONSIN "COUNTY HEALTH RANKINGS" STUDY TO IDENTIFY SPECIFIC OPPORTUNITIES FOR IMPROVEMENT. COMMUNITY MEMBERS' PERCEPTIONS REGARDING HEALTH NEEDS ARE CAPTURED IN NON-SCIENTIFIC SURVEYS CONDUCTED AT THE CONCLUSION OF FREE HEALTH- AND WELLNESS-RELATED SEMINARS AND SIMILAR COMMUNITY EVENTS HOSTED BY THE MEDICAL CENTER. | ||
| PART VI, LINE 3: SKY LAKES MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR ASSISTANCE IS LOCATED ON THE HOSPITAL'S WEB SITE, IS REFERENCED IN THE ONLINE BILL-MANAGEMENT SECTION OF THE SITE, AND IS FEATURED IN THE MEDICAL CENTER'S ANNUAL REPORT AND PUBLISHED IN THE ANNUAL LIVE HEALTHY MAGAZINE. THE ANNUAL REPORT IS MAILED TO SOME 2,300 HOUSEHOLDS IN THE AREA AND THE MAGAZINE IS DISTRIBUTED TO ROUGHLY 17,000 HOUSEHOLDS IN THE MEDICAL CENTER'S CATCHMENT AREA USING THE LOCAL NEWSPAPER'S DISTRIBUTION NETWORK; BOTH ARE AVAILABLE ONLINE AND THE MAGAZINE IS PROMOTED VIA THE NEWSPAPER. THE FINANCIAL ASSISTANCE POLICY ALSO IS AVAILABLE WHEN SERVICES ARE PERFORMED. IN ADDITION, UNINSURED PATIENTS ARE PROVIDED PATIENT ADVOCACY BASED ELIGIBILITY AND ENROLLMENT SERVICES FOR MEDICAID AND OTHER BENEFIT PROGRAMS.THE MEDICAL CENTER ENSURES INFORMATION ABOUT FINANCIAL ASSISTANCE AND APPLICATIONS FOR ASSISTANCE IS AT ALL PATIENT REGISTRATION AREAS AND OUR SPECIALLY TRAINED FINANCIAL COUNSELORS HELP APPLICANTS COMPLETE THE FORM. ADDITIONALLY, FINANCIAL COUNSELORS TELEPHONE UNINSURED PATIENTS WITH LARGE BALANCES TO PROACTIVELY OFFER ASSISTANCE.OUR ABILITY TO OFFER FINANCIAL ASSISTANCE IS CLEARLY LISTED ON EVERY STATEMENT AND MOST FORM LETTERS WE MAIL. IT ALSO IS COVERED DURING COURTESY PHONE CALLS IF THERE IS MENTION OF DIFFICULTY IN PAYING MADE. THE ASSISTANCE ALSO IS DISCUSSED IF DIFFICULTY IN PAYING IS MENTIONED DURING INCOMING PHONE CALLS.IN ADDITION, SKY LAKES PROVIDES INFORMATION ABOUT FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS. WE HAVE ENGAGED THE SERVICES OF CHAMBERLIN EDMONDS, A COMPANY THAT SPEAKS WITH ALL UNINSURED INPATIENTS WHO MEET CLEARLY DEFINED CRITERIA.CHAMBERLIN EDMONDS STAFF ALSO REVIEW ALL QUALIFYING OUTPATIENT ACCOUNTS AND CONTACT PATIENTS TO DISCUSS THEIR ELIGIBILITY. THOSE STAFF FURTHER ASSIST PATIENTS IN COMPLETING FINANCIAL ASSISTANCE APPLICATIONS IF THEY ARE UNSUCCESSFUL GETTING ON A GOVERNMENT PROGRAM.BESIDES THE MAIN MEDICAL CENTER, THE SKY LAKES CANCER TREATMENT CENTER ALSO HAS FINANCIAL COUNSELORS WHO ASSIST WITH PHARMACEUTICAL CO-PAY RELIEF THROUGH THE DRUG MANUFACTURERS, RELIEVING PATIENTS OF SOME OF THAT FINANCIAL OBLIGATION. THE MEDICAL CENTER, THROUGH A THIRD-PARTY RELATIONSHIP, ROUTINELY PROVIDES NO-CHARGE MEDICATIONS TO INDIGENT PATIENTS THROUGH MAJOR PHARMACEUTICAL COMPANIES. | ||
| PART VI, LINE 4: COMMUNITIES IN A 10,000-SQUARE MILE AREA ENCOMPASSING SOUTH-CENTRAL OREGON AND NORTH-CENTRAL CALIFORNIA COMPRISE THE SKY LAKES MEDICAL CENTER SERVICE AREA. WHILE KLAMATH COUNTY IS THE LARGEST POLITICAL UNIT IN THE SERVICE AREA, A TOTAL OF ROUGHLY 80,000 TO 100,000 PEOPLE IN TWO OREGON COUNTIES AND TWO CALIFORNIA COUNTIES RELY ON SKY LAKES FOR THEIR ACUTE HEALTHCARE NEEDS.CENSUS DATA FROM 2010 SHOW KLAMATH COUNTY'S POPULATION AT 66,380, A 4.1 PERCENT INCREASE SINCE 2000, WITH 17.1 PERCENT 65 OR OLDER AND 23.1 PERCENT YOUNGER THAN 18. THE POPULATION'S GENDER SPLIT IS ALMOST EVEN WITH 50.1 PERCENT FEMALE. THE MEDIAN HOUSEHOLD INCOME IN THE COUNTY IS REPORTED AT $39,057, ALMOST $10,000 LESS THAN THE STATEWIDE MEDIAN, AND 20.2 PERCENT OF THE COUNTY'S POPULATION IS BELOW THE POVERTY LEVEL. THAT COMPARES WITH 14.3 PERCENT STATEWIDE.THE POPULATION SERVED BY THE MEDICAL CENTER IS FURTHER DESCRIBED BY THE RELATIVE RANKINGS FROM THE UNIVERSITY OF WISCONSIN STUDY. THE 2011 REPORT NOTES KLAMATH COUNTY IS RANKED 31ST OUT OF 33 RANKED OREGON COUNTIES (UP FROM 32ND A YEAR EARLIER) ON SUCH FACTORS AS: - POOR OR FAIR HEALTH (18 PERCENT VS THE NATIONAL BENCHMARK OF 10 PERCENT AND THE OREGON BENCHMARK OF 14 PERCENT),- ADULT SMOKING (24 PERCENT VS 14 PERCENT NATIONALLY AND 18 PERCENT IN OREGON),- UNINSURED ADULTS (23 PERCENT VS 11 PERCENT NATIONALLY AND 19 PERCENT IN OREGON), - PRIMARY CARE PROVIDERS (489:1 VS 631:1 NATIONALLY AND 739:1 IN OREGON),- UNEMPLOYMENT (13.4 PERCENT VS 5.4 PERCENT NATIONALLY AND 10.8 IN OREGON), - CHILDREN IN POVERTY (26 PERCENT VS 13 PERCENT NATIONALLY AND 16 PERCENT IN OREGON), AND- VIOLENT CRIME RATE (265 VS 73 NATIONALLY AND 271 IN OREGON.DURING 2011, APPROXIMATELY 28 PERCENT OF THE NEARLY 20,000 VISITS TO SKY LAKES MEDICAL CENTER'S EMERGENCY DEPARTMENT RESULTED IN AN INPATIENT STAY. ABOUT TWO-THIRDS OF THE INPATIENTS AT SKY LAKES CAME IN VIA THE ER, VERSUS THE STATE AVERAGE OF ABOUT HALF. | ||
| PART VI, LINE 6: BESIDES PROVIDING HIGH-QUALITY HEALTHCARE, SKY LAKES MEDICAL CENTER FURTHERS ITS TAX-EXEMPT PURPOSE AND FULFILLS ITS MEDICAL MISSION TO THE COMMUNITY BY PROVIDING OR SUBSIDIZING NUMEROUS CLASSES, SUPPORT GROUPS, SCREENINGS AND SELF-HELP PROGRAMS; A FREE GENERAL COMMUNITY HEALTH FAIR ATTENDED BY MORE THAN 1,500 PEOPLE A YEAR, AND A SEPARATE FREE FAIR FOCUSED ON INFORMATION FOR PEOPLE WITH DIABETES; A VARIETY OF LECTURES AIMED AT ENCOURAGING GREATER FITNESS AND CULMINATING IN A SERIES OF COMPETITIONS, AND OTHER AGE-SPECIFIC PROGRAMS FOCUSING ON STRETCHING, TAI CHI AND LOW-IMPACT DANCE. MOST OF THESE EVENTS ARE EITHER FREE, OR LOW COST AND SCHOLARSHIPS ARE FREQUENTLY AVAILABLE. SKY LAKES MEDICAL CENTER ROUTINELY PARTNERS WITH OSU EXTENSION TO PROMOTE HEALTHIER NUTRITION CHOICES COUPLED WITH HANDS-ON COOKING CLASSES.THE MEDICAL CENTER, OSU, THE KLAMATH COUNTY HEALTH DEPARTMENT, KLAMATH TRIBAL HEALTH AND FAMILY SERVICES, AND CASCADES EAST FAMILY MEDICINE WORKED TOGETHER ON THE BETTER HEALTH PARTNERSHIP TO PROMOTE INCREASED PHYSICAL ACTIVITY AND IMPROVED NUTRITION WITH PARTICIPANTS RECEIVING ONE-ON-ONE MENTORING. TO ENCOURAGE PEOPLE TO BE MORE ACTIVE, SKY LAKES GAVE AWAY PEDOMETERS TO SOME 3,000 PEOPLE INTERESTED IN KEEPING TRACK OF THEIR STEPS EN ROUTE TO A DAILY GOAL OF 10,000 STEPS.MANY OF THOSE PEOPLE ALSO PARTICIPATED IN THE FREE 'COUCH TO 5K' SERIES, WHICH DEMONSTRATED WAYS TO BE MORE ACTIVE. THE CLIMAX OF THE SIX-SESSION SERIES IS THE ANNUAL 15-KILOMETER RUN, A 5K RUN/WALK FOR ADULTS, AND TWO SHORTER EVENTS - ONE-HALF AND ONE-MILE - EVENTS FOR CHILDREN. THE EVENTS DRAW NEARLY 500 ENTRANTS FROM AROUND THE WEST WHO CROWD THE FIELD FOR THE RACES SPONSORED AND ORGANIZED BY THE MEDICAL CENTER STAFF AND VOLUNTEERS.SKY LAKES FAMILY BIRTH CENTER NURSES SPECIALLY TRAINED TO CHECK TO BE SURE INFANT CAR SEATS ARE APPROPRIATE AND PROPERLY INSTALLED INSPECT DOZENS OF SEATS A YEAR AT ONCE-A-MONTH FREE CHECKS. THE NURSES, IN COLLABORATION WITH KLAMATH COUNTY FIRE DISTRICT NO. 1, KLAMATH TRIBAL HEALTH AND FAMILY SERVICES, AND THE LOCAL HEAD START PROGRAM LAUNCHED THE CHECKS TWO YEARS AGO. THEY ALSO PROVIDE SEATS AT NO CHARGE TO QUALIFYING PARENTS.THE FAMILY BIRTH CENTER ALSO HOSTS FREE CLASSES TO HELP SOON-TO-BE SIBLINGS AND NO-CHARGE SESSIONS TO ENSURE THE EMOTIONAL HEALTH OF MOMS DURING AND AFTER PREGNANCY.SKY LAKES MEDICAL CENTER IS THE PRINCIPAL UNDERWRITER FOR CASCADES EAST FAMILY MEDICINE, A CLINIC AND A FAMILY PRACTICE RESIDENCY PROGRAM OPERATED IN PARTNERSHIP WITH OREGON HEALTH & SCIENCES UNIVERSITY. SKY LAKES FINANCIAL SUPPORT FOR 2010 WAS $3.18 MILLION. ALSO, THE MEDICAL CENTER CARRIES THE VAST MAJORITY OF COSTS INCURRED IN THE RUNNING OF THE CHILD ABUSE RESOURCE AND EDUCATIONAL SERVICES AGENCY THAT SERVES KLAMATH AND LAKE COUNTIES. CASCADES EAST ALSO OPERATES A MOBILE CLINIC THAT PROVIDES NO-CHARGE HEALTHCARE SERVICES TO UN- AND UNDERINSURED POPULATIONS IN THE REGION. THE 15 CASCADES EAST MEDICAL STAFF LOG MORE THAN 1,000 MILES IN THE RV EACH YEAR AND PERFORM MORE THAN 200 PATIENT EXAMS. BESIDES REGULAR CLINICS AT KLAMATH FALLS LOCATIONS, THE RV VISITS THE RURAL COMMUNITIES OF GILCHRIST AND SPRAGUE RIVER. THE FUEL, MAINTENANCE, AND SUPPLIES ARE ALL A PAID FOR BY SKY LAKES MEDICAL CENTER; THE SUM EXCEEDS $6,000 A YEAR.SKY LAKES CONTRIBUTES $10,000 A YEAR AND PROVIDES STAFF TO HELP COORDINATE AND PROVIDE COLLATERAL SUPPORT IN THE WAY OF ADDITIONAL MULTI-MEDIA ADVERTISING TO FURTHER THE MESSAGE OF THE LOCAL 'STOP THE HURT' AND 'PERIODS OF PURPLE CRYING' CAMPAIGNS. THE PROGRAMS ARE AIMED AT STOPPING INCIDENTS OF INFANT AND CHILD ABUSE AT THE HANDS OF ADULTS.SIMILARLY, SKY LAKES IS AMONG THE COMMUNITY PARTNERS INVESTING IN THE 'SOUTHERN OREGON METH PROJECT,' WHICH TARGETS DRUG USE BY TEENS. THE MEDICAL CENTER ANNUALLY CONTRIBUTES $9,000 TO THE PUBLIC AWARENESS CAMPAIGN.IN ADDITION, KLAMATH COUNTY IS A PHYSICIAN-SHORTAGE AREA SO PHYSICIAN RECRUITMENT EFFORTS ARE ALSO UNDERWRITTEN BY THE MEDICAL CENTER RATHER THAN LOCAL MEDICAL PRACTICES INCURRING THAT EXPENSE. THE MEDICAL CENTER INVESTS UPWARDS OF $1 MILLION A YEAR IN RECRUITING ACTIVITIES. SKY LAKES PROVIDES FREE EDUCATION IN OR FOR THE SCHOOLS THROUGH ITS PARTNERSHIP WITH OREGON STATE UNIVERSITY EXTENSION'S NUTRITION EDUCATION PROGRAM. THE MEDICAL CENTER ALSO PARTNERS WITH OSU EXTENSION FOR THE EDUCATION SERIES FOR PEOPLE WITH DIABETES, AND THE THREE-CLASS 'MASTERY OF AGING WELL' SERIES. AND A NUMBER OF SKY LAKES MEDICAL CENTER EMPLOYEES PROVIDE VOLUNTEER EDUCATIONAL SUPPORT IN THE FORM OF TEACHING, MENTORING, PROGRAM DEVELOPMENT, AND TOURS AND DEMONSTRATIONS FOR LOCAL SCHOOLS AND COLLEGES.OTHER PARTNERSHIPS HELP ENSURE THE SUCCESS OF PROGRAMS SUCH AS:- THE KLAMATH CRISIS CENTER BY PROVIDING A NO-RENT VENUE FOR TWICE-A-MONTH EDUCATION AND TRAINING PROGRAMS; - THE LOCAL KLAMATH AND LAKE COMMUNITY ACTION SERVICES PROGRAM BY DONATING MATERIAL FOR ITS PROGRAM TO PROVIDE QUALIFYING INDIVIDUALS AND FAMILIES ACCESS TO MEDICAL AND DENTAL CARE, HYGIENE RESOURCES AND THE LIKE;- THE KLAMATH COUNTY RELAY FOR LIFE BY CONTRIBUTING $1,000 TOWARD CANCER RESEARCH AND PROVIDING SOME 700 SERVINGS OF HOME-MADE SOUP TO THOSE AT THE EVENT;- THE RED CROSS BY GIVING AT NO-CHARGE SPACE IN SKY LAKES FACILITIES FOR COMMUNITY BLOOD DRIVES;- THE LOCAL CHAPTERS OF THE MARCH OF DIMES, MUSCULAR SCLEROSIS ORGANIZATIONS, AND LOCAL EARLY CANCER DETECTION CAMPAIGNS BY CONTRIBUTING HUNDREDS OF DOLLARS EACH TO THEIR MISSIONS. - THE 'BASIN HEALTHY CHOICES' INITIATIVE COORDINATED BY THE KLAMATH COUNTY HEALTH DEPARTMENT AND THE HEALTHY ACTIVE KLAMATH COALITION, WHICH INCLUDES SKY LAKES MEDICAL CENTER. SKY LAKES CONTRIBUTES COUNTLESS HOURS OF STAFF TIME AND TALENT, AS WELL AS FACILITY AND OTHER RESOURCES, IN THE CAMPAIGN AIMED AT IMPROVING THE HEALTH OF PEOPLE IN THE REGION BY PROMOTING WORKPLACE WELLNESS, BETTER NUTRITION THROUGH FOOD CHOICES, AND INCREASED PHYSICAL ACTIVITY. HERE IS A LIST OF SOME OTHER SKY LAKES COMMUNITY PARTNERSHIPS:- AMERICAN ASSOCIATION OF UNIVERSITY WOMEN- AMERICAN CANCER SOCIETY- GOSPEL MISSION- HEALTHY ACTIVE KLAMATH- AREA PUBLIC SCHOOLS AND STUDENTS- INVEST IN YOUTH CONFERENCE - KLAMATH COMMUNITY COLLEGE AND STUDENTS- KLAMATH COUNTY CASA- KLAMATH COUNTY CHAMBER OF COMMERCE- KLAMATH CRISIS CENTER- KLAMATH FIRE PREVENTION COOPERATIVE- KLAMATH HOSPICE- KLAMATH-LAKE FOOD BANK- KLAMATH TRIBAL HEALTH AND FAMILY SERVICES- MULTIPLE SCLEROSIS SOCIETY- 'OPERATION PROM NIGHT' TO PREVENT DISTRACTED DRIVING - OREGON AIR NATIONAL GUARD AT KINGSLEY FIELD- OREGON INSTITUTE OF TECHNOLOGY AND STUDENTS (CLINICAL PRECEPTING, ETC.)- PREGNANCY HOPE CENTER- SANFORD HEALTH FOUNDATION- UNITED WAY OF THE KLAMATH BASIN- AREA 4-H PROGRAMS | ||
| 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 (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| KLAMATH COUNTY SCHOOL DISTRICT | |||||||
| 10501 WASHBURN WAY | KLAMATH FALLS | OR | 97603 | 936000543 | GOVERNMENT ENTITY | 22000 | HEALTH OCCUPATIONS PROGRAM ASSISTANCE |
| SKY LAKES MEDICAL CENTER FOUNDATION | |||||||
| 2865 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | 930946020 | 501(C)(3) | 34950 | INFECTIOUS DISEASE CONFERENCE, STOP THE HURT CAMPAIGN, AND CHILD ABUSE RESPONSE AND EVALUATION SERVICES (CARES) AWARENESS & PREVENTION EDUCATION PROGRAM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| EMPLOYEE STUDENT LOAN FORGIVENESS | 24 | 104684 |
| EXTERNSHIP STIPENDS | 5 | 13600 |
| EMPLOYEE TUITION REIMBURSEMENT - FORGIVEN | 8 | 83423 |
| STUDENT LOAN ASSISTANCE TO EMPLOYEES | 19 | 65480 |
| PATIENT ASSISTANCE | 242 | 10329 |
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: THE BOARD OF DIRECTORS MAKES DECISIONS ON LARGE GRANT AWARDS. SCHOLARSHIP AWARDS ARE BASED ON A WRITTEN POLICY. OTHER STIPENDS AND EDUCATIONAL SUPPORT REQUIRE, RESPECTIVELY, WORKED HOURS OR MINIMUM GRADING CRITERIA. PATIENT ASSISTANCE GRANTS ARE BASED ON ASSESSMENT OF NEED BY ASSIGNED PERSONNEL. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GRANT NISKANEN MD | |||||||||||||
| 259750 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 0 | 0 | 272000 | 0 | 0 | 0 |
| PAUL R STEWART | |||||||||||||
| 317525 | 0 | 0 | 0 | 175000 | 0 | 12250 | 0 | 13824 | 0 | 518599 | 0 | 0 | 0 |
| RICHARD RICO | |||||||||||||
| 248409 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 18816 | 0 | 279475 | 0 | 0 | 0 |
| PATRICK MAVEETY MD | |||||||||||||
| 406375 | 0 | 0 | 0 | 0 | 0 | 12116 | 0 | 5235 | 0 | 423726 | 0 | 0 | 0 |
| TZANN T FANG MD | |||||||||||||
| 393703 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 17984 | 0 | 423937 | 0 | 0 | 0 |
| NASSER G ABU-ERREISH MD | |||||||||||||
| 290654 | 0 | 0 | 0 | 0 | 0 | 8750 | 0 | 12672 | 0 | 312076 | 0 | 0 | 0 |
| KURT J SLATER DO | |||||||||||||
| 216870 | 0 | 0 | 0 | 0 | 0 | 4973 | 0 | 12444 | 0 | 234287 | 0 | 0 | 0 |
| W CLAY MCCORD MD | |||||||||||||
| 201769 | 0 | 0 | 0 | 0 | 0 | 11513 | 0 | 13824 | 0 | 227106 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 931061020 | IssuerEIN |
| CUSIP Number | 498413DQ3 | CUSIPNumber |
| Date Issued | 2006-08-31 | DateIssued |
| Issue Price | 39329258 | IssuePrice |
| Description Of Purpose | REVENUE AND REFUNDING; MERLE WEST MEDICAL CENTER PROJECT | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 39329258 | TotalProceeds |
| Issuance Costs From Proceeds | 558445 | IssuanceCostsFromProceeds |
| Credit Enhancement | 1170952 | CreditEnhancement |
| Capital Expenditures | 15000000 | CapitalExpenditures |
| Other Spent Proceeds | 22599861 | OtherSpentProceeds |
| Year Of Subst Completion | 2007 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| SOUTH VALLEY BANK & TRUST (SVBT) | |||
| PAUL STEWART IS THE CEO OF SLMC AND IS A VOTING BOARD MEMBER AT SVBT | 134101 | SLMC PAYS FEES AND INTEREST TO SVBT | 0 |
| (no name) | |||
| 0 | |||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BY THE CONTROLLER AND OTHER STAFF BEFORE FILING. | |
| ANNUALLY EACH MEMBER OF THE BOARD SIGNS THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. ANYONE WHO DOES NOT COMPLETE IT IS REMINDED UNTIL ALL STATEMENTS ARE RECEIVED. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARATIVE DATA FOR CEO AND ALL VP POSITIONS. FOR THE CEO POSITION, THE COMPENSATION COMMITTEE COMPLETES A PERSONNEL ACTION FORM, WHICH IS SIGNED BY THE BOARD CHAIR. FOR ALL VP POSITIONS, THE COMMITTEE ACTS ON THE RECOMMENDATIONS MADE BY THE CEO. | FORM 990, PART VI, SECTION B, LINE 15 | |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL MADE AVIALABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -392,015. BOOK/TAX DIFFERENCE ON PASSTHROUGH INCOME -61,861. MISC CONSOLIDATION ADJUSTMENT 65. TOTAL TO FORM 990, PART XI, LINE 5: -453,811. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN OREGON EMERGENCY CARE LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611595709 | EIN |
| Primary Activities | PHYSICIAN SERVICES | PrimaryActivities |
| Legal Domicile State | OR | LegalDomicileState |
| Total Income | 0 | TotalIncome |
| EOY Assets | 583909 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SKY LAKES MEDICAL CENTER | BusinessNameLine1 |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| SKY LAKES MEDICAL CENTER FOUNDATION | ||||||||||
| 2865 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | 930946020 | FUNDRAISING AND STEWARDSHIP; SUPPORT MED CENTER | OR | 501(C)(3) | 11C | SKY LAKES MEDICAL CENTER | 0 |
| KLAMATH CARE SERVICES INC | ||||||||||
| 2865 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | 930946018 | SUPPORT MED CENTER (INACTIVE) | OR | 501(C)(3) | 11C | SKY LAKES MEDICAL CENTER | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KLAMATH MEDICAL BUSINESS CENTER LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2865 DAGGETT AVENUE | AddressLine1 |
| City | KLAMATH FALLS | City |
| State | OR | State |
| ZIP Code | 97601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020731372 | EIN |
| Primary Activity | REAL AND PERSONAL PROPERTY RENTAL | PrimaryActivity |
| Legal Domicile State | OR | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | INVESTMENT | PredominantIncomeType |
| Share Of Total Income | 71567 | ShareOfTotalIncome |
| Share Of EOY Assets | 534630 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| Code V | $7,215 | CodeVAmount |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
| Percentage Ownership | 0.50000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WEST PHYSICIAN SERVICES LLC | |||||||||||
| 2865 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | 870696029 | PHYSICIAN SERVICES | OR | SKY LAKES MEDICAL CENTER | C | -95848 | 2794723 | 1.00000 |
| PREFERRED HEALTH PLAN INC | |||||||||||
| 2865 DAGGETT AVENUE | KLAMATH FALLS | OR | 97601 | 931304315 | HEALTH INSURANCE | OR | SKY LAKES MEDICAL CENTER | C | -107568 | 471184 | 0.87000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 1 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| KLAMATH MEDICAL BUSINESS CENTER LLC | ||
| J | 104517 | CASH TRANSFERRED |
| WEST PHYSICIAN SERVICES LLC | ||
| D | 284477 | CASH TRANSFERRED |