2012-08-15T12:13:22-05:00 2011-09-30 MOSS ADAMS LLP 805 SW BROADWAY 1200 PORTLAND OR 97205 990 2010-10-01 930508781 SKY LAKES MEDICAL CENTER SKYL 5412746311 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 RICHARD RICO 5412746311 2012-08-13 1 WENDY CAMPOS 5032421447 2010 2016-02-24 21:20:13Z PAUL STEWART 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 357497651 0 X WWW.SKYLAKES.ORG X 1979 OR 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. 10 7 1209 347 7215 5199 640948 583985 321053289 354932861 609910 634469 461533 352404 322765680 356503719 327147 334466 0 0 65459152 72952593 0 0 0 239866341 268370292 305652640 341657351 17113040 14846368 158047175 175539803 64829606 67929677 93217569 107610126 X 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. 0 0 276513512 10329 351368851 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. 23564681 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%. 5856878 267187 1859777 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. 11269093 32725 2267917 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. 11269093 32725 2267917 317204164 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 224 0 1 1209 1 1 1 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OR X RICHARD RICO CFO 5412746150 2865 DAGGETT AVENUE KLAMATH FALLS OR 97601 JOHN BELL 3.00 X X 0 0 0 ROD WENDT 1.00 X X 0 0 0 KERMIT HOUSER 1.00 X 0 0 0 CLARK PEDERSON 1.00 X 0 0 0 BERNARD SIMONSON 1.00 X 0 0 0 WENDY WARREN MD 1.00 X 0 0 0 DOUGLAS MCINNIS DVM 1.00 X 0 0 0 GREGORY SINDMACK MD 1.00 X 26000 0 0 GRANT NISKANEN MD 40.00 X 259750 0 12250 PAUL R STEWART 50.00 X X 492525 0 26074 RICHARD RICO 50.00 X 248409 0 31066 PATRICK MAVEETY MD 40.00 X 406375 0 17351 TZANN T FANG MD 40.00 X 393703 0 30234 NASSER G ABU-ERREISH MD 40.00 X 290654 0 21422 KURT J SLATER DO 40.00 X 216870 0 17417 W CLAY MCCORD MD 40.00 X 201769 0 25337 2536055 0 181151 51 0 1 0 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 22 583985 583985 PATIENT REVENUE 621990 351368851 351368851 OTHER PROGRAM REVENUE 621990 3564010 3564010 354932861 759690 759690 801250 692693 108557 108557 108557 3990 129211 -125221 -125221 -125221 119729 172028 -52299 -52299 SUB/PASSTHROUGH INCOME 621990 570899 563684 7215 OTHER INCOME 900099 -274753 -274753 296146 356503719 355496545 7215 415974 56950 56950 277516 277516 1182415 1182415 55385441 51090350 4295091 2181807 1990306 191501 8877499 8090346 787153 5325431 3603825 1721606 234558 33895 200663 150289 150289 6316982 5867636 449346 706661 86713 619948 1994701 1325812 668889 1716216 37434 1678782 2400587 2115654 284933 130355 112824 17531 419520 335852 83668 3026796 2005 3024791 7505469 2476791 5028678 2620761 576714 2044047 CONTRACTUAL ALLOWANCE 178497907 178497907 SUPPLIES 26507717 26354669 153048 CHARITY CARE 11867802 11867802 BAD DEBT EXPENSE 11696879 11696879 TAXES PAID ON UBI 650 650 12576442 10706284 1870158 341657351 317204164 24453187 0 467564 388095 25715056 37710047 21702325 20664948 2699898 2487606 2191378 2890033 166196429 80604779 87326153 85591650 1134829 4745469 2368682 2959246 14441290 18102709 158047175 175539803 4705771 4669107 2622197 2608182 52122247 51137164 1247993 1171848 4131398 8343376 64829606 67929677 X 93217569 107610126 93217569 107610126 158047175 175539803 X 14846368 -453811 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1325402 1325402 106834107 45000639 61833468 4172451 2095067 2077384 38111114 26892814 11218300 15753355 6616259 9137096 85591650 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 18102709 CAPITAL LEASE OBLIGATIONS 5857035 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 2486341 8343376 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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. 1 1 1 X 1 X 1 1 0 1 1 6640 9212930 9212930 0.02790 37542 26075924 24642775 1433149 0.00430 44182 35288854 24642775 10646079 0.03220 8 528362 111408 21887 89521 0.00030 2 5855 4796732 1617322 3179410 0.00960 4 205267 9758269 6569904 3188365 0.00970 3 260 1031 1031 0.00000 17 739744 14667440 8209113 6458327 0.01960 17 783926 49956294 32851888 17104406 0.05180 12 258081 863706 457006 406700 0.00120 2 2077 7022 7022 0.00000 3 229 3688 3688 0.00000 17 150065 364739 364739 0.00110 2 23 412867 412867 0.00130 1 100 100 0.00000 37 410475 1652122 457006 1195116 0.00360 0 4576859 869603 44192724 44863006 -670282 X 1 1 1 1 SKY LAKES MEDICAL CENTER

2865 DAGGETT AVENUE KLAMATH FALLS OR 97601

X X X X SKY LAKES MEDICAL CENTER 1 9 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 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 REPORTS FILED WITH STATES PART VI, LINE 7 OR 1 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 1 1 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 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: 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. X X X 0 0 0 0 0 0 0 0 0 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 KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY 931061020 498413DQ3 2006-08-31 39329258 REVENUE AND REFUNDING; MERLE WEST MEDICAL CENTER PROJECT 0 0 0 39329258 558445 1170952 15000000 22599861 2007 0 1 1 1 0 0 0 0 1 0 0 0 0 0 0 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 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE CONTROLLER AND OTHER STAFF BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL MADE AVIALABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: 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. 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