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GRANDE RONDE HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
GRANDE RONDE HOSPITAL INC (EIN 93-0505325)
Tax period
2010-05-01 to 2011-04-30
Filed
2012-03-15
IRS object ID
201240759349300424
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-15T10:58:48-05:00Timestamp
Tax Period End Date2011-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY & PULLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1201 N HARRISON STREET SUITE 300AddressLine1
CityDAVENPORTCity
StateIAState
ZIP Code528011999ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930505325EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRANDE RONDE HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGRANNameControl
Phone5419638421Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3290AddressLine1
CityLA GRANDECity
StateORState
ZIP Code97850ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAMES A MATTESName
TitlePRESIDENT & CEOTitle
Phone5419638421Phone
Date Signed2012-03-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN J ROMANOName
Phone5638884000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJAMES A MATTESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 3290AddressLine1
CityLA GRANDECity
StateORState
ZIP Code97850ZIPCode
FieldValueIRS element (for citing)
Gross Receipts68309256GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GRH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1962YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO ENSURE ACCESS TO HIGH-QUALITY, COST EFFECTIVE HEALTH SERVICES IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees566TotalNbrEmployees
Total Nbr Volunteers118TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year194057ContributionsGrantsPriorYear
Contributions Grants Current Year137478ContributionsGrantsCurrentYear
Program Service Revenue Prior Year51470047ProgramServiceRevenuePriorYear
Program Service Revenue CY59586282ProgramServiceRevenueCY
Investment Income Prior Year-477044InvestmentIncomePriorYear
Investment Income Current Year213571InvestmentIncomeCurrentYear
Other Revenue Prior Year364913OtherRevenuePriorYear
Other Revenue Current Year305593OtherRevenueCurrentYear
Total Revenue Prior Year51551973TotalRevenuePriorYear
Total Revenue Current Year60242924TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year34955GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY32332GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year33445839SalariesEtcPriorYear
Salaries Etc Current Year36811751SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year-17859TotalFundrsngExpCurrentYear
Other Expense Prior Year19610068OtherExpensePriorYear
Other Expenses Current Year20154625OtherExpensesCurrentYear
Total Expenses Prior Year53090862TotalExpensesPriorYear
Total Expenses Current Year56998708TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1538889RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3244216RevenuesLessExpensesCY
Total Assets BOY62595406TotalAssetsBOY
Total Assets EOY68538853TotalAssetsEOY
Total Liabilities BOY4954837TotalLiabilitiesBOY
Total Liabilities EOY5504211TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY57640569NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY63034642NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO ENSURE ACCESS TO HIGH-QUALITY, COST EFFECTIVE HEALTH SERVICES IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense49833041Expense
Grants32332Grants
Revenue59586282Revenue
DescriptionGRANDE RONDE HOSPITAL, INC. (GRH) IS DEDICATED TO PROVIDING HIGH-QUALITY, COST-EFFECTIVE HEALTH SERVICES TO THE LOCAL COMMUNITY THROUGH THE OPERATION OF A 25 BED CRITICAL ACCESS HOSPITAL, 24-HOUR EMERGENCY DEPARTMENT, FAMILY BIRTHING CENTER, HOME HEALTH AND HOSPICE PROGRAMS, AND 3 PROVIDER-BASED CLINICS. GRH ALSO SUPPORTS A TELEMEDICINE PROGRAM WHICH ENABLES PATIENTS TO OBTAIN THE SERVICES OF SPECIALISTS SUCH AS ICU INTENSIVISTS, CARDIOLOGISTS, NEONATOLOGISTS, AND DERMATOLOGISTS THAT THEY WOULD OTHERWISE HAVE TO TRAVEL OUT OF THE AREA TO VISIT. DURING THE TAX YEAR 2010, GRH SERVED 1,773 INPATIENTS, 83,695 OUTPATIENTS, 13,107 EMERGENCY PATIENTS, AND BIRTHED 270 BABIES. ADDITIONALLY, GRH PROVIDED 2,932 HOME HEALTH VISITATIONS, 3,417 HOSPICE VISITS, AND HAD 50,831 VISITS TO ITS PROVIDER-BASED OUTPATIENT CLINICS. DURING THE PAST YEAR, GRH WAS ABLE TO PROVIDE $4,382,888 IN CHARITY CARE SERVICES TO THOSE WHO COULD NOT OTHERWISE AFFORD NECESSARY MEDICAL CARE. GRH ALSO PUBLISHES AN ANNUAL COMMUNITY BENENFIT REPORT WHICH IS AVAILABLE UPON REQUEST AND PROVIDES ADDITIONAL DETAIL REGARDING ITS SERVICES AND ACTIVITIES.Description
Total Program Service Expense49833041TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109658NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees566NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form1098 C Filed1Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1GRANDE RONDE HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5419638421TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 SUNSET DRIVEAddressLine1
CityLA GRANDECity
StateORState
ZIP Code97850ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
LIBBY GOBEN
BOARD MEMBER3.00X000
ANNA BAUM
BOARD MEMBER3.00X000
STEVE LYON
BOARD MEMBER3.00X000
DEBBIE VOTAW
BOARD MEMBER3.00X000
BRAD TRISLER
INTERIM SECRETARY/BOARD MEMBER3.00X000X
MARK ALDAPE MD
BOARD MEMBER/MED STAFF PAST PRESIDENT3.00X000
SUSAN RICE MD
BOARD MEMBER/MED STAFF PRESIDENT40.00X162753039477
BETSY NEELEY MD
BOARD MEMBER40.00X212394032498
LYNN HARRIS DMD
CHAIRMAN/BOARD MEMBER10.00X000X
STEVE WEISHAAR
SECRETARY/BOARD MEMBER3.00X000X
BURR BETTS
VICE CHAIRMAN/BOARD MEMBER3.00X000X
JAMES MATTES
PRESIDENT/CEO40.00X277826045423X
WADE WEIS
SR. DIRECTOR OF FINANCE/CFO40.00132638032737X
DALE ROBINSON MD
PHYSICIAN40.00309421035913X
GARY ZEIGLER MD
PHYSICIAN40.00291300037879X
LEWIS BAYNES MD
PHYSICIAN40.00279903041773X
RODRIGO LIM MD
PHYSICIAN40.00272674022523X
KENNETH CHASTEEN MD
PHYSICIAN40.00253069031741X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2191978TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation319964TotalOtherCompensation
Number Individuals GT100 K40NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCKESSON INFORMATION SOLUTIONS
PO BOX 98347CHICAGOIL606938347INSTALL OF H.I.S. SYSTEM749896
INTERPATH LABORATORY INC
PO BOX 1208PENDELTONOR97801LAB TESTING SERVICES487611
TURN-KEY MEDICAL INC
PO BOX 1180MERIDIANID83680MAINTENANCE SERVICES288949
KREIZENBECK LLC
251 EAST FRONT ST STE 110BOISEID83702CONSTRUCTION258743
STOEL RIVES LLP
900 SW FIFTH AVE STE 2600PORTLANDOR97204LEGAL SERVICES180305
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Related Organizations38142RelatedOrganizations
Government Grants5211GovernmentGrants
All Other Contributions94125AllOtherContributions
Noncash Contributions22841NoncashContributions
Total Contributions137478TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
ANCILLARY PATIENT REVE6219907858205078582050
ROUTINE PATIENT REVENU62199092023859202385
LESS: OTHER ADJUSTMENT621990-807921-807921
LESS: CHARITY CARE621990-4382888-4382888
LESS: CONTRACTUAL ADJU621990-23109489-23109489

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column102145TotalRevenueColumn
Related Or Exempt Function Income102145RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue59586282TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column508545TotalRevenueColumn
Exclusion$508,545ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real62481Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real21375Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real41106Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column41106TotalRevenueColumn
Exclusion$41,106ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities7704151Securities
Other156Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7995380Securities
Other3901Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-291229Securities
Other-3745Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-294974TotalRevenueColumn
Exclusion-$294,974ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory83802GrossSalesOfInventory
Cost Of Goods Sold45676CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column38126TotalRevenueColumn
Exclusion$38,126ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA621990163690$163,690
WELLNESS CENTER6219901085010850
INSURANCE PROCEEDS6219901179$1,179

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column50642TotalRevenueColumn
Related Or Exempt Function Income50642RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue226361TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column60242924TotalRevenueColumn
Related Or Exempt Function Income59647774RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$457,672ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total32332Total
Program Services32332ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total895693Total
Program Services431454ProgramServices
Management And General464239ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total27318072Total
Program Services24503530ProgramServices
Management And General2813986ManagementAndGeneral
Fundraising556Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1482235Total
Program Services1339942ProgramServices
Management And General139878ManagementAndGeneral
Fundraising2415Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4994026Total
Program Services4367634ProgramServices
Management And General627278ManagementAndGeneral
Fundraising-886Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2121725Total
Program Services1894215ProgramServices
Management And General227639ManagementAndGeneral
Fundraising-129Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total186165Total
Management And General186165ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total22300Total
Management And General22300ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2750891Total
Program Services1276543ProgramServices
Management And General1474348ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total65676Total
Program Services65676ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7653653Total
Program Services7412995ProgramServices
Management And General240204ManagementAndGeneral
Fundraising454Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total696068Total
Program Services624405ProgramServices
Management And General71663ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total33579Total
Program Services8013ProgramServices
Management And General25581ManagementAndGeneral
Fundraising-15Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total354848Total
Program Services291512ProgramServices
Management And General62679ManagementAndGeneral
Fundraising657Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3491768Total
Program Services3491768ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total319487Total
Program Services99620ProgramServices
Management And General219867ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT EXPENSE29911622991162
REPAIRS & MAINTENANCE9612599213843980867
MISCELLANEOUS EXPENSES30862348551281050-20978
RECRUITING222601222601
MEMBERSHIPS965453230564240

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total56998708Total
Program Services49833041ProgramServices
Management And General7183526ManagementAndGeneral
Fundraising-17859Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY102461BOY
EOY1848969EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6008385BOY
EOY8985742EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8702053BOY
EOY7358647EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY790154BOY
EOY882331EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY412180BOY
EOY576749EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis66088047LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec38564085LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24320241BOY
EOY27523962EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY19026812BOY
EOY19840487EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY14426BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY10537BOY
EOY3099EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3208157BOY
EOY1518867EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY62595406BOY
EOY68538853EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4954837BOY
EOY5503911EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY300EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4954837BOY
EOY5504211EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY57640569BOY
EOY62075674EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY958968EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY57640569BOY
EOY63034642EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY62595406BOY
EOY68538853EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3244216ReconcilationRevenueExpenses
Reconcilation Other Changes2149857ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1189674OtherCostOrOtherBasis
Book Value1189674BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis34580605OtherCostOrOtherBasis
Depreciation18796117Depreciation
Book Value15784488BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2934940OtherCostOrOtherBasis
Depreciation2173664Depreciation
Book Value761276BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis26555825OtherCostOrOtherBasis
Depreciation17594304Depreciation
Book Value8961521BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis827003OtherCostOrOtherBasis
Book Value827003BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings27523962TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE HOSPITAL HAS ADOPTED THE PROVISIONS OF ASC 740 (FORMALLY FINANCIAL INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES) ON JANUARY 1, 2009. ASC 740 PRESCRIBES A NEW THRESHOLD FOR DETERMINING WHEN AN INCOME TAX BENEFIT CAN BE RECOGNIZED, WHICH IS A HIGHER THRESHOLD THAN THE ONE IMPOSED FOR CLAIMING DEDUCTION ON INCOME TAX RETURNS. THE ADOPTION OF ASC 740 DID NOT HAVE ANY IMPACT ON THE HOSPITAL'S FINANCIAL STATEMENTS. THE HOSPITAL'S FEDERAL AND STATE INCOME TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES UNTIL THE EXPIRATION OF THE RELATED STATUTES OF LIMITATIONS ON THOSE TAX RETURNS. IN GENERAL, THE FEDERAL AND STATE INCOME TAX RETURNS HAVE A THREE YEAR STATUTE OF LIMITATIONS. THE HOSPITAL WOULD RECOGNIZE ACCRUED INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX PROVISIONS, IF ANY, AS PART OF THE INCOME TAX PROVISION.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2673562TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2673562NetCommunityBenefitExpense
Percent Of Total Expense0.04950PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7870229TotalCommunityBenefitExpense
Direct Offsetting Revenue7957111DirectOffsettingRevenue
Net Community Benefit Expense-86882NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense10543791TotalCommunityBenefitExpense
Direct Offsetting Revenue7957111DirectOffsettingRevenue
Net Community Benefit Expense2586680NetCommunityBenefitExpense
Percent Of Total Expense0.04950PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense174964TotalCommunityBenefitExpense
Direct Offsetting Revenue1235DirectOffsettingRevenue
Net Community Benefit Expense173729NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense208234TotalCommunityBenefitExpense
Direct Offsetting Revenue10340DirectOffsettingRevenue
Net Community Benefit Expense197894NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1695601TotalCommunityBenefitExpense
Direct Offsetting Revenue1109818DirectOffsettingRevenue
Net Community Benefit Expense585783NetCommunityBenefitExpense
Percent Of Total Expense0.01080PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense51149TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense51149NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2129948TotalCommunityBenefitExpense
Direct Offsetting Revenue1121393DirectOffsettingRevenue
Net Community Benefit Expense1008555NetCommunityBenefitExpense
Percent Of Total Expense0.01860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense12673739TotalCommunityBenefitExpense
Direct Offsetting Revenue9078504DirectOffsettingRevenue
Net Community Benefit Expense3595235NetCommunityBenefitExpense
Percent Of Total Expense0.06810PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,824,609BadDebtExpenseAmount
Amount Attributable To1533219AmountAttributableTo
Amount Reimbursed By Medicare18149899AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare17985669CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall164230MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRANDE RONDE HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1900 SUNSET DRIVEAddressLine1
CityLA GRANDECity
StateORState
ZIP Code97850ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
GRANDE RONDE HOSPITAL REGIONAL MEDICAL
506 4TH STREETLA GRANDEOR97850PROVIDER BASED CLINIC
GRANDE RONDE HOSPITAL WOMEN'S CLINIC
610 SUNSET DRIVELA GRANDEOR97850PROVIDER BASED CLINIC
GRANDE RONDE HOSPITAL CHILDREN'S CLINIC
612 SUNSET DRIVELA GRANDEOR97850PROVIDER BASED CLINIC
GRANDE RONDE HOSPITAL HOME CARE SERVICES
802 SUNSET DRIVELA GRANDEOR97850OUTPATIENT HOME HEALTH & HOSPICE SERVICES

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: NOT APPLICABLE
PART I, LINE 6A: NOT APPLICABLE
PART I, LINE 7: THE COSTS ASSOCIATED WITH LINES 7A AND 7B WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FORM WORKSHEET 2. THE COSTS ON LINE 7E, 7F, AND 7I INCLUDE THE DIRECT AND INDIRECT COSTS AS ALLOWED FOR IN WORKSHEETS 4, 5, AND 8. LINE 7G UTILIZED A COST TO CHARGE RATION USING THE MEDICARE COST REPORT AS FILED.
PART I, LINE 7G: NOT APPLICABLE
PART I, L7 COL(F): $2,991,162 OF BAD DEBT EXPENSE IS SUBTRACTED FOR PURPOSES OF COMPUTING THE PERCENTAGE IN PART I, LINE 7K, COLUMN F. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES, LESS BAD DEBT, IS 23.47%, AND THE PERCENTAGE INCREASE TO 56.76% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE.
PART II: NOT APPLICABLE
PART III, LINE 4: I. THE COSTING METHODOLOGY USED TO DETERMINE THE TOTAL COST OF BAD DEBT IS THE RATIO OF COST TO CHARGES AS DETERMINED USING WORKSHEET 2 OF THE FORM 990 SCHEDULE H INSTRUCTIONS. II. THE ESTIMATED AMOUNT OF BAD DEBT THAT IS ATTRIBUTED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS EQUAL TO THE AVERAGE OF ACTUAL DISCOUNTS ON FULLY EXECUTED PATIENT ACCOUNTS WITH FINANCIAL ASSISTANCE. THE RATE FOR TAX YEAR 2010 IS 84.03%. THE RATIONALE FOR APPLYING THE SAME AVERAGE DISCOUNT AMOUNT TO BAD DEBT IS DUE TO THE FACT THAT MULTIPLE FINANCIAL APPLICATIONS ARE SENT TO THE FINANCIAL GUARANTOR PRIOR TO DETERMINING BAD DEBT STATUS. THEREFORE, IF ALL APPLICATIONS WERE TO BE RETURNED, THE EXPERIENCE RATE IS ESTIMATED TO BE SIMILAR.III. NO BAD DEBT WAS CLASSIFIED AS COMMUNITY BENEFIT. IV. THE FINANCIAL STATEMENTS DISCLOSE BAD DEBTS AS FOLLOWS:NOTE 1(G) PATIENT RECEIVABLES AND CREDIT POLICY: PATIENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT AND THIRD-PARTY PAYOR OBLIGATIONS. THE HOSPITAL DOES NOT CHARGE INTEREST ON PAST DUE ACCOUNTS. PAYMENTS OF PATIENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED ON THE REMITTANCE ADVICE. THE CARRYING AMOUNT OF PATIENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AN RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION.
PART III, LINE 8: THE MEDICARE COST REPORT FILED FOR THE FISCAL YEAR ENDED 4/30/2011 WAS USED AS THE SOURCE FOR THE MEDICARE ALLOWABLE COSTS OF CARE REPORTED ON LINE 6.
PART VI, LINE 2: THE BOARD ESTABLISHED COMMUNITY BENEFITS COMMITTEE ENGAGES AN EXTERNAL CONSULTANT TO PERFORM A COMMUNITY NEEDS ASSESSMENT. DATA IS COLLECTED THROUGH RESEARCH OF EXISTING SOURCES AND BY GATHERING COMMUNITY INPUT THROUGH PRESENTATIONS AND FOCUS GROUPS. THE DATA IS UTILIZED IN PRIORITIZING THE NEEDS OF THE COMMUNITY AND USED IN DISTRIBUTING COMMUNITY GRANTS.
PART VI, LINE 3: PATIENTS ARE INFORMED OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM VERBALLY AT ADMISSIONS AS WELL AS THROUGH LITERATURE PROVIDED IN THE ADMITTING AREAS OF PATIENT CARE FACILITIES. IN ADDITION, ALL ACCOUNTS THAT ARE TURNED OVER TO INTERNAL COLLECTIONS RECEIVE A FINANCIAL ASSISTANCE APPLICATION THROUGH THE MAIL WHICH IS FOLLOWED UP WITH A TELEPHONE CALL.
PART VI, LINE 4: GRANDE RONDE HOSPITAL, INC. IS LOCATED IN UNION COUNTY, OREGON WHICH IS ISOLATED BY MOUNTAIN RANGES IN BOTH FREEWAY DIRECTIONS. THE MOUNTAIN PASSES ARE FREQUENTLY CLOSED DURING THE WINTER. GRANDE RONDE HOSPITAL IS LOCATED 42 MILES AWAY AND 50 MILES AWAY FROM ITS TWO CLOSEST HOSPITALS. THE CLOSEST REFERRAL HOSPITAL IS 87 MILES AWAY. THE HOSPITAL ALSO REFERS CARE TO BOISE, ID AND PORTLAND, OR WHICH ARE 3 AND 4 HOURS AWAY. THE APPROXIMATE POPULATION BASE FOR THE HOSPITAL'S PRIMARY SERVICE AREA IS 25,810 WITH A REGIONAL SERVICE AREA OF 56,640. FOR THE PRIMARY SERVICE AREA OF UNION COUNTY, THE AGE IN YEARS OF THE POPULATION IS 6.6% UNDER 5, 22.7% UNDER 18, 54.4% UNDER 65 AND 16.3% OVER 65. THE RACIAL MAKEUP OF THE COUNTY WAS 93.9% WHITE, 0.7% BLACK OR AFRICAN AMERICAN, 1.1% NATIVE AMERICAN, 1.2% ASIAN, 1.2% PACIFIC ISLANDER, AND 1.9% FROM TWO OR MORE RACES. ADDITIONALLY, THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $41,896 WITH 15.0% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL AS ESTIMATED THROUGH 2008. DURING THE FISCAL YEAR, THE COUNTY'S SEASONALLY ADJUSTED UNEMPLOYMENT RATE HAS BEEN AS HIGH AS 12.1% AND AS LOW AS 9.0% AND WAS AT 9.9% AT YEAR END.
PART VI, LINE 6: GRANDE RONDE HOSPITAL, INC. HAS AN ELEVEN MEMBER BOARD OF TRUSTEES THAT GOVERNS ITS ACTIVITIES. OF THOSE ELEVEN MEMBERS, NINE ARE FROM THE COMMUNITY AT LARGE. THE REMAINING TWO MEMBERS ARE THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE PROFESSIONAL STAFF PRESIDENT. THE NINE COMMUNITY MEMBERS USE THEIR UNIQUE EXPERIENCE AND ABILITIES TO LEAD THE HOSPITAL IN DIRECTIONS THAT SUPPORT THE NEEDS OF THE COMMUNITY. THE STATED MISSION OF THE ORGANIZATION IS AS FOLLOWS: "WE WILL ENSURE ACCESS TO HIGH-QUALITY, COST-EFFECTIVE HEALTH SERVICES IN A SAFE, CUSTOMER-FRIENDLY ENVIRONMENT FOR ALL THOSE IN NEED OF OUR SERVICES."
PART VI, LINE 7: DURING THE TAX YEAR, THE HOSPITAL AFFILIATED WITH ST. ALPHONSUS HEALTH SYSTEM WHICH IS A MEMBER OF THE TRINITY HEALTHCARE SYSTEM. THE AFFILIATION IS FOR THE BENEFIT OF IMPROVING HEALTHCARE AND PROVIDING ACCESS TO AFFORDABLE SPECIALIZED CARE TO THE RURAL COMMUNITY.
ORREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
CITY OF LA GRANDE
1000 ADAMS AVENUELA GRANDEOR97850936002197501(C)(3)12500PROVIDE SUPPLIES & TRAINING FOR CITIZEN POLICE VOLUNTEER PROGRAM
CITY OF LA GRANDE
1000 ADAMS AVENUELA GRANDEOR97850936002197501(C)(3)4800PROMOTE YOUTH ACTIVITY BY PROVIDING COORDINATOR SALARY & SUPPLIES FOR MOBILE FUN UNIT
UNION COUNTY
1106 K AVENUELA GRANDEOR97850936002313501(C)(3)7200PROMOTE EXERCISE BY PROVIDING COORDINATOR SALARY & SUPPLIES FOR WALK TO SCHOOL PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierOTHER INFORMATION:Identifier
Return ReferencePART IV:ReturnReference
ExplanationTHE COMMUNITY BENEFIT COMMITTEE IDENTIFIES AND PRIORITIZES COMMUNITY NEEDS; SOLICITS, RECEIVES, AND PRIORITIZES APPLICATIONS FOR FUNDING; AND APPROVES BENEFICIARIES AND FUNDING. FOLLOWING APPROVAL, THE COMMUNITY BENEFITS COMMITTEE AUTHORIZES FUNDING AND THE SENIOR DIRECTOR OF FINANCE DEVELOPS A SCHEDULE OF DISTRIBUTIONS. THROUGHOUT THE YEAR, THE FUNDED ORGANIZATIONS ARE ASKED TO SUBMIT A SUMMARY REPORT/EVALUATION OF THE PROJECT AND ITS OUTCOMES/RESULTS TO THE COMMUNITY BENEFITS COMMITTEE.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SUSAN RICE MD
145053012000165000165000229770202230000
BETSY NEELEY MD
127177068717016500097220227760244892000
JAMES MATTES
225227000525990196000258230323249000
WADE WEIS
1226480009990070750256620165375000
DALE ROBINSON MD
2340290588920165000122500236630345334000
GARY ZEIGLER MD
276400000149000138560240230329179000
LEWIS BAYNES MD
257903000220000171500246230321676000
RODRIGO LIM MD
1949600643170133970113980111250295197000
KENNETH CHASTEEN MD
231069000220000126180191230284810000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationCERTAIN MEDICAL PROVIDERS ARE COMPENSATED BASED ON THE GROSS PROFESSIONAL CHARGES THEY INDIVIDUALLY GENERATE.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
LAURA WEISHAAR
RELATIVE OF BOARD MEMBER29367COMPENSATION0
TRISHA ALEXANDER
RELATIVE OF BOARD MEMBER109678COMPENSATION0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2STEVE WEISHAAR AND ANNA BAUM - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES PRIOR TO FILING. INDIVIDUAL BOARD COMMITTEES ARE CHARGED WITH REVIEWING SPECIFIC SECTIONS OF THE 990 AND ITS SUPPLEMENTAL SCHEDULES AS FOLLOWS: FINANCE COMMITTEE - PART VIII-XI COMMUNITY BENEFIT COMMITTEE - SCHEDULES H & I GOVERNANCE COMMITTEE - PARTS I & VI CONTRACT & COMPENSATION COMMITTEE - SCHEDULE J & OTHER APPLICABLE SECTIONS AUDIT COMMITTEE - ENTIRE 990 AFTER REVIEW, EACH COMMITTEE ISSUES A RECOMMENDATION OF APPROVAL TO THE FULL BOARD, WHICH THEN VOTES TO APPROVE THE ENTIRE 990 PRIOR TO ITS FILING.
OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A STATEMENT IDENTIFYING ANY POSSIBLE CONFLICTS OF INTEREST EACH FISCAL YEAR. THE FORMS ARE REVIEWED BY THE CORPORATION'S COMPLIANCE OFFICER AND/OR THE BOARD OF TRUSTEES, WHO THEN DETERMINE(S) IF A CONFLICT OF INTEREST ACTUALLY EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, A DISINTERESTED PERSON OR COMMITTEE IS APPOINTED TO INVESTIGATE ALTERNATIVES TO THE BUSINESS TRANSACTION OR ARRANGEMENT. IF A REASONABLE ALTERNATIVE IS NOT ATTAINABLE, A DECISION IS MADE AS TO WHETHER THE ARRANGEMENT IS FAIR AND REASONABLE AND IN THE CORPORATION'S BEST INTEREST, AND THEREFORE WHETHER OR NOT TO ENTER INTO THE BUSINESS TRANSACTION IN CONFORMITY WITH SUCH DETERMINATIONS.FORM 990, PART VI, SECTION B, LINE 12C
THE HOSPITAL BOARD HAS A CONTRACT AND COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT TRUSTEES, THAT OVERSEES THE PROCESS OF ESTABLISHING REASONABLE COMPENSATION FOR THE PRESIDENT/CEO, EXECUTIVES, AND KEY EMPLOYEES. THE COMMITTEE ANNUALLY EVALUATES THE COMPENSATION OF THESE INDIVIDUALS AS COMPARED TO FAIR MARKET VALUE. AN INDEPENDENT THIRD PARTY CONSULTANT IS HIRED AS NEEDED TO CONDUCT A FULL SALARY AND BENEFITS SURVEY OF COMPARABLE ORGANIZATIONS AND TO RECOMMEND COMPENSATION RANGES FOR THESE INDIVIDUALS. THE COMMITTEE ANALYZES THE RESULTS OF THE THIRD PARTY SURVEY AND/OR MARKET REPORT AND DECIDES ON A RECOMMENDED COMPENSATION PACKAGE FOR THE PRESIDENT/CEO. THIS RECOMMENDATION IS THEN PRESENTED TO THE BOARD OF TRUSTEES FOR APPROVAL. ALL FINAL DECISIONS ARE MADE IN EXECUTIVE SESSION AND ARE DOCUMENTED IN DETAILED MINUTES. ADDITIONALLY, AFTER REVIEWING THE RESULTS OF THE SURVEY, THE COMMITTEE DECIDES ON AND PRESENTS A SALARY RANGE FOR EACH EXECUTIVE AND KEY EMPLOYEE TO THE PRESIDENT/CEO, WHO THEN DETERMINES EACH INDIVIDUAL'S COMPENSATION WITHIN THE COMMITTEE'S RECOMMENDED RANGE.FORM 990, PART VI, SECTION B, LINE 15
THE HOSPITAL'S FORM 1023 AND THREE MOST RECENT FORM 990'S ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, WHICH CAN BE MADE EITHER IN PERSON, BY U.S. MAIL, FAX, EMAIL, OR BY PRIVATE DELIVERY SERVICE. ADDITIONALLY, THE HOSPITAL'S FORMS 990 ARE AVAILABLE ON GUIDESTAR.COM. THE HOSPITAL DOES NOT MAKE AVAILABLE TO THE PUBLIC ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, OR FINANCIAL STATEMENTS, ALTHOUGH LIMITED FINANCIAL INFORMATION IS PROVIDED TO THE PUBLIC ON THE HOSPITAL'S WEB SITE, GUIDESTAR.COM, AND THE OREGON DEPARTMENT OF JUSTICE CHARITABLE ACTIVITIES WEBSITE.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 2,149,857.FORM 990, PART XI, LINE 5:
THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR.FORM 990, PART XII, LINE 2C:
NEGATIVE EXPENSES REPORTED IN COLUMN DIN FISCAL YEAR 2010, GRANDE RONDE HOSPITAL PAID CERTAIN EXPENSES FOR GRANDE RONDE HOSPITAL FOUNDATION, A RELATED ORGANIZATION, WITH THE UNDERSTANDING THAT THE EXPENSES WOULD NOT BE REPAID. IN FISCAL YEAR 2011, GRANDE RONDE HOSPITAL FOUNDATION DECIDED TO REIMBURSE GRANDE RONDE HOSPITAL FOR THE EXPENSES PAID ON THEIR BEHALF. AS A RESULT, GRANDE RONDE HOSPITAL REDUCED THE RELATED EXPENSES IN FISCAL YEAR 2011 TO REFLECT THE REIMBURSEMENT.FORM 990, PART IX, COLUMN D

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrg
GRANDE RONDE HOSPITAL FOUNDATION INC
900 SUNSET DRIVELA GRANDEOR97850931174357SUPPORT THE HOSPITALOR501(C)(3)11A, TYPE I1
GRANDE RONDE HOSPITAL AUXILIARY
900 SUNSET DRIVELA GRANDEOR97850237090684SUPPORT THE HOSPITALOR501(C)(3)11B, TYPE II1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1GRANDE RONDE HOSPITAL FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved73670AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination