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SKY LAKES MEDICAL CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SKY LAKES MEDICAL CENTER INC (EIN 93-0508781)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201122289349301227
Schema version
2009v1.7
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)
Timestamp2011-08-12T15:48:36-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Moss Adams LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1805 SW Broadway 1200AddressLine1
CityPortlandCity
StateORState
ZIP Code97205ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930508781EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sky Lakes Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSKYLNameControl
Phone5412746311Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12865 Daggett AvenueAddressLine1
CityKlamath FallsCity
StateORState
ZIP Code97601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRichard RicoName
TitleVP/CFOTitle
Phone5412746311Phone
Date Signed2011-08-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWendy CamposName
Phone5032421447Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD RICONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12865 Daggett AvenueAddressLine1
CityKlamath FallsCity
StateORState
ZIP Code97601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts323530004GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.skylakes.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1979YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionSky 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 Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees1209TotalNbrEmployees
Total Nbr Volunteers322TotalNbrVolunteers
Total Gross UBI6018TotalGrossUBI
Net Unrelated Business Txbl Income4187NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year739439ContributionsGrantsPriorYear
Contributions Grants Current Year640948ContributionsGrantsCurrentYear
Program Service Revenue Prior Year294833936ProgramServiceRevenuePriorYear
Program Service Revenue CY321053289ProgramServiceRevenueCY
Investment Income Prior Year3898207InvestmentIncomePriorYear
Investment Income Current Year609910InvestmentIncomeCurrentYear
Other Revenue Prior Year-501304OtherRevenuePriorYear
Other Revenue Current Year461533OtherRevenueCurrentYear
Total Revenue Prior Year298970278TotalRevenuePriorYear
Total Revenue Current Year322765680TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year818659GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY327147GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year63678823SalariesEtcPriorYear
Salaries Etc Current Year65459152SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year227701018OtherExpensePriorYear
Other Expenses Current Year239866341OtherExpensesCurrentYear
Total Expenses Prior Year292198500TotalExpensesPriorYear
Total Expenses Current Year305652640TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6771778RevenuesLessExpensesPriorYear
Revenues Less Expenses CY17113040RevenuesLessExpensesCY
Total Assets BOY143654620TotalAssetsBOY
Total Assets EOY158047175TotalAssetsEOY
Total Liabilities BOY67656092TotalLiabilitiesBOY
Total Liabilities EOY64829606TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY75998528NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY93217569NetAssetsOrFundBalancesEOY
Mission DescriptionSky 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 Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense252214794Expense
Grants48428Grants
Revenue317571920Revenue
DescriptionPatient 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

FieldValueIRS element (for citing)
Expense14817997Expense
DescriptionUncompensated Care - During Fiscal Year 2010, 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 $14,817,997. As a percentage of charges, these represent 5.6%. For fiscal years 2009 and 2008, the percentage was 5.9% and 4.4%, respectively.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8538269Expense
Grants192594Grants
Revenue1412423Revenue
DescriptionEducational 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: Financial contributions to the Oregon Institute of Technology's (OIT) Allied Health Program and to the OIT Nursing Scholarship Fund; 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

FieldValueIRS element (for citing)
Expense6237313Expense
Grants86125Grants
Revenue1813630Revenue
DescriptionExpenses 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
FieldValueIRS element (for citing)
Total Of Other Program Service Exp6237313TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt86125TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev1813630TotalOfOtherProgramServiceRev
Total Program Service Expense281808373TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096203NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1209NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Body0Form990ProvidedToGoverningBody
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRICHARD RICO CFONamePerson
Telephone Number5412746150TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12865 DAGGETT AVENUEAddressLine1
CityKLAMATH FALLSCity
StateORState
ZIP Code97601ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
John Bell
Chairman3.00XX000
Rod Wendt
Vice Chairman1.00XX000
Kermit Houser
Board Member1.00X000
Clark Pederson
Board Member1.00X000
Bernard Simonson
Board Member1.00X000
Wendy Warren MD
board Member1.00X000
Linda Weider
board Member1.00X000
Gregory Sindmack MD
board Member1.00X000
Paul Stewart
PRESIDENT/CEO/SECRETARY/TREASURER40.00XX423169025933
RICHARD RICO
VP/CFO40.00X194941022262
GRANT W NISKANEN MD
HOSPITALIST40.00201567012250X
FREDERICK L ZWARTVERWER MD
VP MEDICAL AFFAIRS35.00179313020255X
DON L YORK
VP HUMAN RESOURCES40.00156652020196X
WILLIAM MILIMUKA
PHYSICIST40.00145118018230X
Mychal B Amos
Pharmacy Director40.00139489024461X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1440249TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation143587TotalOtherCompensation
Number Individuals GT100 K37NumberIndividualsGT100K
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
HEALTH FUTURE
777 MURPHY ROADMEDFORDOR97504THIRD PARTY ADMIN SERVICES1780518
ASD HEALTHCARE
PO BOX 848104DALLASTX75284CONTRACT LABOR787469
SOUTHERN OREGON LINEN SERVICES INC
635 AVENUE CWHITE CITYOR97503LAUNDRY533741
REVENUE CYCLE PARTNERS LLC
1643 LEWIS AVENUE 203BILLINGSMT59102SELF PAY COLLECTION SERVICE489711
THE MANDALA AGENCY
2855 NW CROSSING DRIVE SUITE 201BENDOR97701MARKETING SERVICES407262
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
Related Organizations640948RelatedOrganizations
Noncash Contributions15218NoncashContributions
Total Contributions640948TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient Revenue621990317571920317571920
Other Program Revenue62199034813693481369
FieldValueIRS element (for citing)
Total Program Service Revenue321053289TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column612135TotalRevenueColumn
Exclusion$612,135ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real922529Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real701589Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real220940Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column220940TotalRevenueColumn
Exclusion$220,940ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2225Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-2225Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2225TotalRevenueColumn
Exclusion-$2,225ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory131838GrossSalesOfInventory
Cost Of Goods Sold60510CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column71328TotalRevenueColumn
Exclusion$71,328ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
OTHER INCOME900099418563$418,563
INCOME FROM SUBSIDIARI621990-249298-2553166018
FieldValueIRS element (for citing)
Total Other Revenue169265TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column322765680TotalRevenueColumn
Related Or Exempt Function Income320797973RelatedOrExemptFunctionIncome
Unrelated Business Revenue6018UnrelatedBusinessRevenue
Exclusion$1,320,741ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total86125Total
Program Services86125ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total241022Total
Program Services241022ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total782046Total
Management And General782046ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total50090050Total
Program Services45410671ProgramServices
Management And General4679379ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2212969Total
Program Services2023703ProgramServices
Management And General189266ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7692919Total
Program Services7107261ProgramServices
Management And General585658ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4681168Total
Program Services3470151ProgramServices
Management And General1211017ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total469487Total
Program Services16896ProgramServices
Management And General452591ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total136437Total
Management And General136437ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5882578Total
Program Services5489457ProgramServices
Management And General393121ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total767701Total
Program Services20474ProgramServices
Management And General747227ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1973684Total
Program Services1305475ProgramServices
Management And General668209ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1482900Total
Program Services41759ProgramServices
Management And General1441141ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1734950Total
Program Services1491642ProgramServices
Management And General243308ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total118309Total
Program Services101338ProgramServices
Management And General16971ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total392858Total
Program Services287700ProgramServices
Management And General105158ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3298355Total
Program Services2055ProgramServices
Management And General3296300ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7650188Total
Program Services2984758ProgramServices
Management And General4665430ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3073289Total
Program Services542297ProgramServices
Management And General2530992ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Contractual Allowance149212998149212998
Supplies2438213124406441-24310
Bad debt expense1481799714817997
Charity Care1274346312743463
TAXES PAID ON UBI15501550

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total11727466Total
Program Services10004690ProgramServices
Management And General1722776ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total305652640Total
Program Services281808373ProgramServices
Management And General23844267ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY186442BOY
EOY467564EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9475730BOY
EOY25715056EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20161503BOY
EOY21702325EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2417207BOY
EOY2699898EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3492605BOY
EOY2191378EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis160201833LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec72875680LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY91734160BOY
EOY87326153EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY1134829EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2031344BOY
EOY2368682EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14155629BOY
EOY14441290EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY143654620BOY
EOY158047175EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5587317BOY
EOY4705771EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2582065BOY
EOY2622197EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY52832329BOY
EOY52122247EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1321903BOY
EOY1247993EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5332478BOY
EOY4131398EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY67656092BOY
EOY64829606EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY75998528BOY
EOY93217569EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY75998528BOY
EOY93217569EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY143654620BOY
EOY158047175EOY
FieldValueIRS element (for citing)
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 Basis1325402OtherCostOrOtherBasis
Book Value1325402BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis106470427OtherCostOrOtherBasis
Depreciation41277110Depreciation
Book Value65193317BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4198224OtherCostOrOtherBasis
Depreciation1870682Depreciation
Book Value2327542BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis34688392OtherCostOrOtherBasis
Depreciation23943775Depreciation
Book Value10744617BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13519388OtherCostOrOtherBasis
Depreciation5784113Depreciation
Book Value7735275BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings87326153TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Assets LIMITED AS TO USE4955968
Other Assets1927630
Estimated third-party payor settlements651972
Deferred Financing Costs1641347
Construction in Process590419
Other Receivables4673954
FieldValueIRS element (for citing)
Total Book Value Other Assets14441290TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCapital Lease obligationsDescription
Amount$4,131,398Amount
FieldValueIRS element (for citing)
Total Of Amounts4131398TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationThe Medical Center had no unrecognized tax benefits at September 30, 2010 or at September 30, 2009. The Medical Center recognizes interest accrued and penalties related to unrecognized tax benefits as an administrative expense. During the years ended September 30, 2010 and 2009, the Medical Center recognized no interest and penalties.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
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 Expense5028691TotalCommunityBenefitExpense
Net Community Benefit Expense5028691NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense22210991TotalCommunityBenefitExpense
Direct Offsetting Revenue22244162DirectOffsettingRevenue
Net Community Benefit Expense-33171NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense27239682TotalCommunityBenefitExpense
Direct Offsetting Revenue22244162DirectOffsettingRevenue
Net Community Benefit Expense4995520NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs34NumberOfActivitiesOrPrograms
Persons Served321864PersonsServed
Total Community Benefit Expense371738TotalCommunityBenefitExpense
Net Community Benefit Expense371738NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served5902PersonsServed
Total Community Benefit Expense4928097TotalCommunityBenefitExpense
Direct Offsetting Revenue1524947DirectOffsettingRevenue
Net Community Benefit Expense3403150NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served202358PersonsServed
Total Community Benefit Expense6431881TotalCommunityBenefitExpense
Direct Offsetting Revenue1663726DirectOffsettingRevenue
Net Community Benefit Expense4768155NetCommunityBenefitExpense
Percent Of Total Expense0.01640PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served382PersonsServed
Total Community Benefit Expense4961TotalCommunityBenefitExpense
Net Community Benefit Expense4961NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs43NumberOfActivitiesOrPrograms
Persons Served530506PersonsServed
Total Community Benefit Expense11736677TotalCommunityBenefitExpense
Direct Offsetting Revenue3188673DirectOffsettingRevenue
Net Community Benefit Expense8548004NetCommunityBenefitExpense
Percent Of Total Expense0.02940PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs43NumberOfActivitiesOrPrograms
Persons Served530506PersonsServed
Total Community Benefit Expense38976359TotalCommunityBenefitExpense
Direct Offsetting Revenue25432835DirectOffsettingRevenue
Net Community Benefit Expense13543524NetCommunityBenefitExpense
Percent Of Total Expense0.04670PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served101432PersonsServed
Total Community Building Expense10528TotalCommunityBuildingExpense
Net Community Building Expense10528NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served100143PersonsServed
Total Community Building Expense9569TotalCommunityBuildingExpense
Net Community Building Expense9569NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served2350PersonsServed
Total Community Building Expense209886TotalCommunityBuildingExpense
Net Community Building Expense209886NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs16NumberOfActivitiesOrPrograms
Persons Served203925PersonsServed
Total Community Building Expense229983TotalCommunityBuildingExpense
Net Community Building Expense229983NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$5,698,508BadDebtExpenseAmount
Amount Attributable To1082717AmountAttributableTo
Amount Reimbursed By Medicare41316360AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare42087961CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-771601MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1SKY LAKES MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12865 DAGGETT AVENUEAddressLine1
CityKLAMATH FALLSCity
StateORState
ZIP Code97601ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Bad Debt FootnotePart 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 $41,023,358 AND $38,018,414 AT SEPTEMBER 30, 2010 AND 2009, RESPECTIVELY.BAD DEBTS ARE ACCRUED MONTHLY AT A FIXED PERCENTAGE OF GROSS CHARGES. BOOKED BAD DEBT EXPENSE IS ROUTINELY COMPARED TO ACTUAL BAD DEBT WRITE OFFS, WHICH INCLUDE PAYMENTS TO PREVIOUSLY RECORDED BAD DEBTS, AND THE ACCRUAL PERCENTAGE IS ADJUSTED ACCORDINGLY. THIS PROCESS HAS THE INTENDED EFFECT OF REALIZING BAD DEBT EACH MONTH AS A LESS VOLATILE EXPENSE.BAD DEBT EXPENSE INCLUDES PAYMENTS - PATIENT AND INSURANCE - TO PREVIOUSLY RECORDED BAD DEBTS.BAD DEBT EXPENSE AT COST IS ESTIMATED BY APPLYING THE COST-TO-CHARGE RATIO TO TOTAL BAD DEBT EXPENSE. SKY LAKES MEDICAL CENTER OFFERS A CHARITY CARE APPLICATION TO ALL PATIENTS, EITHER IN PERSON, VIA US MAIL OR ON THE HOSPITAL'S WEBSITE. A SAMPLE OF PROCESSED CHARITY CARE APPLICATIONS WAS TAKEN, AND IT WAS FOUND THAT 19% OF CHARITY CARE APPLICATIONS WERE TURNED TO BAD DEBT DUE TO LACK OF INFORMATION SUPPLIED BY THE HOUSEHOLD. THE COST OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY IS THEREFORE ESTIMATED AT 19% OF THE TOTAL ESTIMATED COST OF BAD DEBT.BadDebtFootnote
Shortfall As Community BenefitPart 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.ShortfallAsCommunityBenefit
Debt Collection PolicyPart 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.DebtCollectionPolicy
Needs AssessmentPart 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.NeedsAssessment
Patient Education AssistancePart VI, Line 3: SKY LAKES MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR ASSISTANCE ARE LOCATED ON THE HOSPITAL'S WEBSITE AND ARE REFERENCED IN THE ONLINE BILL-MANAGEMENT SECTION OF THE SITE. THEY ALSO ARE AVAILABLE WHEN SERVICES ARE PERFORMED. IN ADDITION, UNINSURED PATIENTS ARE PROVIDED PATIENT ADVOCACY BASED ON ELIGIBILITY AND ENROLLMENT SERVICES FOR MEDICAID AND OTHER BENEFIT PROGRAMS. THE MEDICAL CENTER ENSURES INFORMATION ABOUT FINANCIAL ASSISTANCE AND APPLICATIONS FOR ASSISTANCE ARE AT ALL PATIENT REGISTRATION AREAS AND SPECIALLY TRAINED FINANCIAL COUNSELORS HELP APPLICANTS COMPLETE THE FORMS. 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 MAILED. IT IS ALSO COVERED DURING COURTESY PHONE CALLS IF THERE IS MENTION OF DIFFICULTY IN PAYING 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 GOVERNMENT PROGRAMS. 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.PatientEducationAssistance
Community InformationPart 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 16.4 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, COMPARED 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 32ND OUT OF 33 RANKED OREGON COUNTIES ON SUCH FACTORS AS: POOR OR FAIR HEALTH (19 PERCENT VS. THE NATIONAL BENCHMARK OF 10 PERCENT), ADULT SMOKING (24 PERCENT VS. 15 PERCENT NATIONALLY), UNINSURED ADULTS (23 PERCENT VS. 13 PERCENT), PRIMARY CARE PROVIDERS (489:1 VS. 631:1), UNEMPLOYMENT (13.8 PERCENT VS. 5.3 PERCENT), CHILDREN IN POVERTY (24 PERCENT VS. 11 PERCENT), HIGH SCHOOL GRADUATION (60 PERCENT VS. 92 PERCENT), TEEN BIRTH RATE (19 PERCENT VS. 22 PERCENT), SEXUALLY TRANSMITTED DISEASE (172 VS. 83), MOTOR VEHICLE CRASH DEATH RATE (24 VS. 12), VIOLENT CRIME RATE (272 VS. 100), AND SINGLE-PARENT HOUSEHOLDS (32 PERCENT VS. 20 PERCENT). DURING 2009, APPROXIMATELY 17 PERCENT OF THE 23,000 VISITS TO SKY LAKES MEDICAL CENTER'S EMERGENCY DEPARTMENT RESULTED IN AN INPATIENT STAY - THAT'S ABOUT 3 PERCENT HIGHER THAN THE STATE AVERAGE. ABOUT TWO-THIRDS OF THE INPATIENTS AT SKY LAKES CAME IN VIA THE ER, VERSUS THE STATE AVERAGE OF ABOUT 53 PERCENT.CommunityInformation
Community Building ActivitiesPart VI, Line 5: COMMUNITY SUPPORT: ACTIVITIES INCLUDE KLAMATH-LAKE CHILD ABUSE RESPONSE AND EVALUATION SERVICES (CARES). CARES IS DEDICATED TO PROVIDING SAFE, COMPREHENSIVE, OBJECTIVE MEDICAL ASSESSMENT, 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. THE LARGEST COMMUNITY SUPPORT ACTIVITY SUPPORTED BY SKY LAKES IS TRAUMA CALL COVERAGE. CALL PAY IS MADE TO SPECIALISTS THAT ARE NEEDED IN THE EVENT OF TRAUMA. THE SPECIALISTS ON THE TRAUMA CALL PANEL INCLUDE ORTHOPEDIC AND GENERAL SURGEONS AS WELL AS A NEUROSURGEON. WITHOUT THIS TRAUMA CALL PANEL, SEVERELY INJURED PATIENTS WOULD NEED TO BE STABILIZED IN THE SKY LAKES EMERGENCY DEPARTMENT AND THEN HAVE TO UNDERGO LIFE THREATENING TRANSPORT TO ANOTHER HOSPITAL WITH AVAILABLE SPECIALISTS. THE NEAREST HOSPITAL IS LOCATED 70 MILES ACROSS THE CASCADE MOUNTAIN RANGE. 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 SUPPORTS EMPLOYEES INTERESTED IN PARTICIPATING IN LEADERSHIP KLAMATH. THIS PROGRAM WAAS DEVELOPED BY THE KLAMATH COUNTY CHAMBER OF COMMERCE IN RESPONSE TO THE ONGOING NEED FOR LEADERSHIP IN ALL AREAS OF PUBLIC SERVICE. FOR PARTICIPANTS, THE PROGRAM CREATES A COMPREHENSIVE AND OBJECTIVE AWARENESS OF THE KLAMATH COMMUNITY IN ACTION. THE PROGRAM FOSTERS COMMITMENT TO OUR REGION AND DEVELOPS LEADERS TO MEET THE DEMANDS OF THE FUTURE. LEADERSHIP KLAMATH EXPOSES PARTICIPANTS TO THE REALITIES, OPPORTUNITIES AND CHALLENGES FACING OUR AREA. THE PROGRAM CHALLENGES CLASS PARTICIPANTS TO BECOME MORE INVOLVED IN THE DECISION-MAKING PROCESS OF KLAMATH COUNTY IN POLITICAL, SOCIAL AND BUSINESS ARENAS. SKY LAKES MEDICAL CENTER ALSO PROVIDES LABOR AND FINANCIAL SUPPORT TO THE LOCAL HIGH SCHOOL AND THE OREGON INSTITUTE OF TECHNOLOGY'S OREGON CENTER FOR HEALTH PROFESSIONS.COALITION BUILDING: AS THE LARGEST EMPLOYER IN KLAMATH COUNTY, EMPLOYEES ARE ENCOURAGED AND SUPPORTED TO PARTICIPATE IN COALITION BUILDING ACTIVITIES. AMONG THE ACTIVITIES SUPPORTED ARE HOSPICE CARE; THE TEACHING OF EMT, CPR AND FIRST AID TRAINING COURSES; SPEAKING ENGAGEMENTS AT LOCAL PARISHES AND CONGREGATIONS; AND INVOLVEMENT IN LOCAL AND STATE CHAPTERS OF SOROPTOMIST AND ROTARY. SOROPTOMIST'S MISSION IS TO IMPROVE THE LIVES OF WOMEN AND GIRLS IN LOCAL COMMUNITIES. THE CLUBS IN THE NORTHWESTERN REGION OF SOROPTOMIST HAVE AN IDENTIFYING PROJECT ENTITLED "PROJECT WOMEN'S HEALTH." THE PROJECT INCLUDES ACTIVITIES THAT ENHANCE AWARENESS, ADVOCACY, AND ACTION FOR WOMEN'S HEALTH ISSUES SUCH AS CARDIOVASCULAR DISEASE, CANCERS, MENOPAUSE AND HORMONE REPLACEMENT THERAPY, OSTEOPOROSIS, DIABETES, EATING DISORDERS, PRENATAL CARE, AND MENTAL AND EMOTIONAL HEALTH.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: SKY LAKES MEDICAL CENTER SUPPORTS A COMMUNITY-BASED, UNIVERSITY-ADMINISTERED THREE-YEAR TRAINING PROGRAM FOR FAMILY PRACTITIONERS. WHILE SKY LAKES SUSTAINS SIGNIFICANT LOSSES IN THE SUPPORT OF THIS PROGRAM, IT DOES PROVIDE OUR COMMUNITY WITH ACCESS TO PHYSICIANS AND COORDINATED MEDICAL CARE THAT WOULD OTHERWISE NOT BE AVAILABLE IN THE KLAMATH "BASIN." THE RESIDENCY MEDICAL PRACTICE INCORPORATES HOME VISITS AND A MOBILE HEALTH CLINIC. THESE EXTENSIONS OF THE CLINIC SETTING PROVIDE OUTREACH MEDICAL CARE TO COMMUNITY MEMBERS THAT ARE NOT OTHERWISE ABLE TO ACCESS MEDICAL CARE IN THE TRADITIONAL CLINIC SETTING. SPORTS PHYSICALS FOR HIGH SCHOOL ATHLETES ARE PROVIDED FREE OF CHARGE AT THE RESIDENCY CLINIC. IN ADDITION TO LOSSES RELATED TO THE RESIDENCY PROGRAM, OTHER UNPROFITABLE HOSPITAL-AFFILIATED MEDICAL PRACTICES ARE SUPPORTED BY THE MEDICAL CENTER. PHYSICIAN ACCESS AND CONTINUITY OF CARE ARE DEEMED ESSENTIAL TO THE COMMUNITY. SKY LAKES ALSO SUPPORTS COMMUNITY HEALTH IMPROVEMENT ADVOCACY VIA THE SOUTHERN OREGON METH PROJECT (SOMP). 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 FACT THAT 8 OUT OF 10 ARRESTS BEING MADE ARE 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 ADDITION TO COMMUNITY MEMBERS, EDUCATIONAL OFFERINGS INCLUDE THOSE MADE TO NURSING STUDENTS; ELEMENTARY, MIDDLE AND HIGH SCHOOLS; AND LOCAL COLLEGES. MEETING ROOMS AND EQUIPMENT ARE MADE AVAILABLE TO THE PUBLIC FOR RELATED ACTIVITIES. EMPLOYEE SUPPORT - TIME AND MONETARY DONATIONS - OF LOCAL FOOD BANKS IS ALSO ENCOURAGED.WORKFORCE DEVELOPMENT: SINCE SKY LAKES IS AN ISOLATED RURAL HOSPITAL LOCATED IN A PHYSICIAN SHORTAGE AREA, SPECIALTY PHYSICIANS ARE ROUTINELY BEING SOUGHT BY LOCAL MEDICAL PRACTICES AND BY THE HOSPITAL. MOST OF THESE SPECIALISTS DO LITTLE TO GENERATE REVENUE FOR THE MEDICAL CENTER BUT ARE NEEDED BY THE COMMUNITY. LOCAL PRACTICES ARE OFTEN NOT FINANCIALLY ABLE TO UNDERGO THE EXPENSIVE AND TIME CONSUMING RECRUITMENT PROCESS SO THEY WILL REQUEST FINANCIAL AND/OR EMPLOYMENT ASSISTANCE FROM THE MEDICAL CENTER. OTHER WORKFORCE DEVELOPMENT ACTIVITIES INCLUDE EDUCATION FOR NURSING STUDENTS, INCLUDING AN ORIENTATION PROGRAM FOR NEW GRADUATES THAT MAY OR MAY NOT BE ELIGIBLE FOR EMPLOYMENT AT SKY LAKES UPON COMPLETION OF THE PROGRAM; EDUCATIONAL LUNCHES FOR COMMUNITY HEALTH PROFESSIONALS; AND VARIOUS MENTORING PROGRAMS.CommunityBuildingActivities
Other InformationPart VI, Line 6: Besides providing 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 upwards of 700 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 very low cost, and scholarships are frequently available. 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 series is the annual 15-kilometer run, a 5K run, and a 5K walk for adults, and two shorter events: one-half and one-mile events for children. In 2011, a record-setting 480 entrants crowded 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 underwrites the losses incurred in running Cascades East Family Medicine, a clinic and a family practice residency program, and the 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 Sprage River. The fuel, maintenance, and supplies are all 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 collateral support in the way of additional 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. 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.OtherInformation
Reports Filed With StatesORReportsFiledWithStates

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
MERLE WEST CENTER FOR MEDICAL RESEARCH
104 N 11TH STREETKlamath FALLSOR97601931256310501(C)(3)15625GENERAL OPERATIONS
OREGON TECH FOUNDATION
3201 CAMPUS DRIVEKlamath FALLSOR97601237056213501(C)(3)50000OREGON CENTER FOR HEALTH PROFESSIONS
KLAMATH COUNTY SCHOOL DISTRICT
10501 WASHBURN WAYKLAmath FALLSOR9760393600054320000HEALTH OCCUPATIONS PROGRAM ASSISTANCE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
EMPLOYEE STUDENT LOAN FORGIVENESS22107638
EXTERNSHIP STIPENDS613200
EMPLOYEE TUITION REIMBURSEMENT - FORGIVEN410007
STUDENT LOAN ASSISTANCE TO EMPLOYEES1961749
PATIENT ASSISTANCE19448428

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule 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

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
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 Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 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
Paul Stewart
3031690001200000122500136830449102000
RICHARD RICO
1949410000066090156530217203000
GRANT W NISKANEN MD
2015670000012250000213817000
FREDERICK L ZWARTVERWER MD
1793130000077030125520199568000
DON L YORK
1566520000089160112800176848000
WILLIAM MILIMUKA
1451180000072560109740163348000
Mychal B Amos
1394890000073850170760163950000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN931061020IssuerEIN
CUSIP Number498413dq3CUSIPNumber
Date Issued2006-08-31DateIssued
Issue Price39329258IssuePrice
Description Of PurposeREVENUE AND REFUNDING; MERLE WEST MEDICAL CENTER PROJECTDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds39329258TotalProceeds
Amount In Reserve Fund1758464AmountInReserveFund
Amount Defeased20841397AmountDefeased
Amount Unspent1170952AmountUnspent
Issuance Costs From Proceeds558445IssuanceCostsFromProceeds
Capital Expenditures15000000CapitalExpenditures
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged0BondCounselRoutinelyEngaged
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed1Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SOUTH VALLEY BANK & TRUST (SVBT)BusinessNameLine1
FieldValueIRS element (for citing)
RelationshipPAUL STEWART IS THE CEO OF SLMC AND IS A VOTING BOARD MEMBER AT SVBTRelationship
Amount Of Transaction63607AmountOfTransaction
Description Of TransactionSLMC PAYS FEES AND INTEREST TO SVBTDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11Form 990 is reviewed by the Controller and other staff before filing.
Form 990, Part VI, Section B, line 12cAnnually 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 15The 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 19Governing documents, conflict of interest policy and financial statements are all made avialable to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SOUTHERN OREGON EMERGENCY CARE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12865 DAGGET AVENUEAddressLine1
CityKLAMATH FALLSCity
StateORState
ZIP Code97601ZIPCode
FieldValueIRS element (for citing)
EIN611595709EIN
Primary ActivitiesPHYSICIAN SERVICESPrimaryActivities
Legal Domicile StateORLegalDomicileState
EOY Assets631210EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
SKY LAKES MEDICAL CENTER FOUNDATION
2865 DAGGETT AVENUEKLAMATH FALLSOR97601930946020FUNDRAISING AND STEWARDSHIP; SUPPORT MED CENTEROR501(C)(3)11cN/A
Klamath Care Services Inc
2865 DAGGETT AVENUEkLAMATH FALLSOR97601930946018SUPPORT MED CENTER (INACTIVE)OR509(c)(3)11cN/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1KLAMATH MEDICAL BUSINESS CENTER LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12865 DAGGETT AVENUEAddressLine1
CityKLAMATH FALLSCity
StateORState
ZIP Code97601ZIPCode
FieldValueIRS element (for citing)
EIN020731372EIN
Primary ActivityREAL AND PERSONAL PROPERTY RENTALPrimaryActivity
Legal Domicile StateORLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeINVESTMENTPredominantIncomeType
Share Of Total Income88019ShareOfTotalIncome
Share Of EOY Assets558994ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
Code V$6,018CodeVAmount
General Or Managing Partner1GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
WEST PHYSICIAN SERVICES LLC
2868 daggett avenueklamath fallsOR97601870696029PHYSICIAN SERVICESORN/AC-65731128901881.00000
PREFERRED HEALTH PLAN INC
2868 daggett avenueklamath fallsOR97601931304315HEALTH INSURANCEORN/AC16090498539000.87000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
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 Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
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 (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
KLAMATH MEDICAL BUSINESS CENTER LLC
J104087
WEST PHYSICIAN SERVICES LLC
D356627
WEST PHYSICIAN SERVICES LLC
P225434