2011-11-15T21:39:16-08:00 2010-12-31 990 2010-01-01 930429015 Portland Adventist Medical Center PORT 5032516150 10123 SE Market Street Portland OR 97216 Mark Perry 2011-11-15 2010 2016-03-07 17:11:31Z RUSSELL THOMAS 10123 SE Market St Portland OR 97216 248411899 false false 1071 X www.adventisthealthnw.com X 1900 OR Our mission is to demonstrate the human expression of the healing ministry of Jesus Christ 13 8 2336 317 6282908 652304 523213 227964496 243719654 5509454 3714261 68692 84950 234194946 248042078 145739 0 134415580 139176205 0 342643 92405453 108338566 226821033 247660510 7373913 381568 280050516 264432198 99622562 84225726 180427954 180206472 X Our mission is to demonstrate the human expression of the healing ministry of Jesus Christ false false 105079618 71079 102744529 Portland Adventist Medical Center (PAMC) provides quality medical health care regardless of race,creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Portland Adventist Medical Center (PAMC), the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at or below costproviding health/wellness activities and community education programsNot only does Portland Adventist Medical Center (PAMC) provide low cost care to individuals covered by government programs and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. PAMC recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2010 was $22,326,300.The following services were provided to our inpatients in 2010. These services included:1,129 Babies delivered2,713 Surgeries performed20,272 Radiology procedures performed2,083 Cardiac Catheterizations and other procedures221,463 Laboratory tests14,750 Patient days (psychiatric services) 63885737 43214 77890990 Outpatient services in 2010 that were provided to patients. These services included45,846 Emergency department visits4,009 Outpatient Surgeries performed88,755 Radiology procedures performed1,947 Cardiac Catheterizations and other procedures291,462 Laboratory tests183,985 Medical clinic visits55,644 Rehab visits 32369937 21898 36957959 PAMC recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. Community Health Improvement Services Community Health Education: Healthful Living Cooking Demonstration Cancer Care Support Group Medical personnel lactation education Safety consults Provided answers to medication questions from the general public Intervention Training Komen Care for The Cure Health Fair focusing on heart health Community Based Clinical Services: Stroke Education and screening Mammography Voucher Program for uninsured women Health Care Support Services: Emergent transportation needs of discharging patients Cancer patient transportation Enrollment assistance in government funded health programs Coupons for homeless shelters Cancer Survivor event Cancer Support Group Grief Classes Health Professionals Education Nurses/Nursing students: Student nurses- 46,036 hours 429 students Nursing school subsidy Other Health Professionals Education: Rosevilla Care Center- Facility Pain education Lacation Consultant Educator Health Resource Kiosk Medical Library open to public Hosted Caremark lecture Series Dietetic Intern Various Grief/Care classes for Home health/Hospice professionals PT, OT, Speech therapy student training Subsidized Health Services: Hospital Outpatient Services: Cardiopulmonary Rehab Wellness Services-2,385 seen at events Subsidized Continuing Care Home Health Hospice Behavioral Health Services Psych and Psych Services PhysiciansFinancial and In-Kind Donations Cash Donations: Medical Teams International In-Kind Donations: Portland Adventist Community Services Medical Supplies to mission fields Compassionate Friends Car seats donated to financially qualified Northwest Mother's Milk bank Administrative support to not-for-profit groups Birch Community Center Special need groups Board and committee memberships Community Benefits Operation Assigned Staff: 1,001 total hoursActivities that we feel should be considered a benefit to the communityCommunity Building Activities Physical Improvements/Housing: Mt. Hood Habitat for HumanityEconomic Development: Various Local Chamber of Commerce time East Metro Economic Alliance Gateway Business Developemnt Citizens Advisory Committee Gateway Eco-District Committee Coalition Building: Columbia Willamette Chapter of the American Society of Safety Engineers NAMI walk Workforce Development Local High School students mentoring 14105442 9541 16346465 215440734 true true false true false false false false false true true false false false true false false true false false false false false false true false true true false true true false false false false false false false false false false false false false false false false true true true false false true 208 0 true 2336 true true true false false false false false false true true false 0 false false false false false false false false false false false X 13 8 false false false false true false true true true false false false true true true true true true true true true false OR X Mark Perry 5032516150 10123 SE Market St Portland OR 97216 KUNAU CAROL 0.00 X 0 200818 24588 JONES DERYL 0.00 X 0 391841 31307 TRYON ELLEN 50.00 X 347116 0 0 RUSSELL DAVID 50.00 X 0 173929 47148 KINZER STEVEN 50.00 X 0 265429 61365 HEISER PAMELA 50.00 X 0 192838 720927 FURLOW LESLIE 50.00 X 0 180974 22207 BENFIELD RONALD 50.00 X 0 163209 29734 PERRY MARK 50.00 X 0 283959 70283 RUSSELL THOMAS 50.00 X 0 373129 329641 WEHTJE RODNEY 50.00 X 0 484703 160891 REINER SCOTT 50.00 X 0 706956 142451 REBOK DOUGLAS 50.00 X 0 701547 140807 DODDS LARRY 50.00 X X 0 789424 159012 CARMEN ROBERT 50.00 X X 0 1485849 256139 TORKELSEN MAX 1.00 X 0 1854 74 RIPPEY WESLEY 8.00 X 143418 1286 74 REIMCHE ALLAN 1.00 X 0 1440 74 JOBE MEREDITH 1.00 X 0 16246 74 HERBER STEVEN 1.00 X 0 146754 74 GRAHAM RICARDO 1.00 X 0 2309 74 FRIESTAD CHRISTINE 1.00 X 0 1311 74 FIKE RUTHITA 1.00 X 0 405 74 CREITZ LYNN 1.00 X 0 2123 74 CAVINESS LARRY 1.00 X 0 2505 74 BRADSHAW ROBERT 1.00 X 0 1321 74 Warda Robert 0.00 X 245437 0 28034 Atwal Kamiljit 40.00 X 269007 0 19572 Nyonator Edem 40.00 X 297000 0 11192 Nerness Curtis 40.00 X 303140 0 31515 Grise Murlan 40.00 X 393424 0 31515 1998542 6572159 2319142 141 true true false Oregon Anesthesiology Grp 120 NW 14th Ave Ste 300 Portland OR 97209 Medical Services 469753 Am Hlthcare Serv Assn PO Box 945 Traverse City MI 49684 Agency Staffing 516189 Northwest Cardiovas Inst 2222 NW Lovejoy Ste 606 Portland OR 97210 Physician 1276251 Novia Stategies 13029 Danielson Street 200 Poway CA 920648811 Business Consultant 1354294 Portland Psyc Assoc Inc 9955 SE Washington 200 Portland OR 97216 Psyc Physician Serv 1718224 19 123159 400054 24210 523213 Partnr inc fr rel prg svc 1009988 1009988 Other Revenue 2289651 2289651 Rental Revenue - MOBs/Oth 4153254 4153254 Lab Pickup Services 5292736 5292736 Program Service Revenue 229038340 229038340 1935685 55477 990172 890036 243719654 3728462 3728462 0 0 0 -14201 -14201 -14201 -14201 60562 123159 99688 -39126 -39126 0 309759 270133 39626 39626 Medical Staff Funds 84450 84450 84450 248042078 232393456 6282908 8842501 0 145739 145739 0 0 57600 57600 0 105260332 97514036 7526238 220058 4277350 4256768 20582 21340467 18602517 2693118 44832 8240456 7627968 596560 15928 0 605196 605196 378595 378595 0 0 0 11010739 6591636 4419103 1219920 103862 1116058 35749131 35073671 656954 18506 7063768 7055541 8227 0 9442170 8898940 523569 19661 764700 507850 253655 3195 0 235562 194232 40465 865 2852999 2852999 0 10846792 10837514 9278 1423594 1406557 17037 Rent/Lease of Equipment 2290201 2290201 All other expense 7628189 210578 7411410 6201 Purchased Services 16827010 11270125 5543488 13397 0 247660510 215440734 31877133 342643 3337225 2114866 93176274 80421344 970013 225813 32991124 35599349 0 0 0 2590132 2614503 1916146 1728541 268268579 139676612 132270310 128591967 156243 3515 2225990 1652585 0 316600 90000 10100459 11389715 280050516 264432198 19272303 17324995 165461 1028585 79740 59131 10988011 69117047 65813015 99622562 84225726 X 175976339 176372456 2082869 1341516 2368746 2492500 180427954 180206472 280050516 264432198 X 381568 -603050 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true false true 235 false false false false true 16835 17070 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description A portion of the dues paid to the following organizations has been determined to be related to lobbying: Oregon Association of Hospitals and Health Systems--lobbying portion $16,413 Portland Business Alliance--lobbying portion $211-2010 plus $211 2011 dues paid in 2010 3253240 151645 38757 -9746 3433896 2980996 247619 32683 -8057 3253240 2928565 19405 37280 -104254 2980996 false false false 6643572 6643572 184197361 78250233 105947128 2088496 1266389 822107 75339150 60159990 15179160 128591967 Payable to related entities 63062658 Payables to third parties -46058 Workers' comp liability 2796415 65813015 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Net Assets Rlsd from Restrictions $ -603050 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. X X X X false Golf Tournament 183721 123159 60562 2560 2326 23620 15965 55217 183721 123159 60562 2560 2326 23620 15965 55217 99688 -39126 true true X true X true X true false false false true true 8623104 8623104 0.03480 35937641 22234445 13703196 0.05530 44560745 22234445 22326300 0.09010 596533 110736 485797 0.00200 314284 49962 264322 0.00110 20112334 18314509 1797825 0.00730 181596 181596 0.00070 21204747 18475207 2729540 0.01110 65765492 40709652 25055840 0.10120 3996 3996 45815 45815 0.00020 1175 1175 2620 2620 53606 53606 0.00020 true 8311044 2659534 33844225 25492499 8351726 X true true 1 0 Portland Adventist Medical Ctr

10123 SE Market Street Portland OR 97216

X X X X Portland Adventist Medical Ctr 1 false false false false false false false false false true false false 41 Adventist Health Physical Workforce

10101 SE Main Street LL Portland OR 97216

Workforce Therapy Clinic Adventist Health Medical Clinic- Diabetes & Endo Ctr

6475 SW Borland Road Suite M Tualatin OR 97062

Physician Clinic Adventist Health Audiology

10201 SE Main Street Suite 1 Portland OR 97216

Audiology Clinic Adventist Health Oregon Hand Specialists

10000 SE Main St Suite 327 Portland OR 97216

Physician Speciality Clinic Adventist Health Speech Therapy

10201 SE Main Street Suite 1 Portland OR 97216

Speech Theraphy Clinic Adventist Health Medical Clinic-Mt Scott Internal Med

9200 SE 91st Ave Suite 300 Portland OR 97086

Physician Clinic Adventist Health Medical Clinic-Camas

411 NE 6th Avenue Camas WA 98607

Physician Clinic Adventist Health Physical Therapy Vancouver

6069 SE 15th Street Vancouver WA 98683

Physical Therapy Clinic Adventist Health Hospice-Tillamook

1015 Third St Tillamook OR 97141

Hospice Services- Tillamook Adventist Health Medical Clinic-Occupational Medicine

10201 SE Main St Suite 29 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic-Gladstone Family Med

1105 Portland Ave Suite 2 Gladstone OR 97027

Physician Clinic Adventist Health Speciality Rehab

10101 SE Main Street LL Portland OR 97216

Speciality Rehab Therapy Clinic Adventist Health Medical Clinic-Arthritis and Bone Care

10201 SE Main St Suite 29 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic- Diabetes & Endo Ctr

10101 SE Main Street Suite 1001 Portland OR 97216

Physician Clinic Adventist Health Home Infusion Therapy

5835 NE 122nd Ave 155 Portland OR 97320

Home Infusion Therapy Service Adventist Health Medical Clinic- Cascade Park

406-A SE 131st Ave Suite 104 Vancouver WA 98683

Physician Clinic Adventist Health Medical Clinic-Eastside Internal Med

10000 SE Main St Suite 128 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic-Hoodland

24461 East Welches Road Welches OR 97067

Physician Clinic Adventist Health Physical Therapy Clackamas

13435 SE 97th LL101 Clackamas OR 97015

Physical Therapy Clinc Adventist Health Medical Clinic-Sandy

17055 Ruben Lane Sandy OR 97055

Physician Clinic Adventist Health Medical Clinic-Hazelwood

12615 NE Halsey Street Portland OR 97230

Physician Clinic Adventist Health Medical Clinic- Clackamas

11211 SE Sunnyside Road Clackamas OR 97015

Physician Clinic Adventist Health Physical Therapy Sandy

37095 SE Hwy 26 Suite 102 Sandy OR 97055

Physical Therapy Clinic Tillamook Home Health

1015 Third Street Tillamook OR 97141

Home Health Services- Tillamook Adventist Health Medical Clinic-Portland Lung Clinic

10201 SE Main St Suite 25 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic- Gresham Station

831 NW Council Drive Suite 101 Gresham OR 97030

Physician Clinic Adventist Health Medical Clinic- Damascus

14450 SE Royer Road Damascus OR 97089

Physician Clinic Adventist Health Medical Clinic- Cherry Park FP

10000 SE Main Street Suite 224 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic-Internal Medicine Assoc

10201 SE Main St Suite 12 Portland OR 97216

Physician Clinic Adventist Health Medical Clinic Gresham Station IM FP

831 NW Council Drive Suite 125 Gresham OR 97030

Physician Clinic Adventist Health Medical Clinic-Ventura Park

11510 SE Stark Street Portland OR 97216

Physician Clinic Adventist Health Occupational Therapy

10101 SE Main Street LL Portland OR 97216

Occupational Therapy Clinic Adventist Health Physical Therapy Gresham

831 NW Council Dr Suite 200 Gresham OR 97030

Physical Therapy Clinic Adventist Health Medical Clinic- Convenient Care

18750 SE Stark Street Portland OR 97233

Physician Clinic Adventist Health Physical Therapy Medical Center Outpt

10101 SE Main Street LL Portland OR 97216

Physical Therapy Clinic Adventist Health Home Medical Equipment

5835 NE 122nd Ave 155 Portland OR 97230

Home Medical Equipment Service Adventist Health Wound Healing and Hyperbaric Medicine

10201 SE Main St Suite 29 Portland OR 97216

Wound Care Service Adventist Health Medical Clinic-Admission & Management

10123 SE Market Street Portland OR 97216

Admission and Management Service Adventist Health Hospice Portland

5835 NE 122nd Ave 155 Portland OR 97230

Hospice Services Adventist Health Home Health Agency

5835 NE 122nd Ave 155 Portland OR 97230

Home Health Services- Portland Adventist Health Gresham Station Imaging Center

831 NW Council Dr Suite 100 Gresham OR 97030

Imaging Center Part VI - Additional Information Supplemental for Part I, Line 7 The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows: (Total expenses - (Provision for bad debts + Other revenue + Interest income)) divided by Gross patient chargesPart V, Section BSchedule H, Part V, Section B is optional for the reporting organization as the tax year began prior to March 23, 2010. Further, IRS Announcement 2011-37 states the entire Part V, Section B is optional for the 2010 Form 990. Lacerte software has not provided a tool for an organization to indicate that it is opting not to complete Part V, Section B. In addition, the software has been programmed so that it populates responses when the organization chooses to provide no data inputs. Part V, Section B should be blank as the reporting organization opts to not complete it. Part V - Explanation of Number of Facility Type Hospice (2), Home Medical Equipment (1), Home Infusion Therapy (1), Physician Clinics (22), Lab (2) Part VI - States Where Community Benefit Report Filed OR Part VI - Affilated Health Care System Roles and Promotion 7# As a part of Adventist Health, the 17 individual hospital's missions are to provide our communities with physical, mental, and spiritual healing in a way that reflects God's love to all. Our corporate office supports the hospital's management in reducing the overall cost of providing health care to the communities we serve. They help in the standardization of electronic medical records which helps to provide a safe environment of care. They also oversee our fiscal strength so we can continue to serve the rural and underserved communities we work in. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose 6# We do not wait until a community member needs our services through our clinics or our Emergency Department. We are active in the community we serve. By involving ourselves in various activities, groups, and outreaches, we communicate our willingness to serve our community and our commitment to our mission. Our community health needs assessment keeps us current with changes in the health of our community. By working with other groups and agencies we are better able to assess the needs of the community than if we relied only on our own resources. Any excess funds generated by the hospital goes to improving the quality of the healthcare we provide and to better serve the needs of the community. Part VI - Community Building Activities 5# Activities in this area focus on the root causes of health problems such as poverty and homelessness. We feel that by addressing the root causes of health problems, we help improve access to health care to individuals who might not be able to do so if these issues are ignored. While there are public health agencies that deal with these problems, they are limited to what they can do by budget limitations. Activites we were involved in 2010 include the following: 1)Work on Jubilee Commons- a complex that will help eliminate substandard housing in East Multnomah county. This complex will house 44 adults and 56 children.2)Health discussions/issues specifically related to underserved Hispanic population.3)Steering committee and treatment workgroup to help represent the needs of cancer patients and services with regards to chronic disease and prevention efforts to the public health initiatives within the State of Oregon.4)Hosted Clackamas county Crisis Intervention Training 5)Hosted a meeting of 15 county/hospital representatives for Flu pandemic 6)Civic involvement and support of local Chambers of Commerce beyond normal business needs. Part VI - Community Information 4# PAMCs primary service area is East Multnomah County. In addition the organization provides services to residents of Clackamas and Washington Counties in Oregon and Clark County in Washington. Portland, Vancouver (WA), and the suburbs surrounding these two cities lay within this four county area. Part VI - Patient Education of Eligibility for Assistance 3# Financial assistance is a part of the community service provided by this hospital and is available to those individuals using our services.For those who are unable to pay, reasonable efforts will be made to assist the patient in obtaining help for payments of their medicalbills from public agencies. If a patient indicates they cannot pay the bill, they are offered a charity care application. We contact an external firm to screen patients for eligibility for government assistance. The discussion of whether they can pay the bill maycome up at any point (before admission, during the stay, after discharge or after the account is sent to a collection agency).Those who do not qualify for public funding will be considered for financial assistance under the hospital's financial assistanceguidelines. Identifying a potential charity discount will begin as soon as information is provided that a patient may be receiving service. Part VI - Needs Assessment #2 Every three years, AMC partners with other local entities to conduct a community health needs assessment that helps to identify the health care gaps that exist within the hospitals service areas. That data and other key sources of information- such as the hospital's situation assessment, discharge data and pertinent healthcare trends- plays a prominent role in the hospital's annual strategic planning. Initiatives to achieve those goals are based on community demographics and the expressed and implied health care needs of the area's residents, communicated through the triennial community health needs assessment and other vehicles. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL Revenue Rec. *Medicare Cost Report Revenue 29,219,423 Prior Year Settlements 54,784 Cost Report Reimbursable Bad Debts 577,801 Estimates and Accrual Variances 71,803 Other 3,920,414 Subtotal - Amount reported in Pt III, line 5 33,844,225 Amounts include in Part 1, lines g and f 6,410,751 Total Medicare Revenue 40,254,976 *Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts.Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. Part III, Line 4 - Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information, those accounts would have been reclassified from bad debt expense to charity care.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. X 0 0 Awards 249 87469 FMV Service Awards Educational Assistance 65 58270 Actual Cash X true true X X X X X true true false false false false false false false false TRYON ELLEN 347116 347116 RUSSELL DAVID 160300 13629 29166 17982 221077 KINZER STEVEN 223100 42329 45362 16003 326794 31898 HEISER PAMELA 185220 7618 704946 15981 913765 FURLOW LESLIE 162960 18014 6210 15997 203181 BENFIELD RONALD 120400 24700 18109 20488 9246 192943 PERRY MARK 240340 43619 50236 20047 354242 36833 RUSSELL THOMAS 337300 35829 311553 18088 702770 WEHTJE RODNEY 324430 71576 88697 144827 16064 645594 REINER SCOTT 510580 135332 61044 122323 20128 849407 REBOK DOUGLAS 512780 137782 50985 122488 18319 842354 DODDS LARRY 588930 152891 47603 142912 16100 948436 CARMEN ROBERT 920840 235922 329087 235392 20747 1741988 211163 Warda Robert 212292 23981 9164 14605 13429 273471 Atwal Kamiljit 258114 10893 15014 4558 288579 Nyonator Edem 297000 10114 1078 308192 Nerness Curtis 286364 16776 15014 16501 334655 Grise Murlan 314935 78489 15014 16501 424939 KUNAU CAROL 169661 31157 11258 13330 225406 JONES DERYL 383559 8282 15212 16095 423148 Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Any items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. Wes Rippey MD Director Physician services false Patient Care Supplies Patient Care supplies ($32,151,523) has been included in the Office Supplies line in the Core form,Part IX, Line 13, Column B (Program Service Expenses). Form 990, Part VII, Line 1a-Board Comp The directors serve on the Board without compensation. Amounts reported generally are for taxable benefits. Further explanation for those directors who receive compensation for services rendered in their professional capacity follows. Steven Herber, MD is the Chief Medical Officer (CMO) for St. Helena Hospital. The hospital paid Dr. Herber $144,001 for his services. The CMO services were provided under contract approved by the Board Compliance Committee.Jobe & Stoterau, a law practice with which Meredith Jobe is affiliated, provided legal services regarding real estate matters to White Memorial Medical Center in the amount of $13,791. Wesley Rippey, MD is the Chief Medical Officer for Portland Adventist Medical Center. The hospital paid Dr. Rippey $57,600 for his CMO services. Additionally, Dr. Rippey provides vascular study interpretations and on call coverage for patients of the hospital. The hospital paid $85,818 for these professional services. These services were provided under contract approved by the Board Compliance Committee. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy publicly available. The hospital files monthly/quarterly summary financial reports with the state health planning agency. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process The completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West. Form 990, Part III, Line 4d Form 990, Part III, Line 4d : Other Program Services Description OTHER PROGRAM SERVICES 4: PAMC recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. Community Health Improvement Services Community Health Education: Healthful Living Cooking Demonstration Cancer Care Support Group Medical personnel lactation education Safety consults Provided answers to medication questions from the general public Intervention Training Komen Care for The Cure Health Fair focusing on heart health Community Based Clinical Services: Stroke Education and screening Mammography Voucher Program for uninsured women Health Care Support Services: Emergent transportation needs of discharging patients Cancer patient transportation Enrollment assistance in government funded health programs Coupons for homeless shelters Cancer Survivor event Cancer Support Group Grief Classes Health Professionals Education Nurses/Nursing students: Student nurses- 46,036 hours 429 students Nursing school subsidy Other Health Professionals Education: Rosevilla Care Center- Facility Pain education Lacation Consultant Educator Health Resource Kiosk Medical Library open to public Hosted Caremark lecture Series Dietetic Intern Various Grief/Care classes for Home health/Hospice professionals PT, OT, Speech therapy student training Subsidized Health Services: Hospital Outpatient Services: Cardiopulmonary Rehab Wellness Services-2,385 seen at events Subsidized Continuing Care Home Health Hospice Behavioral Health Services Psych and Psych Services PhysiciansFinancial and In-Kind Donations Cash Donations: Medical Teams International In-Kind Donations: Portland Adventist Community Services Medical Supplies to mission fields Compassionate Friends Car seats donated to financially qualified Northwest Mother's Milk bank Administrative support to not-for-profit groups Birch Community Center Special need groups Board and committee memberships Community Benefits Operation Assigned Staff: 1,001 total hoursActivities that we feel should be considered a benefit to the communityCommunity Building Activities Physical Improvements/Housing: Mt. Hood Habitat for HumanityEconomic Development: Various Local Chamber of Commerce time East Metro Economic Alliance Gateway Business Developemnt Citizens Advisory Committee Gateway Eco-District Committee Coalition Building: Columbia Willamette Chapter of the American Society of Safety Engineers NAMI walk Workforce Development Local High School students mentoring White Memorial Medical Center 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital WA 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Dr Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Foundn of Tillamook 1000 Third St Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind Down after sale of Hospital Facilities CA 501(c)(3) 3 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital & Hlth Care Svcs 2975 N Sycamore Dr Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Selma Community Hospital Inc 1141 Rose Ave Selma CA 93662 770509133 Supporting Hanford Community Hospital CA 501(c)(3) 11, Typ 3 func integ Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Ave Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Rd St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilities CA 501(c)(3) 1 Adventist Health SystemWest false Willits Hospital Inc 1 Madrone St Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Hanford Community Hospital 450 Mall Dr Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Glendale Adventist Medical Center 1509 Wilson Ter Glendale CA 91206 951816017 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Road Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Central Valley General Hospital 1025 N Douty Street Hanford CA 93230 770324630 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Clearlake Hospital Inc 15630 Ave 18th Ave Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 NA false PAR LLC 10610 SE Clay Street Portland OR 97216 931262371 Sr Living OR N/A 4862642 10964152 true 39 false 0.5 Assn Unit Owners Portland Adv Condo 10101 SE Main St Portland OR 97216 930887521 Condo Assn-MOB OR N/A C corp 209765 15361 0.78000 Healthcare Resources Northwest 305 NE 102nd Ave 250 Portland OR 97292 931166731 Medical Mgnt Services OR N/A C corp 15285733 5283613 1.00000 Gresham Family Medical Center 1700 SW 257th Ave Troutdale OR 97060 911768081 Physician Office OR N/A 2081446 254111 1.00000 true false true false true false false false true true true true true true true true true true Assn Unit Owners Portland Adv Condo p 185124 Healthcare Resources Northwest r 679082 Healthcare Resources Northwest q 429187 Healthcare Resources Northwest p 1883545 Healthcare Resources Northwest n 1035882 Healthcare Resources Northwest i 878 Healthcare Resources Northwest a 106973 Gresham Family Medical Center p 514227 Gresham Family Medical Center m 30959 Gresham Family Medical Center a 131789 PAR LLC r 760000