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SALEM HEALTH HOSPITALS AND CLINICS: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SALEM HEALTH HOSPITALS AND CLINICS (EIN 93-0823471)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201142279349304634
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)
Timestamp2011-08-15T18:44:14-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1AKT LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15665 SW Meadows Rd Suite 200AddressLine1
CityLake OswegoCity
StateORState
ZIP Code97035ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930823471EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Salem HealthBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSALENameControl
Phone5035615150Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1890 Oak Street SEAddressLine1
CitySalemCity
StateORState
ZIP Code97301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAaron R CraneName
TitleChief Finance & Strategy OfficerTitle
Phone5035615150Phone
Date Signed2011-08-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMartin MollName
Phone5036204489Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonAaron R CraneNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1890 Oak Street SEAddressLine1
CitySalemCity
StateORState
ZIP Code97301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17186GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.salemhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO SUPPORT SALEM HOSPITAL, WEST VALLEY HOSPITAL AND SALEM HOSPITAL FOUNDATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year983InvestmentIncomePriorYear
Investment Income Current Year501InvestmentIncomeCurrentYear
Other Revenue Prior Year14439OtherRevenuePriorYear
Other Revenue Current Year16685OtherRevenueCurrentYear
Total Revenue Prior Year15422TotalRevenuePriorYear
Total Revenue Current Year17186TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year115OtherExpensePriorYear
Other Expenses Current Year0OtherExpensesCurrentYear
Total Expenses Prior Year115TotalExpensesPriorYear
Total Expenses Current Year0TotalExpensesCurrentYear
Revenues Less Expenses Prior Year15307RevenuesLessExpensesPriorYear
Revenues Less Expenses CY17186RevenuesLessExpensesCY
Total Assets BOY1057122TotalAssetsBOY
Total Assets EOY1074308TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1057122NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1074308NetAssetsOrFundBalancesEOY
Mission DescriptionTO SUPPORT SALEM HOSPITAL, WEST VALLEY HOSPITAL AND SALEM HOSPITAL FOUNDATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense0Expense
Revenue16685Revenue
DescriptionLeases land to Salem HospitalDescription
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
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
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
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 Required0ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
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 Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1salem hospitalBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5035615150TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1890 Oak Street SEAddressLine1
CitysalemCity
StateORState
ZIP Code97301ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
KATHERINE KEENE
TRUSTEE10.00X000
GEORGE HAPP
TRUSTEE10.00X000
BRUCE CARTER MD
TRUSTEE10.00X000
KENNETH SHERMAN JR
VICE-CHAIR15.00X000X
DAVID ELMGREN MD
TRUSTEE10.00X000
CHUCK HUDKINS
TRUSTEE10.00X000
BONNIE DRIGGERS RN
CHAIRPERSON15.00X000X
THERESA TAAFFE
TRUSTEE10.00X000
JENNIFER NEAHRING MD
TRUSTEE10.00X000
ALAN WYNN
SECRETARY/TREASURER15.00X000X
ALAN COSTIC
TRUSTEE10.00X000
LANE SHETTERLY
TRUSTEE10.00X000
ROBERT WELLS
TRUSTEE10.00X000
NORMAN GRUBER
PRESIDENT40.00073570462177X
AARON CRANE
CHIEF FINANCIAL OFFICER40.00035266874347X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1088372TotalReportableCompFrmRltdOrgs
Total Other Compensation136524TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column501TotalRevenueColumn
Exclusion$501ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real16685Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real16685Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column16685TotalRevenueColumn
Exclusion$16,685ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17186TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$17,186ExclusionAmount

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY124287BOY
EOY124788EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis917063LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY917063BOY
EOY917063EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15772BOY
EOY32457EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1057122BOY
EOY1074308EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1057122BOY
EOY1074308EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1057122BOY
EOY1074308EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1057122BOY
EOY1074308EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
salem hospital
9305797223111$0
west valley hospital
4319602213111$0
salem hospital foundation
2370026877111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis917063OtherCostOrOtherBasis
Book Value917063BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings917063TotalOfBookValueLandBuildings
Total Revenue17186TotalRevenue
Total Expenses0TotalExpenses
Excess Or Deficit For Year17186ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS17186ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17186TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal17186RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99017186TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt0TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal0ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9900TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 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
NORMAN GRUBER
0581199065000089505027500034677079788100
AARON CRANE
03503190002349039166035181042701500

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 7ReturnReference
ExplanationThe Governance Committee of the Board of Trustees, in consultation with independent compensation consultants, reviews CEO total compensation and performance annually. As part of the committee's actions, a non-fixed bonus may be awarded to the CEO.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The Governance Committee of the Board of Trustees reviews the 990. It is then forwarded to the entire Board of Trustees.
Form 990, Part VI, Section B, line 12cOn an annual basis the Secretary of the Hospital shall send to each person who is a trustee, officer, or member of a committee, and to those employees of the Hospital as the Board may determine, a copy of the Policy regarding Conflicts of Interest, together with a questionnaire inquiring as to conflicts, to be completed a and returned to the Secretary by the trustee, officer, committee member or employee prior to the beginning of each calendar year.
Executive compensation at Salem Hospital is designed to allow the organization to recruit and retain qualified senior leaders. The Governance Committee of the Salem Hospital Board of Trustees, none of whom is a Salem Hospital employee, engages one or more independent consultants to provide market data on executive compensation, including benefits, for the CEO and other executives in similar roles at comparable organizations. This information is used by the Governance Committee in its discussions and decisions on CEO compensation. The CEO, in conjunction with other salary survey or public information and the independent consultant, ensures that each executive's compensation is competitive in the market for similar positions at comparable organizations.
Form 990, Part VI, Section C, line 19The conflict of interest policy and governing documents are available on the hospital website.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
Salem Hospital Foundation
890 Oak Street SESalemOR97301237002687Supports Salem HospitalOR501(c)(3)7Salem Health
Salem Hospital Auxiliary
890 Oak Street SESalemOR97301931081113Supports Salem HospitalOR501(c)(3)9N/A
Salem Hospital
890 Oak Street SESalemOR97301930579722HospitalOR501(c)(3)3Salem Health
West Valley Hospital
525 Southeast Washington StreetDallasOR97338431960221HospitalOR501(c)(3)3Salem Health
West Valley Hospital Foundation
525 Southeast Washington StreetDallasOR97338931298564Supports West Valley HospitalOR501(c)(3)11 Type 1Salem Health
Willamette Valley Insurance Company
745 Fort StreetHonoluluHI96813201836190Captive InsuranceHI501(c)(3)11 Type 1Salem Health
Willamette Valley Professional Services
890 Oak Street SESalemOR97301753175249Billing Service for Professional FeesOR501(c)(3)3Salem Health

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Oregon Community Imaging LLC
2925 Ryan DR SESalemOR97301202683062Medical Imaging CooperativeORSalem HospitalRelated5941731926300
Salem Cardio Diagnostics
665 Winter Street SESalemOR97301930579722Cardio DiagnosticsORSalem HospitalRelated2216946157866100
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Salem Hospital
A16685
Salem Hospital
D32457