2011-11-15T21:25:20-08:00 2010-12-31 990 2010-01-01 930622075 Northwest Medical Foundation Tillamook dba Tillamook County General Hospital NORT 5038424444 1000 Third Street Tillamook OR 97141 Walt Larson 2011-11-15 2010 2016-02-24 21:20:13Z Larry Davy 1000 Third St Tillamook OR 97141 49986876 false false 1071 X www.AdventistHealth.org X 1973 OR To share God's love by providing physical, mental and spiritual healing. 13 8 401 49 3553 -36 122916 365119 43464902 47772477 832418 1025897 779554 789970 45199790 49953463 0 0 23889847 26070206 0 0 18216064 20875293 42105911 46945499 3093879 3007964 40696249 43230171 3276143 3528722 37420106 39701449 To share God's love by providing physical, mental and spiritual healing. false false 43594327 48547086 Tillamook County General Hospital 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 Tillamook County General Hospital the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's 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 below costproviding health/wellness activities and community education programsNot only does Tillamook County General Hospital provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. Tillamook County General Hospital recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed value of providing care to these patients in 2010 was $25,083,611.Inpatient services in 2010 were provided to 1,036 patients. These services included:Babies delivered 163Surgeries performed 315Radiology procedures performed 1,778Laboratory tests performed 13,047Outpatient services in 2010 were provided to 12,218 patients. These services included:Emergency room visits 10,061Outpatient surgeries performed 989Radiology procedures performed 19,675Laboratory tests performed 87,773Tillamook County General Hospital 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:Teddy Bear FairsHealth FairsBlood Pressure ClinicsFaith In ActionWomens Resource Center TrainingMultimodularRespite careSeniors DayGrief Support Group 43594327 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false false true false false false false true 103 0 true 401 true true true false false false false false false false false 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 false false X NW Medical Foundation of Tilla 5038424444 1000 Third St Tillamook OR Tillamook OR 97141 X Donna Bechthold 50.00 X 0 193068 43018 Walter Larson 50.00 X 0 195674 44353 Larry Davy 50.00 X 0 314819 69174 Rodney Wehtje 50.00 X 0 484703 160891 Scott Reiner 50.00 X 0 706956 142451 Douglas Rebok 50.00 X 0 701547 140807 Larry Dodds 50.00 X X 0 789424 159012 Robert Carmen 50.00 X X 0 1485849 256139 Max Torkelsen 1.00 X 0 1854 74 Wesley Rippey 1.00 X 0 144704 74 Allan Reimche 1.00 X 0 1440 74 Meredith Jobe 1.00 X 0 16246 74 Steven Herber 1.00 X 0 146754 74 Ricardo Graham 1.00 X 0 2309 74 Christine Friestad 1.00 X 0 1311 74 Ruthita Fike 1.00 X 0 405 74 Lynn Creitz 1.00 X 0 2123 74 Larry Caviness 1.00 X 0 2505 74 Robert Bradshaw 1.00 X 0 1321 74 Scott Doherty 0.00 X 210859 0 0 Calvin Hill 40.00 X 214993 0 0 Brandon Mitchell 40.00 X 220173 0 0 Todd Pitts 40.00 X 436532 0 0 Brittany Gerken 40.00 X 498832 0 0 1581389 5193012 1016659 31 false true false Cardinal Health 21377 Network Place Chicago IL 60673 Pharmacist 220214 Staff Care Inc PO Box 281923 Atlanta GA 30384 Staffing Agency 259387 Paul J Dennis MD 1000 Third St Tillamook Tillamook OR 97141 Anesthesiologist 539553 Bivens Medical Corporation 1000 Third St Tillamook Tillamook OR 97141 Radiologist Physicia 1366586 Tillamook Emergency Services 1000 Third St Tillamook Tillamook OR 97141 ER Physician Group 2114056 13 41455 323664 365119 Other revenue 621990 29862 26309 3553 Education 621990 32454 32454 Rental Income 621990 60994 60994 Dietary Services 621990 180105 180105 Patient Service Revenue 621990 47469062 47457244 11818 47772477 1029440 1029440 0 0 0 -3543 -3543 -3543 -3543 0 0 51271 33413 17858 17858 Other 45489 45489 Released fr Restriction 726623 726623 772112 49953463 48543533 3553 1041258 0 0 0 0 0 0 19980128 18883466 1096662 810905 810905 3886655 3562934 323721 1392518 1310933 81585 0 85562 85562 215207 215207 0 0 0 5987673 5905593 82080 89338 89338 5242095 5137143 104952 1767984 1762305 5679 0 834447 829647 4800 180667 13526 167141 0 167220 154534 12686 0 0 1686801 1663535 23266 287783 287783 Misc 163258 146043 17215 Purchased Services 4167258 3125980 1041278 0 46945499 43594327 3351172 0 119219 47115 21405167 22534835 0 6802608 8794523 0 0 0 688639 735381 389456 258126 30546683 22109461 9191339 8437222 0 0 0 0 2099821 2422969 40696249 43230171 2840077 3079134 436066 449588 3276143 3528722 X 33101185 35982528 4318921 3718921 37420106 39701449 40696249 43230171 X 3007964 -726621 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 2896 2896 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Oregon Association of Hospitals and Health Systems dues incorporates an amount they attribute to lobbying. 653633 653633 18224572 12544184 5680388 1002312 795737 206575 10666166 8769540 1896626 8437222 Third Party Receivable 1182545 Other Assets 873593 Workers Comp Investment 366831 2422969 Other -1 Workers Comp 449589 449588 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Net Assets Released from Restriction $ -726621 true true X true X true X true false false false true true 3394075 64019 3330056 0.07090 5551525 4936822 614703 0.01310 8945600 5000841 3944759 0.08400 278000 278000 0.00590 278000 278000 0.00590 9223600 5000841 4222759 0.08990 2000 2000 2000 2000 true 579482 272356 19202069 16998221 2203848 X true true 1 0 NW Medical FoundationTillamook

1000 3rd St Tillamook OR 97141

X X X X NW Medical FoundationTillamook 1 false false false false false false false false false true false false Part VI - Additional Information Part 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 VI - Affilated Health Care System Roles and Promotion The hospital is a member of a larger health care system, which provides services in diversified areas of the Western United States. The hospital shares some services with other hospitals in its geographic area. Using today's technology, hospitals outside the geographic area are able to support the hospital by providing remote services such as telepharmacy and robotics surgery. The Corporate Office provides support for the rural health clinics, quality of care, and other clinical needs. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. Part VI - Community Information The hospital is in a rural setting, predominately agricultural based. The average income is at or below the FPG. The population is predominately Caucasian, high-school educated, and geriatric in nature. Part VI - Patient Education of Eligibility for Assistance At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients also are orally informed of their right to request charity assistance. Signs and other communiques are posted and displayed throughout the hospital in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. 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. 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. Part I, Line 7 - Explanation of Costing Methodology 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)) / Gross patient charges X X X X false true false false false true true false false false Donna Bechthold 149840 20656 22572 27059 15959 236086 15886 Walter Larson 156020 21467 18187 28390 15963 240027 Larry Davy 245300 53286 16233 51141 18033 383993 Rodney Wehtje 324430 71576 88697 144827 16064 645594 54524 Scott Reiner 510580 135332 61044 122323 20128 849407 Douglas Rebok 512780 137782 50985 122488 18319 842354 Larry Dodds 588930 152891 47603 142912 16100 948436 Robert Carmen 920840 235922 329087 235392 20747 1741988 211163 Scott Doherty 210859 210859 Calvin Hill 214993 214993 Brandon Mitchell 220173 220173 Todd Pitts 436532 436532 Brittany Gerken 498832 498832 Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or An incentive plan is included as part of the board-approved compensation plan for hospital executives. The hospital has a similar plan for department directors. The purpose of these plans is to provide incentives to hospital management to accomplish the financial, operational, quality, and mission objectives of the hospital during each fiscal year. Each member of the management team is evaluated against pre-determined objectives to arrive at the incentive amount, if any, for the fiscal year. See Schedule O for additional detail. 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. 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