{"success":true,"data":{"_id":930426018,"filings":[{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"Provide healthcare with special concern for the poor & vulnerable in the Oregon City area.","primary_activities":"Acute Care - Outpatient: Visits - 178,861Willamette Falls Hospital became Providence Willamette Falls Medical Center on Oct. 1, 2009, joining Providence Health & Services as the fourth hospital in the Portland Service Area. Integration activities began immediately to support and communicate the new Providence brand to patients, employees, volunteers, medical staff and community members. Willamette Falls entities included the main hospital facility, the foundation, hospice, the community center, two immediate care clinics and four employed physician groups. During 2010, the immediate care clinics and physician groups transitioned to the Providence Medical Group entity.A multifaceted strategy included conversion of all print materials, building signage, print advertising, heightened internal communications, Web presence and community visibility. In addition, mission and cultural integration were key components to a successful first year as part of Providence.2010 accomplishments, community events and sponsorships:\"Cooking from the Heart, For the Heart\". The February event increased knowledge of the attendees. Event included blood pressure checks (78), blood glucose screenings (40) and food samples during the month Heart healthy meals served in cafeteria (1,297).Women's health fair and health education presentations at the community center. Over 800 health fair attendees; 55 vendors and health screenings including foot care, blood pressure, glucose and mini-massages. Participants were provided helpful health information and resources.Meet & Eat presentations 50+ membership group. Eight different programs throughout the year focused on various senior health topics including knee pain, joint replacement, and colon cancer.Two events for \"Trusting Us with Your Heart: Past Present and Future\" with approximately 275 attendees. Presentations by Albert Starr, M.D., and Aly Rahimtoola, M.D., PHVI helped to raise awareness of heart and vascular services at PWFMC.Community safety appreciation luncheon. In partnership with the North Clackamas County Chamber of Commerce. This event is a long standing sponsorship by PWFMC.Prescription drug turn-in. Two events in partnership with the Canby Police Department, staffed by PWFMC pharmacists and technicians. Pills, liquid medication and drug related items turned in by the community.Health and Safety Fair at Hilltop Mall, Oregon City. Annual Clackamas County Fire District event to promote safety. PWFMC provided information for emergency and immediate care services.Komen Race for the Cure. 43 PWFMC employees joined team Providence.Senior Resource Health Fair, West Linn Adult Center. PWFMC provided information on services at this first time event partnership with the West Linn Chamber and City of West Linn.\n\nAcute Care - Inpatient: Admissions - 4,264Patient Days - 11,825\n\nLong-term Care, Homecare, Hospice, Housing & Assisted Living:Hospice Days - 42,858\n\nPrimary Care: Visits - 18,617\n\nGrants and allocations to community organizations - see Schedule I\n\nAs part of the affiliation with Providence Health & Services in 2009, certain transitions took effect during 2010. Primary Care Services were transferred from Willamette Falls Hospital to Providence Health & Services - Oregon.\n\nIt is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, the President/CEO utilizes the market information provided by the consultant along with formal performance evaluations, to determine salary recommendations for other senior executives. This process includes a rigorous analysis of those recommendations with the Human Resources Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the \"Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability\" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector.","year":2010,"name":"WILLAMETTE FALLS HOSPITAL","phone":"5036561631","website":"www2.providence.org/oregon/facilities/hospitals","type":"990","principal_officer":"John F Koster MD","year_formation":1954,"state_legal_domicile":"OR","total_volunteers":301,"tax_period_begin":"2010-01-01T00:00:00","tax_period_end":"2010-12-31T00:00:00","address":"1500 DIVISION STREET, OREGON CITY, OR, 970451527, USA","city":"OREGON CITY","state":"OR","country":"USA","zip_code":"970451527"},"Governance":{"501c3 determination":true,"Number of voting members":14,"Number of independent voting members":14,"Number of employees total":0,"Total Gross UBI":281939,"Net unrelated business taxable income":0,"Number of employees":0,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":false,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":true,"Independent audit financial statements":true,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":92994278,"Contributions":{"value":101746,"Other contributions":4971,"Grant revenue":60775,"Related organizations":36000},"Program revenue":{"value":90440324,"Total revenue":{"value":90440324,"VARIOUS":90440324},"Unrelated business revenue":281939},"Investment income":{"value":736978,"Investment income total":623463,"Net investment gain":113515},"Other revenues":{"value":1715230,"Other total":1183030,"Net rental income":532200}},"Expenses":{"value":97013878,"Grant expense":{"value":274373,"Grants to domestic orgs":188422,"Grants to domestic individuals":85951},"Total professional fundraising expense":{"value":0},"Benefits paid to members":{"value":0},"Salaries":{"value":51735136,"Current officers":1062220,"Other salaries and wages":38990896,"Pension plan contributions":2441628,"Other employee benefits":5809290,"Payroll taxes":3431102},"Other expenses":{"value":45004369,"Legal":192119,"Accounting":61226,"Lobbying services":4971,"Investment management fees":30465,"Other services":10151714,"Advertising":147915,"Office expenses":13832131,"Information technology":640058,"Occupancy":1818011,"Travel":184543,"Conferences and meetings":115848,"Interest":1711118,"Payments to affiliates":1345322,"Depreciation and depletion":5681426,"Insurance":570801,"Itemized Expenses":{"value":8109629,"VARIOUS":8109629},"All other expenses":407072}},"Assets":{"value":92154621,"Non-interest bearing cash":4798,"Savings and temp cash investments":2051923,"Accounts receivable":12613709,"Other net note and loans":184887,"Inventories for sale or use":1505695,"Prepaid expenses deferred charges":355015,"Land, building, equipment":48635256,"Investments publicly traded":17857700,"Investments program related":2736115,"Intangible assets":734399,"Other assets":5475124},"Liabilities":{"value":55745640,"Accounts payable, accrued":7033814,"Deferred, revenue":73731,"Tax exempt bond liabilities":29140000,"Other liabilities":19498095},"Fund balance":{"value":36408981},"Form990Details":{"program_service_accomplishments":[{"description":"Acute Care - Outpatient: Visits - 178,861Willamette Falls Hospital became Providence Willamette Falls Medical Center on Oct. 1, 2009, joining Providence Health & Services as the fourth hospital in the Portland Service Area. Integration activities began immediately to support and communicate the new Providence brand to patients, employees, volunteers, medical staff and community members. Willamette Falls entities included the main hospital facility, the foundation, hospice, the community center, two immediate care clinics and four employed physician groups. During 2010, the immediate care clinics and physician groups transitioned to the Providence Medical Group entity.A multifaceted strategy included conversion of all print materials, building signage, print advertising, heightened internal communications, Web presence and community visibility. In addition, mission and cultural integration were key components to a successful first year as part of Providence.2010 accomplishments, community events and sponsorships:\"Cooking from the Heart, For the Heart\". The February event increased knowledge of the attendees. Event included blood pressure checks (78), blood glucose screenings (40) and food samples during the month Heart healthy meals served in cafeteria (1,297).Women's health fair and health education presentations at the community center. Over 800 health fair attendees; 55 vendors and health screenings including foot care, blood pressure, glucose and mini-massages. Participants were provided helpful health information and resources.Meet & Eat presentations 50+ membership group. Eight different programs throughout the year focused on various senior health topics including knee pain, joint replacement, and colon cancer.Two events for \"Trusting Us with Your Heart: Past Present and Future\" with approximately 275 attendees. Presentations by Albert Starr, M.D., and Aly Rahimtoola, M.D., PHVI helped to raise awareness of heart and vascular services at PWFMC.Community safety appreciation luncheon. In partnership with the North Clackamas County Chamber of Commerce. This event is a long standing sponsorship by PWFMC.Prescription drug turn-in. Two events in partnership with the Canby Police Department, staffed by PWFMC pharmacists and technicians. Pills, liquid medication and drug related items turned in by the community.Health and Safety Fair at Hilltop Mall, Oregon City. Annual Clackamas County Fire District event to promote safety. PWFMC provided information for emergency and immediate care services.Komen Race for the Cure. 43 PWFMC employees joined team Providence.Senior Resource Health Fair, West Linn Adult Center. PWFMC provided information on services at this first time event partnership with the West Linn Chamber and City of West Linn.","expense":41298370,"grants":0,"revenue":45969695},{"description":"Acute Care - Inpatient: Admissions - 4,264Patient Days - 11,825","expense":32545839,"grants":0,"revenue":36227152},{"description":"Long-term Care, Homecare, Hospice, Housing & Assisted Living:Hospice Days - 42,858","expense":6318588,"grants":0,"revenue":7033294},{"description":"Primary Care: Visits - 18,617","expense":1224666,"grants":0,"revenue":1363190},{"description":"Grants and allocations to community organizations - see Schedule I","expense":274373,"grants":274373,"revenue":0}],"program_service_revenue_detail":[{"business_code":"621400","description":"ACUTE CARE OUTPATIENT","total_revenue":45892055,"related_or_exempt_function_income":45892055},{"business_code":"900099","description":"ACUTE CARE 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Director","average_hours_per_week":0.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":32220,"other_compensation":0,"former":true},{"title":"Former VP/Advocacy","average_hours_per_week":0.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":359717,"other_compensation":0,"former":true},{"title":"Former VP/Public Affairs","average_hours_per_week":0.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":2137748,"other_compensation":17773,"former":true},{"title":"Former VP/Communications","average_hours_per_week":0.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":325409,"other_compensation":91452,"former":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleC":{"lobbying_activities":{"volunteers":false,"paid_staff_or_management":false,"media_advertisements":false,"mailings_members":false,"publications_or_broadcast":false,"grants_other_organizations":false,"direct_contact_legislators":false,"rallies_demonstrations":false,"other_activities":true,"other_activities_amount":4971,"total_lobbying_expenditures":4971,"not_described_section_501c3":false},"supplemental_information":[{"identifier":"Explanation of Other Lobbying Activities:","form_and_line_reference":"Part II-B, Line 1i:","explanation":"Payments made to Oregon Association of Hospitals and Health Systems for lobbying activities."}]},"ScheduleD":{"land_buildings_equipment":{"land":{"other_cost_or_other_basis":6005456,"book_value":6005456},"buildings":{"other_cost_or_other_basis":62895672,"book_value":30536840,"depreciation":32358832},"leasehold_improvements":{"other_cost_or_other_basis":2985632,"book_value":1266817,"depreciation":1718815},"equipment":{"other_cost_or_other_basis":46588740,"book_value":9822873,"depreciation":36765867},"other_land_buildings":{"other_cost_or_other_basis":1003270,"book_value":1003270},"total_book_value":48635256},"other_assets":{"assets":[{"description":"Trustee Held Funds","book_value":5156470},{"description":"Due from Affiliate","book_value":318654}],"total_book_value":5475124},"other_liabilities":{"liabilities":[{"description":"Third Party Settlements","amount":489249},{"description":"Miscellaneous Payables","amount":3882},{"description":"Provider Tax","amount":1532},{"description":"Bond Premium Discounts","amount":48142},{"description":"Capitalized Lease Obligations","amount":438664},{"description":"Due to Affiliates","amount":3937408},{"description":"Pension Benefit Obligation","amount":14579218}],"total_liability":19498095},"net_assets_reconciliation":{"total_revenue":92994278,"total_expenses":97013878,"excess_or_deficit_for_year":-4019600,"net_unrealized_gains_losses_on_investments":333623,"other_amount":-350991,"total_adjustments":-17368,"excess_or_deficit_per_financial_statements":-4036968},"revenue_reconciliation":{"total_revenue_audited_financial_statements":95586975,"net_unrealized_gains_investments":333623,"other_revenue":1469602,"revenue_not_reported":1803225,"revenue_subtotal":93783750,"investment_expenses_not_included":19814,"other_revenues_not_included":-809286,"revenue_not_reported_financial_statement":-789472,"total_revenue_per_990":92994278},"expense_reconciliation":{"total_expenses_audited_financial_statements":99273135,"other_expenses_included":2306862,"expenses_not_reported":2306862,"expenses_subtotal":96966273,"investment_expenses_not_included":19814,"other_expenses_not_included":27791,"expenses_not_reported_financial_statement":47605,"total_expenses_per_990":97013878},"supplemental_information":[{"identifier":"Description of Uncertain Tax Positions Under FIN 48:","explanation":"Income tax positions that meet the \"more-likely than-not\" recognition threshold are measured at the largest amount of income tax benefit that is more than 50% likely of being realized upon settlement with the applicable taxing authority. The portion of the benefits associated with income tax positions taken that exceeds the amount measured as described above would be reflected as a liability for unrecognized income tax benefits in the accompanying balance sheet along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Interest and penalties associated with unrecognized income tax benefits would be classified as additional income taxes in the statement of operations. There were no unrecognized income tax benefits, nor any interest and penalties associated with unrecognized income tax benefits, accrued or expensed as of December 31, 2010 and for the year ended December 31, 2010."},{"identifier":"Part XI, Line 8 - Other Adjustments:","explanation":"Cumulative Effect of FAS 136 881,476. Net Asset Transfers 157,521. Income on Medical Staff Funds -183. Change in Pension Liability -1,389,805."},{"identifier":"Part XII, Line 2d - Other Adjustments:","explanation":"Internal Assessments 1,469,602."},{"identifier":"Part XII, Line 4b - Other Adjustments:","explanation":"Net Rental Expense Reclassification -891,961. Cafeteria Expense Reclassification -122,867. VHA Rebates 177,568. Medical Staff Income 183. Foundation Subsidized Expense Reclassification 6,571. Health Care Joint Venture Loss Reclassification 21,220."},{"identifier":"Part XIII, Line 2d - Other Adjustments:","explanation":"Employee Benefits/Pension Expense Reclassification -720,000. Purchased Services/Telephone Expense Reclassification -32,000. Bad Debt Reclassification 752,000. Net Rental Expense Reclassification 891,961. Cafeteria Expense Reclassification 122,867. VHA Rebates -177,568. Internal Assessments 1,469,602."},{"identifier":"Part XIII, Line 4b - Other Adjustments:","explanation":"Foundation subsidized expense reclassification 6,571. Health Care Joint Venture Loss reclassification 21,220."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1968918,"bad_debt_expense_attributable_to_financial_assistance":0,"reimbursed_by_medicare":24494000,"cost_of_care_reimbursed_by_medicare":32147000,"medicare_surplus_or_shortfall":-7653000,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":4795000,"net_community_benefit_expense":4795000,"total_expense_percentage":0.0522},"unreimbursed_medicaid":{"total_community_benefit_expense":9849000,"direct_offsetting_revenue":5043000,"net_community_benefit_expense":4806000,"total_expense_percentage":0.0523},"total_financial_assistance":{"total_community_benefit_expense":14644000,"direct_offsetting_revenue":5043000,"net_community_benefit_expense":9601000,"total_expense_percentage":0.1045},"community_health_services":{"total_community_benefit_expense":118915,"direct_offsetting_revenue":28499,"net_community_benefit_expense":90416,"total_expense_percentage":0.001},"subsidized_health_services":{"total_community_benefit_expense":26157,"net_community_benefit_expense":26157,"total_expense_percentage":0.0003},"cash_and_inkind_contributions":{"total_community_benefit_expense":200519,"direct_offsetting_revenue":3960,"net_community_benefit_expense":196559,"total_expense_percentage":0.0021},"total_other_benefits":{"total_community_benefit_expense":345591,"direct_offsetting_revenue":32459,"net_community_benefit_expense":313132,"total_expense_percentage":0.0034},"total_community_benefits":{"total_community_benefit_expense":14989591,"direct_offsetting_revenue":5075459,"net_community_benefit_expense":9914132,"total_expense_percentage":0.1079}},"community_building":{"community_support":{"total_community_benefit_expense":28409,"direct_offsetting_revenue":18320,"net_community_benefit_expense":10089,"total_expense_percentage":0.0001},"total_community_building_activities":{"total_community_benefit_expense":28409,"direct_offsetting_revenue":18320,"net_community_benefit_expense":10089,"total_expense_percentage":0.0001}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Providence Willamette Falls Med Ctr","address_line1":"1500 Division Street","city":"Oregon City","state":"OR","zip":"97045","licensed_hospital":true,"emergency_room_24_hours":true,"name":"Providence Willamette Falls Med Ctr","address":"1500 Division Street, Oregon City, OR, 97045"}],"facility_policies":[{"business_name_line1":"Providence Willamette Falls Med Ctr","facility_number":1,"name":"Providence Willamette Falls Med Ctr"}],"other_health_care_facility_count":5,"other_health_care_facilities":[{"business_name_line1":"Providence Willamette Falls Hospice","address_line1":"1505 Division Street","city":"Oregon City","state":"OR","zip":"97045","facility_type":"Hospice Services","name":"Providence Willamette Falls Hospice","address":"1505 Division Street, Oregon City, OR, 97045"},{"business_name_line1":"Providence WF - Canby Plaza","address_line1":"200 S Hazel Dell Way","city":"Canby","state":"OR","zip":"97013","facility_type":"Urgent Care & Diagnostics Imaging Services","name":"Providence WF - Canby Plaza","address":"200 S Hazel Dell Way, Canby, OR, 97013"},{"business_name_line1":"Providence WF MedGroup-Sunnyside","address_line1":"9775 SE Sunnyside Rd","city":"Clackamas","state":"OR","zip":"97015","facility_type":"Primary Care & Occupational Health","name":"Providence WF MedGroup-Sunnyside","address":"9775 SE Sunnyside Rd, Clackamas, OR, 97015"},{"business_name_line1":"Providence WF Med Group-OR City","address_line1":"1510 Division Street","city":"Oregon City","state":"OR","zip":"97045","facility_type":"Primary Care Spine Center & General Surgery","name":"Providence WF Med Group-OR City","address":"1510 Division Street, Oregon City, OR, 97045"},{"business_name_line1":"Providence WF Med Group-West Linn","address_line1":"18676 Willamette Dr Suite 100","city":"West Linn","state":"OR","zip":"97068","facility_type":"Primary Care","name":"Providence WF Med Group-West Linn","address":"18676 Willamette Dr Suite 100, West Linn, OR, 97068"}],"supplemental_information":[{"explanation":"Part I, Line 6a: Willamette Falls Hospital Community Benefit information is included in the consolidated Providence Health & Services - Oregon and consolidated Providence Health & Services Community benefit reports."},{"explanation":"Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5128345."},{"explanation":"Part II: COMMUNITY BUILDING ACTIVITIES:Basic needs including food, security and housingProvidence Willamette Falls Medical Center recognizes that the social determination of health needs includes adequate housing, food, transportation, utilities and primary education. These deficits fall disproportionately on low-income and multicultural populations and therefore Providence has aligned its community building and diversity programs to intersect with and advise our community benefit giving. Oregon ranks first in homelessness per capita according to the U.S. Department of Housing and Urban Development. Lack of adequate housing contributes to poor health; therefore, Providence supports a number of not-for-profit organizations that help homeless people or work to prevent homelessness. Although Clackamas County has the highest per capita income in the state, it still has significant low income communities with sizable homelessness. Women and children are the most impacted in Clackamas. Providence Willamette Falls partners with organizations in multiple Canby, Estacada and Molalla that provide or support low-income housing. Some important partners include: Canby Cares, Compassion Connect, North Clackamas Community Center, Clackamas County Health Department and the Children's Center. Providence has been a leader in recognizing the significant impact of hunger on the health and well being of all residents in the state. Oregon ranks as one of the five \"hungriest states\" with nearly 50 percent of all school age children qualifying for free or reduced lunches. Providence works with the Oregon Food Bank, The Governor's Task Force to End Hunger and Farmers Ending Hunger as well as numerous food pantries in every ministry we serve. Economic DevelopmentEconomic development has an important impact on available housing and services for the underserved. An economically depressed area cannot easily support and care for the vulnerable. Providence looks for partnerships with like-minded organizations that will encourage a stable and strong economy. We participate in local and state organization in each of our ministries, as well as provide executive leadership to city, county and state boards. Leadership Development and Training for Community Members and Youth In this area, Providence has put a strong focus on diverse and low-income communities. For example, for some years we have provided scholarships for youth in multicultural and diverse populations, including Asian, African-American and Hispanic communities. Community partners include Milwaukie High School and the Gladstone School District. Building Health Equity and Community Inclusion Providence has long known that, while we can do a great deal to help our communities, we often can get the best results in meeting health needs, and those basic needs that contribute to or affect health, by aligning with other organizations that have an established presence and expertise. Throughout our history, we have sought like-minded partners with a mission to care for the vulnerable in the communities we serve. We continue to lead and support the Community Health Access and Improvement Council (CHAI). Community Health Improvement AdvocacyIn keeping with our strong commitment to social justice, Providence is an advocate for those among us who do not have a voice in policy development and community decision making. During 2010, we joined with Community Connections, Community Health Partnerships, Parish Health Promoters, the Foundation for Medical Excellence, Ecumenical Ministries of Oregon, Oregon Primary Care Association, NAMI, Office of Health Equity and Ride Connection, among others, to ensure that the needs of those we serve have been articulated to policy makers. We actively supported initiatives to improve provider cultural competence in care giving with required continuing education courses. Community Emergency Preparedness As part of a regional emergency preparedness initiative, the hospital was requested to put in the emergency water source to serve the larger community with a small portion for themselves. Providence Willamette Falls pursued a federal grant to cover part of the expense of the well that will serve the entire Oregon City community."},{"explanation":"Part III, Line 4: It is Providence's policy to exclude all bad debts from Community benefit information.The Audited Financial Statements do not contain a footnote specific to Bad Debt Expense.Bad debt expense is reported in the audited financials as a separate line item within expenses from operations. Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy."},{"explanation":"Part III, Line 8: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue."},{"explanation":"Part III, Line 9b: BILLING & COLLECTION PRACTICESProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient (or the patient's legal representative) seeking financial assistance from Providence provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals' own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service."},{"explanation":"Part III, Section A, Line 1The reporting entity reports bad debt expense in accordance with HFMA Statement #15 with the exception of the following sections: 8.1(b) and 9.1."},{"explanation":"Part I, Line 7, Col. fOur total expense from Form 990, Part IX, Line 25, column (A) was $97,013,878. The bad debt expense included in this amount was $5,128,345. This left us with total expense of $91,885,533 for purposes of calculating line 7, column f."},{"explanation":"Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care."},{"explanation":"Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients."},{"explanation":"Part VI, Line 4: COMMUNITY INFORMATION:Providence Willamette Falls Medical Center serves both urban and rural areas throughout a geographically large and diverse Clackamas County including a hospitals, limited physician clinics, and affiliated urgent health services. Providence Willamette Falls Medical Center is a full service community hospital with 143 licensed beds. Clackamas is one of three counties that make up the Portland metropolitan area. Located south of Portland, the county has experienced rapid population growth in recent years. Between 1990 and 2000, the population increased 21.35 percent. Clackamas County's 2010 population totals 375,992 and 48,830 households have income at or below 250 percent of the federal poverty level. This represents 40.9 percent of total households. Poverty levels for single parent households with children are high, at 21 percent.Within Clackamas County, Canby is a higher-needs community with a Community Needs Index score of 3.2 and 429 children and 3,067 singles with kids are living in poverty. Canby also has a higher than average rate of homeless children.All of our hospitals, clinics and other facilities are open to underserved populations and 20% of all emergency department cases were uninsured and 10% of all hospital admissions were uninsured. Nearly 39% of patients are private or other insurance; 37% receive Medicare and 11% Medicaid.In September 2010, Clackamas County unemployment was 9.6 percent; in September 2011, unemployment dropped only slightly to 9.0 percent, placing Clackamas County at the national average and better than the state overall. Between 2006 and 2010 overall community benefits have increased 61.6 percent at Providence ministries in Oregon."},{"explanation":"Part VI, Line 6: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet.Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care."},{"explanation":"Part VI, Line 7: AFFILIATED HEALTH SYSTEM:Providence Health & Services owns and operates 27 general acute care hospitals, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center and Montessori school, a high school, a university, 12 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 20 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California."},{"explanation":"WA,OR,CA,MT,AK"}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":188422,"reported_domestic_individual_grants":85951,"reported_domestic_org_grants_program_services":188422,"reported_domestic_individual_grants_program_services":85951,"total_501c3_and_government_organizations":3,"total_other_organizations":0,"grants":[{"ein":753027143,"irc_section":"501(c)(3)","noncash":148422,"purpose":"Donation of Property for Children's Center","noncash_description":"Donated Land","valuation_method":"Book","address_line1":"1713 Penn Lane","city":"Oregon City","state":"OR","zip":"97045","name":"Children's Center","address":"1713 Penn Lane, Oregon City, OR, 97045"},{"ein":383672046,"irc_section":"501(c)(3)","cash":10000,"purpose":"Donation in support of Clinic Program-Treatment of urgent medical problem for uninsured individuals","address_line1":"266 West Main MS68","city":"Hillsboro","state":"OR","zip":"97123","name":"Essential Health Clinic","address":"266 West Main MS68, Hillsboro, OR, 97123"},{"ein":208928388,"irc_section":"501(c)(3)","cash":30000,"purpose":"Support of care coordination efforts-Clackamas County","address_line1":"Po Box 10953","city":"Portland","state":"OR","zip":"97296","name":"Project Access NOW","address":"Po Box 10953, Portland, OR, 97296"}],"individual_grants":[{"type":"Scholarships to Nursing Students","recipient_count":7,"noncash":85951,"noncash_description":"Nursing Education Scholarships","valuation_method":"FMV"}],"total_domestic_grants":274373,"total_domestic_program_services":274373,"detail_org_grants_total":188422,"detail_individual_grants_total":85951,"detail_domestic_grants_total":274373,"supplemental_information":[{"identifier":"Procedure for Monitoring Grants in the U.S.:","form_and_line_reference":"Part I, Line 2:","explanation":"Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds are used. Scholarships are awarded on a competitive basis. Recipients must meet specified guidelines including GPA."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds are used. Scholarships are awarded on a competitive basis. Recipients must meet specified guidelines including GPA.","form_and_line_reference":"Part I, Line 2:"}},"ScheduleJ":{"benefits_and_procedures":{"first_class_or_charter_travel":true,"tax_indemnification_and_gross_up_payments":true,"discretionary_spending_account":true,"housing_allowance_or_residence":true,"substantiation_required":true,"written_policy_travel_and_entertainment":true},"compensation_process":{"compensation_committee":true,"independent_consultant":true,"written_employment_contract":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":true,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"John F Koster MD","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":1236674,"compensation_based_on_related_orgs":1073328,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":777729,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":16974,"other_compensation_filing_org":0,"other_compensation_related_orgs":36500,"total_compensation_filing_org":0,"total_compensation_related_orgs":3141205,"name":"John F Koster MD"},{"person_name":"Michael L 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Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approval by the VP, CHRO. During 2010, a total of four first-class tickets were purchased. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2010, the following Key Employees received gross-up payments: Russell Danielson Joel Gilbertson Orest Holubec Eugene \"Al\" Parrish Arnold R. Schaffer Myron Berdischewsky The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding \"rent\" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The vice president/chief human resources officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2010, the following Key Employees received relocation payments: Joel Gilbertson Orest Holubec Arnold R. Schaffer Myron Berdischewsky The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation."},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"NONQUALIFIED RETIREMENT PLANS A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DCSERP = Defined Contribution Supplemental Executive Retirement Plan C) DBCBRP = Defined Benefit Cash Balance Restoration Plan D) DCRP = Defined Contribution Restoration Plan E) ESP = Elective Survivor Plan F) SOP = Share Option Plan 1) John F. Koster, MD a) Taxable DBSERP Vested but not Paid - $736,499 b) DCSERP Earned - $756,501 2) Michael L. Butler a) DBSERP Earned but not Vested - $1,296 b) DCSERP Earned - $292,794 3) Jeffrey W. Rogers a) Taxable DBSERP Vested but not Paid - $697,854 b) Non-Taxable DBSERP Vested but not Paid - $ 283,728 c) DCSERP Earned - $44,923 d) ESP Interest Credit - $73,103 4) Russell Danielson a) Taxable DBSERP Paid - $ 3,315,890 b) Non-Taxable DBSERP Vested but not Paid - $74,603 c) DCSERP Earned - $217,379 d) ESP Interest Credit - $69,081 5) Gregory Van Pelt a) Taxable DBSERP Vested but not Paid - $ 1,308,937 b) Non-Taxable DBSERP Vested but not Paid - $248,979 c) DCSERP Earned - $89,556 d) ESP Interest Credit - $80,697 e) SOP Paid - $54,162 6) Arnold R. Schaffer a) Taxable DBSERP Vested but not Paid - $873,172 b) DCSERP Earned - $333,896 7) John V. Fletcher a) Taxable DBSERP Vested but not Paid - $ 484,554 b) Non-Taxable DBSERP Vested but not Paid - $20,519 c) DCSERP Earned - $474,635 d) ESP Interest Credit - $42,239 e) SOP Paid - $15,818 8) Janice J. Jones a) Taxable DBSERP Vested but not Paid - $ 299,823 b) Taxable DBCBRP Vested but not Paid - $ 64 c) DCSERP Earned - $303,348 c) SOP Paid - $15,749 9) Eugene \"Al\" Parrish a) Taxable DBSERP Vested but not Paid - $288,259 b) DCSERP Earned - $295,970 10) John O. Mudd a) Taxable DBSERP Vested but not Paid - $362,132 b) DCSERP Earned - $372,693 11) Keith Marton, MD a) DBSERP Earned but not Vested - $180 b) DCSERP Earned - $193,810 12) Myron Berdischewsky, MD a) DCSERP Earned - $222,924 13) Claudia Haglund a) Taxable DBSERP Vested but not Paid - $41,847 b) DCSERP Earned - $43,139 c) ESP Interest Credit - $20,878 d) SOP Paid - $ 14,583 14) Michael Hunn a) DBSERP Earned but not Vested - $324 b) DCSERP Earned - $141,373 15) Cindra R. Syverson a) DCSERP Earned - $78,225 16) Joel S. Gilbertson a) DCSERP Earned - $25,015 17) John Kenagy a) DBSERP Earned but not Vested - $324 b) DCSERP Earned - $108,023 18) David S. Brown a) DCSERP Earned - $70,731 19) Deborah Burton a) DBSERP Earned but not Vested - $300 b) DCSERP Earned - $135,764 20) Orest Holubec a) DCSERP Earned - $6,543 21) Gary K. Flaming a) DCSERP Earned - $15,811 22) David H. Hunter a) DBCBRP Earned but not Paid - $203 b) DCSERP Earned - $110,680 23) Patricia A. Roscoe a) DCSERP Earned - $38,038 24) Charles E. Hawley a) Taxable DBSERP Paid - $ 1,947,717 b) DCSERP Earned - $12,926 c) SOP Paid - $ 28,456 25) Michael J. Madden a) Taxable DBSERP Paid - $ 343,217 26) Thomas Johnson a) DCSERP Earned - $82,979 27) Richard J. Umbdenstock a) DBSERP Paid - $ 32,220 28) Terry L. Smith a) Taxable DBSERP Vested but not Paid - $ 101,805 b) Non-Taxable DBSERP Vested but not Paid - $ 65,519 c) Taxable DBCBRP Vested but not Paid - $ 278 d) DCSERP Earned - $ 120,876 e) ESP Interest Credit - $ 56,258 29) Russell Reinhard a) DCSERP Earned - $ 45,490 30) Shelly M. Handkins a) DCSERP Earned - $ 180,181 31) John T. Flanders a) DCRP Earned - $ 2,671 32) Timothy D. Blanchard a) DCRP Earned - $ 1,783 33) Ralph A. Juarez a) DCRP Earned - $ 4,727 34) Shawn M. Morgan a) DCRP Earned - $ 4,108 35) Robby J. Azar a) DCRP Earned - $ 3,867 36) Kevin R. Johnson a) DCRP Earned - $ 4,012"},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"SEVERANCE 1)Keith Marton, MD - $201,412 2)Thomas Johnson - $223,731"},{"form_and_line_reference":"Part III","explanation":"FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2010, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and quality focused. In 2010 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 10%. To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":930847114,"business_name_line1":"Hospital Facility Authority of Clackamas","cusip_number":"179027UM7","date_issued":"2005-05-24T00:00:00","issue_price":14968980,"purpose":"Current Refunding of 1993 Series; Hospital Expansion & Renovation","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"Hospital Facility Authority of Clackamas"}],"bond_proceeds":[{"total_proceeds":14968980,"gross_proceeds_in_reserve_funds":2032776,"issuance_costs_from_proceeds":299380,"capital_expenditures":7106780,"other_spent_proceeds":6475381,"substantial_completion_year":2006,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":true,"management_contract":false,"bond_counsel_routinely_engaged":true,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"business_name_line1":"John F Koster MD","relationship":"Officer","description":"Purchase of Supplies Through Cooperative on which Dr. Koster is a Director","amount":7320671,"sharing_of_revenues":false,"name":"John F Koster MD"}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":510216586,"business_name_line1":"Providence Health & Services - 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The popular Northwest Guide to Heart-Healthy Living was distributed. Free online heart attack risk assessments were offered. The Hospital also provided vascular health screenings. Community forums included presentations by Providence experts on caring for our hearts, as well as cooking demonstrations by Providence chefs. Providence Heart & Vascular Institute presented a community forum titled \"Heart Attack: What Do I Do Before and After\", discussing the treatment and prevention of heart attack and cardiovascular disease. A new program at Providence Willamette Falls Medical Center (PWFMC), Connections, includes a team of experts who assist patients and families develop a care plan to support them in the context of their life-changing illness. The consultation may include pain assessment, social and spiritual assessment, understanding of the illness, prognosis and treatment options and identification of patient-centered goals of care. When patients are diagnosed with life-changing conditions or illnesses, such as heart failure, dialysis, stroke or cancer, Providence Connections can help with their medical and emotional needs. Connections is a palliative care consultation service for inpatients and outpatients. It's designed to provide specialty level care for difficult-to-manage symptoms, complex family dynamics and challenging decisions about transitioning care settings.Providence Integrative Medicine physicians discussed food and exercise choices that affect breast cancer risk; whole foods and the Mediterranean-style diet; why good food choices (and not supplements) are your best bet for good health; and how acupuncture, massage and naturopathic medicine can reduce the side effects of cancer treatment. A free class \"Next Steps Against Cancer: Nutrition, Exercise and Natural Medicine to Reduce Risk, Enhance Survival and Improve Quality of Life,\" was offered at Providence Willamette Falls Medical Center.At the recent CleanMed 2011, a national meeting for health care organizations sharing sustainability best practices, Providence Willamette Falls Medical Center was recognized with Practice Greenhealth Environmental Excellence Awards (Partner for Change Award and Making Medicine Mercury-Free Award). Practice Greenhealth is a national membership association devoted to environmentally responsible health care by helping organizations reduce their environmental footprint.Providence Willamette Falls Hospice was the beneficiary of an $11,000 donation from the 23rd annual Oregon Cancer Ski-Out, March 2011. The event began as a way for the founder and a group of his friends to channel the sadness they felt after losing family members and friends to cancer. Oregon Cancer Ski-Out is a team-based ski race with a format that rewards consistency, not speed, making it possible for skiers and snowboarders of all abilities to participate. Since 1992, PWF Hospice has received more than $180,000 from the event.PWFMC supports the Power of Produce Club for children ages 5 to 12 at Oregon City Saturday Market. When children register for a \"Passport To Health,\" they receive a POP Club reusable shopping bag, a PWFMC pedometer to record their \"steps to health\" while shopping at the market, and $5 in wooden tokens to spend on fresh veggies, fruit and food plants for each visit to the market (while funding lasts). More than 400 new POP Club members registered at the first three days of the market. The pedometers help kids focus on exercise as well as nutrition.New software was installed at Providence Willamette Falls Medical Center to adopt two secure electronic systems in mid-August for viewing Providence Health & Services diagnostic images and patient medical records. The iSite system allows providers from other parts of the region to view images generated from PWFMC and Canby Diagnostic Imaging. Likewise, PWFMC providers will be able to view images from other Providence facilities. PWFMC also implemented Horizon Patient Folder, or HPF, a document management system for scanned and electronic medical record information. This is an easy-to-use system that stores patient records and provides access to scanned patient charts online within 24 hours of patient discharge.PWFMC presented \"Providence Diabetes Conference: Toolkit for Clinicians\". The event is geared to all practitioners, with presentations by Providence physicians, nurses, nutritionists, pharmacists and educators.A new oncology clinic opened October 2011. Providence Oncology and Hematology Care Clinic - Willamette Falls, part of Providence Cancer Center, serving patients with cancer and blood disorders. The chief oncologist and hematologist is joined by a team of specialty trained staff, including certified oncology nurses who help educate patients about their disease and treatment plan. The clinic offers a wide spectrum of testing and treatments to meet the needs of each patient, including chemotherapy and other infusion treatments. The clinic partners with PWFMC laboratory services to minimize patient wait times. New patients can be scheduled within 24 hours, and staff see that all needed follow up tests and treatments are arranged, including IV infusions, radiation therapy, physical therapy and other specialty care.Providence Willamette Falls Medical Center received a one-year grant from the Providence Willamette Falls Medical Foundation for a part-time certified music thanatologist to be at PWFMC on Tuesdays, Thursdays and every other Friday. Music-thanatology is a clinical discipline that addresses the physical and spiritual needs of those with a life-limiting illness. Symptoms such as pain and anxiety can be alleviated through live, prescriptive music of harp and voice at the bedside. The music is tailored to each patient's condition, even as it changes over time. 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The pedometers help kids focus on exercise as well as nutrition.New software was installed at Providence Willamette Falls Medical Center to adopt two secure electronic systems in mid-August for viewing Providence Health & Services diagnostic images and patient medical records. The iSite system allows providers from other parts of the region to view images generated from PWFMC and Canby Diagnostic Imaging. Likewise, PWFMC providers will be able to view images from other Providence facilities. PWFMC also implemented Horizon Patient Folder, or HPF, a document management system for scanned and electronic medical record information. This is an easy-to-use system that stores patient records and provides access to scanned patient charts online within 24 hours of patient discharge.PWFMC presented \"Providence Diabetes Conference: Toolkit for Clinicians\". 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Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":4763969,"bad_debt_expense_attributable_to_financial_assistance":0,"reimbursed_by_medicare":23743000,"cost_of_care_reimbursed_by_medicare":31710000,"medicare_surplus_or_shortfall":-7967000,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":3977000,"net_community_benefit_expense":3977000,"total_expense_percentage":0.0419},"unreimbursed_medicaid":{"total_community_benefit_expense":11060000,"direct_offsetting_revenue":4999000,"net_community_benefit_expense":6061000,"total_expense_percentage":0.0638},"total_financial_assistance":{"total_community_benefit_expense":15037000,"direct_offsetting_revenue":4999000,"net_community_benefit_expense":10038000,"total_expense_percentage":0.1057},"subsidized_health_services":{"total_community_benefit_expense":33936,"net_community_benefit_expense":33936,"total_expense_percentage":0.0004},"total_other_benefits":{"total_community_benefit_expense":33936,"net_community_benefit_expense":33936,"total_expense_percentage":0.0004},"total_community_benefits":{"total_community_benefit_expense":15070936,"direct_offsetting_revenue":4999000,"net_community_benefit_expense":10071936,"total_expense_percentage":0.1061}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Providence Willamette Falls Med Ctr","address_line1":"1500 Division Street","city":"Oregon City","state":"OR","zip":"97045","licensed_hospital":true,"emergency_room_24_hours":true,"name":"Providence Willamette Falls Med Ctr","address":"1500 Division Street, Oregon City, OR, 97045"}],"facility_policies":[{"business_name_line1":"Providence Willamette Falls Med Ctr","facility_number":1,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_family_income_limit_discounted_care_percentage":400.0,"fpg_used_determine_discounted_care":true,"income_level_criteria":true,"asset_level_criteria":true,"medical_indigency_criteria":true,"insurance_status_criteria":true,"basis_explained":true,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"other_publicity":true,"fap_actions_on_nonpayment":true,"posted_in_admission_office":true,"posted_in_emergency_room":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"medicaid_medicare":true,"state_regulation":true,"uninsured_discount":true,"amounts_generally_billed":false,"gross_charges":true,"name":"Providence Willamette Falls Med Ctr"}],"other_health_care_facility_count":5,"other_health_care_facilities":[{"business_name_line1":"Providence Willamette Falls Hospice","address_line1":"1505 Division Street","city":"Oregon City","state":"OR","zip":"97045","facility_type":"Hospice Services","name":"Providence Willamette Falls Hospice","address":"1505 Division Street, Oregon City, OR, 97045"},{"business_name_line1":"Providence WF - Canby Plaza","address_line1":"200 S Hazel Dell Way","city":"Canby","state":"OR","zip":"97013","facility_type":"Urgent Care & Diagnostics Imaging Services","name":"Providence WF - Canby Plaza","address":"200 S Hazel Dell Way, Canby, OR, 97013"},{"business_name_line1":"Providence WF MedGroup-Sunnyside","address_line1":"9775 SE Sunnyside Rd","city":"Clackamas","state":"OR","zip":"97015","facility_type":"Primary Care & Occupational Health","name":"Providence WF MedGroup-Sunnyside","address":"9775 SE Sunnyside Rd, Clackamas, OR, 97015"},{"business_name_line1":"Providence WF Med Group-OR City","address_line1":"1510 Division Street","city":"Oregon City","state":"OR","zip":"97045","facility_type":"Primary Care Spine Center & General Surgery","name":"Providence WF Med Group-OR City","address":"1510 Division Street, Oregon City, OR, 97045"},{"business_name_line1":"Providence WF Med Group-West Linn","address_line1":"18676 Willamette Dr Suite 100","city":"West Linn","state":"OR","zip":"97068","facility_type":"Primary Care","name":"Providence WF Med Group-West Linn","address":"18676 Willamette Dr Suite 100, West Linn, OR, 97068"}],"supplemental_information":[{"explanation":"Part I, Line 6a: Although Willamette Falls Hospital dba Providence Willamette Falls Medical Center (PWFMC) is part of the Providence Oregon Region and the report is prepared by Providence Health & Services - OR, there is a separate community benefit report for PWFMC."},{"explanation":"Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 4763969."},{"explanation":"Part II: COMMUNITY BUILDING ACTIVITIES:Basic needs including food, security and housing.Although no Community Building activities were tracked during 2011, Providence Willamette Falls Medical Center recognizes that the social determination of health needs includes adequate housing, food, transportation, utilities and primary education. These deficits fall disproportionately on low-income and multicultural populations and therefore Providence has aligned its community building and diversity programs to intersect with and advise our community benefit giving. Oregon ranks first in homelessness per capita according to the U.S. Department of Housing and Urban Development. Lack of adequate housing contributes to poor health; therefore, Providence supports a number of not-for-profit organizations that help homeless people or work to prevent homelessness. Although Clackamas County has the highest per capita income in the state, it still has significant low income communities with sizable homelessness. Women and children are the most impacted in Clackamas. Providence Willamette Falls partners with organizations in multiple Canby, Estacada and Molalla that provide or support low-income housing. Some important partners include: Canby Cares, Compassion Connect, North Clackamas Community Center, Clackamas County Health Department and the Children's Center. Providence has been a leader in recognizing the significant impact of hunger on the health and well being of all residents in the state. Oregon ranks as one of the five \"hungriest states\" with nearly 50 percent of all school age children qualifying for free or reduced lunches. Providence works with the Oregon Food Bank, The Governor's Task Force to End Hunger and Farmer's Ending Hunger as well as numerous food pantries in every ministry we serve. Economic DevelopmentEconomic development has an important impact on available housing and services for the underserved. An economically depressed area cannot easily support and care for the vulnerable. Providence looks for partnerships with like-minded organizations that will encourage a stable and strong economy. We participate in local and state organization in each of our ministries, as well as provide executive leadership to city, county and state boards. Leadership Development and Training for Community Members and Youth In this area, Providence has put a strong focus on diverse and low-income communities. For example, for some years we have provided scholarships for youth in multicultural and diverse populations, including Asian, African-American and Hispanic communities. Community partners include Milwaukie High School and the Gladstone School District. Building Health Equity and Community Inclusion Providence has long known that, while we can do a great deal to help our communities, we often can get the best results in meeting health needs, and those basic needs that contribute to or affect health, by aligning with other organizations that have an established presence and expertise. Throughout our history, we have sought like-minded partners with a mission to care for the vulnerable in the communities we serve. We continue to lead and support the Community Health Access and Improvement Council (CHAI). Community Health Improvement AdvocacyIn keeping with our strong commitment to social justice, Providence is an advocate for those among us who do not have a voice in policy development and community decision making. We joined with Community Connections, Community Health Partnerships, Parish Health Promoters, the Foundation for Medical Excellence, Ecumenical Ministries of Oregon, Oregon Primary Care Association, NAMI, Office of Health Equity and Ride Connection, among others, to ensure that the needs of those we serve have been articulated to policy makers. We actively supported initiatives to improve provider cultural competence in care giving with required continuing education courses. Community Emergency Preparedness As part of a regional emergency preparedness initiative, the hospital was requested to put in the emergency water source to serve the larger community with a small portion for themselves. Providence Willamette Falls pursued a federal grant to cover part of the expense of the well that will serve the entire Oregon City community."},{"explanation":"Part III, Line 4: Bad Debt expense consists of actual write off of accounts sent to collection, recovery of collections and an estimated amount based on outstanding AR. The charity policy states that Providence makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment. In regards to outstanding AR for Providence Willamette Falls Medical Center:1. The process takes into account the adjustments and payments that have already occurred. The process then valuates the responsibility based on the net AR balance.2. Historical write off percentages are applied.3. The Bad Debt is based on Self Insured and Uninsured balances at the financial class (payer) level.4. PWFMC is in a transitional period since they are not on the same AR patient accounting system as the rest of the Providence Oregon Region.5. The audited Financial Statement does not contain a footnote specific to Bad Debt expense."},{"explanation":"Part III, Line 9b: BILLING & COLLECTION PRACTICESProvidence has written policies about when and under whose authority patient debt is advanced for collection and uses its best efforts to ensure that patient accounts are processed fairly and consistently. Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital. When sending a bill to a patient, Providence includes:A) A statement that indicates that if the patient meets certain income requirements that the patient may be eligible for a government-sponsored program or for financial assistance from the hospital.B) A statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient asking for financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (ie: income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs. For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service."},{"explanation":"Part V, Section B, Line 13g: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office."},{"explanation":"Part V, Section B, Line 19d: Charges are based on full billed charges and the uninsured discount is taken and then Financial Assistance off the full billed charges."},{"explanation":"Part V, Section B, Line 21: When services are deemed \"medically unnecessary\", a patient would be charged normal charges."},{"explanation":"Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care."},{"explanation":"Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients."},{"explanation":"Part VI, Line 4: COMMUNITY INFORMATION:Providence Willamette Falls Medical Center serves both urban and rural areas throughout a geographically large and diverse Clackamas County including a hospital, limited physician clinics and affiliated urgent health services. Providence Willamette Falls Medical Center is a full service community hospital with 143 licensed beds. Clackamas is one of three counties that make up the Portland metropolitan area. Located south of Portland, the county has experienced rapid population growth in recent years. Between 1990 and 2000, the population increased more than 21%. Clackamas County's 2011 population totals 380,207, with 9% of the population living at or below the federal poverty guidelines. Children, as in most communities, are disproportionately impacted by poverty, with 21% of all children in Clackamas living at or below the federal poverty guidelines. Within Clackamas County, Mollalla and North Clackamas are higher-needs communities, with Community Needs Index scores of 3.4. Approximately 16% of the residents of Clackamas County are from communities of color and 11% of all households report English as a second language in the home. All of our hospitals, clinics and other facilities are open to underserved populations and 20% of all emergency department cases were uninsured and 10% of all hospital admissions were uninsured. Nearly 39% of patients are private or other insurance; 37% receive Medicare and 11% Medicaid.Personal and family income in Clackamas County is the highest in the state with an average family income of $62,007 and an unemployment rate of 8.2% in 2011."},{"explanation":"Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.In each of the communities where we serve, our ministries are actively involved with public, private and other health systems in working towards better health outcomes for the entire community. Examples of this include: participation by all Portland area hospitals and four county health departments in Project Access NOW. Working as a founder and ongoing partner, Providence facilities represent four of 14 participating hospitals and 3,300 providers who agree to provide needed medical care to Oregon community members who have low incomes and urgent needs. The stated goal of Project Access NOW is to become the recognized source for care for all low income uninsured in the metro community. Providence's participation and support helps to ensure that this is achievable and has expanded to found a like organization in Hood River called Gorge Access Project (GAP). Another example from Hood River County, where Providence Hood River hosts the county's community health collaborative, MOCHA, which brings together the hospital, the schools, the growers, the public health department, community health center and private providers to identify and work on community health needs in a collaborative manner."},{"explanation":"Part VI, Line 6: AFFILIATED HEALTH SYSTEM:Providence Health & Services owns and operates 27 general acute care hospitals, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center and Montessori school, a high school, a university, 12 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 20 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for those who are poor and vulnerable, Providence has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. As a part of the integrated health system, Providence Health & Services - Oregon Region and Providence Health Plans (based in Oregon), Providence Willamette Falls Medical Center provides extensive services that support and promote the health needs of the communities we serve. In particular, the Providence Willamette Falls Community Education Facility provides meeting space for many community agencies and is at full capacity use by community groups.Throughout its more than 155-year-history, Providence has responded to community need, with special emphasis on helping the most vulnerable. Thousands of adults and children received help and support through these grants, donations and community outreach. Our areas of focus include primary care and new models of team-based care delivery for uninsured, low-income and culturally diverse populations, as well as access to behavioral health care for underserved populations. We also help provide palliative care and safety net health care services for underserved populations.Providence in Oregon collaborates with community partners to help manage the cost of health care and change the way patients are cared for in our community. We believe patient-centered, team-based primary care is the foundation of health care transformation. Disparities are a feature of health care in Oregon as they are nationally. Providence's integrated delivery of care in Oregon allows us to provide leadership in developing new clinical models to coordinate care, standardize processes and improve patient outcomes. Providence is developing new patient centered primary care home models of health care delivery in Portland using employed physicians in partnership with Providence Health Plans, other commercial insurers and the Medicaid population. We currently have medical home models in 19 sites throughout the state. Many of these sites are targeted at underserved and high risk populations. Within Oregon, Providence has been an active participant in shaping the transformation of the state's health care system. Providence leaders were selected by the governor to participate in workshops that will help define the details of coordinated care organizations and make additional recommendations to the 2012 legislative session. 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Danielson","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":108402,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":0,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":124987,"total_compensation_filing_org":0,"total_compensation_related_orgs":233389,"name":"Russell Danielson"}],"supplemental_information":[{"form_and_line_reference":"Part I, Line 1a","explanation":"The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approval by the VP/Chief Human Resources Officer. During 2011, a total of three first-class tickets were purchased for disclosed personnel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employees behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executives Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2011, the following Key Employees received gross-up payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding \"rent\" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The VP/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2011, the following Key Employees received relocation payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation."},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"NONQUALIFIED RETIREMENT PLANS A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DCSERP = Defined Contribution Supplemental Executive Retirement Plan C) DBCBRP = Defined Benefit Cash Balance Restoration Plan D) DCRP = Defined Contribution Restoration Plan E) ESP = Elective Survivor Plan F) SOP = Share Option Plan 1) John F. Koster, MD a) Taxable DBSERP Earned but not Paid- $3,063,813 b) Non-Taxable DBSERP Earned but not Paid - $781,587 c) Non-Taxable DCSERP Earned - $339,126 d) DBSERP Interest Credit - $439,580 2) Jeffrey W. Rogers a) Taxable DBSERP Earned but not Paid - $1,005,741 b) Non-Taxable DBSERP Earned but not Paid - $135,144 c) Taxable DCSERP Earned but not Paid - $8,561 d) Non-Taxable DCSERP Earned - $48,099 e) ESP Interest Credit - $79,952 f) DBSERP Interest Credit - $202,199 3) Todd Hofheins a) Non-Taxable DCRP Earned - $9,603 4) Gregory Van Pelt a) Taxable DBSERP Earned but not Paid - $ 2,008,828 b) Non-Taxable DBSERP Earned but not Paid - $185,993 c) Taxable DCSERP Earned but not Paid - $276,749 d) Non-Taxable DCSERP Earned - $292,233 e) ESP Interest Credit - $88,256 f) DBSERP Interest Credit - $319,032 5) Terry L. Smith a) Taxable DBSERP Earned but not Paid - $2,293,039 b) Non-Taxable DBSERP Earned but not Paid - $236,604 c) Taxable DCSERP Earned but not Paid - $21,722 d) Taxable DBCBRP Earned - $400 e) Non-Taxable DCSERP Earned - $69,165 f) ESP Interest Credit - $61,528 g) DBSERP Interest Credit - $231,388 6) Janice J. Jones a) Taxable DBSERP Earned but not Paid - $ 1,844,829 b) Non-Taxable DBSERP Earned but not Paid - $189,772 c) Taxable DBCBRP Earned but not Paid - $ 142 d) Non-Taxable DCSERP Earned - $154,703 e) SOP Paid - $29,819 f) DBSERP Interest Credit - $184,939 7) Arnold R. Schaffer a) Taxable DBSERP Earned but not Paid - $750,268 b) Non-Taxable DBSERP Earned but not Paid - $33,694 c) Taxable DCSERP Earned but not Paid - $832,896 d) Non-Taxable DCSERP Earned - $630,732 e) DBSERP Interest Credit - $82,122 8) Claudia Haglund a) Taxable DBSERP Earned but not Paid - $1,339,590 b) Non-Taxable DBSERP Earned but not Paid - $195,498 c) Taxable DCSERP Earned but not Paid - $29,245 d) Non-Taxable DCSERP Earned - $37,706 e) ESP Interest Credit - $22,834 f) SOP Paid - $ 69,768 g) DBSERP Interest Credit - $141,491 9) John V. Fletcher a) Taxable DBSERP Earned but not Paid - $648,808 b) Non-Taxable DBSERP Earned but not Paid - $52,905 c) Taxable DCSERP Earned but not Paid - $290,961 d) Non-Taxable DCSERP Earned - $388,497 e) ESP Interest Credit - $46,196 f) SOP Paid - $104,155 g) DBSERP Interest Credit - $86,372 10) Michael Hunn a) Taxable DBSERP Earned but not Paid - $327,914 b) Taxable DCSERP Earned but not Paid - $370,385 c) Non-Taxable DCSERP Earned - $216,958 d) DBSERP Interest Credit - $20,014 11) Michael L. Butler a) Non-Taxable DCSERP Earned - $435,962 b) DBSERP Interest Credit - $95,665 12) Eugene \"Al\" Parrish a) Taxable DBSERP Earned but not Paid - $346,852 b) Non-Taxable DBSERP Earned but not Paid - $268,971 c) Non-Taxable DCSERP Earned - $56,382 d) DBSERP Interest Credit - $128,312 13) John O. Mudd a) Taxable DBSERP Earned but not Paid - $226,235 b) Non-Taxable DBSERP Earned but not Paid - $71,542 c) Taxable DCSERP Earned but not Paid - $125,304 d) Non-Taxable DCSERP Earned - $254,702 e) DBSERP Interest Credit - $53,501 14) Andrew Agwunobi, MD a) Non-Taxable DCSERP Earned - $158,816 b) DBSERP Interest Credit - $8,147 15) Myron Berdischewsky, MD a) Non-Taxable DCSERP Earned - $404,844 b) DBSERP Interest Credit - $12,137 16) Craig L. Wright, MD a) Non-Taxable DCSERP Earned - $199,302 b) DBSERP Interest Credit - $38,604 17) Bruce Lamoureux a) Taxable DBCBRP Earned - $518 b) Non-Taxable DCSERP Earned - $166,650 c) DBSERP Interest Credit - $22,275 18) Medrice Coluccio a) Non-Taxable DCSERP Earned - $344,898 b) DBSERP Interest Credit - $4,529 19) David T. Brooks a) Non-Taxable DCSERP Earned - $149,660 b) DBSERP Interest Credit - $21,641 20) Cindra R. Syverson a) Non-Taxable DCSERP Earned - $130,173 b) DBSERP Interest Credit - $14,305 21) Joel S. Gilbertson a) Non-Taxable DCSERP Earned - $48,086 22) David S. Brown a) Non-Taxable DCSERP Earned - $74,666 23) Orest Holubec a) Non-Taxable DCSERP Earned - $9,236 24) Keith Marton, MD a) Taxable DBSERP Earned but not Paid - $501,372 b) Taxable DCSERP Earned but not Paid - $284,714 c) Non-Taxable DCSERP Earned - $114,423 d) DBSERP Interest Credit - $30,600 25) Russell Danielson a) Taxable DBSERP Paid - $ 108,402 b) ESP Paid - $57,407 26) Shelly M. Handkins a) Non-Taxable DCSERP Earned - $204,337 27) Russell Reinhard a) DBSERP Interest Credit - $1,562 b) Non-Taxable DCSERP Earned - $130,515 28) John T. Flanders a) Taxable DBCBRP Earned but not Paid - $2,671"},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"SEVERANCE 1) Keith Marton, MD - $428,716"},{"form_and_line_reference":"Part III","explanation":"FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2011, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and quality focused. In 2011 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 10%. To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"business_name_line1":"John F Koster MD","relationship":"Officer","description":"Purchase of Supplies Through Cooperative on which Dr. Koster is a Director","amount":6639118,"sharing_of_revenues":false,"name":"John F Koster MD"}]},"ScheduleN":{"termination_or_liquidation":{"assets_distributed":true,"liabilities_paid":true,"bonds_outstanding":true,"bond_liabilities_discharged":true,"required_to_notify_attorney_general":true,"attorney_general_notified":true},"successor_relationships":{"director_of_successor":true,"employee_of_successor":true,"owner_of_successor":false},"liquidations":[{"business_name_line1":"PH&S - Oregon","ein":510216587,"irc_section":"501(c)(3)","distribution_date":"2011-12-31T00:00:00","description":"All Assets and Liabilities","fair_market_value":9606144,"method_of_fmv_determination":"Book Value at December 31, 2011","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"98057","name":"PH&S - Oregon","address":"1801 Lind Avenue SW 9016, Renton, WA, 98057"}],"supplemental_information":[{"explanation":"Part I, Line 2e: All employees of Willamette Falls Hospital"},{"explanation":"Part I, Line 2e: Board of Directors"},{"explanation":"Part I, Line 2e: Became employees of Providence Health & Services - Oregon"},{"explanation":"Part I, Line 2e: Same governing body for PH & S - Oregon."},{"explanation":"Part I, Line 7c: Tax-exempt bonds [$22,355,000 Oregon Facilities Authority Revenue Bonds, Series 2011C (Providence Health & Services)] were issued on November 17, 2011. The proceeds were used to fund a defeasance escrow invested in SLGs to redeem the defeased bonds at their earliest eligible call dates."}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":510216586,"business_name_line1":"Providence Health & Services - Washington","primary_activities":"Healthcare System","exempt_code_section":"501( c)(3)","public_charity_status":"Line 3","controlled_organization":false,"legal_domicile_state":"WA","direct_controlling_business_name_line1":"Providence Health & Services","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"980579016","name":"Providence Health & Services - Washington","address":"1801 Lind Avenue SW 9016, Renton, WA, 980579016"},{"ein":510216587,"business_name_line1":"Providence Health & Services - Oregon","primary_activities":"Healthcare System","exempt_code_section":"501( c)(3)","public_charity_status":"Line 3","controlled_organization":false,"legal_domicile_state":"OR","direct_controlling_business_name_line1":"Providence Health & Services","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"980579016","name":"Providence Health & Services - 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Outpatient: Acute Outpatients Visits - 158,266ER Visits - 26,114OP Surgeries - 3,565In February-American Heart Month- Providence Heart and Vascular Institute offered free community forums. The popular Northwest Guide to Heart-Healthy Living was distributed. Free online heart attack risk assessments were offered. The Hospital also provided vascular health screenings. Community forums included presentations by Providence experts on caring for our hearts, as well as cooking demonstrations by Providence chefs. Providence Heart & Vascular Institute presented a community forum titled \"Heart Attack: What Do I Do Before and After\", discussing the treatment and prevention of heart attack and cardiovascular disease. A new program at Providence Willamette Falls Medical Center (PWFMC), Connections, includes a team of experts who assist patients and families develop a care plan to support them in the context of their life-changing illness. The consultation may include pain assessment, social and spiritual assessment, understanding of the illness, prognosis and treatment options and identification of patient-centered goals of care. When patients are diagnosed with life-changing conditions or illnesses, such as heart failure, dialysis, stroke or cancer, Providence Connections can help with their medical and emotional needs. Connections is a palliative care consultation service for inpatients and outpatients. It's designed to provide specialty level care for difficult-to-manage symptoms, complex family dynamics and challenging decisions about transitioning care settings.Providence Integrative Medicine physicians discussed food and exercise choices that affect breast cancer risk; whole foods and the Mediterranean-style diet; why good food choices (and not supplements) are your best bet for good health; and how acupuncture, massage and naturopathic medicine can reduce the side effects of cancer treatment. A free class \"Next Steps Against Cancer: Nutrition, Exercise and Natural Medicine to Reduce Risk, Enhance Survival and Improve Quality of Life,\" was offered at Providence Willamette Falls Medical Center.At the recent CleanMed 2011, a national meeting for health care organizations sharing sustainability best practices, Providence Willamette Falls Medical Center was recognized with Practice Greenhealth Environmental Excellence Awards (Partner for Change Award and Making Medicine Mercury-Free Award). Practice Greenhealth is a national membership association devoted to environmentally responsible health care by helping organizations reduce their environmental footprint.Providence Willamette Falls Hospice was the beneficiary of an $11,000 donation from the 23rd annual Oregon Cancer Ski-Out, March 2011. The event began as a way for the founder and a group of his friends to channel the sadness they felt after losing family members and friends to cancer. Oregon Cancer Ski-Out is a team-based ski race with a format that rewards consistency, not speed, making it possible for skiers and snowboarders of all abilities to participate. Since 1992, PWF Hospice has received more than $180,000 from the event.PWFMC supports the Power of Produce Club for children ages 5 to 12 at Oregon City Saturday Market. When children register for a \"Passport To Health,\" they receive a POP Club reusable shopping bag, a PWFMC pedometer to record their \"steps to health\" while shopping at the market, and $5 in wooden tokens to spend on fresh veggies, fruit and food plants for each visit to the market (while funding lasts). More than 400 new POP Club members registered at the first three days of the market. The pedometers help kids focus on exercise as well as nutrition.New software was installed at Providence Willamette Falls Medical Center to adopt two secure electronic systems in mid-August for viewing Providence Health & Services diagnostic images and patient medical records. The iSite system allows providers from other parts of the region to view images generated from PWFMC and Canby Diagnostic Imaging. Likewise, PWFMC providers will be able to view images from other Providence facilities. PWFMC also implemented Horizon Patient Folder, or HPF, a document management system for scanned and electronic medical record information. This is an easy-to-use system that stores patient records and provides access to scanned patient charts online within 24 hours of patient discharge.PWFMC presented \"Providence Diabetes Conference: Toolkit for Clinicians\". The event is geared to all practitioners, with presentations by Providence physicians, nurses, nutritionists, pharmacists and educators.A new oncology clinic opened October 2011. Providence Oncology and Hematology Care Clinic - Willamette Falls, part of Providence Cancer Center, serving patients with cancer and blood disorders. The chief oncologist and hematologist is joined by a team of specialty trained staff, including certified oncology nurses who help educate patients about their disease and treatment plan. The clinic offers a wide spectrum of testing and treatments to meet the needs of each patient, including chemotherapy and other infusion treatments. The clinic partners with PWFMC laboratory services to minimize patient wait times. New patients can be scheduled within 24 hours, and staff see that all needed follow up tests and treatments are arranged, including IV infusions, radiation therapy, physical therapy and other specialty care.Providence Willamette Falls Medical Center received a one-year grant from the Providence Willamette Falls Medical Foundation for a part-time certified music thanatologist to be at PWFMC on Tuesdays, Thursdays and every other Friday. Music-thanatology is a clinical discipline that addresses the physical and spiritual needs of those with a life-limiting illness. Symptoms such as pain and anxiety can be alleviated through live, prescriptive music of harp and voice at the bedside. The music is tailored to each patient's condition, even as it changes over time. While the main focus will be on end-of-life care, music thanatology also can be used to support and comfort any patient.Providence Willamette Falls Medical center opened a new Rehab clinic, October 2011, at Providence Canby Medical Plaza. Services include physical therapy, occupational therapy, sports therapy and hand therapy. As the only clinic in Canby to offer hand therapy, the clinic will care for patients with a variety of needs, including post-op hand surgery, work injuries, tendon lacerations, carpal tunnel syndrome, tennis elbow, arthritis and customized hand splints.The March of Dimes Greater Oregon Chapter presented its first annual Nurse of the Year awards in 14 categories, with three Providence nurses among the recipients. The Nurse of the Year program was created to honor Oregon nurses for their care and compassion for patients. The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. The agency supports research, provides education and advocates for health coverage for all pregnant women and children. It also supports medical screening of newborns to save lives and prevent disability.Providence Willamette Falls Medical Center has joined the Providence Telestroke Network, December 2011, to provide after-hours access to acute stroke care experts. Through an Internet video connection, the network allows stroke neurologists from Providence Brain and Spine Institute to be in the room with PWFMC emergency physicians. The neurologists can review patient records and diagnostic results, remotely conduct an examination and consult with on-site clinicians to help determine the best treatment. Telestroke complements the hospital's interdisciplinary stroke program, which includes daytime physician coverage from hospitalists, rehabilitation services and discharge planning from Oregon Neurology, PC. With the assistance of Providence Telestroke Network, our hospital is able to care for most stroke patients right here, close to home.\n\nAcute Care - Inpatient: Admissions - 4,275Patient Days - 12,075IP Sugeries - 1,299Deliveries - 991\n\nLong-Term Care, Homecare, Hospice, Housing & Assisted Living:Hospice Days - 40,178\n\nPrimary Care\n\nGrants and allocations to community organizations - see Schedule I","year":2011,"name":"WILLAMETTE FALLS HOSPITAL","phone":"5036561631","website":"www2.providence.org/oregon/facilities/hospitals","type":"990","principal_officer":"John F Koster MD","year_formation":1954,"state_legal_domicile":"OR","total_volunteers":293,"tax_period_begin":"2011-01-01T00:00:00","tax_period_end":"2011-12-31T00:00:00","address":"1500 DIVISION STREET, OREGON CITY, OR, 970451527, USA","city":"OREGON CITY","state":"OR","country":"USA","zip_code":"970451527"},"Governance":{"501c3 determination":true,"Number of voting members":13,"Number of independent voting members":13,"Number of employees total":0,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":0,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":false,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":true,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":true,"Independent audit financial statements":false,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":93592496,"Contributions":{"value":90325,"Related organizations":90325},"Program revenue":{"value":90689499,"Total revenue":{"value":90689499,"VARIOUS":90689499},"Unrelated business revenue":0},"Investment income":{"value":934787,"Investment income total":674914,"Net investment gain":259873},"Other revenues":{"value":1877885,"Other total":1316954,"Net rental income":560931}},"Expenses":{"value":99756626,"Grant expense":{"value":13137,"Grants to domestic orgs":13137},"Total professional fundraising expense":{"value":0},"Benefits paid to members":{"value":0},"Salaries":{"value":49520713,"Current officers":854779,"Other salaries and wages":36040464,"Pension plan contributions":3176183,"Other employee benefits":6172701,"Payroll taxes":3276586},"Other expenses":{"value":50222776,"Legal":36182,"Lobbying services":5913,"Investment management fees":26635,"Other services":7701725,"Advertising":24775,"Office expenses":3312602,"Information technology":1741829,"Occupancy":1856005,"Travel":164181,"Conferences and meetings":74374,"Interest":1540194,"Payments to affiliates":6187911,"Depreciation and depletion":5795612,"Insurance":575000,"Itemized Expenses":{"value":20487030,"VARIOUS":20487030},"All other expenses":692808}},"Assets":{"value":0,"Non-interest bearing cash":0,"Savings and temp cash investments":0,"Pledges and grants receivable":0,"Accounts receivable":0,"Receivables from officers":0,"Receivables from disqual persons":0,"Other net note and loans":0,"Inventories for sale or use":0,"Prepaid expenses deferred charges":0,"Land, building, equipment":0,"Investments publicly traded":0,"Investments other":0,"Investments program related":0,"Intangible assets":0,"Other assets":0},"Liabilities":{"value":0,"Accounts payable, accrued":0,"Deferred, revenue":0,"Tax exempt bond liabilities":0,"Other liabilities":0},"Fund balance":{"value":0},"Form990Details":{"program_service_accomplishments":[{"description":"Acute Care - Outpatient: Acute Outpatients Visits - 158,266ER Visits - 26,114OP Surgeries - 3,565In February-American Heart Month- Providence Heart and Vascular Institute offered free community forums. The popular Northwest Guide to Heart-Healthy Living was distributed. Free online heart attack risk assessments were offered. The Hospital also provided vascular health screenings. Community forums included presentations by Providence experts on caring for our hearts, as well as cooking demonstrations by Providence chefs. Providence Heart & Vascular Institute presented a community forum titled \"Heart Attack: What Do I Do Before and After\", discussing the treatment and prevention of heart attack and cardiovascular disease. A new program at Providence Willamette Falls Medical Center (PWFMC), Connections, includes a team of experts who assist patients and families develop a care plan to support them in the context of their life-changing illness. The consultation may include pain assessment, social and spiritual assessment, understanding of the illness, prognosis and treatment options and identification of patient-centered goals of care. When patients are diagnosed with life-changing conditions or illnesses, such as heart failure, dialysis, stroke or cancer, Providence Connections can help with their medical and emotional needs. Connections is a palliative care consultation service for inpatients and outpatients. It's designed to provide specialty level care for difficult-to-manage symptoms, complex family dynamics and challenging decisions about transitioning care settings.Providence Integrative Medicine physicians discussed food and exercise choices that affect breast cancer risk; whole foods and the Mediterranean-style diet; why good food choices (and not supplements) are your best bet for good health; and how acupuncture, massage and naturopathic medicine can reduce the side effects of cancer treatment. A free class \"Next Steps Against Cancer: Nutrition, Exercise and Natural Medicine to Reduce Risk, Enhance Survival and Improve Quality of Life,\" was offered at Providence Willamette Falls Medical Center.At the recent CleanMed 2011, a national meeting for health care organizations sharing sustainability best practices, Providence Willamette Falls Medical Center was recognized with Practice Greenhealth Environmental Excellence Awards (Partner for Change Award and Making Medicine Mercury-Free Award). Practice Greenhealth is a national membership association devoted to environmentally responsible health care by helping organizations reduce their environmental footprint.Providence Willamette Falls Hospice was the beneficiary of an $11,000 donation from the 23rd annual Oregon Cancer Ski-Out, March 2011. The event began as a way for the founder and a group of his friends to channel the sadness they felt after losing family members and friends to cancer. Oregon Cancer Ski-Out is a team-based ski race with a format that rewards consistency, not speed, making it possible for skiers and snowboarders of all abilities to participate. Since 1992, PWF Hospice has received more than $180,000 from the event.PWFMC supports the Power of Produce Club for children ages 5 to 12 at Oregon City Saturday Market. When children register for a \"Passport To Health,\" they receive a POP Club reusable shopping bag, a PWFMC pedometer to record their \"steps to health\" while shopping at the market, and $5 in wooden tokens to spend on fresh veggies, fruit and food plants for each visit to the market (while funding lasts). More than 400 new POP Club members registered at the first three days of the market. The pedometers help kids focus on exercise as well as nutrition.New software was installed at Providence Willamette Falls Medical Center to adopt two secure electronic systems in mid-August for viewing Providence Health & Services diagnostic images and patient medical records. The iSite system allows providers from other parts of the region to view images generated from PWFMC and Canby Diagnostic Imaging. Likewise, PWFMC providers will be able to view images from other Providence facilities. PWFMC also implemented Horizon Patient Folder, or HPF, a document management system for scanned and electronic medical record information. This is an easy-to-use system that stores patient records and provides access to scanned patient charts online within 24 hours of patient discharge.PWFMC presented \"Providence Diabetes Conference: Toolkit for Clinicians\". The event is geared to all practitioners, with presentations by Providence physicians, nurses, nutritionists, pharmacists and educators.A new oncology clinic opened October 2011. Providence Oncology and Hematology Care Clinic - Willamette Falls, part of Providence Cancer Center, serving patients with cancer and blood disorders. The chief oncologist and hematologist is joined by a team of specialty trained staff, including certified oncology nurses who help educate patients about their disease and treatment plan. The clinic offers a wide spectrum of testing and treatments to meet the needs of each patient, including chemotherapy and other infusion treatments. The clinic partners with PWFMC laboratory services to minimize patient wait times. New patients can be scheduled within 24 hours, and staff see that all needed follow up tests and treatments are arranged, including IV infusions, radiation therapy, physical therapy and other specialty care.Providence Willamette Falls Medical Center received a one-year grant from the Providence Willamette Falls Medical Foundation for a part-time certified music thanatologist to be at PWFMC on Tuesdays, Thursdays and every other Friday. Music-thanatology is a clinical discipline that addresses the physical and spiritual needs of those with a life-limiting illness. Symptoms such as pain and anxiety can be alleviated through live, prescriptive music of harp and voice at the bedside. The music is tailored to each patient's condition, even as it changes over time. While the main focus will be on end-of-life care, music thanatology also can be used to support and comfort any patient.Providence Willamette Falls Medical center opened a new Rehab clinic, October 2011, at Providence Canby Medical Plaza. Services include physical therapy, occupational therapy, sports therapy and hand therapy. As the only clinic in Canby to offer hand therapy, the clinic will care for patients with a variety of needs, including post-op hand surgery, work injuries, tendon lacerations, carpal tunnel syndrome, tennis elbow, arthritis and customized hand splints.The March of Dimes Greater Oregon Chapter presented its first annual Nurse of the Year awards in 14 categories, with three Providence nurses among the recipients. The Nurse of the Year program was created to honor Oregon nurses for their care and compassion for patients. The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. The agency supports research, provides education and advocates for health coverage for all pregnant women and children. It also supports medical screening of newborns to save lives and prevent disability.Providence Willamette Falls Medical Center has joined the Providence Telestroke Network, December 2011, to provide after-hours access to acute stroke care experts. Through an Internet video connection, the network allows stroke neurologists from Providence Brain and Spine Institute to be in the room with PWFMC emergency physicians. The neurologists can review patient records and diagnostic results, remotely conduct an examination and consult with on-site clinicians to help determine the best treatment. Telestroke complements the hospital's interdisciplinary stroke program, which includes daytime physician coverage from hospitalists, rehabilitation services and discharge planning from Oregon Neurology, PC. 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OR, there is a separate community benefit report for PWFMC."},{"explanation":"Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 4763969."},{"explanation":"Part II: COMMUNITY BUILDING ACTIVITIES:Basic needs including food, security and housing.Although no Community Building activities were tracked during 2011, Providence Willamette Falls Medical Center recognizes that the social determination of health needs includes adequate housing, food, transportation, utilities and primary education. These deficits fall disproportionately on low-income and multicultural populations and therefore Providence has aligned its community building and diversity programs to intersect with and advise our community benefit giving. Oregon ranks first in homelessness per capita according to the U.S. Department of Housing and Urban Development. Lack of adequate housing contributes to poor health; therefore, Providence supports a number of not-for-profit organizations that help homeless people or work to prevent homelessness. Although Clackamas County has the highest per capita income in the state, it still has significant low income communities with sizable homelessness. Women and children are the most impacted in Clackamas. Providence Willamette Falls partners with organizations in multiple Canby, Estacada and Molalla that provide or support low-income housing. Some important partners include: Canby Cares, Compassion Connect, North Clackamas Community Center, Clackamas County Health Department and the Children's Center. Providence has been a leader in recognizing the significant impact of hunger on the health and well being of all residents in the state. Oregon ranks as one of the five \"hungriest states\" with nearly 50 percent of all school age children qualifying for free or reduced lunches. Providence works with the Oregon Food Bank, The Governor's Task Force to End Hunger and Farmer's Ending Hunger as well as numerous food pantries in every ministry we serve. Economic DevelopmentEconomic development has an important impact on available housing and services for the underserved. An economically depressed area cannot easily support and care for the vulnerable. Providence looks for partnerships with like-minded organizations that will encourage a stable and strong economy. We participate in local and state organization in each of our ministries, as well as provide executive leadership to city, county and state boards. Leadership Development and Training for Community Members and Youth In this area, Providence has put a strong focus on diverse and low-income communities. For example, for some years we have provided scholarships for youth in multicultural and diverse populations, including Asian, African-American and Hispanic communities. Community partners include Milwaukie High School and the Gladstone School District. Building Health Equity and Community Inclusion Providence has long known that, while we can do a great deal to help our communities, we often can get the best results in meeting health needs, and those basic needs that contribute to or affect health, by aligning with other organizations that have an established presence and expertise. Throughout our history, we have sought like-minded partners with a mission to care for the vulnerable in the communities we serve. We continue to lead and support the Community Health Access and Improvement Council (CHAI). Community Health Improvement AdvocacyIn keeping with our strong commitment to social justice, Providence is an advocate for those among us who do not have a voice in policy development and community decision making. We joined with Community Connections, Community Health Partnerships, Parish Health Promoters, the Foundation for Medical Excellence, Ecumenical Ministries of Oregon, Oregon Primary Care Association, NAMI, Office of Health Equity and Ride Connection, among others, to ensure that the needs of those we serve have been articulated to policy makers. We actively supported initiatives to improve provider cultural competence in care giving with required continuing education courses. Community Emergency Preparedness As part of a regional emergency preparedness initiative, the hospital was requested to put in the emergency water source to serve the larger community with a small portion for themselves. Providence Willamette Falls pursued a federal grant to cover part of the expense of the well that will serve the entire Oregon City community."},{"explanation":"Part III, Line 4: Bad Debt expense consists of actual write off of accounts sent to collection, recovery of collections and an estimated amount based on outstanding AR. The charity policy states that Providence makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment. In regards to outstanding AR for Providence Willamette Falls Medical Center:1. The process takes into account the adjustments and payments that have already occurred. The process then valuates the responsibility based on the net AR balance.2. Historical write off percentages are applied.3. The Bad Debt is based on Self Insured and Uninsured balances at the financial class (payer) level.4. PWFMC is in a transitional period since they are not on the same AR patient accounting system as the rest of the Providence Oregon Region.5. The audited Financial Statement does not contain a footnote specific to Bad Debt expense."},{"explanation":"Part III, Line 9b: BILLING & COLLECTION PRACTICESProvidence has written policies about when and under whose authority patient debt is advanced for collection and uses its best efforts to ensure that patient accounts are processed fairly and consistently. Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital. When sending a bill to a patient, Providence includes:A) A statement that indicates that if the patient meets certain income requirements that the patient may be eligible for a government-sponsored program or for financial assistance from the hospital.B) A statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient asking for financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (ie: income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs. For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service."},{"explanation":"Part V, Section B, Line 13g: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office."},{"explanation":"Part V, Section B, Line 19d: Charges are based on full billed charges and the uninsured discount is taken and then Financial Assistance off the full billed charges."},{"explanation":"Part V, Section B, Line 21: When services are deemed \"medically unnecessary\", a patient would be charged normal charges."},{"explanation":"Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care."},{"explanation":"Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients."},{"explanation":"Part VI, Line 4: COMMUNITY INFORMATION:Providence Willamette Falls Medical Center serves both urban and rural areas throughout a geographically large and diverse Clackamas County including a hospital, limited physician clinics and affiliated urgent health services. Providence Willamette Falls Medical Center is a full service community hospital with 143 licensed beds. Clackamas is one of three counties that make up the Portland metropolitan area. Located south of Portland, the county has experienced rapid population growth in recent years. Between 1990 and 2000, the population increased more than 21%. Clackamas County's 2011 population totals 380,207, with 9% of the population living at or below the federal poverty guidelines. Children, as in most communities, are disproportionately impacted by poverty, with 21% of all children in Clackamas living at or below the federal poverty guidelines. Within Clackamas County, Mollalla and North Clackamas are higher-needs communities, with Community Needs Index scores of 3.4. Approximately 16% of the residents of Clackamas County are from communities of color and 11% of all households report English as a second language in the home. All of our hospitals, clinics and other facilities are open to underserved populations and 20% of all emergency department cases were uninsured and 10% of all hospital admissions were uninsured. Nearly 39% of patients are private or other insurance; 37% receive Medicare and 11% Medicaid.Personal and family income in Clackamas County is the highest in the state with an average family income of $62,007 and an unemployment rate of 8.2% in 2011."},{"explanation":"Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.In each of the communities where we serve, our ministries are actively involved with public, private and other health systems in working towards better health outcomes for the entire community. Examples of this include: participation by all Portland area hospitals and four county health departments in Project Access NOW. Working as a founder and ongoing partner, Providence facilities represent four of 14 participating hospitals and 3,300 providers who agree to provide needed medical care to Oregon community members who have low incomes and urgent needs. The stated goal of Project Access NOW is to become the recognized source for care for all low income uninsured in the metro community. Providence's participation and support helps to ensure that this is achievable and has expanded to found a like organization in Hood River called Gorge Access Project (GAP). Another example from Hood River County, where Providence Hood River hosts the county's community health collaborative, MOCHA, which brings together the hospital, the schools, the growers, the public health department, community health center and private providers to identify and work on community health needs in a collaborative manner."},{"explanation":"Part VI, Line 6: AFFILIATED HEALTH SYSTEM:Providence Health & Services owns and operates 27 general acute care hospitals, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center and Montessori school, a high school, a university, 12 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 20 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for those who are poor and vulnerable, Providence has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. As a part of the integrated health system, Providence Health & Services - Oregon Region and Providence Health Plans (based in Oregon), Providence Willamette Falls Medical Center provides extensive services that support and promote the health needs of the communities we serve. In particular, the Providence Willamette Falls Community Education Facility provides meeting space for many community agencies and is at full capacity use by community groups.Throughout its more than 155-year-history, Providence has responded to community need, with special emphasis on helping the most vulnerable. Thousands of adults and children received help and support through these grants, donations and community outreach. Our areas of focus include primary care and new models of team-based care delivery for uninsured, low-income and culturally diverse populations, as well as access to behavioral health care for underserved populations. We also help provide palliative care and safety net health care services for underserved populations.Providence in Oregon collaborates with community partners to help manage the cost of health care and change the way patients are cared for in our community. We believe patient-centered, team-based primary care is the foundation of health care transformation. Disparities are a feature of health care in Oregon as they are nationally. Providence's integrated delivery of care in Oregon allows us to provide leadership in developing new clinical models to coordinate care, standardize processes and improve patient outcomes. Providence is developing new patient centered primary care home models of health care delivery in Portland using employed physicians in partnership with Providence Health Plans, other commercial insurers and the Medicaid population. We currently have medical home models in 19 sites throughout the state. Many of these sites are targeted at underserved and high risk populations. Within Oregon, Providence has been an active participant in shaping the transformation of the state's health care system. Providence leaders were selected by the governor to participate in workshops that will help define the details of coordinated care organizations and make additional recommendations to the 2012 legislative session. Providence is already making changes internally and working with other health systems and community partners to begin this transformation"},{"explanation":"WA,OR,CA,MT,AK"}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":13137,"reported_domestic_org_grants_program_services":13137,"total_501c3_and_government_organizations":1,"total_other_organizations":0,"grants":[{"ein":931003750,"irc_section":"501(c)(3)","cash":5050,"purpose":"Community Health Support","address_line1":"1500 Division Street","city":"Oregon City","state":"OR","zip":"97045","name":"Providence Willamette Falls Medical Foundation","address":"1500 Division Street, Oregon City, OR, 97045"}],"total_domestic_grants":13137,"total_domestic_program_services":13137,"detail_org_grants_total":5050,"detail_domestic_grants_total":5050,"supplemental_information":[{"identifier":"Procedure for Monitoring Grants in the U.S.:","form_and_line_reference":"Part I, Line 2:","explanation":"Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds are used."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. 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However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approval by the VP/Chief Human Resources Officer. During 2011, a total of three first-class tickets were purchased for disclosed personnel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employees behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executives Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2011, the following Key Employees received gross-up payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding \"rent\" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The VP/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2011, the following Key Employees received relocation payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation."},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"NONQUALIFIED RETIREMENT PLANS A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DCSERP = Defined Contribution Supplemental Executive Retirement Plan C) DBCBRP = Defined Benefit Cash Balance Restoration Plan D) DCRP = Defined Contribution Restoration Plan E) ESP = Elective Survivor Plan F) SOP = Share Option Plan 1) John F. Koster, MD a) Taxable DBSERP Earned but not Paid- $3,063,813 b) Non-Taxable DBSERP Earned but not Paid - $781,587 c) Non-Taxable DCSERP Earned - $339,126 d) DBSERP Interest Credit - $439,580 2) Jeffrey W. Rogers a) Taxable DBSERP Earned but not Paid - $1,005,741 b) Non-Taxable DBSERP Earned but not Paid - $135,144 c) Taxable DCSERP Earned but not Paid - $8,561 d) Non-Taxable DCSERP Earned - $48,099 e) ESP Interest Credit - $79,952 f) DBSERP Interest Credit - $202,199 3) Todd Hofheins a) Non-Taxable DCRP Earned - $9,603 4) Gregory Van Pelt a) Taxable DBSERP Earned but not Paid - $ 2,008,828 b) Non-Taxable DBSERP Earned but not Paid - $185,993 c) Taxable DCSERP Earned but not Paid - $276,749 d) Non-Taxable DCSERP Earned - $292,233 e) ESP Interest Credit - $88,256 f) DBSERP Interest Credit - $319,032 5) Terry L. Smith a) Taxable DBSERP Earned but not Paid - $2,293,039 b) Non-Taxable DBSERP Earned but not Paid - $236,604 c) Taxable DCSERP Earned but not Paid - $21,722 d) Taxable DBCBRP Earned - $400 e) Non-Taxable DCSERP Earned - $69,165 f) ESP Interest Credit - $61,528 g) DBSERP Interest Credit - $231,388 6) Janice J. Jones a) Taxable DBSERP Earned but not Paid - $ 1,844,829 b) Non-Taxable DBSERP Earned but not Paid - $189,772 c) Taxable DBCBRP Earned but not Paid - $ 142 d) Non-Taxable DCSERP Earned - $154,703 e) SOP Paid - $29,819 f) DBSERP Interest Credit - $184,939 7) Arnold R. Schaffer a) Taxable DBSERP Earned but not Paid - $750,268 b) Non-Taxable DBSERP Earned but not Paid - $33,694 c) Taxable DCSERP Earned but not Paid - $832,896 d) Non-Taxable DCSERP Earned - $630,732 e) DBSERP Interest Credit - $82,122 8) Claudia Haglund a) Taxable DBSERP Earned but not Paid - $1,339,590 b) Non-Taxable DBSERP Earned but not Paid - $195,498 c) Taxable DCSERP Earned but not Paid - $29,245 d) Non-Taxable DCSERP Earned - $37,706 e) ESP Interest Credit - $22,834 f) SOP Paid - $ 69,768 g) DBSERP Interest Credit - $141,491 9) John V. Fletcher a) Taxable DBSERP Earned but not Paid - $648,808 b) Non-Taxable DBSERP Earned but not Paid - $52,905 c) Taxable DCSERP Earned but not Paid - $290,961 d) Non-Taxable DCSERP Earned - $388,497 e) ESP Interest Credit - $46,196 f) SOP Paid - $104,155 g) DBSERP Interest Credit - $86,372 10) Michael Hunn a) Taxable DBSERP Earned but not Paid - $327,914 b) Taxable DCSERP Earned but not Paid - $370,385 c) Non-Taxable DCSERP Earned - $216,958 d) DBSERP Interest Credit - $20,014 11) Michael L. Butler a) Non-Taxable DCSERP Earned - $435,962 b) DBSERP Interest Credit - $95,665 12) Eugene \"Al\" Parrish a) Taxable DBSERP Earned but not Paid - $346,852 b) Non-Taxable DBSERP Earned but not Paid - $268,971 c) Non-Taxable DCSERP Earned - $56,382 d) DBSERP Interest Credit - $128,312 13) John O. Mudd a) Taxable DBSERP Earned but not Paid - $226,235 b) Non-Taxable DBSERP Earned but not Paid - $71,542 c) Taxable DCSERP Earned but not Paid - $125,304 d) Non-Taxable DCSERP Earned - $254,702 e) DBSERP Interest Credit - $53,501 14) Andrew Agwunobi, MD a) Non-Taxable DCSERP Earned - $158,816 b) DBSERP Interest Credit - $8,147 15) Myron Berdischewsky, MD a) Non-Taxable DCSERP Earned - $404,844 b) DBSERP Interest Credit - $12,137 16) Craig L. Wright, MD a) Non-Taxable DCSERP Earned - $199,302 b) DBSERP Interest Credit - $38,604 17) Bruce Lamoureux a) Taxable DBCBRP Earned - $518 b) Non-Taxable DCSERP Earned - $166,650 c) DBSERP Interest Credit - $22,275 18) Medrice Coluccio a) Non-Taxable DCSERP Earned - $344,898 b) DBSERP Interest Credit - $4,529 19) David T. Brooks a) Non-Taxable DCSERP Earned - $149,660 b) DBSERP Interest Credit - $21,641 20) Cindra R. Syverson a) Non-Taxable DCSERP Earned - $130,173 b) DBSERP Interest Credit - $14,305 21) Joel S. Gilbertson a) Non-Taxable DCSERP Earned - $48,086 22) David S. Brown a) Non-Taxable DCSERP Earned - $74,666 23) Orest Holubec a) Non-Taxable DCSERP Earned - $9,236 24) Keith Marton, MD a) Taxable DBSERP Earned but not Paid - $501,372 b) Taxable DCSERP Earned but not Paid - $284,714 c) Non-Taxable DCSERP Earned - $114,423 d) DBSERP Interest Credit - $30,600 25) Russell Danielson a) Taxable DBSERP Paid - $ 108,402 b) ESP Paid - $57,407 26) Shelly M. Handkins a) Non-Taxable DCSERP Earned - $204,337 27) Russell Reinhard a) DBSERP Interest Credit - $1,562 b) Non-Taxable DCSERP Earned - $130,515 28) John T. Flanders a) Taxable DBCBRP Earned but not Paid - $2,671"},{"form_and_line_reference":"Part I, Lines 4a-b","explanation":"SEVERANCE 1) Keith Marton, MD - $428,716"},{"form_and_line_reference":"Part III","explanation":"FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2011, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and quality focused. In 2011 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 10%. To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"business_name_line1":"John F Koster MD","relationship":"Officer","description":"Purchase of Supplies Through Cooperative on which Dr. Koster is a Director","amount":6639118,"sharing_of_revenues":false,"name":"John F Koster MD"}]},"ScheduleN":{"termination_or_liquidation":{"assets_distributed":true,"liabilities_paid":true,"bonds_outstanding":true,"bond_liabilities_discharged":true,"required_to_notify_attorney_general":true,"attorney_general_notified":true},"successor_relationships":{"director_of_successor":true,"employee_of_successor":true,"owner_of_successor":false},"liquidations":[{"business_name_line1":"PH&S - Oregon","ein":510216587,"irc_section":"501(c)(3)","distribution_date":"2011-12-31T00:00:00","description":"All Assets and Liabilities","fair_market_value":9606144,"method_of_fmv_determination":"Book Value at December 31, 2011","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"98057","name":"PH&S - Oregon","address":"1801 Lind Avenue SW 9016, Renton, WA, 98057"}],"supplemental_information":[{"explanation":"Part I, Line 2e: All employees of Willamette Falls Hospital"},{"explanation":"Part I, Line 2e: Board of Directors"},{"explanation":"Part I, Line 2e: Became employees of Providence Health & Services - Oregon"},{"explanation":"Part I, Line 2e: Same governing body for PH & S - Oregon."},{"explanation":"Part I, Line 7c: Tax-exempt bonds [$22,355,000 Oregon Facilities Authority Revenue Bonds, Series 2011C (Providence Health & Services)] were issued on November 17, 2011. The proceeds were used to fund a defeasance escrow invested in SLGs to redeem the defeased bonds at their earliest eligible call dates."}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":510216586,"business_name_line1":"Providence Health & Services - Washington","primary_activities":"Healthcare System","exempt_code_section":"501( c)(3)","public_charity_status":"Line 3","controlled_organization":false,"legal_domicile_state":"WA","direct_controlling_business_name_line1":"Providence Health & Services","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"980579016","name":"Providence Health & Services - Washington","address":"1801 Lind Avenue SW 9016, Renton, WA, 980579016"},{"ein":510216587,"business_name_line1":"Providence Health & Services - Oregon","primary_activities":"Healthcare System","exempt_code_section":"501( c)(3)","public_charity_status":"Line 3","controlled_organization":false,"legal_domicile_state":"OR","direct_controlling_business_name_line1":"Providence Health & Services","address_line1":"1801 Lind Avenue SW 9016","city":"Renton","state":"WA","zip":"980579016","name":"Providence Health & Services - 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