Legacy Health

What it reported doing in 2024

Legacy provides administrative services for the System in the areas of general administration, finance, legal services, human resources, information management, patient billing, quality and patient safety, and marketing and also oversees and supports health education and community wellness programs throughout the System's service area. Legacy is the sole corporate member of six nonprofit corporations: Legacy Emanuel Hospital & Health Center (LEHHC), Legacy Good Samaritan Hospital and Medical Center (LGSHMC), Legacy Meridian Park Hospital (LMPH), Legacy Mount Hood Medical Center (LMHMC), Legacy Salmon Creek Hospital(LSCH), Silverton Health (SH) and Legacy Visiting Nurse Association (LVNA). While there is investment in a variety of community-based activities and programs as a part of its non-profit status, an overwhelming majority of Legacy community benefit comes in the form of providing uncompensated care. Legacy's policy of providing care regardless of the ability to pay makes it one of the region's largest providers of uncompensated care in the four-county metropolitan area. Legacy, collectively provided over $62 million, $261 million, $319 million, and $18 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2025. In addition, Legacy provided over $39 million in other community benefit activities during fiscal year 2025.In support of its mission, Legacy provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are uninsured. The criteria for charity care are determined based on eligibility for insurance coverage, household income, catastrophic medical events, or other information supporting a patients inability to pay for services provided. Specifically, Legacy provides an uninsured discount of 35% to self-pay patients with no coverage. A 75% discount is available to patients whose household income is between 301% and 400% of the federal poverty level. For patients whose household income is at or below 300% of the federal poverty level, a full subsidy is available. In certain situations, charity care is awarded to individuals without any patient action required. In addition to the household income criteria, other catastrophic or economic circumstances are considered in determining eligibility for charity care. During 2025, Legacy provided charity care on 92,018 patient accounts, representing 9,367 inpatient accounts, and 82,651 outpatient accounts. In 2025, 8% of the patients receiving charity care received a full subsidy representing roughly 20% of the total charity provided. The top five services provided to patients qualifying for charity care were emergency/trauma, surgery, cardiovascular, pediatrics, and general acute care.In addition to charity care, Legacy provides services under various states' Medicaid programs for low-income patients, to Medicare beneficiaries, and to beneficiaries under other government programs(such as Tricare). The cost of providing services to these beneficiaries generally exceeds the reimbursement from these programs.Legacy also employs financial counselors and social workers, who assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans' assistance, and public assistance programs such as Medicaid. This program assists many patients in obtaining coverage through a third party, reducing the patients' financial responsibility.

Financial Efficiency

• Mission deployment rate: 100%; rating input score 100
• Program expense ratio: 99.1%; rating input score 99
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 93.8%; rating input score 94; 25th percentile among comparable filings
• Pay-setting controls: 5 of 6 controls in place; rating input score 83
  • Compensation committee: Pass
  • Independent consultant: Pass
  • Other Form 990s reviewed: Missing
  • Written employment contract: Pass
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Scored; rating input score 0
• Grant itemization coverage: 91.4%; rating input score 91; 23rd percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 66.7%; rating input score 67; 19th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 3.2%; rating input score 48; 48th percentile among comparable filings
• Total-asset coverage ratio: 5; rating input score 85; 85th percentile among comparable filings
• Liabilities to assets ratio: 0.69; rating input score 22; 22nd percentile among comparable filings
• Officer compensation ratio: 4.8%; rating input score 18; 18th percentile among comparable filings

Growth

• Program expense growth: 6.3% per year; rating input score 100; 51st percentile among comparable filings
• Revenue growth: 7.1% per year; rating input score 100; 61st percentile among comparable filings
• Asset growth: 6.3% per year; rating input score 100; 46th percentile among comparable filings