2024-05-09T12:10:37-05:00 2023-06-30 135565207 KPMG LLP 1300 SW 5TH AVENUE SUITE 3800 PORTLAND OR 97201 990 2022-07-01 237002687 SALEM HEALTH FOUNDATION SALE 5038141938 890 OAK STREET SALEM OR 97301 JAMES PARR EVP OF OPERATIONS & CFO 5038141938 2024-05-07 1 JAMES PARR 999009999 0 JAMES LANCASTER P00742579 5032216500 2024-05-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JAMES PARR 890 OAK STREET SALEM OR 97301 3398014 0 X WWW.SALEMHEALTH.ORG/FOUNDATION X 1968 OR DEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HEALTH ACHIEVE ITS MISSION. 13 13 0 15 0 0 2040282 3205010 0 0 1016745 171145 -9260 -17044 3047767 3359111 320970 2039251 0 0 0 0 0 0 0 720250 698944 1041220 2738195 2006547 620916 10900708 11730641 160181 290538 10740527 11440103 THE SALEM HEALTH FOUNDATION IS DEDICATED TO RAISING, MANAGING AND DISTRIBUTING FUNDS TO HELP SALEM HEALTH ACHIEVE ITS MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY IT SERVES. 0 0 2432376 1894079 PROPOSALS TO FUND CAPITAL EQUIPMENT AND MEDICALLY RELATED ACTIVITIES AT SALEM HEALTH ARE RECEIVED AND REVIEWED BY THE FOUNDATION'S CHIEF DEVELOPMENT OFFICER. PROPOSALS ARE FORWARDED TO THE FOUNDATION'S BOARD OF DIRECTORS FOR FURTHER REVIEW AND APPROVAL IF THEY ARE CONSIDERED TO BE CONSISTENT WITH THE FOUNDATION'S ARTICLES OF INCORPORATION, STATING THAT ITS FUNDS ARE TO BE USED FOR HEALTH CARE, CHARITABLE, AND SCIENTIFIC PURPOSES, AND FOR MEDICAL AND SCIENTIFIC EDUCATION AND RESEARCH FOR THE USE AND BENEFIT OF SALEM HEALTH. 97000 97000 SCHOLARSHIPS: NURSING, MEDICAL SCHOOL AND OTHER HEALTHCARE PROGRAMS. RECIPIENTS OF HEALTH CARE RELATED ACADEMIC SCHOLARSHIPS AND THE AMOUNTS OF THE AWARDS ARE DETERMINED BY ANALYSES OF THE CANDIDATES' QUALIFICATIONS, SCHOLARSHIP AWARDS ALREADY AWARDED TO THEM FOR THE YEAR BY OTHER ORGANIZATIONS, AND THE COSTS OF THE SPECIFIC SCHOOLS THE CERTAIN RESTRICTED FUNDS HAVE BEEN CREATED AND ARE USED FOR THE PURPOSE VARIOUS CANDIDATES WISH TO ATTEND. 48172 48172 CERTAIN RESTRICTED FUNDS HAVE BEEN CREATED AND ARE USED FOR THE PURPOSE OF ASSISTING DIABETES AND CANCER PATIENTS WITH THE COSTS OF THEIR EDUCATIONAL, SUPPLY AND OTHER CARERELATED EXPENSES. IN ADDITION, FUNDS ARE DISTRIBUTED TO ASSIST LOW INCOME INDIVIDUALS MEDICAL REQUIREMENTS. 2577548 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X SALEM HEALTH 5038141938 890 OAK STREET SALEM OR 97301 PAT FORCE CHAIR 1.00 0.00 X X 0 0 0 ALEX RHOTEN VICE CHAIR 1.00 0.00 X X 0 0 0 RYAN ALLBRITTON SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 ALEX CASEBEER PAST CHAIR 1.00 0.00 X 0 0 0 STEVE ALTMAN DIRECTOR 1.00 0.00 X 0 0 0 GARTH BRANDAW DIRECTOR 1.00 0.00 X 0 0 0 TIM DUENAS MD DIRECTOR 1.00 0.00 X 0 0 0 ERIC FISKUM DIRECTOR 1.00 0.00 X 0 0 0 KATHY GORDON DIRECTOR 1.00 0.00 X 0 0 0 RAGHU KAMINENI MD DIRECTOR 1.00 0.00 X 0 0 0 JOHN POLLINO DIRECTOR 1.00 0.00 X 0 0 0 ROBERT PONEC MD DIRECTOR 1.00 0.00 X 0 0 0 YVONNE TAMAYO DIRECTOR 1.00 0.00 X 0 0 0 CHERYL NESTER WOLFE CEO & PRESIDENT 1.00 39.00 X 0 1574830 41448 JAMES PARR EVP OF OPERATIONS & CFO 1.00 39.00 X 0 981205 104173 JAMES R BAUER CHIEF DEVELOPMENT OFFICER 1.00 39.00 X 0 391654 54811 0 2947689 200432 0 0 1 0 0 93775 3111235 1692000 3205010 171145 171145 6130 93775 38903 -32773 -32773 HAMPSHIRE RENTAL 900099 15729 15729 15729 3359111 0 0 154101 1894079 1894079 145172 145172 614177 491342 122835 26560 21248 5312 21015 16812 4203 11119 8895 2224 HAMPSHIRE PROP. MAINT. 24408 24408 LICENSES AND PERMITS 1405 1405 EQUIPMENT & INSTRUMENTS 205 205 DUES 55 55 2738195 2577548 160647 0 2704769 399122 152381 158934 7173 6190 15869 16439 692000 0 692000 692000 7328516 10457956 10900708 11730641 160181 290538 160181 290538 X 1211073 1370237 9529454 10069866 10740527 11440103 10900708 11730641 X 620916 415644 -336984 X 0 1 X 1 0 X 969371 1206307 451593 2040282 3205010 7872563 969371 1206307 451593 2040282 3205010 7872563 3503476 4369087 184976 1575 402845 1016745 171145 1777286 1950 13777 13454 24505 21859 75545 9725394 0.44920 0.52490 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: HAMPSHIRE PROPERTIES - 2019 AMOUNT: $ 13,777. 2020 AMOUNT: $ 13,454. 2021 AMOUNT: $ 14,430. 2022 AMOUNT: $ 15,729. SPECIAL EVENTS - 2018 AMOUNT: $ 1,950. 2021 AMOUNT: $ 10,075. 2022 AMOUNT: $ 6,130. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3814370 10324 53012 63610 3814095 3463649 427969 77248 3814370 3414730 20925 216671 188677 3463649 3470860 53207 -1810 107527 3414730 3330813 54838 111368 26158 3470861 0.59500 0.40500 0 0 685000 685000 7000 7000 692000 DUE TO SALEM HEALTH 290538 290538 X PART V, LINE 4: SALEM HEALTH FOUNDATION HOLDS ENDOWMENT FUNDS FOR THE BENEFIT OF SALEM HEALTH AND FOR USE TOWARDS THE FOUNDATION'S MISSION. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURSIDCTIONS; THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE CORPORATION MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2020. GOLF TOURNAMENT 99905 93775 6130 3225 10804 11235 13639 99905 93775 6130 3225 10804 11235 13639 38903 -32773 1 SALEM HEALTH 890 OAK STREET SALEM OR 97301 930579722 3 1797154 0 N/A N/A TO PAY FOR GENERAL EXPENSES AND CAPITAL EXPENDITURES SALEM HEALTH HOSPITALS & CLINICS 890 OAK STREET SALEM OR 97301 930823471 3 89630 0 N/A N/A TO SUPPORT SHHC PROGRAMS 3 3 SCHOLARSHIPS FOR STUDENTS 96 97000 0 N/A N/A THE FOUNDATION'S PATIENT ASSISTANCE PROGRAM 183 48172 0 N/A N/A PART I, LINE 2: DECISIONS ON GRANTS TO SALEM HEALTH ARE MADE BY THE SALEM HEALTH FOUNDATION BOARD OF DIRECTORS. MINUTES OF THE MEETINGS OF THE FOUNDATION BOARD ARE SHARED WITH THE SALEM HEALTH BOARD OF TRUSTEES AT THEIR MONTHLY MEETINGS. SCHOLARSHIPS ARE GRANTED TO COLLEGE STUDENTS THAT RESIDE IN MARION AND POLK COUNTIES AND ARE PURSUING A HEALTHCARE RELATED CAREER. A SCHOLARSHIP COMMITTEE REVIEWS INDIVIDUAL APPLICATIONS AND RECOMMENDS TO THE BOARD RECIPIENT AWARDS FOR APPROVAL. SCHOLARSHIPS AWARDED ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS FOR TUITION OR RELATED COSTS. 0 1 0 0 0 0 0 0 0 CHERYL NESTER WOLFE CEO & PRESIDENT 0 1003551 0 264799 0 306480 0 25925 0 15523 0 1616278 0 276324 JAMES PARR EVP OF OPERATIONS & CFO 0 773768 0 154507 0 52930 0 80418 0 23755 0 1085378 0 50230 JAMES R BAUER CHIEF DEVELOPMENT OFFICER 0 317642 0 63864 0 10148 0 39299 0 15512 0 446465 0 0 PART I, LINE 3 COMPENSATION OF THE OFFICERS IS DETERMINED BY THE CEO OF SALEM HEALTH, IN CONJUNCTION WITH OTHER SALARY SURVEY OR PUBLIC INFORMATION AND INDEPENDENT CONSULTANTS TO ENSURE THE COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. PART I, LINE 4B SOME OF THE HOSPITAL'S EMPLOYEES RECEIVE DEFERRED COMPENSATION UNDER A 457(F) NONQUALIFIED PLAN. THIS COMPENSATION IS INCLUDED IN COMPENSATION REPORTED IN PART II. THE TOTAL NONQUALIFIED PORTION OF EACH PERSON'S DEFERRED COMPENSATION IS: JAMES PARR $54,493 JAMES R. BAUER $22,524 SCHEDULE J, PART II, LINE 1: COMPENSATION AND BENEFITS REPORTED FOR OFFICERS ON SCHEDULE J ARE PAID BY SALEM HEALTH. THE FOUNDATION HAS A MANAGEMENT AGREEMENT TO REIMBURSE SALEM HEALTH FOR A PORTION OF OFFICER COMPENSATION AND BENEFITS. THIS AMOUNT IS INCLUDED ON FORM 990 PART IX; LINE 11A UNDER MANAGEMENT SERVICES. X 1 1692000 FMV 0 0 1 1 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. PART I, LINE 32B: DURING THE FISCAL YEAR 2023, THE SALEM HEALTH FOUNDATION, A RELATED ORGANIZATION OF SALEM HEALTH HOSPITALS AND CLINICS ("SHHC"), FACILITATED A SIGNIFICANT TRANSFER OF IN-KIND PROPERTY TO SHHC (THE RECIPIENT). THIS TRANSFER ALIGNS WITH OUR MISSION TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITY WE SERVE. THE IN-KIND PROPERTY TRANSFERRED ENCOMPASSED VACANT INDUSTRIAL LAND, 11.95 ACRES IN DALLAS, OR, VALUED AT $1,692,000 AS ASSESSED BY INDEPENDENT APPRAISAL. THE DECISION TO TRANSFER THIS IN-KIND PROPERTY WAS REACHED AFTER CAREFUL CONSIDERATION BY OUR BOARD OF DIRECTORS AND IN CONSULTATION WITH SHHC TO ENSURE THAT THE TRANSFER WOULD DIRECTLY CONTRIBUTE TO THEIR OPERATIONAL NEEDS AND FURTHER THEIR MISSION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SALEM HEALTH FOUNDATION IS SALEM HEALTH HOSPITALS & CLINICS ("SHHC"), A NOT-FOR-PROFIT ENTITY. THE SALEM HEALTH FOUNDATION DIRECTORS ARE ELECTED BY SHHC WHO ALSO APPROVES SIGNIFICANT DECISIONS OF THE SALEM HEALTH FOUNDATION GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A THE BYLAWS OF SALEM HEALTH FOUNDATION STATE THAT THE DIRECTORS OF SALEM HEALTH FOUNDATION SHALL BE ELECTED BY SHHC AT EACH ANNUAL ORGANIZATION MEETING OF THE BOARD OF DIRECTORS OF SHHC, OR IF ANY SUCH ANNUAL MEETING IS NOT HELD, THEN THE DIRECTORS MAY BE ELECTED AT A REGULAR OR SPECIAL MEETING OF THE BOARD OF DIRECTORS OF SHHC. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO THE SALEM HEALTH FOUNDATION BYLAWS, SHHC SHALL HAVE THE SOLE AND EXCLUSIVE RIGHT TO ACT WITH RESPECT TO THE FOLLOWING AFFAIRS OF SALEM HEALTH FOUNDATION: A. APPROVAL OF THE MERGER OR CONSOLIDATION OF SALEM HEALTH FOUNDATION WITH ANY OTHER ORGANIZATION OR ENTITY; PROVIDED, HOWEVER, THAT THE BOARD OF DIRECTORS MAY SUBMIT MERGER AND CONSOLIDATION PROPOSALS TO SHHC FOR ITS APPROVAL; B. ELECTION TO DISSOLVE AND WIND UP THE AFFAIRS OF SALEM HEALTH FOUNDATION; PROVIDED THAT THE BOARD OF DIRECTORS MAY SUBMIT A DISSOLUTION PROPOSAL TO SHHC FOR ITS APPROVAL; C. SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF SALEM HEALTH FOUNDATION; PROVIDED, HOWEVER, THAT THE BOARD OF DIRECTORS MAY SUBMIT PROPOSALS FOR SUCH DISPOSITIONS TO SHHC FOR ITS APPROVAL; FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S ACCOUNTING & FINANCE TEAM WORKS CLOSELY WITH THE OUTSIDE ACCOUNTING FIRM IT ENGAGES TO PREPARE AND REVIEW THE RETURN. THE CONTROLLER AND CFO REVIEW A DRAFT OF THE FORM 990 BEFORE IT IS PRESENTED TO THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES. FINANCE ADMINISTRATION ADDRESSES AND RESPONDS TO QUESTIONS RAISED BY MEMBERS OF THE GOVERNANCE COMMITTEE. AFTER IT IS REVIEWED BY THE GOVERNANCE COMMITTEE, THE FINAL FORM 990 IS FORWARDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS THE SECRETARY SHALL SEND TO EACH PERSON WHO IS A TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE A COPY OF THE POLICY REGARDING CONFLICTS OF INTEREST, TOGETHER WITH A QUESTIONNAIRE INQUIRING AS TO CONFLICTS, TO BE COMPLETED AND RETURNED TO THE SECRETARY BY THE TRUSTEE, OFFICER OR COMMITTEE MEMBER PRIOR TO THE BEGINNING OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION AT SALEM HEALTH (SH) IS DESIGNED TO ALLOW THE ORGANIZATION TO RECRUIT AND RETAIN QUALIFIED SENIOR LEADERS. ONE OR MORE INDEPENDENT CONSULTANTS ARE RETAINED TO REVIEW EXECUTIVE COMPENSATION. THE SH CEO, IN CONJUNCTION WITH THE INDEPENDENT CONSULTANTS, ENSURES THAT EACH EXECUTIVE'S COMPENSATION IS COMPETITIVE IN THE MARKET FOR SIMILAR POSITIONS AT COMPARABLE ORGANIZATIONS. THE CEO ALSO PROVIDES INFORMATION TO THE BOARD GOVERNANCE COMMITTEE ON THE LEVELS OF EXECUTIVE COMPENSATION. FORM 990, PART VI, LINES 15A AND 15B ALL COMPENSATION IS PAID BY A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. FORM 990, PART XI, LINE 9: ASSETS RELEASED FROM RESTRICTIONS -336,984. HAMPSHIRE PROPERTIES LLC 890 OAK STREET SALEM OR 97301 870804582 REAL ESTATE OR 15729 803192 SHF SALEM HEALTH 890 OAK STREET SALEM OR 97301 930579722 HOSPITAL OR 501(C)(3) LINE 3 SHHC 0 SALEM HEALTH HOSPITALS & CLINICS 890 OAK STREET SALEM OR 97301 930823471 LEASES LAND OR 501(C)(3) LINE 12A, I N/A 0 SALEM HEALTH WEST VALLEY 525 SOUTHEAST WASHINGTON ST DALLAS OR 97338 431960221 HOSPITAL OR 501(C)(3) LINE 3 SHHC 0 WEST VALLEY HOSPITAL FOUNDATION 525 SOUTHEAST WASHINGTON ST DALLAS OR 97338 931298564 SUPPORT SHWV OR 501(C)(3) LINE 12A, I SHHC 0 WILLAMETTE VALLEY INSURANCE COMPANY 745 FORT STREET HONOLULU HI 96813 201836190 CAPTIVE INS HI 501(C)(3) LINE 12A, I SHHC 0 SALEM HEALTH PROFESSIONAL SERVICES 890 OAK STREET SALEM OR 97301 753175249 BILLING OR 501(C)(3) LINE 12A, I SHHC 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0