2025-11-13T15:30:08-06:00 2024-12-31 990 2024-01-01 930391573 GOOD SAMARITAN HOSPITAL CORVALLIS GOOD 5417684857 CO SHS ACCOUNTING PO BOX 3000 CORVALLIS OR 973393000 DANIEL SMITH SVP / CFO 5417684857 2025-10-28 1 2024 2025-03-06 01:10:19Z GOOD SAMARITAN REGIONAL MEDICAL CTR JOSIAH JOHNSON 3600 NW SAMARITAN DR CORVALLIS OR 97330 615579416 0 X WWW.SAMHEALTH.ORG X 1948 OR TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY THROUGH ITS MEDICAL AND SURGICAL HOSPITAL. 11 10 2747 110 126904 0 1650452 919483 578146106 606169596 2015044 2434995 3336539 3511001 585148141 613035075 541856 771204 0 0 282670996 313433815 0 0 0 320164468 321732553 603377320 635937572 -18229179 -22902497 213051184 227419796 183594299 218133420 29456885 9286376 X GOOD SAMARITAN HOSPITAL, CORVALLIS (GSH) ACHIEVES ITS MISSION OF IMPROVING THE HEALTH AND WELL BEING OF THE COMMUNITY THROUGH ITS MEDICAL AND SURGICAL HOSPITAL AND HEALTHCARE CLINICS PROVIDING OUTPATIENT CARE SERVICES AT SEVERAL AREA LOCATIONS.GSH IS A MEMBER OF SAMARITAN HEALTH SERVICES (SHS), A REGIONAL NETWORK OF HOSPITALS AND PHYSICIANS. THE NETWORK, FORMED IN THE LATE 1990'S, SERVES APPROXIMATELY 290,000 RESIDENTS IN LINN, BENTON, LINCOLN AND PORTIONS OF POLK AND MARION COUNTIES IN OREGON. IT IS LOCALLY OWNED, AND ITS BOARDS OF DIRECTORS INCLUDE HOSPITAL LEADERS, PHYSICIANS AND COMMUNITY REPRESENTATIVES. THE MISSION OF SHS IS "BUILDING HEALTHIER COMMUNITIES TOGETHER." THE COLLECTIVE VISION OF THE SHS SYSTEM IS TO SERVE OUR COMMUNITIES WITH PRIDE (PASSION, RESPECT, INTEGRITY, DEDICATION, AND EXCELLENCE). SHS SEEKS TO BE THE FIRST CHOICE OF CONSUMERS IN THE REGION AND TO LEAD COLLABORATIVE EFFORTS AMONG THOSE WHO SHARE SIMILAR GOALS. 0 0 572772481 606155373 GOOD SAMARITAN HOSPITAL CORVALLIS (GSH), THE LARGEST HOSPITAL IN LINN, BENTON AND LINCOLN COUNTIES, OFFERS MORE THAN 22 MEDICAL SPECIALTIES INCLUDING COMPREHENSIVE CANCER CARE, A FULL-SERVICE CARDIOLOGY AND VASCULAR SURGERY PROGRAM, NEUROSURGERY AND OTHER REGIONAL SERVICES. GSH HAS MORE THAN 2,500 EMPLOYEES AND 100 VOLUNTEERS SERVING THE MEDICAL NEEDS OF THE COMMUNITY. IT IS LICENSED TO OPERATE 188 BEDS AND IS A 'LEVEL 2' TRAUMA CENTER. DURING 2024, GSH SERVED 8,491 INPATIENTS, HAD 33,780 EMERGENCY DEPARTMENT VISITS, PERFORMED 11,168 SURGERIES AND DELIVERED 957 BABIES. IN ADDITION, GSH PERFORMED 121,130 IMAGING PROCEDURES, AND HAD 280,868 PHYSICIAN CLINIC VISITS. 771204 771204 GRANTS AND ASSISTANCE PROVIDED BY GOOD SAMARITAN HOSPITAL CORVALLIS TO VARIOUS ORGANIZATIONS AND INDIVIDUALS TO SUPPORT THE MEDICAL, DENTAL, MENTAL HEALTH AND OTHER NEEDS OF COMMUNITY MEMBERS, CONSISTENT WITH PRIORITIES IDENTIFIED IN THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT. SEE PART IX, LINES 1 AND 2 AND RELATED SCHEDULE I FOR MORE DETAILS. 573543685 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 2747 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X SAMARITAN HEALTH SERVICES 5417684857 PO BOX 3000 CORVALLIS OR 973393000 ABBE MONTGOMERY MD BOARD MEMBER / PHYSICIAN 1.00 1.00 X 0 4175 0 DAVID MARSHALL BOARD MEMBER 1.00 X 0 0 0 SURINDER VASDEV MD BOARD MEMBER 1.00 X 0 0 0 NANCY SEIFERT PHD BOARD CHAIR 1.00 2.00 X X 0 0 0 KELLY GALLAGHER BOARD VICE CHAIR 1.00 2.00 X X 0 0 0 ERIC THOMPSON BOARD SECRETARY 1.00 1.00 X X 0 0 0 RICHARD CRONK MD BOARD TREASURER 1.00 X X 0 0 0 JUDY LIST BOARD MEMBER 1.00 1.00 X 0 0 0 TIM HENNESSY BOARD MEMBER 1.00 X 0 0 0 STEVE UERLINGS BOARD MEMBER 1.00 1.00 X 0 0 0 LYLE HUTCHENS BOARD MEMBER 1.00 X 0 0 0 KATHARINE HARRIS BOARD MEMBER 1.00 X 0 0 0 LAURA HENNUM CEO (END AUG) 39.00 1.00 X 0 802185 45907 DANIEL SMITH SVP / CFO 2.00 38.00 X 0 622805 66116 JOSIAH JOHNSON CEO (START DEC) 39.00 1.00 X 0 19779 1 DOUGLAS AUKERMAN MD CHIEF MEDICAL OFFICER 40.00 X 400922 0 72274 BRANDON SCHMIDGALL VP COO 40.00 X 346738 0 53481 JOHN BLENKINSOPP VP PATIENT CARE SVCS 40.00 X 321383 0 53212 MICHAEL MENNINGER MD MEDICAL DIRECTOR 40.00 X 1324909 0 74796 CAY MIERISCH MD PHYSICIAN 40.00 X 1252920 0 74169 WAEL GHACHAM MD PHYSICIAN 40.00 X 1013977 0 74731 CHRISTOPHER MCCRUM MD PHYSICIAN 40.00 X 961883 0 75590 ESTHER KIM MD MEDICAL DIRECTOR 40.00 X 958405 0 47249 6581137 1448944 637526 766 0 1 0 0 866775 5297 47411 919483 NET PATIENT REVENUE 622110 532939922 532939922 RETAIL PHARMACY 456110 68526518 68526518 QUALITY INCENTIVES 900099 2358038 2358038 OTHER PATIENT REVENUE 622110 838136 838136 LAB SERVICE REVENUE 621500 410370 410370 1096612 1082389 14223 606169596 1518438 1518438 960611 126941 833670 833670 833670 3331438 738 2415619 0 915819 738 916557 916557 9754 1781 7973 7973 CAFETERIA 722514 2564650 2564650 FITNESS CENTER 713940 104708 104708 2669358 613035075 606155373 126904 5833315 X 444577 444577 326627 326627 1248009 1248009 244083694 240456620 3627074 14966401 14745132 221269 36198294 35663125 535169 16937417 16687008 250409 1397874 1397874 110372 110372 18996 18996 33927675 33098189 829486 4687 4389 298 13602390 13020744 581646 13159672 12596667 563005 6768449 6549924 218525 321305 316801 4504 828443 825012 3431 3295848 3154843 141005 10378313 10224976 153337 7778195 7061154 717041 MEDICAL SUPPLIES 139289218 139289218 PURCHASED SERVICES 63405439 9019348 54386091 PROVIDER TAXES 26318449 26318449 DUES, TAXES, & LICENSES 1127228 1094999 32229 635937572 573543685 62393887 0 13850 13805 228974 347174 76072036 86257117 1142795 1905031 10881937 12135479 1154076 1546009 287331712 198516099 88709698 88815613 26623241 29201464 649054 761559 7575523 6436545 213051184 227419796 38227345 41036153 76144 157968 2505344 1789641 142785466 175149658 183594299 218133420 X 29456885 9286376 29456885 9286376 213051184 227419796 X -22902497 706580 2025408 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6186492 51886 496482 55762 6679098 5539790 17509 742378 113185 6186492 6624459 150534 -1043913 191290 5539790 6036395 117058 596472 125466 6624459 5471420 52626 646419 134070 6036395 0.22960 0.62810 0.14230 0 1 1 1700000 358114 2058114 1860262 167529148 110666490 58722920 5689573 3078088 2611485 95630886 76974777 18656109 14563729 7796744 6766985 88815613 PROFESSIONAL LIABILITY RESERVE 2769720 OTHER LIABILITIES 929163 PAYABLE TO CONTRACTUAL AGENCIES 3525497 MINIMUM PENSION LIABILITY 9486557 ACCOUNTS PAYABLE-AFFILIATES 158438721 175149658 X PART V, LINE 4: THE BOARD-DESIGNATED AND GENERAL ENDOWMENTS ARE USED FOR GENERAL HOSPITAL SUPPORT. THE BERNIER ENDOWMENT IS USED FOR STAFF CONTINUING EDUCATION. THE PASTEGA HOUSE ENDOWMENT IS USED TO HELP UNDERWRITE THE OPERATING COSTS OF THE MARIO PASTEGA GUEST HOUSE. THE VRTISKA ENDOWMENT IS USED TO SUPPORT THE HOSPITAL'S LABORATORY FOR EDUCATIONAL PURPOSES. THE WISH ENDOWMENT IS USED FOR HOSPITAL-BASED PROGRAMS SUPPORTING WOMEN'S AND CHILDREN'S HEALTH. THE HALL ENDOWMENT IS USED TO HOST VISITING PHYSICIAN EDUCATORS, WITH AN EMPHASIS ON MEDICAL ETHICS AND END OF LIFE DECISIONS. THE CARDIOLOGY ENDOWMENT IS FOR SUPPORT AND ADVANCEMENT OF CARDIOVASCULAR CARE INCLUDING EDUCATION, EQUIPMENT AND FACILITIES. THE BETH RAY ENDOWMENT IS FOR PEDIATRIC AND OB PATIENT SUPPORT SERVICES AND PATIENT CARE PROGRAMS. THESE INCLUDE THERAPEUTIC DEVICES, NEW TECHNOLOGY AND EQUIPMENT FOR SHS DEPARTMENTS THAT SUPPORT PEDIATRIC AND OB CARE. PART X, LINE 2: FOOTNOTE DISCLOSURE FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE THE SHS' MANAGEMENT TO EVALUATE TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF SHS 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 SHS AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. SHS IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SHS' MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2021. 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 25 24675 4114158 4114158 0.00650 17 114363 113348784 83923256 29425528 0.04630 42 139038 117462942 83923256 33539686 0.05280 6 5885 1290765 10437 1280328 0.00200 3 697 27248704 15453298 11795406 0.01850 28 124642 68779290 32618377 36160913 0.05690 4 10921 1235591 287647 947944 0.00150 41 142145 98554350 48369759 50184591 0.07890 83 281183 216017292 132293015 83724277 0.13170 1 3 1539 1539 0.00000 1 3 1539 1539 0.00000 0 2887891 84446006 77809750 6636256 X 1 1 1 CORVALLIS MED BLDGS LLC REAL PROPERTY RENTAL 0.54500 0.21500 2 HULL IMAGING LLC IMAGING SERVICES 0.60000 0.40000 3 SAMARITAN ENDOSCOPY CENTER MEDICAL SERVICES 0.20000 0.80000 4 CORVALLIS MRI LLC IMAGING SERVICES 0.50000 0.50000 5 CASCADE VIEW MEDICAL OFFICE BUILDING LLC REAL PROPERTY RENTAL 0.26300 0.73700 1 1 GOOD SAMARITAN HOSPITAL CORVALLIS 3600 NW SAMARITAN DRIVE CORVALLIS OR 97330 WWW.SAMHEALTH.ORG STATE LICENSE: 14-1074 X X X X X GOOD SAMARITAN HOSPITAL CORVALLIS 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X HTTPS://WWW.SAMHEALTH.ORG/COMMUNITYBENEFIT X X 1 23 1 HTTPS://WWW.SAMHEALTH.ORG/COMMUNITYBENEFIT 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X X 1 X WWW.SAMHEALTH.ORG/FINANCIALASSISTANCE X WWW.SAMHEALTH.ORG/FINANCIALASSISTANCE X WWW.SAMHEALTH.ORG/FINANCIALASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 GOOD SAMARITAN HOSPITAL, CORVALLIS PART V, SECTION B, LINE 5: STAFF MEMBERS FROM THE SAMARITAN HEALTH SERVICES (SHS) COMMUNITY HEALTH PROMOTION DEPARTMENT PARTNERED WITH THE LINN, BENTON, LINCOLN, REGIONAL HEALTH ASSESSMENT TEAM (LBLRHAT) AND A PRIVATE CONSULTANT TO CONDUCT THE 2023-2026 COMMUNITY HEALTH NEEDS ASSESSMENT FOR GOOD SAMARITAN HOSPITAL, CORVALLIS THAT WAS COMPLETED DURING 2022. MEMBERSHIP OF THE LINN, BENTON, LINCOLN REGIONAL HEALTH ASSESSMENT TEAM ARE REPRESENTATIVES FROM BENTON COUNTY HEALTH DEPARTMENT, LINN COUNTY HEALTH SERVICES, LINCOLN COUNTY HEALTH AND HUMAN SERVICES, THE CONFEDERATED TRIBE OF SILETZ INDIANS, THE UNITED WAY OF LINN, BENTON AND LINCOLN COUNTIES, INTERCOMMUNITY HEALTH NETWORK-CCO, THE LINN, BENTON, LINCOLN HEALTH EQUITY ALLIANCE, AND SAMARITAN HEALTH SERVICES. SHS STAFF, LBLRHAT AND THE CONSULTANT CONDUCTED SURVEYS BOTH ON-LINE AND ON PAPER WITH OVER 2,900 RESIDENTS IN THE REGION. THE LBLRHAT AND THE CONSULTANT ALSO COLLECTED SECONDARY DATA FROM VARIOUS STATE AND NATIONAL ORGANIZATIONS SUCH AS THE OREGON DEPARTMENT OF EDUCATION, THE OREGON HEALTH AUTHORITY, THE U.S. CENSUS BUREAU AND THE CENTERS FOR DISEASE CONTROL. SHS STAFF, LBLRHAT AND THE CONSULTANT HELD FOCUS GROUPS AND CONDUCTED KEY-INFORMANT INTERVIEWS TO OBTAIN INPUT FROM COMMUNITY MEMBERS AND PERSONS WITH SPECIALIZED KNOWLEDGE AND EXPERTISE. FINALLY, SHS STAFF, LBLRHAT, AND THE CONSULTANT HELD LISTENING SESSIONS TO OBTAIN ADDITIONAL INFORMATION REGARDING COMMUNITY NEEDS AND PRIORITIES.PERSONS FROM THE FOLLOWING ORGANIZATIONS WERE CONSULTED FOR THE HOSPITAL'S CHNA: THE BENTON COUNTY HEALTH DEPARTMENT, COMMUNITY OUTREACH INC., BENTON EAST LINN HEALTH CENTER, OREGON STATE UNIVERSITY, SAMARITAN HEALTH PLANS, WESTERN UNIVERSITY-COMP NORTHWEST, LINN-BENTON COMMUNITY COLLEGE, THE CORVALLIS SCHOOL DISTRICT, THE LINN BENTON LINCOLN HEALTH EQUITY ALLIANCE, THE OLD MILL CENTER FOR CHILDREN AND FAMILIES, STRENGTHENING RURAL FAMILIES, LOVE INC, THE CHURCH OF THE GOOD SAMARITAN, THE OREGON CASCADES WEST COUNCIL OF GOVERNMENTS, THE BOYS & GIRLS CLUB OF CORVALLIS, INTERCOMMUNITY HEALTH NETWORK-CCO, THE DEPARTMENT OF HUMAN SERVICES, THE OREGON HEALTH AUTHORITY, THE OREGON OFFICE OF RURAL HEALTH, COMMUNITY SERVICES CONSORTIUM, THE CORVALLIS CLINIC, THE MONROE SCHOOL DISTRICT, THE ALSEA SCHOOL DISTRICT, THE PHILOMATH SCHOOL DISTRICT, THE LINN-BENTON-LINCOLN EARLY LEARNING HUB, THE LINN-BENTON HISPANIC ADVISORY COUNCIL, THE BENTON COUNTY ORAL HEALTH COALITION, THE REGIONAL MENTAL HEALTH/SUBSTANCE USE DISORDER COALITION, AND THE UNITED WAY OF BENTON, LINN AND LINCOLN COUNTIES. GOOD SAMARITAN HOSPITAL, CORVALLIS PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE LINN, BENTON, LINCOLN, REGIONAL HEALTH ASSESSMENT TEAM. MEMBERS OF THE TEAM ARE: THE BENTON COUNTY HEALTH DEPARTMENT, LINN COUNTY HEALTH SERVICES, LINCOLN COUNTY HEALTH AND HUMAN SERVICES, THE CONFEDERATED TRIBE OF SILETZ INDIANS, THE UNITED WAY OF LINN, BENTON, AND LINCOLN COUNTIES, INTERCOMMUNITY HEALTH NETWORK-CCO, THE LINN, BENTON, LINCOLN, HEALTH EQUITY ALLIANCE, SAMARITAN HEALTH SERVICES, AND BRANDAN KEARNEY, LLC. GOOD SAMARITAN HOSPITAL, CORVALLIS PART V, SECTION B, LINE 7D: COPIES OF THE CHNA WERE EMAILED TO KEY COMMUNITY PARTNERS AND DISTRIBUTED TO LOCAL LIBRARIES, COUNTY OFFICES, SCHOOL DISTRICT OFFICES AND DURING LOCAL COALITION MEETINGS. GOOD SAMARITAN HOSPITAL, CORVALLIS PART V, SECTION B, LINE 11: THE HOSPITAL PROVIDES GRANT FUNDING TO LOCAL COMMUNITY AGENCIES THAT ADDRESS ONE OR MORE OF THE PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IS INCLUDED IN THE HOSPITAL'S COMMUNITY BENEFIT PLAN IMPLEMENTATION STRATEGY. HOSPITAL STAFF MEMBERS SERVE ON COMMUNITY ADVISORY BOARDS AND COALITIONS TO ADDRESS THE MOST PRESSING NEEDS IN THE COMMUNITY. THE HOSPITAL PROVIDES WORKSHOPS, CLASSES, AND SUPPORT GROUPS TO ADDRESS THE MOST CRITICAL HEALTH CONCERNS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. BECAUSE SEVERAL NEEDS TO IMPROVE HEALTH WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL DOES NOT HAVE THE FINANCES, RESOURCES, OR THE EXPERTISE TO ADDRESS ALL THE NEEDS PRIORITIZED BY THE COMMUNITY. GOOD SAMARITAN HOSPITAL, CORVALLIS PART V, SECTION B, LINE 15E: REGISTRATION REFERS UNINSURED AND/OR LOW INCOME PATIENTS TO THE ONSITE PATIENT FINANCIAL ADVOCATE AND A THIRD PARTY VENDOR WHO CONTACTS THE PATIENTS TO ASSESS THEIR FINANCIAL STATUS AND NEEDS. 49 1 - CORVALLIS MRI LLC 3615 NW SAMARITAN DR STE 101 CORVALLIS OR 97330 IMAGING SERVICES 2 - GSRMC - INPATIENT MENTAL HEALTH 3509 NW SAMARITAN DR STE 100 CORVALLIS OR 97330 MENTAL HEALTH SERVICES 3 - GSRMC - NEVILLE BUILDING IMAGING 3615 NW SAMARITAN DR CORVALLIS OR 97330 IMAGING SERVICES 4 - GSRMC - NEVILLE BUILDING LABORATORY 3615 NW SAMARITAN DR STE 102 CORVALLIS OR 97330 LABORATORY SERVICES 5 - GSRMC AMBULATORY INFUSION 441 NW ELKS DR STE 200 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 6 - GSRMC GYNECOLOGIC ONCOLOGY 441 NW ELKS DR STE 101 CORVALLIS OR 97330 CANCER TREATMENT 7 - GSRMC HEMATOLOGY & ONCOLOGY 441 NW ELKS DR STE 100 CORVALLIS OR 97330 CANCER TREATMENT 8 - GSRMC HOME INFUSION SERVICE 441 NW ELKS DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 9 - GSRMC PREOPERATIVE CLINIC 3620 NW SAMARITAN DR CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 10 - GSRMC RADIATION ONCOLOGY 501 NW ELKS DR CORVALLIS OR 97330 CANCER TREATMENT 11 - OUTPATIENT NUTRITION CLINIC 3517 NW SAMARITAN DR STE 200 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 12 - SAM CARE EXPRESS - CORVALLIS 850 SW 26TH ST CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 13 - SAMARITAN ATHLETIC MEDICINE CENTER 845 SW 30TH ST CORVALLIS OR 97331 MEDICAL CLINIC - OUTPATIENT 14 - SAMARITAN BREAST RECONST & SURG ONC 996 NW CIRCLE BLVD STE 103 CORVALLIS OR 97330 CANCER TREATMENT 15 - SAMARITAN CANCER RES CTR - CORVALLIS 441 NW ELKS DR CORVALLIS OR 97330 CANCER RESOURCE CENTER 16 - SAMARITAN CARDIOLOGY - CORVALLIS 3640 NW SAMARITAN DR STE 100 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 17 - SAMARITAN CARDIOVASCULAR SURGERY 3640 NW SAMARITAN DR STE 120 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 18 - SAMARITAN ENDOCRINOLOGY 3615 NW SAMARITAN DR STE 110 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 19 - SAMARITAN ENDOSCOPY CENTER 3509 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 ENDOSCOPY CENTER 20 - SAMARITAN FAMILY MED RESIDENT CLINIC 3517 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 21 - SAMARITAN FAMILY MEDICINE SOUTHWEST 5234 SW PHILOMATH BLVD CORVALLIS OR 97333 MEDICAL CLINIC - OUTPATIENT 22 - SAMARITAN GASTRO - CORVALLIS 3521 NW SAMARITAN DR STE 101 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 23 - SAMARITAN GYNECOLOGY & SURG ASSOC 400 NW WALNUT BLVD STE 300 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 24 - SAMARITAN HAND TO SHOULDER THERAPY 3620 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 25 - SAMARITAN INFECTIOUS DISEASE 3640 NW SAMARITAN DR STE 210 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 26 - SAMARITAN INTERNAL MED - CORVALLIS 3521 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 27 - SAMARITAN KIDNEY SPEC - CORVALLIS 3615 NW SAMARITAN DR STE 203 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 28 - SAMARITAN MENTAL HEALTH - ALBANY 1052 SW 29TH ST ALBANY OR 97321 MENTAL HEALTH SERVICES 29 - SAMARITAN MENTAL HLTH - CIRCLE BLVD 1112 NW CIRCLE BLVD CORVALLIS OR 97330 MENTAL HEALTH SERVICES 30 - SAMARITAN MENTAL HEALTH - CORVALLIS 3509 NW SAMARITAN DR STE 215 CORVALLIS OR 97330 MENTAL HEALTH SERVICES 31 - SAMARITAN OBGYN & MIDWIFERY 3640 NW SAMARITAN DR STE 220 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 32 - SAMARITAN OCC MED - ALBANY 1100 7TH AVE SW ALBANY OR 97321 MEDICAL CLINIC - OUTPATIENT 33 - SAMARITAN OCC MED - LEBANON 100 MULLINS DRIVE STE B2 LEBANON OR 97355 MEDICAL CLINIC - OUTPATIENT 34 - SAMARITAN OCC MEDICINE - CORVALLIS 5234 SW PHILOMATH BLVD STE B CORVALLIS OR 97333 MEDICAL CLINIC - OUTPATIENT 35 - SAMARITAN PEDIATRICS 330 NW ELKS DR CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 36 - SAMARITAN PHYS REHAB SPEC CORVALLIS 815 NW 9TH ST STE 180 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 37 - SAMARITAN RHEUMATOLOGY 3620 NW SAMARITAN DR STE 202 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 38 - SAMARITAN SURGICAL SPECIALISTS 3615 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 39 - SAMARITAN UROLOGY - CORVALLIS 990 NW CIRCLE BLVD STE 102 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 40 - SAMARITAN WALK-IN CLINIC - CORVALLIS 5234 SW PHILOMATH BLVD CORVALLIS OR 97333 MEDICAL CLINIC - OUTPATIENT 41 - SAMARITAN WEIGHT MGMT INSTITUTE 3517 NW SAMARITAN DR STE 100 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 42 - SAMCARE MOBILE MEDICINE 2555 NE BELVUE ST CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 43 - SMG BRAIN & SPINE CENTER - CORVALLIS 3615 NW SAMARITAN DR STE 210 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 44 - SMG FAMILY MEDICINE - 26TH STREET 850 SW 26TH ST CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 45 - SMG FAMILY MEDICINE - CIRCLE BLVD 1112 NW CIRCLE BLVD CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 46 - SMG FAMILY MEDICINE - NINTH ST 777 NW 9TH ST STE 320 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 47 - SMG HAND TO SHOULDER ORTHO 3620 NW SAMARITAN DR STE 201 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 48 - SMG ORTHOPEDICS - CORVALLIS 3620 NW SAMARITAN DR STE 202 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT 49 - SMG PULMONOLOGY - CORVALLIS 3600 NW SAMARITAN DR STE 227 CORVALLIS OR 97330 MEDICAL CLINIC - OUTPATIENT PART I, LINE 6A: THE FILING ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE STATE OF OREGON. IN ADDITION, THE PARENT ORGANIZATION, SAMARITAN HEALTH SERVICES (SHS) PROVIDES AN ANNUAL REPORT TO THE COMMUNITY THAT INCLUDES COMMUNITY BENEFIT REPORTING FOR THE SYSTEM AS A WHOLE. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN SCHEDULE H, PART I, LINE 7A AND 7B IS A COST-TO-CHARGE RATIO DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES FROM THE SCHEDULE H INSTRUCTIONS. FOR LINE 7G, A COST-TO-CHARGE RATIO IS ALSO USED, BUT IT IS CALCULATED AT THE DEPARTMENT OR SERVICE LINE LEVEL FOR THOSE SERVICES THAT QUALIFY AS SUBSIDIZED HEALTH SERVICES. PART I, LINE 7G: PHYSICIAN CLINICS MEETING THE DEFINITION OF SUBSIDIZED HEALTH SERVICES WERE INCLUDED IN THE REPORTING FOR LINE 7G. CONSISTENT WITH THE SCHEDULE H INSTRUCTIONS, PHYSICIAN CLINIC ACTIVITY HAS BEEN COMBINED WITH ASSOCIATED HOSPITAL SERVICES IN DETERMINING WHETHER THE SERVICES WERE PROVIDED AT A LOSS. THE PORTION OF NET COMMUNITY BENEFIT EXPENSE RELATED TO PHYSICIAN CLINICS, COMBINED WITH ASSOCIATED HOSPITAL ACTIVITY, THAT IS BEING COUNTED AS SUBSIDIZED HEALTH SERVICES IN 2024 IS 25,257,313. PART II, COMMUNITY BUILDING ACTIVITIES: GSH PROVIDES SERVICES AND ACTIVITIES THAT ARE CLASSIFIED AS COMMUNITY BUILDING TO PROMOTE THE HEALTH OF BENTON COUNTY. RECOGNIZING THAT THE HEALTH OF A COMMUNITY ENCOMPASSES MULTIPLE FACTORS, GSH LEADERSHIP AND STAFF ARE INVOLVED IN A VARIETY OF ACTIONS THAT WORK TO IMPROVE COMMUNITY OUTCOMES. GSH BELIEVES THAT TRAINED AND COMPETENT STAFF IN ALL ASPECTS OF THE ORGANIZATION PROMOTES COMMUNITY HEALTH. GSH ACTIVELY PARTICIPATES IN WORKFORCE DEVELOPMENT IN PARTNERSHIP WITH OREGON STATE UNIVERSITY, LINN-BENTON COMMUNITY COLLEGE, AND WESTERN UNIVERSITY-COMP NW TO RECRUIT, TRAIN AND RETAIN HEALTHCARE WORKERS AT ALL LEVELS. GSH ALSO HOSTS LOCAL EVENTS SUPPORTED BY THE HOSPITAL'S FOUNDATION AND OTHER DEPARTMENTS IN THE ORGANIZATION. SUPPORTING AND PARTICIPATING IN ANNUAL EVENTS SUCH AS SENIOR HEALTH FAIRS, FESTIVAL LATINO, CHILDREN'S HEALTH FAIRS, THE BENTON COUNTY FAIR AND PROJECT HOMELESS CONNECT ARE A FEW EXAMPLES OF HOW GSH PROMOTES THE HEALTH OF THE COMMUNITY. GSH HAS BEEN ACTIVELY IMPLEMENTING THE SAMARITAN HEALTH SERVICE EQUITY AND INCLUSION PLAN TO OPTIMIZE OUR SERVICE DELIVERY PROCESS TO UNDERSERVED, UNDERREPRESENTED, AND MARGINALIZED COMMUNITIES. GSH PROVIDES EDUCATION AND TRAINING TO ALL STAFF ON EQUITY, DIVERSITY AND INCLUSION TOPICS THAT WILL IMPROVE THE PATIENT EXPERIENCE IN THR HOSPITAL AND CLINICS. GSH STAFF SERVED ON MANY LOCAL COALITIONS AND BOARDS THAT PROMOTE THE HEALTH OF THE COMMUNITY. BOARD AFFILIATIONS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY OUTREACH INC., OREGON CASCADES WEST COUNCIL OF GOVERNMENTS, AND THE UNITED WAY OF BENTON, LINN, AND LINCOLN COUNTIES. ADDITIONALLY, GSH STAFF SERVED ON THE OREGON HEALTH POLICY ADVISORY BOARD, THE OREGON HEALTH RESOURCES COMMISSION, THE MEDICAID ADVISORY COMMITTEE, THE OREGON ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS AND REGIONAL BOARDS THAT ADDRESS HEALTH CARE ISSUES. PART III, LINE 2: BAD DEBT EXPENSE IS RECORDED FOR THOSE PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AND DO NOT PAY AFTER REPEATED ATTEMPTS TO COLLECT PAYMENT, INCLUDING INFORMING THEM OF THE OPPORTUNITY TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. IF INDEPENDENT EVIDENCE INDICATES THAT THE PATIENT IS UNABLE TO PAY, SHS MAY CHOOSE TO CLASSIFY DELINQUENT ACCOUNTS AS "PRESUMPTIVE CHARITY" RATHER THAN BAD DEBT. PATIENT PAYMENTS (OR RECOVERIES) ON ACCOUNTS THAT WERE PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE RECORDED AS A REDUCTION TO BAD DEBT EXPENSE. PART III, LINE 4: GOOD SAMARITAN HOSPTIAL, CORVALLIS (GSH) IS ONE OF FIVE HOSPITALS OF SAMARITAN HEALTH SERVICES (SHS). AS A NETWORK, SHS PREPARES ITS FINANCIAL STATEMENTS ON A CONSOLIDATED BASIS. AS OF JANUARY 1, 2018, SHS IMPLEMENTED THE NEW REVENUE RECOGNITION STANDARD (ASU NO. 2014-09) ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB). UNDER THIS NEW STANDARD, RATHER THAN REPORTING A BAD DEBT ALLOWANCE FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE PATIENTS WITHOUT INSURANCE), BEGINNING IN 2018, SHS RECORDS AN IMPLICIT PRICE CONCESSION IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE (SEE FOOTNOTE 3, "PATIENT SERVICE REVENUE" ON PAGES 12, 13 AND 14 OF THE 2024 CONSOLIDATED FINANCIAL STATEMENTS). WITH THIS CHANGE, PATIENT SERVICE REVENUE CONTINUES TO BE REPORTED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS AT THE ESTIMATED NET REALIZABLE AMOUNT FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. PART III, LINE 8: TOTAL MEDICARE ALLOWABLE COSTS REPORTED ON PART III, SECTION B, LINE 6 IS CALCULATED BY UTILIZING WORKSHEET A IN THE SCHEDULE H INSTRUCTIONS IN CONJUNCTION WITH AMOUNTS TAKEN DIRECTLY FROM THE FILING ORGANIZATION'S MEDICARE COST REPORT (CALCULATED BASED ON A COST-TO-CHARGE RATIO). CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED, AS THESE PATIENTS TYPICALLY HAVE LOW OR FIXED INCOMES AND GOVERNMENT REIMBURSEMENT IS NOT SUFFICIENT TO COVER THE COSTS OF PROVIDING CARE FOR THESE PATIENTS. MEDICARE PATIENTS ARE A GROWING SEGMENT OF THE LOCAL POPULATION, AND MANY ARE BECOMING INCREASINGLY DEPENDENT ON OUR HOSPITAL AND NON-PROFIT AFFILIATES TO PROVIDE FOR THEIR CARE, ESPECIALLY AS OTHER FOR-PROFIT HEALTHCARE PROVIDERS IN THE COMMUNITY DISCONTINUE ACCEPTING MEDICARE PATIENTS.THE AMOUNT ON LINE 7 OF PART III, SECTION B SHOWS A SURPLUS FOR MEDICARE REVENUES LESS ALLOWABLE COSTS. THIS IS PRIMARILY DUE TO THE FACT THAT THE MEDICARE COST REPORT INCLUDES ACTIVITY FOR MEDICARE FEE-FOR-SERVICE PATIENTS BUT NOT MEDICARE MANAGED CARE PATIENTS. MEDICARE MANAGED CARE ACCOUNTS FOR ROUGHLY HALF OF OUR MEDICARE ACTIVITY. IN ADDITION, CERTAIN COSTS OF PROVIDING HEALTHCARE SERVICES, SUCH AS PHYSICIAN COMPENSATION, ARE NOT ALLOWABLE ON THE MEDICARE COST REPORTS. THEREFORE, THE AMOUNT ON LINE 7 WOULD RESULT IN A SHORTFALL, AND NOT A SURPLUS, IF WE USED ALL OF THE REVENUE AND COST DATA FOR ALL MEDICARE PATIENT ACTIVITY, AS FOLLOWS:NET REV RECEIVED FROM MEDICARE (ALL MEDICARE PATIENT PROGRAMS):175,609,838MEDICARE COSTS (BASED ON A COST-TO-CHARGE RATIO): 195,695,035UNPAID COST OF PROVIDING SERVICES TO ALL MEDICARE PATIENTS: -20,085,197 PART III, LINE 9B: PER HOSPITAL GUIDELINES, IF A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO SENDING AN ACCOUNT TO COLLECTIONS, THE FINANCIAL ASSISTANCE WRITE-OFF IS PROCESSED AND NO COLLECTION ATTEMPT IS MADE. IF AN ACCOUNT IS ALREADY IN COLLECTIONS AND MEDICAID ELIGIBILITY IS DEEMED ACTIVE DURING THE ACCOUNT DATE OF SERVICE, NO FURTHER COLLECTION ATTEMPT WILL BE MADE. PART VI, LINE 2: GOOD SAMARITAN HOSPITAL, CORVALLIS (GSH) ACTIVELY PARTICIPATES IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY. EVERY THREE YEARS, AS REQUIRED BY FEDERAL AND STATE LAW, GSH CONDUCTS A COUNTYWIDE HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE LINN, BENTON, LINCOLN REGIONAL HEALTH RESOURCE ASSESSMENT TEAM THAT CONSISTS OF REPRESENTATIVES FROM THE BENTON COUNTY HEALTH DEPARTMENT, LINN COUNTY HEALTH SERVICES, LINCOLN COUNTY HEALTH AND HUMAN SERVICES, INTERCOMMUNITY HEALTH NETWORK-CCO, THE CONFEDERATED TRIBES OF SILETZ INDIANS, THE UNITED WAY OF LINN, BENTON, AND LINCOLN COUNTIES, THE LINN-BENTON-LINCOLN HEATH EQUITY ALLIANCE, SAMARITAN HEALTH SERVICES AND OTHER COMMUNITY PARTNERS. THE PROCESS INCLUDES EXAMINING PRIMARY DATA COLLECTED THROUGH SURVEYS, FOCUS GROUPS, LISTENING SESSIONS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS WHO RESIDE THROUGHOUT BENTON COUNTY. SECONDARY DATA IS GATHERED FROM FEDERAL, STATE AND LOCAL AGENCIES THAT ADDRESS THE HEALTH NEEDS OF CHILDREN, YOUTH AND FAMILIES. THE INFORMATION IS REVIEWED BY HOSPITAL STAFF MEMBERS, PARTNERS, AND COMMUNITY MEMBERS TO PRIORITIZE THE HEALTH CARE NEEDS FOR BENTON COUNTY. EACH YEAR THE GSH BOARD OF DIRECTORS AND VARIOUS INTERNAL AND EXTERNAL COMMITTEES REVIEW THE PRIORITIES TO ENSURE WE ARE CONTINUING TO ADDRESS THE NEEDS OF THE COMMUNITY. PART VI, LINE 3: GSH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTH CARE SERVICES TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. IF QUALIFICATIONS ARE MET, PATIENTS' CARE MAY BE PROVIDED FOR FREE OR AT A REDUCED COST. THE DETERMINATION IS BASED IN PART ON POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. GSH INFORMS AND EDUCATES PATIENTS AND COMMUNITY MEMBERS REGARDING FINANCIAL ASSISTANCE THROUGH A VARIETY OF METHODS. SIGNS AND BROCHURES ARE POSTED AND AVAILABLE IN THE HOSPITAL WAITING AREAS, CLINIC WAITING ROOMS, VISITING ROOMS, THE INFORMATION DESKS, IN THE EMERGENCY DEPARTMENT, AND AT URGENT CARE SITES. FINANCIAL ASSISTANCE INFORMATION IS SENT EACH YEAR TO THE LOCAL HEALTH DEPARTMENT, MEDICAID OFFICES, SOCIAL SERVICES AGENCIES, AND DOCTOR'S OFFICES. FINANCIAL ASSISTANCE INFORMATION IS ALSO POSTED ON THE HOSPITAL'S WEBSITE INCLUDING, THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY, AND THE FINANCIAL ASSISTANCE APPLICATION. PATIENTS WHO ARE SELF-PAY OR ARE UNINSURED ARE SCREENED THROUGH PRESUMPTIVE ELIGIBILITY QUESTIONS TO DETERMINE IF THEY ARE ELIGIBLE FOR THE OREGON HEALTH PLAN MEDICAID ASSISTANCE PROGRAM (OHP). THESE PATIENTS ARE ASSIGNED TO A FINANCIAL COUNSELOR TO ASSIST WITH COMPLETING AND SUBMITTING THEIR OHP APPLICATION PACKET TO THE OREGON HEALTH AUTHORITY OFFICE. HOWEVER, THIS IS NOT A REQUIREMENT TO APPLY FOR OR RECEIVE FINANCIAL ASSISTANCE. ALL PATIENTS INCLUDING INSURED, UNINSURED, AND UNDERINSURED ARE PROVIDED FINANCIAL ASSISTANCE INFORMATION ON BILLING STATEMENTS, AT SHS CUSTOMER SERVICE DESKS AND ON THE SHS WEBSITE.ALL APPLICATION MATERIALS ARE AVAILABLE IN ENGLISH, SPANISH AND CHINESE (SIMPLE) AND INTERPRETATIVE SERVICES ARE AVAILABLE FOR NON-ENGLISH SPEAKING PATIENTS EITHER FACE-TO-FACE OR THROUGH VARIOUS ELECTRONIC DEVICES. PART VI, LINE 4: GSH PRIMARILY SERVES RESIDENTS OF BENTON COUNTY. ESTABLISHED BY THE PROVISIONAL LEGISLATURE IN 1847, BENTON COUNTY OCCUPIES 679 SQUARE MILES OF THE CENTRAL WILLAMETTE VALLEY. BENTON COUNTY IS BORDERED ON THE EAST BY THE WILLAMETTE RIVER AND LINN COUNTY, WITH LINCOLN COUNTY ON THE WEST, POLK COUNTY ON THE NORTH, AND BY LANE COUNTY ON THE SOUTH. ACCORDING TO THE US CENSUS 2022 POPULATION ESTIMATES, BENTON COUNTY HAS A POPULATION OF 97,630 RESIDENTS OF WHICH APPROXIMATELY 25,000 ARE STUDENTS AT OREGON STATE UNIVERSITY. THE CITY OF CORVALLIS IS THE COUNTY SEAT FOR BENTON COUNTY AND HAS A POPULATION OF 59,864 (US CENSUS 2022). ALTHOUGH THE MAJORITY OF RESIDENTS LIVE IN CORVALLIS OR OTHER INCORPORATED CITIES IN THE COUNTY, APPROXIMATELY 21% OF RESIDENTS LIVE IN RURAL BENTON COUNTY. THESE RURAL COMMUNITIES INCLUDE ALSEA, KINGS VALLEY, WREN, BLODGETT, SUMMIT AND BELLFOUNTAIN. PORTIONS OF BENTON COUNTY HAVE DESIGNATIONS OF MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ACCORDING TO THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, WITH GSH BEING THE ONLY HOSPITAL LOCATED IN BENTON COUNTY. THE CHART BELOW SUMMARIZES THE RACIAL & ETHNIC DEMOGRAPHICS OF BENTON COUNTY:RACE/ETHNICITY POPULATIONWHITE/CAUCASIAN 86.6%BLACK/AFRICAN AMERICAN 1.3%AMERICAN INDIAN/ALASKA NATIVE 1.0%ASIAN 6.6%HISPANIC 8.2%NATIVE HAWAIIAN/PACIFIC ISLANDER 0.3%REPORTING TWO OR MORE RACES 4.1%SOURCE: U.S. CENSUS BUREAU, 2022 CENSUS QUICK FACTS, PUBLIC LAW 94-171 SUMMARY FILEHEALTH AND SOCIAL INDICATORS ARE USED TO GENERALIZE THE CONDITIONS OF BENTON COUNTY:HEALTH AND SOCIAL INDICATORS TOTALSMEDIAN INCOME $68,732UNEMPLOYMENT 4.9%POVERTY 17.3%UNINSURED CHILDREN 3.3%CHILD ABUSE (REFERRED CASES) 698 SUBSTANCE USE DISORDER OVERDOSES 139JUVENILE JUSTICE REFERRALS 10.7/1000OREGON EMPLOYMENT DEPARTMENT DECEMBER 2022, U.S. CENSUS BUREAU, 2022 CENSUS QUICK FACTS, PUBLIC LAW 94-171 SUMMARY FILE, 2022 CHILD WELL-BEING IN OREGON COUNTY DATA BOOK, 2022 COUNTY HEALTH RANKINGS. PART VI, LINE 5: GSH'S GOVERNING BOARD IS COMPRISED OF LOCAL-AREA RESIDENTS. THE MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT, MEANING THEY AND THEIR FAMILY MEMBERS ARE NOT EMPLOYEES OF GSH NOR DO THEY HAVE ANY SIGNIFICANT BUSINESS RELATIONSHIPS WITH GSH. GSH EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GSH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. GSH INVESTS IN UPDATING EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. GSH IS ACCREDITED FOR CONTINUING MEDICAL EDUCATION AND OFFERS WEEKLY PROGRAMS FOR AREA PHYSICIANS AND OTHER HEALTH PROFESSIONALS. THE CENTER FOR HEALTH RESEARCH AND QUALITY, A DEPARTMENT OF GSH'S PARENT COMPANY, SAMARITAN HEALTH SERVICES (SHS), PROVIDES ADMINISTRATIVE OVERSIGHT FOR HEALTH AND CLINICAL RESEARCH, QUALITY IMPROVEMENT PROJECTS AND STUDIES, AND OTHER SPONSORED ACTIVITIES FOR GSH AND ITS AFFILIATED HOSPITALS. PART VI, LINE 6: "BUILDING HEALTHIER COMMUNITIES TOGETHER" IS THE MISSION OF SAMARITAN HEALTH SERVICES (SHS), A NETWORK OF OREGON HOSPITALS AND PHYSICIANS THAT SERVE THE HEALTH CARE NEEDS OF PEOPLE IN THE MID-WILLAMETTE VALLEY AND THE CENTRAL OREGON COAST.AS THE INDIVIDUAL ENTITIES OF SHS CAME TOGETHER, THEY WERE DRAWN BY A SHARED DESIRE "TO ENHANCE COMMUNITY HEALTH AND ACHIEVE HIGH VALUE THROUGH QUALITY SERVICES ACROSS THE CONTINUUM OF CARE." WITH THE MISSION OF "BUILDING HEALTHIER COMMUNITIES TOGETHER," SHS LOOKS CAREFULLY AT LOCAL HEALTH CARE NEEDS, AND IT GIVES THOUGHTFUL CONSIDERATION TO THE MOST EFFECTIVE WAYS TO MEET THOSE NEEDS. THE RESULT IS A RICH MIX OF LOCAL AND CENTRALIZED REGIONAL SERVICES WHICH PROVIDE HIGH VALUE AND EXCELLENT HEALTHCARE FOR PEOPLE AT ALL STAGES OF THEIR LIVES. SERVICES ARE PROVIDED TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY. THE COLLECTIVE VISION OF SHS IS TO SERVE OUR COMMUNITIES WITH PRIDE (PASSION, RESPECT, INTEGRITY, DEDICATION, AND EXCELLENCE). SHS IS GOVERNED BY A PARTNERSHIP OF COMMUNITY MEMBERS, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. SHS SEEKS TO LEAD COLLABORATIVE EFFORTS AMONG PROVIDERS, EMPLOYERS, HEALTH PLANS AND CONSUMERS WHO SHARE SIMILAR GOALS AND VALUES TO MEET THE CHALLENGES OF THE FUTURE.GSH IS THE FLAGSHIP HOSPITAL OF SHS. IT PRIMARILY SERVES RESIDENTS OF BENTON COUNTY. OTHER AFFILIATED HOSPITALS ARE ALBANY GENERAL HOSPITAL AND SAMARITAN LEBANON COMMUNITY HOSPITAL, SERVING RESIDENTS OF LINN COUNTY, AND SAMARITAN NORTH LINCOLN HOSPITAL AND SAMARITAN PACIFIC COMMUNITIES HOSPITAL, SERVING RESIDENTS OF LINCOLN COUNTY. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 ALBANY HELPING HANDS PO BOX 2252 ALBANY OR 97321 931244271 501(C)(3) 10800 0 SUPPORT FOR UNHOUSED PEOPLE BOYS AND GIRLS CLUB OF CORVALLIS 1112 NW CIRCLE BLVD CORVALLIS OR 97330 237153987 501(C)(3) 10000 0 SUPPORT TO IMPROVE YOUTH FITNESS AND ACCESS TO NUTRITIOUS FOODS CASA LATINOS UNIDOS BENTON COUNTY 1435 SW 35TH ST CORVALLIS OR 97333 263639798 501(C)(3) 13930 0 EMERGENCY FINANCIAL ASSISTANCE TO SPANISH-SPEAKING COMMUNITY MEMBERS BENTON COUNTY 4077 SW RESEARCH WAY CORVALLIS OR 97333 936002285 GOV'T 6000 0 SUPPORT TO ADDRESS URGENT ORAL HEALTH NEEDS TO UNINSURED AND LOW-INCOME BENTON COUNTY RESIDENTS CORVALLIS DAYTIME DROP-IN CENTER 316 SW WASHINGTON AVE CORVALLIS OR 97333 800019915 501(C)(3) 27775 0 EQUITABLE AND INCLUSIVE BEHAVIORAL HEALTH SUPPORT FOR UNHOUSED COMMUNITY MEMBERS CORVALLIS ENVIRONMENTAL CENTER PO BOX 456 CORVALLIS OR 97339 931140056 501(C)(3) 15000 0 SUPPORT TO REDUCE FOOD INSECURITY FOR LOCAL VULNERABLE POPULATIONS LOVE IN THE NAME OF CHRIST OF BENTON COUNTY 4900 NW HWY 99 CORVALLIS OR 97330 931326307 501(C)(3) 8550 0 SUPPORT FOR URGENT ORAL HEALTH NEEDS TO UNINSURED AND LOW-INCOME BENTON CO., OREGON RESIDENTS NORTHWEST COASTAL HOUSING PO BOX 1457 NEWPORT OR 97365 943141603 501(C)(3) 54000 0 HOUSING SUPPORT FOR LOW INCOME OREGON COASTAL RESIDENTS PHILOMATH YOUTH ACTIVITIES CLUB INC PO BOX 1358 PHILOMATH OR 97370 931127754 501(C)(3) 16277 0 SUPPORT TO REDUCE FOOD INSECURITY FOR LOCAL VULNERABLE POPULATIONS STONE SOUP CORVALLIS INC PO BOX 2381 CORVALLIS OR 97339 462438435 501(C)(3) 9060 0 MEALS FOR FOOD INSECURE FAMILIES IN SOUTH CORVALLIS STRENGTHENING RURAL FAMILIES PO BOX 1528 PHILOMATH OR 97370 202934930 501(C)(3) 10450 0 SUPPORT FOR URGENT ORAL HEALTH NEEDS TO UNINSURED AND LOW-INCOME BENTON CO., OREGON RESIDENTS UNITY SHELTER INC 4515 SW WEST HILLS RD CORVALLIS OR 97333 845104870 501(C)(3) 6000 0 SUPPORT FOR UNHOUSED PEOPLE VINA MOSES WELFARE CENTER INC 968 NW GARFIELD AVE CORVALLIS OR 97330 930615775 501(C)(3) 5863 0 RENTAL, UTILITY, AND TRANSPORTATION ASSISTANCE TO FAMILIES IN BENTON CO., OREGON WE CARE 125 NW 10TH ST CORVALLIS OR 97330 930822417 501(C)(3) 19680 0 EMERGENCY FINANCIAL ASSISTANCE TO SPANISH-SPEAKING COMMUNITY MEMBERS COMMUNITY OUTREACH INC 865 NW REIMAN AVE CORVALLIS OR 97330 930602094 501(C)(3) 231192 0 RESPITE BED SUPPORT FOR LOW INCOME RECENTLY DISCHARGED PATIENTS 15 ACCOMMODATIONS - PASTEGA HOUSE 1469 326627 BOOK TEMPORARY HOUSING FOR PATIENTS AND THEIR FAMILY MEMBERS PART I, LINE 2: AGENCIES IN THE COMMUNITY ARE INVITED TO SUBMIT GRANT PROPOSALS THROUGH AN APPLICATION PROCESS. A COMMITTEE REVIEWS THE APPLICATIONS TO DETERMINE IF THE FUNDS REQUESTED WILL BE USED TO ADDRESS THE ORGANIZATION'S ESTABLISHED COMMUNITY HEALTH PRIORITIES, IDENTIFIED NEEDS, AND SUPPORTS THE ORGANIZATION'S MISSION. ONCE APPROVED AND FUNDED, AGENCIES MUST SUBMIT A COMPLETE ANNUAL REPORT DESCRIBING HOW THE FUNDS WERE USED, THE NUMBER OF CLIENTS SERVED, AND HOW OUTCOMES WERE ACHIEVED. X 1 1 1 1 0 1 0 0 0 0 0 MICHAEL MENNINGER MD MEDICAL DIRECTOR 1278516 0 0 0 46393 0 27756 0 47040 0 1399705 0 0 0 CAY MIERISCH MD PHYSICIAN 1056293 0 167696 0 28931 0 27756 0 46413 0 1327089 0 0 0 WAEL GHACHAM MD PHYSICIAN 1013143 0 0 0 834 0 27756 0 46975 0 1088708 0 0 0 CHRISTOPHER MCCRUM MD PHYSICIAN 741663 0 193314 0 26906 0 27756 0 47834 0 1037473 0 0 0 ESTHER KIM MD MEDICAL DIRECTOR 931792 0 0 0 26613 0 27756 0 19493 0 1005654 0 0 0 LAURA HENNUM CEO (END AUG) 0 290885 0 21914 0 489386 0 27756 0 18151 0 848092 0 0 DANIEL SMITH SVP / CFO 0 539235 0 31558 0 52012 0 27756 0 38360 0 688921 0 0 DOUGLAS AUKERMAN MD CHIEF MEDICAL OFFICER 370779 0 7138 0 23005 0 27756 0 44518 0 473196 0 0 0 BRANDON SCHMIDGALL VP COO 339372 0 6220 0 1146 0 11192 0 42289 0 400219 0 0 0 JOHN BLENKINSOPP VP PATIENT CARE SVCS 293236 0 19425 0 8722 0 9242 0 43970 0 374595 0 0 0 PART I, LINE 1A IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. EMPLOYEES CAN USE THEIR WELLNESS BENEFIT AT EITHER NON-SAMARITAN OR SAMARITAN (SAMFIT) GYM/FITNESS FACILITIES. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR FEES. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THEIR TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE KEY EMPLOYEE USED THE NON-SAMARITAN GYM REIMBURSEMENT DURING THE FILING YEAR. IF EMPLOYEES USE THEIR WELLNESS BENEFIT AT A SAMARITAN (SAMFIT) GYM/FITNESS FACILITY, THEN THE ANNUAL COST OF EMPLOYEE MEMBERSHIP, $300, IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. ONE KEY EMPLOYEE, ONE OFFICER, AND TWO HIGHEST PAID EMPLOYEES USED THE SAMARITAN (SAMFIT) GYM/FITNESS FACILITY BENEFIT DURING THE FILING YEAR. PART I, LINE 3 THE CHIEF EXECUTIVE OFFICER IS EMPLOYED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION CONDUCTS A COMPENSATION ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. PERIODICALLY, THE RELATED ORGANIZATION WILL ALSO USE WRITTEN EMPLOYMENT CONTRACTS, FORM 990 OF OTHER ORGANIZATIONS, AND INDEPENDENT COMPENSATION CONSULTANTS TO DETERMINE THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. PART I, LINES 4A-B LINE 4A: LAURA HENNUM, AN OFFICER, RECEIVED A SEVERANCE PAYMENT OF $476,597 PURSUANT TO THE TERMINATION OF HER EMPLOYMENT CONTRACT. LINE 4B: A RELATED ORGANIZATION MAINTAINS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. HOWEVER, NO PERSONS LISTED IN PART VII OF FORM 990 ACCRUED DEFERRED COMPENSATION BENEFITS OR RECEIVED ANY PAYMENTS FROM THESE PLANS DURING THE FILING YEAR. PART I, LINE 5 VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION. FORM 990, PART VI, SECTION A, LINE 6 GOOD SAMARITAN HOSPITAL CORVALLIS HAS A SOLE CORPORATE MEMBER, SAMARITAN HEALTH SERVICES, INC., WHICH IS A SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A GOOD SAMARITAN HOSPITAL CORVALLIS ELECTS MEMBERS OF ITS BOARD OF DIRECTORS. THOSE ELECTED MEMBERS ARE THEN SUBMITTED TO THE SOLE CORPORATE MEMBER FOR APPROVAL. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE CORPORATE MEMBER HAS SEVERAL RESERVED POWERS OVER THE ORGANIZATION. THESE RESERVED POWERS INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL AT CERTAIN THRESHOLD LEVELS: THE BORROWING OF FUNDS, MERGERS AND ACQUISITIONS, AND SALES OR TRANSFERS OF ASSETS. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ANY CHANGE IN THE MISSION OF THE ORGANIZATION, THE ANNUAL BUDGET, AND ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE ORGANIZATION'S FINAL FORM 990 (INCLUDING REQUIRED SCHEDULES), AS ULTIMATELY FILED WITH THE IRS, WAS PROVIDED TO EACH VOTING MEMBER OF THE SAMARITAN HEALTH SERVICES (SHS) AUDIT AND COMPLIANCE COMMITTEE PRIOR TO ITS FILING WITH THE IRS. SHS IS A 501(C)(3) CORPORATION AND IS THE SOLE MEMBER OF THE FILING ORGANIZATION. SHS'S CHIEF FINANCIAL OFFICER CONDUCTED THE FORM 990 REVIEW WITH THE COMMITTEE AND PROVIDED TIME FOR QUESTIONS FROM THE GROUP. A FORMAL REPORT OF THIS COMMITTEE HAS BEEN MADE TO THE FULL BOARD OF DIRECTORS OF SHS. ADDITIONALLY, A COMPLETE COPY OF THE FILING ORGANIZATION'S FINALIZED FORM 990 AND RELATED SCHEDULES WAS PROVIDED ELECTRONICALLY TO ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BOARD PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBER CONFLICTS OF INTEREST: THE MEMBERS OF THE BOARD MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH REQUIRES DISCLOSURE OF ANY CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE CHIEF FINANCIAL OFFICER AND CORPORATE COMPLIANCE OFFICER. IF A CONFLICT IS DISCLOSED THAT COULD PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THIS IS EVALUATED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES (SHS) BOARD OF DIRECTORS TO DETERMINE WHETHER THE MEMBER SHOULD CONTINUE TO SERVE ON THE BOARD. IF A CONFLICT IS DISCLOSED THAT DOES NOT PROHIBIT A MEMBER FROM SERVING ON THE BOARD, THE CONFLICT IS MANAGED THROUGH A PROCESS SET FORTH IN THE ORGANIZATION'S BYLAWS. THE BYLAWS PROHIBIT ANY BOARD MEMBER FROM VOTING ON AN ACTION WHERE AN INDIVIDUAL MEMBER HAS A CONFLICT OF INTEREST. EMPLOYEE CONFLICTS OF INTEREST: THE SHS CODE OF CONDUCT AND BUSINESS ETHICS POLICY REQUIRES THAT ALL SHS EMPLOYEES COMPLETE AN ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST. THROUGH THE HUMAN RESOURCES SOFTWARE, PERFORMANCE MANAGER, THE DISCLOSURE REQUIREMENT NOTICE IS ASSIGNED TO ALL EMPLOYEES AND BY YEAR END ALL TASKS ARE TO BE COMPLETED. IF THERE IS A PERCEIVED CONFLICT OF INTEREST IT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER, LEGAL COUNSEL AND/OR SENIOR MANAGEMENT. ACTUAL CONFLICTS OF INTEREST ARE REVIEWED AND DISCUSSED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE SAMARITAN HEALTH SERVICES BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: THE CEO OF THE PARENT COMPANY, SAMARITAN HEALTH SERVICES (SHS) USES PUBLICLY AVAILABLE INFORMATION TO DETERMINE THE COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION. HE CONSULTS WITH THE INDEPENDENT CONSULTANT AS TO THE REASONABLENESS OF THIS DATA TO ENSURE THAT THE TOP MANAGEMENT OFFICIAL'S COMPENSATION IS REASONABLE AS COMPARED TO SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. LINE 15B: PHYSICIAN EMPLOYEE COMPENSATION, INCLUDING PHYSICIANS WHO ARE BOARD MEMBERS, IS REVIEWED AT LEAST ANNUALLY BY SENIOR MANAGEMENT. THIS REVIEW INCLUDES COMPARISON WITH PUBLISHED PHYSICIAN COMPENSATION STUDIES. FOR ALL OTHER EMPLOYEES, THE ORGANIZATION PERFORMS AN ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. SYSTEM-WIDE SUMMARIZED DATA IS ALSO PROVIDED IN THE ANNUAL REPORT TO THE COMMUNITY. THIS REPORT IS MADE AVAILABLE IN KIOSKS AND HIGH-TRAFFIC AREAS OF THE HOSPITALS AND PHYSICIAN CLINICS, AS WELL AS COMMUNITY PLACES SUCH AS THE PUBLIC LIBRARY. IT IS ALSO DISTRIBUTED TO THE BOARDS OF DIRECTORS AND DIRECTLY MAILED TO DONORS AND NEW RESIDENTS IN THE COMMUNITY. ADDITIONALLY, THE REPORT IS MADE AVAILABLE AT EVENTS, COMMUNITY OUTREACH PROJECTS, AND SCREENINGS ATTENDED THROUGHOUT THE YEAR. GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX COL D THE FUNDRAISING FUNCTIONS FOR THE FILING ORGANIZATION ARE CENTRALIZED THROUGH AND REPORTED BY THE PARENT ORGANIZATION, SAMARITAN HEALTH SERVICES, INC. (SHS) (FEIN 93-0951989). SEE THE SHS 990 FOR THE FUNDRAISING EXPENSES ASSOCIATED WITH THE CONTRIBUTION REVENUE REPORTED ON LINE 1 PART VIII. FORM 990, PART XI, LINE 9: DISTRIBUTIONS TO MINORITY INTEREST CONSOLIDATED JVS -1,130,625. CHANGE IN MINIMUM PENSION LIABILITY 3,284,193. OTHER CHANGES -128,160. 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