Form 990 for tax year 2022
Filed by SALMON CREEK HOSPITAL FOUNDATION.
Totals
- Total revenue
- $73,776
- Total expenses
- $458,302
- Contributions and grants received
- $275,176
- Grants paid
- $458,302
- Program service revenue
- $0
- Investment income
- -$168,602
- Other revenue
- -$32,798
- Total assets, end of year
- $3,976,856
- Total liabilities, end of year
- $0
- Net assets or fund balances, end of year
- $3,976,856
- Program services expenses (Part IX)
- $458,302
- Management and general expenses
- $0
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $458,302
Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1c · Fundraising events
$116,935
-
1d · Related organizations
$5,000
-
1f · All other contributions, gifts and grants
$153,241
-
3 · Investment income
total -$168,602 · excluded -$168,602
-
4 · Income from investment of tax-exempt bond proceeds
total $0
-
5 · Royalties
total $0
-
6d · Net rental income or loss
total $0
-
7d · Net gain or loss
total $0
-
8a · Fundraising events: gross income
$6,180
-
8a · Fundraising events: contributions included on line 1c
$116,935
-
8b · Fundraising events: direct expenses
$38,978
-
8c · Net income from fundraising events
total -$32,798 · excluded -$32,798
-
9c · Net income from gaming
total $0
-
10c · Net income from sales of inventory
total $0
-
11e · Other revenue, total
$0
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $458,302 · program services $458,302
-
2 · Grants to domestic individuals
total $0
-
3 · Grants to foreign organizations and individuals
total $0
-
4 · Benefits paid to or for members
total $0
-
5 · Compensation of officers, directors and key employees
total $0
-
6 · Compensation of disqualified persons
total $0
-
7 · Other salaries and wages
total $0
-
8 · Pension plan contributions
total $0
-
9 · Other employee benefits
total $0
-
10 · Payroll taxes
total $0
-
11a · Fees: management
total $0
-
11b · Fees: legal
total $0
-
11c · Fees: accounting
total $0
-
11d · Fees: lobbying
total $0
-
11e · Fees: professional fundraising services
total $0
-
11f · Fees: investment management
total $0
-
11g · Fees: other
total $0
-
12 · Advertising and promotion
total $0
-
13 · Office expenses
total $0
-
14 · Information technology
total $0
-
15 · Royalties
total $0
-
16 · Occupancy
total $0
-
17 · Travel
total $0
-
18 · Travel or entertainment for public officials
total $0
-
19 · Conferences, conventions and meetings
total $0
-
20 · Interest
total $0
-
21 · Payments to affiliates
total $0
-
22 · Depreciation, depletion and amortization
total $0
-
23 · Insurance
total $0
-
24e · All other expenses
total $0
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
end of year $0
-
2 · Savings and temporary cash investments
end of year $0
-
3 · Pledges and grants receivable
end of year $0
-
4 · Accounts receivable
end of year $0
-
5 · Loans and receivables from officers and key people
end of year $0
-
6 · Loans and receivables from disqualified persons
end of year $0
-
7 · Other notes and loans receivable
end of year $0
-
8 · Inventories for sale or use
end of year $0
-
9 · Prepaid expenses and deferred charges
end of year $0
-
10c · Land, buildings and equipment, net
end of year $0
-
11 · Investments: publicly traded securities
end of year $0
-
12 · Investments: other securities
beginning of year $4,339,648 · end of year $3,976,856
-
13 · Investments: program-related
end of year $0
-
14 · Intangible assets
end of year $0
-
15 · Other assets
end of year $0
-
27 · Net assets without donor restrictions
beginning of year $1,511,614 · end of year $1,359,130
-
28 · Net assets with donor restrictions
beginning of year $2,828,034 · end of year $2,617,726
Mission and programs · 2022
Mission
SALMON CREEK HOSPITAL FOUNDATION'S PURPOSE IS TO PROVIDE SUPPORT FOR THE VISION AND MISSION OF LEGACY SALMON CREEK HOSPITAL BY RAISING FUNDS AND PROMOTING VISIBILITY IN THE VANCOUVER COMMUNITY AND THROUGHOUT SW WASHINGTON.
-
Charitable gifts to Salmon Creek Hospital Foundation support the programs and services of Legacy Salmon Creek Medical Center, many of which are not supported by traditional means of reimbursement.Legacy Salmon Creek Medical Center opened in August 2005 as a full-service community hospital for the southwest Washington area, including Clark, Cowlitz, Skamania, Klickitat, and Wahkiakum counties. Services include: Emergency Department, including a special pediatric emergency area Surgical Services Family Birth Center and Center for Maternal-Fetal Medicine A neonatal intensive care unit (NICU) Cancer Services Cardiac Services Neuroscience Center, including Stroke Program Total Joint Center Rehabilitation Services Pediatric Outpatient Services, including Development and Rehabilitation and the Child Abuse Assessment TeamIn addition, the Foundation supports several Legacy Medical Group primary and specialty care clinics in southwest Washington.In fiscal year 2023, philanthropic contributions supported programs in these major areas:Patient Care $435,610Education and Training $21,705Community Benefit & Other Programs $39,966Some of the projects funded in this year included: Provided support for the Child Abuse Assessment Team (CAAT). Provided emergency medications, durable medical equipment, transitional housing, and other health-related supplies to uninsured, under-insured, and low-income patients. Purchased cameras for the NICU so families can view their baby when not at the hospital. Provided support for families with extended stays in the Neonatal Intensive Care Unit. Supported musical care on all hospital units. Purchased therapy equipment for the pediatric rehabilitation program. Supported child passenger safety seat activities for the community. Provided continuing education scholarships for nurses.
Expenses $458,302 · Grants $458,302 · Revenue $296,910
As filed on the 2022 return.
Listed in Part VII
-
Bryce R HelgersonBRYCE R HELGERSON
FORMER EX-OFFICIO
- Total calculated
- $858,561
- From this org
- $0
- From related orgs
- $937,453
- Other
- -$78,892
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $155,209 related
- Bonus
- not reported
- Other
- not reported + $782,244 related
- Deferred
- not reported + -$82,689 related
- Nontaxable benefits
- not reported + $3,797 related
- Filer's total
- not reported + $858,561 related
-
Jon J HersenJON J HERSEN
EX-OFFICIO
- Total calculated
- $615,728
- From this org
- $0
- From related orgs
- $555,209
- Other
- $60,519
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $554,872 related
- Bonus
- not reported
- Other
- not reported + $337 related
- Deferred
- not reported + $26,311 related
- Nontaxable benefits
- not reported + $34,208 related
- Filer's total
- not reported + $615,728 related
-
Maureen A BradleyMAUREEN A BRADLEY
EX- OFFICIO
- Total calculated
- $413,805
- From this org
- $0
- From related orgs
- $419,150
- Other
- -$5,345
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $411,327 related
- Bonus
- not reported
- Other
- not reported + $7,823 related
- Deferred
- not reported + -$24,803 related
- Nontaxable benefits
- not reported + $19,458 related
- Filer's total
- not reported + $413,805 related
-
Mehrdad Shojaei MDMEHRDAD SHOJAEI MD
Trustee
- Total calculated
- $388,676
- From this org
- $0
- From related orgs
- $344,081
- Other
- $44,595
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $276,345 related
- Bonus
- not reported + $49,217 related
- Other
- not reported + $18,519 related
- Deferred
- not reported + $21,070 related
- Nontaxable benefits
- not reported + $23,525 related
- Filer's total
- not reported + $388,676 related
-
Anne T GreerANNE T GREER
FORMER OFFICER
- Total calculated
- $368,122
- From this org
- $0
- From related orgs
- $372,488
- Other
- -$4,366
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $37,602 related
- Bonus
- not reported
- Other
- not reported + $334,886 related
- Deferred
- not reported + -$6,422 related
- Nontaxable benefits
- not reported + $2,056 related
- Filer's total
- not reported + $368,122 related
-
Jennifer NewJENNIFER NEW
ASST. TREASURER
- Total calculated
- $285,444
- From this org
- $0
- From related orgs
- $251,052
- Other
- $34,392
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $253,507 related
- Bonus
- not reported
- Other
- not reported + -$2,455 related
- Deferred
- not reported + $12,317 related
- Nontaxable benefits
- not reported + $22,075 related
- Filer's total
- not reported + $285,444 related
-
Heather G MartinHEATHER G MARTIN
Executive Dir.
- Total calculated
- $246,274
- From this org
- $0
- From related orgs
- $213,889
- Other
- $32,385
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- not reported + $216,401 related
- Bonus
- not reported
- Other
- not reported + -$2,512 related
- Deferred
- not reported + $10,188 related
- Nontaxable benefits
- not reported + $22,197 related
- Filer's total
- not reported + $246,274 related
-
Marg C NelsonMARG C NELSON
Secretary
- Total calculated
- $0
- Hours/week
- 1
-
Douglas BartocciDOUGLAS BARTOCCI
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Allan E JeskaALLAN E JESKA
EX-OFFICIO
- Total calculated
- $0
- Hours/week
- 1
-
Dennis R MalinDENNIS R MALIN
Chairman
- Total calculated
- $0
- Hours/week
- 1
-
Lisa K DowLISA K DOW
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Michael R BurgoyneMICHAEL R BURGOYNE
Treasurer
- Total calculated
- $0
- Hours/week
- 1
-
Kiersten J Seeger WareKIERSTEN J SEEGER WARE
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Jessica Engblom StrykerJESSICA ENGBLOM STRYKER
Trustee
- Total calculated
- $0
- Hours/week
- 0
-
Erik W PaulsenERIK W PAULSEN
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Douglas C Greene SrDOUGLAS C GREENE SR
VICE CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
Mei C WuMEI C WU
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Michele L RudiMICHELE L RUDI
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Suzanne D Slayton-Milam MDSUZANNE D SLAYTON-MILAM MD
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Monte PhillipsMONTE PHILLIPS
Trustee
- Total calculated
- $0
- Hours/week
- 1
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 4b · Supplemental nonqualified retirement plan
- 5b · Pay contingent on a related organization's revenues
- 6b · Pay contingent on a related organization's net earnings
Answered no
- 4a · Severance or change-of-control payment
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- Part I, Line 5b: Explanation of organization compensation based on revenues of related organization
- Physicians employed by Legacy affiliates are paid variable compensation based on quality, value, and production. Production is based upon the level of effort of services provided during the year measured by industry standard relative value units (RVU) and which generate revenue.
- Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or
- Legacy has an at-risk incentive compensation plan for management. The plan is based on meeting goals related to employee engagement, work processes, customer service, clinical quality, financial management, and certain key strategic tactics. In order to payout any at-risk incentive compensation, Legacy must exceed operating margin targets.
- Part II, Compensation from Unrelated Organizations
- Sch J, Part 1, Question 3 Regarding Compensation PracticesThe following describes the compensation practices of Legacy Health and its affiliates.The Compensation Committee of the Board of Directors, none of whom is a Legacy employee, reviews the compensation for executive positions. The Committee oversees the system's governance procedures with respect to intermediate sanctions legislation and the evaluation of reasonableness of compensation. The Committee reports to the Board in sufficient detail to enable the entire Board to take such actions as are required to obtain the rebuttable presumption of reasonableness. The Compensation Committee also reviews tax-reporting disclosures.Sch J, Part II, Column Breakdown Of W-2 Or Misc-1099:Column B(i) - Base compensation consists of regular base pay including employee elected deferrals for retirement plans (403(b) and 457(b) plans).Column B(ii) - The incentive compensation program for Legacy is based on predetermined criteria and reviewed and approved by the Board. Bonuses are paid to key employees for interim duties outside their primary responsibilities (e.g. Acting in Capacity).Column B(iii) - Other compensation consists of deferred compensation amounts paid to executives during the current year and were reported on prior form 990 returns. These amounts include arrangements that contain elements of a substantial risk of forfeiture conditioned on continued employment, vesting and/or a noncompete provision upon termination of employment. Distributions from 457(b) plans, reported to the employee on a 1099-R, are also included as other compensation. In addition, imputed income for insurance and other benefits is included in other compensation as well as any severance related payments.Column C - Deferred compensation includes the contributions to defined contribution plans, amounts deferred under the 457(f) plan including earnings, earnings in the 457(b) plan, and the value of the pension restoration plan. Earnings on the 457(f) and 457(b) include gains and losses on the underlying investments. The defined contribution plan is available to all employees as they become qualified to participate. The pension restoration plan provides executive pension benefits in excess of IRS mandated limits on eligible compensation to key executives. The benefits are unfunded and subject to forfeiture. Executive pension benefits are intended to make the executive's retirement benefit, as a proportion of their final average salary, comparable to all other employees, and are treated as income when paid.Column D - Nontaxable benefits include company paid health and welfare and long term care and disability benefits under group plans.Column F - Current year compensation reported as deferred in prior years.
- Part III, Additional Information
- SCHEDULE J REPORTING OF TRUSTEE AND OFFICERS ON LEGACY AFFILIATE RETURNS.The Foundation Ex-Officio Trustees and Officers who are also Legacy employees have their compensation paid from Legacy Health and Legacy Salmon Creek Hospital. The compensation is reported for informational purposes on the Foundation return.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
-
$404,877
-
$42,257
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
501(C)(3) · HEALTHCARE · OR
-
501(C)(3) · HOSPITAL · WA
-
LEGACY EMANUEL HOSPITAL & HEALTH CENTER
501(C)(3) · HOSPITAL · OR
-
LEGACY GOOD SAMARITAN HOSPITAL & MEDICAL
501(C)(3) · HOSPITAL · OR
-
501(C)(3) · HOSPITAL · OR
-
LEGACY MOUNT HOOD MEDICAL CENTER
501(C)(3) · HOSPITAL · OR
-
LEGACY VISITING NURSE ASSOCIATION
501(C)(3) · HOSPICE · OR
-
RANDALL CHILDRENS HOSPITAL FOUNDATION
501(C)(3) · CHARITABLE FOUNDATION · OR
-
501(C)(3) · CHARITABLE FOUNDATION · OR
-
501(C)(3) · CHARITABLE FOUNDATION · OR
-
501(C)(3) · HOSPITAL · OR
-
501(C)(3) · CHARITABLE FOUNDATION · OR
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 15 February 2024
- IRS schema version
- 2022v5.0
- Source object
- 202410469349301771
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