Community Benefit Insight - Tax-exempt hospital

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Silverton Health Dba Legacy Silverton Health

Silverton Hospital

342 Fairview Street
Silverton, OR 97381

Bed count	48	Medicare provider number	380029	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 930281321

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

11.03%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 4,668,439 3.76 %
Medicaid as % of operating expenses	$ 6,182,808 4.98 %
Costs of other means-tested government programs as % of operating expenses	$ 989,713 0.80 %
Health professions education as % of operating expenses	$ 345,604 0.28 %
Subsidized health services as % of operating expenses	$ 1,098,377 0.88 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 179,161 0.14 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 227,469 0.18 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 3,343,916 2.69 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 2,742,011 82.00 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 91277773 including grants of $ 51744) (Revenue $ 121559156)
SH provides inpatient and outpatient care and education services to the communities it serves. In support of its mission, SH voluntarily provides medically necessary patient care services that are discounted or free of charge to persons who have insufficient resources and/or who are unisured. During fiscal year 2022, SH incurred uncompensated costs of roughly $4,668,400 associated with its financial assistance program. In addition to charity care, SH provides services under various states' Medicaid programs for financially needy patients and Medicare beneficiaries for which the cost of treating these patients exceeds the government payments received. During fiscal year 2022, SH incurred approximately $6,182,800, $11,368,600 and $989,700 in uncompensated costs attributable to Medicaid, Medicare, and other government programs, respectively. SH also provides a variety of other community benefit activities such as medical education, donations to other charitable entities, research, and other health improvement services which totaled roughly $1,850,612 during fiscal year 2022.SH is part of Legacy, which collectively provided over $40 million, $292 million, $265 million, and $13 million in uncompensated care attributable to its financial assistance, Medicaid, Medicare, and other government programs, respectively, in fiscal year 2022. In addition, Legacy provided over $26 million in other community benefit activities during fiscal year 2022.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

Facility: Silverton Hospital - Part V, Section B, Line 5
Every five years, Marion and Polk Counties, in partnership with local health professionals and community organizations, come together to describe the health of the community by conducting a Community Health Assessment (CHA). The CHA gathers data from various reliable sources to identify local strengths and the most pressing health challenges usingan evidence based framework.In January 2018, Marion County Health & Human Services, Polk County Health Department, Willamette Valley Community Health (WVCH), local health professionals, and community partners began a new MAPP (Mobilizing for Action through Planning and Partnerships) cycle to assess and improve the health of the community. MAPP is a flexible, evidence-based framework, created by the National Association ofCounty Health Officials (NACCHO).MAPP was started by building a diverse partnership from various health sectors, education, and social service areas to ensure adequate representation and input into the process. This included the formation of the Core Group and Steering Committee, which served two separate and distinct roles. Additionally, a subcommittee was created for each of the Four MAPP Assessments. The Core Group was primarily concerned with the planning and managing of the MAPP process, which included creating agendas, gathering/reviewing data, and broadly coordinating efforts to complete the Community Health Assessment. The Steering Committee provided direction and guidance for the MAPP process.Silverton Health (SH) participated in the 2019 Marion-Polk Community Health Assessment (CHA) conducted by Marion and Polk counties, as well as participated in the Marion-Polk CHA Steering Committee that provided direction for the MAPP process and development of the Marion-Polk Community Health Assessment. The Steering Committee was comprised of members from Marion and Polk county public health agencies, the regional coordinated care organization, hospital organizations, academia, community-based organizations, transportation and local governmental agencies.The Steering Committee identified community health needs through a comprehensive study of population, state, county, and community data, including: Surveying community partners working in social, health, community and educational settings and the community at large An assessment of the Marion County public health system Compiling data from national and state surveillance systems such as the Centers for Disease Control and Prevention, Oregon Health Authority Behavioral Risk Factor Surveillance Survey, as well as state and local data from birth and death records Community forums in Woodburn, Salem, Stayton

Facility: Silverton Hospital - Part V, Section B, Line 6a
The Core Group was made up of staff from Marion County Health & Human Services, Polk County Health Department, and the local CCO Willamette Valley Community Health (WVCH).The following organizations were represented on the Steering Committee:* Behavioral Care Network* Chemeketa Community College* Cherriots* City of Woodburn* Community Action Agency* Community Advisory Council* Early Learning Hub* Kaiser Permanente* Legacy Health Silverton* Marion County Health & Human Services* Northwest Senior & Disability Services* Polk County Health Department* Salem Health* Santiam Hospital* Western Oregon University* Willamette Valley Community Health

Facility: Silverton Hospital - Part V, Section B, Line 11
The 2019 Marion Polk Community Health Assessment provided notable findings about the community Legacy Silverton serves in the following area:* Population* Race and ethnicity* Social determinants of health* Chronic health conditions* Emergency department admissions* Morbidity and mortalityThe voice of the community was captured through local forums and a community wide online survey. In the community survey, respondents were asked to report overall community health, quality of life, neighborhood health, health care access, the most important health problems in the community, the health behaviors that affect the community most, and demographics. On reviewing the data from the various assessment approaches, specific issues and common themes emerged as the priority health issues facing the community that Legacy Silverton serves.Based on the findings of the Marion Polk Community Health Assessment, and how we can best apply our resources and expertise to help address these needs, Legacy Silverton is focusing its efforts on thesepriority issues:Access to care -Improving residents ability to get the health care services they need, with an emphasis on primary/preventive care and management of chronic conditions such as obesity, diabetes and hypertension in adults.Behavioral health -Expanding the availability of and access to behavioral and mental health services for youth and adults to help address such conditions as substance-use disorder, depression, suicide and PTSD.Social determinants of health -Addressing the need for policies, systems, services and environments that support healthy behaviors, which means advancing solutions for such issues as homelessness and affordable housing for the underserved, food scarcity and, once again, access to health care. Education, meaningful employment, and removing barriers to culturally competent services arekey to improving the health of the community.Details on the specific initiatives Legacy Silverton is undertaking to address these priority issues can be found in our Community Health Improvement Plan (CHIP).

Supplemental Information

Schedule H (Form 990) Part VI

Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense
Silverton Health (SH) uses many different approaches to inform and educate patients on the availability of financial assistance as is described later in Part VI of Schedule H. Still, many patients do not respond to requests for information or provide appropriate documentation to benefit from financial assistance. As a result, SH must report these amounts as bad debt. A portion of bad debt expense should be considered as charity care, using reasonable methodologies to analyze the information.

Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit
The estimated amount of bad debt expenses attributable to charity care policy was calculated using the FY2021 demographic profile of household income and average household size in the zip code areas around the hospital. 82% of Households in the LSMC service area would qualify for financial assistance with incomes under 400% of the Federal Poverty Guidelines using this methodology.

Part III, Line 4 - Bad Debt Expense
The footnote that explains the Legacy bad debt expense can be found on page 9 of the attached audited financial statements.

Part III, Line 8 - Explanation Of Shortfall As Community Benefit
The entire Medicare shortfall should be considered a community benefit. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in the community served by the hospital. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. The Medicare amounts listed in Part III Section B. on lines 5, 6, and 7 do not represent all of the organization's revenues and costs associated with its participation in Medicare programs. The methodology used in reporting in Part III Section B Medicare is inconsistent with the other sections in Schedule H, as the instructions limit Medicare revenues and allowable cost to those from only the Medicare Cost Report. Revenue and costs from Medicare Part C patients, Part B physician services billed by the organization, and clinical laboratory services weren't included. In addition, hospitals incur other costs to provide care that Medicare does not allow in the cost report, such as Physician Call pay to ensure adequate physician coverage for the ED. The total revenues and costs attributable to all Medicare services are $21,782,455 and $33,151,100 respectively. This results in a total Medicare shortfall of $11,368,645.Costing Methodology (Part III, Line 8).Medicare allowable costs were calculated using the costing methodologies in the Medicare Cost Report. The cost report arrives at total allowable hospital cost through a cost finding process that includes direct cost allocations and a step-down allocation of indirect or overhead costs. Inpatient operating costs are composed of general inpatient routine and ICU unit costs derived from cost per diems, as well as inpatient ancillary service costs that utilize cost to charge ratios to arrive at cost. Apportionment of cost applicable to hospital outpatient services is through the application of cost to charge ratios. This excludes other costs incurred to provide services of the hospital to the community that the cost report deems as unallowable costs, such as Physician on-call pay.

Part III, Line 9b - Provisions On Collection Practices For Qualified Patients
Legacy provides care without charge or at amounts less than its established rates to patients who meet certain criteria under its financial assistance policy. Since Legacy does not pursue collection of amounts determined to qualify as charity care, they are excluded from net patient service revenues.

Part VI, Line 2 - Needs Assessment
Legacy Senior leadership, in conjunction with the Community Benefit staff works with local community-based partners to understand the needs of the community. The goal is to develop programs specific to the needs of the community. Involvement is both proactive and responsive - a leadership role in initiating programs as well as being readily available as a collaborative partner when the community asks. The outcome of this work is the development of both long-term and fiscal year plans. These are then aligned to the community health needs identified in the formal CHNA. The region served by the Legacy Silverton, along with most of Oregon, is experiencing significant challenges in population growth, economic development, education and health care. Recognizing that social and economic determinants impact health, Legacy Silverton has been and will remain committed to addressing these issues to improve the health of all residents in the community and ensure equity among ethnically diverse populations.

Part VI, Line 3 - Patient Education of Eligibility for Assistance
Legacy Silverton Medical Center employs financial counselors and social workers that assist patients in obtaining coverage for their healthcare needs. This includes assistance with workers compensation, motor vehicle accident policies, COBRA, veterans assistance, Legacys financial assistance program, and public assistance programs, such as Medicaid. In support of its mission, Legacy Silverton 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 Silverton provides an uninsured discount of 35% to self-pay patients with no coverage. Additional discounts, on a sliding scale, are available to patients whose household income is less than 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 addition to the household income criteria, other catastrophic or economic circumstances are considered in determining eligibility for charity care. In addition to financial counselors and social workers, Legacy Silverton makes every effort to communicate its Financial Assistance Program to all patients. This includes signage in main admitting areas of the hospital and brochures explaining financial assistance in all patient care areas, translated for patients/individuals with limited English proficiency (LEP). Financial counselors are available to assist patients in understanding and applying for available resources, including the Legacy Silverton Financial Assistance Program. Legacy Silvertons website also has information about the availability of financial assistance. Legacy Silverton offers financial assistance customer service Monday through Friday, as well as the availability of voicemail so patients can leave confidential, detailed messages during non-business hours. Patients are encouraged to sign up for MyHealth, a secure online tool to access their medical record. Using their MyHealth account they can correspond with a financial counselor via email. Finally, all of Legacys billing statements include information regarding the availability of financial assistance. If Legacy Silverton requires the use of a collection agency, those agencies are required to provide a telephone number for patients to call to request financial assistance. Annual education is provided to all billing and admitting staff, so they can be kept informed of and speak with knowledge about current financial assistance policies and options. Legacy Silverton provides copies of the latest policies in main admitting areas, as well as with the hospital financial counselor, online via the website and through MyHealth.

Part VI, Line 4 - Community Information
The Legacy Silverton is located in Marion County, the fifth most populous county in Oregon. Marion Countys largest cities include Keizer, Salem, Silverton, Stayton, and Woodburn which are home to 66% of the countys total population. The remaining 34% live in one of the smaller 15 cities or on unincorporated land. Those who live outside of larger cities may experience greater difficulty accessing resources like health care services and healthy foods. Given the limited availability of public transportation in these rural areas, access to a vehicle is likely required to support a healthy lifestyle. As of 2020, it is estimated that 345,920 people live in Marion County. Since 2010, the population has increased by about 10% which is similar to the increase in the state as a whole (10%). In Marion County there were a larger number of people living per square mile compared to the state. About 27% of community members identified as Hispanic or Latinx which was higher than the state (13%) and had a higher proportion of members who identified as Multiracial or Other race. About one out of every four households (25%) in Marion County spoke a language other than English at home compared to the state (15%), with Spanish being the most common language followed by various Asian or Pacific Islander languages and Russian. Marion County residents have a lower household income compared to the state and although poverty rates have been decreasing in this community and the state in recent years, Marion has a higher proportion of community members living below the federal poverty level and greater reliance on public assistance. Marion County has a lower percentage of members who earned a high school diploma, GED, or higher level of degree (81-85%) compared to the state (87%), and a smaller percent of people with a bachelors degree or higher (24%) compared to the state (34%).

Part VI, Line 5 - Promotion of Community Health
The Legacy Health system is involved in several activities and provides a wide variety of services that engage community members and promote community health. For example, the Legacy Health Board is comprised of volunteer community leaders, hospital administrators and representatives of the Lutheran and Episcopal churches who guide Legacys efforts in meeting its mission of providing good health for our people, our patients, our communities and our world. Legacy Silverton Medical Center has its own Board of Directors with representatives from the Medical Center administration and local community-based organizations, businesses and agencies. This Board reports to the Legacy Health Board of Directors.A Community-Based Advisory Committee (CBAC) was formed to assist the Community Benefit department with the development and implementation of the Community Health Needs Assessments (CHNAs) and Community Health Implementation Plans (CHIPs) for each Legacy Medical Center. Legacy Community Benefit and the CBAC work closely with partners in Marion and Polk counties to assess local community needs and describe how the Legacy Silverton Medical Center will address these needs and evaluate the effectiveness of its efforts within its service community.Legacy Silverton Medical Center and other Legacy hospitals contribute in-kind lab services to safety net clinics in their service areas. Non-cash donations of clinical and non-clinical services and items, e.g., screenings and support services, internships, information and referral services, and health fairs, also are provided to the community. Legacy Healths supply warehouse is open to local non-profit organizations to obtain surplus equipment and furniture. In addition, free office and conference space and other infrastructure services are made available to local non-profit organizations in the Legacy Silverton service area for a variety of uses. In addition, Legacy provides training for interns and residents through its nationally accredited graduate medical education program, Legacy Health supports over 500 employed and visiting medical trainees annually across many disciplines. Health professions training ranged from nursing, occupational and physical therapy, and radiography to public health, lab assistant, emergency medical technician, and many others. Legacy also partners with schools to provide training and education for nursing and other health professionals.Legacy Silverton's medical staff is open, with physicians submitting credentialing information that is reviewed according to Legacy Health policies and standards.Legacy Silverton Medical Center collaborates with other health care providers, community-based organizations, business and the public on projects to improve the health of the community. One example of clinically based partnerships includes, among others: CARES NW (Child Abuse Response and Evaluation Services), a collaboration among four health systems Kaiser Permanente, OHSU Doernbecher Childrens Hospital, Providence Childrens Health and Randall Childrens Hospital at Legacy Emanuel; Legacy Emanuel serves as the employer and donates the infrastructure. Additionally, the first collaborative medical initiative of its kind in the Pacific Northwest, Unity Center for Behavioral Health, is a joint effort between Adventist Health, Kaiser Permanente, Oregon Health & Science University and Legacy Health, providing psychiatric emergency services. Legacy has collaborated with more than a dozen community mental health partners in developing this new psychiatric center.

Part VI, Line 7 - States Filing of Community Benefit Report
OR

Part VI, Line 6 - Affilated Health Care System
The Legacy Silverton Medical Center is a subsidiary of Legacy Health. Legacy Health (Legacy) is an integrated health system headquartered in Portland, Oregon. Legacy operates six acute care hospitals, provides dedicated childrens care at the Randall Childrens Hospital at Legacy Emanuel, Unity Center for Behavioral Health and offers related services (e.g., physician practices, hospice, preferred provider network) in the four-county metro area of Portland, Oregon (Clackamas, Multnomah, Washington counties in Oregon and Clark County in SW Washington) and in Marion County, Oregon, which is approximately 50 miles south of Portland. Legacy Health conducts system-wide projects and activities to improve the health of its service communities. For example, Legacy's policy of providing care regardless of an individuals ability to pay makes it one of the region's largest providers of uncompensated care. As the health needs of communities surrounding our hospitals are frequently changing, Legacy Health continues to identify investments for underserved populations. In FY2022, Legacy contributed more than one million dollars ($1,027,420.00) to two health care collaboratives (Project Access NOW and the Health Systems Access to Care Fund (see below)) that increase access to culturally responsive primary and specialty health services for community members in Legacy service areas. In response to the lack of diversity within health professions and the persistent inequities in education, employment, and income among communities of color, Legacy Health established the Health Occupation Profession and Education program (HOPE, formerly Youth Employment in Summer) to provide work experiences through paid summer internships in the health care professions for underserved students of color. The primary goal of the program is to increase the number of underserved persons of color entering health care careers and to promote greater diversity in health care professions. Each summer between 5-15 students from ethnically diverse communities participate in the program. Students are paid between $15-18 per hour and may work up to 400 hours within available clinical and non-clinical departments across the Legacy Health system. Students meet weekly with a mentor and/or attend workshops to ensure the needs of the student and the department are being met.Students who perform well during the summer internship qualify for college tuition assistance ranging from $3,000 to $10,000 annually. These successful students also may continue in the HOPE program the following summer if they maintain the educational requirements for the program. Some students have remained in the program for seven years. Program alumni graduate with a range of degrees including imaging technology, nursing, and medicine. Most students are the first in their family to go to college. At all sites, Legacy Health trains interns and residents through its nationally accredited graduate medical education program and partners with local nursing and other health professional schools and programs to provide practical training and education.Legacy Health also partners with and supports other health care systems, public health agencies and community-based organizations to improve the health of the community. For example, in the fall of 2018, Legacy Health, Kaiser Permanente NW, PeaceHealth and Providence Health & Services, came together to create the Health Systems Access to Care Fund through the Oregon Community Foundation. The goal of this fund is to strengthen the capacity and infrastructure for community clinics that are expanding and/or adapting their current models to respond to the changing needs of patient populations due to ongoing healthcare reform, Medicaid transformation, and the increasing pressure on the safety net for access to care. Community clinics in Oregon and SW Washington were awarded multiyear grants up to $50,000. In 2022, eleven clinics continued existing work focused on four main areas which included assuring easy access to care, improving the quality of care, strengthening leadership and enhancing data collection. Finally, Legacy Community Benefit supports organizations and partnerships serving the Legacy Medical Centers service communities whose work addresses community-identified needs and aligns with the objectives and strategies of each Medical Centers Community Health Implementation Plan. In FY2022, Community Benefit funded 18 community-based organizations ($668,500.00) within the communities served by Legacy Health. Four of these partner organizations used their funds to promote educational attainment, address behavioral health issues and meet social needs (housing, food) within underserved populations in the Legacy Silverton Medical Center community.

Operating expenses	$ 124,142,045
Total amount spent on community benefits as % of operating expenses	$ 13,691,571 11.03 %