Community Benefit Insight - Tax-exempt hospital

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Samaritan North Lincoln Hospital

North Lincoln Hospital

3043 Ne 28th Street
Lincoln City, OR 97367

Bed count	15	Medicare provider number	381302	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 931305493

Display data for year:

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

8.37%

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	$ 1,926,250 2.51 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 376,575 0.49 %
Subsidized health services as % of operating expenses	$ 4,019,994 5.24 %
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.	$ 4,363 0.01 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 91,711 0.12 %
Community building* as % of operating expenses	$ 614,804 0.80 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	4
Physical improvements and housing	0
Economic development	0
Community support	2
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	1
Community health improvement advocacy	0
Workforce development	1
Other	0
Persons served (optional)	5,988
Physical improvements and housing	0
Economic development	0
Community support	1,573
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	4,403
Community health improvement advocacy	0
Workforce development	12
Other	0
Community building expense as % of operating expenses	$ 614,804 0.80 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 309,549 50.35 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 85,171 13.85 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 220,084 35.80 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 345,157
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 345,157
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	$ 658,510 0.86 %
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	$ 0 0 %

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 $ 68974051 including grants of $ 0) (Revenue $ 76590056)
SAMARITAN NORTH LINCOLN HOSPITAL (SNLH) HAS BEEN A PART OF THE FABRIC OF ITS COMMUNITY, SERVING THE CITIZENS IN LINCOLN COUNTY, SINCE 1967. SNLH INCLUDES A CRITICAL-ACCESS HOSPITAL AND SEVERAL MEDICAL CLINICS, WITH APPROXIMATELY 330 EMPLOYEES AND 35 VOLUNTEERS PROVIDING QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. DURING 2021, SNLH SERVED 870 INPATIENTS, HAD 11,547 EMERGENCY DEPARTMENT VISITS, PERFORMED 1,480 SURGERIES, AND DELIVERED 119 BABIES. IN ADDITION, SNLH PERFORMED 29,144 IMAGING PROCEDURES, AND HAD 41,322 PHYSICIAN CLINIC VISITS.

4B (Expenses $ 610406 including grants of $ 0) (Revenue $ 327319)
THE SAMARITAN EARLY LEARNING CENTER (SELC) OFFERS HANDS-ON LEARNING EXPERIENCES FOR CHILDREN THAT REFLECT THEIR DEVELOPMENTAL STAGE. THE PROGRAM IS BASED ON CREATIVE CURRICULUM, WHERE CHILDREN GROW AND LEARN IN THE AREAS OF SOCIAL, EMOTIONAL, PHYSICAL, COGNITIVE AND CREATIVE DEVELOPMENT AT THEIR OWN RATE IN THEIR LEARNING STYLE. THE CENTER CARES FOR CHILDREN, RANGING FROM INFANTS TO PRESCHOOLERS.

4C (Expenses $ 79901 including grants of $ 79901) (Revenue $ 0)
GRANTS AND ASSISTANCE PROVIDED BY SAMARITAN NORTH LINCOLN HOSPITAL TO VARIOUS ORGANIZATIONS AND INDIVIDUALS TO REDUCE FOOD INSECURITY IN THE LOCAL COMMUNITY, AND TO SUPPORT CHILD AND YOUTH SERVICES FOR LOW INCOME RESIDENTS OF THE LOCAL COMMUNITY. SEE PART IX, LINES 1 & 2 AND RELATED SCHEDULE I FOR MORE DETAILS.

Facility Information

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

SAMARITAN NORTH LINCOLN HOSPITAL
PART V, SECTION B, LINE 5: THE STAFF FROM SAMARITAN HEALTH SERVICES COMMUNITY HEALTH PROMOTION DEPARTMENT PARTNERED WITH A PRIVATE CONSULTANT TO CONDUCT THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FOR SAMARITAN NORTH LINCOLN HOSPITAL. THE STAFF AND THE CONSULTANT CONDUCTED SURVEYS BOTH ON-LINE AND ON PAPER WITH OVER 75 RESIDENTS IN LINCOLN COUNTY. THE STAFF AND THE CONSULTANT ALSO COLLECTED SECONDARY DATA FROM VARIOUS STATE AND NATIONAL ORGANIZATIONS SUCH AS THE THE OREGON DEPARTMENT OF EDUCATION, THE OREGON HEALTH AUTHORITY, THE U.S. CENSUS BUREAU AND THE CENTERS FOR DISEASE CONTROL. THE CONSULTANT HELD FOCUS GROUPS AND CONDUCTED KEY-INFORMANT INTERVIEWS TO OBTAIN INPUT FROM COMMUNITY MEMBERS AND PEOPLE WITH SPECIAL KNOWLEDGE AND EXPERTISE. FINALLY, SHS STAFF AND THE CONSULTANT HELD LISTENING SESSIONS TO OBTAIN ADDITIONAL INFORMATION REGARDING COMMUNITY NEEDS AND PRIORITIES.PERSONS CONSULTED FOR THE HOSPITAL'S CHNA WERE FROM THE FOLLOWING ORGANIZATIONS: LINCOLN COUNTY HEALTH DEPARTMENT, COMMUNITY OUTREACH INC., LINCOLN COUNTY FEDERALLY QUALIFIED HEALTH CENTER, OREGON STATE UNIVERSITY, SAMARITAN HEALTH PLANS, WESTERN UNIVERSITY-COMP NORTHWEST, OREGON COAST COMMUNITY COLLEGE, LINCOLN COUNTY UNIFIED SCHOOL DISTRICT, LINN-BENTON COUNTY HEALTH EQUITY ALLIANCE, OREGON CASCADES WEST COUNCIL OF GOVERNMENTS, INTERCOMMUNITY HEALTH PLANS INC., THE DEPARTMENT OF HUMAN SERVICES, THE OREGON HEALTH AUTHORITY, THE OREGON OFFICE OF RURAL HEALTH, COMMUNITY SERVICES CONSORTIUM, NEIGHBORS FOR KIDS, LINCOLN CITY ROTARY, UNITED WAY OF LINCOLN COUNTY, CENTRO DE AYUDA, ZONTA, CASA OF LINCOLN COUNTY, LINCOLN COUNTY EARLY CHILDHOOD COUNCIL, LINN-BENTON-LINCOLN EARLY LEARNING HUB, LINN-BENTON HISPANIC ADVISORY COUNCIL, LINCOLN COUNTY ORAL HEALTH COALITION AND COMMUNITY MEMBERS.

SAMARITAN NORTH LINCOLN HOSPITAL
PART V, SECTION B, LINE 6A: SAMARITAN PACIFIC COMMUNITIES HOSPITAL

SAMARITAN NORTH LINCOLN HOSPITAL
PART V, SECTION B, LINE 6B: BRANDAN KEARNEY, LLC - CONSULTANT

SAMARITAN NORTH LINCOLN HOSPITAL
PART V, SECTION B, LINE 7D: COPIES OF THE CHNA WERE EMAILED TO KEY COMMUNITY PARTNERS AND DISTRIBUTED TO LOCAL LIBRARIES, COUNTY OFFICES, THE SCHOOL DISTRICT OFFICE AND DURING LOCAL COALITION MEETINGS.

SAMARITAN NORTH LINCOLN HOSPITAL
PART V, SECTION B, LINE 11: SAMARITAN NORTH LINCOLN HOSPITAL (SNLH) IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS THROUGH MULTIPLE STRATEGIES. FIRST, SNLH 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. SECOND, HOSPITAL STAFF SERVE ON COMMUNITY ADVISORY BOARDS AND COALITIONS TO ADDRESS THE MOST PRESSING NEEDS IN THE COMMUNITY. AND FINALLY, THE HOSPITAL IS PROVIDING WORKSHOPS, CLASSES AND SUPPORT GROUPS TO ADDRESS THE HIGHEST HEALTH CONCERNS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. BECAUSE SEVERAL NEEDS TO IMPROVE HEALTH WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, SNLH DOES NOT HAVE THE FINANCES, RESOURCES OR EXPERTISE TO ADDRESS ALL THE NEEDS.

SAMARITAN NORTH LINCOLN HOSPITAL
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.

PART V, SECTION B, LINE 7, CHNA REPORT WEBSITE:
WWW.SAMHEALTH.ORG/ABOUT-SAMARITAN/COMMUNITY-BENEFIT-INITIATIVES

Supplemental Information

Schedule H (Form 990) Part VI

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 2021 IS $3,475,960.

PART II, COMMUNITY BUILDING ACTIVITIES:
SNLH PROVIDES SERVICES AND ACTIVITIES THAT ARE CLASSIFIED AS COMMUNITY BUILDING TO PROMOTE THE HEALTH OF LINCOLN COUNTY. RECOGNIZING THAT THE HEALTH OF A COMMUNITY ENCOMPASSES MULTIPLE FACTORS, SNLH LEADERSHIP AND STAFF ARE INVOLVED IN A VARIETY OF ACTIONS THAT WORK TO IMPROVE COMMUNITY OUTCOMES. THIS IS DEMONSTRATED THROUGH THE ONGOING SUPPORT TO THE SAMARITAN EARLY LEARNING CENTER (SELC). THE SELC OFFERS LOW-COST INFANT/TODDLER CARE TO FAMILIES IN LINCOLN COUNTY AND IS THE ONLY FACILITY IN NORTH LINCOLN COUNTY TO OFFER THIS SERVICE. THE SELC HAS BEEN A CRITICAL SERVICE FOR WORKING FAMILIES DURING THE PANDEMIC AS THEY WERE THE ONLY CERTIFIED FACILITY AVAILABLE TO PROVIDE CHILDCARE. SNLH BELIEVES THAT TRAINED AND COMPETENT STAFF IN ALL ASPECTS OF THE ORGANIZATION PROMOTES COMMUNITY HEALTH. SNLH ACTIVELY PARTICIPATES IN WORKFORCE DEVELOPMENT IN PARTNERSHIP WITH OREGON STATE UNIVERSITY, OREGON COAST COMMUNITY COLLEGE AND WESTERN UNIVERSITY-COMP NW TO RECRUIT, TRAIN AND RETAIN HEALTHCARE WORKERS AT ALL LEVELS. SNLH HAS BEEN ACTIVELY IMPLEMENTING THE SAMARITAN HEALTH SERVICES EQUITY AND INCLUSION PLAN TO OPTIMIZE OUR SERVICE DELIVERY PROCESS TO UNDERSERVED, UNDERREPRESENTED AND MARGINALIZED COMMUNITIES. SNLH IS PROVIDING EDUCATION AND TRAINING TO ALL STAFF ON EQUITY, DIVERSITY AND INCLUSION TOPICS THAT WILL IMPROVE THE PATIENT EXPERIENCE IN OUR HOSPITAL AND CLINICS. SNLH ALSO PROVIDES OPPORTUNITIES FOR COMMUNITY MEMBERS TO OBTAIN TRAINING ON CIVIC AND CULTURAL ISSUES THAT IMPACT HEALTH. SOME OF THE TRAINING OPPORTUNITIES INCLUDED HEALTHY LIFESTYLES, FITNESS AND HEALTH EQUITY. THESE TRAININGS CONTINUED VIRTUALLY DURING 2021.SNLH STAFF SERVED ON MANY LOCAL COALITIONS AND BOARDS THAT PROMOTE THE HEALTH OF THE COMMUNITY. BOARD AFFILIATIONS INCLUDE, BUT ARE NOT LIMITED TO, LINCOLN CITY ROTARY CLUB, ALTRUSA INTERNATIONAL, LINCOLN COUNTY ECONOMIC DEVELOPMENT COUNCIL, JOINT TRANSPORTATION COMMITTEE AND THE UNITED WAY OF LINCOLN COUNTY. ADDITIONALLY, SNLH STAFF SERVED ON THE OREGON HEALTH POLICY ADVISORY BOARD, THE OREGON HEALTH CARE WORKFORCE INSTITUTE, 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:
"SAMARITAN NORTH LINCOLN HOSPITAL (SNLH) 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, ""NET PATIENT SERVICE REVENUE"" ON PAGES 12, 13, AND 14 OF THE 2021 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. THE COST REPORT INCLUDES ACTIVITY FOR MEDICARE FEE-FOR-SERVICE PATIENTS BUT NOT MEDICARE MANAGED CARE PATIENTS.

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 7, REPORTS FILED WITH STATES
OR

PART VI, LINE 2:
SAMARITAN NORTH LINCOLN HOSPITAL (SNLH) ACTIVELY PARTICIPATES IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY. EVERY THREE YEARS, AS REQUIRED BY FEDERAL AND STATE LAW, SNLH CONDUCTS A COUNTYWIDE HEALTH NEEDS ASSESSMENT IN CONJUNCTION WITH THE LINCOLN COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, LINCOLN COUNTY FEDERALLY QUALIFIED HEALTH CENTER, LINCOLN COUNTY UNIFIED SCHOOL DISTRICT, OREGON COAST COMMUNITY COLLEGE, UNITED WAY OF LINCOLN COUNTY, THE LINCOLN COUNTY EARLY CHILDHOOD TEAM AND OTHER COMMUNITY PARTNERS. THE PROCESS INCLUDES EXAMINING PRIMARY DATA COLLECTED THROUGH SURVEYS, FOCUS GROUPS, COMMUNITY FORUMS AND PERSONAL INTERVIEWS WITH COMMUNITY MEMBERS WHO RESIDE THROUGHOUT LINCOLN COUNTY. SECONDARY DATA IS GATHERED FROM FEDERAL, STATE AND LOCAL AGENCIES THAT ADDRESS HEALTH NEEDS OF CHILDREN, YOUTH AND FAMILIES. THE INFORMATION IS REVIEWED BY THE STAFF, PARTNERS AND COMMUNITY MEMBERS TO PRIORITIZE THE HEALTH CARE NEEDS FOR LINCOLN COUNTY. EACH YEAR SNLH BOARD 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:
SNLH 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 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. SNLH INFORMS AND EDUCATES PATIENTS AND COMMUNITY MEMBERS REGARDING FINANCIAL ASSISTANCE THROUGH A VARIETY OF METHODS. SIGNS AND BROCHURES ARE AVAILABLE IN THE HOSPITAL WAITING AREAS, CLINIC WAITING ROOMS, VISITING ROOMS, THE INFORMATION DESKS, IN EMERGENCY DEPARTMENTS AND URGENT CARE SITES. FINANCIAL ASSISTANCE INFORMATION IS SENT EACH YEAR TO 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 APPLICATION. PATIENTS WHO REGISTER FOR AN INPATIENT, OUTPATIENT, CLINICAL OR EMERGENCY SERVICE RECEIVE BOTH VERBAL AND WRITTEN INFORMATION ON FINANCIAL ASSISTANCE AND MAY APPLY FOR FINANCIAL ASSISTANCE BEFORE, DURING OR AFTER TREATMENT. PATIENTS WHO ARE IDENTIFIED AS SELF-PAY OR UNINSURED AT REGISTRATION ARE SCREENED THROUGH PRESUMPTIVE ELIGIBILITY QUESTIONS TO DETERMINE IF THEY QUALIFY FOR THE FINANCIAL ASSISTANCE PROGRAM, HOWEVER, ANY PATIENT MAY REQUEST A FINANCIAL ASSISTANCE APPLICATION.THE PERSON WHO MAY BE BILLED FOR THE PATIENT CARE IS PROVIDED INFORMATION FOR THE FINANCIAL ASSISTANCE PROGRAM AT REGISTRATION. THE FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN THE FIRST PAYMENT REQUEST. THE PATIENT OR PERSON WHO MAY BE BILLED FOR THE PATIENT CARE IS INFORMED THEY HAVE UP TO 240 DAYS AFTER THE FIRST BILL IS SENT TO APPLY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN THE FIRST BILL.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:
SNLH IS A CRITICAL-ACCESS HOSPITAL THAT PRIMARILY SERVES THE RESIDENTS OF NORTH LINCOLN COUNTY. LOCATED ON A RURAL PORTION OF OREGON'S CENTRAL COAST, LINCOLN COUNTY IS HOME TO 50,395 (2020 U.S. CENSUS) RESIDENTS. LINCOLN COUNTY IS ALSO HOME TO THE CONFEDERATED TRIBES OF THE SILETZ INDIANS. APPROXIMATELY 5,600 MEMBERS ARE ENROLLED WITH THE CONFEDERATED TRIBES OF THE SILETZ INDIANS (CTSI ENROLLMENTS 2021) AND OVER 22% OF THE MEMBERS RESIDE WITHIN THE COUNTY. LINCOLN COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED POPULATION AND THE MIGRANT SEASONAL FARMWORKER POPULATION HAS BEEN DESIGNATED A PRIMARY MEDICAL CARE HEALTH PROVIDER SHORTAGE AREA BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION. THE 3,666-ACRE RESERVATION OF THE CONFEDERATED TRIBES OF SILETZ INDIANS IS A DESIGNATED HEALTH PROVIDER SHORTAGE AREA. A SISTER HOSPITAL, SAMARITAN PACIFIC COMMUNITIES HOSPITAL, SERVES PATIENTS WHO RESIDE IN THE SOUTH PORTION OF LINCOLN COUNTY. THE MAJOR CITIES IN LINCOLN COUNTY ARE OUTLINED BELOW: CITY POPULATIONLINCOLN CITY 9,815NEWPORT 10,256SOURCE: U.S. CENSUS BUREAU, 2021 CENSUS QUICK FACTS, PUBLIC LAW 94-171 SUMMARY FILETHE CHART BELOW SUMMARIZES THE RACIAL AND ETHNIC DEMOGRAPHICS OF LINCOLN COUNTY:RACE/ETHNICITY POPULATIONWHITE/CAUCASIAN 89.6%BLACK/AFRICAN AMERICAN 0.9%AMERICAN INDIAN/ALASKA NATIVE 4.0%ASIAN 1.4%NATIVE HAWAIIAN/PACIFIC ISLANDER 0.2%LATINO 9.5%REPORTING TWO OR MORE RACES 3.9%SOURCE: U.S. CENSUS BUREAU, 2021 CENSUS QUICK FACTS, PUBLIC LAW 94-171 SUMMARY FILEHEALTH AND SOCIAL INDICATORS ARE USED TO GENERALIZE THE CONDITIONS OF LINCOLN COUNTY:HEALTH AND SOCIAL INDICATORS TOTALSMEDIAN INCOME $47,882UNEMPLOYMENT 5.5%POVERTY 14.4%ADEQUATE PRENATAL CARE 83.9%IMMUNIZATIONS 68.0%UNINSURED CHILDREN 6.0%CHILD ABUSE 19.8/1000HOMELESS STUDENTS 801TEEN PREGNANCY 27.1%HIGH SCHOOL GRADUATION 78.9%JUVENILE JUSTICE REFERRALS 15.8/1000SOURCE: OREGON EMPLOYMENT DEPARTMENT DECEMBER 2021, OREGON DEPARTMENT OF EDUCATION GRADUATION RATES 2021, U.S. CENSUS BUREAU, 2021 CENSUS QUICK FACTS, PUBLIC LAW 94-171 SUMMARY FILE, 2020 CHILD WELL-BEING IN OREGON COUNTY DATA BOOK, 2021 COUNTY HEALTH RANKINGS, OREGON HEALTH AUTHORITY IMMUNIZATION PROGRAM 2021, OREGON HEALTH AUTHORITY TEEN PREGNANCY RATES 2021

PART VI, LINE 5:
SNLH'S GOVERNING BOARD IS COMPRISED OF LOCAL-AREA RESIDENTS AND OFFICERS OF AFFILIATED ORGANIZATIONS. SNLH EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SNLH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. SNLH INVESTS IN UPDATING EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. SNLH IS ACCREDITED FOR CONTINUING MEDICAL EDUCATION AND OFFERS FREQUENT PROGRAMS FOR AREA PHYSICIANS AND OTHER HEALTH PROFESSIONALS. THE CENTER FOR HEALTH RESEARCH AND QUALITY, A DEPARTMENT OF SNLH'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 SNLH AND ITS AFFILIATED HOSPITALS. SNLH ALSO PROVIDES SCHOLARSHIPS FOR STUDENTS AND EMPLOYEES IN HEALTH OCCUPATIONS.

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.SNLH IS ONE OF TWO CRITICAL ACCESS HOSPITALS OF SHS PRIMARILY SERVING RESIDENTS OF LINCOLN COUNTY. OTHER AFFILIATED HOSPITALS ARE GOOD SAMARITAN HOSPITAL SERVING RESIDENTS OF BENTON COUNTY, ALBANY GENERAL HOSPITAL AND SAMARITAN LEBANON COMMUNITY HOSPITAL, SERVING RESIDENTS OF LINN COUNTY, AND SAMARITAN PACIFIC COMMUNITIES HOSPITAL, SERVING RESIDENTS OF SOUTH LINCOLN COUNTY."

Operating expenses	$ 76,658,387
Total amount spent on community benefits as % of operating expenses	$ 6,418,893 8.37 %