TY 2013 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
KLAMATH RADIOLOGY ASSOCIATES PC2900 DAGGETT AVENUEKLAMATH FALLSOR97601	PHYSICIAN PRACTICE	3,152,104
FOCUSONE SOLUTIONS LLC13609 CALIFORNIA STREETOMAHANE68154	STAFFING SERVICES	701,052
CORE FINANCE TEAM AFFILIATES LLC3901 WEST 86TH STREET SUITE 310INDIANAPOLISIN46268	CONSULTING SERVICES	698,482
KLAMATH ORTHOPEDIC CLINIC2220 BRYANT WILLIAMS DRIVEKLAMATH FALLSOR97601	PHYSICIAN PRACTICE	607,385
MEDICUS HOSPITALISTS WEST LLC22 ROULSTON ROADWINDHAMNH03087	STAFFING SERVICES	522,596
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 18

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	32,333	32,333
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	146,309	146,309
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,123,193		1,123,193
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	70,025,166	64,530,680	5,494,486
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,755,508	2,429,743	325,765
9	Other employee benefits .......	11,033,132	9,833,097	1,200,035
10	Payroll taxes ...........	5,532,005	4,436,011	1,095,994
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	234,511	7,490	227,021
c	Accounting ...........	152,518	117	152,401
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	6,046,131	6,046,131
12	Advertising and promotion ....	889,586	337,523	552,063
13	Office expenses .......	1,987,935	1,284,757	703,178
14	Information technology ......	2,983,592	58,133	2,925,459
15	Royalties ..
16	Occupancy ...........	3,376,391	3,279,529	96,862
17	Travel ............	177,969	138,443	39,526
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	693,512	544,929	148,583
20	Interest ...........	2,971,607		2,971,607
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	9,785,665	3,517,200	6,268,465
23	Insurance ..............	2,425,503	1,056,707	1,368,796
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	CONTRACTUAL ALLOWANCE	282,115,893	282,115,893
b	SUPPLIES	27,428,450	27,264,789	163,661
c	BAD DEBTS	15,963,751	15,963,751
d	TAXES PAID ON UBI	600		600
e	All other expenses	40,452,384	37,487,542	2,964,842
25	Total functional expenses. Add lines 1 through 24e	488,333,644	460,511,107	27,822,537	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	10,740,249	1	16,795,518
2	Savings and temporary cash investments .........	24,067,447	2	27,054,272
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	21,815,609	4	24,347,970
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		150,313	5	304,981
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	1,814,623	8	2,181,720
9	Prepaid expenses and deferred charges ..........	2,416,059	9	2,696,455
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	198,098,259
b	Less: accumulated depreciation .....	10b	107,465,418	88,843,570	10c	90,632,841
11	Investments—publicly traded securities ..........	37,089,769	11	48,760,547
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....	3,712,125	13	4,557,044
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	26,174,266	15	19,915,820
16	Total assets. Add lines 1 through 15 (must equal line 34)......	216,824,030	16	237,247,168
	17	Accounts payable and accrued expenses .........	6,166,803	17	6,840,114
18	Grants payable .................		18
19	Deferred revenue ................	2,541,306	19	2,507,868
20	Tax-exempt bond liabilities .............	55,834,010	20	54,587,427
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	1,014,735	23	0
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	10,490,547	25	9,971,076
26	Total liabilities. Add lines 17 through 25.........	76,047,401	26	73,906,485
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	140,776,629	27	163,340,683
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	140,776,629	33	163,340,683
34	Total liabilities and net assets/fund balances ........	216,824,030	34	237,247,168

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization SKY LAKES MEDICAL CENTER

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization SKY LAKES MEDICAL CENTER

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	14,589,830	13,956,740	11,698,651	12,339,426	11,694,819
b	Contributions ........	170,459	12,716	20,361	98,175	86,864
c	Net investment earnings, gains, and losses	-420,216	2,126,606	2,760,201	-202,310	1,209,992
d	Grants or scholarships .....	580,298	10,509	12,270	32,407	37,029
e	Other expenditures for facilities and programs ........	0	1,214,051	220,861	256,108	390,645
f	Administrative expenses ....	214,074	281,672	289,342	248,125	224,575
g	End of year balance ......	13,545,701	14,589,830	13,956,740	11,698,651	12,339,426

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

100.000 %

Permanent endowment SchDMd Bullet

0 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	2,066,980		2,066,980
b	Buildings ................	117,202,388	56,550,317	60,652,071
c	Leasehold improvements ............	4,298,718	2,745,746	1,552,972
d	Equipment ................	70,798,696	47,963,168	22,835,528
e	Other .................	3,731,477	206,187	3,525,290
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				90,632,841

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) ASSETS LIMITED AS TO USE				5,006,061
(2) OTHER ASSETS				1,460,358
(3) RISK POOL WITHHOLD RECEIVABLE				2,744,067
(4) DEFERRED FINANCING COSTS				1,693,174
(5) CONSTRUCTION IN PROCESS				1,451,700
(6) OTHER RECEIVABLES				7,560,460



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				19,915,820

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
CAPITAL LEASE OBLIGATIONS		7,247,107
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS		2,723,969







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		9,971,076
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	ENDOWMENTS ARE HELD BY A RELATED ORGANIZATION, SKY LAKES MEDICAL CENTER FOUNDATION, FOR THE BENEFIT OF SKY LAKES MEDICAL CENTER. THE CONTINUED GROWTH OF THE ENDOWMENT FUNDS ALLOWS FOR LARGER EXPENDITURES OF INVESTMENT AND OTHER INCOME TO BE SPENT WITHOUT EXPENDING ANY OF THE INITIAL GIFTED FUNDS OR DESIGNATED FUNDS, WHICH REMAIN AS ENDOWED FUNDS.
PART X, LINE 2:	FIN 48 (ASC 740) UNCERTAIN TAX POSITION FOOTNOTE - THE MEDICAL CENTER HAD NO UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2014 OR 2013. THE MEDICAL CENTER RECOGNIZES INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED SEPTEMBER 30, 2014 AND 2013, THE MEDICAL CENTER RECOGNIZED NO INTEREST AND PENALTIES. THE MEDICAL CENTER FILES AN EXEMPT ORGANIZATION INFORMATION AND AN UNRELATED BUSINESS INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION AND AN UNRELATED BUSINESS INCOME TAX RETURN WITH THE OREGON DEPARTMENT OF REVENUE.

Return Reference

Explanation

PART V, LINE 4:

ENDOWMENTS ARE HELD BY A RELATED ORGANIZATION, SKY LAKES MEDICAL CENTER FOUNDATION, FOR THE BENEFIT OF SKY LAKES MEDICAL CENTER. THE CONTINUED GROWTH OF THE ENDOWMENT FUNDS ALLOWS FOR LARGER EXPENDITURES OF INVESTMENT AND OTHER INCOME TO BE SPENT WITHOUT EXPENDING ANY OF THE INITIAL GIFTED FUNDS OR DESIGNATED FUNDS, WHICH REMAIN AS ENDOWED FUNDS.

PART X, LINE 2:

FIN 48 (ASC 740) UNCERTAIN TAX POSITION FOOTNOTE - THE MEDICAL CENTER HAD NO UNRECOGNIZED TAX BENEFITS AT SEPTEMBER 30, 2014 OR 2013. THE MEDICAL CENTER RECOGNIZES INTEREST ACCRUED AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AS AN ADMINISTRATIVE EXPENSE. DURING THE YEARS ENDED SEPTEMBER 30, 2014 AND 2013, THE MEDICAL CENTER RECOGNIZED NO INTEREST AND PENALTIES. THE MEDICAL CENTER FILES AN EXEMPT ORGANIZATION INFORMATION AND AN UNRELATED BUSINESS INCOME TAX RETURN IN THE U.S. FEDERAL JURISDICTION AND AN UNRELATED BUSINESS INCOME TAX RETURN WITH THE OREGON DEPARTMENT OF REVENUE.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..		11,143	12,931,403		12,931,403	2.740 %
b	Medicaid (from Worksheet 3, column a) ....			42,040,508	38,751,529	3,288,979	0.700 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .		11,143	54,971,911	38,751,529	16,220,382	3.440 %
Other Benefits		12	146,899	526,991	5,046	521,945	0.110 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	12	146,899	526,991	5,046	521,945	0.110 %
f	Health professions education (from Worksheet 5) ..	2	7,000	4,598,347	2,090,442	2,507,905	0.530 %
g	Subsidized health services (from Worksheet 6) ..	5	344,041	28,628,862	25,130,164	3,498,698	0.740 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			144,823		144,823	0.030 %
j	Total. Other Benefits ..	19	497,940	33,899,023	27,225,652	6,673,371	1.410 %
k	Total. Add lines 7d and 7j .	19	509,083	88,870,934	65,977,181	22,893,753	4.850 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	9	231,143	671,439	503,566	167,873	0.040 %
4	Environmental improvements
5	Leadership development and training for community members	1	1,660	16,420	0	16,420	0 %
6	Coalition building	1	4,800	1,020	0	1,020	0 %
7	Community health improvement advocacy	12	107,303	174,340	0	174,340	0.040 %
8	Workforce development	3	100,030	700,633	0	700,633	0.150 %
9	Other
10	Total	26	444,936	1,563,852	503,566	1,060,286	0.230 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

15,963,751

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

1,915,650

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

51,737,964

Enter Medicare allowable costs of care relating to payments on line 5.....

52,704,091

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-966,127

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	SKY LAKES MEDICAL CENTER 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 SKYLAKES.ORG 14-0724	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SKY LAKES MEDICAL CENTER
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SKYLAKES.ORG

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

Yes

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 1J: WHAT BEGAN AS A CONVERSATION BETWEEN THE COMMUNITY HEALTH OUTREACH MANAGER AT SKY LAKES MEDICAL CENTER, KLAMATH FALLS, ORE., AND THE HEALTH PROMOTION/DISEASE PREVENTION COORDINATOR AT KLAMATH COUNTY (ORE.) PUBLIC HEALTH BECAME THE SEED THAT TOOK ROOT AND THEN FLOURISHED INTO A MAJOR COLLABORATION AMONG LOCAL PUBLIC AND PRIVATE PARTNERS.THE COLLABORATION OF COMMUNITY PARTNERS SEEKING BETTER HEALTH EVOLVED INTO HEALTHY KLAMATH, A SEMI-FORMAL ORGANIZATION REPRESENTING A WIDE VARIETY OF PUBLIC-SECTOR AGENCIES AND DEPARTMENTS AS WELL AS PRIVATE PARTIES WITH INFLUENCE IN LOCAL HEALTH. AT ITS CORE IS SKY LAKES MEDICAL CENTER, THE LOCAL HEALTH DEPARTMENT, A MANAGED CARE ORGANIZATION FOR THE MEDICAID POPULATION, AND A FEDERALLY QUALIFIED HEALTHCARE PRACTICE WITH TWO FAMILY PRACTICE CLINICS IN THE COUNTY. KLAMATH FALLS CITY AND KLAMATH COUNTY GOVERNMENT, STATE OF OREGON AGENCIES, AND LOCAL SCHOOL DISTRICTS AND HIGHER EDUCATION ARE ALSO REPRESENTED.FURTHER, THE PARTNERSHIP ALSO INCLUDES CASCADES EAST FAMILY MEDICINE CENTER, A RURAL RESIDENCY PROGRAM AND CLINIC, OREGON STATE UNIVERSITY'S EXTENSION IN KLAMATH COUNTY, OREGON HEALTH & SCIENCE UNIVERSITY'S NURSING PROGRAM AT OREGON INSTITUTE OF TECHNOLOGY, THE LOCAL NEWSPAPER AND THE REGION'S LARGEST RADIO STATION.THE ASSESSMENT LAUNCHED AS A RESULT OF SKY LAKES LEADERSHIP RECOGNIZING THERE ARE MYRIAD CAUSES FOR POOR HEALTH AND THE PROBLEM IS TOO LARGE FOR ANY ONE ORGANIZATION TO TAKE ON ALONE, AND SO WORKED AS A COMMUNITY CONVENER TO GET OTHERS TO THE TABLE TO PLAN AND IMPLEMENT CHANGE. THE INTENT WAS TO HEAR FROM MANY VOICES AND TO STRIVE FOR HARMONY AS WE WORKED TOGETHER TO MAKE IMPROVEMENTS THAT WOULD LAST.AT THE SAME TIME, MEDICAL CENTER LEADERS RIGHTLY UNDERSTOOD THERE ARE POTENTIAL SOLUTIONS TO THE PROBLEMS OF POOR HEALTH THAT ARE BEYOND THEIR PURVIEW. THE MEDICAL CENTER TOOK THE LEAD TO HELP FIND WAYS EACH OF THE PARTNERS COULD USE THEIR UNIQUE EXPERTISE TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR SUCCESS IS MONITORED AND MEASURED BY THE HEALTHY COMMUNITIES INSTITUTE (HCI) INDICATORS AND DISPLAYED ON A PUBLIC WEBSITE, HEALTHYKLAMATH.ORG.WITHIN TWO MONTHS OF THE INITIAL MEETING, UNDER THE LEADERSHIP OF THE MEDICAL CENTER AND WITH THE FULL COOPERATION OF THE PARTNERS, THE CORE FOUR HAD AGREED TO A PLAN TO DEPLOY THE HCI WEB-BASED INDICATORS TOOL (HEALTHKLAMATH.ORG) AND A FRAMEWORK TO ACCOMMODATE THE VARIOUS OTHER COMMUNITY PARTNERS IN THE PROCESS.THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COORDINATED BY SKY LAKES MEDICAL CENTER DONE IN CONCERT WITH KLAMATH COUNTY HEALTH REPRESENTS THE COLLABORATIVE WORK BETWEEN SKY LAKES MEDICAL CENTER AND ITS LOCAL PARTNERS. THIS CHNA IS THE FIRST OF ITS KIND TO FORMALLY ASSESS AND DOCUMENT THE HEALTH OF OUR COMMUNITY UTILIZING A COORDINATED AND COLLABORATIVE PROCESS. IT IS THE FIRST STEP TO THE ONGOING PROCESS OF COMMUNITY HEALTH IMPROVEMENT. THE COMMUNITY ASSESSMENT IS UPDATED WHENEVER MORE DATA ARE RECEIVED TO POPULATE MORE THAN 100 HEALTH INDICATORS. THE HEALTHY KLAMATH ORGANIZATION MEETS REGULARLY TO EVALUATE DATA AND PROGRESS OF STRATEGIES TO IMPROVE HEALTH ACCORDING TO THE PREVIOUSLY IDENTIFIED PRIORITIES.THE PRIMARY GOAL OF THE CHNA IS TO BETTER UNDERSTAND THE HEALTH OF OUR COMMUNITY AND TO DEVELOP LOCAL STRATEGIES TO ADDRESS OUR COMMUNITY'S SPECIFIC NEEDS AND IDENTIFIED PRIORITY ISSUES. THE CHNA INFORMS THE GROUP AND HELPS SET COMMUNITY PRIORITIES, ESTABLISH BENCHMARKS AND MONITOR TRENDS IN THE HEALTH STATUS OF KLAMATH COUNTY RESIDENTS. THERE IS AN ADDED BENEFIT IN THAT THE IMPROVEMENT EFFORTS EXTEND TO OTHER REGIONS IN THE CATCHMENT AREA OUTSIDE THE DEFINED COMMUNITY.WE ACKNOWLEDGE THAT THE CHNA IS A LIVING DOCUMENT, ALLOWING US TO SEEK CONTINUOUS IMPROVEMENT AND FURTHER ANALYZE THE DATA AND, ULTIMATELY, IMPROVE THE HEALTH OF OUR COMMUNITY. UNDERSTANDING THAT HEALTH IS A PRODUCT OF MANY CONDITIONS AND FACTORS, AN ADAPTED VERSION OF THE STRATEGIC PLANNING FRAMEWORK DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) IN COOPERATION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WAS MADE TO CREATE THIS CHNA.THE STRATEGIC PLANNING FRAMEWORK THAT WAS ADAPTED FOR KLAMATH COUNTY IS KNOWN AS MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). MAPP IS A COMMUNITY-DRIVEN PROCESS THAT RESULTS IN THE IDENTIFICATION OF HEALTH ISSUES AND HEALTH IMPROVEMENT STRATEGIES THROUGH COMMUNITY MEMBER AND STAKEHOLDER ENGAGEMENT.FACILITATED BY COMMUNITY HEALTH LEADERS, MAPP IS INTENDED TO IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND PERFORMANCE OF LOCAL HEALTHCARE SYSTEMS SKY LAKES IS A PRINCIPAL PART OF THAT LOCAL SYSTEM. MAPP ALLOWS FOR AN ENHANCED UNDERSTANDING OF THE INFLUENCES ON COMMUNITY HEALTH THROUGH THE ANALYSIS OF POPULATION-BASED QUANTITATIVE DATA, LOCALLY GATHERED QUALITATIVE DATA, AND THE EXPERTISE OF KEY STAKEHOLDERS. THESE VARIOUS DATA-COLLECTION METHODS ALLOW FOR A BETTER UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CIRCUMSTANCES IN WHICH PEOPLE ARE BORN, RAISED, LIVE, AND WORK, IN ADDITION TO AVAILABLE RESOURCES.THE SOCIAL DETERMINANTS OF HEALTH PROVIDE A LENS THROUGH WHICH TO VIEW DIFFERENT POPULATIONS AND COMMUNITIES AND IDENTIFY CONDITIONS THAT PROMOTE HEALTH, RATHER THAN LIMIT IT. WITH THIS INFORMATION WE CAN COLLECTIVELY BETTER UNDERSTAND THE DRIVERS OF HEALTH OUTCOMES IN KLAMATH COUNTY AND DEVELOP STRATEGIES FOR HEALTH IMPROVEMENT. WHILE THE STANDARD MAPP INCLUDES FOUR ASSESSMENTS (COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, AND THE FORCES OF CHANGE ASSESSMENT), THE LOCAL PARTNERS AS HEALTHY KLAMATH TAILORED MAPP TO BETTER FIT OUR COMMUNITY. THE PARTNERS DECIDED TO COMBINE THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND FORCES OF CHANGE ASSESSMENT INTO A SINGLE ASSESSMENT. THIS SPECIFIC COMBINATION INCREASED EFFICIENCY AND UTILIZES RESOURCES MOST EFFECTIVELY. THE INFORMATION FOR THIS COMBINED ASSESSMENT WAS COLLECTED FROM STAKEHOLDERS WITH THE ABILITY TO SPEAK TO THE CURRENT SYSTEM AS WELL AS THE FUTURE OPPORTUNITIES AND UNCERTAINTIES THAT MAY AFFECT THE CURRENT SYSTEM.COLLECTING AND ANALYZING THE VOLUME OF DATA NECESSARY TO FULLY UNDERSTAND COMMUNITY HEALTH IS TIME- AND RESOURCE-INTENSIVE HEALTHY KLAMATH PARTNERS COLLABORATIVELY SOUGHT A SOLUTION TO UTILIZE RESOURCES IN THE MOST EFFECTIVE MANNER. THE PARTNERS AGREED TO UTILIZE THE HEALTHY COMMUNITIES INSTITUTE (HCI), WHICH MANAGES AND CONTINUALLY UPDATES A CENTRALIZED PUBLICALLY AVAILABLE WEB-BASED SOURCE OF POPULATION DATA AND COMMUNITY HEALTH INFORMATION.HCI PROVIDES A PLATFORM FOR CONTINUAL MONITORING AND TRACKING ON MORE THAN 100 INDICATORS SELECTED BY THE COMMUNITY PARTNERS THE INDICATORS ARE ROUTINELY UPDATED. THESE INDICATORS WERE ASSESSED ON FOUR FACTORS:1) COMPARISON TO OREGON AND NATIONAL BENCHMARKS,2) TRENDS OVER TIME,3) HEALTH DISPARITIES, AND4) SEVERITY OF HEALTH ISSUE.THE HEALTH INDICATORS SELECTED MET AT LEAST THREE OF THE FOUR CONDITIONS: - KLAMATH COUNTY RATE IS HIGHER THAN THE OREGON STATE AVERAGE AND/OR DOES NOT MEET THE NATIONAL HEALTHY PEOPLE 2020 BENCHMARK - THE TREND IS WORSENING - CERTAIN POPULATIONS ARE EXPERIENCING A DISPARITY OR - LONG-TERM CONSEQUENCE, PREMATURE DEATH, AND/OR HIGH HEALTH-RELATED EXPENDITURES ARE ASSOCIATED.THE FORMULATION OF THE CHNA COORDINATED BY SKY LAKES MEDICAL CENTER WAS STRONGLY INFLUENCED BY INPUT FROM COMMUNITY PARTNERS AND STAKEHOLDERS AS WELL AS INDIVIDUALS IN KLAMATH COUNTY COMMUNITIES. COMMUNITY INVOLVEMENT IS ESSENTIAL TO SUCCESSFUL PUBLIC HEALTH ACTION, AND THE PRIORITY AREAS FOR HEALTH IMPROVEMENT SHOULD REFLECT THE PROBLEMS OF GREATEST CONCERN TO THE LOCAL COMMUNITIES. HEALTHY KLAMATH PARTNERS REGULARLY SEEK COMMUNITY INPUT VIA LISTENING SESSIONS, FOCUS GROUPS, AND SURVEYS.COMMUNITY PERCEPTIONS REGARDING HEALTH NEEDS ARE CAPTURED IN NON-SCIENTIFIC SURVEYS AND INTERVIEWS CONDUCTED AT THE CONCLUSION OF FREE HEALTH- AND WELLNESS-RELATED SEMINARS AND SIMILAR COMMUNITY EVENTS HOSTED BY THE MEDICAL CENTER. INFORMATION FROM THESE ACTIVITIES HELP INFORM FOLLOW-ON STRATEGIES AND PROGRAMS.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 3: THE KLAMATH COUNTY CHNA COORDINATED BY SKY LAKES MEDICAL CENTER IN PARTNERSHIP WITH OTHER PUBLIC AGENCIES IN THE COMMUNITY TAKES INTO ACCOUNT AN UNDERSTANDING OF THE ENVIRONMENT WITHIN WHICH WE OPERATE. UNDERSTANDING THE STRENGTHS AND WEAKNESSES OF THE CURRENT LOCAL HEALTHCARE SYSTEM, IN ADDITION TO ANY UPCOMING SOCIAL, POLITICAL, OR ECONOMIC CHANGES THAT COULD AFFECT THE SYSTEM, IS INTEGRAL TO DEVELOPING PRIORITY AREAS OF FOCUS. HEALTHCARE REFORM AND THE CURRENT ECONOMIC CLIMATE ARE LARGELY IMPACTING THE LOCAL HEALTHCARE SYSTEM AND THESE STRUCTURAL CHANGES MUST BE ACCOUNTED FOR.THE HEALTHY KLAMATH PARTNERS IDENTIFIED A LIST OF KEY STAKEHOLDERS ORGANIZED BY SECTOR TO INTERVIEW FOR THIS ASSESSMENT. THE ORIGINAL STAKEHOLDERS WERE SELECTED FOR THEIR ORGANIZATIONS INFLUENCE ON COMMUNITY HEALTH AND THEIR ROLE IN THE PUBLIC HEALTH SYSTEM.THE STAKEHOLDERS, IN ADDITION TO SKY LAKES MEDICAL CENTER, INCLUDE KLAMATH COUNTY PUBLIC HEALTH, CASCADE COMPREHENSIVE CARE, CASCADE HEALTH ALLIANCE, KLAMATH OPEN DOOR CLINICS, THE CITY OF KLAMATH FALLS, KLAMATH FALLS PUBLIC SCHOOLS AND KLAMATH COUNTY SCHOOL DISTRICT, KLAMATH COMMUNITY COLLEGE, OREGON INSTITUTE OF TECHNOLOGY, AND APPROXIMATELY 16 OTHER AGENCIES AND ORGANIZATIONS.AS PART OF THE ASSESSMENT, THE PARTNERS CONDUCTED 20 INTERVIEWS WITH MORE THAN 25 LOCAL STAKEHOLDERS. EACH INTERVIEW BEGAN WITH AN EXPLANATION OF THE CHNA USING THE CHNA FRAMEWORK AND WITH A WRITTEN AND VISUAL DEFINITION OF HEALTH.THIS IS THE WRITTEN DEFINITION OF HEALTH USED IN THE INTERVIEWS: HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY (WORLD HEALTH ORGANIZATION). FURTHER, HEALTH IS NOT SIMPLY A STATE FREE FROM DISEASE BUT IS THE CAPACITY OF PEOPLE TO BE RESILIENT AND MANAGE LIFE'S CHALLENGES AND CHANGES (PUBLIC HEALTH ACCREDITATION BOARD).AFTER ANY QUESTIONS REGARDING THE CHNA WERE ANSWERED, THREE INTERVIEW QUESTIONS FOLLOWED:1. HOW DOES YOUR ORGANIZATION CONTRIBUTE TO THE HEALTH OF THE COMMUNITY?2. WHAT DO YOU SEE AS YOUR ORGANIZATION'S ROLE IN THE LOCAL PUBLIC HEALTH SYSTEM?3. WHAT CHALLENGES DO YOU SEE THAT MAY AFFECT YOUR WORK (UPCOMING CHANGES IN LEGISLATION, FUNDING, TECHNOLOGY, NEW COLLABORATIONS, AND THE LIKE)?COMPLETE ANALYSIS OF THOSE INTERVIEWS AND THEIR RECOMMENDATIONS INFORMS THE ONGOING STRATEGY.ALSO, OREGON HEALTH & SCIENCE UNIVERSITY SCHOOL OF NURSING STUDENTS CONDUCTED LISTENING SESSIONS AND FOCUS GROUPS IN SIX OUTLYING COMMUNITIES (MERRILL, MALIN, BONANZA, CHILOQUIN, MIDLAND, AND KENO) IN RURAL KLAMATH COUNTY. INFORMATION FROM THOSE SESSIONS AND INTERVIEWS ARE IN APPENDIX A OF THE CHNA.FURTHER QUALITATIVE ANALYSIS IN THE FORM OF A WEB-BASED SURVEY WAS CONDUCTED BY THE PARTNERS AND SPONSORED BY SKY LAKES MEDICAL CENTER. NEARLY 900 SELF-SELECTED RESPONDENTS TO THAT SURVEY PROVIDED ADDITIONAL COMMUNITY PERSPECTIVE FOR THE CHNA AND WILL BE USEFUL TO DEFINE STRATEGIES AND TACTICS GOING FORWARD. RESULTS FROM THE SURVEY ARE INCLUDED IN THE FULL CHNA REPORT, WHICH IS AVAILABLE UPON REQUEST VIA WEBMASTER@SKYLAKES.ORG.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 5D: BESIDES THE SKY LAKES MEDICAL CENTER WEBSITE (SKYLAKES.ORG), THE CHNA CONDUCTED BY THE HEALTHY KLAMATH PARTNERS AND COORDINATED BY THE MEDICAL CENTER ALSO WILL RESIDE ON THE HEALTHY KLAMATH WEBSITE (HEALTHYKLAMATH.ORG), ON THE KLAMATH COUNTY HEALTH DEPARTMENT WEBSITE, AND WILL BE AVAILABLE IN PRINT FORM AT SKY LAKES MEDICAL CENTER, AT THE HEALTH DEPARTMENT, AT THE LOCAL NEWSPAPER OFFICE (HERALD AND NEWS, 2701 FOOTHILLS ROAD, KLAMATH FALLS, OR), AND AT THE KLAMATH COUNTY LIBRARY.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 7: AS EARLIER NOTED, THERE ARE SOME SOCIO-ECONOMIC AND INFRASTRUCTURE NEEDS IDENTIFIED IN THE ASSESSMENT THAT ARE BEYOND THE PURVIEW OF THE MEDICAL CENTER. THE ORGANIZATION, HOWEVER, STRIVES TO PROVIDE LEADERSHIP TO FACILITATE PROGRESS AND COOPERATION AMONG THE PUBLIC AND NGO AGENCIES THAT CAN ADDRESS THOSE NEEDS.INFORMATION GATHERED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FACILITATED BY THE COMMUNITY PARTNERS SEEKING BETTER HEALTH AND USING THE HEALTHY KLAMATH INITIATIVE INDICATES A STRATIFICATION OF PRIORITIES.DATA COLLECTED BY VARIOUS SURVEYS AGGREGATED BY THE HEALTHY COMMUNITIES INSTITUTE AND ORGANIZED AT HEALTHYKLAMATH.ORG INDICATE A RANGE OF NEEDS. AMONG THE TOP ARE: - ADULTS 65+ WITH INFLUENZA VACCINATION - ADULTS 65+ WITH PNEUMONIA VACCINATION - BABIES WITH LOW BIRTH WEIGHT - MOTHERS WHO RECEIVED EARLY PRENATAL CARE - DEATH RATE DUE TO COLORECTAL CANCER (AGE ADJUSTED).FURTHER, THE NUMBER OF LOCAL RESIDENTS WHO SELF-REPORTED THEIR HEALTH AS GOOD OR BETTER IS SIGNIFICANTLY LOWER THAN THE COMPARISON GROUP.WITH THAT AS A BACKDROP, THE COMMUNITY PARTNERS BROKE THE KEY DRIVERS OF HEALTH ACCORDING TO THE DATA INTO BROADER CATEGORIES, AND ASKED AREA RESIDENTS TO ASSIGN PRIORITY RANKS TO THEM.NEARLY 1,000 PEOPLE PARTICIPATED IN THE ONLINE, SELF-SELECT SURVEY. DATA COLLECTION REMAINED OPEN NINE DAYS (ONE WORK WEEK AND TWO WEEKENDS).ACCORDING TO THE DATA, RESIDENTS IDENTIFIED OBESITY, ACCESS TO MENTAL HEALTH AND LIMITING THE EFFECTS OF SUBSTANCE AND ALCOHOL ABUSE AND TOBACCO USE TOP SHORT-TERM (12-18 MONTHS) PRIORITIES. SIMILARLY, THE PRIORITIES FOR AN INTERMEDIATE TERM (18-36 MONTHS) LEFT IN PLACE THREE OF THE SHORT-TERM PRIORITIES AND ADDED TO THE TOP PRIORITIES LIST HEALTH INSURANCE COVERAGE AND YOUTH MENTORING.THE LONG-TERM (3+ YEARS) PRIORITIES CLOSELY ALIGN WITH THE OTHER CATEGORIES WITH THE TOP PRIORITY TO DECREASE POVERTY WHILE INCREASING THE HIGH SCHOOL GRADUATION RATE, ENCOURAGING HEALTHIER LIFESTYLES WITH BETTER NUTRITION AND MORE EXERCISE OPPORTUNITIES, AND BROADER HEALTH INSURANCE COVERAGE COMPRISING THE TOP SPOTS. IT IS CLEAR TO MOST THAT THOSE WHO PARTICIPATED IN THE SURVEY RECOGNIZE THAT OBESITY AND ITS ASSOCIATED COMPONENTS, PRIMARILY HEALTHIER EATING HABITS AND INCREASED ACTIVITY, ARE CLOSELY LINKED TO A VARIETY OF OTHER UNHEALTHFUL CONDITIONS. FURTHER, THERE IS A RECOGNITION THAT IN ORDER FOR THE CHANGES TO BE MORE OR LESS PERMANENT REQUIRES BROAD-BASED SYSTEMIC CHANGES RATHER THAN SO-CALLED INSTANT FIXES.THE COMMUNITY COALITION, LED IN NO SMALL MEASURE BY SKY LAKES MEDICAL CENTER AND RESPONSIBLE FOR ENSURING THERE IS PROGRESS TOWARD MAKING IMPROVEMENTS IN THE PRIORITIES, BROKE THE SHORT-, INTERMEDIATE- AND LONG-TERM PRIORITIES INTO AN EIGHT-POINT PROJECT LIST. SUCCESS ON ANY OF THE POINTS SUPPORTS PROGRESS ON OTHER POINTS.COMMUNITY PARTNERS SEEKING BETTER HEALTH TEAMS PARTICIPATING IN THE HEALTHY KLAMATH INITIATIVE WERE FORMED AROUND:1. OBESITY, HEALTHY EATING, EXERCISE2. ACCESS TO MENTAL HEALTH3. SUBSTANCE AND ALCOHOL ABUSE4. TRANSPORTATION5. YOUTH MENTORING6. INFRASTRUCTURE7. DECREASING POVERTY, AND8. HEALTH POLICY CHANGES.NONE OF THE ISSUES CAN BE RESOLVED WITHOUT CONSIDERABLE ENERGY AND RESOURCES, YET PROGRESS IS BEING MADE. FOR INSTANCE, SKY LAKES MEDICAL CENTER HIRED A PHYSICIAN AND NURSE, BOTH WITH PUBLIC HEALTH CREDENTIALS, TO OPEN AND OPERATE A FIRST-EVER WELLNESS CENTER AIMED SPECIFICALLY AT IMPROVING OBESITY-RELATED HEALTH.AT THE SAME TIME, SKY LAKES MEDICAL CENTER HAS MADE SIGNIFICANT CONTRIBUTIONS TO SUPPORT BETTER NUTRITION AND INCREASED PHYSICAL ACTIVITY. ALSO, SKY LAKES MEDICAL CENTER HAS COMMITTED TO BE A MAJOR SOURCE OF ALTERNATE REVENUE TO ENSURE THE MUNICIPAL POOL CONTINUES TO HAVE SWIMMING OPPORTUNITIES, RECOGNIZING IT AS AN IMPORTANT TYPE OF ACTIVITY FOR MANY PEOPLE, PARTICULARLY MOBILITY IMPAIRED INDIVIDUALS.SKY LAKES MEDICAL CENTER AND COMMUNITY PARTNERS ARE ACTIVELY IMPROVING ACCESS TO MENTAL HEALTH THROUGH A VARIETY OF MECHANISMS. THE MEDICAL CENTER, FOLLOWING A RIGOROUS RECRUITING EFFORT, HAS ATTRACTED TO THE COMMUNITY A PSYCHIATRIST TO PRACTICE AT THE NEWLY FORMED KLAMATH BASIN BEHAVIORAL HEALTH. THE ADDITION OF THE PROVIDER WILL LEVERAGE ADDITIONAL MENTAL HEALTH SERVICES FOR THE REGION.EFFORTS ARE UNDER WAY TO INCREASE: - THE AWARENESS AND THE FREQUENCY OF CANCER SCREENING OPPORTUNITIES TO ENCOURAGE AND SUPPORT THE EARLY DETECTION OF TUMORS - DIRECT INTERVENTIONS FOR PEOPLE AT RISK OF DIABETES OR WHO HAVE BEEN DIAGNOSED WITH DIABETES TO IMPROVE THEIR CONDITIONS WITHOUT HOSPITALIZATION AND - AWARENESS OF THE BENEFITS OF REGULAR LOW-IMPACT EXERCISES TO IMPROVE HEALTH AS WELL AS TO CONTROL AN ASSORTMENT OF CHRONIC DISEASES.WORKING WITH PHYSICIANS AND OTHER MEDICAL PROFESSIONALS, SKY LAKES MEDICAL CENTER ACTIVELY PROMOTES PRE-NATAL EDUCATION AMONG THE TARGET DEMOGRAPHIC BY OFFERING NO-CHARGE CHILDBIRTH PREPARATION CLASSES. THE MEDICAL CENTER ALSO HAS UNDERWAY A MORE EXPANSIVE PROGRAM USING NON-TRADITIONAL METHODS TO GET APPROPRIATE NUTRITION, EXERCISE AND CHILDBIRTH PREPARATION INFORMATION TO FIRST-TIME MOTHERS.MEASUREMENT DATA COLLECTED ON THE PROGRAMS ARE INCOMPLETE SO FIRM CONCLUSIONS REGARDING THEIR SUCCESS WOULD NOT BE APPROPRIATE.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 12I: HOUSEHOLD SIZE AND A MAXIMUM OUT-OF-POCKET EXPENDITURE.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 18E: SKY LAKES EMPLOYS A FIRM, CHAMBERLIN EDMONDS, THAT QUALIFIES PATIENTS FOR BENEFIT PROGRAMS. THEY SCREEN ALL OF SKY LAKES UNINSURED PATIENTS FOR POSSIBLE MEDICAID, MEDICARE AND/OR DISABILITY BENEFITS.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 20D: SKY LAKES IS AWAITING CLARIFICATION ON 501(R) REGULATIONS, WHICH ARE PROPOSED.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 22: SOME PATIENTS ARE ONLY ELIGIBLE FOR AN ANNUAL MAXIMUM OUT-OF-POCKET REDUCTION.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?15
Name and address		Type of Facility (describe)
1	CANCER TREATMENT CENTER 2610 UHRMANN ROAD KLAMATH FALLS,OR97601	MEDICAL CLINIC
2	OUTPATIENT IMAGING 2900 DAGGETT AVENUE KLAMATH FALLS,OR97601	OUTPATIENT DIAGNOSTIC IMAGING CENTER
3	FAMILY MEDICINE RESIDENCY 2801 DAGGETT AVENUE KLAMATH FALLS,OR97601	MEDICAL CLINIC & MEDICAL RESIDENCY PROGRAM
4	MEDICAL OFFICE BUILDING I 2200 BRYANT WILLIAMS DRIVE KLAMATH FALLS,OR97601	MEDICAL CLINIC
5	CENTER FOR OCCUPATIONAL HEALTH 2621 CROSBY AVENUE KLAMATH FALLS,OR97603	REHABILITATION SERVICES, HOME HEALTH SERVICES, EMPLOYEE ASSISTANCE PROGRAM
6	MEDICAL OFFICE BUILDING II 3000 BRYANT WILLIAMS DRIVE KLAMATH FALLS,OR97601	MEDICAL CLINIC
7	FAMILY PRACTICE CLINIC 1905 MAIN KLAMATH FALLS,OR97601	MEDICAL CLINIC
8	FAMILY PRACTICE CLINIC 2617 ALMOND STREET KLAMATH FALLS,OR97601	MEDICAL CLINIC
9	COMMUNITY HEALTHEDUCATION 2200 NORTH ELDORADO AVENUE KLAMATH FALLS,OR97601	COMMUNITY EDUCATION FACILITY
10	UROLOGY CLINIC 2630 CAMPUS DRIVE KLAMATH FALLS,OR97601	MEDICAL CLINIC
11	MEDICAL OFFICE BUILDING III 2680 UHRMANN ROAD KLAMATH FALLS,OR97601	MEDICAL CLINIC
12	ADULT MEDICINE & FAMILY PRACTICE 3001 DAGGETT AVENUE KLAMATH FALLS,OR97601	MEDICAL CLINICS
13	PULMONARY MEDICINE 2301 CLAIRMONT DRIVE KLAMATH FALLS,OR97601	MEDICAL CLINIC
14	FAMILY PRACTICE CLINIC 2600 CLOVER KLAMATH FALLS,OR97601	MEDICAL CLINIC
15	HUGH CURRIN HOUSE 2601 DAGGETT AVENUE KLAMATH FALLS,OR97601	RESIDENTIAL FACILITY FOR FAMILIES UNDERGOING CARE

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 1J: WHAT BEGAN AS A CONVERSATION BETWEEN THE COMMUNITY HEALTH OUTREACH MANAGER AT SKY LAKES MEDICAL CENTER, KLAMATH FALLS, ORE., AND THE HEALTH PROMOTION/DISEASE PREVENTION COORDINATOR AT KLAMATH COUNTY (ORE.) PUBLIC HEALTH BECAME THE SEED THAT TOOK ROOT AND THEN FLOURISHED INTO A MAJOR COLLABORATION AMONG LOCAL PUBLIC AND PRIVATE PARTNERS.THE COLLABORATION OF COMMUNITY PARTNERS SEEKING BETTER HEALTH EVOLVED INTO HEALTHY KLAMATH, A SEMI-FORMAL ORGANIZATION REPRESENTING A WIDE VARIETY OF PUBLIC-SECTOR AGENCIES AND DEPARTMENTS AS WELL AS PRIVATE PARTIES WITH INFLUENCE IN LOCAL HEALTH. AT ITS CORE IS SKY LAKES MEDICAL CENTER, THE LOCAL HEALTH DEPARTMENT, A MANAGED CARE ORGANIZATION FOR THE MEDICAID POPULATION, AND A FEDERALLY QUALIFIED HEALTHCARE PRACTICE WITH TWO FAMILY PRACTICE CLINICS IN THE COUNTY. KLAMATH FALLS CITY AND KLAMATH COUNTY GOVERNMENT, STATE OF OREGON AGENCIES, AND LOCAL SCHOOL DISTRICTS AND HIGHER EDUCATION ARE ALSO REPRESENTED.FURTHER, THE PARTNERSHIP ALSO INCLUDES CASCADES EAST FAMILY MEDICINE CENTER, A RURAL RESIDENCY PROGRAM AND CLINIC, OREGON STATE UNIVERSITY'S EXTENSION IN KLAMATH COUNTY, OREGON HEALTH & SCIENCE UNIVERSITY'S NURSING PROGRAM AT OREGON INSTITUTE OF TECHNOLOGY, THE LOCAL NEWSPAPER AND THE REGION'S LARGEST RADIO STATION.THE ASSESSMENT LAUNCHED AS A RESULT OF SKY LAKES LEADERSHIP RECOGNIZING THERE ARE MYRIAD CAUSES FOR POOR HEALTH AND THE PROBLEM IS TOO LARGE FOR ANY ONE ORGANIZATION TO TAKE ON ALONE, AND SO WORKED AS A COMMUNITY CONVENER TO GET OTHERS TO THE TABLE TO PLAN AND IMPLEMENT CHANGE. THE INTENT WAS TO HEAR FROM MANY VOICES AND TO STRIVE FOR HARMONY AS WE WORKED TOGETHER TO MAKE IMPROVEMENTS THAT WOULD LAST.AT THE SAME TIME, MEDICAL CENTER LEADERS RIGHTLY UNDERSTOOD THERE ARE POTENTIAL SOLUTIONS TO THE PROBLEMS OF POOR HEALTH THAT ARE BEYOND THEIR PURVIEW. THE MEDICAL CENTER TOOK THE LEAD TO HELP FIND WAYS EACH OF THE PARTNERS COULD USE THEIR UNIQUE EXPERTISE TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR SUCCESS IS MONITORED AND MEASURED BY THE HEALTHY COMMUNITIES INSTITUTE (HCI) INDICATORS AND DISPLAYED ON A PUBLIC WEBSITE, HEALTHYKLAMATH.ORG.WITHIN TWO MONTHS OF THE INITIAL MEETING, UNDER THE LEADERSHIP OF THE MEDICAL CENTER AND WITH THE FULL COOPERATION OF THE PARTNERS, THE CORE FOUR HAD AGREED TO A PLAN TO DEPLOY THE HCI WEB-BASED INDICATORS TOOL (HEALTHKLAMATH.ORG) AND A FRAMEWORK TO ACCOMMODATE THE VARIOUS OTHER COMMUNITY PARTNERS IN THE PROCESS.THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COORDINATED BY SKY LAKES MEDICAL CENTER DONE IN CONCERT WITH KLAMATH COUNTY HEALTH REPRESENTS THE COLLABORATIVE WORK BETWEEN SKY LAKES MEDICAL CENTER AND ITS LOCAL PARTNERS. THIS CHNA IS THE FIRST OF ITS KIND TO FORMALLY ASSESS AND DOCUMENT THE HEALTH OF OUR COMMUNITY UTILIZING A COORDINATED AND COLLABORATIVE PROCESS. IT IS THE FIRST STEP TO THE ONGOING PROCESS OF COMMUNITY HEALTH IMPROVEMENT. THE COMMUNITY ASSESSMENT IS UPDATED WHENEVER MORE DATA ARE RECEIVED TO POPULATE MORE THAN 100 HEALTH INDICATORS. THE HEALTHY KLAMATH ORGANIZATION MEETS REGULARLY TO EVALUATE DATA AND PROGRESS OF STRATEGIES TO IMPROVE HEALTH ACCORDING TO THE PREVIOUSLY IDENTIFIED PRIORITIES.THE PRIMARY GOAL OF THE CHNA IS TO BETTER UNDERSTAND THE HEALTH OF OUR COMMUNITY AND TO DEVELOP LOCAL STRATEGIES TO ADDRESS OUR COMMUNITY'S SPECIFIC NEEDS AND IDENTIFIED PRIORITY ISSUES. THE CHNA INFORMS THE GROUP AND HELPS SET COMMUNITY PRIORITIES, ESTABLISH BENCHMARKS AND MONITOR TRENDS IN THE HEALTH STATUS OF KLAMATH COUNTY RESIDENTS. THERE IS AN ADDED BENEFIT IN THAT THE IMPROVEMENT EFFORTS EXTEND TO OTHER REGIONS IN THE CATCHMENT AREA OUTSIDE THE DEFINED COMMUNITY.WE ACKNOWLEDGE THAT THE CHNA IS A LIVING DOCUMENT, ALLOWING US TO SEEK CONTINUOUS IMPROVEMENT AND FURTHER ANALYZE THE DATA AND, ULTIMATELY, IMPROVE THE HEALTH OF OUR COMMUNITY. UNDERSTANDING THAT HEALTH IS A PRODUCT OF MANY CONDITIONS AND FACTORS, AN ADAPTED VERSION OF THE STRATEGIC PLANNING FRAMEWORK DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) IN COOPERATION WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WAS MADE TO CREATE THIS CHNA.THE STRATEGIC PLANNING FRAMEWORK THAT WAS ADAPTED FOR KLAMATH COUNTY IS KNOWN AS MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). MAPP IS A COMMUNITY-DRIVEN PROCESS THAT RESULTS IN THE IDENTIFICATION OF HEALTH ISSUES AND HEALTH IMPROVEMENT STRATEGIES THROUGH COMMUNITY MEMBER AND STAKEHOLDER ENGAGEMENT.FACILITATED BY COMMUNITY HEALTH LEADERS, MAPP IS INTENDED TO IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND PERFORMANCE OF LOCAL HEALTHCARE SYSTEMS SKY LAKES IS A PRINCIPAL PART OF THAT LOCAL SYSTEM. MAPP ALLOWS FOR AN ENHANCED UNDERSTANDING OF THE INFLUENCES ON COMMUNITY HEALTH THROUGH THE ANALYSIS OF POPULATION-BASED QUANTITATIVE DATA, LOCALLY GATHERED QUALITATIVE DATA, AND THE EXPERTISE OF KEY STAKEHOLDERS. THESE VARIOUS DATA-COLLECTION METHODS ALLOW FOR A BETTER UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CIRCUMSTANCES IN WHICH PEOPLE ARE BORN, RAISED, LIVE, AND WORK, IN ADDITION TO AVAILABLE RESOURCES.THE SOCIAL DETERMINANTS OF HEALTH PROVIDE A LENS THROUGH WHICH TO VIEW DIFFERENT POPULATIONS AND COMMUNITIES AND IDENTIFY CONDITIONS THAT PROMOTE HEALTH, RATHER THAN LIMIT IT. WITH THIS INFORMATION WE CAN COLLECTIVELY BETTER UNDERSTAND THE DRIVERS OF HEALTH OUTCOMES IN KLAMATH COUNTY AND DEVELOP STRATEGIES FOR HEALTH IMPROVEMENT. WHILE THE STANDARD MAPP INCLUDES FOUR ASSESSMENTS (COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, AND THE FORCES OF CHANGE ASSESSMENT), THE LOCAL PARTNERS AS HEALTHY KLAMATH TAILORED MAPP TO BETTER FIT OUR COMMUNITY. THE PARTNERS DECIDED TO COMBINE THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT AND FORCES OF CHANGE ASSESSMENT INTO A SINGLE ASSESSMENT. THIS SPECIFIC COMBINATION INCREASED EFFICIENCY AND UTILIZES RESOURCES MOST EFFECTIVELY. THE INFORMATION FOR THIS COMBINED ASSESSMENT WAS COLLECTED FROM STAKEHOLDERS WITH THE ABILITY TO SPEAK TO THE CURRENT SYSTEM AS WELL AS THE FUTURE OPPORTUNITIES AND UNCERTAINTIES THAT MAY AFFECT THE CURRENT SYSTEM.COLLECTING AND ANALYZING THE VOLUME OF DATA NECESSARY TO FULLY UNDERSTAND COMMUNITY HEALTH IS TIME- AND RESOURCE-INTENSIVE HEALTHY KLAMATH PARTNERS COLLABORATIVELY SOUGHT A SOLUTION TO UTILIZE RESOURCES IN THE MOST EFFECTIVE MANNER. THE PARTNERS AGREED TO UTILIZE THE HEALTHY COMMUNITIES INSTITUTE (HCI), WHICH MANAGES AND CONTINUALLY UPDATES A CENTRALIZED PUBLICALLY AVAILABLE WEB-BASED SOURCE OF POPULATION DATA AND COMMUNITY HEALTH INFORMATION.HCI PROVIDES A PLATFORM FOR CONTINUAL MONITORING AND TRACKING ON MORE THAN 100 INDICATORS SELECTED BY THE COMMUNITY PARTNERS THE INDICATORS ARE ROUTINELY UPDATED. THESE INDICATORS WERE ASSESSED ON FOUR FACTORS:1) COMPARISON TO OREGON AND NATIONAL BENCHMARKS,2) TRENDS OVER TIME,3) HEALTH DISPARITIES, AND4) SEVERITY OF HEALTH ISSUE.THE HEALTH INDICATORS SELECTED MET AT LEAST THREE OF THE FOUR CONDITIONS: - KLAMATH COUNTY RATE IS HIGHER THAN THE OREGON STATE AVERAGE AND/OR DOES NOT MEET THE NATIONAL HEALTHY PEOPLE 2020 BENCHMARK - THE TREND IS WORSENING - CERTAIN POPULATIONS ARE EXPERIENCING A DISPARITY OR - LONG-TERM CONSEQUENCE, PREMATURE DEATH, AND/OR HIGH HEALTH-RELATED EXPENDITURES ARE ASSOCIATED.THE FORMULATION OF THE CHNA COORDINATED BY SKY LAKES MEDICAL CENTER WAS STRONGLY INFLUENCED BY INPUT FROM COMMUNITY PARTNERS AND STAKEHOLDERS AS WELL AS INDIVIDUALS IN KLAMATH COUNTY COMMUNITIES. COMMUNITY INVOLVEMENT IS ESSENTIAL TO SUCCESSFUL PUBLIC HEALTH ACTION, AND THE PRIORITY AREAS FOR HEALTH IMPROVEMENT SHOULD REFLECT THE PROBLEMS OF GREATEST CONCERN TO THE LOCAL COMMUNITIES. HEALTHY KLAMATH PARTNERS REGULARLY SEEK COMMUNITY INPUT VIA LISTENING SESSIONS, FOCUS GROUPS, AND SURVEYS.COMMUNITY PERCEPTIONS REGARDING HEALTH NEEDS ARE CAPTURED IN NON-SCIENTIFIC SURVEYS AND INTERVIEWS CONDUCTED AT THE CONCLUSION OF FREE HEALTH- AND WELLNESS-RELATED SEMINARS AND SIMILAR COMMUNITY EVENTS HOSTED BY THE MEDICAL CENTER. INFORMATION FROM THESE ACTIVITIES HELP INFORM FOLLOW-ON STRATEGIES AND PROGRAMS.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 3: THE KLAMATH COUNTY CHNA COORDINATED BY SKY LAKES MEDICAL CENTER IN PARTNERSHIP WITH OTHER PUBLIC AGENCIES IN THE COMMUNITY TAKES INTO ACCOUNT AN UNDERSTANDING OF THE ENVIRONMENT WITHIN WHICH WE OPERATE. UNDERSTANDING THE STRENGTHS AND WEAKNESSES OF THE CURRENT LOCAL HEALTHCARE SYSTEM, IN ADDITION TO ANY UPCOMING SOCIAL, POLITICAL, OR ECONOMIC CHANGES THAT COULD AFFECT THE SYSTEM, IS INTEGRAL TO DEVELOPING PRIORITY AREAS OF FOCUS. HEALTHCARE REFORM AND THE CURRENT ECONOMIC CLIMATE ARE LARGELY IMPACTING THE LOCAL HEALTHCARE SYSTEM AND THESE STRUCTURAL CHANGES MUST BE ACCOUNTED FOR.THE HEALTHY KLAMATH PARTNERS IDENTIFIED A LIST OF KEY STAKEHOLDERS ORGANIZED BY SECTOR TO INTERVIEW FOR THIS ASSESSMENT. THE ORIGINAL STAKEHOLDERS WERE SELECTED FOR THEIR ORGANIZATIONS INFLUENCE ON COMMUNITY HEALTH AND THEIR ROLE IN THE PUBLIC HEALTH SYSTEM.THE STAKEHOLDERS, IN ADDITION TO SKY LAKES MEDICAL CENTER, INCLUDE KLAMATH COUNTY PUBLIC HEALTH, CASCADE COMPREHENSIVE CARE, CASCADE HEALTH ALLIANCE, KLAMATH OPEN DOOR CLINICS, THE CITY OF KLAMATH FALLS, KLAMATH FALLS PUBLIC SCHOOLS AND KLAMATH COUNTY SCHOOL DISTRICT, KLAMATH COMMUNITY COLLEGE, OREGON INSTITUTE OF TECHNOLOGY, AND APPROXIMATELY 16 OTHER AGENCIES AND ORGANIZATIONS.AS PART OF THE ASSESSMENT, THE PARTNERS CONDUCTED 20 INTERVIEWS WITH MORE THAN 25 LOCAL STAKEHOLDERS. EACH INTERVIEW BEGAN WITH AN EXPLANATION OF THE CHNA USING THE CHNA FRAMEWORK AND WITH A WRITTEN AND VISUAL DEFINITION OF HEALTH.THIS IS THE WRITTEN DEFINITION OF HEALTH USED IN THE INTERVIEWS: HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY (WORLD HEALTH ORGANIZATION). FURTHER, HEALTH IS NOT SIMPLY A STATE FREE FROM DISEASE BUT IS THE CAPACITY OF PEOPLE TO BE RESILIENT AND MANAGE LIFE'S CHALLENGES AND CHANGES (PUBLIC HEALTH ACCREDITATION BOARD).AFTER ANY QUESTIONS REGARDING THE CHNA WERE ANSWERED, THREE INTERVIEW QUESTIONS FOLLOWED:1. HOW DOES YOUR ORGANIZATION CONTRIBUTE TO THE HEALTH OF THE COMMUNITY?2. WHAT DO YOU SEE AS YOUR ORGANIZATION'S ROLE IN THE LOCAL PUBLIC HEALTH SYSTEM?3. WHAT CHALLENGES DO YOU SEE THAT MAY AFFECT YOUR WORK (UPCOMING CHANGES IN LEGISLATION, FUNDING, TECHNOLOGY, NEW COLLABORATIONS, AND THE LIKE)?COMPLETE ANALYSIS OF THOSE INTERVIEWS AND THEIR RECOMMENDATIONS INFORMS THE ONGOING STRATEGY.ALSO, OREGON HEALTH & SCIENCE UNIVERSITY SCHOOL OF NURSING STUDENTS CONDUCTED LISTENING SESSIONS AND FOCUS GROUPS IN SIX OUTLYING COMMUNITIES (MERRILL, MALIN, BONANZA, CHILOQUIN, MIDLAND, AND KENO) IN RURAL KLAMATH COUNTY. INFORMATION FROM THOSE SESSIONS AND INTERVIEWS ARE IN APPENDIX A OF THE CHNA.FURTHER QUALITATIVE ANALYSIS IN THE FORM OF A WEB-BASED SURVEY WAS CONDUCTED BY THE PARTNERS AND SPONSORED BY SKY LAKES MEDICAL CENTER. NEARLY 900 SELF-SELECTED RESPONDENTS TO THAT SURVEY PROVIDED ADDITIONAL COMMUNITY PERSPECTIVE FOR THE CHNA AND WILL BE USEFUL TO DEFINE STRATEGIES AND TACTICS GOING FORWARD. RESULTS FROM THE SURVEY ARE INCLUDED IN THE FULL CHNA REPORT, WHICH IS AVAILABLE UPON REQUEST VIA WEBMASTER@SKYLAKES.ORG.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 5D: BESIDES THE SKY LAKES MEDICAL CENTER WEBSITE (SKYLAKES.ORG), THE CHNA CONDUCTED BY THE HEALTHY KLAMATH PARTNERS AND COORDINATED BY THE MEDICAL CENTER ALSO WILL RESIDE ON THE HEALTHY KLAMATH WEBSITE (HEALTHYKLAMATH.ORG), ON THE KLAMATH COUNTY HEALTH DEPARTMENT WEBSITE, AND WILL BE AVAILABLE IN PRINT FORM AT SKY LAKES MEDICAL CENTER, AT THE HEALTH DEPARTMENT, AT THE LOCAL NEWSPAPER OFFICE (HERALD AND NEWS, 2701 FOOTHILLS ROAD, KLAMATH FALLS, OR), AND AT THE KLAMATH COUNTY LIBRARY.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 7: AS EARLIER NOTED, THERE ARE SOME SOCIO-ECONOMIC AND INFRASTRUCTURE NEEDS IDENTIFIED IN THE ASSESSMENT THAT ARE BEYOND THE PURVIEW OF THE MEDICAL CENTER. THE ORGANIZATION, HOWEVER, STRIVES TO PROVIDE LEADERSHIP TO FACILITATE PROGRESS AND COOPERATION AMONG THE PUBLIC AND NGO AGENCIES THAT CAN ADDRESS THOSE NEEDS.INFORMATION GATHERED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FACILITATED BY THE COMMUNITY PARTNERS SEEKING BETTER HEALTH AND USING THE HEALTHY KLAMATH INITIATIVE INDICATES A STRATIFICATION OF PRIORITIES.DATA COLLECTED BY VARIOUS SURVEYS AGGREGATED BY THE HEALTHY COMMUNITIES INSTITUTE AND ORGANIZED AT HEALTHYKLAMATH.ORG INDICATE A RANGE OF NEEDS. AMONG THE TOP ARE: - ADULTS 65+ WITH INFLUENZA VACCINATION - ADULTS 65+ WITH PNEUMONIA VACCINATION - BABIES WITH LOW BIRTH WEIGHT - MOTHERS WHO RECEIVED EARLY PRENATAL CARE - DEATH RATE DUE TO COLORECTAL CANCER (AGE ADJUSTED).FURTHER, THE NUMBER OF LOCAL RESIDENTS WHO SELF-REPORTED THEIR HEALTH AS GOOD OR BETTER IS SIGNIFICANTLY LOWER THAN THE COMPARISON GROUP.WITH THAT AS A BACKDROP, THE COMMUNITY PARTNERS BROKE THE KEY DRIVERS OF HEALTH ACCORDING TO THE DATA INTO BROADER CATEGORIES, AND ASKED AREA RESIDENTS TO ASSIGN PRIORITY RANKS TO THEM.NEARLY 1,000 PEOPLE PARTICIPATED IN THE ONLINE, SELF-SELECT SURVEY. DATA COLLECTION REMAINED OPEN NINE DAYS (ONE WORK WEEK AND TWO WEEKENDS).ACCORDING TO THE DATA, RESIDENTS IDENTIFIED OBESITY, ACCESS TO MENTAL HEALTH AND LIMITING THE EFFECTS OF SUBSTANCE AND ALCOHOL ABUSE AND TOBACCO USE TOP SHORT-TERM (12-18 MONTHS) PRIORITIES. SIMILARLY, THE PRIORITIES FOR AN INTERMEDIATE TERM (18-36 MONTHS) LEFT IN PLACE THREE OF THE SHORT-TERM PRIORITIES AND ADDED TO THE TOP PRIORITIES LIST HEALTH INSURANCE COVERAGE AND YOUTH MENTORING.THE LONG-TERM (3+ YEARS) PRIORITIES CLOSELY ALIGN WITH THE OTHER CATEGORIES WITH THE TOP PRIORITY TO DECREASE POVERTY WHILE INCREASING THE HIGH SCHOOL GRADUATION RATE, ENCOURAGING HEALTHIER LIFESTYLES WITH BETTER NUTRITION AND MORE EXERCISE OPPORTUNITIES, AND BROADER HEALTH INSURANCE COVERAGE COMPRISING THE TOP SPOTS. IT IS CLEAR TO MOST THAT THOSE WHO PARTICIPATED IN THE SURVEY RECOGNIZE THAT OBESITY AND ITS ASSOCIATED COMPONENTS, PRIMARILY HEALTHIER EATING HABITS AND INCREASED ACTIVITY, ARE CLOSELY LINKED TO A VARIETY OF OTHER UNHEALTHFUL CONDITIONS. FURTHER, THERE IS A RECOGNITION THAT IN ORDER FOR THE CHANGES TO BE MORE OR LESS PERMANENT REQUIRES BROAD-BASED SYSTEMIC CHANGES RATHER THAN SO-CALLED INSTANT FIXES.THE COMMUNITY COALITION, LED IN NO SMALL MEASURE BY SKY LAKES MEDICAL CENTER AND RESPONSIBLE FOR ENSURING THERE IS PROGRESS TOWARD MAKING IMPROVEMENTS IN THE PRIORITIES, BROKE THE SHORT-, INTERMEDIATE- AND LONG-TERM PRIORITIES INTO AN EIGHT-POINT PROJECT LIST. SUCCESS ON ANY OF THE POINTS SUPPORTS PROGRESS ON OTHER POINTS.COMMUNITY PARTNERS SEEKING BETTER HEALTH TEAMS PARTICIPATING IN THE HEALTHY KLAMATH INITIATIVE WERE FORMED AROUND:1. OBESITY, HEALTHY EATING, EXERCISE2. ACCESS TO MENTAL HEALTH3. SUBSTANCE AND ALCOHOL ABUSE4. TRANSPORTATION5. YOUTH MENTORING6. INFRASTRUCTURE7. DECREASING POVERTY, AND8. HEALTH POLICY CHANGES.NONE OF THE ISSUES CAN BE RESOLVED WITHOUT CONSIDERABLE ENERGY AND RESOURCES, YET PROGRESS IS BEING MADE. FOR INSTANCE, SKY LAKES MEDICAL CENTER HIRED A PHYSICIAN AND NURSE, BOTH WITH PUBLIC HEALTH CREDENTIALS, TO OPEN AND OPERATE A FIRST-EVER WELLNESS CENTER AIMED SPECIFICALLY AT IMPROVING OBESITY-RELATED HEALTH.AT THE SAME TIME, SKY LAKES MEDICAL CENTER HAS MADE SIGNIFICANT CONTRIBUTIONS TO SUPPORT BETTER NUTRITION AND INCREASED PHYSICAL ACTIVITY. ALSO, SKY LAKES MEDICAL CENTER HAS COMMITTED TO BE A MAJOR SOURCE OF ALTERNATE REVENUE TO ENSURE THE MUNICIPAL POOL CONTINUES TO HAVE SWIMMING OPPORTUNITIES, RECOGNIZING IT AS AN IMPORTANT TYPE OF ACTIVITY FOR MANY PEOPLE, PARTICULARLY MOBILITY IMPAIRED INDIVIDUALS.SKY LAKES MEDICAL CENTER AND COMMUNITY PARTNERS ARE ACTIVELY IMPROVING ACCESS TO MENTAL HEALTH THROUGH A VARIETY OF MECHANISMS. THE MEDICAL CENTER, FOLLOWING A RIGOROUS RECRUITING EFFORT, HAS ATTRACTED TO THE COMMUNITY A PSYCHIATRIST TO PRACTICE AT THE NEWLY FORMED KLAMATH BASIN BEHAVIORAL HEALTH. THE ADDITION OF THE PROVIDER WILL LEVERAGE ADDITIONAL MENTAL HEALTH SERVICES FOR THE REGION.EFFORTS ARE UNDER WAY TO INCREASE: - THE AWARENESS AND THE FREQUENCY OF CANCER SCREENING OPPORTUNITIES TO ENCOURAGE AND SUPPORT THE EARLY DETECTION OF TUMORS - DIRECT INTERVENTIONS FOR PEOPLE AT RISK OF DIABETES OR WHO HAVE BEEN DIAGNOSED WITH DIABETES TO IMPROVE THEIR CONDITIONS WITHOUT HOSPITALIZATION AND - AWARENESS OF THE BENEFITS OF REGULAR LOW-IMPACT EXERCISES TO IMPROVE HEALTH AS WELL AS TO CONTROL AN ASSORTMENT OF CHRONIC DISEASES.WORKING WITH PHYSICIANS AND OTHER MEDICAL PROFESSIONALS, SKY LAKES MEDICAL CENTER ACTIVELY PROMOTES PRE-NATAL EDUCATION AMONG THE TARGET DEMOGRAPHIC BY OFFERING NO-CHARGE CHILDBIRTH PREPARATION CLASSES. THE MEDICAL CENTER ALSO HAS UNDERWAY A MORE EXPANSIVE PROGRAM USING NON-TRADITIONAL METHODS TO GET APPROPRIATE NUTRITION, EXERCISE AND CHILDBIRTH PREPARATION INFORMATION TO FIRST-TIME MOTHERS.MEASUREMENT DATA COLLECTED ON THE PROGRAMS ARE INCOMPLETE SO FIRM CONCLUSIONS REGARDING THEIR SUCCESS WOULD NOT BE APPROPRIATE.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 12I: HOUSEHOLD SIZE AND A MAXIMUM OUT-OF-POCKET EXPENDITURE.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 18E: SKY LAKES EMPLOYS A FIRM, CHAMBERLIN EDMONDS, THAT QUALIFIES PATIENTS FOR BENEFIT PROGRAMS. THEY SCREEN ALL OF SKY LAKES UNINSURED PATIENTS FOR POSSIBLE MEDICAID, MEDICARE AND/OR DISABILITY BENEFITS.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 20D: SKY LAKES IS AWAITING CLARIFICATION ON 501(R) REGULATIONS, WHICH ARE PROPOSED.
SKY LAKES MEDICAL CENTER	PART V, SECTION B, LINE 22: SOME PATIENTS ARE ONLY ELIGIBLE FOR AN ANNUAL MAXIMUM OUT-OF-POCKET REDUCTION.

Schedule H (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
SKY LAKES MEDICAL CENTER

Employer identification number
93-0508781

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) KLAMATH COUNTY SCHOOL DISTRICT 10501 WASHBURN WAY KLAMATH FALLS,OR97603	93-6000543	KLAMATH COUNTY, OR	32,333	HOSA PROGRAM ASSISTANCE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) EMPLOYEE STUDENT LOAN FORGIVENESS	11	54,938
(2) EXTERNSHIP STIPENDS	7	21,200
(3) STUDENT LOAN ASSISTANCE TO EMPLOYEES	12	43,396
(4) PATIENT ASSISTANCE	118	26,774

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE BOARD OF DIRECTORS MAKES DECISIONS ON LARGE GRANT AWARDS. SCHOLARSHIP AWARDS ARE BASED ON A WRITTEN POLICY. OTHER STIPENDS AND EDUCATIONAL SUPPORT REQUIRE, RESPECTIVELY, WORKED HOURS OR MINIMUM GRADING CRITERIA. PATIENT ASSISTANCE GRANTS ARE BASED ON ASSESSMENT OF NEED BY ASSIGNED PERSONNEL.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)PAUL R STEWARTPRESIDENT/CEO/SECRETARY/TREASURER	(i) (ii)	347,702 0	219,000 0	0 0	26,173 0	15,813 0	608,688 0	0 0
(2)RICHARD RICOVP/CFO	(i) (ii)	300,364 0	57,540 0	0 0	27,715 0	22,023 0	407,642 0	0 0
(3)NASSER ABU-ERREISH MDMEDICAL PROVIDER	(i) (ii)	429,663 0	0 0	0 0	12,750 0	15,813 0	458,226 0	0 0
(4)PATRICK MAVEETY MDMEDICAL PROVIDER	(i) (ii)	413,436 0	0 0	0 0	12,750 0	9,581 0	435,767 0	0 0
(5)RICHARD DEVORE MDMEDICAL PROVIDER	(i) (ii)	376,830 0	0 0	0 0	12,750 0	21,564 0	411,144 0	0 0
(6)STANTON SMITH MDMEDICAL PROVIDER	(i) (ii)	371,635 0	0 0	0 0	12,750 0	21,781 0	406,166 0	0 0
(7)ZEINA EL-AMIL MDMEDICAL PROVIDER	(i) (ii)	356,836 0	0 0	0 0	12,750 0	14,617 0	384,203 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
SKY LAKES MEDICAL CENTER

Employer identification number
93-0508781

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY	93-1061020	498413DQ3	08-31-2006	39,329,258	REVENUE AND REFUNDING MERLE WEST MEDICAL CENTER PROJECT	X		X			X
B	KLAMATH FALLS INTERCOMMUNITY HOSPITAL AUTHORITY	93-1061020	498413EF6	11-29-2012	18,288,334	REFUNDING OF 2002 BONDS ENERGY EFFICIENCY COSTS RESERVE FUND		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,065,000		840,000
2 Amount of bonds legally defeased . . . . . . . . . . .	11,772,436		11,772,436
3 Total proceeds of issue . . . . . . . . . . . . . .	39,329,258		18,288,334
4 Gross proceeds in reserve funds . . . . . . . . . . . .	59,879		59,879
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	558,445		257,477
8 Credit enhancement from proceeds . . . . . . . . . . .	1,170,952
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	15,000,000		6,198,542
11 Other spent proceeds . . . . . . . . . . . . . .	22,599,861
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2007		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X	X
b Exception to rebate? . . . . . . . .		X		X
c No rebate due? . . . . . . . .		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) PAUL STEWART	PRES/CEO	LIFE INSURANCE POLICY PURCHASE		X	300,000	304,981		No	Yes		Yes





Total ...... $						304,981

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 IS REVIEWED BY THE CONTROLLER, CFO, CEO AND OTHER STAFF BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C	IT IS THE DUTY OF THE BOARD OF DIRECTORS OF SKY LAKES MEDICAL CENTER TO SAFEGUARD THE TAX EXEMPT STATUS OF SKY LAKES MEDICAL CENTER, AND AS SUCH THE BOARD WILL TAKE SERIOUSLY ANY CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER OR POTENTIAL BOARD MEMBER. ALL BOARD MEMBERS AND POTENTIAL MEMBERS MUST DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST. AN UPDATED STATEMENT OF SUCH POTENTIAL CONFLICTS SHALL BE SUBMITTED YEARLY BY ALL BOARD MEMBERS FOR REVIEW AT THE BOARD'S ANNUAL MEETING. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT OF INTEREST AND AFTER ANY DISCUSSION WITH THE INTERESTED PARTY, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES OF THE BOARD SHALL CONTAIN 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST 2) THE NATURE OF THE FINANCIAL INTEREST 3) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR THE DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT 4) THE CONTENT OF THE DISCUSSION INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT 5) ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT AND, 6) THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPARATIVE DATA FOR CEO AND ALL VP POSITIONS. FOR THE CEO POSITION, THE COMPENSATION COMMITTEE COMPLETES A PERSONNEL ACTION FORM, WHICH IS SIGNED BY THE BOARD CHAIR. FOR ALL VP POSITIONS, THE COMMITTEE ACTS ON THE RECOMMENDATIONS MADE BY THE CEO. THIS PROCESS WAS LAST UNDERTAKEN IN MARCH 2015.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	BOOK/TAX DIFFERENCE ON PASSTHROUGH INCOME -39,634.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

SKY LAKES MEDICAL CENTER

Employer identification number

93-0508781

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) SOUTHERN OREGON EMERGENCY CARE LLC 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 61-1595709	PHYSICIAN SERVICES	OR	0	-5,688	SKY LAKES MEDICAL CENTER

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) SKY LAKES MEDICAL CENTER FOUNDATION 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 93-0946020	FUNDRAISING AND STEWARDSHIP SUPPORT MED CENTER	OR	501(C)(3)	LINE 11A, I	SKY LAKES MEDICAL CENTER		No
(2) KLAMATH CARE SERVICES INC 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 93-0946018	SUPPORT MED CENTER (INACTIVE)	OR	501(C)(3)	LINE 11C, III-FI	SKY LAKES MEDICAL CENTER		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) KLAMATH MEDICAL BUSINESS CENTER LLC 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 02-0731372	REAL AND PERSONAL PROPERTY RENTAL	OR	SKY LAKES MEDICAL CENTER	INVESTMENT	91,943	540,594		No	8,710	Yes		50.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) WEST PHYSICIAN SERVICES LLC 2865 DAGGETT AVENUE KLAMATH FALLS,OR97601 87-0696029	PHYSICIAN SERVICES	OR	SKY LAKES MEDICAL CENTER	C	-4,054,564	2,524,497	100.000 %	Yes

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) WEST PHYSICIAN SERVICES LLC	D	147,834	BOOK CHANGE IN LIABILITY
(2) KLAMATH MEDICAL BUSINESS CENTER LLC	K	120,571	CASH TRANSFERRED

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SKY LAKES MEDICAL CENTER WILL CONTINUALLY STRIVE TO REDUCE THE BURDEN OF ILLNESS, INJURY AND DISABILITY, AND TO IMPROVE THE HEALTH, SELF- RELIANCE AND WELL-BEING OF THE PEOPLE WE SERVE. WE WILL DEMONSTRATE THAT WE ARE COMPETENT AND CARING IN ALL WE DO. WE SHALL ENDEAVOR TO BE SO SUCCESSFUL IN THIS EFFORT THAT WE WILL BECOME A PREEMINENT HEALTHCARE CENTER.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	1,436
6	Total number of volunteers (estimate if necessary) .............	6	360
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	8,710
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	4,433

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,108,577	1,216,620
9	Program service revenue (Part VIII, line 2g) .........	443,177,926	507,426,845
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,891,059	2,072,795
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-239,830	201,359
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	447,937,732	510,917,619
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	252,388	178,642
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	83,990,919	90,469,004
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	348,624,683	397,685,998
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	432,867,990	488,333,644
19	Revenue less expenses. Subtract line 18 from line 12.......	15,069,742	22,583,975
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	216,824,030	237,247,168
21	Total liabilities (Part X, line 26).............	76,047,401	73,906,485
22	Net assets or fund balances. Subtract line 21 from line 20.....	140,776,629	163,340,683

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 426,799,187 including grants of $ 32,333 ) (Revenue $ 496,633,314 )
	PATIENT CARE EXPENSES - ACUTE INPATIENT CARE FOR ADULT AND PEDIATRIC PATIENTS A LEVEL III TRAUMA EMERGENCY DEPARTMENT SERVICES RELATED TO CHILD ABUSE, HOME CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES A CANCER TREATMENT CENTER WITH BOTH MEDICAL AND RADIATION ONCOLOGY AND DIAGNOSTIC TESTING (LABORATORY AND DIAGNOSTIC IMAGING) AVAILABILITY IN SETTINGS AROUND THE COMMUNITY.

4b	(Code: ) (Expenses $ 27,626,060 including grants of $ ) (Revenue $ )
	UNCOMPENSATED CARE - DURING FISCAL YEAR 2014, LIKE MOST US HOSPITALS SKY LAKES MEDICAL CENTER SAW A SHIFT AWAY FROM CHARITY CARE APPLICATIONS DUE TO THE AFFORDABLE CARE ACT. CHARGES WRITTEN OFF UNDER OUR BROAD REACHING CHARITY CARE POLICY TOTALED $11,662,310 (COMPARED TO $15,764,015 FOR FISCAL YEAR 2013). IN ADDITION TO CHARITY CARE WRITE OFFS, CHARGES WRITTEN OFF AS BAD DEBT TOTALED $15,963,751 (VERSUS THE $14,128,143 WRITTEN OFF IN FISCAL YEAR 2013). AS A PERCENTAGE OF CHARGES, FISCAL YEAR 2014 WRITE OFFS REPRESENT 2.3% (CHARITY CARE) AND 2.5% (BAD DEBT) RESPECTIVELY. THESE PERCENTAGES FOR THE PRIOR YEAR WERE 4.1% AND 3.2%. THE AVERAGE CHARITY CARE WRITE OFFS BACK TO 2004 RAN 1.8%. WE CONTINUE TO DO A MUCH BETTER JOB OF IDENTIFYING PATIENTS REQUIRING CHARITY CARE AT THE TIME SERVICE IS PROVIDED AND AVOIDING, AS MUCH AS POSSIBLE, HAVING SERVICES LATER CHARGED OFF AS BAD DEBT. THIS CONTINUES TO BRING DOWN OUR BAD DEBT WRITE OFF PERCENTAGE.

4c	(Code: ) (Expenses $ 6,085,860 including grants of $ 146,309 ) (Revenue $ 2,594,008 )
	EDUCATIONAL SUPPORT - SKY LAKES MEDICAL CENTER COMMITS SIGNIFICANT DOLLARS AND MAN-HOURS TO BENEFIT EDUCATIONAL EFFORTS IN AND FOR THE COMMUNITY. AMONG THOSE COMMITMENTS ARE THE FOLLOWING: OREGON HEALTH & SCIENCE UNIVERSITY AFFILIATED FAMILY PRACTICE RESIDENCY PROGRAM AND CLINIC AN RN I TRAINING PROGRAM TO INCLUDE 6 MONTHS OF ONE-ON-ONE SUPERVISED ORIENTATION TO THE INPATIENT CARE AREAS AWARDING OF SCHOLARSHIPS TO COMMUNITY MEMBERS AND/OR EMPLOYEES IN HEALTHCARE- RELATED PROGRAMS A HOSPITAL DEPARTMENT, LEARNING RESOURCES, DEDICATED TO THE EDUCATION OF PHYSICIANS, EMPLOYEES AND COMMUNITY MEMBERS COMMITMENT TO EMPLOYEES ACTING, EITHER FULL-TIME OR PART-TIME, AS INSTRUCTORS IN ACCREDITED COURSES AT THE HIGH SCHOOL, COMMUNITY COLLEGE OR UNIVERSITY LEVEL STIPEND PAYMENTS TO STUDENTS PERFORMING WORK AND/OR ON-THE-JOB TRAINING WITHIN THE HOSPITAL SETTING TUITION REIMBURSEMENTS PAID TO EMPLOYEES ENROLLED IN COLLEGE-LEVEL COURSEWORK JOINT PARTICIPATION IN A SIMULATION LABORATORY WITH OIT FREE OR MINIMAL COST COMMUNITY EDUCATIONAL OPPORTUNITIES SUCH AS DIABETES EDUCATION, NUTRITION AND OTHER EDUCATION PROGRAMS IN OR FOR THE SCHOOLS AND HEALTH FAIRS.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ 8,223,929 )
	EXPENSES RELATED TO MEDICAL CENTER SUPPORTING SERVICES SUCH AS ADMINISTRATION, INFORMATION SYSTEMS, FINANCIAL SERVICES, REVENUE CYCLE PROCESSES, HUMAN RESOURCES, ENGINEERING, ENVIRONMENTAL SERVICES, RISK MANAGEMENT, AND SAFETY AND SECURITY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ 8,223,929 )
4e	Total program service expenses460,511,107

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) JOHN BELL........................................................................ CHAIRMAN	3.00 .......................1.00	X	X		0	0	0
(2) ROD WENDT........................................................................ VICE CHAIRMAN	1.00 .......................1.00	X	X		0	0	0
(3) PAUL R STEWART........................................................................ PRESIDENT/CEO/SECRETARY/TREASURER	50.00 .......................1.00	X	X		566,702	0	41,986
(4) KERMIT HOUSER........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(5) JEAN PHILLIPS........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(6) CLARK PEDERSON........................................................................ BOARD MEMBER	1.00 .......................3.00	X			0	0	0
(7) WENDY WARREN MD........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(8) DOUGLAS MCINNIS DVM........................................................................ BOARD MEMBER	1.00 .......................1.00	X			0	0	0
(9) JOHN R PATTEE MD........................................................................ BOARD MEMBER	1.00 .......................1.00	X			22,550	0	0
(10) RICHARD RICO........................................................................ VP/CFO	50.00 .......................		X		357,904	0	49,738
(11) NASSER ABU-ERREISH MD........................................................................ MEDICAL PROVIDER	40.00 .......................			X	429,663	0	28,563
(12) PATRICK MAVEETY MD........................................................................ MEDICAL PROVIDER	40.00 .......................			X	413,436	0	22,331
(13) RICHARD DEVORE MD........................................................................ MEDICAL PROVIDER	40.00 .......................			X	376,830	0	34,314
(14) STANTON SMITH MD........................................................................ MEDICAL PROVIDER	40.00 .......................			X	371,635	0	34,531
(15) ZEINA EL-AMIL MD........................................................................ MEDICAL PROVIDER	40.00 .......................			X	356,836	0	27,367

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,895,556	0	238,830

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		1,206,385
e	Government grants (contributions)1e		10,235

f	All other contributions, gifts, grants, and similar amounts not included above1f

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,216,620
			Business Code
2a	PATIENT REVENUE		621990	496,778,330	496,778,330
b	OTHER PROGRAM REVENUE		621990	10,648,515	10,648,515
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			507,426,845
3	Investment income (including dividends, interest, and other similar amounts).......			2,056,141			2,056,141
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	689,618
b	Less: rental expenses	697,481
c	Rental income or (loss)	-7,863
d	Net rental income or (loss).......			-7,863			-7,863
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		20,683
b	Less: cost or other basis and sales expenses		4,029
c	Gain or (loss)		16,654
d	Net gain or (loss)..........			16,654			16,654
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a		114,827
b	Less: cost of goods sold ..b		84,788
c	Net income or (loss) from sales of inventory..			30,039			30,039
Miscellaneous Revenue			Business Code
11a	PASSTHROUGH INCOME		621990	116,349	24,406	8,710	83,233
b	OTHER INCOME		900099	62,834			62,834
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			179,183
12	Total revenue. See Instructions......			510,917,619	507,451,251	8,710	2,241,038


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			10,740,249	1	16,795,518
2	Savings and temporary cash investments .........			24,067,447	2	27,054,272
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			21,815,609	4	24,347,970
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				150,313	5	304,981
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			1,814,623	8	2,181,720
9	Prepaid expenses and deferred charges ..........			2,416,059	9	2,696,455
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	198,098,259
b	Less: accumulated depreciation .....	10b	107,465,418	88,843,570	10c	90,632,841
11	Investments—publicly traded securities ..........			37,089,769	11	48,760,547
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....			3,712,125	13	4,557,044
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			26,174,266	15	19,915,820
16	Total assets. Add lines 1 through 15 (must equal line 34)......			216,824,030	16	237,247,168
17	Accounts payable and accrued expenses .........			6,166,803	17	6,840,114
18	Grants payable .................				18
19	Deferred revenue ................			2,541,306	19	2,507,868
20	Tax-exempt bond liabilities .............			55,834,010	20	54,587,427
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			1,014,735	23	0
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			10,490,547	25	9,971,076
26	Total liabilities. Add lines 17 through 25.........			76,047,401	26	73,906,485
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			140,776,629	27	163,340,683
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			140,776,629	33	163,340,683
34	Total liabilities and net assets/fund balances ........			216,824,030	34	237,247,168