Nonprofit hospitals in Oregon are increasingly pushing to take newly acquired property off public tax rolls, and assessors in cash-strapped counties are pushing back.

Nationwide, hospitals are swallowing private practices, hiring their practitioners, absorbing their patients, and buying or leasing buildings and equipment.

Counties have long granted charitable tax exemptions to nonprofit hospitals in exchange for their care for the poor. But health reform’s coordinated care model along with changes to Medicare are driving mergers between hospitals and private practices to an all-time high.

In Oregon, county assessors are fighting the trend. Douglas County recently denied Roseburg’s Mercy Medical Center’s request to extend its exemption to four properties worth $18 million. Hood River and Josephine counties, currently gathering information, may follow suit on similar requests, assessors there say.

Oregon’s county assessors challenge hospital acquisitions’ new tax breaks, murky law

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News Flash: Protest Rally at the Providence Bridge Pedal Health & Wellness Expo

This from the Facebook page, Save Providence Therapy Pool.

Come out this sunday for a protest rally at Providence Health and Wellness Expo, help highlight the hypocrisy of Providence’s move to promote health for some while taking it away from others!

JELD-WEN Field
Sunday, Aug. 12
9 a.m. to 1 p.m.

 

directions http://www.portlandtimbers.com/stadium-renovation

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Protest over Providence Pool closure caught the eye of KOIN6

Why is Providence closing the warm-water therapy pool?

We keep hearing that the pool will close at the end of August 2012. How can that be true? Why would it close then? Construction on remodeling the Professional Plaza, the building that houses the pool, is at least two years away and maybe more. At least that’s what we have been told in community meetings by the CEO of the hospital.

Watch this video from KOIN 6 that captures the protest that users of the therapy pool staged on Saturday, August 4, at 10:30 in the afternoon. There would have been even more folks there but many of them were unable to tolerate the heat. Thank you to KOIN 6 for posting the video footage on their website!

KOIN 6 coverage of Pool Closure Protest 

Could they be closing the pool at the end of this month to save money? According to Dr. Bruce Becker, MD, director of the National Aquatics and Sports Medicine Institute, a pool needs 1,100 users to pay for itself. The Providence Therapy Pool has 2,000 monthly users. Is this just a rumor and the pool will continue to operate? Are we being threatened so we will concede on some other topic we don’t even realize will affect our lives in even more significant ways?

Is the health department pressuring Providence to upgrade facilities? If not, what is the rush to change the facilities? Even if Providence upgraded the facilities to meet ADA requirements it would not make sense to do anything until construction on the larger building remodel begins. There is more than enough time to put out a request for donations to pay for the upgrade of the pool showers and locker rooms. This is exactly the kind of project donors love.

This leads us to ask again, why is this program the one being chopped? Could this have anything to do with the fact that a large percentage of the users are uninsured or underinsured? Why is Providence not continuing this program that benefits so many who have been injured and are no longer able to work or who have no other means at their disposal to get the amenities a pool like this provides. They are not individuals who can access an expensive gym for the jacuzzi or pay for regular massages. They maintain their day-to-day functioning because they use the warm water therapy this pool provides.  Ironically, the group of people who uses the therapy pool are the very folks that Providence promises to help. And, it’s likely to be you and me, someday. This is the type of preventive medicine that needs to be accessible for all and who will do that for the community, if not the hospital?

Providence is complaining about spending 1.2 million dollars to upgrade the facilities, sometimes the repairs are quoted as 1.5 million dollars. 1.5 million is not much more than the hundreds of thousands of dollars Providence spends on attorney Michael Robinson’s legal counsel as he escorts them in their every move with neighbors and the City of Portland. Another comparison is that 1.5 million dollars is the cost of building 60 parking spaces. And for sure, with all those day surgery patients, more parking spaces will be needed.

Another interesting question is, how much would it cost to build a pool like this in today’s economy? A pool of this nature is no small undertaking and the chances of getting another one like this in Portland are very, very slim. We don’t understand why Providence doesn’t use this pool as a publicity tool and bring more users and make the pool support itself even more clearly. With healthcare heading in the direction of self-directed and preventive types of models, the warm-water therapy pool is EXACTLY the kind of treatment many individuals need.

Finally, how does eliminating the pool fit with the new mission? You can read the details of the new mission here…….

Below are a couple of items that jumped out at us from the mission Providence posted this last week or so. We didn’t think this represented how they treat their neighbors. We don’t mean Portlanders in general, we mean residents of North Tabor, Laurelhurst, Rose City Park, and Hollywood.

  • We reach out to people in need and give comfort as Jesus did. We nurture the spiritual, physical and emotional well-being of one another and those we serve. We embrace those who are suffering. (one really huge way to show this is your mission is to keep the pool operating)
  • We believe everyone has a right to the basic goods of the earth. We strive to remove the causes of oppression. We join with others to work for the common good and to advocate for social justice. (the social justice piece here is that the folks who use the pool don’t have the means to have a hot tub in the back yard or a jacuzzi tub in the bath.)
  • Much will be expected of those who are entrusted with much.   

Neighbors . . . Providence has much. And while they will be impacted by the cuts to Medicare and Medicaid, they are still and will remain a profitable company. It is easy to confuse non-profit status with not being profitable and we think Providence is using that imagery as they fundraise and make decisions about what to cut or not cut. But, if you go back to our post about the revenue Providence posted with the IRS for the last few years, you will find an organization that can easily absorb the price of a few locker room upgrades.

Providence, we expect much because you are entrusted with much.

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Alert: Providence Therapy Pool users plan a demonstration

This announcement was posted on the Facebook page for Save Providence Therapy Pool:

all you portland people, come out this saturday, aug. 4th at 130 pm to show your support for the save providence therapy pool. rally will be held on the sidewalk of Glisan ave at about 45th ave. bring your signs, spirit and become the change you want to see in the world!

I think they mean 52nd Ave, which is right outside the pool.

Join me, I’ll be there with my video running so we can get something up on YouTube. I’m not an organizer of this effort, but I support them completely in preserving something that we may all be needing in the future. A swimming pool is not something that gets built every day, or every year, or every decade.

Hope to see you there!

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Providence and it’s Neighbors: What Has Changed?

One of the most common questions neighbors have asked me over the last 6 months has been, “What has changed at Providence. Why does it feel like Providence cares less and less about the good of the community?”

That got me to thinking about when things began to change and when Providence adopted a new tone and a new way of relating to the neighborhood in which they live.

To be fair, there has been conflict between Providence and the neighbors for decades. For decades, neighbors have stood up and gone on record as opposed to development of Providence especially when that development has left the neighborhood with less than community-oriented spaces. The bottom line is this: the same organizations that carry a mission of aiding the sick and suffering also cause conflict within the neighborhoods where they do business.

However, despite those obvious conflicts, the best hospitals find ways to embrace what the neighbors need and to incorporate neighbor concerns into their development goals. We’ve highlighted Seattle Children’s as a case in point. They used to have conflict with their neighbors, much like Providence has with its neighbors because they didn’t take the residential nature of their surroundings to heart. They were expanding and traffic was causing problems and parking was a problem and tensions were high. They got smart and changed their tune, they reduced the number of commuters, and they now build pedestrian infrastructures all around their campus as a way to give back to the neighbors in exchange for the inconvenience of having a hospital in their midst.

It’s unlikely Seattle Children’s made this change in direction without some external pressure. But, it seems they’ve embraced the change whole-heartedly, in fact it’s now a marketing coup for them. At a time when all large corporations are pressured to reduce vehicular trips, Seattle Children’s can relax a bit, they are under 38% single occupancy rate. That’s an incredible feat and they should brag about it. We wish our neighborhood hospital was able to brag about such an amazing accomplishment.

But I digress.

What has changed at Providence? 

For one thing, in 2009, the Vatican turned the power and control of the hospitals in Oregon away from the Sisters of Providence Ministry and into the hands of the Providence Ministries, which is legally a Public Juridic Person. This from the 2011 annual statement of Providence Corporation:

The Provincial Superior, Provincial Council, and Provincial Treasurer of the Sisters of Providence – Mother Joseph Province historically controlled certain aspects of the various corporations comprising Providence Health & Services (the Health System), through certain reserved rights. Effective January 1, 2010, essentially all of the sponsorship of the Health System was transferred to the new Public Juridic Person, Providence Ministries, which was approved by the Vatican on February 2, 2009. The reserved rights, held by the Provincial Superior, Provincial Council, and Provincial Treasurer of the Sisters of Providence Mother Joseph Province, were transferred through the change in sponsorship to Providence Ministries.

Sister Bernardo and Mary Jane Groce, circa 1942

It seems Catholic hospitals have been less nimble in the competitive hospital world. As secular hospitals have entered into joint ventures with them, views on controversial issues have ended key negotiations. You can read an excellent description of what that means here . . . 

The biggest change at Providence? The nuns are gone and there’s a new order in charge.

We can tell.

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Community Service, a Parking Ticket, and Providence Portland

This morning, a neighbor and I swept the south end of the 42nd Ave overpass and steps at the Hollywood Transit Center, something we do three or four times a year. Today we had extra time so we cleaned up the bike/wheelchair ramp.

The garbage bags were heavy with cigarette butts and leaf debris and there was too much to put into our garbage cans at home so I drove to the Hollywood Senior Center because Amber Kern-Johnson, the director there, has been so kind to offer up dumpster space when we’ve cleaned the Hollywood Business District in the past. Today was no different in that regard. Amber confirmed that we were welcome to use the dumpster because it was a community service. We thanked her for her generosity.

Sadly, in the time it took for me to park, go in and ask about the dumpster, and get back to my car, the Diamond-Parking-Attendant and his parking-attendant-in-training had taken a picture of my license and were completing their info entry to process a parking ticket.

When I pleaded that I was bringing garbage from cleaning up the overpass, he curled his lip and said “garbage?,” pressed a button on the ticket machine, watched with a sneer as it reeled out of the printer and, with a flourish, placed the $41 ticket on the windshield of my car.

I emptied the heavy bags from my trunk into the dumpster and drove home analyzing the situation. I was on their property, it is marked, I was technically in the wrong. My motives were good, I was cleaning community space for no profit of my own. However, the parking attendant swooped in aggressively, a lot like a vulture guarding his road kill, moments after I walked into the senior center. Maybe he works on commission and therefore it’s not in his best interest to listen to my story or sympathize with my situation.  He might have to shut off his emotions to the plight of others in order to make a living.

Only after I’d written a check and put the envelope out for the mail carrier did it occur to me that the situation wasn’t that different than the predatory nature of insurance companies and hospitals. Their mission is always lofty: to care for us, including the poor. However, most wellness and prevention strategies are not a covered benefit. It’s the rare insurance company that really focuses on the best interest of their insured.

By the nature of the way our system is designed, hospitals and the insurance companies benefit when we are sick. They make money off of us when we have problems. They compete with other insurers to get our business when we are vulnerable and can’t make other choices.

The hospital that sits in our midst, Providence Portland, has long deserved a reputation for being a little different, a little more altruistic, a little more caring of the neighbors.

That no longer seems true.

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Our Not-For-Profit Neighbor (Part 1): Providence Portland Medical Center

Many neighbors have asked what it means to be a non-profit hospital. We’re following up to answer that question with as many facts as we can and this is the first of several posts that will address the topic. 

This week we are posting Providence – Oregon’s IRS Form 990, also known as the “Return of Organization Exempt From Income Tax,” for the years 2010, 2009, and 2008.

Form 990 is the IRS form required to maintain Providence’s 501(c)(3) not-for-profit status as a charitable hospital. Officially known as Providence Health & Services
– Oregon, and headquartered in Renton, Washington, the corporation is made up of seven Oregon hospitals, of which Providence Portland Medical Center is the largest, in terms of revenue.

On the first page of the Form 990 for 2010, not surprisingly, Providence describes its mission as “Healthcare with special concern for the poor and vulnerable.”

Gross receipts were $3.5 billion.

Total assets equaled $2.4 billion.

Program revenue of $2.1 billion is broken out by inpatient acute care ($891 million), outpatient acute care ($813 million), long term care/home care/hospice ($206 million), and primary care ($191 million).

Investment income equaled $20 million.

Highest paid officers included John Koster, MD with compensation of $3.1 million; Russell Danielson with compensation of $4.8 million and Gregory Van Pelt with compensation of $2.8 million. A curious note in Schedule L, part IV, mentions the “purchase of supplies through a cooperative of which Dr Koster is a director.” The amount of the supplies purchased was $222 million.

Two entities, Providence Fairview and Providence Padden, 1235 NE 47th, own and manage land for future development.

. . .

Note: We’ve mapped out the properties owned by Providence, many of which are listed as PROVIDENCE HEALTH & SERVICES-OREGON, ATTN PROPERTY MANAGEMENT on the http://www.portlandmaps.com.
You will see all the properties owned by Providence in the NE part of Portland in the picture below. The property in green is operated as part of the current hospital system. The properties in blue are owned by Providence but are still held as rentals. The light blue properties are owned by what we call “friends of Providence” and could be developed in the future when certain zoning changes (more on that in another blog post). Double-click on the map for larger image. In fact, you can see how the current operations impact the neighborhoods of North Tabor, Hollywood, Rose City Park, and Laurelhurst. 

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