2024-11-11T09:23:30+00:00 2023-12-31 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE INDIANAPOLIS IN 462045100 990 2023-01-01 350877574 Elkhart General Hospital Inc ELKH 5745233208 600 EAST BLVD ELKHART IN 46514 JEFFREY COSTELLO CFO 5746473549 2024-11-11 true Jennifer D Rhoderick P00395735 3176817000 2024-11-05 2023 2024-10-15 13:58:12Z CARL RISK 600 EAST BLVD ELKHART IN 46514 366115022 false X WWW.BEACONHEALTHSYSTEM.ORG X 1909 IN WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART. 10 10 2013 64 366785 0 8407429 318234 348118132 362276419 66856 276807 2716704 2764538 359309121 365635998 505213 431718 0 144975364 125698773 0 0 198965807 194689436 344446384 320819927 14862737 44816071 270751853 274314068 88546374 79266586 182205479 195047482 WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART. false false 291125988 431718 362928440 SEE SCHEDULE O 291125988 true true false true false false false false true true false false false true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true true true false false true 124 0 true 2013 true true true false false false false false false false false false false false X 10 10 false false false false true true true true true false false true true true true true true false false false IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 Levon Johnson Secretary thru 3/31/23 2.0 2.0 X X 0 1314 0 Matt Zimmerman Vice Chair 2.0 0 X X 1220 0 0 Sam Borrelli MD Secretary 2.0 0 X X 225 0 0 Tim Morgan MD Chair 2.0 40.0 X X 0 348029 19149 Bruce Newswanger DO Director 2.0 0 X 225 0 0 Chris Annis MD Director 2.0 0 X 225 0 0 Dawn Fisher Director 2.0 0 X 1220 0 0 John Deputy Director 2.0 0 X 1220 0 0 Lupita Zepeda Director 2.0 0 X 479 0 0 Shelley Moore Director 2.0 0 X 225 0 0 Tonja Lucchese Director 2.0 0 X 900 0 0 Carl W Risk II President 40.0 0 X 467217 0 91278 Jeffrey P Costello CFO 2.0 50.0 X 0 744234 118036 Kreg R Gruber CEO 2.0 50.0 X 0 1162712 170134 Cindie L McPhie VP Operations 40.0 0 X 206499 0 9769 James E Cantrell Lead Perfusionist 40.0 0 X 341455 0 36227 John P Scheu Perfusionist 40.0 0 X 304117 0 35279 Kaleena M Freeman Perfusionist 40.0 0 X 246147 0 32490 Michelle R Bache VP Medical Affairs 40.0 0 X 393300 0 15330 1964675 2256289 527693 286 false true false APOGEE PHYSICIANS 2525 E CAMELBACK RD PHOENIX AZ 85016 PHYSICIAN SERVICES 4652609 AYA HEALTHCARE PO BOX 123519 DALLAS TX 75312 TEMPORARY LABOR 4086171 TONN AND BLANK CONSTRUCTION LLC 1623 GREENWOOD AVE MICHIGAN CITY IN 46360 CONSTRUCTION SERVICES 2648472 LABCORP INDIANA PO BOX 8014 BURLINGTON NC 27216 LAB SERVICES 2033535 SOUTH BEND MEDICAL FOUNDATION 530 NORTH LAFAYETTE BLVD SOUTH BEND IN 46601 LAB SERVICES 1960085 42 112893 205341 318234 NET PATIENT REVENUE 622110 354437841 354437841 0 0 OUTPATIENT PHARMACY 446110 6572521 0 310306 6262215 RENT FROM RELATED PARTIES 622110 1228276 1228276 0 0 MEDICAL EDUCATION 611710 37781 37781 0 0 0 0 0 0 362276419 190831 0 0 190831 0 0 0 0 0 0 0 0 872886 418762 454124 0 454124 454124 146238 60262 0 85976 85976 85976 Quality Incentive 622110 584423 584423 0 0 Cafeteria 722514 1290775 0 0 1290775 Primley Distribution 523000 311139 0 0 311139 124077 67598 56479 0 2310414 365635998 356355919 366785 8595060 282291 282291 149427 149427 564435 564435 100818654 88613899 12204755 2983863 2669393 314470 14263776 12497935 1765841 7068045 6184539 883506 4469249 3910593 558656 17132 17132 131142 131142 1052 1052 283907 283907 13359311 11685444 1673867 0 3785835 3310731 475104 22759 19914 2845 3397134 2948370 448764 40160 35140 5020 9446 8265 1181 1483050 1297669 185381 16104660 14089845 2014815 1725111 1509472 215639 Patient Supplies, Drugs 70822010 70822010 Corporate Allocation Fee 42555871 37236387 5319484 Hospital Assessment Fee 20377393 17830219 2547174 Bad Debt Expense 15466066 15466066 638148 558379 79769 0 320819927 291125988 29693939 0 7810 7810 11219644 14485661 61436608 66587288 0 0 0 0 49174 328003 8866110 11539619 516925 522020 429363388 260714694 172277305 168648694 7814426 8420513 0 0 2536226 2536226 6027625 1238234 270751853 274314068 30305642 24912022 56589119 52721476 0 0 1651613 1633088 88546374 79266586 X 174391053 186626969 7814426 8420513 182205479 195047482 270751853 274314068 X 44816071 606087 -32580155 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1052 1052 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ELKHART GENERAL HOSPITAL PAID DUES TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: INDIANA HOSPITAL ASSOCIATION - 32% AND (ACADEMY OF NUTRITION AND DIETETICS) - 10.0% ACHE (AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES - 1% AMA (AMERICAN MEDICAL ASSOCIATION) - 65% ACCP (AMERICAN COLLEGE OF CLINICAL PHARMACY) - 22% ASHP (AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS) - 19% APA (AMERICAN PSYCHIATRIC ASSOCIATION) - 12% INDIANA PSYCHOLOGICAL ASSOC. - 12% ELKHART GENERAL HOSPITAL PAYS DUES TO OTHER ORGANIZATIONS THAT DON'T INCLUDE A SPECIFIC PERCENTAGE. FOR THOSE OTHER ORGANIZATIONS THAT WE ARE UNABLE TO ASCERTAIN ALLOCATION OF DUES ATTRIBUTED TO LOBBYING A CONSERVATIVE ESTIMATE OF 32% IS APPLIED BASED ON THE INDIANA HOSPITAL ASSOCIATION PERCENTAGE. 46573387 2440358 3598804 1424963 311139 0 50876447 51847680 3689060 -5391156 3270255 301942 0 46573387 45447655 3126708 5095842 1536648 285877 0 51847680 42268939 1692784 3115564 1353300 276332 0 45447655 37414420 2588248 4251002 1740359 244372 0 42268939 0.6215 0.0079 0.3706 false true true 4973897 4973897 278533064 147316781 131216283 141454843 113397913 28056930 4401584 4401584 168648694 MED MAL IBNR 1633088 OTHER LT LIABILITIES OTHER DEFERRED TAX 1633088 X Schedule D, Part V, Line 4 Intended uses of endowment funds NET ASSETS WITH DONOR RESTRICTIONS CONSIST OF ASSETS WHOSE USE IS LIMITED BY DONOR IMPOSED, TIME AND/OR PURPOSE RESTRICTIONS. SOME NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY THE CORPORATION IN PERPETUITY. IN ACCORDANCE WITH THE RESTRICTION, A MAJORITY OF THE INVESTMENT INCOME AND INVESTMENT GAINS OR LOSSES FROM THESE NET ASSETS ARE RESTRICTED BY THE DONOR FOR A SPECIFIC PURPOSE. A SPECIFIED PORTION OF INCOME EARNED BY THE NET ASSETS IS RELEASED FROM RESTRICTION AND USED FOR OPERATIONS EACH YEAR AND, THEREFORE, IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS OTHER REVENUE. THE HOSPITAL HAS ONE ENDOWMENT FUND ESTABLISHED FOR PATIENT CARE PURPOSES WITH A VALUE OF $8,419,675. THE HOSPITAL HAS ESTABLISHED INVESTMENT AND SPENDING POLICIES RELATED TO THE APPRECIATION OF THIS ENDOWMENT. SHOULD THE UNDERLYING ASSETS FALL BELOW THIS TARGETED AMOUNT THE HOSPITAL PURSUES ACTION CONSISTENT WITH ESTABLISHED POLICIES TO RETURN THE ENDOWMENT TO THE TARGETED AMOUNT. BASED ON THESE POLICIES, ENDOWMENT AMOUNTS ARE TEMPORARILY RESTRICTED UNTIL BOARD AUTHORIZED RELEASE OF FUNDS FOR PATIENT CARE PURPOSES ARE APPROVED. AS A MEMBER ORGANIZATION OF BEACON HEALTH SYSTEM, THE HOSPITAL ALSO CAN BENEFIT FROM ENDOWMENT FUNDS HELD BY RELATED ENTITIES, THE VALUE OF WHICH WAS $42,456,771 AT 12/31/2023. IN 2023, THE HOSPITAL RECEIVED $0 FROM THE RELATED PARTY ENDOWMENT FUNDS. "Two Years Back" Line C has been reduced by $400,000 due to this being double counted. The balance has been restated to correctly account for this error. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote ASC 740, INCOME TAXES, REQUIRES THAT REALIZATION OF AN UNCERTAIN INCOME TAX POSITION IS MORE LIKELY THAN NOT (I.E., GREATER THAN 50% LIKELIHOOD OF RECEIVING A BENEFIT) BEFORE IT IS RECOGNIZED IN THE FINANCIAL STATEMENTS AS THE AMOUNT MOST LIKELY TO BE REALIZED ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. THIS INTERPRETATION ALSO CLARIFIES THE FINANCIAL STATEMENT CLASSIFICATION OF TAX-RELATED PENALTIES AND INTEREST AND SETS FORTH NEW DISCLOSURES REGARDING UNRECOGNIZED TAX BENEFITS. NO AMOUNT WAS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2023 OR 2022. true true X true X true X true true false true true 1169365 1169365 0.0038 61854799 51314704 10540095 0.0345 0 0.0 0 0 63024164 51314704 11709460 0.0383 1095112 105743 989369 0.0032 1502114 120 1501994 0.0049 0 0.0 0 0.0 255350 255350 0.0008 0 0 2852576 105863 2746713 0.0090 0 0 65876740 51420567 14456173 0.0473 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 3435013 1717507 53239047 73049185 -19810138 X true true 1 1 ELKHART GENERAL HOSPITAL INC 600 EAST BLVD ELKHART IN 46514 WWW.BEACONHEALTHSYSTEM.ORG 23-005017-1 X X X ELKHART GENERAL HOSPITAL INC 1 false false true X X X X X X X X X 21 true true false true X WWW.BEACONHEALTHSYSTEM.ORG/CHNA X X true 22 true WWW.BEACONHEALTHSYSTEM.ORG/CHNA false true X 200.0 350.0 X X X true true X X X true X BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS X BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS X BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ELKHART GENERAL HOSPITAL, INC.. BEGINNING IN JANUARY 2021, BEACON HEALTH SYSTEM UNDERTOOK COMPLETING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). OUR APPROACH UTILIZES BOTH QUANTITATIVE DATA (SECONDARY DATA, KEY INFORMANT SURVEY) AND QUALITATIVE DATA (FOCUS GROUPS, OPEN-ENDED RESPONSES). ONCE THE RESULTS OF THE SURVEY WERE DETERMINED, A QUALITATIVE APPROACH WAS USED TO GATHER RICHER INSIGHT INTO THE MAIN ISSUES FACED BY THE COMMUNITY. THEREFORE, THE METHODOLOGY FOLLOWED FOR THIS NEEDS ASSESSMENT CONSISTS OF THREE STEPS: 1) IDENTIFY NEEDS; 2) ANALYZE THE LINKS BETWEEN THE NEEDS AND THE INFORMATION REQUIRED TO MAKE DECISIONS; 3) MAKE RECOMMENDATIONS THAT GUIDE DECISION-MAKING. THE DATA COLLECTION AND ANALYSIS PROCESS STARTED IN JANUARY 2021 AND CONCLUDED IN NOVEMBER 2021. THE KEY FINDINGS WERE CONSOLIDATED IN ONE REPORT WHICH PROVIDED A SNAPSHOT OF THE THREE-COUNTY OVERALL HEALTH STATUS. THE KEY INFORMANT SURVEY COLLECTED INFORMATION FROM FEBRUARY 2021 THROUGH MAY 2021. FOCUS GROUPS LAUNCHED IN AUGUST 2021 AND CONCLUDED IN OCTOBER 2021. THIS ASSESSMENT FOCUSED ON CREATING A BETTER UNDERSTANDING OF THE HEALTH NEEDS OF THE BEACON COMMUNITY (ELKHART, LAPORTE, MARSHALL, AND ST. JOSEPH COUNTIES) AND THE RESPONSE NECESSARY TO ADDRESS THE NEED. DATA WAS COLLECTED THROUGH SECONDARY DATA COLLECTION, A KEY INFORMANT SURVEY, AND COMMUNITY FOCUS GROUPS ON A VARIETY OF TOPICS CENTERED ON HEALTH INDICATORS AND SOCIAL DETERMINANTS OF HEALTH. THE GOAL OF THE CHNA IS TO PROVIDE BEACON HEALTH SYSTEM WITH A CLEAR PICTURE OF ELKHART, LAPORTE, MARSHALL, AND ST. JOSEPH COUNTY, WHICH CONSTITUTES THE SERVICE AREAS OF ELKHART GENERAL HOSPITAL, MEMORIAL HOSPITAL OF SOUTH BEND, AND COMMUNITY HOSPITAL OF BREMEN. THE FINDINGS FROM THE ASSESSMENT WILL BE USED BY BEACON HEALTH SYSTEM TO PRIORITIZE HEALTH ISSUES IN THE COMMUNITY. THE RESEARCH TOOK THE FOLLOWING APPROACH TO BETTER UNDERSTAND THE COMMUNITY HEALTH NEEDS: KEY INFORMANT SURVEY - A SURVEY WAS PROVIDED TO COMMUNITY LEADERS AND THOSE KNOWLEDGEABLE ABOUT THE COMMUNITIES' HEALTH ISSUES. THE LIST OF KEY INFORMANTS WAS DEVELOPED BY BEACON COMMUNITY IMPACT STAFF ALONG WITH INPUT FROM A VARIETY OF KEY STAKEHOLDERS. TWO HUNDRED AND SEVEN COMPLETED RESPONSES WERE COLLECTED AND ANALYZED. SECONDARY DATA RESEARCH - INFORMATION RELATED TO THE CURRENT STATE OF THE COMMUNITIES' ECONOMIC, SOCIAL AND HEALTH STATUS PUBLISHED BY ESTABLISHED SOURCES. DATA, WHEN POSSIBLE, WAS COLLECTED FOR A THREE-YEAR PERIOD IN ORDER TO ESTABLISH A TREND. OVER 1,000 DATA POINTS WERE COLLECTED AND ANALYZED, ENCOMPASSING MORE THAN 80 BEST PRACTICE INDICATORS. DATA FROM BEACON HEALTH SYSTEM'S ELECTRONIC HEALTH RECORD (EHR) WERE ALSO USED AS A SECONDARY DATA SOURCE. THE SECONDARY DATA REVIEWED SO FAR HAS ALL BEEN AGGREGATED AT THE COUNTY LEVEL, AND DOES NOT REVEAL WHEN THERE ARE DIFFERENCES IN INDICATORS BASED ON RACE, ETHNICITY, AGE, NEIGHBORHOOD, OR SOCIO-ECONOMIC STATUS. WHEN STRATIFIED BY THESE CATEGORIES, PUBLICALLY AVAILABLE SOURCES AND DATA FROM BEACON'S ELECTRONIC HEALTH RECORD (EHR) FROM LATE 2020 - EARLY 2021, DEMONSTRATE DISPARITIES IN BOTH HEALTH OUTCOMES AND SOCIAL DETERMINANTS OF HEALTH. COMMUNITY FOCUS GROUPS - GROUPS OF 3 - 18 INDIVIDUALS WERE ENGAGED IN CONVERSATIONS ABOUT THE CURRENT HEALTH NEEDS OF THE COMMUNITY. BEACON COMMUNITY IMPACT UTILIZED STANFORD'S FOCUS GROUP GUIDE AND CONDUCTED THREE FOCUS GROUPS PER COUNTY (ELKHART, MARSHALL, AND ST. JOSEPH). STAFF CONDUCTED AT LEAST TWO ENGLISH AND ONE SPANISH FOCUS GROUP PER COUNTY. EACH FOCUS GROUP WAS RECORDED FOR CONTINUITY. FOCUS GROUP RECORDINGS WERE TRANSCRIBED AND DE-IDENTIFIED USING A PROFESSIONAL TRANSCRIPTION SERVICE AND QUALITATIVE RESEARCH SOFTWARE TOOLS WERE UTILIZED TO ANALYZE THE TRANSCRIPTS FOR COMMON THEMES. STAFF THEN ENGAGED IN AN INTERRATER RELIABILITY CHECK TO ENSURE ACCURACY OF IDENTIFIED THEMES. FOR THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE COMMUNITY SERVED IS DEFINED AS THOSE PERSONS RESIDING IN ELKHART AND ST JOSEPH COUNTIES, WHO WERE PROGRAM PARTICIPANTS. BEACON COMMUNITY IMPACT MAKES A SPECIAL EFFORT TO FOCUS ON POPULATIONS WITH THE HIGHEST UNMET NEEDS, SPECIFICALLY THOSE PERSONS WHO ARE KNOWN AS VULNERABLE, THROUGH CHRONIC DISEASES, LOWER-INCOME AND POVERTY, MEMBERS OF A MINORITY POPULATION AND/OR THE UNINSURED. STAKEHOLDERS IN THE COMMUNITY PARTICIPATED AND REPRESENTED A BROAD KNOWLEDGE OF INTERESTS, INCLUDING PUBLIC HEALTH, AND MINORITY, CULTURAL, AND UNDERSERVED POPULATIONS. THROUGH THE FOLLOWING ORGANIZATIONS BEACON ENSURED THAT UNDER-REPRESENTED POPULATIONS (MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS) WERE ENGAGED IN THE CONSULTATION PROCESS, ACTIVELY REACHING OUT TO THEM, ENSURING THAT NEEDS AND PERCEPTIONS FROM A WIDE RANGE OF DEMOGRAPHIC AND SOCIOECONOMIC GROUPS WERE TAKEN INTO CONSIDERATION IN THE DEFINITION OF TOP COMMUNITY HEALTH ISSUES. THE FOLLOWING ORGANIZATIONS HELPED INCREASE THE REACH OF THE SURVEY, HENCE SOLICITED IN ORDER FOR BEACON TO TAKE INTO ACCOUNT INPUT RECEIVED FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY IT SERVES: AIDS MINISTRIES, AMERICAN CANCER SOCIETY, AMERICAN UNIVERSITY BEIRUT, BAUGO COMMUNITY SCHOOLS, BEACON CANCER CARE, BEACON COMMUNITY IMPACT, BEACON HEALTH SYSTEM, POKAGON HEALTH SERVICES, IU SCHOOL OF MEDICINE - SOUTH BEND, BEACON MEDICAL GROUP, BEACON PEDIATRIC SPECIALTY, BEACON - NORTH CENTRAL INDIANA SICKLE CELL INITIATIVE, BIG BROTHERS BIG SISTERS SOUTHERN LAKE MICHIGAN, REGION, BOWEN CENTER, BOYS & GIRLS CLUB OF ST. JOSEPH COUNTY, BREMEN PUBLIC SCHOOLS, CAPS, CATHOLIC CHARITIES, CENTER FOR CIVIC INNOVATION, CENTER FOR HEALING & HOPE, CENTER FOR THE HOMELESS, CHILD AND PARENT SERVICES, INC., CITY OF SOUTH BEND, COMMUNITY HOSPITAL OF BREMEN, CROSSROADS UNITED WAY, CULTIVATE FOOD RESCUE, DAVID'S COURAGE, DIVISION OF FAMILY RESOURCES, ELKHART COMMUNITY SCHOOLS, ELKHART COUNTY HEALTH DEPARTMENT, ELKHART EDUCATION FOUNDATION, ELKHART GENERAL HOSPITAL, ENFOCUS, INC., GOODWILL INDUSTRIES OF MICHIANA, INC., GOSHEN FAMILY PHYSICIANS, GREENSPIRE SOLUTIONS, HARPER CANCER RESEARCH INSTITUTE, HEALTH IMPROVEMENT ALLIANCE OF ST. JOSEPH COUNTY, HEALTHLINC, HEALTHMARKETS, HORIZON EDUCATION ALLIANCE, ELKHART CITY COUNCIL, IMANI UNIDAD, INDIANA UNIVERSITY INDIANA UNIVERSITY SOUTH BEND, INDIANA UNIVERSITY SOUTH BEND - ELKHART CENTER, IVY TECH COMMUNITY COLLEGE, JUNIOR ACHIEVEMENT, LA CASA DE AMISTAD, MARSHALL COUNTY PROJECT HOPE, MARSHALL COUNTY, BOARD OF HEALTH, MARSHALL COUNTY COMMUNITY FOUNDATION, MEMORIAL HOSPITAL OF SOUTH BEND, MENTAL HEALTH AWARENESS OF MICHIANA, MICHIANA AREA COUNCIL OF GOVERNMENTS, MICHIANA HEALTH INFORMATION, NETWORK/INDIANA HEALTH INFORMATION EXCHANGE, MIDDLEBURY COMMUNITY SCHOOLS, MINORITY HEALTH, COALITION ELKHART COUNTY, NEAR NORTHWEST NEIGHBORHOOD, NORTHERN INDIANA HISPANIC HEALTH COALITION, OAKLAWN PSYCHIATRIC CENTER, OI, PARTNERSHIP FOR DRUG-FREE ST. JOSEPH COUNTY, PURDUE EXTENSION - ST. JOSEPH COUNTY, REAL SERVICES, REINS OF LIFE, INC., RIBBON OF HOPE, INC., RIVER BEND CANCER SERVICES, ROBINSON COMMUNITY LEARNING CENTER, SAINT JOSEPH HEALTH SYSTEM, SCHOOL CITY OF MISHAWAKA, SHAW CENTER FOR CHILDREN AND FAMILIES AT THE UNIVERSITY OF NOTRE DAME, SJC CARES, SMOKE FREE ST. JOE, SOUTH BEND ADULT EDUCATION, SOUTH BEND COMMON COUNCIL, SOUTH BEND COMMUNITY SCHOOL CORPORATION, SOUTH BEND ELKHART REGIONAL PARTNERSHIP, SOUTH BEND HERITAGE FOUNDATION, SOUTH BEND REGIONAL CHAMBER, SPIRITUAL & PERSONAL ADJUSTMENTS - WOMEN'S MINISTRY HOMES, ST. JOSEPH COUNTY DEPARTMENT OF HEALTH, ST. JOSEPH COUNTY PUBLIC LIBRARY, ST. VINCENT DE PAUL SOCIETY, THE COMMUNITY FOUNDATION OF ELKHART COUNTY, THE JEWISH COMMUNITY, THE LGBTQ CENTER, THE MICHIANA ATHLETIC AND RECREATION ASSOCIATION, UNITED HEALTH SERVICES SUICIDE PREVENTION CENTER, UNITED WAY OF LAPORTE COUNTY, UNITED WAY OF MARSHALL COUNTY, UNITED WAY OF ST. JOSEPH COUNTY, UNITY GARDENS INC., UNIVERSITY OF NOTRE DAME, UPPER ROOM RECOVERY COMMUNITY, WIC, YMCA OF GREATER MICHIANA, YOUTH SERVICE BUREAU OF ST. JOSEPH COUNTY, YWCA NORTH CENTRAL INDIANA. THE ASSESSMENT PROCESS IDENTIFIED TWO HEALTH PRIORITIES THAT CAN BE STREAMLINED INTO THE ESSENTIAL COMPONENTS OF BEACON HEALTH SYSTEM'S MISSION. PRIORITY AREAS - HEALTHCARE ACCESS (HEALTH LITERACY) AND MENTAL HEALTH PROVIDE A FRAMEWORK FOR THE ALIGNMENT OF INTERVENTION STRATEGIES WITH BHS MISSION AND VALUES THAT AIM FOR 1) PROVIDING INFORMATION AND ENHANCE SKILLS TO PATIENTS/PRACTITIONERS/COMMUNITY; 2) IMPROVING EQUITABLE ACCESS TO HEALTH AND WELLNESS; 3) LEVERAGING INCENTIVES FOR LONG-TERM BEHAVIORAL CHANGE; AND 4) IMPROVING AND STRENGTHENING THE SOCIAL AND HEALTHCARE SYSTEMS IN THE THREE-COUNTY AREA. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - . CONTINUED Three Rivers Health, which serves St. Joseph County in Michigan, joined the Beacon family after the completion of the 2021 CHNA. They participated in their local health department's CHNA, which found mental health and resource accessibility to be among the top three health needs, which aligns with our priority areas and implementation strategy. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ELKHART GENERAL HOSPITAL, INC.. ELKHART GENERAL HOSPITAL (EGH) DEVELOPED THE 2021 ST. JOSEPH COUNTY CHNA IN PARTNERSHIP WITH MEMORIAL HOSPITAL OF SOUTH BEND, COMMUNITY HOSPITAL OF BREMEN, BEACON HEALTH SYSTEM (BHS) CARE PARTNERS. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - ELKHART GENERAL HOSPITAL, INC.. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS MADE WIDELY AVAILABLE TO THE COMMUNITY THROUGH POSTING ON THE EGH WEBSITE AT BEACONHEALTHSYSTEM.ORG/CHNA AND THROUGH EMAIL TRANSMISSION UPON REQUEST. HOSPITAL STAFF WERE ALSO AVAILABLE TO DISCUSS THE RESULTS OF THE CHNA AND IMPLEMENTATION STRATEGIES IN REQUESTED COMMUNITY FORUMS. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ELKHART GENERAL HOSPITAL. Beacon Health System's 2021 Community Health Needs Assessment identified two top health priorities: Mental Health and Healthcare Access. These were common across all three counties where Beacon operates a hospital. Our approach to Community Benefit includes addressing these health needs from three angles. With each approach, both internal programs and externally funded partners are required to report on common metrics. This allows Beacon to focus its resources to achieve and demonstrate a deeper impact in our priority health areas. Beacon Community Impact provided community resources to 52,794 individuals across our service area - Elkhart, Marshall, and St. Joseph, IN Counties. In 2023, we first recognized the importance of partnering with other organizations who are experts in what they do, Beacon funds community non-profits who have boots on the ground in the most vulnerable neighborhoods in our service area, and with more diverse populations. Each of our funded partners who are addressing one of the tactics outlined on the Implementation Strategy are responsible for reporting both the number of participants they serve and one or more outcome metric in the priority areas of Mental Health or Healthcare Access. Within Beacon Health System, the Beacon Community Impact Department leads efforts impact our priority areas of mental health and healthcare access using a combination of internal programs and collaborative partnerships. Our implementation strategy incorporates a three-pronged approach: We provide direct services to clients through Beacon's Early Childhood Services and Community Health Services teams. Early Childhood Services include the St. Joseph County (Ind.) WIC program, two sickle cell programs and our Family & Infants Support Program. These programs focus on the health status of women, infants and young families, particularly the most vulnerable in Beacon's service area. Our Community Health Services team focuses on prevention through community health educators with school curricula delivered throughout middle and high schools in the three Indiana counties we serve. Summer programming shifts to health-related day camps and participation at community health fairs. Though it may not be their primary focus, these community health teams screen for and provide referrals for clients experiencing mental health challenges. Likewise, they emphasize the importance of trusted adults as protective factors for youth. We fund local community organizations with expertise in their service areas. These organizations are community nonprofits with boots-on-the-ground services in the most vulnerable neighborhoods and more diverse populations. Each of the funded partners addresses the top two health priorities and reports on the number of participants and on an outcome metric for either mental health or healthcare access. In addition, Beacon partnered with the local health department in Three Rivers, Michigan, to support building out their Community Health Worker Program to increase services addressing healthcare access and mental health. Beacon administers state and federal grants as the fiscal agent to deliver direct programming funded by the grants and to build out the data infrastructure in Beacon communities. In 2023, we completed the final year of the COVID grants from the Health Resources and Services Administration (HRSA) under the U. S. Dept. of Health and Human Services. These grants funded two programs to provide COVID vaccines and vaccine education. This was also the final year of administering Project HOPE and the second year for Supported and Safe, also funded by HRSA, which established a coalition of organizations to address opioid use in Marshall County. In the fall of 2023, we were awarded the Indiana Safety Pin - FIMR grant for St. Joseph County, IN, to re-establish the fetal infant mortality review (FIMR) program. Beacon Community Impact also provides services and collaborates with outside organizations with funding from a State of Indiana Safety Pin grant. Finally, Beacon functions as the fiscal agent for programming run by local outpatient mental health provider Oaklawn to build crisis response teams. Mental Health Strategy - Provide wrap-around mental health support with a multidisciplinary team from various referral sources. - Partner on the development of a Self-Healing Community to build resilience and relieve stress on the traditional mental health care system. - Drive the rollout of Trauma-Informed Care throughout Beacon and the community. - Health and Wellness Team - provide evidence-based community and school education. - Community Health Workers (CHWs) on the Early Childhood Services and Community Health Services teams provide peer-led education to address mental wellness and resilience. Healthcare Access Strategy - Embed in Beacon Medical Group practices to work with pregnant women with adverse childhood experiences and social determinants of health needs. - Have a community health worker at Community Hospital of Bremen. - Grow and standardize the use of community health workers for scaling out in the future. - Implement experts in navigating the healthcare system. - Educate patients to optimize their use of the health system. - Refer to insurance navigators for insurance enrollment. - Build organizational health literacy between Beacon and Community Impact departments. Mental Health Metrics % of the population with frequent mental health distress % of the population with two or more trusted support people Healthcare Access Metrics % of the population with health insurance (adults<65 and children) % of adults who reported their healthcare providers always involved them in decisions about their care, as much as they wanted. NEEDS NOT BEING ADDRESSED: By overlapping the top identified needs from the Key Informants, Secondary Data, and Focus Groups, we see that Mental Health, Chronic Disease, and Healthcare Access are the top health issues identified by all data sources combined. Other issues may have ranked higher by just one source, but not all three. Notably, sexually transmitted disease, immunization and infectious disease, and injury and violence prevention were among the top issues according to secondary data, but among the lowest rated issues according to key informants and focus groups. Overweight / obesity is also a top health issue according to secondary data; it ranked as a moderate health issue according to the other sources, just not at the top. Community Gaps Key Informants provided many ideas on areas of improvement. Most commonly, is the concern about the lack of mental health providers in the area. "From my experience, our biggest challenge stems from workforce shortages in mental health. If we could hire the amount of staff we need, our capacity would be much greater. It has been very difficult to find a competent and caring staff that can maintain a career in mental health and substance use." More specifically, the area needs more programs and/or services around pediatric mental health. As one Key Informant stated, "Mental health issues have drastically increased in our K-12 student population. We need to empower more school personnel to help students with these issues, and we need more mental health professionals in our school systems." Accessing mental health and more broadly, health services, is increasingly hard for low-income individuals. Focus group participants and Key Informants noted how navigating the healthcare system is too complex. Health insurance navigators and additional community resources are needed to ensure everyone can get to the appointments they need to get to and are informed. "I believe we need more outreach efforts. I think Beacon has the ability to meet families where they are-- whether it's at the childcare provider or a place of employment. We need to make healthcare more accessible." Another Key Informant went on to mirror these thoughts, "I think our wellness system is still not accessible to everyone. Self-advocacy, tenacity, and resilience are necessary to access health systems and to navigate social support systems. We need ways to reach people by attraction and positive experiences without screening highest need which causes further barriers." Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - . CONTINUED Community Strengths Key informants identified collaboration among non-profit service providers, agencies addressing food insecurity, and the public parks system, particularly South Bend's Venues Parks and Arts, as strengths in the community. They identified a number of organizations who do quality work to improve the health of the community. These include medical providers who serve low-income or the uninsured population, multiple organizations who provide emergency food access, some who serve specific populations such as homeless individuals, people with cancer, children, or people with substance use disorder. Again, collaborative efforts were noticed by the key informants. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - ELKHART GENERAL HOSPITAL, INC. FINANCIAL ASSISTANCE CRITERIA THE POLICY ALLOWS FOR PATIENTS TO QUALIFY FOR ASSISTANCE BY TWO MEANS: FINANCIAL OR CATASTROPHIC. THE FINANCIAL ASSISTANCE PROGRAM ALSO ALLOWS FOR PARTIAL ASSISTANCE OR FULL ASSISTANCE BASED ON ELIGIBILITY CRITERIA IN THIS POLICY. FINANCIAL ASSISTANCE 1. A PATIENT QUALIFYING FOR FINANCIAL ASSISTANCE IS A PERSON WHO IS UNINSURED OR UNDERINSURED, RECEIVES CARE AND IS UNABLE TO PAY THEIR BILL. 2. TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE GUIDELINES, A PERSON'S INCOME SHALL BE AT OR BELOW A PERCENTAGE OF THE FEDERAL POVERTY LEVEL (FPL) AS DETERMINED BY FEDERAL POVERTY GUIDELINES. HOUSEHOLD SIZE AND INCOME DETERMINES THE % OF FPL. ELKHART GENERAL HOSPITAL OR ITS DESIGNEE MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. 3. ELKHART GENERAL HOSPITAL WILL USE THE MOST CURRENT POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE POVERTY INCOME GUIDELINES ARE PUBLISHED ANNUALLY IN THE FEDERAL REGISTER AND FOR THE PURPOSES OF THIS POLICY WILL BECOME EFFECTIVE THE FIRST DAY OF THE MONTH FOLLOWING THE MONTH OF PUBLICATION. 4. TO QUALIFY UNDER THE FINANCIAL ASSISTANCE PORTION OF THIS POLICY, A COMPLETED, SIGNED FINANCIAL ASSISTANCE APPLICATION MUST BE SUBMITTED AND PROOF ON INCOME, PROOF OF NO INCOME, PROOF OF LACK OF FINANCIAL ASSETS AND OTHER REQUIRED DOCUMENTS MUST ACCOMPANY THE APPLICATION. CATASTROPHIC ASSISTANCE CRITERIA 1. A PATIENT QUALIFYING FOR CATASTROPHIC ASSISTANCE IS A PERSON WHOSE HOSPITAL BILLS EXCEED A SPECIFIED PERCENTAGE OF THE PERSON'S ANNUAL GROSS INCOME AS SET FORTH IN THE POLICY AND WHO IS UNABLE TO PAY THE REMAINING BILL. 2. TO BE ELIGIBLE FOR CATASTROPHIC ASSISTANCE THE AMOUNT OWED BY THE PATIENT MUST EXCEED ONE HUNDRED FIFTY (150) PERCENT OF THE PATIENT'S ANNUAL GROSS INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. ELKHART GENERAL HOSPITAL MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ABILITY TO PAY. 3. IF A DETERMINATION IS MADE THAT A PATIENT HAS THE ABILITY TO PAY THE REMAINDER OF THE BILL, SUCH A DETERMINATION DOES NOT PREVENT A REASSESSMENT OF THE PATIENT'S ABILITY TO PAY AT A LATER DATE SHOULD THEIR FINANCIAL CIRCUMSTANCES CHANGE. 4. AFTER ELIGIBILITY IS DETERMINED UNDER THIS PROVISION, ASSISTANCE WILL BE PROVIDED TO DISCOUNT THE BILL BY 75% OF THE CURRENT BALANCE. 5. IF A PATIENT HAS CASH ASSETS, THOSE ASSETS WILL BE ADDED TO THEIR INCOME WHEN DETERMINING ELIGIBILITY FOR ASSISTANCE. 0 Schedule H, Part I, Line 3c FACTORS TO BE CONSIDERED FOR FINANCIAL ASSISTANCE HOUSEHOLD SIZE AND INCOME THE FOLLOWING FACTORS MAY BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR ASSISTANCE AND MUST BE PROVIDED BY ALL INCOME EARNING RESIDENTS IN THE COUNTABLE HOUSEHOLD UNIT UNLESS THEY ARE NOT DEPENDENTS BASED ON IRS GUIDELINES FOR DETERMINING WHETHER A HOUSEHOLD MEMBER CAN BE CONSIDERED A DEPENDENT. 1. INDIANA WORKFORCE WAGE REPORT FOR LAST 2 QUARTERS (UNEMPLOYMENT INCOME). 2. LAST 3 PAY STUBS OR A LETTER OR PRINTOUT FROM EMPLOYER(S) PROVIDING VERIFICATION OF GROSS INCOME IF CURRENTLY EMPLOYED. THIS DOCUMENTATION SHOULD NOT BE MORE THAN 30 DAYS OLD FROM DATE OF ISSUE AND INCLUDE YEAR-TO-DATE INFORMATION. 3. LAST 3 BANK STATEMENTS (INCLUDING EXPLANATIONS OF REGULAR DEPOSITS NOT EXPLAINED BY PAY STUBS). 4. SOCIAL SECURITY AWARD OR ENTITLEMENT LETTER OR OTHER PROOF OF GROSS MONTHLY AWARD. 5. RETIREMENT INCOME. 6. INVESTMENT INCOME. 7. STATEMENT FROM PERSON(S) THAT ARE PROVIDING DIRECT SUPPORT. 8. NUMBER OF DEPENDENTS. 9. MOST RECENT TAX RETURN (INCLUDING W2 AND ALL SUPPORTING SCHEDULES). 10. OTHER FINANCIAL OBLIGATIONS. 11. THE AMOUNT AND FREQUENCY OF HOSPITAL/MEDICAL BILLS. 12. OTHER FINANCIAL RESOURCES THAT PRODUCE INCOME. 13. IF SELF-EMPLOYED, GROSS INCOME LESS COST OF GOODS SOLD AND EMPLOYEE SALARIES. FINANCIAL CAPACITY 1. INDIVIDUALS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE MAY BE REQUIRED TO PURCHASE AND WILL BE PROVIDED ACCESS TO MEET WITH AN INDIANA CERTIFIED NAVIGATOR AS A MEANS OF ASSURING ACCESS TO HEALTHCARE SERVICES, FOR THEIR OVERALL PERSONAL HEALTH, AND FOR THE PROTECTION OF THEIR INDIVIDUAL ASSETS. 2. INDIVIDUALS FOUND TO BE INELIGIBLE FOR MEDICAID OR OTHER AFFORDABLE HEALTH CARE COVERAGE MUST PROVIDE PROOF OF DENIAL. 3. FOOD STAMPS OR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) WILL NOT BE COUNTED AS INCOME. 4. COSMETIC SERVICES ARE NOT ELIGIBLE FOR ANY TYPE OF ASSISTANCE AND CANNOT BE INCLUDED IN THE AMOUNT OF HOSPITAL/MEDICAL BILLS OWED. Schedule H, Part I, Line 6a EXPLANATION OF ORGANIZATION'S PREPARATION OF COMMUNITY BENEFIT REPORT CREATING COMMUNITY HEALTH IS AT THE CORE OF ELKHART GENERAL HOSPITAL'S MISSION. PROMOTION OF COMMUNITY HEALTH IS OUR SOCIAL RESPONSIBILITY AND A KEY TO LONG-TERM COST EFFECTIVENESS. IN ADDITION, IMPROVING THE HEALTH STATUS OF A COMMUNITY IS AS MUCH A SOCIAL, ECONOMIC, AND ENVIRONMENTAL ISSUE, AS IT IS A MEDICAL ONE. CONSEQUENTLY, THE ORGANIZATION TAKES A BROAD APPROACH TO CREATING COMMUNITY HEALTH. THIS APPROACH HAS INCLUDED: ONGOING EDUCATION OF BOARD MEMBERS, STAFF AND LOCAL LEADERS THROUGH A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT AND PROMOTION OF VOLUNTEER INVOLVEMENT AND COMMUNITY PARTNERSHIPS. ELKHART GENERAL HOSPITAL INVESTS IN THE COMMUNITY. THIS INVESTMENT IS IN ADDITION TO THE HOSPITAL'S FINANCIAL ASSISTANCE AND PREVENTION, AND EDUCATION ACTIVITIES SUPPORTED THROUGH ITS OPERATING BUDGET. THE BEACON COMMUNITY IMPACT ADVISORY COUNCIL MAKES ONGOING POLICY AND OVERSEES THE ADMINISTRATION OF THE FUND AND DETERMINES SPECIFIC INVESTMENT ALLOCATIONS BASED UPON THE ASSETS AND NEEDS OF THE COMMUNITY. STAFF ARE COMMITTED TO PRUDENTLY INVESTING THESE RESOURCES IN AN ACCOUNTABLE MANNER. AS A COMMUNITY NOT-FOR-PROFIT ORGANIZATION, WE TAKE SERIOUSLY OUR RESPONSIBILITY TO INVEST OUR RESOURCES AND ENERGIES INTO UNDERSTANDING AND MEETING THE DIVERGENT HEALTH CARE NEEDS OF ALL, AND ENSURE THAT EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY, RECEIVES THE CARE THEY NEED. ELKHART GENERAL HOSPITAL HAS LONG BEEN RECOGNIZED FOR THE COLLABORATION EFFORTS WHICH ENGAGE INDIVIDUALS AND ORGANIZATIONS WITH DIVERSE SOCIO-ECONOMIC RELIGIOUS, ETHNIC, RACE, AGE, AND GENDER IDENTITY HARACTERISTICS. OUR TEAM OF PASSIONATE AND DEDICATED HEALTH CARE PROFESSIONALS, ALONG WITH MANY PARTNERS THROUGHOUT THE NORTHERN INDIANA AND SOUTHERN MICHIGAN (MICHIANA) REGION, HELPED US CONTRIBUTE SIGNIFICANTLY TO THE HEALTH AND WELL-BEING OF OUR COMMUNITY. FURTHER, ELKHART GENERAL HOSPITAL PLAYS A KEY ROLE IN SERVING THE COMMUNITY AS A WHOLE. BEACON HEALTH SYSTEM, INC. EIN 45-3864076, PREPARES THE ANNUAL COMMUNITY BENEFIT REPORTING FOR ELKHART GENERAL HOSPITAL. Schedule H, Part I, Line 6a Community benefit report prepared by related organization BEACON HEALTH SYSTEM PREPARED THE ANNUAL COMMUNITY BENEFIT REPORT. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 15466066 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHOD USED TO CALCULATE FINANCIAL ASSISTANCE REPORTED ON LINES 7 A THROUGH D WAS THE COST-TO-CHARGE RATIO. ALL OTHER COMMUNITY BENEFITS WERE CALCULATED USING DIRECT COSTS. PART I, LINE 7 COLUMN (F) BAD DEBT EXPENSE OF $15,466,066 WAS REMOVED FROM TOTAL EXPENSES. Schedule H, Part II Community Building Activities Elkhart County's early childhood initiative, Building Strong Brains, represents an unprecedented coordinated, system approach to kindergarten readiness. Five local organizations agree to collectively lead a coalition of stakeholders across education, health, business, nonprofit, and philanthropic sectors, with the goal of increasing kindergarten readiness for the children in Elkhart County. The comprehensive approach includes maternal & child health, community supports for children and families, and quality childcare and early learning environments. The coalition has been divided into three action teams that each have a specialty of focus to map the current system of services and supports and identify opportunities and gaps and identifies potential strategies to address need. Beacon Community Impact gladly supports this coalition, we have had an associate serving as an Action Team Chair since the inception in 2022. The Greater Elkhart Chamber of Commerce has many councils, the purpose of the Education/Career Development Council is to support, promote and align with our education system, worker training and instruction programs to help our citizens in Elkhart County meet the demands of the future. Beacon Community Impact supports this effort, we have an associate serving as a Co-Chair to share information from our health system and bridge the needs of the community with educators and local businesses in the greater Elkhart area. By meeting with local school administrators we are able to share updates from our CHNA strategies, provide resources and connect partners more efficiently. Beacon Health System is also able to support the goal of the council in which to increase the level of career and college readiness in Elkhart County by welcoming internships from our local Elkhart County high schools at Elkhart General Hospital and offices. In addition, BCI is active with the Greater Elkhart Chamber of Commerce Leadership Academy Advisory Council, this work promotes servant leadership through an awareness program combining key community issues and enhanced leadership skill development to advance community stewardship. Together We Rock Program, which serves and brings together infant and early childhood providers in Elkhart County for learning circles, training and collaboration. This work parallels the Partnership for Children (PFC) program in many ways, just with an early childhood focus. Beacon Community Impact has a representative on this coalition. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE CORPORATION EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RCEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYOR CLASS, AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. COSTING METHODOLOGY IS THE SAME AS TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE IS COST ADJUSTED BY NON-PATIENT ACTIVITY, EXPENSES, AND PATIENT CARE CHARGES. THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 IS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO, AS DETERMINED BY WORKSHEET 2, TO TOTAL BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE WHICH IS ATTRIBUTABLE TO ELIGIBLE PATIENTS IS CONSIDERED PART OF ELKHART GENERAL HOSPITAL'S COMMUNITY BENEFIT BECAUSE OF OUR MISSION TO CREATE A HEALTHIER COMMUNITY WHILE CONTINUING OUR CHARITABLE ROLE IN THE COMMUNITY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BAD DEBT ATTRIBUTABLE TO THE FAP IS ESTIMATED BASED ON THE HISTORICAL TREND OF THE SOURCES OF THE BAD DEBT. THE MAJORITY OF BAD DEBT IS ATRIBUTABLE TO UNINSURED PATIENTS WHICH REPRESENT THE MAJORITY OF THE POPULATION THAT WOULD FALL UNDER THE FAP. WE HAVE APPLIED THE HISTORICAL ESTIMATE (50%) TO THE TOTAL BAD DEBT EXPENSE TO DETERMINE THE AMOUNT ATTRIBUTABLE TO THE FAP. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION THE TRENDS IN HEALTH CARE COVERAGE, HISTORICAL ECONOMIC TRENDS, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCES PERIODICALLY THROUGHOUT THE YEAR BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN UTILIZED TO MAKE MODIFICATIONS, AS NECESSARY, TO THE PROVISION FOR BAD DEBTS TO PROVIDE FOR AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. PARTICIPATION IN THE GOVERNMENTAL MEDICARE PROGRAM DOES NOT PROVIDE THE OPPORTUNITY FOR A HOSPITAL TO NEGOTIATE A REIMBURSEMENT RATE OR STRUCTURE THAT WOULD ALLOW THE HOSPITAL TO COVER THE COST OF THE MEDICAL SERVICE RENDERED TO THE PROGRAM PARTICIPANT, AS WOULD BE THE CASE IN CONTRACTUAL NEGOTIATIONS WITH COMMERCIAL INSURANCE COMPANIES. NOR IS THE HOSPITAL ALLOWED TO PROVIDE ONLY THE SERVICES FOR WHICH REIMBURSEMENT COVERS THE DIRECT COST OF CARE. THIS PRODUCES THE SAME SHORTFALL OUTCOME AS DOES THE PARTICIPATION IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM IS RECOGNIZED AS A COMMUNITY BENEFIT ON SCHEDULE H AND ON COMMUNITY BENEFIT REPORTS FOR MOST STATES. THE QUALITY AND COST OF THE PATIENT CARE IS THE SAME REGARDLESS OF PAYOR SOURCE. HENCE THE ACCEPTANCE OF MEDICARE REIMBURSEMENT REPRESENTS A REDUCTION OR RELIEF OF THE GOVERNMENT BURDEN TO PAY THE FULL COST OF CARE PROVIDED. THE SOURCE USED FOR THE COSTING METHODOLOGY FOR THE AMOUNT REPORTED ON LINE 6 WAS THE 2022 MEDICARE COST REPORT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE FOLLOW THE SAME COLLECTION POLICY AS ALL INDIVIDUALS WITH BALANCES REMAINING AFTER APPLICATION OF FINANCIAL ASSISTANCE. CREDIT AND COLLECTIONS POLICY: ELHART GENERAL HOSPITAL RELIES ON TIMELY PAYMENT OF PATIENT ACCOUNTS RECEIVABLE TO ALLOW THE HOSPITAL TO CONTINUE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND TO SECURE THE LATEST IN HEALTH CARE TECHNOLOGY FOR ITS PATIENTS. ELKHART GENERAL HOSPITAL, RECOGNIZING THE BURDEN THAT UNEXPECTED HEALTH CARE EXPENSES CAN PLACE ON PATIENTS AND THEIR FAMILIES, WILL ASSIST PATIENTS TO RESOLVE OPEN ACCOUNTS FOR HOSPITAL SERVICES BY WORKING WITH THIRD PARTY PAYERS TO ADJUDICATE PATIENT'S INSURANCE CLAIMS AND BY PROVIDING ALTERNATIVE PAYMENT PLANS FOR PATIENTS. THE HOSPITAL ALSO PROVIDES SUBSIDIZED CARE FOR THOSE PATIENTS WHO QUALIFY. HOWEVER, WITH THE EXCEPTION OF SOME GOVERNMENT AND CONTRACTED CARE PLANS, ULTIMATE RESPONSIBILITY FOR RESOLUTION OR PAYMENT OF ACCOUNTS RESTS WITH THE PATIENT. PATIENTS ARE EXPECTED TO WORK WITH HOSPITAL PERSONNEL TO RESOLVE ACCOUNTS WITH THEIR INSURANCE COMPANIES AND/OR EMPLOYERS AS APPROPRIATE. WHERE THERE IS AN ESTIMATED SELF-PAY BALANCE DUE, ELKHART GENERAL HOSPITAL WILL ASK NON-EMERGENCY PATIENTS TO PAY THAT BALANCE PRIOR TO OR AT THE TIME OF ADMISSION/REGISTRATION. 1. IF A PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND DOES NOT PAY THEIR ACCOUNT ACCORDING TO THE OPTIONS PROVIDED, THEN THE PATIENT'S ACCOUNT WILL BE PROCESSED ACCORDING TO THE BAD DEBT WRITE OFF POLICY. 2. IF A PATIENT HAS BEGUN MAKING PAYMENTS BUT THEN IS LATER DETERMINED TO QUALIFY UNDER THE FAP, ELKHART GENERAL HOSPITAL WOULD ISSUE A REFUND TO THE PATIENT FOR ANY AMOUNT THAT HAS BEEN DETERMINED TO EXCEED THEIR NEWLY DETERMINED FINANCIAL RESPONSIBILITY. 3. ELKHART GENERAL HOSPITAL MAY REQUEST AND COLLECT A DEPOSIT, BASED ON THE PATIENT'S TOTAL ESTIMATED PORTION OF A BILL, FROM APPROPRIATE NON-EMERGENCY INPATIENT ADMISSIONS, SAME DAY SURGERY PATIENTS, AND PATIENTS SCHEDULED FOR HIGH-DOLLAR OUTPATIENT PROCEDURES PRIOR TO OR AT THE TIME OF ADMISSION OR REGISTRATION. IN THE EVENT THAT A REQUEST FOR PAYMENT IS NOT MADE PRIOR TO OR AT THE TIME OF THE PATIENT'S ARRIVAL, A FINANCIAL COUNSELOR MAY CALCULATE THE ESTIMATED DEPOSIT AMOUNT AND CONFER WITH THE PATIENT/GUARANTOR FOR PAYMENT FOLLOWING THE ADMISSION OR REGISTRATION PROCESS VIA A FINANCIAL INTERVIEW. (IN SOME INSTANCES, THIS COULD OCCUR WHILE THE PATIENT IS IN HIS/HER ASSIGNED ROOM.) AT THE TIME OF DISCHARGE, EMERGENCY PATIENTS MAY BE REQUESTED TO PAY ANY CO-PAY OR DEDUCTIBLE. 4. WHERE APPROPRIATE, ELKHART GENERAL HOSPITAL WILL IDENTIFY, AND REQUEST PAYMENT OF, AGED PATIENT BALANCES AS PART OF THE REQUEST FOR DEPOSIT. PAYMENT FOR OPEN PRIOR BALANCES WILL NOT DELAY CARE FOR EMERGENCY OR MEDICALLY NECESSARY CARE. AGED OPEN PRIOR BALANCES WILL BE CONSIDERED BY THE COLLECTION STAFF IN PATIENT ACCOUNT SERVICES WHENEVER PAYMENT ARRANGEMENTS OR AN ALTERNATIVE PAYMENT PROGRAM IS DEVELOPED FOR A PATIENT. 5. UNINSURED PATIENTS ARE GIVEN A 35% DISCOUNT FROM GROSS CHARGES. 6. ELKHART GENERAL HOSPITAL WILL CONDUCT FINANCIAL INTERVIEWS WITH PATIENTS AND/OR GUARANTORS WHEN NECESSARY. ALL FINANCIAL INTERVIEWS WILL BE CONDUCTED IN AN ENVIRONMENT THAT IS BOTH PRIVATE AND PROFESSIONAL. 7. IN ADDITION TO CASH, CHECK, AND CREDIT CARDS, THE APPROVED PAYMENT ARRANGEMENT METHODS MIGHT INCLUDE: A. HOSPITAL PAYMENT PLAN - A PAYMENT PLAN WITH THE HOSPITAL IS NOT TO EXCEED THREE MONTHS. EXCEPTIONS MUST BE APPROVED BY THE MANAGER OF PATIENT ACCOUNT SERVICES OR REVENUE CYCLE DIRECTOR. PATIENTS MAY BE REQUIRED TO SIGN A PROMISSORY NOTE BASED ON THE AGREED UPON PAYMENT ARRANGEMENT. B. CAREPAYMENT - AN EXTENDED PAYMENT PLAN WHICH ALLOWS THE PATIENT AN EXTENDED PERIOD NOT TO EXCEED 36 MONTHS AT 0% INTEREST TO PAY THEIR BALANCE BETWEEN $100 AND $15,000. PATIENTS MAY BE AUTOMATICALLY ENROLLED IN THE CAREPAYMENT PLAN IF THEIR ACCOUNT HAS NOT BEEN PAID IN FULL 2 MONTHS AFTER THEIR FIRST STATEMENT. ALL PATIENTS ARE ELIGIBLE PROVIDED THAT THEY PROVIDE A VALID SOCIAL SECURITY NUMBER, ARE OVER 18 AND HAVE NOT PREVIOUSLY DEFAULTED ON THEIR CAREPAYMENT ACCOUNT. C. MEDICAID/HIP - PATIENTS WHO DO NOT HAVE COVERAGE WHEN THEY PRESENT TO THE HOSPITAL FOR TREATMENT WILL BE SCREENED FOR OTHER COVERAGE THROUGH STATE ASSISTANCE PROGRAMS. AN ELIGIBILITY SPECIALIST WILL ASSIST THE PATIENT/GUARANTOR TO COMPLETE AND SUBMIT ALL NECESSARY FORMS REQUIRED BY THE INDIANA DEPARTMENT OF PUBLIC AID FOR THESE TYPES OF PROGRAMS. D. HOSPITAL FINANCIAL ASSISTANCE (UNCOMPENSATED CARE) - REASONABLE EFFORTS WILL BE MADE TO DETERMINE IF PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ALL FINANCIAL ASSISTANCE MUST BE APPROVED ACCORDING TO THE FAP FOR THE HOSPITAL. (REFER TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY) 8. EXTRAORDINARY COLLECTION ACTIONS WILL NOT BE TAKEN UNTIL AFTER ELKHART GENERAL HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT WILL QUALIFY FOR FINANCIAL ASSISTANCE. EXTRAORDINARY COLLECTION ACTIONS INCLUDE SUIT, WAGE GARNISHMENT, LIEN OR ADVERSE CREDIT BUREAU REPORTING. Schedule H, Part V, Section B, Line 16a FAP website - ELKHART GENERAL HOSPITAL, INC.: Line 16a URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS; Schedule H, Part V, Section B, Line 16b FAP Application website - ELKHART GENERAL HOSPITAL, INC.: Line 16b URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ELKHART GENERAL HOSPITAL, INC.: Line 16c URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND VISITORS; Schedule H, Part VI, Line 2 Needs assessment BEACON COMMUNITY IMPACT FORMED THE FIRST COMMUNITY HEALTH ADVISORY COUNCIL IN 2016. STILL OPERATING ON AN AS NEEDED BASIS TODAY THE COUNCIL CONSISTS OF REPRESENTATION FROM COMMUNITY HOSPITAL OF BREMEN, ELKHART GENERAL HOSPITAL, AND MEMORIAL HOSPITAL OF SOUTH BEND. THE COUNCIL IS MADE UP OF INDIVIDUALS FROM BEACON HEALTH SYSTEM AND COMMUNITY STAKEHOLDERS - I.E. COUNCIL AT LARGE, PUBLIC SCHOOL SYSTEMS, OTHER HEALTH CARE ENTITIES, INDIANA UNIVERSITY SOUTH BEND, UNIVERSITY OF NOTRE DAME, IVY TECH COMMUNITY COLLEGE, COMMUNITY ORGANIZATIONS, LOCAL CHURCHES, COMMUNITY PERSONS, ETC. THE ADVISORY COUNCIL WILL MEET 2-4 TIMES PER YEAR TO LEARN ABOUT COMMUNITY HEALTH, THE CHNA PROCESS, AND TO REVIEW LOCAL HOSPITAL AND COMMUNITY DATA COLLECTED REGARDING HEALTH IN OUR COMMUNITY; THERE ARE PERIODIC EMAIL COMMUNICATIONS AS WELL. THE ADVISORY COUNCIL PROVIDES INPUT ON THE HEALTH PRIORITY AREAS, OFFERS BEST PRACTICES, IDENTIFIES AREAS OF OPPORTUNITIES, AND MONITORS PROGRESS ON ADDRESSING HEATH NEEDS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance WHEN UNINSURED PATIENTS PRESENT TO OUR HOSPITAL, THEY ARE OFFERED THE OPPORTUNITY TO MEET WITH OUR ELIGIBILITY SPECIALISTS. OUR ELIGIBILITY SPECIALISTS DISCUSS THE POTENTIAL ELIGIBILITY OF THE PATIENT FOR MULTIPLE ASSISTANCE PROGRAMS, INCLUDING OUR OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. OUR STATEMENTS ALSO INCLUDE A NOTICE THAT FINANCIAL ASISTANCE IS AVAILABLE TO PATIENTS, AND THEY CAN CONTACT OUR CUSTOMER SERVICE GROUP FOR GUIDELINES. PATIENTS ARE ALSO MADE AWARE OF OUR FINANCIAL ASSISTANCE PROGRAM VIA TELEPHONE CONVERSATION WITH OUR PATIENT ACCOUNTS STAFF. STAFF IS PARTICULARLY SENSITIVE TO ADDRESS THIS PROGRAM WITH ANYONE WHO INDICATES THERE MIGHT BE A FINANCIAL NEED. Schedule H, Part VI, Line 4 Community information Elkhart County, Indiana, was established in 1830, with the original county seat in Dunlap and was later moved to Goshen. Today Elkhart County has three growing cities, four towns, and 16 townships with a population of 206,841 individuals according to the U.S. Census Bureau. Elkhart County is located in northern Indiana and borders the state of Michigan. The County is approximately 463.16 square miles in size. Elkhart County lies halfway between Chicago and Cleveland and is located near Interstate 80/90 and the Indiana Toll Road. Elkhart County's service providers have a history of actively forming partnerships in an effort to meet the health needs of its residents. Elkhart County takes pride in offering its residents a great place to live and continually strives to establish new businesses and provide an entrepreneurial atmosphere. Elkhart, Marshall and St. Joseph Counties are all located in Northern Indiana. They have a total of 6 cities and 16 towns with a combined population of525,437. St. Joseph is the largest and Marshall the smallest, which is classified as rural. St. Joseph County, Michigan borders Elkhart County, Indiana and is similar in rural classification as Marshall County. Although each varies in population density, they are closer in geographic size (SJC, IN-457 square miles, Elkhart-463, Marshall-443, SJC, MI-521). The median household income (2018-2022) is comparable in Elkhart ($63,978) ,St. Joseph, IN ($61,877) and St. Joseph, MI ($62,281)but higher in Marshall county -$66,016 where 10.5 % of people live in poverty compared to the higher rates of 13.8% in St. Joseph, IN 12% in Elkhart and 13% in St. Joseph, MI. Elkhart's RV industry is a multi-billion-dollar industry and nearly 1,000 RV manufacturers are located there. Marshall County has become one of the leading agricultural counties in Indiana. St. Joseph, IN is the regional center for higher education, with more than eight colleges and universities. These campuses have shifted the county's focus from manufacturing to health, education, and customer services. St. Joseph, MI has over 42 lakes and over 220 acres of woodlands in one of the towns, Sturgis. Schedule H, Part VI, Line 5 Promotion of community health In partnership with Beacon Health System (BHS), the mission of Elkhart General Hospital (EGH) is to deliver outstanding care, inspire health and connect with heart. BHS is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead BHS to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both BHS and EGH consistently invest funds to improve the quality of life for our communities. BHS values reflect an unwavering commitment to the communities we serve. EGH has as its values: Patients are at the center - Patient needs, care and safety are our top priority. - Trust - Our actions will firmly demonstrate our integrity, abilities and our character. - Respect - We will treat our patients, community members, and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. - Integrity - We will continually do the right thing for patients, associates, and communities we serve. - Compassion - We will appropriately demonstrate empathy and sympathy, and express the desire to help. Elkhart General Hospital seeks to promote the health and wellbeing of Elkhart County residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community as a whole. A key mechanism by which this goal is carried out is Elkhart General Hospital's serious, consistent, deliberate search for and partnership with like-minded organizations. Elkhart General Hospital continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances included local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers. Elkhart General Hospital's governing body is comprised of persons who reside in Elkhart County. Board of Directors, who serve without pay, guides the system in its mission to provide high quality, affordable health care to the communities it serves. The Board's roles include guaranteeing fair and equal access, approving new medical staff members and approving long-term strategies for the continued success of the hospital. Additionally, Elkhart General Hospital extends medical staff privileges to all qualified physicians in our community. Beacon Health System welcomed Three Rivers Health in Three Rivers, Michigan, to the Beacon family in September 2021. In 2023, Community Impact established a working relationship with the local health department, Branch-Hillsdale-St. Joseph Community Health Agency, to address the top needs in the community. After seeing the impact of food insecurity on patients, a Beacon family medicine resident dedicated her service project to addressing this need. Now more than 50 bags of food are given to families and individuals in our community every month. Individuals experiencing homelessness often have poor access to medical care, for a variety of reasons that range from costs to transportation to social barriers. The Street Medicine South Bend program established by the Beacon Memorial Family Medicine Residency program a year ago has enabled physician volunteers to begin building trust and meeting these individuals where they are. So far, the physicians have seen more than 120 individuals experiencing homelessness. The St. Joseph County (Ind.) WIC program, hosted by Beacon Health System continues to promote breastfeeding, once again putting it in the top five WIC agencies in Indiana - and ensuring that more women can successfully breastfeed their infants, giving them a healthier start in life. Beacon Health System-funded Self-Healing Communities of Greater Michiana is building resilience to trauma and adversity by teaching people to care for themselves and each other, creating learning communities and establishing a website to share neuroscience-based resources. Through Beacon Community Impact, Beacon Health System was awarded over $3.8 million in external grant funds to prevent child abuse, help people stop smoking, improve the health of mothers and babies, increase access to COVID-19 vaccination and much more. Schedule H, Part VI, Line 6 Affiliated health care system In 2011, Elkhart General Hospital affiliated with Memorial Hospital South Bend, Indiana, under the name of Beacon health system. In 2018, Beacon Health System affiliated with Community Hospital of Bremen. In October 2021, Beacon Health System affiliated with Three Rivers Health System. All organizations continue as full-care providers for their respective Counties, and they are committed to promoting the health of the communities they serve. The Elkhart General Hospital board of directors consists of 10 voting board members. The Beacon Health System Board of Directors consists of 14 voting board members. Schedule H, Part VI, Line 7 State filing of community benefit report IN true United Way of Elkhart Co 601 CR 17 ELKHART IN 46515 350953433 501 (C) (3) 50000 CORPORATE MATCH Center for Healing Hope PO Box 195 Goshen IN 46527 020560511 501 (C) (3) 15700 MEDICAL/ADVOCACY SVC Ribbon of Hope 600 East Boulevard Elkhart IN 46514 352118856 501 (C) (3) 25000 CANCER SUPPORT Community Foundation of Elkhart County 300 Nibco Parkway Suite 301 Elkhart IN 46516 311255886 501 (C) (3) 5000 SPONSOR PROGRAMS Economic Development Corp of Elkhart 300 Bibco Parkway Elkhart IN 46516 351973845 501 (C) (3) 7500 FINANCIAL INVESTMENT Child & Parent Services 100 W Hively Ave Elkhart IN 46517 350888765 501 (C) (3) 25000 HEALTHY FAMILIES Elkhart County Health Department 117 N Second Street Goshen IN 46526 356000142 GOV 30000 PRENATAL CARE SPA Women's Ministry Homes 23221 Old US 20E Elkhart IN 46516 431998891 501 (C) (3) 25000 HEALTHY SPIRIT Potawatomi Zoological Society 500 S Greenlawn Ave SB 46615 South Bend IN 46615 351183974 501 (C) (3) 5000 SPONSOR PROGRAMS Junior Achievement of Northern Indiana 601 Noble Drive Fort Wayne IN 46825 350922731 501 (C) (3) 10000 SPONSOR PROGRAMS Boys and Girls Club of Greater Goshen Inc PO Box 614 Goshen IN 46527 350953433 501 (C) (3) 10000 SPONSOR PROGRAMS Horizon Education Alliance Inc 124 E Washington ST Goshen IN 46528 460803293 501 (C) (3) 30000 Parenting Program Mental Health Awareness of Michiana 3220 E Jefferson Blvd 46615 South Bend IN 46615 824359500 501 (C) (3) 20000 SPONSOR PROGRAMS Elkhart Education Foundation 2746 Old US 20W ELKHART IN 46514 463429545 501 (C) (3) 5000 SPONSOR PROGRAMS 14 0 TRANSPORTATION SERVICES 232 126003 TUITION REIMBURSEMENT 2 23424 Schedule I, Part III NUMBER OF RECIPIENTS FOR THE TRANSPORTATION SERVICES IS ESTIMATED BASED ON THE NUMBER OF INVOICES FROM OUTSIDE ORGANIZATIONS FOR OTHER ASSISTANCE MADE FOR THE BENEFIT OF INDIVIDUAL RECEPIENTS. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. PART OF ELKHART GENERAL HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF ITS COMMUNITY. IN ORDER TO FULFILL THIS GOAL, OUR ADMINISTRATORS HAVE THE ABILITY TO MAKE DONATIONS TO ORGANIZATIONS THAT IMPROVE THE HEALTH AND WELL BEING OF OUR COMMUNITY. SINCE THE MAJORITY OF GRANTS TO ORGANIZATIONS ARE MADE TO 501(C)(3) ENTITIES, THERE ARE NO PROCEDURES FOR MONITORING THE USE OF THE FUNDS. ELKHART GENERAL HOSPITAL ALSO PAYS FOR THE TRANSPORTATION OF SPECIFIC INDIVIDUALS FROM THE HOSPITAL FACILITY TO NEARBY NURSING HOMES AND OTHER ASSISTED LIVING FACILITIES. THESE PAYMENTS ARE MADE DIRECTLY TO THE THIRD PARTY TRANSPORTATION SERVICE PROVIDER AT COST. X true true false true false false false false false true false Tim Morgan MD Chair 0 316747 0 0 0 31282 0 0 0 19149 0 367178 0 0 Jeffrey P Costello CFO 0 607351 0 0 0 136883 0 95606 0 22430 0 862270 0 88827 Kreg R Gruber CEO 0 1003311 0 0 0 159401 0 149636 0 20498 0 1332846 0 131845 Carl W Risk II President 401359 0 0 0 65858 0 66872 0 24407 0 558496 0 43682 0 Michelle R Bache VP Medical Affairs 391369 0 0 0 1931 0 12068 0 3262 0 408630 0 0 0 James E Cantrell Lead Perfusionist 221196 0 100000 0 20259 0 13200 0 23027 0 377682 0 0 0 Kaleena M Freeman Perfusionist 146040 0 100000 0 107 0 10082 0 22408 0 278637 0 0 0 Cindie L McPhie VP Operations 70143 0 0 0 136356 0 2873 0 6896 0 216268 0 0 0 John P Scheu Perfusionist 195075 0 100000 0 9042 0 12560 0 22718 0 339396 0 0 0 Schedule J, Part I, Line 1a Health or social club dues or initiation fees ELKHART GENERAL HOSPITAL, INC. OFFERS COMPLIMENTARY HEALTH CLUB MEMBERSHIP TO BEACON HEALTH SYSTEM'S HEALTH AND LIFESTYLE CENTER, A RELATED PARTY. ELKHART GENERAL HOSPITAL INC. REIMBURSES DIRECTORS FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS FOR SPOUSAL TRAVEL. There was no spousal travel in 2023. BEACON HEALTH SYSTEM ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: JOHN DEPUTY, DAWN FISHER, TIM MORGAN, MATT ZIMMERMAN, AND TONJA LUCCHESE. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ELKHART GENERAL HOSPITAL,INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTED TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2023, REFLECTED IN COLUMN (B)(III): * KREG GRUBER, $113,175 * JEFFREY COSTELLO, $96,631 * CARL RISK, $57,098 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2023 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: * KREG GRUBER, $136,436 * JEFFREY COSTELLO, $82,406 * CARL RISK, $53,672 Schedule J, Part I, Line 7 Non-fixed payments THE ORGANIZATION HAS THREE INCENTIVE PLANS (EMPLOYEE, MANAGEMENT, AND EXECUTIVE WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR BEACON HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $4,500,000. THE PAYOUT AND AMOUNT OF THE PAYOUT FOR THE EMPLOYEE INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. THE MANAGEMENT INCENTIVE PLAN IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE MANAGEMENT INCENTIVE IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. A INDIANA FINANCE AUTHORITY 351602316 2017-09-08 40210000 REFUND BONDS ISSUED 12/09/2008 false false false B INDIANA FINANCE AUTHORITY 351602316 2023-06-16 20026050 REFUND TAXABLE BONDS ISSUED ON 9/21/2021 false false false A 7010000 40210000 40210000 2017 true false true true B 7010000 20026050 46832 19979218 2013 false true true true A false true true true false 0.019 0.0 0.019 false false true B false false true true false 0.0 0.0 0.0 false false true A false false true false true false false false true B false true false false false false false true A true B true Schedule K, Part IV, Line 2c PART IV, LINE 2C, COLUMN B THE DATE THE REBATE COMPUTATION WAS PERFORMED ON THE HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY AND INDIANA FINANCE AUTHORITY WAS 5/18/2018. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS ELKHART GENERAL HOSPITAL, INC. HAS BEEN PROVIDING COMPREHENSIVE, ADVANCED MEDICAL CARE PRIMARILY TO ELKHART COUNTY AND OTHER CONTIGUOUS COUNTIES IN NORTH CENTRAL INDIANA AND SOUTH CENTRAL MICHIGAN FOR OVER 100 YEARS. ELKHART GENERAL HOSPITAL, INC. CONSISTS OF A 365-BED LICENSED HOSPITAL THAT PROVIDES SERVICES WITHOUT REGARD TO PATIENT RACE, RELIGION, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING 2023, THE HOSPITAL ADMITTED 11,136 PATIENTS FOR A TOTAL OF 43,910 INPATIENT DAYS. INPATIENT UNITS CONSISTED OF MEDICAL, POST-SURGICAL, ONCOLOGY, PEDIATRIC, CRITICAL CARE, CARDIAC CARE, BEHAVIORAL HEALTH, REHABILITATION, OBSTETRIC, AND NURSERY INTENSIVE CARE. THE HOSPITAL ALSO PROVIDED 5,068 OUTPATIENT SURGERIES, 44,540 EMERGENCY ROOM VISITS, AND 45,817 ANCILLARY SERVICES. ELKHART GENERAL HOSPITAL ALSO PROVIDED $40,079,761 IN UNREIMBURSED CARE TO THE ELDERLY COVERED BY MEDICARE, AND $5,295,845 IN FINANCIAL ASSISTANCE. PART OF THE MISSION OF ELKHART GENERAL HOSPITAL IS TO PROVIDE FOR A HEALTHIER COMMUNITY THROUGH MEDICATION ASSISTANCE PROGRAMS AND COMMUNITY HEALTH EDUCATION. Due to the Non-Revenue generating or community investment nature of many of the programs, they operate at a loss. See Schedule H for the details on the community outreach represented in other program services. Form 990, Part VI, Line 15 Process for determining executive compensation BEACON HEALTH SYSTEM, INC., THE PARENT COMPANY OF ELKHART GENERAL HOSPITAL, CONDUCTS THE REVIEW OF ALL COMPENSATION. VICE PRESIDENT AND HIGHER COMPENSATION IS DETERMINED AFTER AN EXTENSIVE EXAMINATION IS CONDUCTED USING COMPARABLE MARKET DATA AND THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. HUMAN RESOURCES CONDUCTS THE ANALYSIS AND MAKES RECOMMENDATIONS TO THE CEO WHO THEN MAKES THE RECOMMENDATIONS TO THE BOARD FOR APPROVAL. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF ELKHART GENERAL HOSPITAL, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF ELKHART GENERAL HOSPITAL, INC. AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF ELKHART GENERAL HOSPITAL, INC. IN THE ABSENCE OF SUCH SELECTION BY THE CORPORATE MEMBER, OR UNTIL THE CORPORATE MEMBER DETERMINES OTHERWISE, DIRECTORS SHALL BE SELECTED AS FOLLOWS: EIGHT (8) DIRECTORS SHALL BE DETERMINED BY THE MEMBER OR BY THE BOARD WITH THE APPROVAL OF THE MEMBER. THE PRESIDENT OF THE MEDICAL STAFF OF THE CORPORATION SHALL NOT BE A DIRECTOR BUT SHALL BE ENTITLED TO PARTICIPATE EX OFFICIO WITH THE BOARD OF DIRECTORS, WITH THE ABILITY TO PARTICIPATE IN DELIBERATIONS BUT WITHOUT THE RIGHT TO VOTE, SO LONG AS SUCH INDIVIDUAL HOLDS THE POSITION OF PRESIDENT OF THE MEDICAL STAFF. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. BEACON HEALTH SYSTEM, THE SOLE MEMBER OF ELKHART GENERAL HOSPITAL, HAS CONTROL OVER ELKHART GENERAL HOSPITAL'S OPERATIONS. THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF BEACON HEALTH SYSTEM'S BOARD: 1. SELECTION AND RETENTION OF AUDITORS. 2. APPROVAL OF ALL CONTRACTS, POLICIES, OR PROGRAMS OF INSURANCE ESTABLISHING THE TYPES OF INSURANCE COVERAGE REQUIRED AS WELL AS THE COVERAGE LEVELS. 3. THE NOMINATION, ELECTION AND REMOVAL OF MEMBERS OF THE BOARD OF THE CORPORATION. 4. OTHER MATTERS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS. IN ADDITION, THE MEMBER MAY ELECT IN ITS DISCRETION TO TAKE ACTION DIRECTLY WITH RESPECT TO ANY MATTER INCLUDING MATTERS WITHIN THE SCOPE OF THE BOARD OF DIRECTORS OF THE CORPORATION, AND SUCH ACTIONS WILL SUPERSEDE ANY INCONSISTENT ACTIONS OF THE BOARD OF DIRECTORS OF THE CORPORATION. 1. THE MEMBER SHALL TAKE ACTION ANNUALLY FOR THE PURPOSE OF ELECTING DIRECTORS AND CONDUCTING SUCH OTHER BUSINESS AS SHALL PROPERLY COME BEFORE SUCH MEETING. THIS MEETING SHALL BE HELD AT SUCH DATE, TIME AND PLACE AS THE MEMBER SHALL DETERMINE, BUT IF NO DETERMINATION IS MADE, SHALL BE HELD ON THE SAME DATE AS THE ANNUAL MEETING OF THE MEMBER, AT THE PRINCIPAL OFFICE OF THE MEMBER. 2. ANY ACTION REQUIRED OR PERMITTED TO BE TAKEN BY THE MEMBER MAY BE TAKEN BY THE MEMBER BY WRITTEN CONSENT TO SUCH ACTION AND DELIVERY OF THE WRITING OR WRITINGS TO THE CORPORATION FOR INCLUSION IN THE MINUTES OF THE MEMBERS FOR FILING WITH THE CORPORATION'S RECORDS. ACTION TAKEN PURSUANT TO THIS SECTION IS EFFECTIVE ON THE DATE THE MEMBER SIGNS THE CONSENT UNLESS THE CONSENT CONTAINS AN EARLIER OR LATER EFFECTIVE DATE. 3. THE CORPORATION MAY RELY ON A CERTIFICATE SIGNED BY THE SECRETARY OR OTHER OFFICER OF THE MEMBER THAT AN ACTION HAS BEEN TAKEN BY THE MEMBER. 4. MEMBERSHIP IN THE CORPORATION MAY BE TRANSFERRED, FOR OR WITHOUT CONSIDERATION, BY THE MEMBER. THE CORPORATION SHALL NOT ADMIT ADDITIONAL MEMBERS WITHOUT THE PRIOR CONSENT OF THE MEMBER. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ORGANIZATION INCORPORATES NUMEROUS PARTIES IN THE PRODUCTION AND REVIEW OF THE FORM 990 AND ASSOCIATED SCHEDULES. SENIOR ACCOUNTING STAFF AND MANAGEMENT COMPLETE THE FORM 990 AND SCHEDULES. SOME FORMS AND SCHEDULES ARE REVIEWED BY THE CONTROLLER. SUBSEQUENT TO THOSE STEPS, THE ORGANIZATION ENGAGED ERNST & YOUNG TO REVIEW THE COMPLETED FORM 990 AND APPROPRIATE SCHEDULES. PRIOR TO FILING THE RETURN, THE CFO, THE AUDIT COMMITTEE OF THE ORGANIZATION, AND THE CEO CONDUCT A GENERAL OVERVIEW OF THE FORM 990, INCLUDING APPLICABLE COMPENSATION SCHEDULES. IN ADDITION, EACH BOARD MEMBER RECEIVES NOTIFICATION OF THE IRS FORM 990 PLACEMENT ON THE OGANIZATION'S BOARD PORTALS WHICH ALLOWS FOR BOARD MEMBER REVIEW PRIOR TO FILING THE RETURN. Form 990, Part VI, Line 12c Conflict of interest policy THERE ARE THREE SEPARATE FORMS THAT ARE SENT OUT THROUGH THE INTERNAL AUDIT DEPARTMENT TO KEY EMPLOYEES OR BOARD MEMBERS REGARDING CONFLICT OF INTEREST. THEY ARE AS FOLLOWS: 1. THE FIRST IS A CONFLICT OF INTEREST STATEMENT THAT IS SENT TO SENIOR LEVEL ADMINISTRATION, MANAGEMENT, AND SELECT STAFF SUCH AS PURCHASING DEPARTMENT EMPLOYEES. THE PURPOSE OF THE STATEMENT IS TO REQUIRE THESE EMPLOYEES TO DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS THEY MAY HAVE. THE STATEMENTS ARE SENT IN JANUARY OF EACH YEAR FOR THE PREVIOUS YEAR ACTIVITIES. WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT 375 STATEMENTS AND ARE WORKING TO ACHIEVE A 100% RESPONSE RATE. EACH RESPONSE IS REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT AND THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AS WELL AS THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 2. THE SECOND STATEMENT IS THE BOARD DUALITY OF INTEREST STATEMENT THAT IS SENT TO CURRENT BOARD MEMBERS, FORMER BOARD MEMBERS FROM THE LAST FIVE YEARS, AND OTHER KEY EMPLOYEES. THE DUALITY OF INTEREST STATEMENT IS SENT USING A WEB-BASED SURVEY TOOL PROVIDED BY ERNST & YOUNG. THE REPLIES ARE REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT. THE RESULTS OF THE SURVEYS ARE SUMMARIZED USING THE WEB-BASED TOOL, AND ARE REVIEWED BY ERNST & YOUNG IN COMPLETING THE 990. THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 3. THE THIRD STATEMENT IS ENTITLED "CODE OF ETHICS FOR SENIOR FINANCIAL OFFICERS." THE STATEMENT REQUIRES AN ACKNOWLEDGEMENT FORM TO BE SIGNED BY BEACON HEALTH SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT ON JANUARY 4, 2024 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2023, 26 DESIGNATED EMPLOYEES WERE REQUESTED TO SIGN THE FORM AND WE HAD A 100% COMPLIANCE RATE. ANY POTENTIAL CONFLICTS OF INTERESTS ARE REVIEWED BY INDEPENDENT PARTIES BOTH INTERNAL AND EXTERNAL TO THE ORGANIZATION, AND IF NECESSARY, CORRECTIVE ACTION WOULD BE TAKEN TO RESOLVE A TRUE CONFLICT. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT OF INTEREST WOULD BE EXCLUDED FROM ALL REVIEW PROCEEDINGS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR BEACON HEALTH SYSTEM, INC. BONDS. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: 124077, Related or Exempt Function Revenue: 67598, Unrelated Business Revenue: 56479, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Write Off Intercompany Balances - -32580155; BEACON MEDICAL GROUP INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 PHY PRACTICES IN 501(c)(3) 10 BHS true BEACON HEALTH FOUNDATION INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536129 FINANCIAL SUP IN 501(c)(3) 7 BHS true MEMORIAL ENDOWMENT FUND FOR MEMORIAL HOS PO BOX 1602 SOUTH BEND IN 46634 356068581 ENDOWMENT IN 501(c)(3) Type III-O MHSB true BEACON HEALTH SYSTEM INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 PARENT ORG. IN 501(c)(3) Type III-FI NA false MEMORIAL HOSPITAL OF SOUTH BEND INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 350868132 HOSPITAL IN 501(c)(3) 3 BHS true ELKHART GENERAL HOSPITAL AUXILIARY 600 EAST BLVD ELKHART IN 46514 350938148 VOL SUPPORT IN 501(c)(3) Type I NA false COMMUNITY HOSPITAL OF BREMEN INC 1020 HIGH ROAD BREMEN IN 46506 350835006 HOSPITAL IN 501(c)(3) 3 BHS true THREE RIVERS HEALTH SYSTEM 701 S HEALTH PARKWAY THREE RIVERS MI 49093 451257972 HOSPITAL MI 501(c)(3) 3 BHS true BEACON HEALTH VENTURES INC 615 N MICHIGAN ST SOUTH BEND IN 46601 351901068 HOME MEDICAL IN BHS C Corporation false BEACON HEALTH VENTURES MICHIGAN INC 615 N MICHGIAN ST SOUTH BEND IN 46601 208259773 HOME MEDICAL MI BHS C Corporation false false false true false false false false false false true false false false false false true true true true BEACON MEDICAL GROUP J 1085418 ACTUAL CHARGES BEACON MEDICAL GROUP P 3629290 ACTUAL CHARGES BEACON MEDICAL GROUP R 365384 CASH BEACON MEDICAL GROUP Q 1114447 ACTUAL CHARGES BEACON MEDICAL GROUP S 1064041 CASH MEMORIAL HOSPITAL OF SOUTH BEND P 1686206 ACTUAL CHARGES MEMORIAL HOSPITAL OF SOUTH BEND Q 908999 ACTUAL CHARGES MEMORIAL HOSPITAL OF SOUTH BEND R 653304 CASH MEMORIAL HOSPITAL OF SOUTH BEND S 1430511 CASH COMMUNITY HOSPITAL OF BREMEN P 67432 ACTUAL CHARGES BEACON HEALTH FOUNDATION C 112893 ACTUAL CHARGES