THREE RIVERS HEALTH SYSTEM INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization: THREE RIVERS HEALTH SYSTEM INC (EIN 45-1257972)
Tax period: 2023-01-01 to 2023-12-31
Filed: 2024-11-11
IRS object ID: 202423169349301662
Schema version: 2023v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-11-11T08:24:22+00:00	ReturnTs
Tax Period End	2023-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	462045100	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2023-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	451257972	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Three Rivers Health System Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	THRE	BusinessNameControlTxt
Phone	2692781145	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 S HEALTH PARKWAY	AddressLine1Txt
City	THREE RIVERS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49093	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEFFREY COSTELLO	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2024-11-11	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (true)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Jennifer D Rhoderick	PreparerPersonNm
PTIN	P00395735	PTIN
Phone	3176817000	PhoneNum
Preparation	2024-11-05	PreparationDt

Field	Value	IRS element (for citing)
Tax	2023	TaxYr
Build TS	2024-10-15 13:58:12Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Three Rivers Health	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARIA BEHR	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 S HEALTH PARKWAY	AddressLine1Txt
City	THREE RIVERS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49093	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$73,875,836	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BEACONHEALTHSYSTEM.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2011	FormationYr
Legal Domicile State	MI	LegalDomicileStateCd
Activity Or Mission	WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	536	TotalEmployeeCnt
Total Volunteers	51	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,516,225	PYContributionsGrantsAmt
CY Contributions Grants	$761,266	CYContributionsGrantsAmt
PY Program Service Revenue	$66,637,564	PYProgramServiceRevenueAmt
CY Program Service Revenue	$71,858,061	CYProgramServiceRevenueAmt
PY Investment Income	$61,987	PYInvestmentIncomeAmt
CY Investment Income	$305,817	CYInvestmentIncomeAmt
PY Other Revenue	$1,825,601	PYOtherRevenueAmt
CY Other Revenue	$882,982	CYOtherRevenueAmt
PY Total Revenue	$73,041,377	PYTotalRevenueAmt
CY Total Revenue	$73,808,126	CYTotalRevenueAmt
PY Grants And Similar Paid	$12,599	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$7,792	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$34,497,956	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$33,346,399	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$41,665,353	PYOtherExpensesAmt
CY Other Expenses	$40,566,733	CYOtherExpensesAmt
PY Total Expenses	$76,175,908	PYTotalExpensesAmt
CY Total Expenses	$73,920,924	CYTotalExpensesAmt
PY Revenues Less Expenses	-$3,134,531	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$112,798	CYRevenuesLessExpensesAmt
Total Assets BOY	$38,845,134	TotalAssetsBOYAmt
Total Assets EOY	$54,102,951	TotalAssetsEOYAmt
Total Liabilities BOY	$11,218,894	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$10,524,344	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$27,626,240	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$43,578,607	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	Yes (true)	SignificantChangeInd
Expense	$59,202,693	ExpenseAmt
Grant	$7,792	GrantAmt
Revenue	$72,447,899	RevenueAmt
Desc	See Schedule O	Desc
Total Program Service Expenses	$59,202,693	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	79	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	536	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFREY P COSTELLO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5746473549	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	615 N Michigan St	AddressLine1Txt
City	South Bend	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46601	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Laurie A Hines
Chair	2.0	0	Yes (X)	Yes (X)	$225	$0	$0
Raymond L Bendure PhD
Vice Chair	2.0	0	Yes (X)	Yes (X)	$225	$0	$0
Rick Cordes
Secretary	2.0	0	Yes (X)	Yes (X)	$225	$0	$0
Adam Goff OD
Director	2.0	0	Yes (X)		$1,021	$0	$0
Jennifer Platz
Director	2.0	0	Yes (X)		$225	$0	$0
Jim Stuck
Director	2.0	0	Yes (X)		$225	$0	$0
Linda Evans MD
Director, Physician	40.0	0	Yes (X)		$213,151	$0	$18,482
Jeffrey P Costello
CFO	2.0	50.0		Yes (X)	$0	$744,234	$118,036
Kreg R Gruber
CEO	2.0	50.0		Yes (X)	$0	$1,162,712	$170,134
Maria A Behr
President	40.0	0		Yes (X)	$264,681	$0	$53,330
Alyssa Erskine
Employed Physician	40.0	0			$370,298	$0	$30,351	Yes (X)
Douglas Van Marel
Employed Physician	40.0	0			$268,597	$0	$13,169	Yes (X)
James MacDonald
Employed Physician	40.0	0			$308,433	$0	$30,793	Yes (X)
Jessica Puckett
Employed Physician	40.0	0			$397,672	$0	$22,385	Yes (X)
Ramon Urrea
Employed Physician	40.0	0			$331,391	$0	$26,316	Yes (X)
Hope Bailey
Former VP Nursing	40.0	0			$194,974	$0	$25,303		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,351,343	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,906,946	TotReportableCompRltdOrgAmt
Total Other Compensation	$508,300	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	50	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
KALAMAZOO FOOT & ANKLE SPECIALISTS PLC
12057 WEST INDIAN LAKE DR	VICKSBURG	MI	49097	Physican Services	$1,949,803
WEST MICHIGAN EAR NOSE & THROAT
3850 GLENKERRY COURT	PORTAGE	MI	49024	Physican Services	$979,243
KALAMAZOO ANESTHESIOLOGY
900 PEELER ST	KALAMAZOO	MI	49008	Physican Services	$806,644
ELITE EMERGENCY PHYSICIANS INC
600 EAST BLVD	ELKHART	IN	46514	Physican Services	$731,423
LABORATORY CORP OF AMERICA HOLDINGS
PO BOX 12140	BURLINGTON	NC	272162140	Lab Services	$436,925

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	48	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$761,266	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$761,266	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Net Patient Revenue	622110	$71,300,434	$71,300,434	$0	$0
IMED Shared Service	622110	$555,207	$555,207
Medical Services to Affiliates	622110	$2,000	$2,000

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$420	TotalRevenueColumnAmt
Related Or Exempt Func Income	$420	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$71,858,061	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$333,855	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$333,855	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$178,604	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,472	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$177,132	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$177,132	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$177,132	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$38,200	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$66,238	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	-$28,038	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$28,038	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$28,038	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
340B	456110	$428,772	$428,772	$0	$0
Administration	622110	$114,012	$0	$0	$114,012
Quality Incentive	622110	$57,377	$57,377	$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$105,689	TotalRevenueColumnAmt
Related Or Exempt Func Income	$105,689	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$705,850	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$73,808,126	TotalRevenueColumnAmt
Related Or Exempt Func Income	$72,449,899	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$596,961	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$7,792	TotalAmt
Program Services	$7,792	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$331,288	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$331,288	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$456,903	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$456,903	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$26,429,952	TotalAmt
Program Services	$23,126,208	ProgramServicesAmt
Management And General	$3,303,744	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$703,617	TotalAmt
Program Services	$615,665	ProgramServicesAmt
Management And General	$87,952	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,597,601	TotalAmt
Program Services	$3,147,901	ProgramServicesAmt
Management And General	$449,700	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,827,038	TotalAmt
Program Services	$1,598,658	ProgramServicesAmt
Management And General	$228,380	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$664,374	TotalAmt
Management And General	$664,374	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,090	TotalAmt
Management And General	$2,090	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$46,352	TotalAmt
Management And General	$46,352	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,368	TotalAmt
Program Services	$2,947	ProgramServicesAmt
Management And General	$421	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$160,232	TotalAmt
Management And General	$160,232	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$11,826,604	TotalAmt
Program Services	$10,348,261	ProgramServicesAmt
Management And General	$1,478,343	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$2,581	TotalAmt
Program Services	$2,258	ProgramServicesAmt
Management And General	$323	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,445,980	TotalAmt
Program Services	$1,265,232	ProgramServicesAmt
Management And General	$180,748	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$401	TotalAmt
Program Services	$351	ProgramServicesAmt
Management And General	$50	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,455,840	TotalAmt
Program Services	$1,273,694	ProgramServicesAmt
Management And General	$182,146	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$109,670	TotalAmt
Program Services	$95,961	ProgramServicesAmt
Management And General	$13,709	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$70,314	TotalAmt
Program Services	$61,525	ProgramServicesAmt
Management And General	$8,789	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$61,081	TotalAmt
Program Services	$53,446	ProgramServicesAmt
Management And General	$7,635	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,152,912	TotalAmt
Program Services	$1,883,798	ProgramServicesAmt
Management And General	$269,114	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$604,051	TotalAmt
Program Services	$528,545	ProgramServicesAmt
Management And General	$75,506	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$7,480,022	$7,480,022
Management Fees	$6,450,769		$6,450,769
Dues & Subscriptions	$2,210,272	$1,933,988	$276,284
Bad Debt Expense	$5,472,794	$5,472,794

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$347,026	TotalAmt
Program Services	$303,647	ProgramServicesAmt
Management And General	$43,379	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$73,920,924	TotalAmt
Program Services	$59,202,693	ProgramServicesAmt
Management And General	$14,718,231	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,928	BOYAmt
EOY	$935	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$10,026,543	BOYAmt
EOY	$19,054,651	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$89,317	BOYAmt
EOY	$138,791	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,855,165	BOYAmt
EOY	$8,055,134	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$495	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$972,746	BOYAmt
EOY	$1,031,334	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$394,894	BOYAmt
EOY	$217,204	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$26,086,217	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$4,404,103	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$17,811,136	BOYAmt
EOY	$21,682,114	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,693,405	BOYAmt
EOY	$3,922,293	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$38,845,134	BOYAmt
EOY	$54,102,951	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,282,641	BOYAmt
EOY	$5,580,863	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$40,998	BOYAmt
EOY	$32,889	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$3,277,438	BOYAmt
EOY	$2,933,947	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,617,817	BOYAmt
EOY	$1,976,645	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$11,218,894	BOYAmt
EOY	$10,524,344	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$27,626,240	BOYAmt
EOY	$43,578,607	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$27,626,240	BOYAmt
EOY	$43,578,607	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$38,845,134	BOYAmt
EOY	$54,102,951	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$112,798	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$16,065,165	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$3,368	OtherActivitiesAmt
Total Lobbying Expenditures	$3,368	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	THREE RIVERS HEALTH PAID DUES TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE AMOUNT OR PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: ACOG (American College of Obstetricians and Gynecologists) - 20% AANP (American Association of Nurse Practitioners) - 5% MHA (Michigan Health & Hospital Association) - 10% ACEND (Academy of Nutrition and Dietetics) - 10% AACVPR (American Association of Cardiovascular and Pulmonary Rehabilitation) - 20% (Michigan Home Care Hospice Association) - 20% APTA (American Physical Therapy Association) - 31% ANFP (Association of Nutrition & Foodservice Professionals) - 20% ACSM (American College of Sports Medicine) - 20% AORN (Association of OR Nurses) - 20% AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) - 20% ACR (American College of Radiology) - 20% ASHT (American Society of Hand Therapists) - 20% ASPAN (American Society of PeriAnesthesia Nurses) - 20% AOTA (American Occupational Therapy Association) - 20% AASM (American Academy of Sleep Medicine) - 20% INCPAS (Indiana CPA Society) - 20% When unable to ascertain allocation of dues attributed to Lobbying a conservative estimate of 20% is applied.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$38,758,960	BeginningYearBalanceAmt
Contributions	$2,440,358	ContributionsAmt
Investment Earnings Or Losses	$2,682,415	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,424,963	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$42,456,770	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
Contributions	$46,675,185	ContributionsAmt
Investment Earnings Or Losses	-$4,645,970	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$3,270,255	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$38,758,960	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
End Year Balance	$0	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.7449	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.0	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.2551	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,425,257	OtherCostOrOtherBasisAmt
Book Value	$6,425,257	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,748,384	OtherCostOrOtherBasisAmt
Depreciation	$1,189,274	DepreciationAmt
Book Value	$10,559,110	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,912,576	OtherCostOrOtherBasisAmt
Depreciation	$3,214,829	DepreciationAmt
Book Value	$4,697,747	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$21,682,114	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
Other Receivables	$405,412
Third Party Receivables	$3,516,881

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$3,922,293	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	Third Party Payables	Desc
Amt	$1,976,645	Amt

Field	Value	IRS element (for citing)
Total Liability	$1,976,645	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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. 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 BOARD HAS DISCRETION TO UTILIZE EACH YEAR THE INCOMES, REVENUES AND PROFITS ARISING AND ACCRUING FROM THE ENDOWMENTS IN DEFRAYING COSTS ASSOCIATED WITH THE TRUST AND THE REMAINDER FOR SUPPORT, BETTERMENT, IMPROVEMENT, UPKEEP, EXPANSION AND REPLACEMENT OF BEACON HEAL TH SYSTEM, INC. AND ITS CORPORATE AFFILIATES.

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 consolidated 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.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,318	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$61,318	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,705,871	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,664,448	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,041,424	NetCommunityBenefitExpnsAmt
Total Expense	0.0152	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$16,767,189	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,664,448	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,102,742	NetCommunityBenefitExpnsAmt
Total Expense	0.0161	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,266	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,266	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$728,709	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$728,709	NetCommunityBenefitExpnsAmt
Total Expense	0.0106	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,774,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,470,606	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,303,687	NetCommunityBenefitExpnsAmt
Total Expense	0.0629	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$12,518,268	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,470,606	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,047,662	NetCommunityBenefitExpnsAmt
Total Expense	0.0737	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$29,285,457	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$23,135,054	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,150,404	NetCommunityBenefitExpnsAmt
Total Expense	0.0899	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,472,793	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,788,509	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$2,857,094	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,539,983	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$6,682,889	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THREE RIVERS HEALTH	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 S HEALTH PARKWAY	AddressLine1Txt
City	THREE RIVERS	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49093	ZIPCd

Field	Value	IRS element (for citing)
State License	1060000006	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	THREE RIVERS HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	23	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://impact.beaconhealthsystem.org/chna/	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	24	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://impact.beaconhealthsystem.org/chna/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The significant health needs are included in the CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - THREE RIVERS HEALTH SYSTEM, INC. The CHNA began in late 2022, in partnership with the Branch-Hillsdale-St. Joseph County Health Department. The work concluded on the Community Health Improvement Plan (CHIP) with final presentations to collaborative groups in each of the three-county service areas for the Branch-Hillsdale-St. Joseph Department of Health in June 2023. The Vice President of Nursing from Three Rivers Health played a key role in the process as a representative. The Implementation Strategy has three priority areas: maternal and child health, mental health, and advocacy. 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. This CHNA identified mental health and resource accessibility as among the top three health needs, aligning with our priority areas and implementation strategy.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - THREE RIVERS HEALTH SYSTEM, INC. In Michigan, local health departments such as Branch-Hillsdale-St.Joseph County Health Department are required to do CHNAs by two oversight bodies. The first is the Public Health Accreditation Board (PHAB). PHAB is a national, non-profit, voluntary association created collaboratively by the CDC and the Robert Wood Johnson Foundation in 2007. PHAB was created because of the obvious lack of uniformity and clear standards in public health across states and territories. The CHNA began in late 2022, in partnership with the Branch-Hillsdale-St.Joseph County Health Department.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - THREE RIVERS HEALTH SYSTEM, INC. The Community Health Needs Assessment (CHNA) was made widely available to the community through posting on the TRH 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 - THREE RIVERS HEALTH SYSTEM, INC. In partnership with the Branch-Hillsdale-St. Joseph Department of Health and other community partners. These focus on maternal and child health and mental health. For the mental health objectives in the CHIP, raising awareness about Pivotal, the Certified Community Behavioral Health Clinic (CCHBC) in St. Joseph, Michigan, needs improvement. Pivotal states they have not launched an awareness campaign before due to a lack of funding. Beacon will fund a marketing campaign to help raise awareness that all residents can access behavioral health services at Pivotal, which will, in turn, increase mental health care access for St. Joseph County residents. The other priority area, maternal and child health, seeks to improve knowledge and use of the Women, Infant and Children's (WIC) program in St. Joseph County, Michigan. The work plan, which can be found at https://impact.beaconhealthsystem.org/wp-content/uploads/2024/05/Three-Rivers-Implementation-Strategy.pdf, provides details on how we will increase knowledge through sharing information with new birth parents, developing a marketing campaign to strengthen awareness of WIC, providing incentives when currently enrolled families need to recertify in the program, and promoting breastfeeding with support groups and items that support breastfeeding. A USDA 2023 report showed that only about 51% of those eligible actually participate in WIC, a program that is vital to the health and well-being of nearly half our nation's babies along with millions of young children up to age 5 and their mothers.
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Three Rivers Health System, Inc. Beacon Health System includes language offering Financial Assistance on every billing statement sent to the patient. Billing Customer Service also offers Financial Assistance to patients when the patient expresses hardship. The Plain Language Summary included with the statement also clearly explains the process for applying for Financial Assistance. If the patient submits a Financial Assistance application, it is assessed timely, and a determination made. Patients are permitted to apply and be considered for Financial Assistance at any point in the billing cycle.

Field	Value	IRS element (for citing)
Facility	20	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (20 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
THREE RIVERS HEALTH CENTER FOR WOUND
721 S HEALTH PARKWAY	THREE RIVERS	MI	49093	WOUND CARE
THREE RIVERS HEALTH FAMILY INTERNAL M
711 S HEALTH PARKWAY	THREE RIVERS	MI	49093	RURAL HEALTH CLINIC - INTERNAL MEDICINE, FAMILY CARE & WOMEN'S SERVICES
WEST MI EAR NOSE AND THROAT
3850 GLENKERRY CT	PORTAGE	MI	49024	EAR, NOSE, AND THROAT CARE
THREE RIVERS HEALTH SPECIALTY CLINIC
711 S HEALTH PARKWAY	THREE RIVERS	MI	49093	OTHER OUTPATIENT CLINIC
THREE RIVERS HEALTH FAMILY CARE
721 6TH AVENUE SUITE B	THREE RIVER	MI	49093	RURAL HEALTH CLINIC
THREE RIVERS BONE AND JOINT
1021 HILL STREET SUITE 300	THREE RIVERS	MI	49093	BONE AND JOINT FACILITY
THREE RIVERS HEALTH ORTHOPEDICS
1021 HILL STREET SUITE 300	THREE RIVERS	MI	49093	ORTHOPEDICS
THREE RIVERS HEALTH HOMECARE
711 S HEALTH PARKWAY	THREE RIVERS	MI	49093	HOMECARE
THREE RIVERS HEALTH SURGICAL SERVICES
715 S HEALTH PARKWAY	THREE RIVERS	MI	49093	SURGICAL SERVICES
THREE RIVERS HEALTH FAMILY CARE
601 E CHICAGO RD PO BOX 295	WHITE PIGEON	MI	49099	RURAL HEALTH CLINIC
THREE RIVERS HEALTH IMED
16587 ENTERPRISE DR	THREE RIVERS	MI	49093	URGENT CARE CENTER
THREE RIVERS HEALTH HOSPICE
711 S HEALTH PARKWAY	THREE RIVERS	MI	49093	HOSPICE CARE
THREE RIVERS HEALTH CENTER FOR FAMILY
850 S HEALTH PARKWAY	THREE RIVERS	MI	49093	OTHER OUTPATIENT CLINIC
VEERA PATEL MD - INTERNAL MEDICINE
1021 HILL STREET SUITE 100	THREE RIVERS	MI	49093	INTERNAL MEDICINE
KALAMAZOO FOOT AND ANKLE SPECIALISTS
7971 MOORSBRIDGE RD	PORTAGE	MI	49024	FOOT AND ANKLE CARE
HAND AND PLASTICS
1021 HILL STREET SUITE 100	THREE RIVERS	MI	49093	HAND AND PLASTICS CARE
THREE RIVERS HEALTH FAMILY CARE
110 EAST MAIN ST	MARCELLUS	MI	49067	OTHER OUTPATIENT CLINIC
HEALTH TRAC - WELLNESS PAVILLION
501 S HEALTH PARKWAY	THREE RIVERS	MI	49093	WELLNESS CENTER
THREE RIVERS HEALTH SLEEP CLINIC
701 S HEALTH PARKWAY	THREE RIVERS	MI	49093	OTHER OUTPATIENT CLINIC
RHC PAWS CLINIC
721 6TH AVENUE SUITE A	THREE RIVERS	MI	49093	PEDIATRIC CLINIC

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT	Three Rivers Health Hospital prepares a community benefit report both for the state of Michigan and for the annual report, which is posted at WWW.BEACONHEALTHSYSTEM.ORG/CHNA.
Schedule H, Part I, Line 7g Subsidized Health Services for Physician Clinics	The amount of cost associated with physician clinics is $10,301,853.
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	5472794
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	BAD DEBT EXPENSE ARE DOLLARS THAT ARE WRITTEN OFF OR RESERVED FOR PATIENTS THAT HAVE AVAILABLE RESOURCES, BUT WOULD NOT PAY FOR SERVICES. THE EXCEPTION TO THIS RULE WOULD BE CHARITY CARE ACCOUNTS THAT ARE INCLUDED IN BAD DEBT BECAUSE OF A LACK OF INFORMATION PROVIDED, OR THE TIMING OF RECEIVING THAT INFORMATION. PAYMENTS ON ACCOUNTS THAT HAVE BEEN WRITTEN OFF WOULD REDUCE THE OVERALL BAD DEBT EXPENSE. DISCOUNTS ON CHARGES ARE NOT INCLUDED IN BAD DEBT EXPENSE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	SEE ABOVE FOR METHODOLOGY. WITH REGARDS TO CHARITY CARE, THE HOSPITAL ESTIMATES THAT APPROXIMATELY $187,632 OF CHARITY CARE IS INCLUDED IN BAD DEBT EXPENSE DUE TO NOT RECEIVING INFORMATION FROM PATIENTS TO HELP DETERMINE ELIGIBILITY, OR NOT RECEIVING THE INFORMATION IN A TIMELY MANNER, THUS WE BELIEVE THE $187,632 SHOULD BE CONSIDERED A COMMUNITY BENEFIT.
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 UNABLE OR 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	MEDICARE IS OUR LARGEST PAYOR, THUS PAYMENTS FOR THIS POPULATION CREATE A FINANCIAL BURDEN ON THE HOSPITAL AS PAYMENTS DO NOT COVER COSTS. MOST OF THE MEDICARE PATIENTS LIVE ON FIXED INCOMES. WE USED THE COST TO CHARGE RATIO TO DETERMINE COSTS. AS MEDICARE IS OUR LARGEST PAYOR, THE SHORTFALL IN COVERING COSTS IS EXTREME, THUS THIS WOULD SEEM TO QUALIFY AS A BENEFIT TO OUR COMMUNITY.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE HOSPITAL'S CURRENT COLLECTION PROCESS APPLIES TO ALL PATIENTS. IF NO INSURANCE IS AVAILABLE FOR SERVICES, AND THEY DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL MAKE THEM AWARE OF THEIR OPTIONS. DISCOUNTS ARE OFFERED WHICH ARE TIED TO COMMERICAL MANAGED CARE CONTRACTS. PAYMENT ARRANGEMENTS CAN BE MADE FOR A SPECIFIC PERIOD OF TIME, WITH NO INTEREST CHARGED. ONCE ARRANGEMENTS ARE MADE, THE ACCOUNT FOLLOWS THE STANDARD COLLECTION PROCESS OF LETTERS AND PHONE CALLS. AFTER 120 DAYS, IF NO PAYMENT HAS BEEN MADE OR IF PAYMENT ARRANGEMENTS ARE NOT KEPT, THE ACCOUNT WILL BE REFERRED TO A COLLECTION AGENCY.
Schedule H, Part V, Section B, Line 16a FAP website	- THREE RIVERS HEALTH: Line 16a URL: HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- THREE RIVERS HEALTH: Line 16b URL: HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- THREE RIVERS HEALTH: Line 16c URL: HTTPS://WWW.BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS/;
Schedule H, Part VI, Line 2 Needs assessment	TRH reviews the health indicators of the county and completes community surveys. TRH assesses whether we have a shortage of physicians in the area annually as well. TRH reviews trends of our patient activity by service and type of patient to see if adjustments in service or resource allocation need to be made. TRH also reviews satisfaction surveys periodically to identify any potential gaps in services. TRH partners with the local schools and community mental health on specific health initiatives throughout the year. The most recent CHNA began in late 2022 in partnership with the Branch-Hillsdale-St. Joseph County Health Department. The work concluded on the Community Health Improvement Plan (CHIP) with final presentations to collaborative groups in each of the three-county service areas for the Branch-Hillsdale-St. Joseph Department of Health in June 2023. The vice president of nursing from Three Rivers Health was a key partner in the process as a representative. The Implementation Strategy has three priority areas; maternal and child health, mental health, and advocacy.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	UPON IDENTIFYING PATIENTS WHO HAVE NO COVERAGE, WE WILL SEND THEM TO OUR PATIENT ASSISTANCE REPRESENTATIVE. THIS PERSON WILL THEN REVIEW THE OPTIONS THAT ARE AVAILABLE FOR THIS INDIVIDUAL. IF MEDICAID IS A POSSIBILITY, WE THEN SEND THIS PERSON TO OUR MEDICAID SPECIALIST, WHO WILL HELP THEM WITH THE PROCESS, AS WELL AS ANY FORMS. WE HAVE A FORMAL FINANCIAL ASSISTANCE PROGRAM THAT IS ADVERTISED HOSPITAL WIDE AND ON OUR WEBSITE. IF THEY QUALIFY FOR FINANCIAL ASSISTANCE, WE WILL EDUCATE THEM AND ASSIST THEM WITH THE PROCESS.
Schedule H, Part VI, Line 4 Community information	Three Rivers Health presently serves St. Joseph County, along with other providers. The county's total population is 60,887. The community was heavily dependent on the auto industry, and thus, the economy has struggled in recent years. While the overall economy in the state has rebounded somewhat, the local county has lagged in the recovery. The County is approximately 521 square miles in size. US 12 and US 131 are two major highways that run through St. Joseph, MI. It is approximately 20 miles south of Kalamazoo, MI. The unemployment rate continues to be high (5.3%), and the population with Medicaid in the community is high (20%). Additionally, people with coverage have also increased. According to the Michigan Department of Health, St. Joseph County ranks 61st out of 83 counties in the state for health status. While the community is classified as rural and is close to urban areas, many people in the community do not have adequate travel arrangements, as can be evidenced by high no-show rates for primary care appointments due to travel issues. We are currently evaluating opportunities with the county to help with the travel issues alongside collaborating with the local health department to address the social drivers of health. 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 of 525,437. 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, IN ($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, IN, 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), Three Rivers Health (TRH) will standardize the training and development of newly hired community health workers, aligning with the training given by community partners. TRH will make the training available on an electronic learning platform for CHWs and establish and follow an Action Plan to develop a referral network for specialized community health and deploy community health workers in the hospital who serve low-income and minority pregnant women to increase health literacy, build protective factors, increase resilience, and provide resources to address social determinants of health. THR will implement the BABE program, which promotes responsible parenting by offering incentives to expectant parents, who earn coupons that can be redeemed at a BABE store for infant-related merchandise such as diapers, clothing, strollers, and cribs. On behalf of Three Rivers Health, Beacon Health System conducts a request for proposal (RFP) process designed to identify programs to collaborate with partners to address the two priority health needs of the community and align with the implementation strategy approved by each hospital governing Board to address the identified needs. BCI offers two types of financial support to community partners to create an impact in St. Joseph County. Technical assistance is also available for all programs. Please note there is the potential for technical assistance to be offered whether financial assistance is awarded or not. Technical assistance supports the work of the programs by providing project-based assistance to increase the capacity of our community to address its most pressing health needs.
Schedule H, Part VI, Line 6 Affiliated health care system	In October 2021, Beacon Health System became affiliated with Three Rivers Health Hospital. All organizations continue as full-care providers for their respective counties and are committed to promoting the health of the communities they serve. The Three Rivers Health board of directors consists of 8 voting board members. Beacon Health System board of directors consists of 14 voting board members.
Schedule H, Part VI, Line 7 State filing of community benefit report	MI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH COUNTY UNITED WAY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	662 E MAIN ST	AddressLine1Txt
City	CENTREVILLE	CityNm
State Abbreviation	MI	StateAbbreviationCd
ZIP	49032	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	386095409	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$5,000	CashGrantAmt
Purpose Of Grant	GENERAL SUPPORT	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	FormAndLineReferenceDesc
Explanation	DONATIONS AND GRANTS GIVEN TO ORGANIZATIONS THAT IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY ARE MONITORED THROUGH OUTCOME MEASUREMENT REPORTS THAT ARE PROVIDED TO THREE RIVERS HEALTH BY THE VARIOUS ORGANIZATIONS. THESE REPORTS INFORM US OF HOW THE DONATIONS AND GRANTS WERE USED.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Linda Evans MD
Director, Physician	$209,098	$0	$0	$0	$4,052	$0	$7,448	$0	$11,035	$0	$231,633	$0	$0	$0
Jeffrey P Costello
CFO	$0	$607,351	$0	$0	$0	$136,883	$0	$95,606	$0	$22,430	$0	$862,270	$0	$88,827
Kreg R Gruber
CEO	$0	$1,003,311	$0	$0	$0	$159,401	$0	$149,636	$0	$20,498	$0	$1,332,846	$0	$131,845
Maria A Behr
President	$253,550	$0	$0	$0	$11,131	$0	$43,339	$0	$9,992	$0	$318,011	$0	$0	$0
Hope Bailey
Former VP Nursing	$194,033	$0	$0	$0	$941	$0	$8,018	$0	$17,284	$0	$220,277	$0	$0	$0
Alyssa Erskine
Employed Physician	$354,847	$0	$0	$0	$15,451	$0	$13,200	$0	$17,151	$0	$400,649	$0	$0	$0
James MacDonald
Employed Physician	$303,839	$0	$0	$0	$4,594	$0	$12,600	$0	$18,194	$0	$339,226	$0	$0	$0
Jessica Puckett
Employed Physician	$396,196	$0	$0	$0	$1,476	$0	$13,200	$0	$9,185	$0	$420,057	$0	$0	$0
Ramon Urrea
Employed Physician	$328,486	$0	$0	$0	$2,905	$0	$7,533	$0	$18,783	$0	$357,707	$0	$0	$0
Douglas Van Marel
Employed Physician	$266,296	$0	$0	$0	$2,301	$0	$7,166	$0	$6,003	$0	$281,766	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	THREE RIVERS HEALTH SYSTEM, INC. OFFERS COMPLIMENTARY HEALTH CLUB MEMBERSHIP TO BEACON HEALTH SYSTEM'S HEALTH AND LIFESTYLE CENTER, A RELATED PARTY. 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: ADAM GOFF.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	THREE RIVERS HEALTH SYSTEM, 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 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 * MARIA BEHR, $33,138
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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4a Program Service Accomplishments	In 2023, Oncology services remained down but showed improvement in volumes. The service line is viewed as a community need therefore; we persevered through with low volumes serving all those we were able. Gaining system support through Beacon Health System Member Substitution Agreement afforded Three Rivers the opportunity to gain consistent providers serving the community on a regular basis with the ability to increase recruitment. The Center for Wound Healing continues to serve this community well offering hyperbaric oxygen therapy and an average healing rate above the state and national average. Having this service line available has proven to allow patients to keep limbs when otherwise travel would be difficult, and treatment may not be possible. Podiatry and Internal Medicine have continued to play an integral role at the Center with regards to wound debridement and offering an interdisciplinary approach to healing and limb retention. Detoxification continued to be a service offered by the organization with medical stabilization to get through the initial acute phase safely. Outpatient infusions continue to be a service need provided on a 24/7 basis. Outpatient therapies (PT, OT and speech) along with Cardiac Rehab are all located on the campus that allow for local care to an underserved community. Three Rivers Health continues to offer many services that would otherwise be impossible for some of the community due to lack of resources and support. These services may or may not be strong revenue stream but are rendered as part of the organization's mission to deliver outstanding care, inspire health and connect with heart. We continue to work to provide high-quality, close to home, and at reasonable cost healthcare; striving to meet the needs of the communities we serve.
Form 990, Part III, Line 3 Significant changes in program services	THREE RIVERS HEALTH CEASED OPERATIONS OF THE HEALTH CLUB AND BEACON HEALTH SYSTEM TOOK IT OVER.
Form 990, Part VI, Line 6 Classes of members or stockholders	BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF THREE RIVERS HEALTH SYSTEM, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	BEACON HEALTH, THE SOLE CORPORATE MEMBER, HAS THE POWER TO NOMINATE, ELECT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY BEACON HEALTH SYSTEM, THE SOLE MEMBER OF THREE RIVERS HEALTH SYSTEM. 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. OTHER MATTERS AS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS
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 ORGANZIATION 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 ORGANIZATION'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 15a Process to establish compensation of top management official	THREE RIVERS HEALTH SYSTEMS, INC'S PARENT, BEACON HEATLH SYSTEM, INC. HAS AN EXTENSIVE EXAMINATION THAT IS CONDUCTED, FOR VICE PRESIDENT AND HIGHER, USING COMPARABLE MARKET DATA THAT IS 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 FOR ALL OTHER EXECUTIVES/OFFICERS TO THE BOARD FOR APPROVAL. THE INDEPENDENT CONSULTING GROUP SEPARATELY MAKES THE RECOMMENDATIONS REGARDING THE CEO'S COMPENSATION 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 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 THE BEACON HEALTH SYSTEM, INC. BONDS.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Affiliate Rent Revenue - Total Revenue: 312, Related or Exempt Function Revenue: 312, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Drug Sales - Total Revenue: 108, Related or Exempt Function Revenue: 108, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Capitations - Total Revenue: 53922, Related or Exempt Function Revenue: 53922, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Unclaimed Property - Total Revenue: 32353, Related or Exempt Function Revenue: 32353, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Surgery Center - Total Revenue: 18214, Related or Exempt Function Revenue: 18214, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Medical Education - Total Revenue: 1200, Related or Exempt Function Revenue: 1200, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part IX, Line 11g Other Fees	Professional fees & Purch. Srvcs - Total Expense: 11816875, Program Service Expense: 10339766, Management and General Expenses: 1477109, Fundraising Expenses: ; Supplies & Other - Total Expense: 9729, Program Service Expense: 8495, Management and General Expenses: 1234, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Write-off Intercompany Balances - 16064860; Rounding - 305;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
BEACON MEDICAL GROUP
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	351536132	PHY PRACTICES	IN	501(c)(3)	10	BHS	Yes (true)
BEACON HEALTH FOUNDATION INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	351536129	FINANCIAL SUPPORT	IN	501(c)(3)	7	BHS	Yes (true)
ELKHART GENERAL HOSPITAL
600 EAST BOULEVARD	ELKHART	IN	46514	350877574	HOSPITAL	IN	501(c)(3)	3	BHS	Yes (true)
COMMUNITY HOSPITAL OF BREMEN INC
1020 HIGH ROAD	BREMEN	IN	46506	350835006	HOSPITAL	IN	501(c)(3)	3	BHS	Yes (true)
MEMORIAL HOSPITAL OF SOUTH BEND INC -
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	350868132	HOSPITAL	IN	501(c)(3)	3	BHS	Yes (true)
TRAH PROPERTIES INC
701 S HEALTH PARKWAY	THREE RIVERS	MI	49093	383366344	PROPERTY MANAGEMENT	MI	501(c)(3)	Type I	TRH	Yes (true)
THREE RIVERS HEALTH AUTHORITY
701 S HEALTH PARKWAY	THREE RIVERS	MI	49093	382317300	HOSPITAL	MI	501(c)(3)	Type III-FI	NA	false
BEACON HEALTH SYSTEM INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	453864076	PARENT ORG	IN	501(c)(3)	Type III-FI	NA	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BEACON HEALTH VENTURES INC
615 N MICHIGAN ST	SOUTH BEND	IN	46601	351901068	HOME MEDICAL	IN	N/A	C Corporation	false
BEACON HEALTH VENTURES MICHIGAN INC
615 N MICHGIAN ST	SOUTH BEND	IN	46601	208259773	HOME MEDICAL	MI		C Corporation	false	BHS

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
BEACON MEDICAL GROUP
P	$2,952,953	ACTUAL CHARGES
BEACON MEDICAL GROUP
Q	$1,109,118	ACTUAL CHARGES
BEACON MEDICAL GROUP
R	$287,199	CASH
BEACON MEDICAL GROUP
S	$2,130,722	CASH
MEMORIAL HOSPITAL OF SOUTH BEND
P	$1,010,907	ACTUAL CHARGES
MEMORIAL HOSPITAL OF SOUTH BEND
S	$1,007,614	CASH