2022-11-12T13:27:41-06:00 2021-12-31 ERNST AND YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2021-01-01 350877574 Elkhart General Hospital Inc % JEFFREY COSTELLO ELKH 5745233208 600 EAST BLVD ELKHART IN 46514 Jeffrey Costello CFO 5746473549 2022-11-11 true Jeffrey Costello 999009999 JENNIFER D RHODERICK P00395735 3176817445 3 2021 2022-09-23 18:48:47Z CARL RISK 600 EAST BLVD ELKHART IN 46514 365032260 false X www.beaconhealthsystem.org X 1909 IN WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART. 11 11 2193 70 324489 0 10912707 4164246 312916968 355865639 26410 50356 2453034 4378764 326309119 364459005 396949 484659 0 0 109586495 136122041 0 0 0 178217661 200731307 288201105 337338007 38108014 27120998 282553250 272178207 128858474 119714663 153694776 152463544 X WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH, AND CONNECT WITH HEART. false false 311293175 484659 357013202 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 2021, the Hospital admitted 11,423 patients for a total of 55,588 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 4,354 outpatient surgeries, 45,836 emergency room visits, and 58,183 Ancillary Services.During 2021, the unreimbursed cost of free or discounted medical care provided to patients that were deemed indigent under state, county, or internal guidelines was $87,116. Elkhart General Hospital also provided $42,468,404 in unreimbursed care to the elderly covered by Medicare, and $2,380,483 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, the hospital incurred $556,000 in unbilled services to the poor and broader community. 311293175 true true false true false 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 true false false false false false false false false false false false false false true true true false false true 146 0 true 2193 true true true false false false false false false false false false false false X 11 11 false false true 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 X KREG R GRUBER CEO 2.0 50.0 X 0 1487125 206853 Jeffrey P Costello CFO 2.0 50.0 X 0 952112 130897 Carl W Risk II President 40.0 0.0 X 522576 0 106037 MICHELLE BACHE VP MEDICAL AFFAIRS 40.0 0.0 X 421489 0 35049 ROSETTA P SPEIGHTS VP NURSING & PT CARE SVC 40.0 0.0 X 274051 0 13226 JAMES CANTRELL LEAD PERFUSIONIST 40.0 0.0 X 254253 0 32252 CINDIE MCPHIE VP OPERATIONS 40.0 0.0 X 255398 0 17919 JOHN SCHEU PERFUSIONIST 40.0 0.0 X 225938 0 34775 Bruce Newswanger DO VICE CHAIR 2.0 0.0 X X 948 0 0 JOHN DEPUTY DIRECTOR 2.0 0.0 X 948 0 0 TIM MORGAN TREASURER 2.0 0.0 X X 768 0 0 MATT ZIMMERMAN DIRECTOR 2.0 0.0 X 672 0 0 SHELLEY MOORE DIRECTOR 2.0 0.0 X 588 0 0 Tim Shelly CHAIR 2.0 0.0 X X 0 0 0 LEVON JOHNSON DIRECTOR 2.0 0.0 X 0 0 0 TONJA LUCCHESE DIRECTOR 2.0 0.0 X 0 0 0 LUPITA ZEPEDA DIRECTOR 2.0 0.0 X 0 0 0 SAM BORRELLI MD DIRECTOR 2.0 2.0 X 0 0 0 CHRIS ANNIS MD DIRECTOR BEGIN 3/2021 2.0 2.0 X 0 0 0 1957629 2439237 577008 126 false true false South Bend Medical Foundation 530 North Lafayette Blvd SOUTH BEND IN 46601 Lab Services 1746314 Northern Indiana Anesthesia Service 600 East Bvld ELKHART IN 46514 Anesthesia Services 4575442 APOGEE PHYSICIANS 2525 E CAMELBACK RD PHOENIX AZ 85016 PHYSICIAN SERVICES 4537695 AYA HEALTHCARE PO BOX 123519 DALLAS TX 75312 TEMPORARY LABOR 22026765 LABCORP INDIANA PO BOX 8014 BURLINGTON NC 27216 LAB SERVICES 2337005 46 244545 3902785 16916 4164246 PATIENT SERVICE REVENUE 622110 350043389 350043389 OUTPATIENT PHARMACY 446110 4436938 264826 4172112 RENT FROM RELATED PARTIES 622110 1342597 1342597 MEDICAL EDUCATION 611710 42715 42715 355865639 122541 122541 0 0 1074669 431070 643599 0 643599 643599 70000 142185 -72185 -72185 -72185 0 0 0 0 0 0 0 0 0 QUAILITY INCENTIVE 622110 791784 791784 CAFETERIA 722514 1033417 1033417 GAIN ON BOND REFUNDING 523000 1494522 1494522 415442 355779 59663 3735165 364459005 352576264 324489 7394006 383428 383428 101231 101231 0 0 632537 632537 0 111647183 100156018 11491165 2803138 2575270 227868 14641481 13093155 1548326 6397702 5713148 684554 8331159 7439725 891434 7428 7428 133908 133908 1507 1507 0 266259 266259 20133586 17975558 2158028 17364 15506 1858 3634364 3243883 390481 7189 6420 769 0 3218579 2855771 362808 49259 43988 5271 0 12398 11071 1327 822954 734898 88056 0 16690384 14901538 1788846 1463449 1306860 156589 PATIENT SUPPLIES, DRUGS 67524383 67524383 BAD DEBT EXPENSE 29764688 29764688 HOSPITAL ASSESSMENT FEE 15341195 13699687 1641508 CORPORATE ALLOCATION FEES 32452849 28980394 3472455 858405 766555 91850 337338007 311293175 26044832 0 7410 7810 16030612 12283523 0 0 66274791 66846780 0 0 0 0 117166 117307 8533865 8766567 923355 1369997 400597159 230313106 176220605 170284053 7893342 8861555 0 0 0 0 2536226 2536226 4015878 1104389 282553250 272178207 51876040 57856581 0 0 0 0 64800849 60181768 0 0 0 0 0 0 0 0 12181585 1676314 128858474 119714663 X 145801434 143601989 7893342 8861555 153694776 152463544 282553250 272178207 X 27120998 968214 -29320444 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1507 1507 false Part II-B, Line 1i Elkhart General Hospital pays the dues TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: INDIANA HOSPITAL ASSOCIATION - 26.47% CHAMBER OF COMMERCE - 3.0% ACHE - 1% ELKHART GENERAL HOSPIAL 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 26.47% IS APPLIED BASED ON THE INDIANA HOSPITAL ASSOCIATION PERCENTAGE. 45447655 3126708 5495842 1536648 285877 0 52247680 42268939 1692784 3115564 1353300 276332 0 45447655 37414420 2588248 4251002 1740359 244372 0 42268939 41373022 1352757 -2805752 2243989 261618 0 37414420 40368863 2155261 3423343 4284345 249461 40639 41373022 0.64290 0.00770 0.34940 false true true 3846371 3846371 264535475 133585092 130950383 129992223 96728014 33264209 2223090 2223090 170284053 0 MED MAL IBNR 1676314 OTHER LT LIABILITIES 0 OTHER DEFERRED TAX 0 1676314 X SCHEDULE D, PART V, LINE 4 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 $9,261,555. 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 $42,986,125 at 12/31/2021. In 2021, the Hospital received $0 from the related party endowment funds. FIN 48 DISCLOSURE PART X, LINE 2 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, 2021 or 2020. true true X true X true X true true false true true 819764 819764 0.00270 59803498 47541796 12261702 0.03990 60623262 47541796 13081466 0.04260 997538 220503 777035 0.00250 1320432 1320432 0.00430 349088 349088 0.00110 2667058 220503 2446555 0.00790 63290320 47762299 15528021 0.05050 true 7804301 3902151 53360397 72509735 -19149338 X true true 1 1 Elkhart General Hospital Inc 600 East Blvd Elkhart IN 46514 www.beaconhealthsystem.org 22-005017-1 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. 350. X X X true true X X X true X See Section C for full URL X See Section C for full URL X See Section C for full URL X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 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. PART V, SECTION B, LINE 6A ELKHART GENERAL HOSPITAL CONDUCTED THE 2021 ELKHART COUNTY CHNA WITH MEMORIAL HOSPITAL OF SOUTH BEND, A BEACON HEALTH SYSTEM PARTNER; and Community Hospital of Bremen. Part V, Section B, Line 7D 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 transmissio 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. Part I, Line 6a 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 COMMUNITY PLUNGES (EXPERIENTIAL ACTIVITIES TO INVOLVE THE COMMUNITY RESIDENTS WITH A NEIGHBORHOOD-BASED AGENCY), COMMUNITY FOUNDATION SUPPORT, STRATEGIC ALLOCATION OF TITHING RESOURCES, A CLEAR STATEMENT OF VISION AND GOALS, A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT AND PROMOTION OF VOLUNTEER INVOLVEMENT AND COMMUNITY PARTNERSHIPS. ELKHART GENERAL HOSPITAL TITHES 10% OF THE PREVIOUS YEAR'S INCOME FROM OPERATIONS AND TRANSFERS IT TO THE COMMUNITY BENEFIT FUND FOR INVESTMENT 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 COMMUNITY HEALTH ENHANCEMENT COMMITTEE OF THE BOARD MAKES ONGOING POLICY AND OVERSEES THE ADMINISTRATION OF THE FUND AND DETERMINES SPECIFIC INVESTMENT ALLOCATIONS BASED UPON THE ASSETS AND NEEDS OF THE COMMUNITY. VOLUNTEERS AND 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 CHARACTERISTICS. 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. Part I, Line 7 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 $29,764,688 was removed from total expenses. Part III, Line 2 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. PART III, LINE 3 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. PART III, LINE 4 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. PART III, LINE 8 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 2020 MEDICARE COST REPORT. PART III, LINE 9B COLLECTION PRACTICES 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. WILL QUALIFY FOR FINANCIAL ASSISTANCE. EXTRAORDINARY COLLECTION ACTIONS INCLUDE SUIT, WAGE GARNISHMENT, LIEN OR ADVERSE CREDIT BUREAU REPORTING. 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. 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. 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 206,921 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 463.91 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 of 525,254. St. Joseph is the largest and Marshall the smallest, which is classified as rural. Although each varies in population density, they are closer in geographic size (SJC-467 square miles, Elkhart-464, Marshall-450). The median household income (2020) is comparable in Marshall and St. Joseph ($54,207, $54,433), but higher in Elkhart county-$58,509 where 9.8% of people live in poverty compared to the higher rate of 12.7% in St. Joseph and a lower rate of 9.3% in Marshall. 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 is the regional center for higher education, with more than eight colleges and universities. These campuses have shifted the county's main focus from manufacturing to health, education and customer services. 5. Promotion of Community Health The mission of Elkhart General Hospital, as a Beacon Health System partner, is to deliver outstanding care, inspire health and connect with heart. Beacon Health System is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead the Health System to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both Beacon Health System and Elkhart General Hospital have community Boards of Directors, and consistently invest funds to improve the quality of life for our communities. Beacon Health System values reflect an unwavering commitment to the communities we serve. Elkhart General Hospital, as a Beacon Health System partner, has as its values: -Patients are at the center - Patient needs, care and safety are our top priority. -Trust - Our actions will firmly demonstrate reliability on 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 our patients, associates and communities we serve. -Compassion - We will demonstrate the emotional capacities of 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. 6. Affiliated Health Care System In 2011 Elkhart General Hospital affiliated with Memorial Hospital of South Bend, Indiana, under the name of Beacon Health System, Inc. 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 BEACON HEALTH SYSTEM BOARD OF DIRECTORS CONSISTS OF 14 VOTING BOARD MEMBERS. 7. State Filing of Community Benefit Report Elkhart General Hospital, Inc., prepares a Community Benefit Report both for the State of Indiana and for the Annual Report, which is posted at www.beaconhealthsystem.org/chna. true RIBBON OF HOPE 600 EAST BOULEVARD ELKHART IN 46514 352118856 501(c)(3) 25000 CASH CANCER SUPPORT UNITED WAY OF ELKHART COUNTY 601 CR 17 ELKHART IN 46515 350953433 501(C)(3) 50000 CASH CORPORATE MATCH BOYS & GIRLS CLUB OF ELKHART CO PO BOX 614 GOSHEN IN 46527 351156334 501(C)(3) 15000 CASH SPONSOR PROGRAMS CENTER FOR HEALING AND HOPE PO BOX 195 GOSHEN IN 46527 020560511 501(c)(3) 25000 CASH MEDICAL/ADVOCACY SVC ECONOMIC DEVELOPMENT CORP 300 BIBCO PARKWAY ELKHART IN 46516 351973845 501(C)(3) 10000 CASH FINANCIAL INVESTMENT ELKHART COUNTY HEALTH DEPARTMENT 117 N SECOND STREET GOSHEN IN 46526 356000142 GOV 25000 CASH PRENATAL CARE CHILD & PARENT SERVICES 100 W HIVELY AVE ELKHART IN 46517 350888765 501(C)(3) 29300 CASH HEALTHY FAMILIES SPA WOMEN'S MINISTRY HOMES 23221 OLD US 20E ELKHART IN 46516 431998891 501(C)(3) 20000 CASH HEALTHY SPIRIT JUNIOR ACHIEVEMENT OF NORTHERN INDIANA 601 NOBLE DRIVE FORT WAYNE IN 46825 350922731 501(C)(3) 15000 CASH GALA AWARD SPONSOR ELKHART EDUCATION FOUNDATION 2746 OLD US 20W ELKHART IN 46514 463429545 501(C)(3) 25000 CASH SPONSOR PROGRAMS MOSAIC HEALTH AND HEALING ARTS 330 LAKEVIEW DR GOSHEN IN 46528 812316014 501(C)(3) 10000 CASH HEALTHY MINDS COMMUNITY FOUNDATION OF ELKHART COUNTY 300 NIBCO PARKWAYSTE 301 ELKHART IN 46516 311255886 501(C)(3) 18000 CASH SPONSOR PROGRAMS NORTHERN INDIANA HISPANIC HEALTH COALITION 444 N NAPPANEE ST ELKHART IN 46514 320039221 501(C)(3) 25000 CASH SPONSOR PROGRAMS DOMESTIC AND SEXUAL ABUSE SERVICES PO BOX 402 THREE RIVERS MI 49093 382590266 501(C)(3) 10000 CASH SPONSOR PROGRAMS ETHOS INC 1025 N MICHIGAN ST ELKHART IN 46514 912094413 501(C)(3) 15000 CASH SPONSOR PROGRAMS NEWTON PARK 810 N MICHIGAN ST LAKEVILLE IN 46530 352118679 501(C)(3) 8000 CASH DOME SPONSOR HOUSING AUTHORITY OF CITY OF ELKHART 1396 BENHAM AVE ELKHART IN 46514 351082584 GOV 20000 CASH SPONSOR PROGRAMS 17 0 TRANSPORTATION SERVICES 283 101231 SCHEDULE I, PART I, LINE 2 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. 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. X true true false true false false false false false true false Jeffrey P Costello CFO 0 575796 0 193976 0 182340 0 115848 0 15049 0 1083009 0 74414 KREG R GRUBER CEO 0 947095 0 389336 0 150694 0 187021 0 19832 0 1693978 0 84167 Carl W Risk II President 385908 0 128268 0 8400 0 80703 0 25334 0 628613 0 0 0 ROSETTA P SPEIGHTS VP NURSING & PT CARE SVC 225486 0 46500 0 2065 0 10941 0 2285 0 287277 0 0 0 MICHELLE BACHE VP MEDICAL AFFAIRS 360678 0 59431 0 1380 0 11600 0 23449 0 456538 0 0 0 JAMES CANTRELL LEAD PERFUSIONIST 210169 0 25000 0 19084 0 7922 0 24330 0 286505 0 0 0 JOHN SCHEU PERFUSIONIST 185463 0 25000 0 15475 0 9439 0 25336 0 260713 0 0 0 CINDIE MCPHIE VP OPERATIONS 207856 0 44601 0 2941 0 8445 0 9474 0 273317 0 0 0 Supplemental Compensation Information PART I, LINE 1A 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. BEACON HEALTH SYSTEM ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. SPOUSAL TRAVEL FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: NONE HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: BRUCE NEWSWANGER, SHELLEY MOORE, TIM MORGAN, MARK ZIMMERMAN AND JOHN DEPUTY. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: NONE PART I, LINE 3 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. PART I, LINE 4B 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 2021, REFLECTED IN COLUMN (B)(III): KREG GRUBER $141,814 JEFFREY COSTELLO $146,062 THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED PAYMENTS IN 2021 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: KREG GRUBER $175,421 JEFFREY COSTELLO $104,248 CARL RISK $69,103 PART I, LINE 7 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-MANAGEMENT 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 GROUWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE MANAGEMENT INCENTIVE IS MADE AT THE DESCRETION 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 45471AQM7 2017-09-08 40210000 REFUND BONDS ISSUED 12/09/2008 false false false B INDIANA FINANCE AUTHORITY 351602316 45471ALS9 2013-05-21 38582380 REFUND BONDS ISSUED 12/15/1998 true false false A 4410000 0 40210000 0 0 0 0 0 0 0 40210000 0 2017 true false true true B 15511522 18537750 38410168 0 0 0 134933 0 0 0 38275235 0 2013 true false true true A false true true true false 0.01900 0.00000 0.01900 false false false true B 0 A false false true false true false 0 false 0 false true B false false false true false false 0 false 0 false true A true B true PART III, COLUMN B: COLUMN B IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND, THROUGH A SERIES OF REFUNDINGS, BONDS ISSUED BEFORE 01/01/2003. PART IV, LINE 2C, COLUMN B THE DATE THE REBATE COMPUTATION WAS PERFORMED ON THE HOSPITAL AUTHORITY OF ELKHART COUNTY WAS 5/18/2018. CORE FORM 990 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 ELKHART GENERAL HOSPITAL, INC. UPDATED THEIR CORPORATE BYLAWS IN 2021. SOME OF THESE CHANGES INCLUDED: 1. THE MEMBER SHALL NO LONGER HAVE THE SOLE POWER WITH RESPECT TO THE APPOINTMENT AND EVALUATION OF THE PRESIDENT OF THE CORPORATION, AND THE COMPENSATION OF EXECUTIVE MANAGEMENT OF THE CORPORATION. THE BEACON HEALTH SYSTEM CEO APPOINTS AND EVALUATES THE PRESIDENT WITHIN THE SYSTEM. 2. SELECTION OF DIRECTORS, TERMS, STAGGERED BOARD TERMS, AND ATTENDANCE WERE UPDATED. 3. BOARD OF DIRECTOR MEETINGS WERE UPDATED TO INCULDE MEETINGS BY INTERNET APPLICATIONS. MEMBERS OF THE ORGANIZATION Form 990, Part VI, SECTION A, LINE 6 Beacon Health System, Inc. is the sole corporate member of Elkhart General Hospital, Inc. ELECTION OF BOARD MEMBERS FORM 990, PART VI, SECTION A, LINE 7A 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. GOVERNANCE DECISIONS FORM 990, PART VI, SECTION A, LINE 7B 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. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, SECTION B, LINE 11B 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 COMPENSATION 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. CONFLICT OF INTEREST STATEMENTS FORM 990, PART VI, SECTION B, LINE 12C 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 364 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 25, 2022 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2021, 23 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. COMPENSATION PROCESS FORM 990, PART VI, SECTION B, LINES 15A & 15B 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. PUBLIC AVAILABILITY FOR DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 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 XI, line 9 Write off of Intercompany Balances, Beacon Health System - ($29,377,784) BEACON HEALTH FOUNDATION CAPITAL DISTRIBUTIONS - $57,340 TOTAL - ($29,320,444) 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) 12D III-O MHSB true BEACON HEALTH SYSTEM INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 PARENT ORG. IN 501(C)(3) 12C 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) 12A,TYPE I NA false Community Hospital of Bremen Inc 1020 HIGH ROAD BREMEN IN 46506 350835006 HOSPITAL IN 501(C)(3) 3 BHS true Community Hospital of Bremen Foundation 1020 HIGH ROAD BREMEN IN 46506 351813755 FINANCIAL SUP IN 501(C)(3) LINE 12B,II BHS true THREE RIVERS HEALTH FOUNDATION 701 S HEALTH PARKWAY THREE RIVERS MI 49093 201384776 FOUNDATION MI 501(C)(3) 12A TRH 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 N/A C Beacon Health Ventures Michigan Inc 615 N Michigan St South Bend IN 46601 208259773 Home Medical MI N/A C INTEGRATED HEALTH SYSTEMS INC 7001 SOUTH HEALTH PARKWAY THREE RIVERS MI 49093 383134384 PERSONNEL MGMT MI TRH C true false true false false false false false false false false false false false true true true true true Memorial Hospital of South Bend q 1386513 ACTUAL CHARGES Memorial Hospital of South Bend p 2603329 ACTUAL CHARGES Beacon Medical Group a 1206893 ACTUAL CHARGES Memorial Hospital of South Bend s 487248 Cash Beacon Medical Group O 640897 PAYROLL Beacon Medical Group P 2327791 ACTUAL CHARGES Beacon Medical Group Q 1156698 ACTUAL CHARGES Community Hospital of Bremen s 2378179 Cash BEACON HEALTH FOUNDATION C 244546 ACTUAL CHARGES Memorial Hospital of South Bend r 729568 Cash Community Hospital of Bremen p 56707 ACTUAL CHARGES