2021-08-16T08:57:09-05:00 2020-09-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2019-10-01 350593390 DEACONESS HOSPITAL INC DEAC 8124503296 600 MARY STREET EVANSVILLE IN 47747 SHAWN W MCCOY CEO OF DEACONESS HEALTH SYSTEM 8124503296 2021-08-16 1 CARRIE A MERRILL CPA P00832283 3176334705 2019 2022-09-23 18:48:47Z SHAWN W MCCOY CEO 600 MARY STREET EVANSVILLE IN 47747 1647192329 0 X WWW.DEACONESS.COM X 1895 IN PROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT CONTINUE TO SCH O TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. 20 14 6707 109 16801911 109821 1646761 18259180 942375847 967249119 20915857 29721186 82689151 86915133 1047627616 1102144618 850589 1157407 0 0 371491921 394333935 0 0 467806 515947339 553580136 888289849 949071478 159337767 153073140 1654034103 1921220397 550747717 703989911 1103286386 1217230486 X SEE SCHEDULE O. 0 0 172711143 521323246 PATIENT SERVICE REVENUE. SEE SCHEDULE O. 644632582 439698325 CHARITY CARE/SUBSIDIZED CARE. SEE SCHEDULE O. 19502364 6227548 GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION AND COMMUNITY BENEFIT. SEE SCHEDULE O. 1157407 1157407 46361896 ALL OTHER ACCOMPLISHMENTS:OTHER PROGRAM SERVICE REVENUE CONSISTS OF DEACONESS HOSPITAL'S INCOME FROM THE INVESTMENT IN JOINT VENTURES. OTHER PROGRAM SERVICE EXPENSES CONSISTED OF COMMUNITY BENEFIT GRANTS/ASSISTANCE. 1157407 1157407 46361896 838003496 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 1 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 0 0 0 1 293 0 1 6707 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 20 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X CHERYL A WATHEN 8124503296 600 MARY STREET EVANSVILLE IN 47747 SHAWN MCCOY CEO OF DEACONESS HEALTH SYSTEM, INC. 33.00 22.00 X X 776739 417300 246070 DANIEL HERMANN CHAIRMAN 3.00 2.00 X 0 0 0 SHARON REED WALKER TREASURER 3.00 2.00 X 0 0 0 DAVE PAPARIELLA SECRETARY 3.00 2.00 X 0 0 0 BRUCE ADYE MD DIRECTOR 3.00 2.00 X 0 0 0 MAQBOOL AHMED MD DIRECTOR 3.00 53.00 X 720 871388 19030 CURTIS BEGLE DIRECTOR 3.00 2.00 X 0 0 0 JEROME BENKERT JR DIRECTOR 3.00 2.00 X 0 0 0 DR LINDA BENNETT DIRECTOR 3.00 2.00 X 0 0 0 SCOTT CORDTS MD DIRECTOR 53.00 2.00 X 310586 3800 45300 TERI HOLLANDER ALBIN DIRECTOR 3.00 2.00 X 0 0 0 ANTHONY KAISER MD DIRECTOR 3.00 2.00 X 0 0 0 KEVIN KOCH DIRECTOR 3.00 2.00 X 0 0 0 BARRY PHILLIPS MD DIRECTOR 3.00 53.00 X 7650 424255 46847 RONALD ROCHON MD DIRECTOR 3.00 2.00 X 0 0 0 JAMES RYAN III DIRECTOR 3.00 2.00 X 0 0 0 DAVID RYON MD DIRECTOR 53.00 2.00 X 447067 10450 45022 ERIC SCHACH DIRECTOR 3.00 2.00 X 0 0 0 STEPHEN TITZER CPA DIRECTOR 3.00 3.00 X 0 0 0 JONATHAN WEINZAPFEL DIRECTOR 3.00 2.00 X 0 0 0 CHERYL WATHEN CHIEF FINANCIAL OFFICER 30.00 25.00 X 452916 270172 177530 JAMES PORTER MD PRESIDENT OF DEACONESS HEALTH SYSTEM, INC. 50.00 3.00 X 1106860 2400 186751 CHERONA HAJEWSKI CHIEF NURSING OFFICER 50.00 0.00 X 442666 0 118675 LYNN LINGAFELTER CHIEF OPERATION OFFICER 50.00 4.00 X 532705 48052 129573 HERMAN BLANTON MD CHIEF MEDICAL OFFICER 50.00 3.00 X 609938 81762 105713 MARC FLORENCE VICE PRESIDENT 50.00 7.00 X 357722 65209 104873 CAROLYN MORTON PHARMACY AND LAB DIRECTOR 50.00 0.00 X 225004 0 43737 SUSAN BRUMLEY IMAGING AND CARDIOVASCULAR SERVICES 50.00 0.00 X 192438 0 38934 RAGHAV GUPTA MD ANESTHESIOLOGIST 50.00 0.00 X 980846 0 40231 VENKATESH MADADI MD ANESTHESIOLOGIST 50.00 0.00 X 871492 0 52316 NIRMAL JOSHI MD ANESTHESIOLOGIST 50.00 0.00 X 799351 0 50018 DAVID FISH MD ANESTHESIOLOGIST 50.00 0.00 X 765327 0 41076 RYAN NEAL MD ANESTHESIOLOGIST 50.00 0.00 X 757339 0 40753 LINDA WHITE FORMER CEO EMERITA, FOUNDATION EXEC. DIRECTOR 50.00 1.00 X 196065 4800 14073 9833431 2199588 1546522 359 1 1 0 EVANSVILLE SURGERY CENTER PO BOX 2185 EVANSVILLE IN 47728 SURGICAL SERVICES 29915061 PROGRESSIVE HEALTH INDIANA LLC 150 N ROSENBERGER AVE EVANSVILLE IN 47712 PHYSICAL THERAPY 16516316 TRI STATE RADIATION ONCOLOGY 700 N BURKHARDT RD EVANSVILLE IN 47715 RADIATION & ONCOLOGY SERVICES 15615460 ORTHOALIGN LLC 4011 GATEWAY BLVD NEWBURGH IN 47630 MEDICAL SERVICES 14347979 EVOLENT HEALTH LLC 800 GLEBE RD SUITE 500 ARLINGTON VA 22203 CONSULTING SERVICES 9061891 124 158681 17264437 836062 52895 18259180 NET PATIENT REVENUE 900099 967249119 967249119 967249119 17049558 17049558 10485645 5637357 4848288 4848288 4848288 552002824 539079571 251625 12923253 -251625 12671628 12671628 120450 158681 79158 41292 41292 INVESTMENT IN JOINT VENTURES 900099 36286116 36286116 OTHER HOSPITAL SERVICES 900099 28937526 10075780 18861746 LABORATORY SALES 621500 13347968 13347968 3453943 3453943 82025553 1102144618 1013611015 16801911 53472512 X 1157407 1157407 6768183 6768183 300805174 275245099 25294462 265613 12087318 10986988 1088027 12303 54177643 44170683 10006960 20495617 18272790 2208654 14173 2186723 2254 2184469 107335 107335 30228 30228 1593900 1593900 139439670 137001322 2417823 20525 1093446 33786 1059660 10351043 8954185 1373956 22902 23626150 13997168 9628982 14809643 9117777 5691866 135421 48285 84893 2243 996774 572728 420438 3608 11394873 6717551 4677322 52004349 33375165 18629135 49 4874468 3911173 963295 MEDICAL/SURGICAL SUPPLI 194440103 194398278 41825 MEDICAID ASSESSMENT FEE 35385201 35385201 0 EQUIP RENTAL/MAINTENANC 14866820 11951083 2915737 DUES & SUBSCRIPTIONS 779511 476339 293307 9865 45464478 32228234 13119719 116525 949071478 838003496 110600176 467806 83582828 222180059 133412369 144630180 1549060 1785214 7388324 8511488 12822146 14069480 1048737818 554877255 504830977 493860563 770685857 844580684 51664486 55478236 48206614 48206614 39891442 87917879 1654034103 1921220397 89449202 100455955 1643957 1600383 295600927 288892997 164053631 313040576 550747717 703989911 X 1097044932 1211096598 6241454 6133888 1103286386 1217230486 1654034103 1921220397 X 153073140 -39129040 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30228 30228 0 PART II-B, LINE 1: LOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS HOSPITAL AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT. 8037280 1075 867885 160715 8745525 7914040 1075 195423 73258 8037280 7389906 120 606614 82600 7914040 6877438 1200 705719 194451 7389906 6660917 50 445045 228574 6877438 0.12000 0.88000 0 0 6556217 16004889 22561106 54284953 670093533 359913436 364465050 270996137 194963819 76032318 30802089 30802089 493860563 ACCRUED RETIREMENT BENEFITS 121236240 RELATED ORGANIZATION PAYABLES 3546242 TAXABLE BOND- SERIES 2016 50400000 DEBT ISSUE COSTS -56104 RIGHT OF USE ASSETS 32914198 MEDICARE ADVANCED FUNDING 103000000 CARES ACT LIABILITY 2000000 313040576 X PART V, LINE 4: THE DEACONESS HOSPITAL FOUNDATION UTILIZES ENDOWMENT FUNDS TO SUPPORT AND BENEFIT THE MISSION OF DEACONESS HOSPITAL. SPECIFICALLY, ENDOWMENT FUNDS ARE USED TO HELP SUPPORT ACTIVITIES OR PROJECTS THAT HELP TO PROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANY AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART VII AND IX: SECTIONS ARE NOT REQUIRED AS THE TOTALS FOR EACH LINE ARE LESS THAN 5% OF THE TOTAL ASSETS LISTED ON FORM 990, PART X, LINE 16. PART XI AND XII: SECTIONS ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENT IS AUDITED BY AN INDEPENDENT ACCOUNTING FIRM AND IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. DH PARTY OF YR 163033 64633 98400 500 36345 3374 DH CLASSIC 116098 94048 22050 5251 22359 160 3012 8157 279131 158681 120450 5251 22859 160 39357 11531 79158 41292 1 1 X 1 X 1 X 1 1 1 0 1 1 18403743 18403743 0.01940 169530610 124740549 44790061 0.04720 187934353 124740549 63193804 0.06660 911125 911125 0.00100 7930670 2586556 5344114 0.00560 237904 237904 0.00030 2075850 40196 2035654 0.00210 11155549 2626752 8528797 0.00900 199089902 127367301 71722601 0.07560 1500 1500 0.00000 1500 1500 0.00000 20059 20059 0.00000 5000 5000 0.00000 19215 19215 0.00000 47274 47274 0.00000 1 21982543 224512832 212667648 11845184 X 1 1 4 1 DEACONESS HOSPITAL INC 600 MARY STREET EVANSVILLE IN 47747 WWW.DEACONESS.COM 20-005074-1 X X X X 2 DEACONESS GATEWAY HOSPITAL 4011 GATEWAY BLVD NEWBURGH IN 47630 WWW.DEACONESS.COM 20-005074-1 X X X X 3 DEACONESS CROSS POINTE 7200 E INDIANA STREET EVANSVILLE IN 47715 WWW.DEACONESS.COM 20-005074-1 X 4 THE HEART HOSPITAL 4007 GATEWAY BLVD NEWBURGH IN 47630 WWW.DEACONESS.COM 18-011772-1 X DEACONESS HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTP://WWW.DEACONESS.COM/CHNA X 1 18 1 HTTP://WWW.DEACONESS.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X 1 X 0 0 DEACONESS GATEWAY HOSPITAL 2 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTP://WWW.DEACONESS.COM/CHNA X 1 18 1 HTTP://WWW.DEACONESS.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X 1 X 0 0 DEACONESS CROSS POINTE 3 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTP://WWW.DEACONESS.COM/CHNA X 1 18 1 HTTP://WWW.DEACONESS.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X 1 X 0 0 THE HEART HOSPITAL 4 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTP://WWW.DEACONESS.COM/CHNA X 1 18 1 HTTP://WWW.DEACONESS.COM/CHNA 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X X 1 X 0 X X X 1 X 0 0 DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 5: PARTNERS CONDUCTING THE CHNA COLLABORATED WITH A WIDE RANGE OF PUBLIC HEALTH AND SOCIAL SERVICE PARTNERS TO ENSURE THAT DIVERSE SCIENTIFIC AND COMMUNITY-BASED INSIGHTS WERE INCLUDED THROUGHOUT THE PROCESS. OF PARTICULAR IMPORTANCE WAS THE INCLUSION OF INDIVIDUALS WHO DIRECTLY OR INDIRECTLY REPRESENTED THE NEEDS OF THREE IMPORTANT GROUPS: 1) THOSE WITH PARTICULAR EXPERTISE IN PUBLIC HEALTH PRACTICE AND RESEARCH, 2) THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, OR CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL, AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED.KEY PARTNER ORGANIZATIONS INCLUDED:-THE UNIVERSITY OF EVANSVILLE. FACULTY, STAFF, AND STUDENTS IN PUBLIC HEALTH AREAS COLLABORATED WITH THE HOSPITAL ON THE DATA-ORIENTED ASPECTS OF THE PROJECT.-INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH. FACULTY AND STUDENTS COLLABORATED WITH THE HOSPITAL THROUGHOUT THE SURVEY PROCESS.-INDIANA UNIVERSITY CENTER FOR SURVEY RESEARCH. FACULTY AND STAFF PROVIDED IN-DEPTH TECHNICAL ASSISTANCE AND GUIDANCE THROUGHOUT THE SURVEY PROCESS, AND WORKED CLOSELY WITH THE HOSPITALS AND THE UNIVERSITY OF EVANSVILLE TO FIELD THE COMMUNITY HEALTH SURVEY.SURVEY PROCESS AND METHODS - 8 KEY PARTNER ORGANIZATIONS: -MEASURES MATTER, LLC. MEASURES MATTER IS A COMMUNITY-BASED RESEARCH CONSULTING FIRM BASED IN BLOOMINGTON, INDIANA AND PALM SPRINGS, CALIFORNIA. MEASURES MATTER CONDUCTED AN INDEPENDENT ANALYSIS OF THE SURVEY DATA AND ALSO FACILITATED THE PRIORITIZATION PROCESS WITH THE HOSPITAL AND ITS PARTNERS.-COUNTY HEALTH DEPARTMENTS. REPRESENTATIVES OF THE VANDERBURGH COUNTY HEALTH DEPARTMENT WERE PARTNERS IN THE LARGER NETWORK OF ORGANIZATIONS AND HOSPITALS THAT WORKED TO ENHANCE CONSISTENCY IN STATEWIDE CHNA ACTIVITIES, PARTICULARLY THE CHNA COMMUNITY SURVEY AND FOCUS GROUPS. ADDITIONALLY, GIVEN THAT THE SURVEY PROCESS WAS COORDINATED IN CONJUNCTION WITH MULTIPLE OTHER HOSPITAL SYSTEMS AND LOCAL ORGANIZATIONS THROUGHOUT THE STATE, OTHER HEALTH DEPARTMENTS INVOLVED IN THE PROCESS INCLUDED THOSE FROM TIPPECANOE, CLAY, FOUNTAIN, WARREN, HOWARD, JENNINGS, LAWRENCE, MADISON, RANDOLPH, WASHINGTON, WARRICK, HAMILTON, AND MARION COUNTIES.-COMMUNITY HEALTH AND SOCIAL SERVICE ORGANIZATIONS. A WIDE RANGE OF COMMUNITY-BASED HEALTH AND SOCIAL SERVICE ORGANIZATIONS COLLABORATED THROUGHOUT THE CHNA PROCESS TO CONSIDER DATA FROM THE CHNA, MAKE DECISIONS REGARDING HEALTH PRIORITIES, AND INITIATE CONSIDERATIONS OF SUBSEQUENT ACTIONS BASED ON THE CHNA.CHNA PRIORITIZATION PROCESS ATTENDEES:LISA MAISH, DEACONESSLISA MEYER, ST. VINCENT EVVASHLEY TENBARGE, ST. VINCENT EVVLORI GRIMM, DEACONESS THE WOMEN'S HOSPITALDR. KEN SPEAR, VANDERBURGH COUNTY HEALTH DEPARTMENTJILL BUTTRY, DEACONESSANDREA HAYS, WELBORN BAPTIST FOUNDATIONAMY CANTERBURY, UNITED WAY OF SWIDR. CHAD PERKINS, ST. VINCENT EVVSANDEE STRADER-MCMILLEN, ECHO HEALTHPAM HIGHT, DEACONESSJANET RAISOR, ST. VINCENT EVVDR. MARIA DEL RIO HOOVER, ST. VINCENT EVVSABRINA JONES, ST. VINCENT EVVSCOTT BRANAM, DEACONESS CROSS POINTEASHLEY JOHNSON, DEACONESSJENNA ALVIA ST. VINCENT WARRICKDR. CARRIE ANN LAWRENCE, IU SCHOOL OF PUBLIC HEALTH - FACILITATOR DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 5: DESCRIPTION OF COMMUNITY INPUT IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 5: DESCRIPTION OF COMMUNITY INPUT IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 5: DESCRIPTION OF COMMUNITY INPUT IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH:EIGHT HEALTH SYSTEMS WORKED TOGETHER TO ADMINISTER THE SAME CHNA SURVEY TO RESIDENTS IN 31 INDIANA COUNTIES. PARTICIPATING HEALTH SYSTEMS (IN ADDITION TO DEACONESS HEALTH SYSTEM) INCLUDED ASCENSION/ST. VINCENT, GIBSON GENERAL HOSPITAL, FRANCISCAN HEALTH, NORTH CENTRAL HEALTH SERVICES D.B.A. RIVER BEND HOSPITAL, IU HEALTH, COMMUNITY HEALTH NETWORK, AND RIVERVIEW HEALTH. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 6B: KEY PARTNER ORGANIZATIONS INCLUDED THE UNIVERSITY OF EVANSVILLE, INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH, INDIANA UNIVERSITY CENTER FOR SURVEY RESEARCH, MEASURES MATTER, LLC. OTHER LOCAL ORGANIZATIONS PARTICIPATED IN OUR FOCUS GROUPS AND PRIORITIZATION SESSIONS. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 6B: OTHER ORGANIZATIONS CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 6B: OTHER ORGANIZATIONS CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 6B: OTHER ORGANIZATIONS CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 11: WE CONTINUE TO USE OUR IMPLEMENTATION PLAN TO GUIDE WORK IN THE IDENTIFIED AREAS OF NEED. CHNA PROJECTS WERE SIGNIFICANTLY DERAILED DUE TO COVID-19.VANDERBURGH COUNTY - FROM THE FIVE ENDORSED ISSUES IDENTIFIED FOR PRIORITIZATION, THE GROUP SELECTED MENTAL HEALTH, SUBSTANCE ABUSE, AND FOOD INSECURITY AS OUR PRIMARY POINTS OF FOCUS. IMPROVEMENT IN CHRONIC HEALTH CONDITIONS SHOULD BE A BY-PRODUCT OF SUCCESSFUL WORK IN THE OTHER THREE AREAS AND "POVERTY" CONSISTS OF MORE VARIABLES THAN THIS GROUP CAN ADDRESS. DURING 2019-2020, SPECIAL ATTENTION FOCUSED ON FOOD INSECURITY. PARTNERSHIPS WITH THE PROMISE ZONE, URBAN SEEDS, AND THE JUNIOR LEAGUE OF EVANSVILLE HELPED FEED THOUSANDS OF FAMILIES AND LED TO THE CREATION OF THE MAYOR'S COMMISSION ON FOOD INSECURITY. RELATED TO SUBSTANCE ABUSE, THE WOMEN'S HOSPITAL CONTINUED TO SCREEN PREGNANT WOMEN AT PRESENTATION FOR DELIVERY USING THE 5PS SCREENING TOOL. THEY SUBMIT DATA TO THE INDIANA STATE DEPARTMENT OF HEALTH TO MONITOR THE PREVALENCE OF SUBSTANCE EXPOSURE IN NEWBORNS AND MEET QUARTERLY TO IDENTIFY CHALLENGES AND OPPORTUNITIES THAT CAN BE ADDRESSED. AFTER EXAMINATION, A GROUP OF PHYSICIANS AND CLINICAL OFFICE STAFF DECIDED NOT TO EMPLOY THE SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) TOOL IN PRIMARY CARE PRACTICES. DEACONESS CREATED A NEW, PUBLIC-FACING WEBPAGE TO PROVIDE INFORMATION AND RESOURCES RELATED TO MENTAL HEALTH AND COPING WITH VARIOUS COVID ISSUES. ADDITIONAL MESSAGING ABOUT "CARING FOR THE CAREGIVERS" WAS SENT ON TUESDAYS AND THURSDAYS EACH WEEK TO ALL HEALTH SYSTEM STAFF. BEHAVIORAL HEALTH PROVIDERS MOVED THERAPY APPOINTMENTS ONLINE AND THE EMPLOYEE ASSISTANCE PROGRAM SAW AN INCREASE IN PARTICIPATION.WARRICK COUNTY - FROM THE FOUR ENDORSED ISSUES IDENTIFIED FOR PRIORITIZATION, THE GROUP SELECTED MENTAL HEALTH, SUBSTANCE ABUSE, AND ACCESS TO CARE AS OUR PRIMARY POINTS OF FOCUS FOR THE NEXT CHNA PERIOD. IMPROVEMENT IN CHRONIC HEALTH CONDITIONS SHOULD BE A BY-PRODUCT OF SUCCESSFUL WORK IN THE OTHER THREE AREAS. EFFORTS AND SUCCESSES MENTIONED FOR VANDERBURGH ALSO COUNT FOR WARRICK COUNTY AS THEY ARE BOTH PART OF THE DEACONESS HEALTHY SYSTEM EFFORTS. ANALYSIS OF TRANSPORTATION ISSUES WAS POSTPONED DUE TO COVID. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 11: HOW THE SIGNIFICANT NEEDS ARE BEING ADDRESSED IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 11: HOW THE SIGNIFICANT NEEDS ARE BEING ADDRESSED IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 11: HOW THE SIGNIFICANT NEEDS ARE BEING ADDRESSED IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 15E: MED ASSIST IS AVAILABLE TO DEACONESS HEALTH SYSTEM PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 15E: OTHER METHOD USED FOR APPLYING FOR FINANCIAL ASSISTANCE IS THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 15E: OTHER METHOD USED FOR APPLYING FOR FINANCIAL ASSISTANCE IS THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 15E: OTHER METHOD USED FOR APPLYING FOR FINANCIAL ASSISTANCE IS THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 16J: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. DEACONESS HOSPITAL FOR FISCAL YEAR 20 IMPACTED THE LIVES OF MORE THAN 18,411 MEMBERS OF OUR COMMUNITY BY HELPING THEM OBTAIN INSURANCE OR PROVIDE ASSISTANCE FOR THE UNDERINSURED. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 16J: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). DEACONESS CROSS POINTE PART V, SECTION B, LINE 16J: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). THE HEART HOSPITAL PART V, SECTION B, LINE 16J: OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1). PART V, SECTION B, LINE 16A, FAP WEBSITE: THE FINANCIAL ASSISTANCE POLICY (FAP) FOR ALL FOUR HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE: THE FINANCIAL ASSISTANCE POLICY (FAP) APPLICATION FOR ALL FOUR HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16B, FAP PLAIN LANGUAGE SUMMARY WEBSITE: THE FINANCIAL ASSISTANCE POLICY (FAP) PLAIN LANGUAGE SUMMARY FOR ALL FOUR HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE 34 1 - CARDIAC REHAB 4015 GATEWAY BLVD SUITE 2122 NEWBURGH IN 47630 OUTPATIENT SERVICES 2 - DEACONESS FAMILY MEDICINE RESIDENCY 415 W COLUMBIA ST SUITE 110 EVANSVILLE IN 47710 OUTPATIENT PHYSICIAN CLINIC 3 - DEACONESS HOSPITAL ANTICOAGMED THERAPY 350 W COLUMBIA ST SUITE 210 EVANSVILLE IN 47747 OUTPATIENT SERVICES 4 - DEACONESS HOSPITAL BREAST CENTER 520 MARY STREET SUITE 140 EVANSVILLE IN 47710 DIAGNOSTIC CENTER 5 - DEACONESS HOSPITAL CANCER SERVICES 4055 GATEWAY BLVD NEWBURGH IN 47630 OUTPATIENT SERVICES 6 - DEACONESS COMPREHENSIVE PAIN CTR-GATEWAY 4099 GATEWAY BLVD NEWBURGH IN 47630 OUTPATIENT SERVICES 7 - DEACONESS COMPREHENSIVE PAIN CTR & PROG 4600 W LLOYD EXPRESSWAY SUITE A EVANSVILLE IN 47712 OUTPATIENT SERVICES 8 - DEACONESS CROSS POINTE OUTPATIENT CLINIC 445 CROSS POINTE BLVD EVANSVILLE IN 47715 OUTPATIENT PHYSICIAN CLINIC 9 - DEACONESS GATEWAY GASTROENTEROLOGY 4133 GATEWAY BLVD SUITE 290 NEWBURGH IN 47630 OUTPATIENT SERVICES 10 - DEACONESS HOSPITAL MAMMOGRAPHY & IMAGING 421 CHESTNUT STREET EVANSVILLE IN 47713 DIAGNOSTIC CENTER 11 - DEACONESS HOSPITAL INFUSION CTRPHARMACY 4111 GATEWAY BLVD NEWBURGH IN 47630 OUTPATIENT SERVICES 12 - DEACONESS HOSPITAL RADIOLOGY EXPRESS 10455 ORTHOPAEDIC DRIVE NEWBURGH IN 47630 DIAGNOSTIC CENTER 13 - DEACONESS HOSPITAL PHYSICAL MEDICINE 520 MARY STREET SUITE 280 EVANSVILLE IN 47747 OUTPATIENT SERVICES 14 - DEACONESS HOSPITAL PHYS MED-OA 10455 ORTHOPAEDIC DRIVE NEWBURGH IN 47630 OUTPATIENT SERVICES 15 - DEACONESS HOSPITAL PHYSICAL MEDICINE 4600 W LLOYD EXPRESSWAY SUITE B EVANSVILLE IN 47715 OUTPATIENT SERVICES 16 - DEACONESS PRIMARY CARE FOR SENIORS 1750 OAK HILL ROAD EVANSVILLE IN 47710 OUTPATIENT PHYSICIAN CLINIC 17 - DEACONESS PRIMARY CARE FOR SENIORS 4498 FIRST AVENUE EVANSVILLE IN 47710 OUTPATIENT PHYSICIAN CLINIC 18 - DEACONESS PROCEDURE CENTER 421 CHESTNUT STREET EVANSVILLE IN 47713 OUTPATIENT SERVICES 19 - MIDWEST RADIOLOGICAL IMAGING 4087 GATEWAY BLVD NEWBURGH IN 47630 DIAGNOSTIC CENTER 20 - DEACONESS REGIONAL LABORATORY 421 CHESNUT STREET EVANSVILLE IN 47713 DIAGNOSTIC CENTER 21 - DEACONESS CLINIC GATEWAY REG LAB 4233 GATEWAY BLVD SUITE 201 NEWBURGH IN 47630 DIAGNOSTIC CENTER 22 - DEACONESS HOSPITAL LAB & EKGDIABETES ED 520 MARY STREET SUITE 330 EVANSVILLE IN 47710 DIAGNOSTIC CENTER 23 - DEACONESS RADIOLOGY LAB & RADIOLOGY 8600 NORTH KENTUCKY AVENUE EVANSVILLE IN 47725 DIAGNOSTIC CENTER 24 - DEACONESS REGIONAL LABORATORY 4494 N FIRST AVENUE EVANSVILLE IN 47710 DIAGNOSTIC CENTER 25 - DEACONESS HOSPITAL LAB & RADIOLOGY 4209 GATEWAY BLVD NEWBURGH IN 47630 DIAGNOSTIC CENTER 26 - MT VERNON MEDICAL CENTER LAB & RADIOLOGY 1900 W FOURTH STREET MT VERNON IN 47620 DIAGNOSTIC CENTER 27 - DEACONESS REGIONAL LABORATORY 4133 GATEWAY BLVD SUITE 110 NEWBURGH IN 47630 DIAGNOSTIC CENTER 28 - DEACONESS SLEEP CENTER 350 W COLUMBIA STREET SUITE 100 EVANSVILLE IN 47710 OUTPATIENT SERVICES 29 - DEACONESS SLEEP CENTER-EAST 7307 E COLUMBIA ST EVANSVILLE IN 47715 DIAGNOSTIC CENTER 30 - DEACONESS SLEEP LAB 350 W COLUMBIA STREET SUITE LL-10 EVANSVILLE IN 47710 DIAGNOSTIC CENTER 31 - DEACONESS WEIGHT LOSS SOLUTIONS 310 W IOWA STREET EVANSVILLE IN 47710 OUTPATIENT PHYSICIAN CLINIC 32 - DEACONESS WOUND CARE CENTER 350 W COLUMBIA STREET SUITE 350 EVANSVILLE IN 47710 OUTPATIENT SERVICES 33 - DEACONESS DIABETES CENTER - EDUCATION 421 CHESNUT STREET EVANSVILLE IN 47713 OUTPATIENT SERVICES 34 - DEACONESS ANTICOAGULATION CLINIC 4107 GATEWAY BLVD EVANSVILLE IN 47630 OUTPATIENT SERVICES PART I, LINE 6A: DEACONESS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS MADE AVAILABLE ON THE DEACONESS WEBSITE AT HTTP://WWW.DEACONESS.COM/CHNA PART I, LINE 7: A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. IRS INSTRUCTION'S WORKSHEET 2 WAS USED FOR THIS CALCULATION. WE DID NOT USE THE COST TO CHARGE RATIO FOR LINE 7G AS IT WAS NOT RELEVANT TO THESE SERVICES. THE ACTUAL COST FROM OUR COSTING SYSTEM WAS USED WHEN AVAILABLE. THE COST TO CHARGE RATIO FOR EACH SERVICE TYPE WAS USED TO ESTIMATE COST WHEN NOT AVAILABLE FROM OUR INTERNAL COSTING SYSTEM. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES ATTRIBUTED TO PHYSICIAN CLINICS HAVE A COST OF $11,047. PART I, LN 7 COL(F): BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) DUE TO ADOPTION OF (ASU) 2014-09 TOPIC 606. PART II, COMMUNITY BUILDING ACTIVITIES: DEACONESS PROVIDES SUPPORT TO NUMEROUS ORGANIZATIONS THAT FOCUS ON EDUCATION, COMMUNITY IMPROVEMENTS, AND LEADERSHIP DEVELOPMENT. DEACONESS BELIEVES THAT IN SUPPORTING THESE LOCAL SCHOOLS AND ORGANIZATIONS WE ARE PROVIDING ASSISTANCE IN BETTERING OUR COMMUNITY AND OUR PATIENTS.NORMAL ACTIVITIES SUCH AS OUR HEALTH SCIENCE INSTITUTE IN WHICH LOCAL HIGH SCHOOL STUDENTS LIVE ON CAMPUS AND LEARN ABOUT HEALTHCARE CAREERS HAD TO BE CANCELLED THIS YEAR DUE TO COVID-19. DEACONESS STILL INCURRED COSTS OF $8,715 FOR THE PROGRAM AND PLANS TO HOST THE INSTITUTE IN 2021.DEACONESS DID PROVIDE SUPPORT TO OUR LOCAL CHAMBER OF COMMERCE TO HOST NUMEROUS LUNCHEONS AND AWARD CEREMONIES THAT PROMOTES LEADERSHIP DEVELOPMENT AND THE IMPORTANCE OF COMMUNITY AND GOVERNMENT INVOLVEMENT. DEACONESS ALSO PROVIDED SUPPORT TO IMPORTANT COMMUNITY ORGANIZATIONS SUCH AS LOCAL SCHOOLS AND OUR ZOO TO SHOW OUR SUPPORT OF THEIR MISSIONS. PART III, LINE 2: THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE SIGNIFICANT AND DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY, DETERMINED ON A PORTFOLIO BASIS, ARE RECORDED AS BAD DEBT EXPENSE. CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PART III, LINE 3: DEACONESS HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 4: THE FOOTNOTE DESCRIBING BAD DEBT EXPENSES IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE "CHARITY CARE, COMMUNITY BENEFIT AND ASSISTANCE TO THE UNINSURED" STARTING ON PAGE 12 AND "PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE" STARTING ON PAGE 11. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE ACTUAL BASED UPON THE 2020 MEDICARE COST REPORT. PART III, LINE 9B: DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY WILL BE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. PART VI, LINE 2: NEEDS ASSESSMENT PROCESS: DEACONESS UTILIZES A VARIETY OF SOURCES TO GATHER DATA ON LOCAL HEALTH CARE NEEDS. WE USE DATA FROM THE UNITED WAY OF SOUTHWESTERN INDIANA'S COMPREHENSIVE NEEDS ASSESSMENT, WELBORN BAPTIST FOUNDATION'S GREATER EVANSVILLE HEALTH SURVEY, COUNTY HEALTH RANKINGS WEBSITE, INDIANA STATE DEPARTMENT OF HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU. ADDITIONAL INFORMATION COMES FROM OUR OWN ELECTRONIC MEDICAL RECORD SYSTEM AND THROUGH OUR INTERACTION WITH LOCAL SERVICE PROVIDERS AND OTHER NON-PROFIT ORGANIZATIONS. THAT INCLUDES "PROMISE ZONE" INITIATIVES THAT KEEP US AWARE OF CHANGING NEEDS IN OUR MOST DISENFRANCHISED POPULATION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DEACONESS HOSPITAL UTILIZES FINANCIAL COUNSELORS TO EDUCATE, INFORM AND ASSIST PATIENTS AND FAMILIES IN UNDERSTANDING THEIR FINANCIAL OBLIGATION, ABILITY TO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH DEACONESS HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PAYMENT OPTIONS. SPECIFICALLY, FINANCIAL COUNSELORS STAFF THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, CASHIER AREA, AS WELL AS, FLOAT AMONG INPATIENT AREAS TO ENSURE EACH AND EVERY PATIENT REQUIRING ASSISTANCE IS REACHED. IN ADDITION TO THE PERSONAL AND INDIVIDUALIZED COUNSELING PROVIDED BY THE FINANCIAL COUNSELORS, VARIOUS FORMS OF MEDIA ARE DISTRIBUTED THROUGHOUT DEACONESS HOSPITAL EXPLAINING THE FINANCIAL ASSISTANCE PROCESS. ADDITIONALLY, POLICIES FOR FINANCIAL ASSISTANCE ARE POSTED WIDELY THROUGHOUT DEACONESS HOSPITAL AND ON THE INTERNET AT WWW.DEACONESS.COM. HTTPS://WWW.DEACONESS.COM/FOR-YOU/PATIENTS-AND-VISITORS/PATIENTS/FINANCIAL-ASSISTANCE. IN ADDITION TO THE VARIOUS PLACES THAT THE PROGRAM IS PUBLISHED, IT IS ALSO REFERENCED ON OUR PATIENT STATEMENT AND PHONE MESSAGE WHEN THE PATIENT CALL THE BILLING PHONE NUMBER. PART VI, LINE 4: DEACONESS DEFINES ITS COMMUNITY AS ALL PEOPLE LIVING IN VANDERBURGH AND WARRICK COUNTIES AT ANY TIME DURING THE YEAR.VANDERBURGH COUNTY VANDERBURGH COUNTY IS MORE DIVERSE THAN MUCH OF INDIANA IN TERMS OF RACIAL AND ETHNIC CHARACTERISTICS, EVENLY SPLIT WITH REGARD TO GENDER, WITH THE MAJORITY OF INDIVIDUALS LIVING IN AREAS CONSIDERED URBAN. VANDERBURGH COUNTY'S POPULATION OF 180,974 PERSONS IS SIMILAR TO THE STATEWIDE POPULATION, WITH ABOUT 84% OF THE POPULATION BEING WHITE, 9.6% BLACK/AFRICAN AMERICAN, 1.3% ASIAN, AND THE REMAINDER BEING OF OTHER OR 2 OR MORE RACES. HOWEVER, VANDERBURGH COUNTY REPORTS A 2.7% HISPANIC POPULATION COMPARED TO 7% FOR THE STATE. VANDERBURGH COUNTY IS ALSO ONE OF THE MORE URBAN AREAS WITH A 9.2% RURAL RATING COMPARED TO THE INDIANA AVERAGE OF 27.6%. ACCORDING TO THE 2020 COUNTY HEALTH RANKINGS, VANDERBURGH COUNTY RANKS 82 OUT OF 92 INDIANA COUNTIES FOR HEALTH OUTCOMES AND 65 OUT OF 92 INDIANA COUNTIES FOR HEALTH FACTORS. INSTANCES OF VIOLENT CRIME, INJURY DEATHS, SEXUALLY TRANSMITTED INFECTIONS, AND CHILDREN LIVING IN POVERTY ARE HIGHER IN VANDERBURGH COUNTY THAN THE INDIANA AVERAGE. THIS INFORMATION MATCHES OUR CHNA DATA.WARRICK COUNTY - CONVERSELY, WARRICK COUNTY RANKS 13 OUT OF 92 INDIANA COUNTIES FOR HEALTH OUTCOMES AND 6 OUT OF 92 INDIANA COUNTIES FOR HEALTH FACTORS ON THE 2020 COUNTY HEALTH RANKINGS. INCIDENTS OF VIOLENT CRIME, INJURY DEATHS, SEXUALLY TRANSMITTED INFECTIONS, AND CHILDREN LIVING IN POVERTY ARE SIGNIFICANTLY LOWER THAN THE STATE AVERAGE. WARRICK COUNTY HAS LESS DIVERSITY THAN VANDERBURGH COUNTY AND THE STATE OF INDIANA. MORE THAN 92% OF PEOPLE THERE IDENTIFY AS WHITE COMPARED TO 79% FOR INDIANA. ONLY 1.6 % OF THE POPULATION IS LISTED AS BLACK/AFRICAN AMERICAN AND 1.9% AS HISPANIC. THAT'S COMPARED TO STATE AVERAGES OF 9.5% AND 7% RESPECTIVELY. WARRICK COUNTY IS ALSO MORE RURAL THAN THE AVERAGE INDIANA COUNTY (29.3% RURAL IN WARRICK COUNTY COMPARED TO 27.6% STATE AVERAGE). PART VI, LINE 5: DEACONESS LED THE COVID-19 RESPONSE FOR THE SOUTHERN PART OF INDIANA AND NEIGHBORING COUNTIES IN KENTUCKY AND ILLINOIS. WE BECAME A TRUSTED RESOURCE BY CREATING SPECIFIC COVID-19 WEBPAGES FOR THE GENERAL PUBLIC AND BUSINESSES SO THEY HAD THE MOST CURRENT INFORMATION ABOUT TESTING, REGULATIONS, AND EVENTUALLY VACCINES. WE ALSO CREATED A SEPARATE COPING PAGE THAT LINKED PEOPLE TO A VARIETY OF RESOURCES ABOUT MENTAL AND EMOTIONAL HEALTH. WE RELEASED A YOUTUBE VIDEO EXPLAINING HOW TO MAKE CLOTH MASKS, COLLABORATED WITH A VARIETY OF HEALTH AND ACADEMIC INSTITUTIONS TO OPERATE A CONVALESCENT PLASMA PROGRAM AND CONDUCT A COMMUNITY PREVALENCE STUDY, AS WELL AS ADMINISTERED MONOCLONAL ANTIBODY TREATMENT.ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND CONCERNS OUR COMMUNITY HAD REGARDING COVID-19. 7/16/2020 - COVID TESTING - DR. GINA HUHNKE7/16/2020 - MASK MYTHS - DR. BRAD SCHEU7/16/2020 - FB LIVE WITH DR. PORTER - MAYOR WINNECKE, DR. PORTER7/20/2020 - HPV PANEL DISCUSSION - DRS. SCHUMAN, CAPRI WEYER7/21/2020 - FB LIVE WITH DR. HUHNKE - DR. GINA HUHNKE7/30/2020 - FB LIVE WITH DR. PORTER - DR. PORTER, BRIAN SPENCER PHARMDE-NEWSLETTER ARTICLES 7/15/2020:-LYME DISEASE T. GEHLHAUSEN, DO, OAKLAND CITY-KEEPING PAIN IN CHECK NP, PAIN CENTER-ABCS OF HEPATITIS MD, DC GASTRO-PREPARING TO GO BACK TO SCHOOL MD, DC PEDIATRICS-SUPER SUMMER NUTRITION RD DIETICIAN8/27/2020:-FB LIVE WITH DR. PORTER DRS. PORTER AND DAVID RYONE-NEWSLETTER ARTICLES 8/15/2020:-EXPERIENCING HEEL PAIN MD, DC PODIATRY-ADULT VACCINES MD, DC MARY STREET-KEEP MOVING FOR BETTER HEALTH DO, DC OAKLAND CITY-HELPING CHILDREN NAVIGATE DIFFICULT TIMES S. BRANAM, CAO CROSS POINTE9/2/2020: COVID TESTING PROCESS APRIL ABBOTT, PHIL GAMBLE9/10/2020: FLU SHOTS DURING PANDEMIC DR. BRAD SCHEU9/24/2020: FB LIVE DR. PORTER AND SHAWN MCCOYE-NEWSLETTER ARTICLES 9/15/2020:-GET A FLU SHOT DURING COVID PANDEMIC DR. SHEU, DC ADMIN-MAMMOGRAMS, WHO NEEDS THEM AND WHEN MD, BREAST RADIOLOGIST-TIPS ON WEARING A FACE MASK MARKETING STAFF-PREVENTING SUICIDE JANIE CHAPPELL, CROSS POINTESCREENING MAMMOGRAMS VIA MOBILE BREAST CENTER:2019 NUMBER SCREENEDOCTOBER - 347NOVEMBER - 242DECEMBER - 1702020 NUMBER SCREENEDJANUARY - 138FEBRUARY - 197MARCH - 130APRIL - 0MAY - 153JUNE - 244JULY - 286AUGUST - 214SEPTEMBER - 272PATIENT CARE:-MEDICATION ASSISTANCE AND FAMILY MEDICINE RESIDENCY CLINIC; DEACONESS PROVIDES FREE AND REDUCED CARE WITHIN OUR HOSPITAL BUILDINGS. THROUGH OUR MEDICATION ASSISTANCE PROGRAM (MAP) AND OUR FAMILY PRACTICE RESIDENCY CLINIC, PATIENTS CAN ACCESS THE HIGH QUALITY HEALTH CARE THEY NEED IN CONVENIENT LOCATIONS AND AT A PRICE THEY CAN AFFORD. IN FY19-20, OUR RESIDENTS TREATED NEARLY 16,000 PATIENTS AT A COST TO THE HOSPITAL OF $3 MILLION. SIMILARLY, ALMOST 2,000 MAP PATIENTS RECEIVED NEEDED MEDICATION AT A COST TO THE HOSPITAL OF $339,000. -BEHAVIORAL HEALTH AND SUICIDE PREVENTION; STAFF FROM DEACONESS CROSS POINTE EDUCATED 14,000 PEOPLE IN THE SURROUNDING COMMUNITY ABOUT BEHAVIORAL HEALTH, RELATED RESOURCES, AND SUICIDE PREVENTION.LOCAL SPONSORSHIPS: IN FY19-20, DEACONESS SPONSORED PROGRAMS AND ACTIVITIES FOR MORE THAN 170,000 PEOPLE, CONTRIBUTING $1.1 MILLION IN SUPPORT OF CLUBS, GROUPS, SOCIAL SERVICE ORGANIZATIONS, AND OTHERS STRIVING TO MAKE OUR COMMUNITY A BETTER PLACE. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:DEACONESS HOSPITAL WORKS IN CONCERT WITH DEACONESS HEALTH SYSTEM, DEACONESS CLINIC AND DEACONESS SPECIALTY PHYSICIANS TO PROVIDE HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. DEACONESS HEALTH SYSTEM WORKS TO INCREASE ACCESS TO HEALTHCARE SERVICES WITHIN OUR COMMUNITY THROUGH DEACONESS HOSPITAL AND DEACONESS CLINIC. DEACONESS HOSPITAL IS A MEDICAL INSTITUTION DEDICATED TO PROVIDING QUALITY PATIENT CARE WITH UNRELENTING ATTENTION TO CLINICAL EXCELLENCE, PATIENT SAFETY AND AN UNPARALLELED PASSION AND COMMITMENT TO ASSURE THE VERY BEST HEALTHCARE FOR THE PATIENTS SERVED. DEACONESS CLINIC PROVIDES EXCELLENT PRIMARY AND MULTI-SPECIALTY HEALTHCARE IN A PERSONALIZED FASHION WITH A DEDICATED FOCUS TO SERVE THE COMMUNITY WITH EXCELLENT, TIMELY AND COMPASSIONATE PATIENT CARE.DEACONESS HEALTH SYSTEM HAS PARTNERED WITH MANY RURAL HOSPITALS TO PROVIDE RESOURCES NEEDED SO THAT RESIDENTS IN THESE COMMUNITIES HAVE ACCESS TO CARE CLOSE TO HOME. THESE HOSPITALS INCLUDE FERRELL HOSPITAL AND LAWRENCE COUNTY HOSPITAL IN ILLINOIS, GIBSON COUNTY HOPSITAL IN INDIANA, AND METHODIST HOSPITAL IN KENTUCKY. PART VI, LINE 7, REPORTS FILED WITH STATES IN 1 ALBION FELLOWS BACON CENTER PO BOX 3164 EVANSVILLE IN 47731 311029051 501(C)(3) 10800 CAPITAL CAMPAIGN & GENERAL SUPPORT AMERICAN CANCER SOCIETY 5250 VOGEL RD SUITE A EVANSVILLE IN 47715 131788491 501(C)(3) 10000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 7500 GENERAL SUPPORT AMERICAN RED CROSS 29 S STOCKWELL RD EVANSVILLE IN 47714 530196605 501(C)(3) 10900 GENERAL SUPPORT BOYS & GIRLS CLUB OF EVANSVILLE PO BOX 6311 EVANSVILLE IN 47719 351007558 501(C)(3) 13000 GENERAL SUPPORT & HEALTHY HABITS PROGRAM CHEMO BUDDIES 3699 EPWORTH RD NEWBURGH IN 47630 453043243 501(C)(3) 10000 GENERAL SUPPORT CITY OF EVANSVILLE PARKS SPECIAL DISTRICT 1 NW MARTIN LUTHER KING BLVD ROOM 300 EVANSVILLE IN 47708 356001021 142857 AQUATIC CENTER CAPITAL CAMPAIGN COMMUNITY PATIENT SAFETY COALITION 13113 BROWNING ROAD EVANSVILLE IN 47725 611646052 501(C)(3) 18752 GENERAL SUPPORT DREAM CENTER EVANSVILLE PO BOX 4793 EVANSVILLE IN 47724 352061699 501(C)(3) 11000 GENERAL SUPPORT & POP-UP STORE-COVID ECHO COMMUNITY HEALTH CARE 315 MULBERRY STREET EVANSVILLE IN 47713 351791786 501(C)(3) 30000 FAMILY PRACTCE - MULTICULTURAL CLINIC ECONOMIC DEVELOPMENT COALITION OF SOUTHWEST INDIANA 318 MAIN STREET SUITE 400 EVANSVILLE IN 47708 320152563 501(C)(6) 25000 ONE REGION-ONE ECONOMY-ONE VOICE CAMPAIGN EVANSVILLE REGIONAL BUSINESS COMMITTEE INC ONE VECTREN SQUARE EVANSVILLE IN 47708 030408032 501(C)(3) 15000 GENERAL SUPPORT EVANSVILLE VANDERBURGH SCHOOL CORP 1 SE NINTH STREET EVANSVILLE IN 47708 351071682 501(C)(3) 7250 CLASSROOM SUPPLIES EVANSVILLE-AREA TRAILS COALITION INC PO BOX 5644 EVANSVILLE IN 47716 271556835 501(C)(3) 18000 GENERAL SUPPORT EVANSVILLE-VANDERBURGH COUNTY CONVENTION & VISITORS COMMISSION 4300 HECKEL ROAD EVANSVILLE IN 47725 472582515 501(C)(3) 25000 SUPPORT HEALTH TRAIL HABITAT FOR HUMANITY OF EVANSVILLE 1401 N FARES AVENUE EVANSVILLE IN 47711 351602775 501(C)(3) 50000 GENERAL SUPPORT INDIANA UNIVERSITY FOUNDATION PO BOX 500 BLOOMINGTON IN 47402 356018940 501(C)(3) 100000 IUSM-EVANSVILLE FURNITURE & FIXTURE FUND ISAIAH 117 HOUSE 1705 STATE LINE RD PO BOX 842 ELIZABETHTON TN 37643 820631497 501(C)(3) 15000 GENERAL SUPPORT JUNIOR ACHIEVEMENT OF SW INDIANA 431 E DIAMOND AVENUE EVANSVILLE IN 47711 356048156 501(C)(3) 27940 ADOPT A SCHOOL PROGRAM & GENERAL SUPPORT OAKLAND CITY UNIVERSITY 138 N LUCRETIA STREET OAKLAND CITY IN 47660 350869063 501(C)(3) 50000 CAPITAL CAMPAIGN OTHERS 5000 95081 GENERAL SUPPORT SOUTHERN INDIANA GRADUATE MEDICAL EDUCATION CONSORTIUM INC 515 WALNUT STREET SUITE 4134 EVANSVILLE IN 47708 472044966 501(C)(3) 150000 GENERAL SUPPORT TRI-STATE FOOD BANK 801 E MICHIGAN STREET EVANSVILLE IN 47711 351539870 501(C)(3) 100000 CAPITAL CAMPAIGN UNITED CARING SHELTERS 324 NW SIXTH STREET EVANSVILLE IN 47708 351892153 501(C)(3) 30000 HOMELESS MEDICAL RESPITE & GENERAL SUPPORT UNITED WAY OF SOUTHWESTERN INDIANA PO BOX 18 EVANSVILLE IN 47701 350868069 501(C)(3) 25000 GENERAL SUPPORT WARRICK COUNTY COUNCIL ON AGING INC 150 WEST STATE ROAD 62 BOONVILLE IN 47601 351342279 501(C)(3) 5055 CAPITAL CAMPAIGN WARRICK WELLNESS PATHWAYS LLC PO BOX 906 NEWBURGH IN 47629 464049559 501(C)(3) 50000 SUPPORT HEALTH TRAIL YOUTH FIRST 111 SE THIRD STREET STE 405 EVANSVILLE IN 47708 352050168 501(C)(3) 15000 GENERAL SUPPORT YWCA 118 VINE ST EVANSVILLE IN 47708 350869075 501(C)(3) 10000 GENERAL SUPPORT 26 2 PART I, LINE 2: DEACONESS HOSPITAL CONFIRMS ALL RECIPIENTS OF FUNDS ARE ORGANIZATIONS WHOSE GOALS COINCIDE WITH DEACONESS' MISSION OF PROVIDING QUALITY HEALTH CARE WITH A COMPASSIONATE AND CARING SPIRIT. THE ORGANIZATIONS PROVIDE NEEDED SERVICES TO OUR COMMUNITY TO IMPROVE HEALTH AND WELLNESS FOR THE CITIZENS IN THE SURROUNDING AREA. X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 SHAWN MCCOY CEO OF DEACONESS HEALTH SYSTEM, INC. 399881 407500 211960 0 164898 9800 111693 96953 18712 18712 907144 532965 79190 79190 MAQBOOL AHMED MD DIRECTOR 0 824804 0 36593 720 9991 0 16845 0 2185 720 890418 0 0 SCOTT CORDTS MD DIRECTOR 239814 0 44865 0 25907 3800 21116 0 24184 0 355886 3800 0 0 BARRY PHILLIPS MD DIRECTOR 0 341895 0 75763 7650 6597 0 22822 0 24025 7650 471102 0 0 DAVID RYON MD DIRECTOR 293260 0 92012 0 61795 10450 19533 0 25489 0 492089 10450 0 0 CHERYL WATHEN CHIEF FINANCIAL OFFICER 251595 259972 97740 0 103581 10200 84900 54972 18829 18829 556645 343973 48884 48884 JAMES PORTER MD PRESIDENT OF DEACONESS HEALTH SYSTEM 584653 0 132813 0 389394 2400 153362 0 33389 0 1293611 2400 386524 0 CHERONA HAJEWSKI CHIEF NURSING OFFICER 318084 0 60843 0 63739 0 91118 0 27557 0 561341 0 55668 0 LYNN LINGAFELTER CHIEF OPERATION OFFICER 389906 44052 79399 0 63400 4000 101561 0 15513 12499 649779 60551 60449 0 HERMAN BLANTON MD CHIEF MEDICAL OFFICER 320976 81762 76849 0 212113 0 73033 13742 9469 9469 692440 104973 207708 0 MARC FLORENCE VICE PRESIDENT 252364 65209 59474 0 45884 0 69893 2030 16475 16475 444090 83714 42296 0 CAROLYN MORTON PHARMACY AND LAB DIRECTOR 195372 0 28229 0 1403 0 15615 0 28122 0 268741 0 0 0 SUSAN BRUMLEY IMAGING AND CARDIOVASCULAR SERVICES 169052 0 21981 0 1405 0 13060 0 25874 0 231372 0 0 0 RAGHAV GUPTA MD ANESTHESIOLOGIST 368545 0 576275 0 36026 0 15262 0 24969 0 1021077 0 0 0 VENKATESH MADADI MD ANESTHESIOLOGIST 800896 0 0 0 70596 0 27164 0 25152 0 923808 0 0 0 NIRMAL JOSHI MD ANESTHESIOLOGIST 568177 0 0 0 231174 0 22236 0 27782 0 849369 0 0 0 DAVID FISH MD ANESTHESIOLOGIST 634375 0 0 0 130952 0 16845 0 24231 0 806403 0 0 0 RYAN NEAL MD ANESTHESIOLOGIST 666795 0 5000 0 85544 0 15262 0 25491 0 798092 0 0 0 LINDA WHITE FORMER CEO EMERITA, FOUNDATION EXEC. 123371 0 16242 0 56452 4800 6720 0 7353 0 210138 4800 11215 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR LINDA WHITE AND SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEES. PART I, LINE 4B SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED SHAWN MCCOY $-0- $19,000 $-0- JAMES PORTER, MD 0 19,000 0 CHERONA HAJEWSKI 0 19,000 0 DAVID RYON, MD 0 19,000 0 VENKATESH MADADI, MD 0 19,000 0 RAGHAV GUPTA, MD 0 19,000 0 NIRMAL JOSHI, MD 0 19,000 0 CHERYL WATHEN 0 19,000 0 LYNN LINGAFELTER 0 19,000 0 MAQBOOL AHMED, MD 0 19,000 0 MARC FLORENCE 0 19,000 0 HERMAN BLANTON, MD 0 19,000 0 PART I, 4B: SHAWN MCCOY: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $182,870 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $158,381 CHERYL WATHEN: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $100,184 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $97,768 JAMES PORTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $122,487 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $386,524 CHERONA HAJEWSKI: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $51,936 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $3,732 LYNN LINGAFELTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $77,613 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $60,449 HERMAN BLANTON: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $71,513 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $207,708 MARC FLORENCE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $52,390 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $42,296 LINDA WHITE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $0 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $11,215 PART I, LINE 6 COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANIZATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. A INDIANA FINANCE AUTHORITY-2016A 351602316 45506DXT7 2016-10-05 109999091 NEW MONEY PROJECTS 0 0 0 B INDIANA FINANCE AUTHORITY-2015A 351602316 45506DUL7 2015-07-09 49772341 03/6/2009 REFUNDING 0 0 0 C INDIANA FINANCE AUTHORITY-2013C 351602316 45471ALU4 2013-07-23 40180000 3/26/09 REFUNDING 0 0 0 D INDIANA FINANCE AUTHORITY-2013B 351602316 2013-03-05 21440000 5/27/04 REFUNDING 0 0 0 A 111373335 4660332 935528 2885418 102892057 2018 0 0 1 1 B 830000 49772341 601847 49170494 0 1 1 1 C 2235000 40180000 180000 40000000 1 0 1 1 D 7880000 21440000 125000 21315000 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 1 0 1 1 FIFTH THIRD 16.000000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: INDIANA FINANCE AUTHORITY-2013A DATE THE REBATE COMPUTATION WAS PERFORMED: 06/22/2015 ISSUER NAME: INDIANA FINANCE AUTHORITY-2012B DATE THE REBATE COMPUTATION WAS PERFORMED: 06/22/2015 PART II, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. A INDIANA FINANCE AUTHORITY-2013A 351602316 45471AKY7 2013-03-05 71336168 5/27/04 AND 3/26/09 REFUNDING 0 0 0 B INDIANA FINANCE AUTHORITY-2012B 351602316 2012-11-20 13005000 1/17/1992 REFUNDING 0 0 0 C INDIANA FINANCE AUTHORITY-2011A 351602316 45471AES7 2011-12-02 20667197 3/15/99 REFUNDING 0 0 0 A 3295000 71336168 729538 70606631 1 0 1 1 B 9605000 13005000 103657 12901343 1 0 1 1 C 8190000 20667197 397197 20270000 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 ABBY PAPARIELLA SEE PART V 58398 COMP. 0 BRITTNEY PHIPPS SEE PART V 57084 COMP. 0 EVANSVILLE SURGICAL ASSOCIATES SEE PART V 3578295 MEDICAL SERVICES 0 SOUTH WESTERN COMMUNICATIONS SEE PART V 293329 ORTHOTIC SUPPLIES 0 JESSICA COX SEE PART V 112772 COMP. 0 JOAN MCCOY SEE PART V 52656 COMP. 0 MARY BETH COLE SEE PART V 40389 COMP. 0 MISTY ADYE SEE PART V 44186 COMP. 0 OLD NATIONAL BANK SEE PART V 267979 INVESTMENT MANAGEMENT FEES 0 SHERRI MCCOY SEE PART V 22528 COMP. 0 UNIVERSITY OF SOUTHERN INDIANA SEE PART V 34689 SUPPORT 0 LINDA HOOVER SEE PART V 10125 COMP. 0 LAUREN WATHEN SEE PART V 11691 COMP. 0 SCH L, PART IV, ABBREVIATION: BD MBR = BOARD MEMBERCOMP. = REPORTABLE COMPENSATIONSRVS. = SERVICES SCH L, PART V, RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: INTERESTED PERSON: ABBY PAPARIELLARELATIONSHIP: DAUGHTER OF DAVE PAPARIELLAINTERESTED PERSON: BRITTNEY PHIPPSRELATIONSHIP: DAUGHTER OF DAVE PAPARIELLAINTERESTED PERSON: EVANSVILLE SURGICAL ASSOCIATES RELATIONSHIP: BOARD MEMBER BRUCE ADYE IS A MEMBER OF ESA. EVANSVILLE SURGICAL ASSOCIATES PROVIDES TRAUMA COVERAGE AS WELL AS OTHER MEDICAL SERVICES.INTERESTED PERSON: SOUTH WESTERN COMMUNICATIONSRELATIONSHIP: BOARD MEMBER KEVIN KOCH IS THE CHAIRMAN OF SOUTH WESTERN COMMUNICATIONS. SOUTH WESTERN COMMUNICATIONS PROVIDES MEDICAL SERVICES.INTERESTED PERSON: JESSICA COXRELATIONSHIP: DAUGHTER TO LYNN LINGAFELTERINTERESTED PERSON: JOAN MCCOYRELATIONSHIP: WIFE OF SHAWN MCCOYINTERESTED PERSON: MARY BETH COLERELATIONSHIP: SISTER TO STEPHEN TITZERINTERESTED PERSON: MISTY ADYERELATIONSHIP: WIFE OF BOARD MEMBER BRUCE ADYEINTERESTED PERSON: OLD NATIONAL BANKRELATIONSHIP: BOARD MEMBER JAMES RYAN IS THE CFO OF OLD NATIONAL BANK. OLD NATIONAL BANK PROVIDES INVESTMENT MANAGEMENT SERVICES.INTERESTED PERSON: SHERRI MCCOYRELATIONSHIP: SISTER OF SHAWN MCCOYINTERESTED PERSON: UNIVERSITY OF SOUTHERN INDIANARELATIONSHIP: BOARD MEMBER RON ROCHON IS PRESIDENT OF UNIVERSITY OF SOUTHERN INDIANA. DEACONESS HOSPITAL PROVIDES GENERAL SUPPORT AND HEALTH PROFESSION SCHOLARSHIPS TO THE UNIVERSITY.INTERESTED PERSON: LINDA HOOVERRELATIONSHIP: MOTHER-IN-LAW OF DOUG WELPINTERESTED PERSON: LAUREN WATHERNRELATIONSHIP: DAUGHTER TO CHERYL WATHEN X OTHER 0 52895 FMV 0 1 0 FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION: DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. AT DEACONESS HOSPITAL, OUR VALUES ARE BASED ON OUR COMMITMENT TO QUALITY. WE DEFINE QUALITY AS THE CONTINUOUS IMPROVEMENT OF SERVICES TO MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF THE CUSTOMERS WE SERVE. OUR VALUES ARE QUALITY IN EVERYTHING WE DO, RESPECT FOR ALL PEOPLE, EFFICIENCY AND EFFECTIVENESS IN THE USE OF RESOURCES, INNOVATION TOWARD CONTINUOUS SYSTEMS IMPROVEMENT, PARTNERSHIP WITH THOSE WE SERVE AND WITH SUPPLIERS, EDUCATION FOR CONTINUOUS GROWTH AND KNOWLEDGE AND PRIDE IN WORKMANSHIP. TO ACCOMPLISH ITS MISSION, DEACONESS HOSPITAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THE PEOPLE OF THE TRI-STATE BY DEMONSTRATING EXCELLENCE IN HEALTHCARE SERVICES, PROVIDING ACCESS TO HEALTHCARE, PROVIDING CHARITY CARE TO THOSE IN NEED,PROMOTING HEALTHY LIFESTYLES, OFFERING SPIRITUAL AND PSYCHOLOGICAL SUPPORT, SUPPORTING HEALTH RELATED EDUCATION, AND ADVANCING HEALTH KNOWLEDGE THROUGH RESEARCH. FORM 990, PART III, LINE 4A PROGRAM SERVICES ACCOMPLISHMENT 1: PATIENT SERVICE REVENUE. DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 26 COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 267 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 41 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 44 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 44 MEDICAL/ SURGICAL BEDS, 39 MEDICAL RENAL BEDS, AND 18 BEDS DEDICATED TO PATIENTS IN OBSERVATION. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 278 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 48 ORTHOPAEDIC BEDS, 48 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS, 48 GENERAL MED/ TELEMETRY BEDS, 24 CARDIAC BEDS, AND 32 BEDS DEDICATED TO PATIENTS IN OBSERVATION. THE ORTHOPEDIC NEUROSCIENCE HOSPITAL OPENED ON THE GATEWAY CAMPUS IN MAY OF 2018. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60 BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE. FORM 990, PART III, LINE 4B PROGRAM SERVICES ACCOMPLISHMENT 2: CHARITY CARE/ SUBSIDIZED CARE. DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES AVAILABLE FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY ARE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. DEACONESS HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT OF REIMBURSEMENT IS BELOW COST, DEACONESS HOSPITAL ABSORBS THESE COSTS IN MEETING ITS MISSION TO THE COMMUNITY. IN SUPPORT OF ITS MISSION, DEACONESS HOSPITAL PROVIDED $18.2 MILLION OF CHARITY CARE AND $42.5 MILLION OF SUBSIDIZED SERVICES TO THE MEDICAID PROGRAM, AND $97.3 MILLION OF SUBSIDIZED SERVICES TO THE MEDICARE PROGRAM. FORM 990, PART III, LINE 4C PROGRAM SERVICES ACCOMPLISHMENT 3: GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION & COMMUNITY BENEFITS. DEACONESS HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM AND A POST-GRADUATE PHARMACY RESIDENCY PROGRAM. DEACONESS HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, COMMUNITY HEALTH PROGRAMS AND A CHAPLAIN RESIDENCY PROGRAM. IN ADDITION TO EDUCATIONAL SERVICES, DEACONESS HOSPITAL PROVIDED $10.1 MILLION IN COMMUNITY BENEFIT ACTIVITIES (ALL ON A COST BASIS), SERVING A MINIMUM OF 996,563 PEOPLE WITHIN THE TRI-STATE AREA. FORM 990, PART VI, SECTION A, LINE 6 CLASS OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF DEACONESS HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF GOVERNING BODY: THE BOARD OF DIRECTORS MAY ELECT ONE OR MORE NON-MEDICAL STAFF MEMBERS OF THE GOVERNING BODY THROUGH AN APPROVED ELECTION AND APPROVAL PROCESS. THE ELECTION AND APPROVAL PROCESS FOR NON-MEDICAL STAFF MEMBERS BEGINS WITH A RECOMMENDATION BY THE GOVERNANCE COMMITTEE FOR MEMBERSHIP TO THE BOARD OF DIRECTORS. THAT RECOMMENDATION IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. DEPENDING ON THE DECISION REACHED BY THE BOARD OF DIRECTORS, MEMBERSHIP MAY OR MAY NOT BE GRANTED TO THAT INDIVIDUAL. MEDICAL STAFF EXECUTIVE COUNCIL LEADERSHIP ARE APPOINTED TO BOARD OF DIRECTOR MEMBERSHIP THROUGH THEIR POSITION AS ELECTED MEDICAL STAFF LEADERS. THROUGH THE ELECTION PROCESS OF THE MEDICAL STAFF EXECUTIVE COUNCIL, THEIR APPOINTMENT IS CONFIRMED AND APPROVED. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE PROCESS THAT DEACONESS HOSPITAL UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND, ANNUALLY, THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE AND/OR "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: DEACONESS HOSPITAL UTILIZES A COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICE COMPENSATION 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: DEACONESS HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. DEACONESS HOSPITAL IS PART OF A CONSOLIDATED FINANCIAL STATEMENT WHICH IS AVAILABLE WITH THE PUBLIC DISCLOSURE COPY OF THE IRS FORM 990. ALSO, AS REQUIRED BY LAW, THE HOSPITAL SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 122,557,289. MANAGEMENT AND GENERAL EXPENSES 2,328,130. FUNDRAISING EXPENSES 20,525. TOTAL EXPENSES 124,905,944. PROFESSIONAL FEES- PHYSICIANS: PROGRAM SERVICE EXPENSES 14,444,033. MANAGEMENT AND GENERAL EXPENSES 89,693. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,533,726. FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY -10,305,811. FOUNDATION MONIES GRANTED FROM RESTRICTION -1,086,878. CHANGE IN GENERAL FUND EQUITY -73,184,847. CHANGE IN UNREALIZED GAIN/LOSS ON INVESTMENTS/SWAP 45,448,496. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. 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