2019-11-10T20:31:46-06:00 2018-12-31 ERNST & YOUNG US LLP 155 N WACKER DRIVE 20 FLOOR CHICAGO IL 60606 990 2018-01-01 350877574 Elkhart General Hospital Inc % JEFFREY COSTELLO ELKH 5745233208 600 EAST BLVD ELKHART IN 46514 JEFFREY COSTELLO CFO 5746473549 2019-11-07 true JACOB J ZEHNDER P01564049 3128792702 24.13.63.122 36964520193145000003 2019-11-10 P 83B848044178BF92E2949FEFB11BC23E77ECEDC2 3D6D3C2D4C8BC107A1740E261440CB51ACA7B417 2018 2020-04-17 16:48:07Z CARL RISK 600 EAST BLVD ELKHART IN 46514 317710183 false X www.beaconhealthsystem.org X 1909 IN SEE SCHEDULE O 7 7 2165 177 299721 249150 66594 295366729 313131282 213027 -274943 3645762 3720756 299474668 316643689 215853 363471 0 0 102612211 107155638 0 0 0 177760242 177644726 280588306 285163835 18886362 31479854 274650255 264437301 109080292 96689255 165569963 167748046 X TO CREATE A HEALTHIER COMMUNITY BY BEING A PREMIER PROVIDER OF HEALTHCARE; PROMOTING THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILIES BY PROVIDING EDUCATION THAT MAY AID IN DETECTION AND PREVENTION OF DISEASE; CONDUCTING OUR ACTIVITIES WITH COMPASSION AND RESPECT; ACTING WITH RECOGNITION THAT HEALTH IS HOLISTIC AND EMBRACES THE BODY, MIND, AND SPIRIT; SEEKING AND PARTNERING WITH THOSE WHO SHARE OUR MISSION; CONTINUOUSLY IMPROVING THE QUALITY AND COST-EFFECTIVENESS OF OUR SERVICES; MAINTAINING THE FINANCIAL VIABILITY OF THE HOSPITAL WHILE CONTINUING OUR CHARITABLE ROLE IN THE COMMUNITY. false false 267584712 363471 314132097 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 2018, the Hospital admitted 10,448 patients for a total of 42,916 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 services for 160,318 of outpatient visits including 3,918 outpatient surgeries, 56,478 emergency room visits, and 99,922 visits for diagnostic services. During 2018, the unreimbursed cost of free or discounted medical care provided to patients that were deemed indigent under state, county, or internal guidelines was $2,048,038. Elkhart General Hospital also provided $36,291,762 in unreimbursed care to the elderly covered by Medicare, and $2,296,596 in Charity Care. 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 $590,000 in unbilled services to the poor and broader community. 267584712 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 false false false false false false false false false false false false false false true true true false false true 180 0 true 2165 true true true false false false false false false false false false false false X 7 7 false false false false true true true true true false false true true true true true true false false false IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 X Wilbur Bontrager Chair THRU 3/2018 2.0 0.0 X X 150 0 0 Bruce Newswanger DO Director 2.0 0.0 X 1370 0 0 Matthew Pletcher CHAIR 2.0 0.0 X X 450 0 0 Leonard Kibiloski MD Secretary 2.0 0.0 X X 1370 0 0 Kelly Puster MD DIRECTOR 2.0 0.0 X 0 0 0 Tim Shelly VICE CHAIR 2.0 0.0 X X 1370 0 0 JOHN DEPUTY DIRECTOR 2.0 0.0 X 1370 0 0 SAMIR PATEL MD DIRECTOR THRU 9/2018 2.0 2.0 X 0 0 0 AMISH SHAH DIRECTOR THRU 4/2018 2.0 2.0 X 1520 0 0 SHELLEY MOORE DIRECTOR 2.0 0.0 X 196 0 0 Jeffrey P Costello CFO/Asst. Treasurer 2.0 48.0 X 0 773461 184073 Phillip A Newbold CEO THRU 10/2017 0.0 0.0 X 0 619376 15351 KREG R GRUBER CEO 2.0 48.0 X 0 1099330 235802 Carl W Risk II President 40.0 0.0 X 382778 0 83574 CINDIE L MCPHIE VP OF OPERATIONS 40.0 0.0 X 190078 0 15201 LIANG Q WANG SENIOR PHYSICIST 40.0 0.0 X 233498 0 29031 Maria A Behr Director of Pharmacy 40.0 0.0 X 187223 0 17150 JAMES E CANTRELL PERFUSIONIST 40.0 0.0 X 199601 0 29627 DONALD G JANSEN VP OF MEDICAL AFFAIRS 40.0 0.0 X 350902 0 10077 1551876 2492167 619886 64 false true false South Bend Medical Foundation 530 North Lafayette Blvd SOUTH BEND IN 46601 Lab Services 6201752 Northern Indiana Anesthesia Service 600 East Bvld ELKHART IN 46514 Anesthesia Services 4750340 APOGEE PHYSICIANS 2525 E CAMELBACK RD PHOENIX AZ 85016 PHYSICIAN SERVICES 2995855 R1 RCM INC 401 NORTH MICHIGAN AVE CHICAGO IL 60611 CONTRACT SERVICES 1025119 OTIS EVEVATOR 50841 PRINCESS WAYSTE1 CHICAGO IL 46530 CONTRACT SVC/REPAIRS 920023 56 41600 24994 66594 PATIENT SERVICE REVENUE 622110 307605435 307605435 OUTPATIENT PHARMACY 446110 4154326 232331 3921995 RENT FROM RELATED PARTIES 622110 1331849 1331849 MEDICAL EDUCATION 611710 39672 39672 313131282 21651 21651 0 0 1234756 417248 817508 0 817508 817508 352652 649246 -296594 -296594 -296594 0 0 0 0 0 0 0 0 0 REBATES AND DISCOUNTS 622110 1016977 1016977 CAFETERIA 722514 818066 818066 PHYSICIAN REIMBURSEMENT 611710 145309 145309 922896 855506 67390 2903248 316643689 309977771 299721 6299603 315465 315465 48006 48006 0 0 474148 474148 0 81644777 75052697 6592080 4217564 3915483 302081 15178050 13904959 1273091 5641099 5161606 479493 7599937 6953942 645995 119111 119111 131328 131328 10514 10514 0 182449 182449 21018348 19228670 1789678 38395 35131 3264 2964581 2711700 252881 27130 24824 2306 0 3015617 2744094 271523 212328 194280 18048 0 186476 170626 15850 1908431 1746214 162217 0 17768123 16254235 1513888 1295019 1184942 110077 PATIENT SUPPLIES, DRUGS 55703714 55703714 0 0 BAD DEBT EXPENSE 27473812 27473812 0 0 HOSPITAL ASSESSMENT FEE 13444535 12301750 1142785 0 CORPORATE ALLOCATION FEES 23031125 21073479 1957646 0 1513753 1385083 128670 285163835 267584712 17579123 0 9585 8876 14505066 13327898 0 4995 47390928 49650816 0 0 0 0 92792 115046 7075885 6969871 968412 1348109 376646535 195121381 193534060 181525154 6722517 6558030 445366 21678 26357 0 2536226 2536226 1343061 2370602 274650255 264437301 21956186 23822002 0 0 0 0 74089968 70981828 0 0 0 0 0 0 0 0 13034138 1885425 109080292 96689255 X 158402080 161168338 6767883 6179708 400000 400000 165569963 167748046 274650255 264437301 X 31479854 -588175 -28713596 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10514 10514 false Part II-B, Line 1i Elkhart General Hospital pays the dues TO THE FOLLOWING ORGANIZATION FOR WHICH THE PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: INDIANA HOSPITAL ASSOCIATION - 22.73% GREATER ELKHART CHAMBER OF COMMERCE - 2.5% WHEN UNABLE TO ASCERTAIN ALLOCATION OF DUES ATTRIBUTED TO LOBBYING A CONSERVATIVE ESTIMATE OF 23% IS APPLIED BASED ON THE INDIANA HOSPITAL ASSOCIATION PERCENTAGE. 41373022 1352757 -2805752 2243989 261618 0 37414420 40368863 2155261 3423343 4284345 249461 40639 41373022 32772897 9605449 850963 2645907 178250 36289 40368863 36228784 4093832 -1549515 5789367 174135 36702 32772897 33921099 2833644 330764 714487 125000 17236 36228784 0.66820 0.01270 0.31910 false true true 3846371 3846371 254068554 114808417 139260137 117263225 80312964 36950261 1468385 1468385 181525154 0 ACCRUED PENSION LIABILITY 1811713 CAPITAL LEASES 73712 1885425 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 $6,579,708. 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 $37,414,420 at 12/31/2018. In 2018, 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, 2018 or 2017. true true X true X true X true true true false true true 1958860 1958860 0.00760 45811803 31441271 14370532 0.05580 47770663 31441271 16329392 0.06340 602020 12465 589555 0.00230 765681 39672 726009 0.00280 164500 164500 0.00060 1532201 52137 1480064 0.00570 49302864 31493408 17809456 0.06910 true 7409687 3704844 56808630 92917471 -36108841 X true true 1 1 Elkhart General Hospital Inc 600 East Blvd Elkhart IN 46514 www.beaconhealthsystem.org 16-005017-1 X X X Elkhart General Hospital Inc 1 false false true X X X X X X X X X 18 true true false true X beaconhealthsystem.org/CHNA X X true 19 true 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 The data collection and analysis process started in February and concluded on September 2018. The key findings were consolidated in two reports: the first provided a snapshot of the three-county overall health status, and the second focused on the health needs of children in Elkhart, St. Joseph and Marshall counties. The Key Informant Survey collected information from March 28th to August 20th, 2018. The Community Survey was launched on May 7th and was closed on August 20th, 2018. The methodology followed for the needs assessment was based on 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. Since community engagement and feedback are essential to the integrity and validity of the CHNA process, input was actively solicited and secured from three sources (elaborated below) to understand community health needs. To ensure a representative sample of the community completed the community survey, a special effort was made to get feedback from hard to reach and minority populations. In addition to the survey being pushed out through digital platforms and listservs in both English and Spanish, the BCH/enFocus team partnered with 35 different organizations to collect feedback and attended 8 community events (listed below) to directly target individuals who typically do not complete community surveys. BCH's partner organizations provided recommendations and restrictions for creating a variety of strategies to engage these harder-to reach samples within the tri-county population. 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 along with Enfocus also 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: St. Joseph County: - 100 Black Men of SJC - Center for the Homeless - Community Foundation of St. Joseph County - Goodwill Industries - Hope Ministries - Imani Unidad - IUSB Division of Health Sciences - IUSB School of Nursing - Ivy Tech Community College - La Casa de Amistad - The LGBTQ Center - Notre Dame - South Bend Community School Corporation - South Bend-Elkhart Regional Partnership - South Bend Heritage Foundation - South Bend Veterans Center - St. Joseph County Public Library - St. Margaret's House - TREES, Inc - United Church of Christ - United Religious Community - United Way - Youth Service Bureau South Bend Elkhart County: - Community Foundation of Elkhart County - Church Community Services - Elkhart County Public Library - Faith Mission of Elkhart - Greater Elkhart Chamber of Commerce - Heart City Health - Mosaic Health & Healing Arts - Minority Health Coalition - Northern Indiana Hispanic Health Coalition - RETA - Reason Enough to Act - Ribbon of Hope Cancer Support - United Health Services Marshall County: -Bowen Center hosting Marshall County System of Care and United Way of Marshall County Additional efforts were made to reach the at-risk individuals in the community. Beacon and Enfocus solicited and received input from the vulnerable and broader community by attending the following community events. Community Outreach Events: - Faith Mission of Elkhart - Elkhart County Public Library - Best Week Ever - St. Joseph County Public Library - Minority Health Coalition - Northern Indiana Hispanic Health Coalition - Center for the Homeless - Heart City Health The assessment process identified four health priorities that can be streamlined into the essential components of Beacon Health System's mission. The Healthy Mind, Healthy Body, Healthy Spirit and Healthy Families pillars 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 2018 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 transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums. PART V, SECTION B, LINE 11 Implementation Strategies - As a general rule, the implementation of any of the four strategies will take into consideration the following approaches: 1) the program should address discrete factors, such as knowledge, beliefs and skills, at individual and family levels; and 2) the program should address context factors such as social support, available resources and services, and access barriers to financial/physical/information resources, at family and community levels. By addressing risk and protective factors in a comprehensive way, BHS acknowledges the fact that comorbidities are very likely to happen to chronic disease patients, because different health issues or disorders share the same risk factors, so the interventions addressing such factors are reasonably expected to reduce the prevalence of these multiple conditions. Healthy Body - Obesity/ Overweight Current Gap: - Obesity rates in 2017 for EC (14.5%), MC (15.2%) and SJC (14.3%) are higher than IN. - 1 in 3 children ages 10-17 are overweight or obese (33.9%), - According to WIC, by 2017, 13.5% of children between 2-5 years of age who were part of the program were obese. Intended Health Outcome: - By the end of the program cycle, obesity and overweight rates are reduced through the adoption of individual habits of healthier nutrition and increased physical activity. Behavioral Objective: -By the end of the program cycle, participants are consuming enough healthier food to cover their caloric needs and are engaged in regular physical activity, in accordance to attitudes and practices promoted by BHS. Rationale: -Obesity results from a combination of causes and contributing factors, including individual factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. -Obesity is often associated with poorer mental health outcomes, reduced quality of life, and the leading causes of death in the U.S. and worldwide, including diabetes, heart disease, stroke, and some types of cancer. Healthy Mind - Mental Health Current Gap: -The prevalence estimates for the IN North Central Region show that 4.7% of resident adults have suffered from a serious mental illness (diagnoses resulting in serious functional impairment). -EC and SJC averaged 4.2 days of poor mental in the past 30 days before being surveyed. Intended Health Outcome: -By the end of the program cycle, participants are better able to cope with mental and emotional distress through enhanced community capacities (ability to provide mental health services). Behavioral Objective: -By the end of the program cycle, participants' socioemotional competences to reduce mental and emotional distress are strengthened. Rationale: -Conditions like depression, anxiety, bipolar disorder, or schizophrenia, among many others, may occur occasionally or over a long period, affecting people's ability to have a normal social life and be functional on a daily basis. - Mental illness, especially depression, increases the risk for many types of physical health problems, particularly long-lasting conditions like stroke, type 2 diabetes, and heart disease. Similarly, the presence of chronic conditions can increase the risk for mental illness. -Several factors can contribute to risk for mental illness, such as A 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 $27,473,812 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 2018 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 30% 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. 2. Needs Assessment Beacon Community Impact formed the first Community Health Advisory Council in 2016. Still going and operating fully 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 Collect, 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 MULTIPLEA 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. 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. As health system representing three the hospitals of the three communities served, St. Joseph County is a mixture of urban and rural (270,434), Elkhart (205,032) and Marshall (47,051) Counties are rural. Across all three communities, 2016 Census data show youth under 18 years of age comprise 24-28% of the population; ages 65+ are 15-17%. African Americans represent 1% of the population in Marshall, 6% in Elkhart and 13% in St. Joseph. The Hispanic/Latino population is 9% in St. Joseph County, 10% in Marshall and 16% in Elkhart. Unemployment rates varied from 4-5% across the three counties. County Health Rankings indicate 15% of the population in Elkhart and Marshall were without health insurance in 2015, 9% in St. Joseph. The rate of persons living below the poverty level was 11% in Elkhart, 12% in Marshall, and 16% in St. Joseph. Median household income was 52,449 in Elkhart, 48,121 in St. Joseph and $51,869 in Marshall. 5. Promotion of Community Health The mission of Elkhart General Hospital, as a Beacon Health System partner, is to enhance the physical, mental, emotional and spiritual well-being of the communities we serve. 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. The 8-member 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. 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) 7000 CASH MEDICAL/ADVOCACY SVC ECONOMIC DEVELOPMENT CORP 300 BIBCO PARKWAY ELKHART IN 46516 351973845 501(C)(3) 10000 CASH FINANCIAL INVESTMENT HORIZON HEALTH ALLIANCE 124 E WASHINGTON ST GOSHEN IN 46528 460803293 501(C)(3) 25000 CASH PARENTING PROGRAM FOUNDATION FOR THE CENTER FOR HOSPICE 111 SUNNYBROOK CT SOUTH BEND IN 46637 300433147 501(C)(3) 15000 CASH HONORING CHOICES ELKHART COUNTY HEALTH DEPARTMENT 117 N SECOND STREET GOSHEN IN 46526 356000142 501(C)(3) 25000 CASH PRENATAL CARE BETHEL COLLEGE 1001 BETHEL CIRCLE MISHAWAKA IN 46545 350935587 501(C)(3) 35000 CASH NURSING LAB DONATION INDIANA UNIVERSITY FOUNDATION PO BOX 500 BLOOMINGTON IN 47402 356018940 501(C)(3) 20000 CASH MEDICINE BALL YWCA 1102 S FELLOWS ST SOUTH BEND IN 46617 350868226 501(C)(3) 10000 CASH DOMESTIC ABUSE PROGRAMS AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 355613797 501(C)(3) 20000 CASH GO RED FOR WOMEN THE CENTER FOR THE HOMELESS 813 SOUTH MICHIGAN SOUTH BEND IN 46601 351768544 501(C)(3) 32000 CASH AUCTION SPONSOR 13 TRANSPORTATION SERVICES 167 48006 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 ALL 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 X X true true false true false false false false false true false Jeffrey P Costello CFO/Asst. Treasurer 0 494865 0 161286 0 117310 0 164827 0 19246 0 957534 0 73501 Phillip A Newbold CEO THRU 10/2017 0 218903 0 200000 0 200473 0 11000 0 4351 0 634727 0 197121 CINDIE L MCPHIE VP OF OPERATIONS 177815 0 10661 0 1602 0 7213 0 7988 0 205279 0 0 0 LIANG Q WANG SENIOR PHYSICIST 223520 0 0 0 9978 0 9479 0 19552 0 262529 0 0 0 KREG R GRUBER CEO 0 736877 0 260000 0 102453 0 207845 0 27957 0 1335132 0 75198 Maria A Behr Director of Pharmacy 175931 0 5090 0 6202 0 7558 0 9592 0 204373 0 0 0 Carl W Risk II President 338226 0 37952 0 6600 0 61653 0 21921 0 466352 0 0 0 JAMES E CANTRELL PERFUSIONIST 156493 0 40000 0 3108 0 6260 0 23367 0 229228 0 0 0 DONALD G JANSEN VP OF MEDICAL AFFAIRS 318392 0 10000 0 22510 0 0 0 10077 0 360979 0 0 0 Supplemental Compensation Information PART I, LINE 1A ELKHART GENERAL HOSPITAL, INC. REIMBURSES DIRECTORS FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS OF COMPLIMENTARY USE OF BEACON'S HEALTH AND LIFESTYLE CENTER AND FOR SPOUSAL TRAVEL. BEACON HEALTH SYSTEM REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. SPOUSAL TRAVEL FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: MATTHEW PLETCHER. HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: TIM SHELLY, LEONARD KIBILOWSKI, MD, BRUCE NEWSWANGER, DO, JOHN DEPUTY, AMISH SHAH, AND SHELLEY MOORE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: TIM SHELLY, LEONARD KIBILOSKI, MD, BRUCE NEWSWANGER, DO, JOHN DEPUTY, AND AMISH SHAH. 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 REPORTING 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 2018, REFLECTED IN COLUMN (B)(III): PHIL NEWBOLD $198,860 KREG GRUBER $92,073 JEFFREY COSTELLO $86,519 THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED PAYMENTS IN 2018 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: KREG GRUBER $131,845 JEFFREY COSTELLO $88,826 CARL RISK $50,653 BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE LONGEVITY BONUS PLAN FOR THE PURPOSE OF PROVIDING A LONGEVITY BONUS FOR ITS' DESIGNATED EXECUTIVES. THIS UNFUNDED PLAN WAS EFFECTIVE APRIL 1, 2014. THE PARTICIPANTS MUST REMAIN IN AN ACTIVE EMPLOYMENT STATUS WITH BEACON FOR A PERIOD OF 5 CONSECUTIVE YEARS FROM THE EFFECTIVE DATE TO BE ELIGIBLE TO RECEIVE THE FULL LONGEVITY BONUS AMOUNT AT WHICH TIME VESTING IS 100%. VESTING PRIOR TO THE 5 YEARS IS AT 0%. THE MAXIMUM BONUS AWARD AT 100% VESTING IS $325,000. THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2018 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: JEFFREY COSTELLO, $65,000 KREG GRUBER, $65,000 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 PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET OPERATING INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. THE PAYOUT OF THE MANAGEMENT INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP PLAN PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETS OPERATING INCOMES. 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 false false false A 0 0 40210000 0 0 0 0 0 0 0 40210000 0 2017 true false true true B 8319279 0 38582380 0 0 0 134933 0 0 0 38275235 0 2013 true false true true A false true true true false 0.01900 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 REFUNDING, 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. MISSION STATEMENT FORM 990, PART I, LINE 1 ELKHART GENERAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY VOLUNTEERS. EMPHASIS IS PLACED ON ENSURING EVERYONE IN THE COMMUNITY RECEIVES THE HEALTH CARE THEY NEED. 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 Chief of the Medical Staff of the Corporation shall be an additional non-voting ex officio member of the Board of Directors, so long as such individual holds the position of Chief of the Medical Staff of the Corporation. 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. Changes to the Articles of Incorporation or Bylaws of Elkhart General Hospital. 2. Appointing or removing with or without cause, the members of the Board, provided, however, that the process of appointment and removal of members of the Board of Elkhart General Hospital shall be as set forth in Elkhart General Hospital's Bylaws, and that appointment of members of the Board of Elkhart General Hospital shall be upon the recommendation of Beacon Health System's Nominating and Governance Committee. 3. The incurrence of debt of Elkhart General Hospital. 4. The sale, transfer or substantial change in use of all or substantially all of the assets of Elkhart General Hospital or the divestiture, dissolution, closure, merger, consolidation, change in corporate membership or ownership, or corporate reorganization of Elkhart General Hospital. 5. The formation of a subsidiary of Elkhart General Hospital, or the sale, transfer or substantial change in use of all or substantially all of the assets of a subsidiary of Elkhart General Hospital, or the divestiture, dissolution, closure, merger, consolidation or change in corporate membership or ownership of a subsidiary of Elkhart General Hospital. 6. The material transfer or encumbrance of the assets of Elkhart General Hospital or a subsidiary of Elkhart General Hospital. 7. The annual operating budget, capital plan, strategic plan, and business plan for Elkhart General Hospital and subsidiaries of Elkhart General Hospital. 8. The mission and vision statements for Elkhart General Hospital and subsidiaries of Elkhart General Hospital. 9. Any material transactions of Elkhart General Hospital or a subsidiary of Elkhart General Hospital which are not otherwise included in the approved operating or capital budgets of Elkhart General Hospital or a subsidiary of Elkhart General Hospital or as otherwise authorized in the bylaws or operating agreement of Elkhart General Hospital or a subsidiary of Elkhart General Hospital. 10. Resolving any issues between Elkhart General Hospital or a subsidiary of Elkhart General Hospital and other affiliates of Beacon Health System as to participation, or failure to participate in, specific managed care agreements, and the terms thereof. 11. Any management agreement for the management of all or any substantial part of Elkhart General Hospital or a subsidiary of Elkhart General Hospital operations. 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 353 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 IN EARLY FEBRUARY, 2019 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2019, 18 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. EXCLUDED FROM ALL REVIEW PROCEEDINGS. 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 Pension Liability - 57,914,930 Write off of Intercompany Balances, Beacon Health System - (21,395,763) GAIN ON SWAP TERMINATION - (65,232,763) Total - (28,713,596). 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) 12AI 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 Beacon Health Ventures Inc 615 N Michigan St South Bend IN 46601 351901068 Home Medical IN C Beacon Health Ventures Michigan Inc 615 N Michigan St South Bend IN 46601 208259773 Home Medical MI C true true true false false false false false true false true false true true true true true true true Memorial Hospital of South Bend q 1195917 ACTUAL CHARGES Memorial Hospital of South Bend p 2770855 ACTUAL CHARGES Beacon Medical Group a 1188770 ACTUAL CHARGES Beacon Medical Group K 85470 ACTUAL CHARGES Beacon Medical Group O 362292 PAYROLL Beacon Medical Group P 1105495 ACTUAL CHARGES Beacon Medical Group Q 156980 ACTUAL CHARGES