MEMORIAL HOSPITAL OF SOUTH BEND: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL OF SOUTH BEND (EIN 35-0868132)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201743189349313914
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-14T21:11:35-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N WACKER DR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350868132 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Memorial Hospital of South Bend Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JEFFREY COSTELLO | InCareOfNm |
| Business Name Control | MEMO | BusinessNameControlTxt |
| Phone | 5746473549 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 N MICHIGAN STREET | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY COSTELLO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5746473549 | PhoneNum |
| Signature | 2017-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACOB ZEHNDER | PreparerPersonNm |
| PTIN | P01564049 | PTIN |
| Phone | 3128792702 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.247.118.182 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 36964520173185000074 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-14 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9EC56A8E4A3D8887D040A3ED15582BADE031077D | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | AA66391A3EB419599D985CB7941CE455993313B6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Larry Tracy | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 N MICHIGAN STREET | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $528,893,274 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.qualityoflife.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 3605 | TotalEmployeeCnt |
| Total Volunteers | 463 | TotalVolunteersCnt |
| Total Gross UBI | $562,885 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $95,226 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,624,707 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,812,391 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $502,549,671 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $505,411,374 | CYProgramServiceRevenueAmt |
| PY Investment Income | $707,304 | PYInvestmentIncomeAmt |
| CY Investment Income | -$678,041 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,853,321 | PYOtherRevenueAmt |
| CY Other Revenue | $14,396,285 | CYOtherRevenueAmt |
| PY Total Revenue | $528,735,003 | PYTotalRevenueAmt |
| CY Total Revenue | $522,942,009 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,609,678 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,418,189 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $178,486,757 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $183,402,987 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $261,667,769 | PYOtherExpensesAmt |
| CY Other Expenses | $258,951,287 | CYOtherExpensesAmt |
| PY Total Expenses | $442,764,204 | PYTotalExpensesAmt |
| CY Total Expenses | $444,772,463 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $85,970,799 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $78,169,546 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $555,878,904 | TotalAssetsBOYAmt |
| Total Assets EOY | $591,066,147 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $245,545,131 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $239,173,330 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $310,333,773 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $351,892,817 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $117,348,902 | ExpenseAmt |
| Revenue | $242,768,790 | RevenueAmt |
| Desc | Ancillary Services offers the following services for patients and facilities: - Imaging Services - Outpatient Physical, Occupational and Speech Therapy - Infusion Treatments - Radiation Oncology Therapy - Cancer Research - Cardiac Cath Lab - Sleep Lab - Interventional Radiology - Environmental Services - Nutritional Services - Pharmacy Services - Laboratory. 2016 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 513,727 INPATIENT PROCEDURES - 395,818 OUTPATIENT PROCEDURES - 918 INPATIENT CATHS - 775 OUTPATIENT CATHS - 152,891 OUTPATIENT VISITS - 517,375 NONPATIENT MEALS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $102,227,464 | ExpenseAmt |
| Revenue | $140,190,381 | RevenueAmt |
| Desc | Surgical Services provides the following services: - General Surgery - Vascular Surgery - Cardiac Surgery - Orthopedic Surgery - Gynecological Surgery - Trauma Surgery - GI Labs - Pulmonary Services - Pain Center - DaVinci Robotic Surgery. 2016 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 4,207 INPATIENT PROCEDURES - 209 OPEN HEART PROCEDURES - 8,684 OUTPATIENT PROCEDURES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $66,136,173 | ExpenseAmt |
| Revenue | $134,403,613 | RevenueAmt |
| Desc | Patient Care Unit Services provides a wide variety of hospital services including: - Inpatient rehabilitation CARF accredited - Medical - Post surgical - Orthopedic - Oncology - Intensive and intermediate - Heart and Vascular - Mother and Child - Special Care Obstetrics - Neonatal Intensive Care Level III - Emergency - Trauma Level II - Pediatrics - Pediatric Intensive Care - Pediatric Hematology Oncology - Medical Flight program - Pediatric Intensive Care Transports. 2016 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 107,566 PATIENT DAYS - 9,642 INPATIENT ER VISITS - 44,441 OUTPATIENT ER VISITS - 2,404 BIRTHS - 15,015 OBSERVATION STAYS - 314 MEDICAL FLIGHTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $108,022,039 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $2,418,189 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $393,734,578 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 263 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 3605 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY COSTELLO | PersonNm |
| Phone | 5746473549 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 N MICHIGAN STREET | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Gerard Duprat MD | ||||||||
| Trustee Thru March 2016 | 2.0 | 40.0 | Yes (X) | $0 | $726,456 | $34,652 | ||
| Carlton Lyons MD | ||||||||
| Trustee Thru March 2016 | 2.0 | 0.0 | Yes (X) | $5,606 | $0 | $0 | ||
| Tracy Graham | ||||||||
| Treasurer Thru March 2016 | 2.0 | 2.0 | Yes (X) | $6,280 | $0 | $0 | Yes (X) | |
| Maria Slager | ||||||||
| Trustee Thru March 2016 | 2.0 | 0.0 | Yes (X) | $1,660 | $0 | $0 | ||
| Perry Watson III | ||||||||
| Chair | 2.0 | 0.0 | Yes (X) | $2,110 | $0 | $0 | Yes (X) | |
| Thomas Burish PhD | ||||||||
| Chair Thru March 2016 | 2.0 | 0.0 | Yes (X) | $1,705 | $0 | $0 | Yes (X) | |
| Peter Baranay | ||||||||
| Vice Chair | 2.0 | 2.0 | Yes (X) | $543 | $0 | $0 | Yes (X) | |
| KAREN BARNETT | ||||||||
| Secretary | 2.0 | 0.0 | Yes (X) | $149 | $0 | $0 | Yes (X) | |
| TIM DURHAM | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $149 | $0 | $0 | ||
| HUGH HEDMAN MD | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN BOYER | ||||||||
| Trustee/Employed Physician | 2.0 | 40.0 | Yes (X) | $0 | $869,303 | $34,345 | ||
| MARK HARMAN | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS HAUCH MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $202 | $0 | $0 | ||
| BRAD TOOTHAKER | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $2,972 | $0 | $0 | ||
| Jeffrey P Costello | ||||||||
| CFO/Asst. Treasurer | 2.0 | 46.0 | $0 | $575,785 | $176,531 | Yes (X) | ||
| Kreg Gruber | ||||||||
| PRESIDENT Thru March 2016 | 4.0 | 36.0 | $0 | $647,771 | $186,157 | Yes (X) | ||
| Cheryl Wibbens-Lesh MD | ||||||||
| Asst. Secr./VP | 40.0 | 2.0 | $368,240 | $0 | $37,365 | Yes (X) | ||
| PHILLIP NEWBOLD | ||||||||
| CEO | 2.0 | 46.0 | $0 | $1,206,427 | $172,549 | Yes (X) | ||
| Larry Tracy | ||||||||
| President | 40.0 | 0.0 | $225,609 | $0 | $25,920 | Yes (X) | ||
| Keith Sherry MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $308,741 | $0 | $34,433 | Yes (X) | ||
| Thomas Sutula MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $288,402 | $0 | $33,920 | Yes (X) | ||
| Dale A Patterson | ||||||||
| Employed Physician | 40.0 | 0.0 | $341,041 | $0 | $33,789 | Yes (X) | ||
| Marion Mahone | ||||||||
| Employeed Physician | 40.0 | 0.0 | $278,629 | $0 | $19,354 | Yes (X) | ||
| Matthew R Reed | ||||||||
| Employeed Physician | 40.0 | 0.0 | $263,064 | $0 | $16,737 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,095,102 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,025,742 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $805,752 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 120 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BALFOUR BEATTY CONSTRUCTION LLC | |||||
| 3100 MCKINNON STREET 6TH FLOOR | DALLAS | TX | 75201 | CONSTRUCTION | $28,777,625 |
| PANZICA BUILDING CORPORATION | |||||
| 416 East Monroe Street Suite 320 | SOUTH BEND | IN | 46601 | CONSTRUCTION | $11,609,366 |
| SOUTH BEND EMERGENCY PHYSICIANS | |||||
| 615 N MICHIGAN | SOUTH BEND | IN | 46601 | PHYSICIAN SERVICES | $7,621,645 |
| SOUTH BEND MEDICAL FOUNDATION | |||||
| 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 46601 | LAB SERVICES | $6,700,169 |
| MICHIANA ANESTHESIA CARE PC | |||||
| 416 E MONROE STREET SUITE 200 | SOUTH BEND | IN | 46601 | ANESTHESIA | $2,567,852 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 65 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,895,615 | RelatedOrganizationsAmt |
| Government Grants | $1,916,776 | GovernmentGrantsAmt |
| Total Contributions | $3,812,391 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $505,240,784 | $505,240,784 |
| AMBULANCE SUPPLY | 621910 | $107,488 | $107,488 |
| CASH DISCOUNTS | 561499 | $28,109 | $28,109 |
| MEDICAL EDUCATION REVENUE | 611710 | $34,993 | $34,993 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $505,411,374 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $709,676 | TotalRevenueColumnAmt |
| Exclusion | $709,676 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,722 | TotalRevenueColumnAmt |
| Exclusion | $5,722 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,000 | TotalRevenueColumnAmt |
| Exclusion | $25,000 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $234,637 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $62,106 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $172,531 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,531 | TotalRevenueColumnAmt |
| Exclusion | $172,531 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,213,661 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,091 | SecuritiesAmt |
| Other | $5,599,009 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$8,091 | SecuritiesAmt |
| Other | -$1,385,348 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,393,439 | TotalRevenueColumnAmt |
| Exclusion | -$1,393,439 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $250,519 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $282,059 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$31,540 | TotalRevenueColumnAmt |
| Exclusion | -$31,540 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| TEAM PHARMACY | 561499 | $5,500,241 | $5,500,241 | |
| HLC ATHLETIC CLB | 713940 | $2,060,080 | $2,026,481 | $33,599 |
| MRI PARTNERSHIP | 561499 | $1,118,240 | $1,118,240 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,551,733 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,306,448 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $562,885 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,682,400 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,230,294 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $522,942,009 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $517,362,784 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $562,885 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,203,949 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,418,189 | TotalAmt |
| Program Services | $2,418,189 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $678,659 | TotalAmt |
| Management And General | $678,659 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,112,047 | TotalAmt |
| Program Services | $118,353,663 | ProgramServicesAmt |
| Management And General | $24,758,384 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,146,854 | TotalAmt |
| Program Services | $5,910,448 | ProgramServicesAmt |
| Management And General | $1,236,406 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,639,144 | TotalAmt |
| Program Services | $18,722,572 | ProgramServicesAmt |
| Management And General | $3,916,572 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,826,283 | TotalAmt |
| Program Services | $8,126,336 | ProgramServicesAmt |
| Management And General | $1,699,947 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,876 | TotalAmt |
| Program Services | $623,455 | ProgramServicesAmt |
| Management And General | $130,421 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,895 | TotalAmt |
| Management And General | $80,895 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,704 | TotalAmt |
| Management And General | $253,704 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,790 | TotalAmt |
| Program Services | $27,117 | ProgramServicesAmt |
| Management And General | $5,673 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,532 | TotalAmt |
| Management And General | $303,532 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,414,371 | TotalAmt |
| Program Services | $41,891,023 | ProgramServicesAmt |
| Management And General | $3,523,348 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,430 | TotalAmt |
| Program Services | $247,629 | ProgramServicesAmt |
| Management And General | $51,801 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,869,867 | TotalAmt |
| Program Services | $3,200,380 | ProgramServicesAmt |
| Management And General | $669,487 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,663 | TotalAmt |
| Program Services | $31,147 | ProgramServicesAmt |
| Management And General | $6,516 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,243,200 | TotalAmt |
| Program Services | $6,817,126 | ProgramServicesAmt |
| Management And General | $1,426,074 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $652,186 | TotalAmt |
| Program Services | $539,358 | ProgramServicesAmt |
| Management And General | $112,828 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,187 | TotalAmt |
| Program Services | $75,412 | ProgramServicesAmt |
| Management And General | $15,775 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,321,958 | TotalAmt |
| Program Services | $4,401,259 | ProgramServicesAmt |
| Management And General | $920,699 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,521,565 | TotalAmt |
| Program Services | $24,414,334 | ProgramServicesAmt |
| Management And General | $5,107,231 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,777,651 | TotalAmt |
| Program Services | $2,297,117 | ProgramServicesAmt |
| Management And General | $480,534 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $84,543,886 | $84,543,886 | $0 | $0 |
| CORPORATE FEE | $30,070,860 | $24,868,601 | $5,202,259 | $0 |
| BAD DEBIT EXPENSE | $29,577,456 | $29,577,456 | $0 | $0 |
| HOSPITAL ASSESSMENT FEE | $14,462,784 | $14,462,784 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,642,426 | TotalAmt |
| Program Services | $2,185,286 | ProgramServicesAmt |
| Management And General | $457,140 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,772,463 | TotalAmt |
| Program Services | $393,734,578 | ProgramServicesAmt |
| Management And General | $51,037,885 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,637 | BOYAmt |
| EOY | $19,775 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,380,509 | BOYAmt |
| EOY | $25,071,146 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,347 | BOYAmt |
| EOY | $385,006 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,575,140 | BOYAmt |
| EOY | $93,322,501 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,145,029 | BOYAmt |
| EOY | $17,028,261 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,132,560 | BOYAmt |
| EOY | $1,015,797 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $783,152,419 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $417,901,337 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,010,801 | BOYAmt |
| EOY | $365,251,082 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,400,164 | BOYAmt |
| EOY | $25,000,887 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,516 | BOYAmt |
| EOY | $316,256 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,474 | BOYAmt |
| EOY | $1,171,474 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,958,727 | BOYAmt |
| EOY | $62,483,962 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $555,878,904 | BOYAmt |
| EOY | $591,066,147 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,864,135 | BOYAmt |
| EOY | $42,624,988 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,264 | BOYAmt |
| EOY | $30,856 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,282,700 | BOYAmt |
| EOY | $159,778,646 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,212 | BOYAmt |
| EOY | $670,966 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,513,820 | BOYAmt |
| EOY | $36,067,874 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,545,131 | BOYAmt |
| EOY | $239,173,330 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,445,019 | BOYAmt |
| EOY | $343,264,467 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,888,754 | BOYAmt |
| EOY | $8,628,350 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,333,773 | BOYAmt |
| EOY | $351,892,817 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $555,878,904 | BOYAmt |
| EOY | $591,066,147 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $78,169,546 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,279,648 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$35,330,854 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $32,790 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $32,790 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Lobbying Detail | FormAndLineReferenceDesc |
| Explanation | SCHEDULE C, PART IV MEMORIAL HOSPITAL PAID DUES TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE AMOUNT OR PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: AAFP (AMERICAN ACADEMY OF FAMILY PHYSICIANS) 13% AASM (American Academy of Sleep Medicine) - 2% ACCC (Association of Community Cancer Centers) - 6% AMA (American Medical Association) - 55% APTA (American Physical Therapy Association) - 20% INDIANA HOSPITAL ASSOCIATION 21.78% ISMA (INDIANA STATE MEDICAL ASSOCIATION) 24% TRAUMA CENTER ASSOCIATION OF AMERICA 29% When unable to ascertain allocation of dues attributed to Lobbying a conservative estimate of 22% is applied. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $26,556,022 | BeginningYearBalanceAmt |
| Contributions | $9,605,449 | ContributionsAmt |
| Investment Earnings Or Losses | $339,397 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,645,907 | GrantsOrScholarshipsAmt |
| End Year Balance | $33,854,961 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $29,619,029 | BeginningYearBalanceAmt |
| Contributions | $4,093,832 | ContributionsAmt |
| Investment Earnings Or Losses | -$1,367,472 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $5,789,367 | GrantsOrScholarshipsAmt |
| End Year Balance | $26,556,022 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $27,642,755 | BeginningYearBalanceAmt |
| Contributions | $2,833,644 | ContributionsAmt |
| Investment Earnings Or Losses | -$142,883 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $714,487 | GrantsOrScholarshipsAmt |
| End Year Balance | $29,619,029 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $24,661,171 | BeginningYearBalanceAmt |
| Contributions | $2,180,336 | ContributionsAmt |
| Investment Earnings Or Losses | $1,785,965 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $984,717 | GrantsOrScholarshipsAmt |
| End Year Balance | $27,642,755 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $22,198,822 | BeginningYearBalanceAmt |
| Contributions | $1,501,904 | ContributionsAmt |
| Investment Earnings Or Losses | $1,884,305 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $923,860 | GrantsOrScholarshipsAmt |
| End Year Balance | $24,661,171 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.73730 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00780 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.25490 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,318,068 | OtherCostOrOtherBasisAmt |
| Book Value | $21,318,068 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $429,186,207 | OtherCostOrOtherBasisAmt |
| Depreciation | $177,097,648 | DepreciationAmt |
| Book Value | $252,088,559 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $851,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $851,999 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $284,145,586 | OtherCostOrOtherBasisAmt |
| Depreciation | $236,182,379 | DepreciationAmt |
| Book Value | $47,963,207 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,650,559 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,769,311 | DepreciationAmt |
| Book Value | $43,881,248 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $365,251,082 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM 3RD PARTY PAYORS | $37,854,975 |
| INT IN NET ASSETS OF REC ORG | $8,628,350 |
| DUE FROM AFFILIATES | $818 |
| INTEREST RECEIVABLE - SWAP | $91,201 |
| DUE FROM SELF INSURED TRUST | $78 |
| OTHER RECEIVABLES | $3,607,568 |
| 2016 BOND FUND | $12,300,972 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $62,483,962 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| INTEREST RATE SWAP | $22,778,724 |
| ASSET RETIREMENT OBLIGATION | $4,443,537 |
| IBNR | $3,366,387 |
| DUE TO THIRD PARTY | $3,519,883 |
| CAPITAL LEASE PAYABLE | $1,302,160 |
| MEDTRONIC O-ARM AGREEMENT | $657,183 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $36,067,874 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4 | THE BOARD HAS DISCRETION TO UTILIZE EACH YEAR THE INCOMES, REVENUES, AND PROFITS ARISING AND ACCRUING FROM THE ENDOWMENTS IN DEFRAYING COSTS ASSOCIATED WITH THE TRUST AND THE REMAINDER FOR SUPPORT, BETTERMENT, IMPROVEMENT, UPKEEP, EXPANSION, AND REPLACEMENT OF BEACON HEALTH SYSTEM, INC. AND ITS CORPORATE AFFILIATES. TERM ENDOWMENTS, WHICH ARE THE TEMPORARILY RESTRICTED NET ASSETS, ARE USED AS DESIGNATED BY THE DONOR. THE PERMANENT ENDOWMENT PROVIDES INCOME TO BE USED FOR HEALTH CARE EDUCATIONAL PURPOSES AND PATIENT CARE. |
| 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, 2016 or 2015. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | MARATHON | Event1Nm |
| Gross Receipts Event1 | $250,519 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $250,519 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $3,875 | CashPrizesEvent1Amt |
| Food And Beverage Event1 | $1,156 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $277,028 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $250,519 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $250,519 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $3,875 | CashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $1,156 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $277,028 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $282,059 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$31,540 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II Event #1 | FormAndLineReferenceDesc |
| Explanation | Memorial Hospital of South Bend conducts an annual Sunburst Marathon that recognizes no contributions. All contributions are directed to and recorded by the Memorial Health Foundation. Memorial Hospital facilitates the Marathon by collecting registration payments and organizing the event. It is common for the event to be run at a loss as all the sponsorship and contribution income is recorded by Beacon Health Foundation. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,876,072 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,876,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,944,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $75,277,800 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,666,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03290 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,820,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $75,277,800 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,542,726 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,226,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,016,753 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,210,026 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02460 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,768,915 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,560,917 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,207,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,676 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $98,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,629 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $322,806 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $322,806 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,425,176 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,675,717 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,749,459 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04280 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $113,245,702 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,953,517 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $34,292,185 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08260 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,161 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,161 | NetCommunityBenefitExpnsAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $860 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $860 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,021 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,021 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,929,716 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,964,858 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $83,259,430 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $107,691,462 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$24,432,032 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL OF SOUTH BEND INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 N MICHIGAN STREET | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.BeaconHealthSystem.org | WebsiteAddressTxt |
| State License | 16-005053-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Research Facility | Yes (X) | ResearchFacilityInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL OF SOUTH BEND INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C FOR FULL URL | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C FOR FULL URL | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Section C for full URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Section C for full URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Section C for full URL | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B, Line 5 | During 2015, Beacon Health System conducted a joint Community Health Needs Assessment (CHNA) representing approximately 267,000 residents of St. Joseph County (SJC) and approximately 200,000 residents of Elkhart County, which reflect the primary market service areas for Memorial Hospital of South Bend (MHSB), and Elkhart General Hospital (EGH), respectively. In late 2014 through February 2015, dialogue on the CHNA planning and coordination occurred among Beacon Health System executives and the Community Benefit staff from both MHSB and EGH. It was agreed that a third party consultant Holleran Consulting of Lancaster, Pennsylvania would serve as the data gathering entity for both hospitals. An online CHNA survey conducted through August 2015 provided insight to barriers to accessing care, the impact of social determinants of health, resource utilization and underserved populations. Community engagement and feedback are essential to the integrity and validity of the SJC CHNA process. Therefore, input was actively solicited and secured from three sources: - Key informants who hold a broad knowledge of the interests of SJC, including public health, and minority, cultural, and underserved populations - Community members at large representing 267,618 SJC residents - Community Health Advisory Council representing medical and health services fields. The first stage of assessment was seeking to gather input from key informants. Organizations invited to provide input included the following: Samaritan Counseling Center; MDWise, a Medicaid Managed Care entity; Harper Cancer Research Institute University of Notre Dame; Junior League of South Bend; Bridges Out of Poverty; City of Mishawaka Fire Department; Memorial Family Residency Program; YMCA of Michiana; Hope Ministries, which serves homeless families; Goodwill Industries; Imani Unidad, a not-for-profit organization providing counseling to minorities and persons with HIV; Saint Mary's College; Bike Michiana Coalition; and Healthy Families of St. Joseph County. Additional input on perceived health priorities and barriers to accessing care was solicited from the community at large through an online survey that could be accessed directly from home or work internet or through the free, community service computers located at St. Joseph County public Libraries. Consideration was given to ensuring the ease of access to survey completion to hard to reach populations, including Hispanic Latino, African American, and low-income populations. Hard copies of the survey were provided as well as assistance for those who requested it. Furthermore, input was solicited and received from the medically underserved, low-income or minority populations by making the assessment available at community meetings, church meetings, neighborhood residential centers and community centers. The assessment was also shared with La Casa de Amistad, a charitable organization that functions as a community center on the west side of South Bend for Spanish speaking families. All sources that were solicited provided input. Based upon primary and secondary data, a Priority Setting Worksheet was created. The secondary data profile depicts population and household statistics, education and economic measures, morbidity and mortality rates, disease incidence rates, and other health statistics. Input from each source, was inserted into a separate column and assigned a unique weighted percentage based on several factors (e.g., sample size): Key Informants (20%); Community Members at Large (40%); Advisory Council (20%); Secondary Data (20%). The 19 rows in the worksheet represented each of the potential health and social issues listed in the CHNA. After tabulating the total scores for each issue (ranging from 0 -100%), the following six issues emerged with a score greater than eighty percent (80%) and were selected as MHSB 2016-2018 priorities: -Access to Health Care/Uninsured -Mental Health/Suicide -Violence/Safety/Trauma -Diabetes -Maternal/Infant Health/Prenatal Care -Obesity/Overweight The first three were also designated priorities from 2013 through 2015. Of the remaining thirteen (13) issues, nine (9) were scored at zero and four (4) cancer, education, poverty, and substance/alcohol abuse were scored from forty (40) to sixty (60) percent. MHSB does not intend to include them in its Implementation Strategy due to other community health needs taking precedent, limited resources, and the need being addressed by organizations within the community. |
| Part V, Section B, Line 6a & 6b | Memorial Hospital of South Bend developed the 2015 St. Joseph County CHNA in partnership with Elkhart General Hospital, a Beacon Health System Care Partner, and the Saint Joseph County Health Department. Elkhart County residents were surveyed at the same time. |
| Part V, Section B, Line 7a, 7d & 10a | In 2015, the Saint Joseph Community Health Needs Assessment (CHNA) and Implementation Strategies Report were submitted to the Memorial Hospital Board of Directors for review and were approved in 2015. These documents were subsequently made widely available to the community through posting on the MHSB website at https://www.beaconhealthsystem.org/community-wellness/community-outreach/c ommunity-health-needs-assessment, through hard copies made available by request, through paper copy made available for MHSB Administration, and through email transmission upon request. MHSB staff were also available to discuss the results of the CHNA and the 2015 implementation strategies in requested community forums. |
| Part V, Section B, Line 11 | MHSB provided leadership throughout the 2015 CHNA process. The data from this collective CHNA input process identified nineteen health needs; 1. Access to care/uninsured 2. Aging population, 3. Cancer 4. Chronic respiratory disease / asthma 5. Dental health 6. Diabetes 7. Education 8. Health disparities 9. Heart disease 10. Maternal/infant health/prenatal care 11. Mental health/suicide 12. Overweight/obesity 13. Poverty 14. Reproductive health/pregnancies/STDs 15. Stroke 16. Substance abuse/ alcohol abuse 17. Tobacco 18. Transportation 19. Violence/safety/trauma. Of these, the following six were identified as being a priority for 2016: access to care/uninsured, mental health/suicide, violence/safety/trauma, diabetes, maternal/infant health/prenatal care, and overweight/obesity. Of the remaining thirteen issues, MHSB does not intend to include them in its Implementation Strategy due to the prominence of other community health needs, limited resources, and other organizations within the community addressing those needs. We will continue to lead and engage in active community dialogues to measure and ensure movement toward goals as MHSBs Implementation Strategy is executed. We also intend to continue helping support other community needs that emerge from key community leaders and stakeholders, community members at large, and prevalence of health indicators. 1. ACCESS TO HEALTH CARE/UNINSURED While the arrival of the Affordable Care Act (ACA) provided many St. Joseph County (SJC) residents with needed health coverage, a large segment of our county continues to fall through the cracks for myriad reasons including ineligibility due to lack of legal residency status, the unaffordability of Indiana ACA Marketplace programs for eligible persons, and the increasing trend of high-deductible employer-sponsored plans that are creating delays or barriers for insured persons to utilize health care at an appropriate time. MHSB data from January through December 2016 indicates more than 5,500 patients are uninsured, but those unsure or without a Primary Care Provider (PCP) outnumber the uninsured by almost 2:1, which hinders the completion of routine wellness visits and could lead to higher demand for ED services when ill. This confirms the need for prioritizing Access to Care among their patients and in the community. Priority Focus 1: Ensure access to health insurance, education and self-management skills Priority Focus 2: Provide screenings and education PROGRAMS TO ADDRESS THIS NEED ARE AS FOLLOWS- AGING IN PLACE (AIP) AIP programming helps seniors in low-income housing remain productively and successfully independent by providing them with caring and holistic services so they can continue to be a rich part of the community and society. The AIP program provides a variety of services that support Access to Care, including: health oversight, medication adherence, assistance in connecting participants to a primary care physician and other health resources. The program is hosted at three South Bend sites (Robertsons Apartments, Monroe Circle Community Center, Heritage Place at LaSalle Square). Outcomes Pre- and post-Intervention packets consisting of a demographic questionnaire and Morisky Medication Adherence Scale were distributed to participants in December of 2015 and August 2016. In addition, attendance logs from November 2015 through October 2016 were reviewed to assess health education participation in the following activities: Physical Health Seminars, Nurse Visits, and eSeniorCare Medical Workshops. During that time period, 77% of the 115 AIP residents reported having a primary care physician compared to 71% in 2014 (no data from 2015). Additionally, 48% were engaged in health education services, a 15% increase from the previous year. The activities/events listed above were all provided on a weekly basis, with the exception of the physical health seminars which occurred monthly. An average of six residents participated in the physical health seminars consistently. Nursing visits that addressed health concerns and blood pressure checks on average could expect ten residents. Every week from November 2015 through August 2016, the University of Notre Dame hosted eSeniorCare medical workshops to help residents electronically monitor their medication adherence. Twenty-six (26) participants attended those workshops where they were trained on the importance of using the adherence component of the application on their tablets and setting health goals. BEACON HEALTH SYSTEM NAVIGATORS and COVERING KIDS & FAMILIES PARTNERSHIP In 2016, Beacon Health System (BHS) and Covering Kids & Families of North Central Indiana (CKF), an entity of United Health Services, developed a plan to provide access to coverage for a wider range of potential patients prior to presenting at any Beacon facility. Memorial Hospital of South Bends Implementation Strategy for addressing access to health coverage is to continue to provide outreach-based, free enrollment and advocacy services for low-income and/or eligible St. Joseph County (SJC) residents. CKF heavily promoted SJC enrollment services through robust outreach to target catchments of low-income individuals. In-reach efforts included enrollment awareness and health coverage education at multiple access points throughout BHS overall, including the emergency room, patient accounts, health information management, cashiers office, social services, physicians practices, and other sites. Due to our agreement with the Indiana Department of Insurance, Indiana Navigators were advised against collecting additional information (e.g., demographics) on applicants. Outcomes In 2016, Beacon/CKF assisted 709 St. Joseph County residents in applying for health coverage assistance through the Affordable Care Act, the Healthy Indiana Plan, and Medicaid. In 2015, this figure was 242. Furthermore, a total of 558 assists for Elkhart and St. Joseph Counties together occurred with applicants and successful enrollees. Although we provided assistance to these individuals during the application processes, we were unable to verify whether an individual ultimately enrolled due to such factors as the inability to select a specific program at time of appointment, missing or incomplete documentation verification, need to follow up with established clinical or prescription providers to confirm participation in specific plans, and inability to commit to specific plans due to affordability issues. Beacon Health Systems health insurance tracker database has been updated to appropriately track the success of enrollment efforts starting in 2017. Now the BHS/CKF threefold access to coverage process includes education about health coverage, how to get it and how to use it. As a result, these steps will maximize the number of individuals who desire healthcare and treatment to have approved insurance in place, thereby reducing charity care and mitigating losses. While this is a time consuming and specialized process requiring a variety of specific actions, it is clear that a large number of uninsured will qualify and will use their coverage once educated, enrolled, and approved. Without this assistance, the enrollment and approval process is laborious, confusing, and difficult to manage through multiple stages that require resources to consistently monitor. ENFOCUS ASTHMA PILOT The South Bend Fire/Emergency Medical Services (EMS) Department and enFocus identified and studied an innovative response to frequent but unnecessary utilizers of the health system known as Mobile Integrated Healthcare (MIH). MIH is used by communities across the U.S. to leverage existing EMS infrastructure and extend care into patients homes by proactively coaching patients on managing their chronic health conditions. This pilot with Beacon Health System specifically aims to address the inaccessibility of healthcare among low-income, at-risk residents of South Bend who suffer from asthma and other respiratory conditions, and disproportionately call paramedics to administer bronchodilator medications. The program supports the training of a Paramedic to proactively engage patients, discuss personal healthcare plans, provide navigation to physical health resources including United Health Services, and coach self-management to prevent future exacerbations and the need for emergency intervention. Outcomes The target population was identified through data analysis of South Bend Fire/EMS Departments run report information. Results showed bronchodilators make up 26% of all medications administered by EMS during ambulatory rides indicating a disproportionate number of incidents related to respiratory distress. When the location of incidents related to bronchodilators was geospatially mapped, it was found there are hotspots of bronchodilator administration on the West and South sides of South Bend, particularly impoverished areas of South Bend. Through this analysis, the population we aim to se |
| SOUTH BEND GUN VIOLENCE INTERVENTION | The South Bend Group Violence Intervention (SBGVI) unites community leaders around a common goal: to stop gun violence and keep South Bends highest risk citizens alive and out of prison. SBGVI is a partnership among 30 community leaders from law enforcement, government, education, civil service, health-care and faith-based agencies. Based on a proven model developed by David M. Kennedy, director of the National Network for Safe Communities at John Jay College of Criminal Justice, SBGVI advocates direct, sustained engagement with street groups that cause the majority of South Bends gun violence. The strategy empowers community members to set clear moral standards against violence in their communities and reclaim a voice in the way they want to live. It coordinates the efforts of local, state and federal law enforcement to focus crime prevention efforts on the groups most associated with gun violence. SBGVI also draws on the expertise of social service providers to offer group members a path away from violence. Outcomes The National Network had suggested four call-ins per year, but the group partners made a conscious decision in early 2016 to commit to consistently doing two call-ins a year, which seemed more appropriate for a community of our size. They also agreed they could increase that number again over time or as need might dictate. Over a 13 month period from 2014 to 2015, 82 men participated in 4 SBVGI Call-Ins; in 2016, 41 men participated in 2 call-ins. There were 60 shooting victims in 2014; 2015 and 2016 had 73 victims each year for the period from January through November. SBVGI continues to work towards decreasing the number of criminally assaulted shooting victims. TRAUMA LIAISON/VIOLENT INJURY PREVENTION SPECIALIST A new staff position of Trauma Liaison was established at Memorial Hospital to work with victims of violent crime and their families. The purpose of this position is to help victims of violence and prevent violent personal injury, retaliation, and recidivism among the population of South Bend through research, data monitoring/evaluation, and community involvement. Outcomes For this position, Memorial Hospital South Bend created a process which provides continued support for violent injured patients and their families. All victims were provided the opportunity to speak to the violent injury prevention specialist. In total, only 41% of victims of violence were able to be contacted. Of those who could be reached, victims of violence and their families were more supported, and more comfortable communicating the details of their incident. Upon request, the prevention specialist visited and communicated with victims post hospitalization (for follow-up, education, and community resource assistance). From the data collected, implementation of this program has not reduced the amount of patients injured in a violent fashion returning or being re-admitted to the hospital. In 2015 0% returned compared to 3% in 2016. The program accomplished some objectives, but not all. However, with more time and communication to our community, all goals of this project can be achieved. MOVING FORWARD For the past few years, Community Health enhancement (CHE) has been very actively involved in efforts to reverse the harmful physical and mental effects of trauma. In addition to partnering with SBGVI to create a safer community and funding the Trauma Liaison position, we have emphasized the building of resilience as a way to both mitigate the influence of trauma and build qualities in youth and adults that enable them to both endure and thrive in the midst of challenging situations. In 2016, a two-pronged effort began to help people recover from and prevent Adverse Childhood Experiences (ACEs). The ACE Interface Network targets professionals who become Master Trainers and/or Facilitators of ACE presentations and build awareness in community members attending the presentations. There are currently 47 trained Master Trainers and Facilitators, who have completed 43 presentations to 1503 people from a wide range of organizations. This work will continue in 2017. In 2017, CHEs investment in the Trauma Liaison position will continue to be funded by MHSBs Trauma Department as they believe the position is valuable and can achieve its goals. CHE support for EMDR training of social work interns in the Trauma Department will also continue. Additionally, Community Health was awarded a $2 million grant to conduct a research project into resiliency education. The Community Resilience Center will include programming offering evidence based curricula that will assist young people who have experienced trauma to become more resilient and develop lifelong skills that will encourage their success. 4. DIABETES Results from the key informant survey show that in both Elkhart and St. Joseph counties, the fourth most pressing health concern is diabetes. Data shows 20% of SJC respondents reported having been diagnosed with diabetes, compared to fewer than 8% in Elkhart County. In SJC the percentage of respondents with diabetes, pre-diabetes, or gestational diabetes has increased from 2012 community member survey responses. Approximately 49% of diabetic respondents in SJC maintain an A1C level of 7% or below, compared with 37% in Elkhart County. To face those challenges and meet this need, Community Health Enhancement has created these focus areas and indicators to assess progress over time. Priority Focus 1: Diabetes disease management Priority Focus 2: Diabetes prevention HEALTHY DIABETICS (HD) The program purpose is to reduce hospitalization and teach self-management skills to high risk clients who suffer from diabetes. The program focuses on behavior changes and is taught by community health workers (CHW) using culturally relevant information to enhance the clients knowledge. The community health workers provide case management, utilize hands-on teaching techniques, and focus on establishing a trusting relationship with clients and their families. HD has also partnered with the Food Bank of Northern Indiana to reduce food insecurities by offering two cooking demonstration sessions per month to its clients. The amount of face-to-face contact between the CHW and a client helped prove that care coordination reduces the need for hospitalizations in the high risk population served by the program. Healthy Diabetics applied for and was approved by the National American Diabetes Association to be recognized and certified as the only diabetes program in the country that includes CHWs as part of the continuum of care. In 2016, the program helped diabetics at two different locations: patients at Centennial clinic, a Beacon Medical Group site; other clients came to their HD clinic on Memorial Hospitals campus. Outcomes The program met the goal of lowering HbA1c levels at both locations. Results suggest work during the first six to nine months in the program was effective in helping lower HbA1c levels in high risk clients who enter with scores greater than 9.0. Paired-sample t-tests for each site supported this change by showing the decreases were statistically significant at both locations. To determine if these lower scores were maintained or decreased even further over time, a repeated measures ANOVA analysis of mean scores from all clients with initial scores and three in-program tests (n=142) showed stability across time and this trend existed at both locations. The program also achieved its second goal by helping clients (regardless of insurance status) reduce emergency department visits and charges. Compared with clients total emergency department visits and charges for the year prior to entering the program, post emergency department visits for the total sample from both sites dropped by 81.6%; emergency department charges decreased by 88.6%. Both bad debt and charity write-offs associated with emergency department charges dropped by 97.7%. HD DIABETES PREVENTION PROGRAM This program is based on the Center for Disease Controls model of helping individuals avoid early onset of diabetes. Outcomes A Diabetes Prevention Program was developed and aired on the Spanish radio station Sabor Latino every Friday over a two month span. The audience participated by phone; information was not collected to determine whether outcomes were met. Other programs in a classroom setting were provided for English speaking clients. All of the participants in the program reported exercising 150 minutes per week. Two months of operation did not lend enough time to achieve outcomes. Overall, if the program were to continue it would be on target for meeting objectives. YMCA-DIABETES PREVENTION PROGRAM (DPP) The YMCA City of South Bends Diabetes Prevention Program (DPP) helps those at high risk for developing type-2 diabetes (i.e., overweight with pre-diabetic conditions) to adopt and maintain more healthy lifestyle habits, and prevent the onset of the disease. The YMCAs DPP is part of a f |
| In 2017, Baby and Me Tobacco Free will continue to refer clients to | Community Healths Prenatal and Infant Health Program, which provides mothers with individualized case management support throughout pregnancy and until the babys first birthday. In its first year, they successfully helped all smokers to reduce or stop smoking by the babys delivery. This support is especially needed as Fetal and Infant Mortality Reviews analysis of infant mortality cases in 2016 highlighted the need for improving smoking cessation as one of its four recommended focus areas. The FIMR teams will also continue using prior tragedies to identify solutions that can be implemented and maintained to improve future outcomes. 6. OVERWIEGHT/OBESITY Over 17% of children in SJC are overweight and/or obese. With the correlation between numerous adverse chronic and emergent health conditions, being overweight or obese was cited as the most significant community health issue in the key informant survey and a high priority during group discussions. To face those challenges and meet this need, Community Health Enhancement has created these focus areas and indicators to assess progress over time. Priority Focus 1: Community and youth engagement in physical activity Priority Focus 2: Knowledge and consumption of healthy food HEALTHWORKS Memorial HealthWorks! Kids Museum, an educational arm of Memorial Childrens Hospital, provides high-quality health education experiences to children and families throughout Michiana and beyond. HealthWorks! is not only on-location but also provides community outreach services, bringing health education flair to churches, schools, businesses, community-wide events, and youth service programs. HealthWorks! Kids Museum, along with its community partners, offers families across Michiana an opportunity to spend time together and participate in fun-filled activities. Passport to Play (P2P) is a free program that gives families the chance every month to enjoy the beauty of local parks (e.g., hayride, ice-travaganza, summer splash), eat a healthy snack (e.g., ingredients from a trail mix bar, lunch of sandwich, fruit and pretzels), exercise in an exciting way (e.g., snow tubing, family fun walk), and learn new things about enhancing your own health and well-being. Outcomes During the Fall of 2015 through the Summer of 2016 a total of 3,093 individuals participated in P2P. Currently, no additional P2P data is collected, other than the number of attendees, but families tell us how they have been positively influenced by this program. Throughout the years, several families have reported lowering their weight to meet a healthy weight range. P2P helps to connect with younger members of the family; this way the adults hold their children accountable and vice versa. LEEPER PARK/MADISON PRIMARY CENTER The purpose of our Park Foundation, Madison Primary Center, Leeper Park, and Memorial Hospital collaboration is to positively impact childhood obesity. This program is five years in duration. A college student and community business partner team-building and project management approach is utilized to execute the plan and leverage resources to achieve a big goal. There are five major projects over a span of five years that strategically link students to active learning in the Park. Year one (2015) project was in West Leeper Park, installing 500 feet of 8 feet wide curved sidewalk to define a curvilinear garden edge. Additionally, historic lighting was installed, a water source was provisioned, and a donated irrigation system was secured. Matching benches and trash receptacles were also installed. The Madison Primary Center students will get more exercise from planting, weeding and harvesting the vegetables and flowers from this garden. They will also learn about healthy food and how it is grown. Programming will be executed using active hands-on participative learning. Year two finished the three brick learning nooks along the Phase one curved sidewalk. College students installed 5,000 bricks to create an inviting spot to see the garden and learn about what is growing there. The next planned project we are actively working on is the design of a lavender labyrinth in Leeper Park on the alignment of Main Street, north of Park Place and Southeast of the duck pond. It will match the formal garden look of the George Kessler Plan for Historic Leeper Park. Outcomes We had a baseline of sedentary students not getting much exercise on a City block of almost entirely building, parking lot, basketball court and small playground with limited recess use only. The school goals are to be a STEAM school teach and show where healthy vegetables come from, engage the students in the nature that surrounds the school in the form of historic Leeper Park, and measure additional steps of representative groups of students using pedometers and strategically logging active days. Second and fourth grade students use Leeper Park to run and play every day for a 20 minute recess from mid-August through the month of November. In addition, five classrooms (one each from grades kindergarten through fourth) once a month earned an extra 30 minute Leeper Park recess for earning the most Paw Print Chips (positive behavior incentive). Additionally, a year-long permission slip was created for students, so that teachers can use all the amenities of the park as an outdoor learning area any time during the school day. Other accomplishments consist of adding a Go Noodle which includes Popsico, Zumba, and Kidz Bop for two minute transitions, five times per day was implemented in 22 classrooms; teachers are transitioning to flex seating which is a standing desk with a foot swinging bar, and 8 wiggle seats; using Imagination Playground and Catch for days when the weather calls for inside recess. Madison Primary Center has been selected for numerous aligned programs, wherein the partnership with Memorial and the City were helpful in winning grants. Many of those programs will begin in 2017 and baseline information will be determined at that time. ST. JOSEPH COUNTY HEALTH DEPARTMENT PRESCRIPTION TO PLAY This free program consists of organized physical games based off the Coordinated Approach to Childrens Health program (CATCH) for families with a prescription referral from a local health provider. Through this program, physical activity and healthy choices will be promoted to elementary through middle school age children (specific ages are 7-12), however we do see a large number of younger children as part of the family unit. Outcomes The first two goals (Increase number of children who were able to reduce their BMI and Increase number of children who met or exceeded their physical fitness ability goal) were not able to be calculated because of insufficient data; there was not a method in place to collect the measurements for BMI and fitness ability. This will be corrected in 2017 in the form of surveys and other data collecting techniques that will allow the fitness and weight-loss goals to be measured. There was a slight decrease in the total number of families and prescription holders who attended the various sites this year compared to the last. In addition, there were 103 prescriptions in 2016 (through October) compared to over 200 in 2015. This is in part due to the loss of two staff members over the spring/summer so keeping active interest in the program was difficult; another factor could possibly be due to changing sites and times of the program days. We are considering whether to restructure the program to off-set this barrier. UNITY GARDENS Unity Gardens Food and Fun Immersion included programs and activities designed to enhance the garden experience and connection with fresh produce for neighbors and the community. This program targeted vulnerable aggregates within the area surrounding LaSalle Square Unity Garden, especially the Beacon Heights Apartments community. Increased garden involvement for youth and adults was designed to improve access to fresh produce, and subsequently decrease obesity rates and increase food security long term. In addition, opportunities for increased physical activity were actively planned, not only with events, but also in the structural plan of the Unity Garden. Outcomes Unity Garden camp was a free day camp where area youth have opportunities for natural exploration, garden immersion, tasting tours, leadership, environmental sustainability, and service. Physical play and eating plenty of fresh produce were woven within the program. This free one-week camp was hosted twice in July to avoid scheduling conflicts and enhance leadership opportunities for the new Counselor in Training (CIT) program. Garden Camp encouraged consumption of fruits and vegetables using a variety of methods; 26 new vegetables were introduced to at least 44 campers. Not all of them liked everything, but they all tried them. In addition, the only snacks offered throughout the day were apples, sweet peppers, grapes, oranges, and bananas. In 2015, 29 camper |
| Part V, Section B, Line 13h | Financial Assistance Criteria The policy allows for patients to qualify for assistance by two means: financial or catastrophic. The Financial Assistance Program also allows for partial assistance or full assistance based on eligibility criteria in this policy. Financial Assistance 1. A patient qualifying for financial assistance is a person who is uninsured or underinsured, receives care and unable to pay their bill. 2. To be eligible for assistance under the financial assistance guidelines, a person's income shall be at or below a percentage of the Federal Poverty Level (FPL) as determined by Federal Poverty Guidelines. Household size and income determines the % of FPL. Memorial Hospital of South Bend, or its designee, may consider other financial assets and liabilities of the person when determining eligibility. 3. Memorial Hospital of South Bend will use the most current poverty income guidelines issued by the U.S. Department of Health and Human Services to determine an individual's eligibility for financial assistance. The poverty income guidelines are published annually in the Federal Register and for the purposes of this policy will become effective the first day of the month following the month of publication. 4. To qualify under the Financial Assistance portion of this policy, a completed, signed Financial Assistance application must be submitted and proof of income, proof of no income, proof of lack of financial assets and other required documents must accompany the application. Catastrophic Assistance Criteria 1. A patient qualifying for catastrophic assistance is a person whose hospital bills exceed a specified percentage of the person's annual gross income as set forth in the policy and who is unable to pay the remaining bill. 2. To be eligible for catastrophic assistance the amount owed by the patient must exceed one hundred fifty (150) percent of the patient's annual gross income and the patient must be unable to pay the remaining bill. Memorial Hospital of South Bend may consider other financial assets and liabilities of the person when determining ability to pay. 3. If a determination is made that a patient has the ability to pay the remainder of the bill, such a determination does not prevent a reassessment of the patient's ability to pay at a later date should their financial circumstances change. 4. After eligibility is determined under this provision, assistance will be provided to discount the bill by 75% of the current balance. |
| Part V, Section B, Line 16 a, b, & c | The Financial Assistance Policy, application and plain language summary can all be found at: https://www.beaconhealthsystem.org/about-us/assist |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MEMORIAL SLEEP DISORDER CENTER | ||||
| 53990 CARMICHAEL DRIVE | SOUTH BEND | IN | 46601 | OUTPATIENT CLINIC PROVIDING SLEEP RELATED DIAGNOSIS AND TREATMENT |
| MEMORIAL HEALTH PLEX | ||||
| 111 W JEFFERSON ST | SOUTH BEND | IN | 46601 | OUTPATIENT REHABILITATION FACILITY AND FITNESS FACILITY |
| MEMORIAL BREAST CARE CENTER | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL CHILDREN'S THERAPY CENTER | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL RADIOLOGY | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL LIGHTHOUSE PHYSICAL THERAPY | ||||
| 6913 N MAIN STREET | GRANGER | IN | 46530 | OUTPATIENT DIAGNOSIS AND TREATMENT |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part VI, Descriptions for Part I, Line 3c | FormAndLineReferenceDesc |
| Explanation | 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. 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 have been found they are 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 VI, Descriptions for Part I, Line 6a Beacon Health System, Inc, EIN 45-3864076, prepares the annual community benefit reporting for Memorial Hospital of South Bend, Inc. Part VI, Descriptions for Part I, Line 7, Column F BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES $ 29,577,456 Part VI, Descriptions for Part I, Line 7G NOT APPLICABLE Part VI, Descriptions for Part I, Line 7 COSTING METHODOLOGY The costing method used to calculate financial assistance reported on lines 7 a through d was the cost-to-charge ratio as derived on TAX FORM 990, SCHEDULE H, WORKSHEET 2. All other community benefits were calculated using direct costs. Part VI, Descriptions for Part II Line 7. Community Health Improvement/Advocacy Throughout 2016, Memorial Hospital South Bend (MHSB) continued to provide health coverage enrollment assistance and program navigation through Beacon Health System health coverage enrollment efforts for the Affordable Care Act (ACA) Marketplace as well as the emergence of Healthy Indiana Plan 2.0, Indianas response to Medicaid expansion under the ACA. In alignment with the ACA, MHSB provided full-service assistance for enrolling uninsured persons into health coverage programs through certified Beacon Navigators. Navigators provide advocacy, education, linguistic, and application assistance for the purpose of assisting eligible low-income SJC residents in enrolling and maintaining viable coverage in the health coverage programs for Indiana residents, including not only ACA Marketplace, but also Medicaid, Hoosier Healthwise (Childrens Health Insurance Program), and Healthy Indiana Plan 2.0 programs. MHSB remains committed to enrolling uninsured, low-income persons into existing programs for which they are currently eligible but unenrolled as a practical first step in addressing access to health care for the community. Eligibility criteria, while similar between the programs, vary with respect to household income level and its documentation, residency verification, etc. The complexity of eligibility criteria and successful navigation through the application process can be formidable barriers for persons attempting to apply for health coverage on their own. Advocacy on behalf of the applicant serves to ensure that a complete and accurate application and all necessary documentation are submitted in a timely fashion. MHSB Navigators monitor the status of applications, and once the application is approved, also assist in maintaining the individuals coverage viability. Line 9. Other Two staff members participated in a WIC and breastfeeding outreach and education Baby Fair for the community. The staff members ran an educational table which gave out information about Baby & Me Tobacco Free, BABE, Early Start and PIHP programs. Part VI, Descriptions for Part III, Line 2 THE CORPORATION EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE 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. THE COSTING METHODOLOGY IS THE SAME AS THE TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE COST IS 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. Part VI, Descriptions for 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 attributable to uninsured patients which represent the majority of the population that would fall under the FAP. We have applied the historical estimate to the total bad debt expense to determine the amount attributable to the FAP. Part VI, Descriptions for 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 UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. Part VI, Descriptions for 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. Part VI, Descriptions for Part III, Line 9b Collections 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: Memorial Hospital of South Bend 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. Memorial 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 patients 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 | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| NORTHEAST NEIGHBORHOOD REVITALIZATION ORGANIZATION | |||||||
| 803 LINCOLNWAY WEST | SOUTH BEND | IN | 46616 | 352118149 | 501(C)(3) | $50,000 | Corporate Sponsor |
| PENN-HARRIS-MADISON EDUC FOUNDATION INC | |||||||
| 55900 BITTERSWEET RD | MISHAWAKA | IN | 46545 | 351996785 | 501(C)(3) | $6,000 | General Support |
| THE CENTER FOR THE HOMELESS | |||||||
| 813 South Michigan | SOUTH BEND | IN | 46601 | 351768544 | 501(C)(3) | $28,500 | Sponsorship |
| UNIVERSITY OF NOTRE DAME | |||||||
| MAIN BUILDING | Notre Dame | IN | 46556 | 350868188 | 501(c)(3) | $45,000 | Research Donation |
| SOUTH BEND HERITAGE FOUNDATION INC | |||||||
| 803 Lincolnway West | SOUTH BEND | IN | 46616 | 237394320 | 501(c)(3) | $5,500 | General Support |
| UNITED WAY OF ST JOSEPH | |||||||
| 3517 E Jefferson | SOUTH BEND | IN | 46660 | 351063368 | 501(c)(3) | $50,000 | Corporate Sponsor |
| UNITY GARDENS INC | |||||||
| PO Box 10022 | South Bend | IN | 46628 | 270901122 | 501(C)(3) | $30,234 | General Support |
| AMERICAN HEART ASSOCIATION INC | |||||||
| 7272 GREENVILLE AVE | DALLAS | TX | 75231 | 135613797 | 501(C)(3) | $10,000 | SPONSORSHIP |
| INDIANA UNIVERSITY FOUNDATION | |||||||
| PO Box 500 | Bloomington | IN | 47402 | 356018940 | 501(C)(3) | $30,000 | Sponsorship |
| YMCA OF MICHIANA INC | |||||||
| 1201 Northside Blvd | South Bend | IN | 46615 | 350868216 | 501(C)(3) | $45,000 | General Support |
| CENTER FOR HOSPICE CARE FOUNDATION | |||||||
| 111 Sunnybrook Ct | South Bend | IN | 46637 | 300433147 | 501(C)(3) | $10,000 | General Support |
| MORRIS PERFORMING ARTS CENTER | |||||||
| Po Box 543 | South Bend | IN | 46624 | 351834689 | 501(C)(3) | $6,000 | General Support |
| INDIANA HEALTH CENTERS INC | |||||||
| 8003 CASTLEWAY DR | INDIANAPOLIS | IN | 46250 | 311003977 | 501(C)(3) | $25,000 | Sponsorship |
| Beacon Medical Group INC | |||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 351536132 | 501(C)(3) | $1,894,542 | CONTRIBUTION FOR CLINICS |
| BETHEL COLLEGE | |||||||
| 1001 BETHEL CIRCLE | MISHAWAKA | IN | 46545 | 350935587 | 501(C)(3) | $30,000 | Nursing Lab Donation |
| DOWNTOWN SOUTH BEND | |||||||
| 217 S MICHIGAN ST | South Bend | IN | 46601 | 351546291 | 501(C)(6) | $25,000 | Sponsorship |
| SOUTH BEND PARKS FOUNDATION INC | |||||||
| 321 E WALTER STREET | South Bend | IN | 46614 | 273843043 | 501(C)(3) | $40,000 | Sponsorship |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 15 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | GRANT MONITORING PROCEDURES | FormAndLineReferenceDesc |
| Explanation | Sch I, PART I, QUESTION 2 Donations and grants given to organizations that improve the health and well-being of our community are monitored through Outcome Measurement Reports that are provided to Memorial by the various organizations. These reports inform us of how the donations and grants were used. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffrey P Costello | ||||||||||||||
| CFO/Asst. Treasurer | $0 | $438,770 | $0 | $107,800 | $0 | $29,215 | $0 | $156,942 | $0 | $19,589 | $0 | $752,316 | $0 | |
| Keith Sherry MD | ||||||||||||||
| Employed Physician | $307,451 | $0 | $0 | $0 | $1,290 | $0 | $10,870 | $0 | $23,563 | $0 | $343,174 | $0 | $0 | $0 |
| Gerard Duprat MD | ||||||||||||||
| Trustee Thru March 2016 | $0 | $591,954 | $0 | $124,255 | $0 | $10,247 | $0 | $10,600 | $0 | $24,052 | $0 | $761,108 | $0 | $0 |
| Kreg Gruber | ||||||||||||||
| PRESIDENT Thru March 2016 | $0 | $439,513 | $0 | $194,395 | $0 | $13,863 | $0 | $159,767 | $0 | $26,390 | $0 | $833,928 | $0 | $0 |
| Cheryl Wibbens-Lesh MD | ||||||||||||||
| Asst. Secr./VP | $328,086 | $0 | $37,564 | $0 | $2,590 | $0 | $12,352 | $0 | $25,013 | $0 | $405,605 | $0 | $0 | $0 |
| Thomas Sutula MD | ||||||||||||||
| Employed Physician | $250,261 | $0 | $14,000 | $0 | $24,141 | $0 | $14,701 | $0 | $19,219 | $0 | $322,322 | $0 | $0 | $0 |
| Dale A Patterson | ||||||||||||||
| Employed Physician | $325,909 | $0 | $14,376 | $0 | $756 | $0 | $10,600 | $0 | $23,189 | $0 | $374,830 | $0 | $0 | $0 |
| PHILLIP NEWBOLD | ||||||||||||||
| CEO | $0 | $769,778 | $0 | $235,000 | $0 | $201,649 | $0 | $157,077 | $0 | $15,472 | $0 | $1,378,976 | $0 | $142,540 |
| BRYAN BOYER | ||||||||||||||
| Trustee/Employed Physician | $0 | $857,737 | $0 | $10,666 | $0 | $900 | $0 | $11,006 | $0 | $23,339 | $0 | $903,648 | $0 | $0 |
| Marion Mahone | ||||||||||||||
| Employeed Physician | $250,679 | $0 | $13,575 | $0 | $14,375 | $0 | $10,600 | $0 | $8,754 | $0 | $297,983 | $0 | $0 | $0 |
| Matthew R Reed | ||||||||||||||
| Employeed Physician | $241,266 | $0 | $13,250 | $0 | $8,548 | $0 | $10,600 | $0 | $6,137 | $0 | $279,801 | $0 | $0 | $0 |
| Larry Tracy | ||||||||||||||
| President | $183,798 | $0 | $35,000 | $0 | $6,811 | $0 | $13,730 | $0 | $12,190 | $0 | $251,529 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | MEMORIAL HOSPITAL OF SOUTH BEND, INC. REIMBURSES DIRECTORS FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS OF COMPLIMENTARY USE OF MEMORIALS HEALTH AND LIFESTYLE CENTER AND SPOUSAL TRAVEL. BEACON HEALTH SYSTEM ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATIONS BEHALF. SPOUSAL TRAVEL FOR THE FOLLOWING 1 EMPLOYEE WAS INCLUDED IN TAXABLE COMPENSATION: TRACY GRAHAM HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING 5 INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: TRACY GRAHAM, CARLTON LYONS, MD, MARIA SLAGER, PERRY WATSON III, AND BRAD TOOTHAKER. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS FOR THE FOLLOWING 10 INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: THOMAS BURISH, PHD, TRACY GRAHAM, CARLTON LYONS, MD, MARIA SLAGER, PERRY WATSON III, PETER BARANAY, THOMAS HAUCH, BRAD TOOTHAKER, TIM DURHAM, and KAREN BARNETT. PART I, LINE 3 MEMORIAL HOSPITAL OF SOUTH BEND, 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. SCH. J PART 1, LINE 4B EXECUTIVE RETENTION PLAN BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUAL RECEIVED VESTED PAYMENTS IN 2016, REFLECTED IN COLUMN (B)(III): PHIL NEWBOLD $143,631 IN MARCH 2016. THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2016 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: PHIL NEWBOLD, $135,317 JEFFREY COSTELLO, $74,414 KREG GRUBER, $84,167 Larry Tracy, $13,730 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 2016 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: JEFFREY COSTELLO, $65,000 KREG GRUBER, $65,000 SCH. J PART 1, LINE 7 - COMPENSATION CONTINGENT ON NET EARNINGS THE RELATED ORGANIZATION, BEACON HEALTH SYSTEM, HAS THREE INCENTIVE PLANS (EMPLOYEE, MANAGEMENT AND EXECUTIVE) WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR BEACON HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $4,500,000. THE PAYOUT AND AMOUNT OF THE PAYOUT FOR THE EMPLOYEE INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. THE MANAGEMENT INCENTIVE PLAN 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 BUDGETED OPERATING INCOME. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY | ||||||||
| A | 356311914 | 79061BCP8 | 2006-03-16 | $38,580,000 | REFUND BONDS ISSUED 12/12/2000 | false | false | false |
| HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY | ||||||||
| B | 356311914 | 79062WAA6 | 2013-05-21 | $45,523,353 | REFUND BONDS ISSUED 05/10/2007 | false | false | false |
| INDIANA FINANCE AUTHORITY | ||||||||
| C | 351602316 | 45471ALS9 | 2013-05-21 | $96,069,836 | REFUND BOND ISSD 2/3/98 & 10/22/08 | false | false | false |
| INDIANA FINANCE AUTHORITY | ||||||||
| D | 351602316 | 000000000 | 2013-04-29 | $7,492,187 | URGENT CARE HELICOPTER | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $1,130,000 | $0 | $45,510,172 | $0 | $0 | $0 | $467,934 | $775,830 | $0 | $0 | $44,266,408 | $0 | 2000 | false | Yes (true) | Yes (true) | Yes (true) |
| B | $0 | $0 | $45,523,353 | $0 | $0 | $0 | $511,271 | $0 | $0 | $0 | $45,012,081 | $0 | 2009 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $14,295,568 | $0 | $96,069,836 | $0 | $0 | $0 | $764,791 | $0 | $0 | $0 | $95,305,045 | $0 | 2003 | Yes (true) | false | Yes (true) | Yes (true) |
| D | $3,847,901 | $0 | $7,492,187 | $0 | $0 | $0 | $66,925 | $0 | $0 | $7,425,262 | $0 | $0 | 2013 | false | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Private Bus Use By OthersPrivateBusUseByOthersPct | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | |||||||||
| B | 0 | false | false | Yes (true) | Yes (true) | false | Yes (true) | |||
| C | 0 | false | false | Yes (true) | Yes (true) | false | Yes (true) | false | false | false |
| D | 0 | false | false | false | false | Yes (true) | false | false | false |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WELLS FARGO BANK NA | |||||||||||||
| A | false | false | false | Yes (true) | Yes (true) | Yes (true) | 21.7 | false | false | false | 0 | false | Yes (true) |
| 0 | |||||||||||||
| B | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
| 0 | |||||||||||||
| C | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
| 0 | |||||||||||||
| D | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
| D | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 3, COLUMN A | FormAndLineReferenceDesc |
| Explanation | THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF THE ISSUE AND THE ISSUE PRICE IS INVESTMENT EARNINGS. PART III, COLUMN A COLUMN A IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND BONDS ISSUED BEFORE 01/01/2003. PART III, LINE 4-6, COLUMN B - D 0% OF BONDS WERE FOR PRIVATE BUSINESS USE PART IV, LINE 2C, COLUMN A - D A: Compliance REPORT DATED March 7, 2016, SHOWED THAT NO REBATE WOULD BE DUE. B - C: REBATE REPORT DATED May 11, 2017, SHOWED THAT NO REBATE WOULD BE DUE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART I, LINE 6 | VOLUNTEERS MEMORIAL HOSPITAL OF SOUTH BEND HAS A DEPARTMENT CALLED AMBASSADOR AND CUSTOMER SERVICES. IT IS THE RESPONSIBILITY OF THIS DEPARTMENT TO RECRUIT, ORIENT, PROCESS AND PLACE NEW AMBASSADORS IN APPROXIMATELY 30 SERVICE AREAS OF THE HOSPITAL. IT IS ALSO THE RESPONSIBILITY OF THE DEPARTMENT TO FOLLOW UP, SCHEDULE AND RECOGNIZE AMBASSADORS. SOME OF THE AREAS OF SERVICE INCLUDE A MAJOR SURGERY WAITING ROOM, PATIENT ESCORTS, FLOWER DELIVERY, MAIL DELIVERY, LIVING HISTORY PROGRAM, EMERGENCY DEPARTMENT VOLUNTEERS AND COOKIE BAKERS. IN 2016, MEMORIAL HAD 463 VOLUNTEERS IN THIS PROGRAM WHO SERVED 40,955 HOURS. FORM 990, PART III, QUESTION 3 IN 2016, BEACON HEALTH SYSTEM, INC. (BHS) CONSOLIDATED ADDITIONAL DEPARTMENTS INTO CORPORATE SERVICES TO BETTER ALIGN WITH THE WORK THE DEPARTMENTS ARE PERFORMING. AS PART OF THE CONSOLIDATION, ALL ACTIVITIES RELATED TO FACILITIES MANAGEMENT ARE NOW INCLUDED ON BHS, WHEREAS IN THE PAST THESE WERE SEPARATE DEPARTMENTS ON THE AFFILATED ENTITIES INCLUDING MEMORIAL HOSPITAL. THE ADDITION OF THE FACILITIES MANAGEMENT ACTIVITIES CAUSED A DECREASE IN RENTAL INCOME IN 2016 COMPARED TO 2015. THESE CHANGES DID NOT SUBSTANTIALLY CHANGE THE PROGRAM SERVICES OF MEMORIAL HOSPITAL, THEREFORE, IT HAS ANSWERED 'NO' TO FORM 990, PART III, QUESTION 3. CORE FORM, PART III, LINE 4D OTHER PROGRAM SERVICES INCLUDE PSYCHIATRIC DEPARTMENTS, SOCIAL SERVICES, COMMUNITY OUTREACH PROGRAMS, TITHING, GRANTS, AND SUPPORTING SERVICES SUCH AS ADMINISTRATION, FINANCE, PAYROLL, PATIENT ACCOUNTING, LAUNDRY SERVICES, HEALTH AND LIFESTYLE CENTER, AND MEDICAL RECORDS. DUE TO THE NON-REVENUE GENERATING OR COMMUNITY INVESTMENT NATURE OF MANY OF THE PROGRAMS, THEY OPERATE AT A LOSS. SEE SCHEDULE H FOR DETAILS ON THE HOSPITALS TITHING AND COMMUNITY OUTREACH REPRESENTED IN OTHER PROGRAM SERVICES. CORE FORM, PART VI, SECTION A, QUESTION 6 MEMBERS OF THE ORGANIZATION - BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF MEMORIAL HOSPITAL OF SOUTH BEND, INC. CORE FORM, PART VI, SECTION A, QUESTION 7A ELECTION OF BOARD MEMBERS THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF MEMORIAL HOSPITAL OF SOUTH BEND AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF MEMORIAL HOSPITAL OF SOUTH BEND. CORE FORM, PART VI, SECTION A, QUESTION 7B DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. CORE FORM, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS 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 ORGANIZATION'S BOARD PORTALS WHICH ALLOWS FOR BOARD MEMBER REVIEW PRIOR TO FILING THE RETURN. CORE FORM, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURE 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 AND WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT OVER 346 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 CHAIMAN, 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 SYSTEMS KEY FINANCIAL EMPLOYEES THAT BEACONS FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT IN EARLY JANUARY 2017 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2017, 20 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. CORE FORM, PART VI, SECTION B, LINE 15A & 15B COMPENSATION DETERMINATION PROCESS MEMORIAL HOSPITAL OF SOUTH BEND'S PARENT, BEACON HEALTH SYSTEM, INC. HAS AN EXTENSIVE EXAMINATION THAT IS CONDUCTED, FOR VICE PRESIDENT AND HIGHER, USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. HUMAN RESOURCES CONDUCTS THE ANALYSIS AND MAKES RECOMMENDATIONS TO THE CEO WHO THEN MAKES THE RECOMMENDATIONS FOR ALL OTHER EXECUTIVES/OFFICERS TO THE BOARD FOR APPROVAL. THE INDEPENDENT CONSULTING GROUP SEPARATELY MAKES THE RECOMMENDATIONS REGARDING THE CEO'S COMPENSATION TO THE BOARD FOR APPROVAL. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD. CORE FORM, PART VI, SECTION C, LINE 19 AVAILABILITY OF ORGANIZATIONAL DOCUMENTS THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR THE BEACON HEALTH SYSTEM, INC. BONDS. |
| PART XI, LINE 9 | Other Changes in the net assets of Fund Balances Write off Inter company, Beacon Medical Group, Inc. (72,113,717) Write off Inter company, Memorial Health Foundation, Inc. (39,173) Write off Inter company, Elkhart General Hospital, Inc. 6,410,604 Write off Inter company, Beacon Health System, Inc. 29,594,921 Write off Inter company, Beacon Health Ventures, Inc. (923,086) Change in interest in recipient org 1,739,597 TOTAL (35,330,854) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FEES - PHYS TOTAL FEES:17573402 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:10216141 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB FEES TOTAL FEES:6506161 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:5230931 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION EXPENSE TOTAL FEES:2999730 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:REPAIR PARTS/MAINTENANCE TOTAL FEES:1312353 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TRANSCRIPTION, P/S MEDICAL TOTAL FEES:968630 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:607023 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Beacon Medical Group Inc | ||||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351536132 | PHY PRACTICES | IN | 501(C)(3) | 10 | BHS | Yes (true) |
| Beacon Health Foundation Inc | ||||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351536129 | Financial Sup | IN | 501(C)(3) | 7 | BHS | Yes (true) |
| Elkhart General Hospital Inc | ||||||||||
| 600 East Boulevard | Elkhart | IN | 46514 | 350877574 | Hospital | IN | 501(C)(3) | 3 | BHS | Yes (true) |
| MEMORIAL ENDOWMENT FUND FOR MEM HOS | ||||||||||
| PO BOX 1602 | SOUTH BEND | IN | 46634 | 356068581 | ENDOWMENT | IN | 501(C)(3) | 12D | MHSB | Yes (true) |
| BEACON HEALTH SYSTEM Inc | ||||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 453864076 | Parent Org | IN | 501(C)(3) | 12A | NA | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt |
|---|---|---|---|---|---|---|---|---|
| BEACON HEALTH VENTURES INC | ||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351901068 | Home Medical | IN | NA | C |
| BEACON HEALTH VENTURES MICHIGAN INC | ||||||||
| 615 N MICHIGAN ST | SOUTH BEND | IN | 46601 | 208259773 | HOME MEDICAL | MI | NA | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (18 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Beacon Health Ventures Inc | ||
| H | $1,419,933 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| P | $4,327,885 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| Q | $923,086 | WRITEOFFINTERCO |
| Beacon Health Ventures Inc | ||
| Q | $1,640,000 | CASH TRANSFER |
| Beacon Health Ventures Inc | ||
| R | $799,135 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| C | $6,410,604 | WRITEOFFINTERCO |
| Elkhart General Hospital Inc | ||
| P | $1,928,882 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| Q | $22,748,414 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| R | $27,232,233 | INTERCO TRNSF |
| Memorial Health Foundation Inc | ||
| C | $1,895,615 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| P | $125,576 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| Q | $147,224 | ACTUAL CHARGES |
| Beacon Medical Group Inc | ||
| B | $72,113,717 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| B | $1,894,542 | ACTUAL CHARGES |
| Beacon Medical Group Inc | ||
| J | $2,370,775 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| P | $2,448,837 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| R | $55,000,000 | CASH TRANSFER |
| Beacon Medical Group Inc | ||
| Q | $19,201,019 | WRITEOFFINTERCO |
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