2017-11-14T21:11:35-06:00 2016-12-31 ERNST & YOUNG US LLP 155 N WACKER DR CHICAGO IL 60606 990 2016-01-01 350868132 Memorial Hospital of South Bend Inc % JEFFREY COSTELLO MEMO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 JEFFREY COSTELLO CFO 5746473549 2017-11-13 true JACOB ZEHNDER P01564049 3128792702 73.247.118.182 36964520173185000074 2017-11-14 P 9EC56A8E4A3D8887D040A3ED15582BADE031077D AA66391A3EB419599D985CB7941CE455993313B6 2016 2017-02-10 21:41:12Z Larry Tracy 615 N MICHIGAN STREET SOUTH BEND IN 46601 528893274 false X www.qualityoflife.org X 1923 IN MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. 9 8 3605 463 562885 95226 7624707 3812391 502549671 505411374 707304 -678041 17853321 14396285 528735003 522942009 2609678 2418189 0 0 178486757 183402987 0 0 0 261667769 258951287 442764204 444772463 85970799 78169546 555878904 591066147 245545131 239173330 310333773 351892817 X MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. false false 117348902 242768790 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. 102227464 140190381 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. 66136173 134403613 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. 108022039 2418189 393734578 true true false true false false false false false true true false false true true true false true false false false false false false true false true true true false true true false false false false false false false false false false false false false false false true true true false false true 263 0 true 3605 true true true false false false false false false false false false X 9 8 false false false false true true true true true false false true true true true true true false false true true IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 Gerard Duprat MD Trustee Thru March 2016 2.0 40.0 X 0 726456 34652 Carlton Lyons MD Trustee Thru March 2016 2.0 0.0 X 5606 0 0 Tracy Graham Treasurer Thru March 2016 2.0 2.0 X X 6280 0 0 Maria Slager Trustee Thru March 2016 2.0 0.0 X 1660 0 0 Perry Watson III Chair 2.0 0.0 X X 2110 0 0 Thomas Burish PhD Chair Thru March 2016 2.0 0.0 X X 1705 0 0 Peter Baranay Vice Chair 2.0 2.0 X X 543 0 0 KAREN BARNETT Secretary 2.0 0.0 X X 149 0 0 TIM DURHAM Trustee 2.0 0.0 X 149 0 0 HUGH HEDMAN MD TRUSTEE 2.0 0.0 X 0 0 0 BRYAN BOYER Trustee/Employed Physician 2.0 40.0 X 0 869303 34345 MARK HARMAN Trustee 2.0 0.0 X 0 0 0 THOMAS HAUCH MD Trustee 2.0 0.0 X 202 0 0 BRAD TOOTHAKER Trustee 2.0 0.0 X 2972 0 0 Jeffrey P Costello CFO/Asst. Treasurer 2.0 46.0 X 0 575785 176531 Kreg Gruber PRESIDENT Thru March 2016 4.0 36.0 X 0 647771 186157 Cheryl Wibbens-Lesh MD Asst. Secr./VP 40.0 2.0 X 368240 0 37365 PHILLIP NEWBOLD CEO 2.0 46.0 X 0 1206427 172549 Larry Tracy President 40.0 0.0 X 225609 0 25920 Keith Sherry MD Employed Physician 40.0 0.0 X 308741 0 34433 Thomas Sutula MD Employed Physician 40.0 0.0 X 288402 0 33920 Dale A Patterson Employed Physician 40.0 0.0 X 341041 0 33789 Marion Mahone Employeed Physician 40.0 0.0 X 278629 0 19354 Matthew R Reed Employeed Physician 40.0 0.0 X 263064 0 16737 2095102 4025742 805752 120 false true false BALFOUR BEATTY CONSTRUCTION LLC 3100 MCKINNON STREET 6TH FLOOR DALLAS TX 75201 CONSTRUCTION 28777625 PANZICA BUILDING CORPORATION 416 East Monroe Street Suite 320 SOUTH BEND IN 46601 CONSTRUCTION 11609366 SOUTH BEND EMERGENCY PHYSICIANS 615 N MICHIGAN SOUTH BEND IN 46601 PHYSICIAN SERVICES 7621645 SOUTH BEND MEDICAL FOUNDATION 530 N LAFAYETTE BLVD SOUTH BEND IN 46601 LAB SERVICES 6700169 MICHIANA ANESTHESIA CARE PC 416 E MONROE STREET SUITE 200 SOUTH BEND IN 46601 ANESTHESIA 2567852 65 1895615 1916776 3812391 NET PATIENT REVENUE 622110 505240784 505240784 AMBULANCE SUPPLY 621910 107488 107488 CASH DISCOUNTS 561499 28109 28109 MEDICAL EDUCATION REVENUE 611710 34993 34993 505411374 709676 709676 5722 5722 25000 25000 234637 62106 172531 0 172531 172531 4213661 8091 5599009 -8091 -1385348 -1393439 -1393439 250519 282059 -31540 -31540 0 0 0 0 0 0 TEAM PHARMACY 561499 5500241 5500241 HLC ATHLETIC CLB 713940 2060080 2026481 33599 MRI PARTNERSHIP 561499 1118240 1118240 5551733 3306448 562885 1682400 14230294 522942009 517362784 562885 1203949 X 2418189 2418189 0 0 0 678659 678659 0 143112047 118353663 24758384 7146854 5910448 1236406 22639144 18722572 3916572 9826283 8126336 1699947 753876 623455 130421 80895 80895 253704 253704 32790 27117 5673 0 303532 303532 45414371 41891023 3523348 299430 247629 51801 3869867 3200380 669487 37663 31147 6516 0 8243200 6817126 1426074 652186 539358 112828 0 91187 75412 15775 5321958 4401259 920699 0 29521565 24414334 5107231 2777651 2297117 480534 MEDICAL SUPPLIES 84543886 84543886 0 0 CORPORATE FEE 30070860 24868601 5202259 0 BAD DEBIT EXPENSE 29577456 29577456 0 0 HOSPITAL ASSESSMENT FEE 14462784 14462784 0 0 2642426 2185286 457140 444772463 393734578 51037885 0 20637 19775 45380509 25071146 623347 385006 103575140 93322501 0 0 0 0 0 0 15145029 17028261 1132560 1015797 783152419 417901337 339010801 365251082 24400164 25000887 0 0 460516 316256 1171474 1171474 24958727 62483962 555878904 591066147 45864135 42624988 0 0 26264 30856 166282700 159778646 0 0 0 0 858212 670966 0 0 32513820 36067874 245545131 239173330 X 303445019 343264467 6888754 8628350 0 0 310333773 351892817 555878904 591066147 X 78169546 -1279648 -35330854 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 32790 32790 false false Lobbying Detail 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. 26556022 9605449 339397 2645907 33854961 29619029 4093832 -1367472 5789367 26556022 27642755 2833644 -142883 714487 29619029 24661171 2180336 1785965 984717 27642755 22198822 1501904 1884305 923860 24661171 0.73730 0.00780 0.25490 false true true 21318068 21318068 429186207 177097648 252088559 851999 851999 284145586 236182379 47963207 47650559 3769311 43881248 365251082 DUE FROM 3RD PARTY PAYORS 37854975 INT IN NET ASSETS OF REC ORG 8628350 DUE FROM AFFILIATES 818 INTEREST RECEIVABLE - SWAP 91201 DUE FROM SELF INSURED TRUST 78 OTHER RECEIVABLES 3607568 2016 BOND FUND 12300972 62483962 0 INTEREST RATE SWAP 22778724 ASSET RETIREMENT OBLIGATION 4443537 IBNR 3366387 DUE TO THIRD PARTY 3519883 CAPITAL LEASE PAYABLE 1302160 MEDTRONIC O-ARM AGREEMENT 657183 36067874 X 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. MARATHON 250519 250519 3875 1156 277028 0 250519 250519 3875 1156 277028 282059 -31540 Part II Event #1 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. true true true X true X true true true false true true 2876072 2876072 0.00690 88944454 75277800 13666654 0.03290 91820526 75277800 16542726 0.03980 12226779 2016753 10210026 0.02460 8768915 1560917 7207998 0.01740 106676 98047 8629 322806 322806 0.00080 21425176 3675717 17749459 0.04280 113245702 78953517 34292185 0.08260 1161 1161 860 860 2021 2021 true 7929716 3964858 83259430 107691462 -24432032 X true true 1 1 MEMORIAL HOSPITAL OF SOUTH BEND INC 615 N MICHIGAN STREET SOUTH BEND IN 46545 www.BeaconHealthSystem.org 16-005053-1 X X X X X X MEMORIAL HOSPITAL OF SOUTH BEND INC 1 false false true X X X X X X X X X 15 true true true true X SEE SECTION C FOR FULL URL X X true 15 true SEE SECTION C FOR FULL URL false true X 200. 350. X X X true true X X X true X See Section C for full URL X See Section C for full URL X See Section C for full URL X X X X X X true X false X X X X true X false false Part V, Section B, Line 5 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 6 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 Part VI, Descriptions for Part I, Line 3c Factors to be considered for Financial Assistance Household Size and Income The following factors may be considered in determining the eligibility of the patient for assistance and must be provided by all income earning residents in the countable household unit unless they are not dependents based on IRS guidelines for determining whether a household member can be considered a dependent. 1. Indiana workforce wage report for last 2 quarters (unemployment income) 2. Last 3 pay stubs or a letter or printout from employer(s) providing verification of gross income if currently employed. This documentation should not be more than 30 days old from date of issue and include year-to-date information. 3. Last 3 bank statements (including explanations of regular deposits not explained by pay stubs) 4. Social Security award or entitlement letter or other proof of gross monthly award. 5. Retirement income. 6. Investment income. 7. Statement from person(s) that are providing direct support 8. Number of dependents. 9. Most recent tax return (including W2 and all supporting schedules) 10. Other financial obligations. 11. 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 true NORTHEAST NEIGHBORHOOD REVITALIZATION ORGANIZATION 803 LINCOLNWAY WEST SOUTH BEND IN 46616 352118149 501(C)(3) 50000 Corporate Sponsor PENN-HARRIS-MADISON EDUC FOUNDATION INC 55900 BITTERSWEET RD MISHAWAKA IN 46545 351996785 501(C)(3) 6000 General Support THE CENTER FOR THE HOMELESS 813 South Michigan SOUTH BEND IN 46601 351768544 501(C)(3) 28500 Sponsorship UNIVERSITY OF NOTRE DAME MAIN BUILDING Notre Dame IN 46556 350868188 501(c)(3) 45000 Research Donation SOUTH BEND HERITAGE FOUNDATION INC 803 Lincolnway West SOUTH BEND IN 46616 237394320 501(c)(3) 5500 General Support UNITED WAY OF ST JOSEPH 3517 E Jefferson SOUTH BEND IN 46660 351063368 501(c)(3) 50000 Corporate Sponsor UNITY GARDENS INC PO Box 10022 South Bend IN 46628 270901122 501(C)(3) 30234 General Support AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 10000 SPONSORSHIP INDIANA UNIVERSITY FOUNDATION PO Box 500 Bloomington IN 47402 356018940 501(C)(3) 30000 Sponsorship YMCA OF MICHIANA INC 1201 Northside Blvd South Bend IN 46615 350868216 501(C)(3) 45000 General Support CENTER FOR HOSPICE CARE FOUNDATION 111 Sunnybrook Ct South Bend IN 46637 300433147 501(C)(3) 10000 General Support MORRIS PERFORMING ARTS CENTER Po Box 543 South Bend IN 46624 351834689 501(C)(3) 6000 General Support INDIANA HEALTH CENTERS INC 8003 CASTLEWAY DR INDIANAPOLIS IN 46250 311003977 501(C)(3) 25000 Sponsorship Beacon Medical Group INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 501(C)(3) 1894542 CONTRIBUTION FOR CLINICS BETHEL COLLEGE 1001 BETHEL CIRCLE MISHAWAKA IN 46545 350935587 501(C)(3) 30000 Nursing Lab Donation DOWNTOWN SOUTH BEND 217 S MICHIGAN ST South Bend IN 46601 351546291 501(C)(6) 25000 Sponsorship SOUTH BEND PARKS FOUNDATION INC 321 E WALTER STREET South Bend IN 46614 273843043 501(C)(3) 40000 Sponsorship 15 1 GRANT MONITORING PROCEDURES 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. X X X true true false true false false false false false true false Jeffrey P Costello CFO/Asst. Treasurer 0 438770 0 107800 0 29215 0 156942 0 19589 0 752316 0 Keith Sherry MD Employed Physician 307451 0 0 0 1290 0 10870 0 23563 0 343174 0 0 0 Gerard Duprat MD Trustee Thru March 2016 0 591954 0 124255 0 10247 0 10600 0 24052 0 761108 0 0 Kreg Gruber PRESIDENT Thru March 2016 0 439513 0 194395 0 13863 0 159767 0 26390 0 833928 0 0 Cheryl Wibbens-Lesh MD Asst. Secr./VP 328086 0 37564 0 2590 0 12352 0 25013 0 405605 0 0 0 Thomas Sutula MD Employed Physician 250261 0 14000 0 24141 0 14701 0 19219 0 322322 0 0 0 Dale A Patterson Employed Physician 325909 0 14376 0 756 0 10600 0 23189 0 374830 0 0 0 PHILLIP NEWBOLD CEO 0 769778 0 235000 0 201649 0 157077 0 15472 0 1378976 0 142540 BRYAN BOYER Trustee/Employed Physician 0 857737 0 10666 0 900 0 11006 0 23339 0 903648 0 0 Marion Mahone Employeed Physician 250679 0 13575 0 14375 0 10600 0 8754 0 297983 0 0 0 Matthew R Reed Employeed Physician 241266 0 13250 0 8548 0 10600 0 6137 0 279801 0 0 0 Larry Tracy President 183798 0 35000 0 6811 0 13730 0 12190 0 251529 0 0 0 PART I, LINE 1A 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. A HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 356311914 79061BCP8 2006-03-16 38580000 REFUND BONDS ISSUED 12/12/2000 false false false B HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 356311914 79062WAA6 2013-05-21 45523353 REFUND BONDS ISSUED 05/10/2007 false false false C INDIANA FINANCE AUTHORITY 351602316 45471ALS9 2013-05-21 96069836 REFUND BOND ISSD 2/3/98 & 10/22/08 false false false D INDIANA FINANCE AUTHORITY 351602316 000000000 2013-04-29 7492187 URGENT CARE HELICOPTER false false false A 1130000 0 45510172 0 0 0 467934 775830 0 0 44266408 0 2000 false true true true B 0 0 45523353 0 0 0 511271 0 0 0 45012081 0 2009 true false true true C 14295568 0 96069836 0 0 0 764791 0 0 0 95305045 0 2003 true false true true D 3847901 0 7492187 0 0 0 66925 0 0 7425262 0 0 2013 false false true true A 0 B false false true true false 0 true C false false true true false 0 false false false true D false false false false 0 false false false true A false false false true true true WELLS FARGO BANK NA 21.7 false false false 0 false true B false false false true false false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true false false 0 false 0 false true A true B true C true D true PART II, LINE 3, COLUMN A 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. 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 Beacon Medical Group Inc 615 N Michigan Street South Bend IN 46601 351536132 PHY PRACTICES IN 501(C)(3) 10 BHS true Beacon Health Foundation Inc 615 N Michigan Street South Bend IN 46601 351536129 Financial Sup IN 501(C)(3) 7 BHS true Elkhart General Hospital Inc 600 East Boulevard Elkhart IN 46514 350877574 Hospital IN 501(C)(3) 3 BHS true MEMORIAL ENDOWMENT FUND FOR MEM HOS PO BOX 1602 SOUTH BEND IN 46634 356068581 ENDOWMENT IN 501(C)(3) 12D MHSB true BEACON HEALTH SYSTEM Inc 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 Parent Org IN 501(C)(3) 12A NA false 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 false true true false false false false true false true true true true false true true true true true Beacon Health Ventures Inc H 1419933 ACTUAL CHARGES Beacon Health Ventures Inc P 4327885 ACTUAL CHARGES Beacon Health Ventures Inc Q 923086 WRITEOFFINTERCO Beacon Health Ventures Inc Q 1640000 CASH TRANSFER Beacon Health Ventures Inc R 799135 ACTUAL CHARGES Elkhart General Hospital Inc C 6410604 WRITEOFFINTERCO Elkhart General Hospital Inc P 1928882 ACTUAL CHARGES Elkhart General Hospital Inc Q 22748414 ACTUAL CHARGES Elkhart General Hospital Inc R 27232233 INTERCO TRNSF Memorial Health Foundation Inc C 1895615 ACTUAL CHARGES Memorial Health Foundation Inc P 125576 ACTUAL CHARGES Memorial Health Foundation Inc Q 147224 ACTUAL CHARGES Beacon Medical Group Inc B 72113717 WRITEOFFINTERCO Beacon Medical Group Inc B 1894542 ACTUAL CHARGES Beacon Medical Group Inc J 2370775 WRITEOFFINTERCO Beacon Medical Group Inc P 2448837 WRITEOFFINTERCO Beacon Medical Group Inc R 55000000 CASH TRANSFER Beacon Medical Group Inc Q 19201019 WRITEOFFINTERCO