MEMORIAL HOSPITAL OF SOUTH BEND: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL OF SOUTH BEND (EIN 35-0868132)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-10
- IRS object ID
- 201613159349303211
- Schema version
- 2015v2.1
- 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 | 2016-11-10T14:30:33-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 2015-01-01 | 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 | 2016-11-09 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kreg Gruber | 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 | $529,485,707 | 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 | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 3654 | TotalEmployeeCnt |
| Total Volunteers | 441 | TotalVolunteersCnt |
| Total Gross UBI | $749,493 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $267,322 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,387,487 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,624,707 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $499,527,555 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $502,549,671 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,383,928 | PYInvestmentIncomeAmt |
| CY Investment Income | $707,304 | CYInvestmentIncomeAmt |
| PY Other Revenue | $20,196,739 | PYOtherRevenueAmt |
| CY Other Revenue | $17,853,321 | CYOtherRevenueAmt |
| PY Total Revenue | $525,495,709 | PYTotalRevenueAmt |
| CY Total Revenue | $528,735,003 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,086,952 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,609,678 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $177,206,268 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $178,486,757 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $265,035,063 | PYOtherExpensesAmt |
| CY Other Expenses | $261,667,769 | CYOtherExpensesAmt |
| PY Total Expenses | $443,328,283 | PYTotalExpensesAmt |
| CY Total Expenses | $442,764,204 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $82,167,426 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $85,970,799 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $553,998,135 | TotalAssetsBOYAmt |
| Total Assets EOY | $555,878,904 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $268,255,961 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $245,545,131 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $285,742,174 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $310,333,773 | 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 | $113,820,221 | ExpenseAmt |
| Revenue | $245,105,066 | 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. 2015 Statistics for this service unit include: - 513,865 Inpatient procedures - 372,878 Outpatient procedures - 962 Inpatient Caths - 810 Outpatient Caths - 180,689 Outpatient visits - 569,932 Meals. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $98,898,395 | ExpenseAmt |
| Revenue | $141,656,761 | 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. 2015 Statistics for this service unit include: - 4,207 Inpatient procedures - 201 Open Heart procedures - 8,371 Outpatient procedures. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $66,446,715 | ExpenseAmt |
| Revenue | $129,526,551 | 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. 2015 Statistics for this service unit include: - 112,694 Patient Days - 9,793 Inpatient ER visits - 44,775 Outpatient ER visits - 2,541 Births - 14,096 Observation stays - 310 Medical flights. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $107,555,600 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $695,980 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $386,720,931 | 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 | false | 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 | Yes (true) | 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 | 303 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 3654 | 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 (31 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 |
|---|---|---|---|---|---|---|---|---|
| Robert Yount MD | ||||||||
| Trustee THRU 3/2015 | 2.0 | 40.0 | Yes (X) | $0 | $867,826 | $35,723 | ||
| Gerard Duprat MD | ||||||||
| Trustee/Employed Physician | 2.0 | 40.0 | Yes (X) | $0 | $758,853 | $36,342 | ||
| Kreg Gruber | ||||||||
| PRESIDENT | 20.0 | 22.0 | Yes (X) | $168,656 | $393,532 | $172,637 | Yes (X) | |
| Carlton Lyons MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $4,083 | $0 | $0 | ||
| Charles Miller | ||||||||
| Secretary THRU 3/2015 | 2.0 | 0.0 | Yes (X) | $2,902 | $0 | $0 | Yes (X) | |
| Etta K Nevel MD | ||||||||
| Trustee THRU 3/2015 | 2.0 | 2.0 | Yes (X) | $3,851 | $0 | $0 | ||
| Steven Cramer | ||||||||
| Trustee THRU 3/2015 | 2.0 | 0.0 | Yes (X) | $500 | $0 | $0 | ||
| Tracy Graham | ||||||||
| Treasurer | 2.0 | 0.0 | Yes (X) | $2,110 | $0 | $0 | Yes (X) | |
| John Mathis MD | ||||||||
| Trustee THRU 3/2015 | 2.0 | 0.0 | Yes (X) | $245 | $0 | $0 | ||
| Maria Slager | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $426 | $0 | $0 | ||
| Perry Watson III | ||||||||
| Vice Chair | 2.0 | 0.0 | Yes (X) | $2,110 | $0 | $0 | Yes (X) | |
| Thomas Burish PhD | ||||||||
| Chair | 2.0 | 0.0 | Yes (X) | $1,913 | $0 | $0 | Yes (X) | |
| Ray Gans | ||||||||
| Trustee THRU 3/2015 | 2.0 | 2.0 | Yes (X) | $500 | $0 | $0 | ||
| Peter Baranay | ||||||||
| Secretary | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEPHEN M HUFFMAN | ||||||||
| PRESIDENT THRU 6/2015 | 40.0 | 2.0 | Yes (X) | $332,572 | $0 | $22,745 | Yes (X) | |
| KAREN BARNETT | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $477 | $0 | $0 | ||
| TIM DURHAM | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $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 | $876,155 | $34,381 | ||
| MARK HARMAN | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS HAUCH MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PHILLIP KAVANAGH DO | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BRAD TOOTHAKER | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Jeffrey P Costello | ||||||||
| CFO/Asst. Treasurer | 2.0 | 46.0 | $0 | $598,975 | $180,373 | Yes (X) | ||
| Cheryl Wibbens-Lesh MD | ||||||||
| Asst. Secr./VP | 40.0 | 2.0 | $377,217 | $0 | $39,198 | Yes (X) | ||
| PHILLIP NEWBOLD | ||||||||
| CEO | 2.0 | 46.0 | $0 | $1,255,794 | $186,041 | Yes (X) | ||
| Keith Sherry MD | ||||||||
| Director | 40.0 | 0.0 | $330,154 | $0 | $35,107 | Yes (X) | ||
| Thomas Sutula MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $279,492 | $0 | $35,806 | Yes (X) | ||
| Dale A Patterson | ||||||||
| Employed Physician | 40.0 | 0.0 | $353,771 | $0 | $33,238 | Yes (X) | ||
| LINDA A MANSFIELD | ||||||||
| EMPLOYED PHYSICIAN | 40.0 | 0.0 | $270,370 | $0 | $32,415 | Yes (X) | ||
| ROBERT J RILEY MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $268,629 | $0 | $31,263 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,399,978 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,751,135 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $875,269 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 125 | 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 |
|---|---|---|---|---|---|
| SOUTH BEND MEDICAL FOUNDATION | |||||
| 530 N Lafayette Blvd | SOUTH BEND | IN | 46601 | Lab services | $7,399,521 |
| SOUTH BEND EMERGENCY PHYSICIANS | |||||
| 615 N MICHIGAN | SOUTH BEND | IN | 46601 | PHYSICIAN SERVICES | $7,163,407 |
| BALFOUR BEATTY CONSTRUCTION LLC | |||||
| 3100 MCKINNON STREET 6TH FLOOR | DALLAS | TX | 75201 | Construction | $4,929,476 |
| CANCER CARE PARTNERS LLC | |||||
| 211 N EDDY STREET | SOUTH BEND | IN | 46617 | ONCOLOGY | $2,713,904 |
| MICHIANA ANESTHESIA CARE PC | |||||
| 416 E MONROE STREET SUITE 200 | SOUTH BEND | IN | 46601 | ANESTHESIA | $2,560,794 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 60 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,742,757 | RelatedOrganizationsAmt |
| Government Grants | $1,881,950 | GovernmentGrantsAmt |
| Total Contributions | $7,624,707 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $500,889,626 | $500,889,626 | |
| AFFILIATE RENTAL REVENUE | 532000 | $1,466,785 | $1,446,337 | $20,448 |
| AMBULANCE SUPPLY | 621910 | $118,641 | $118,641 | |
| CASH DISCOUNTS | 561499 | $32,668 | $32,668 | |
| MEDICAL EDUCATION | 611710 | $41,951 | $41,951 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $502,549,671 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $792,817 | TotalRevenueColumnAmt |
| Exclusion | $792,817 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,830 | TotalRevenueColumnAmt |
| Exclusion | $18,830 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,050 | TotalRevenueColumnAmt |
| Exclusion | $56,050 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,760,020 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $324,963 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,435,057 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,435,057 | TotalRevenueColumnAmt |
| Exclusion | $1,435,057 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,744 | SecuritiesAmt |
| Other | $10,919 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $119,006 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,744 | SecuritiesAmt |
| Other | -$108,087 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$104,343 | TotalRevenueColumnAmt |
| Exclusion | -$104,343 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $260,058 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $306,735 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$46,677 | TotalRevenueColumnAmt |
| Exclusion | -$46,677 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 | $5,846,745 | $5,846,745 | |
| HLC ATHLETIC CLB | 713940 | $1,955,860 | $1,915,176 | $40,684 |
| MRI PARTNERSHIP | 561499 | $1,174,958 | $1,174,958 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,431,328 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,801,828 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $729,045 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,900,455 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $16,408,891 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $528,735,003 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $516,267,930 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $749,493 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,092,873 | 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 | $2,609,678 | TotalAmt |
| Program Services | $2,609,678 | 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 | $1,021,240 | TotalAmt |
| Management And General | $1,021,240 | 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 | $139,875,919 | TotalAmt |
| Program Services | $114,698,254 | ProgramServicesAmt |
| Management And General | $25,177,665 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,184,653 | TotalAmt |
| Program Services | $5,071,415 | ProgramServicesAmt |
| Management And General | $1,113,238 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,621,496 | TotalAmt |
| Program Services | $17,729,627 | ProgramServicesAmt |
| Management And General | $3,891,869 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,783,449 | TotalAmt |
| Program Services | $8,022,428 | ProgramServicesAmt |
| Management And General | $1,761,021 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $920,062 | TotalAmt |
| Program Services | $754,451 | ProgramServicesAmt |
| Management And General | $165,611 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,851 | TotalAmt |
| Management And General | $94,851 | 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 | $32,927 | TotalAmt |
| Program Services | $27,000 | ProgramServicesAmt |
| Management And General | $5,927 | 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 | $320,727 | TotalAmt |
| Management And General | $320,727 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,595,124 | TotalAmt |
| Program Services | $36,568,003 | ProgramServicesAmt |
| Management And General | $8,027,121 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,866 | TotalAmt |
| Program Services | $60,570 | ProgramServicesAmt |
| Management And General | $13,296 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,779,840 | TotalAmt |
| Program Services | $3,099,469 | ProgramServicesAmt |
| Management And General | $680,371 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,700 | TotalAmt |
| Program Services | $56,334 | ProgramServicesAmt |
| Management And General | $12,366 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,046,396 | TotalAmt |
| Program Services | $6,598,045 | ProgramServicesAmt |
| Management And General | $1,448,351 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $828,685 | TotalAmt |
| Program Services | $679,522 | ProgramServicesAmt |
| Management And General | $149,163 | 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 | $64,882 | TotalAmt |
| Program Services | $53,203 | ProgramServicesAmt |
| Management And General | $11,679 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,770,044 | TotalAmt |
| Program Services | $3,911,436 | ProgramServicesAmt |
| Management And General | $858,608 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,911,844 | TotalAmt |
| Program Services | $23,707,712 | ProgramServicesAmt |
| Management And General | $5,204,132 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,321,730 | TotalAmt |
| Program Services | $2,723,819 | ProgramServicesAmt |
| Management And General | $597,911 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $86,382,718 | $86,382,718 | $0 | $0 |
| BAD DEBT EXPENSE | $36,368,656 | $36,368,656 | $0 | $0 |
| CORPORATE FEE | $25,686,125 | $21,062,623 | $4,623,502 | $0 |
| HOSPITAL ASSESSMENT FEE | $13,752,884 | $13,752,884 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,394,004 | TotalAmt |
| Program Services | $2,783,084 | ProgramServicesAmt |
| Management And General | $610,920 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,764,204 | TotalAmt |
| Program Services | $386,720,931 | ProgramServicesAmt |
| Management And General | $56,043,273 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,625 | BOYAmt |
| EOY | $20,637 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,328,827 | BOYAmt |
| EOY | $45,380,509 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $428,383 | BOYAmt |
| EOY | $623,347 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,595,970 | BOYAmt |
| EOY | $103,575,140 | 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 | $14,162,033 | BOYAmt |
| EOY | $15,145,029 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,559,378 | BOYAmt |
| EOY | $1,132,560 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $735,782,103 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $396,771,302 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,700,282 | BOYAmt |
| EOY | $339,010,801 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,593,180 | BOYAmt |
| EOY | $24,400,164 | 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 | $510,558 | BOYAmt |
| EOY | $460,516 | 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 | $36,928,425 | BOYAmt |
| EOY | $24,958,727 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,998,135 | BOYAmt |
| EOY | $555,878,904 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,623,766 | BOYAmt |
| EOY | $45,864,135 | 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 | $23,795 | BOYAmt |
| EOY | $26,264 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,318,330 | BOYAmt |
| EOY | $166,282,700 | 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 | $1,014,251 | BOYAmt |
| EOY | $858,212 | 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 | $41,275,819 | BOYAmt |
| EOY | $32,513,820 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $268,255,961 | BOYAmt |
| EOY | $245,545,131 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,614,507 | BOYAmt |
| EOY | $303,445,019 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,127,667 | BOYAmt |
| EOY | $6,888,754 | 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 | $285,742,174 | BOYAmt |
| EOY | $310,333,773 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,998,135 | BOYAmt |
| EOY | $555,878,904 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $85,970,799 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,974,063 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$68,353,263 | 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 | $32,927 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $32,927 | 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) 9.5% ASA (AMERICAN SOCIETY OF ANESTHESIOLOGISTS) 20% INDIANA HOSPITAL ASSOCIATION 22.12% ISMA (INDIANA STATE MEDICAL ASSOCIATION) 24% SOCIETY OF TEACHERS OF FAMILY MEDICINE 10% TRAUMA CENTER ASSOCIATION OF AMERICA 30% When unable to ascertain allocation of dues attributed to Lobbying a conservative estimate of 25% 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 | $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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $21,769,701 | BeginningYearBalanceAmt |
| Contributions | $2,155,236 | ContributionsAmt |
| Investment Earnings Or Losses | -$543,657 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,182,458 | GrantsOrScholarshipsAmt |
| End Year Balance | $22,198,822 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.73340 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00720 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.25940 | 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 | $22,038,068 | OtherCostOrOtherBasisAmt |
| Book Value | $22,038,068 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $403,923,357 | OtherCostOrOtherBasisAmt |
| Depreciation | $163,623,130 | DepreciationAmt |
| Book Value | $240,300,227 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $851,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $850,545 | DepreciationAmt |
| Book Value | $1,454 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $285,458,465 | OtherCostOrOtherBasisAmt |
| Depreciation | $228,637,412 | DepreciationAmt |
| Book Value | $56,821,053 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,510,214 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,660,215 | DepreciationAmt |
| Book Value | $19,849,999 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $339,010,801 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| INTEREST RATE SWAP | $20,522,999 |
| ASSET RETIREMENT OBLIGATION | $4,301,999 |
| IBNR | $3,456,891 |
| DUE TO THIRD PARTY | $2,154,853 |
| CAPITAL LEASE PAYABLE | $2,077,078 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $32,513,820 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 1 | MHF BOOKED A PLEDGE OF $500,000 IN 2014 THAT WAS INCLUDED ON ITS AUDITED FINANCIAL STATEMENTS, AND WHICH MHF UNBOOKED IN 2015 BASED ON INFORMATION RECEIVED FROM MHF IN 2015. FOR MORE ACCURATE REPORTING, MHF DID NOT INCLUDE THE PLEDGE ON ITS 2014 FORM 990, WHICH RESULTED IN A DIFFERENCE FROM ITS AUDITED FINANCIAL STATEMENTS IN 2014 AND 2015 OF $500,000. 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. |
| FIN 48 (ASC 740) Footnote | PART X, LINE 2 Memorial Hospital did not have a footnote addressing Fin 48 (ASC 740) liabilities for uncertain tax positions. Memorial Hospital does not have any uncertain tax positions recorded during fiscal year 2015. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | MARATHON | Event1Nm |
| Gross Receipts Event1 | $260,058 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $260,058 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $8,849 | CashPrizesEvent1Amt |
| Food And Beverage Event1 | $288 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $297,598 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $260,058 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $260,058 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $8,849 | CashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $288 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $297,598 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $306,735 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$46,677 | 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 net loss as all net income is sent to the Memorial 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 | $3,062,921 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,062,921 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,278,933 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $83,256,948 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,021,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,341,854 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $83,256,948 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,084,906 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01250 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,722,782 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,931,138 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,791,644 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02410 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,039,898 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,550,503 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,489,395 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01590 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,626 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,568 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,058 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,834,306 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,545,209 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,289,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $108,176,160 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $86,802,157 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,374,003 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05250 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,493 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,493 | NetCommunityBenefitExpnsAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,234 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,227 | NetCommunityBenefitExpnsAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,595 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,595 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,322 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,007 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,315 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,888,638 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $4,944,319 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $83,195,631 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $105,912,563 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$22,716,932 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | false | 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.QUALITYOFLIFE.ORG | WebsiteAddressTxt |
| State License | 15-005053-1 | 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 |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| 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 | www.qualityoflife.org | 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 | www.BeaconHealthSystem.org/community-wellness | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | qualityoflife.org/assist/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | qualityoflife.org/assist/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | qualityoflife.org/assist/ | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility Information | 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 (n=44) who hold a broad knowledge of the interests of SJC, including public health, and minority, cultural, and underserved populations - Community members at large (n=543) 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. 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 7d | 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 www.beaconhealthsystem.org/community-wellness/community-outreach/assessing -community-needs; 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 this 2015 CHNA process. The data from this collective CHNA input process identified nineteen health needs; access to care / uninsured, aging population, caner, chronic respiratory disease / asthma, dental health, diabetes, education, health disparities, heart disease, maternal / infant health / prenatal care, mental health / suicide, overweight / obesity, poverty, reproductive health / pregnancies / STDs, stroke, substance abuse / alcohol abuse, tobacco, transportation, and violence / safety / trauma. Of these, the following six were identified as being a priority for 2015: access to care / uninsured, diabetes, maternal / infant health / prenatal care, mental health / suicide, overweight / obesity, and violence / safety / trauma. 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 NEED: 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 a myriad of 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 the most appropriate time. CURRENT PROGRAMMING: - MHSB provides residents access to health care through the Trauma Center and Emergency Department. MHSB and Beacon Health System also serve the community with three Memorial Neighborhood Health Centers: the Southeast Clinic, Father Richard Warner Clinic at the Center for the Homeless, and Centennial Clinic on the Hospitals campus. - Health coverage enrollment services are available through Federal Navigators at the Federally Qualified Health Centers, notably, HealthLinc and Indiana Health Center. Enrollment services are similarly available through community centers including Olive Street Clinic, United Health Services, Ivy Tech, and the Center for the Homeless. Indiana Navigators are available throughout MHSB and also through Saint Joseph Health System. - Beacon Medical Group physicians practices provide health care at various locations within SJC. Similar to MHSB, these office teams abide by a financial assistance policy. - MHSB provides assistance for low-income SJC residents in securing needed prescription medications through a full-time Medications Assistance Program. MHSB IMPLEMENTATION STRATEGY: - Expand the community-based enrollment platform with a robust outreach-based hub for enrollment, and advocacy services for low-income and/or eligible SJC residents. - Dedicate resources to a multi-agency partnership with Covering Kids and Families Indiana (CKF), a statewide advocacy entity for health coverage. - Dedicate resources to collectively staff a full-time, community-based outreach and enrollment CKF Indiana position for targeting specific eligible but uninsured SJC residents in the ACA Marketplace, Medicaid, Health Indiana Plan, and Hoosier Healthwise. These targeted populations include low-income, the uninsured or underinsured, minority, and working poor. Specific education and enrollment events are held during the ACA Open Enrollment Period, as well as one-on-one assistance during both Open Enrollment and Special Enrollment Periods. - Provide additional hours dedicated to in-reach within MHSB and Beacon Health System overall. MEASUREMENT AND POTENTIAL IMPACT: SJC residents who sign up for insurance and receive services will be tracked. We expect an increase in the provision of health care to SJC residents and referrals to appropriate community resource organizations. (2) MENTAL HEALTH/SUICIDE NEED: Collective results ranked mental health/suicide as a pressing health need in both St. Joseph and Elkhart counties. The suicide rate per 100,000 is higher in SJC (13.4) than the nation (12.6), and Memorials Childrens Hospital reported a dramatic increase in pediatric patients hospitalized from failed suicide attempts. The years of potential life lost before age 75 per age-adjusted 100,000 is also higher in SJC (7,424) than Elkhart County (6,524) and the national benchmark of 5,200. Both counties report more average days of poor mental health when compared to the national benchmark (3.7 and 3.6 versus 2.3 out of 30 days). Of the 549 community survey respondents, 27% reported living with someone depressed, mentally ill, or suicidal; up from 14% in 2012. Mirroring this, 21.5% of SJC respondents repored having been diagnosed with an anxiety disorder (15% in 2012) and 29.2% were diagnosed with a depressive disorder (21% in 2012). CURRENT PROGRAMMING: - Memorial Childrens Hospital is the co-convener of the Suicide Task Force for St. Joseph County. Its purpose is to generate interest in having a community-wide conversation with various stakeholders, with the intent to develop and implement a collective impact strategy for suicide prevention. - Provide training and expert knowledge regarding Adverse Childhood Experiences to South Bend Community School Corporation (SBCSC) administration and personnel in order to educate them on the effects of trauma on children and the link to negative health and educational outcomes. Interventional programming is also delivered when appropriate. - MHSB hosts training in Eye Movement Desensitization and Reprocessing (EMDR) for therapists and licensed community and hospital-based social workers in St. Joseph and Elkhart counties. Additionally, training is offered in Acute-Trauma Intervention Process (A-Tip), a short-term intervention to help individuals become more stable and calm, diminishing the possibility of becoming more traumatized. MHSB IMPLEMENTATION STRATEGIES: - Collaborate with Memorial Childrens Hospital, St. Joseph County Health Department, and the St. Joseph County Suicide Prevention Center to build and implement a best practice model of youth suicide prevention programming. - Continue with current programs listed above. - Collaborate with Indiana University South Bend and University of Notre Dames Mental Health Counseling programs to provide interns to local service agencies. MEASUREMENT AND POTENTIAL IMPACT:The anticipated impact of these efforts will be to identify local risk factors, increase education and prevention activities, increase health outcomes, and improve mental health outcomes. (3) VIOLENCE/ SAFETY/ TRAUMA NEED: The violent crime rate per 100,000 is higher in SJC (370) than in Elkhart County (264), Indiana (334) and the national benchmark (59). Almost 40% of the Key Informants indicated Violence/Safety/Trauma was a key theme. The Community Survey data showed 23% had been hit, beaten, kicked, or physically hurt by a parent or adult in the home, up from the 18.9% in 2012. CURRENT PROGRAMMING: - MHSB is an active partner in the South Bend Group Violence Intervention (SBGVI) commissioned by South Bend Mayor, Pete Buttigieg. The intervention unites community leaders around the common goal of stopping gun violence and keeping South Bends highest risk citizens alive and out of prison. Community members are empowered to set clear moral standards against violence in their communities and reclaim a voice in the way they want to live. SBGVI coordinates the efforts of local, state and federal law enforcement. - In 2014 St. Joseph County Cares was formed by multiple agencies and organizations in our community (e.g., CHE, Oaklawn, the designated community behavioral and mental health provider; the Juvenile Justice Center and Probate Court; Change Matrix, and enFocus, a not-for-profit business providing training and knowledge in the application of data analytics). Their goal is for all public and private environments to provide consistent, trauma-informed experiences, services, and support for all children in utero through their transition to independence, as well as their families, so they can lead productive and healthy lives. - The Trauma Intervention Specialist builds and strengthens working relationships between law enforcement officers, Trauma and Emergency Department personnel, and victims of crime and their families. MHSB IMPLEMENTATION STRATEGIES: - Continue with current programs listed above. - Collaboration between MHSB School Health and Wellness Educator team with Oaklawns STAND (Students Taking a New Direction) team to deliver resiliency educatio |
| 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 this 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 16i | Memorial Hospital of South Bend Patient statements note where to obtain information about financial aid by listing both the Hospitals website and a customer service number. |
| Part V, Section B Line 22d | When Memorial Hospital makes a determination that an individual is eligible for assistance under this financial assistance policy, Memorial will not charge such individual more than the amounts generally billed (AGB) to individuals who have insurance covering emergency or other medically necessary care. Memorial uses the look-back method to calculate the AGB percentage that it uses to determine AGB for particular care provided to individuals eligible for financial assistance. Memorial calculated its current AGB percentage, 64%, by dividing (1) sum of payments on all claims allowed during the 12-month period from 1/1/2014 to 12/31/2014 by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility by (2) the sum of the associated gross charges for those claims. To determine AGB for a particular episode of care, Memorial multiplies its gross charges for that care by the AGB percentage. |
| 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 | Supplemental Information | FormAndLineReferenceDesc |
| Explanation | 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 $36,368,656 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 6. Coalition Building Memorial Hospital South Bend (MHSB) has long been a supporter for leadership building. In 2015, that included community members attending multiple-day trainings at the Pfeil Innovation Center, hosting education forums, and inviting community members to leadership presentations. Smoke Free St. Joe MHSB also has a history of supporting coalitions. Smoke Free St. Joe is a coalition working together to create healthier and safer communities by providing tobacco education to reduce tobacco use, promoting tobacco cessation to help smokers quit, and supporting stronger smoke free policies that prevent unnecessary exposure to secondhand smoke throughout our community. The coalition, established in 2009 (Previously Known As Tobacco Free St. Joseph County Coalition), has worked with health organizations, civic groups, businesses and schools countywide to reduce the burden of tobacco use on our community and increase everyone's quality of life. The coalition is made up of several community partners including: Interdenominational Ministerial Alliance, Neighborhood Resource Corporation, Select Health Network, South Bend Community School Corporation, St. Joseph County Health Department, St. Joseph Community Wellness Partners and St. Joseph Health System. SJC Suicide Prevention Task Force Mental health was an identified health need from the 2015 CHNA, and as a result MHSB and Memorial Childrens Hospital co-convened the SJC Suicide Prevention Task Force in 2015. The purpose is to generate interest in having a community-wide conversation with various stakeholders with the intent to develop and implement a collective impact strategy for suicide prevention. St. Joseph County Cares - Trauma affects children, youth, families and communities from every race, ethnicity, gender, sexual orientation, geography and socio-economic status. It shows up frequently when addressing children and youth and substance abuse, juvenile justice, child welfare, special education and increasingly in mental health treatment. Understanding and addressing trauma is most effective if it happens on a community-wide basis and therefore, requires a multi-agency and organization approach to create an integrated system of care. Their goal is for all children to have consistent, trauma-informed experiences, services and supports in all public and private environments leading to productive and healthy lives from before they are born through the time they are transitioning to independence, as well as for their families. Line 7. Community Health Improvement/Advocacy Throughout 2015, 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 In 2015, Memorial Hospital South Bend began the planning and launch of Blue Zones. Blue Zones is a community well-being improvement initiative designed to make healthy choices easier through permanent changes to environment, policy, and social networks. 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 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 T | 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 | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|---|---|---|---|---|---|
| NORTHEAST NEIGHBORHOOD REVITALIZATION ORGANIZATION | ||||||||||
| 803 LINCOLNWAY WEST | SOUTH BEND | IN | 46616 | 352118149 | 501(C)(3) | $50,000 | CONTRIBUTION | |||
| COMMUNITY HEALTH PARTNERS OF SOUTH BEND | ||||||||||
| 1010 N Bendix Drive | SOUTH BEND | IN | 46628 | 263051440 | 501(C)(3) | $131,212 | Contribution | |||
| THE CENTER FOR THE HOMELESS | ||||||||||
| 813 South Michigan | SOUTH BEND | IN | 46601 | 351768544 | 501(C)(3) | $69,100 | PEDS PROGRAM | |||
| RONALD MCDONAL HOUSE CHARITIES | ||||||||||
| PO Box 1274 | South Bend | IN | 46628 | 351831691 | 501(c)(3) | $5,100 | Sponsorship | |||
| ENFOCUS INC | ||||||||||
| 506 W South St | South Bend | IN | 46601 | 455638209 | 501(C)(3) | $100,500 | Contribution | |||
| RIVERBEND CANCER SERVICES | ||||||||||
| 919 E JEFFERSON BLVD | SOUTH BEND | IN | 46617 | 350872359 | 501(C)(3) | $20,500 | Contribution | |||
| YMCA OF MICHIANA INC | ||||||||||
| 1201 Northside Blvd | South Bend | IN | 46615 | 350868216 | 501(C)(3) | $10,000 | Contribution | |||
| FRIENDS OF THE ST JOSEPH CNTY JUVENILE JUSTICE CEN | ||||||||||
| 1000 S Michigan St | South Bend | IN | 46601 | 352097175 | 501(C)(3) | $50,000 | Contribution | |||
| SAINT ADALBERTS PARISH | ||||||||||
| 2505 Grace St | South Bend | IN | 46619 | 351095958 | 501(C)(3) | $31,945 | Contribution | |||
| SOUTH BEND ALUMNI ASSOCIATION | ||||||||||
| 215 S ST Joseph St | South Bend | IN | 46601 | 351674506 | 501(C)(3) | $15,000 | Contibution | |||
| CHAMBER OF COMMERCE OF ST JOE COUNTY | ||||||||||
| 401 East Colfax | South Bend | IN | 46634 | 350153330 | 501(C)(6) | $30,000 | Contribution | |||
| COUNCIL ON AGING OF ELKHART COUNTY | ||||||||||
| 230 East Jackson | Elkhart | IN | 46516 | 510178910 | 501(C)(3) | $10,000 | Contribution | |||
| Dr Weldy's Associates Inc | ||||||||||
| 114 N Elkhart St | Wakarusa | IN | 46573 | 999999999 | Medical Supply Donation | $8,861 | Book Value | Medical Supplies | ||
| St Luke Foundation for Haiti | ||||||||||
| 3999 Great Harvest Ct | Dumfries | VA | 22025 | 274377746 | 501(C)(3) | Medical Supplies Donation | $33,429 | Book Value | Medical Supplies | |
| UNITED WAY OF ELKHART COUNTY INC | ||||||||||
| PO Box 3048 | Elkhart | IN | 46515 | 350953433 | 501(C)(3) | $50,250 | Sponsorship | |||
| 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) | $1,913,698 | CONTRIBUTION | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 15 | Total501c3OrgCnt |
| Total Other Org | 2 | 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 (13 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 | $432,410 | $0 | $137,200 | $0 | $29,365 | $0 | $160,505 | $0 | $19,868 | $0 | $779,348 | $0 | $0 |
| Robert Yount MD | ||||||||||||||
| Trustee THRU 3/2015 | $0 | $832,248 | $0 | $26,988 | $0 | $8,590 | $0 | $10,600 | $0 | $25,123 | $0 | $903,549 | $0 | $0 |
| Keith Sherry MD | ||||||||||||||
| Director | $329,055 | $0 | $0 | $0 | $1,099 | $0 | $10,893 | $0 | $24,214 | $0 | $365,261 | $0 | $0 | $0 |
| Gerard Duprat MD | ||||||||||||||
| Trustee/Employed Physician | $0 | $620,831 | $0 | $126,988 | $0 | $11,034 | $0 | $10,600 | $0 | $25,742 | $0 | $795,195 | $0 | $0 |
| Kreg Gruber | ||||||||||||||
| PRESIDENT | $125,095 | $291,889 | $38,775 | $90,475 | $4,786 | $11,168 | $44,511 | $103,859 | $7,280 | $16,987 | $220,447 | $514,378 | $0 | $0 |
| Cheryl Wibbens-Lesh MD | ||||||||||||||
| Asst. Secr./VP | $332,985 | $0 | $41,642 | $0 | $2,590 | $0 | $12,503 | $0 | $26,695 | $0 | $416,415 | $0 | $0 | $0 |
| Thomas Sutula MD | ||||||||||||||
| Employed Physician | $252,968 | $0 | $24,544 | $0 | $1,980 | $0 | $15,056 | $0 | $20,750 | $0 | $315,298 | $0 | $0 | $0 |
| Dale A Patterson | ||||||||||||||
| Employed Physician | $326,130 | $0 | $26,988 | $0 | $653 | $0 | $10,600 | $0 | $22,638 | $0 | $387,009 | $0 | $0 | $0 |
| LINDA A MANSFIELD | ||||||||||||||
| EMPLOYED PHYSICIAN | $245,730 | $0 | $23,933 | $0 | $707 | $0 | $10,600 | $0 | $21,815 | $0 | $302,785 | $0 | $0 | $0 |
| STEPHEN M HUFFMAN | ||||||||||||||
| PRESIDENT THRU 6/2015 | $134,376 | $0 | $117,240 | $0 | $80,956 | $0 | $11,237 | $0 | $11,508 | $0 | $355,317 | $0 | $0 | $0 |
| PHILLIP NEWBOLD | ||||||||||||||
| CEO | $0 | $767,590 | $0 | $295,000 | $0 | $193,204 | $0 | $165,268 | $0 | $20,773 | $0 | $1,441,835 | $0 | $140,103 |
| ROBERT J RILEY MD | ||||||||||||||
| Employed Physician | $243,731 | $0 | $23,608 | $0 | $1,290 | $0 | $15,537 | $0 | $15,726 | $0 | $299,892 | $0 | $0 | $0 |
| BRYAN BOYER | ||||||||||||||
| Trustee/Employed Physician | $0 | $853,417 | $0 | $21,788 | $0 | $950 | $0 | $11,041 | $0 | $23,340 | $0 | $910,536 | $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 1 EMPLOYEE (KREG GRUBER). 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. PART I, 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 INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2015, REFLECTED IN COLUMN (B)(III): PHIL NEWBOLD $140,103 IN MARCH 2015. THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2015 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: PHIL NEWBOLD, $142,540 JEFFREY COSTELLO, $77,377 KREG GRUBER, $72,770 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 2015 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: JEFFREY COSTELLO, $65,000 KREG GRUBER, $65,000 PART I, 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 | 999999999 | 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 | $920,000 | $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 | $10,935,387 | $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 | $1,092,394 | $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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 - D: REBATE REPORT DATED April 21, 2016, SHOWED THAT NO REBATE WOULD BE DUE. |
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 2015, MEMORIAL HAD 441 VOLUNTEERS IN THIS PROGRAM WHO SERVED 38,567 HOURS. CORE FORM, PART III, LINE 4D OTHER PROGRAM SERVICES 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 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 425 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 2016 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2016, 22 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. (69,263,923) Write off Inter company, Memorial Health Foundation, Inc. 12,058 Write off Inter company, Elkhart General Hospital, Inc. 17,738,065 Write off Inter company, Beacon Health System, Inc. (10,233,525) Write off Inter company, Beacon Health Ventures, Inc. (4,367,025) Change in interest in recipient org (2,238,913) TOTAL (68,353,263) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FEES - PHYSICIANS TOTAL FEES:16461486 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:10775788 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB FEES TOTAL FEES:6625842 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:4499104 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION EXPENSE TOTAL FEES:3108349 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:REPAIRS PARTS AND MAINT. TOTAL FEES:1641950 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TRANSCRIPTION, RADIOLOGY FEES TOTAL FEES:838460 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:644145 |
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) | 9 | BHS | Yes (true) |
| Memorial 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) | 11D III-O | MHSB | Yes (true) |
| BEACON HEALTH SYSTEM Inc | ||||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 453864076 | Parent Org. | IN | 501(C)(3) | 11A I | 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 | false | 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 (15 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Beacon Health Ventures Inc | ||
| P | $4,060,507 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| Q | $6,271,001 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| R | $909,193 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| Q | $30,602,880 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| R | $46,500,000 | CASH TRANSFER |
| Elkhart General Hospital Inc | ||
| P | $1,845,888 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| C | $17,738,065 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| C | $5,742,757 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| Q | $59,384 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| R | $73,489 | ACTUAL CHARGES |
| Beacon Medical Group Inc | ||
| J | $1,515,729 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| B | $69,263,922 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| Q | $50,000,000 | CASH TRANSFER |
| Beacon Medical Group Inc | ||
| P | $46,713,264 | WRITEOFFINTERCO |
| Beacon Medical Group Inc | ||
| S | $64,499,519 | WRITEOFFINTERCO |
Comments