MEMORIAL HOSPITAL OF SOUTH BEND: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL OF SOUTH BEND (EIN 35-0868132)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-13
- IRS object ID
- 201503179349303660
- Schema version
- 2014v5.0
- 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 F
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-13T10:28:17-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | 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 | 111 MONUMENT CIRCLE SUITE 4000 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | 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 |
| Signature | 2015-11-12 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Angela Moore | PreparerPersonNm |
| PTIN | P00244342 | PTIN |
| Phone | 3176817000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | 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 | $547,609,968 | 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 | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 3554 | TotalEmployeeCnt |
| Total Volunteers | 503 | TotalVolunteersCnt |
| Total Gross UBI | $562,812 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $101,095 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,234,519 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,387,487 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $465,853,310 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $499,527,555 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,211,086 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,383,928 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,580,506 | PYOtherRevenueAmt |
| CY Other Revenue | $20,196,739 | CYOtherRevenueAmt |
| PY Total Revenue | $492,879,421 | PYTotalRevenueAmt |
| CY Total Revenue | $525,495,709 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $747,022 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,086,952 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $169,980,705 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $177,206,268 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $241,560,947 | PYOtherExpensesAmt |
| CY Other Expenses | $265,035,063 | CYOtherExpensesAmt |
| PY Total Expenses | $412,288,674 | PYTotalExpensesAmt |
| CY Total Expenses | $443,328,283 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $80,590,747 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $82,167,426 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $895,471,000 | TotalAssetsBOYAmt |
| Total Assets EOY | $553,998,135 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $270,335,025 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $268,255,961 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $625,135,975 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $285,742,174 | 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 | $108,028,550 | ExpenseAmt |
| Revenue | $241,440,093 | 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. 2014 Statistics for this service unit include: - 502,653 Inpatient procedures - 345,913 Outpatient procedures - 986 Inpatient Caths - 824 Outpatient Caths - 176,223 Outpatient visits - 563,123 Meals. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $97,188,271 | ExpenseAmt |
| Revenue | $141,540,976 | 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. 2014 Statistics for this service unit include: - 4,244 Inpatient procedures - 233 Open Heart procedures - 8,402 Outpatient procedures. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $66,400,663 | ExpenseAmt |
| Revenue | $134,601,905 | 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. 2014 Statistics for this service unit include: - 107,067 Patient Days - 9,041 Inpatient ER visits - 46,247 Outpatient ER visits - 2,532 Births - 12,512 Observation stays - 280 Medical flights. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $123,436,708 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $1,086,952 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $395,054,192 | 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 | Yes (true) | 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 | 316 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 3554 | 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 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; Employed Physician | 2.0 | 40.0 | Yes (X) | $0 | $928,881 | $31,621 | ||
| Keith Sherry MD | ||||||||
| Trustee Thru March 27 | 20.0 | 20.0 | Yes (X) | $347,781 | $0 | $34,212 | ||
| Gerard Duprat MD | ||||||||
| Trustee | 2.0 | 40.0 | Yes (X) | $0 | $655,736 | $35,509 | ||
| Maurice Hurwich MD | ||||||||
| Trustee Thru March 27 | 40.0 | 4.0 | Yes (X) | $31,874 | $0 | $0 | ||
| Kreg Gruber | ||||||||
| PRESIDENT | 20.0 | 20.0 | Yes (X) | $263,348 | $263,350 | $150,765 | Yes (X) | |
| Carlton Lyons MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $4,114 | $0 | $0 | ||
| Charles Miller | ||||||||
| Secretary | 2.0 | 0.0 | Yes (X) | $2,138 | $0 | $0 | Yes (X) | |
| Etta K Nevel MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $1,924 | $0 | $0 | ||
| M Rose Meissner | ||||||||
| Officer/Chair Thru March 27 | 2.0 | 0.0 | Yes (X) | $1,157 | $0 | $0 | Yes (X) | |
| Steven Cramer | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Tracy Graham | ||||||||
| Treasurer | 2.0 | 0.0 | Yes (X) | $1,876 | $0 | $0 | Yes (X) | |
| John Mathis MD | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Maria Slager | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Perry Watson III | ||||||||
| Vice Chair | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Thomas Burish PhD | ||||||||
| Chair | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Ray Gans | ||||||||
| Trustee | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| Peter Baranay | ||||||||
| Trustee | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN M HUFFMAN | ||||||||
| PRESIDENT | 20.0 | 20.0 | Yes (X) | $186,979 | $186,980 | $73,303 | Yes (X) | |
| KAREN BARNETT | ||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $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 | ||
| Jeffrey P Costello | ||||||||
| CFO/Asst. Treasurer | 2.0 | 45.0 | $0 | $553,140 | $158,748 | Yes (X) | ||
| Cheryl Wibbens-Lesh MD | ||||||||
| Asst. Secr./VP | 40.0 | 2.0 | $374,003 | $0 | $39,209 | Yes (X) | ||
| PHILLIP NEWBOLD | ||||||||
| CEO | 1.0 | 45.0 | $0 | $1,248,237 | $184,054 | Yes (X) | ||
| Scott Thomas MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $409,769 | $38,011 | $16,983 | Yes (X) | ||
| Thomas Sutula MD | ||||||||
| Employed Physician | 40.0 | 0.0 | $265,987 | $0 | $36,078 | Yes (X) | ||
| Dale A Patterson | ||||||||
| Employed Physician | 40.0 | 0.0 | $333,736 | $0 | $33,141 | Yes (X) | ||
| Anton J Crepinsek | ||||||||
| Employed Physician | 40.0 | 0.0 | $272,968 | $0 | $35,805 | Yes (X) | ||
| LINDA A MANSFIELD | ||||||||
| EMPLOYED PHYSICIAN | 40.0 | 0.0 | $256,333 | $0 | $28,188 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,753,987 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,874,335 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $857,616 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 101 | 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 | $6,627,446 |
| SOUTH BEND EMERGENCY PHYSICIANS | |||||
| 615 N MICHIGAN | SOUTH BEND | IN | 46601 | PHYSICIAN SERVICES | $7,080,514 |
| MICHIANA ANESTHESIA CARE PC | |||||
| 416 E MONROE STREET SUITE 200 | SOUTH BEND | IN | 46601 | ANESTHESIA | $2,104,957 |
| CANCER CARE PARTNERS LLC | |||||
| 211 N EDDY STREET | SOUTH BEND | IN | 46617 | ONCOLOGY | $2,553,551 |
| SYNTHES USA | |||||
| 1302 Wrights Lane East | WEST CHESTER | PA | 19380 | Medical Devices | $1,922,882 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 54 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $646,131 | RelatedOrganizationsAmt |
| Government Grants | $1,741,356 | GovernmentGrantsAmt |
| Noncash Contributions | $20,000 | NoncashContributionsAmt |
| Total Contributions | $2,387,487 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $496,271,367 | $496,271,367 | |
| RENTAL REVENUE | 532000 | $3,136,422 | $3,115,974 | $20,448 |
| AMBULANCE SUPPLY | 621910 | $69,353 | $69,353 | |
| CASH DISCOUNTS | 561499 | $36,853 | $36,853 | |
| MEDICAL EDUCATION | 611710 | $13,560 | $13,560 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $499,527,555 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,878,468 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,165 | TotalRevenueColumnAmt |
| Exclusion | $68,165 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,000 | TotalRevenueColumnAmt |
| Exclusion | $52,000 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $95,562 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $95,562 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,562 | TotalRevenueColumnAmt |
| Exclusion | $95,562 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $23,193,264 | SecuritiesAmt |
| Other | $29,479 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $21,785,447 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,407,817 | SecuritiesAmt |
| Other | $29,479 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,437,295 | TotalRevenueColumnAmt |
| Exclusion | $1,437,295 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $316,811 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $328,812 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,001 | TotalRevenueColumnAmt |
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 |
|---|---|---|---|---|
| 340B REVENUE | 561499 | $5,943,917 | $5,943,917 | |
| TEAM PHARMACY | 561499 | $3,263,259 | $3,263,259 | |
| HLC ATHLETIC CLB | 713940 | $1,906,539 | $1,863,721 | $42,818 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,947,463 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,984,522 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $542,364 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,420,577 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $20,061,178 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $525,495,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $517,562,526 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $562,812 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,116,417 | 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 | $1,086,952 | TotalAmt |
| Program Services | $1,086,952 | 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 | $1,400,651 | TotalAmt |
| Management And General | $1,400,651 | 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 | $137,145,865 | TotalAmt |
| Program Services | $116,162,548 | ProgramServicesAmt |
| Management And General | $20,983,317 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,901,304 | TotalAmt |
| Program Services | $4,151,404 | ProgramServicesAmt |
| Management And General | $749,900 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,011,292 | TotalAmt |
| Program Services | $20,337,564 | ProgramServicesAmt |
| Management And General | $3,673,728 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,747,156 | TotalAmt |
| Program Services | $8,255,841 | ProgramServicesAmt |
| Management And General | $1,491,315 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $927,590 | TotalAmt |
| Program Services | $785,669 | ProgramServicesAmt |
| Management And General | $141,921 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,933 | TotalAmt |
| Management And General | $153,933 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,255 | TotalAmt |
| Management And General | $267,255 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,219 | TotalAmt |
| Program Services | $5,267 | ProgramServicesAmt |
| Management And General | $952 | 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 | $376,806 | TotalAmt |
| Management And General | $376,806 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,533,507 | TotalAmt |
| Program Services | $38,566,880 | ProgramServicesAmt |
| Management And General | $6,966,627 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,598 | TotalAmt |
| Program Services | $34,387 | ProgramServicesAmt |
| Management And General | $6,211 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,384,080 | TotalAmt |
| Program Services | $3,713,316 | ProgramServicesAmt |
| Management And General | $670,764 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,530 | TotalAmt |
| Program Services | $60,586 | ProgramServicesAmt |
| Management And General | $10,944 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,634,516 | TotalAmt |
| Program Services | $7,313,435 | ProgramServicesAmt |
| Management And General | $1,321,081 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $920,963 | TotalAmt |
| Program Services | $780,056 | ProgramServicesAmt |
| Management And General | $140,907 | 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 | $87,697 | TotalAmt |
| Program Services | $74,279 | ProgramServicesAmt |
| Management And General | $13,418 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,800,818 | TotalAmt |
| Program Services | $4,066,293 | ProgramServicesAmt |
| Management And General | $734,525 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,564,998 | TotalAmt |
| Program Services | $23,347,553 | ProgramServicesAmt |
| Management And General | $4,217,445 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,277,255 | TotalAmt |
| Program Services | $1,928,835 | ProgramServicesAmt |
| Management And General | $348,420 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $81,616,822 | $81,616,822 | |
| BAD DEBT EXPENSE | $35,599,378 | $35,599,378 | |
| CORPORATE FEE | $24,578,355 | $20,817,867 | $3,760,488 |
| HOSPITAL ASSESSMENT FEE | $21,679,785 | $21,679,785 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,512,958 | TotalAmt |
| Program Services | $4,669,475 | ProgramServicesAmt |
| Management And General | $843,483 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $443,328,283 | TotalAmt |
| Program Services | $395,054,192 | ProgramServicesAmt |
| Management And General | $48,274,091 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,625 | BOYAmt |
| EOY | $19,625 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,887,394 | BOYAmt |
| EOY | $28,328,827 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $649,018 | BOYAmt |
| EOY | $428,383 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,488,831 | BOYAmt |
| EOY | $80,595,970 | 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 | $13,331,926 | BOYAmt |
| EOY | $14,162,033 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,792,967 | BOYAmt |
| EOY | $1,559,378 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $704,187,087 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $367,486,805 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,042,366 | BOYAmt |
| EOY | $336,700,282 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229,696,989 | BOYAmt |
| EOY | $53,593,180 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,548,858 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,400,833 | BOYAmt |
| EOY | $510,558 | 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 | $22,440,719 | BOYAmt |
| EOY | $36,928,425 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $895,471,000 | BOYAmt |
| EOY | $553,998,135 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,081,812 | BOYAmt |
| EOY | $54,623,766 | 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 | $22,299 | BOYAmt |
| EOY | $23,795 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,232,539 | BOYAmt |
| EOY | $171,318,330 | 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 | $1,217,101 | BOYAmt |
| EOY | $1,014,251 | 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 | $46,781,274 | BOYAmt |
| EOY | $41,275,819 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,335,025 | BOYAmt |
| EOY | $268,255,961 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $618,651,851 | BOYAmt |
| EOY | $276,614,507 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,484,124 | BOYAmt |
| EOY | $9,127,667 | 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 | $625,135,975 | BOYAmt |
| EOY | $285,742,174 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $895,471,000 | BOYAmt |
| EOY | $553,998,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $82,167,426 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $15,108,343 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$436,669,570 | 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 | $6,219 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,219 | 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: AASM (AMERICAN ACADEMY OF SLEEP MEDICINE) - 2% AND (ACADEMY OF NUTRITION & DIETETICS) - 14% AADE (AMERICAN ASSOCIATION OF DIABETES EDUCATORS) - 35% ACCC (ASSOCIATION OF COMMUNITY CANCER CENTERS) - 6% AAFP (AMERICAN ACADEMY OF FAMILY PHYSICIANS) - 9.5% AOTA (AMERICAN OCCUPATION THERAPY ASSOCIATION) - 30% APTA (AMERICAN PHYSCIAL THERAPY ASSOCIATION) - 20% ASA (AMERICAN SOCIETY OF ANESTHESIOLOGISTS) - 20% ANFP (ASSOCIATION OF NUTRITION AND FOODSERVICE PROFESSIONALS) - 1% INDIANA HOSPITAL ASSOCIATION - 5.26% INDIANA PSYCHOLOGICAL ASSOCIATION - 30% ISMA (INDIANA STATE MEDICAL ASSOCIATION) - 28% SOCIETY OF TEACHERS OF FAMILY MEDICINE - 10% TRAUMA CENTER ASSOCIATION OF AMERICA - 30% AORN (ASSOCIATION OF PERIOPERATIVE REGISTERED NURSES) - $15.39 | 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 | $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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $22,665,989 | BeginningYearBalanceAmt |
| Contributions | $1,296,194 | ContributionsAmt |
| Investment Earnings Or Losses | $1,929,600 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,122,082 | GrantsOrScholarshipsAmt |
| End Year Balance | $21,769,701 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.70230 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00640 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.29130 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,922,667 | OtherCostOrOtherBasisAmt |
| Book Value | $21,922,667 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $394,333,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $150,550,150 | DepreciationAmt |
| Book Value | $243,783,541 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $851,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $847,206 | DepreciationAmt |
| Book Value | $4,793 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $273,486,860 | OtherCostOrOtherBasisAmt |
| Depreciation | $212,716,904 | DepreciationAmt |
| Book Value | $60,769,956 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,591,870 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,372,545 | DepreciationAmt |
| Book Value | $10,219,325 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $336,700,282 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INT. IN NET ASSETS OF REC. ORG | $9,127,667 |
| INTEREST RATE SWAP | $338,833 |
| UNAMORTIZED BOND ISSUANCE COST | $1,458,137 |
| DUE FROM SELF INSURED TRUST | $78 |
| DUE FROM THIRD PARTY PAYORS | $17,199,602 |
| DUE FROM AFFILATES | $3,583,485 |
| OTHER RECEIVABLES | $5,220,623 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $36,928,425 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $4,535,682 |
| INTEREST RATE SWAP | $27,752,280 |
| CAPITAL LEASE PAYABLE | $2,387,952 |
| IBNR | $3,752,022 |
| DUE TO THIRD PARTY | $2,847,883 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $41,275,819 | 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 WILL UNBOOK IN 2015 BASED ON INFORMATION RECEIVED FROM MHF IN 2015. FOR MORE ACCURATE REPORTING, MHF HAS NOT INCLUDED THE PLEDGE ON ITS 2014 FORM 990, WHICH WILL RESULT 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 2014. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Central America and the Caribbean | RegionTxt |
| Type Of Activities Conducted | Investments | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $0 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Spent | $0 | SubtotalSpentAmt |
| Total Spent | $0 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (true) | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (true) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | Yes (true) | PassiveForeignInvestmestCoInd |
| Foreign Partnership | Yes (true) | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule F Line 3 Column f | FormAndLineReferenceDesc |
| Explanation | Memorial Hospital of South Bend, Inc transferred all of its investments to its parent entity effective May 1, 2014 and the book value on that date was approximately $93,500,000. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed States | IN | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Marathon | Event1Nm |
| Gross Receipts Event1 | $316,811 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $316,811 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $18,651 | CashPrizesEvent1Amt |
| Food And Beverage Event1 | $3,862 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $306,299 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $316,811 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $316,811 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $18,651 | CashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $3,862 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $306,299 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $328,812 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$12,001 | 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 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 | $5,383,583 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,383,583 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,235,254 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $69,739,878 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,495,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,618,837 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $69,739,878 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,878,959 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02670 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,065,046 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,889,089 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,175,957 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,592,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,557,980 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,034,546 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01480 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,435 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,134 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,704,141 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,457,504 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,246,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $100,322,978 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $73,197,382 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $27,125,596 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06650 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $142 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $142 | NetCommunityBenefitExpnsAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,046 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,919 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $127 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,188 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,919 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $269 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,060,384 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $5,030,192 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $81,014,906 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $102,223,860 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$21,208,954 | 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 | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL OF SOUTH BEND INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 615 N MICHIGAN STREET | AddressLine1Txt |
| City | SOUTH BEND | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.QUALITYOFLIFE.ORG | WebsiteAddressTxt |
| State License | 14-005053-1 | 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.STJOSEPHCOUNTYINDIANA.COM | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | qualityoflife.org/che/community-health-needs | 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 |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | X | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | X | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | X | 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY INFORMATION | Part V, Section B Line 5, 6b, 11 The Patient Protection and Affordable Care Act mandates non-profit hospitals to complete a Community Health Needs Assessment (CHNA) to guide the evaluation of community health priorities. Memorial, in partnership with SJCHD, successfully completed a CHNA that includes these elements required by the Patient Protection and Affordable Care Act: 1) Input from representatives of the broad community through a random telephone survey of 599 individuals, a Latino survey, interviews with key informants, and a number of focus groups; 2) Input from public health experts was evidenced in both the preliminary work with the local health system conducted by Purdue University and the Center for Disease Control and Prevention's Behavioral Risk Factor Surveillance System based survey; 3) the CHNA results are made widely available by posting them on the Hospital's website https://qualityoflife.org/ , on the County Health Department's website, http://www.stjosephcountyindiana.com/departments/sjchd/PDFs/MemHospSouthBe nd.pdf, and attainable in paper-copy upon request; 4) the CHNA provided the basis for a written implementation strategy to address identified needs, with explanations if those needs were not addressed; and 5) it provides the foundation for the CHNA. An advisory committee of 23 community-based and health system staff spent six months prioritizing the indicators from the quantitative and qualitative research findings. With the continued commitment of partner organizations to improve the health status of our community, the 2013 CHNA directed Memorial to the most pressing needs in the community, to ultimately establish programs to improve the well-being of the residents of St. Joseph County, Indiana. This comprehensive CHNA process has identified the county's priority health issues as follows: A. Health Disparities: Income, Education, Race, Age, Gender B. Physical Health: Chronic Disease, Childhood Obesity, Diabetes, Exercise, Smoking, Binge Drinking C. Reproductive Health: Infant Mortality, Teen Birth Rate, Sexually Transmitted Infection D. Aging Population: Health Care Availability, Safe Housing, Alzheimer's Disease E. Early Childhood Development F. Access to Health and Medical Care G. Violence/Safety: Street/Neighborhood Violence, Domestic/Relationship Violence, Child Abuse H. Mental Health I. Economic Stability: Unemployment, Uninsured/underinsured, Generational Poverty, Affordable, Quality Housing The following are examples of 2014 programming Memorial has initiated to address the CHNA priorities: A. Health Disparities: Income, Education, Race, Age, Gender -In collaboration with 100 Black Men of Greater South Bend we support the Minority Diversity Leadership Initiative, and the African American Men's Barbershop Health program. -African American Literacy Councils are sponsored at Charles Martin Youth Center, and New Generations Christian Ministries. -Sickle Cell Anemia education and screening is a part of the health and teacher education with the South Bend School Corporation, including high school athletes. -Memorial continues to work with St. Joseph Bridges Out of Poverty, to understand poverty as a social determinant of health. We are working with the South Bend Community School Corporation, on disproportionality in expulsions and suspensions, using the CDC's Adverse Childhood Experiences study as the foundation for becoming a Trauma Informed Community for children. -Memorial's Latino Diabetes was expanded to be both language and culturally appropriate, the curriculum was designed to facilitate disease state management with Limited-English-Proficient (LEP) individuals, as well as those with minimal literacy skills. -Equity in Birth Outcomes - the racial disparity in death during the first 12 months of life was among the top five priorities of the CHNA for Elkhart and St. Joseph Counties. This request attempted to identify variables that were highly correlated with early death. Data was analyzed by a consultant jointly hired by Memorial, Elkhart General Hospital, Saint Joseph Regional Medical Center (SJRMC), IU-Goshen, Elkhart County Health Department and SJCHD, the proposal was approved by all four hospitals' Institutional Review Boards in partnership with the Otro Mar project; a social venture LLC dedicated to the elimination of health disparities. Until the Health Systems know what the determinants are impacting the problem, activities cannot be targeted for remediation. Initial results were inconclusive; further analysis is currently underway. -Bebes Dulces sin Azucar is a gestational diabetes programming for Latino women which was began more than ten years ago to assist vulnerable, limited-English-speakers learn the necessary tools to provide for healthy birth outcomes and recovery. -Alcance de Salud Latino, Latino Health Outreach, is broadcast weekly at WSBL - Sabor Latino 93.5FM, South Bend, Indiana -Unity Gardens has become an expert in connecting our community to healthy food: 22 of their 56 Unity Gardens focus on children, especially those from vulnerable populations such as: Juvenile Justice Center, Migrant Farm Workers, Red Cross Refugees, Kroc Center, Robinson Learning Center, Youth Service Bureau, Muessel School, El Campito Children's Center, and the children living at South Bend Beacon Heights Apartments. In 2014, they: --Designed a new curriculum to engage children from Beacon Heights in enriching garden education and discovery activities via two weekly summer classes and a one week day camp. 14 students attended the weekly sessions; 40 students attended the camp, mostly primary and intermediate aged; 25% were from Beacon Heights. --Created a Unity Gardens Youth Discovery Garden with areas devoted to learning and play, including an heirloom vegetable section, grain garden, permaculture garden and food forest area, composting and eco-recycling station, butterfly garden, soil and water conservation shed station, discovery trail, outdoor-classroom seating area, and an active play zone. Goals were to increase access to and awareness of healthy food, increase physical activity, and develop leadership skills in older youth. -Voyages targets African American males in grades 4-5; it consists of 19 sessions of Afrocentric curriculum led by a certified clinical social worker and other members of the community. In 2014, topics focused on African American History, culture and identity, social skills, personal/social responsibility, peer resistance skills relative to risky behaviors, health/sexuality, life skills, reading comprehension, math skills, and collaborative problem solving. The class size is limited to 20 students who are struggling academically and/or behaviorally. Students also have the opportunity to earn money through an incentive/ reward economy. -Augustus F. Hawkins Literacy Center- Charles Martin Youth Center -Students (grades 3-5) from South Bend's Census Tracts 19, 20, and 21 attend the center three days a week, from 2:30-5:30 p.m. They complete homework assignments and then access the myOn reader computer program to read enhanced digital books. The program assesses students' interests and reading abilities and creates a personalized profile for each person with a recommended book list. The program tracks the books read and measures time to complete as well as level of comprehension. In 2014, the program also established a literacy activity center with books, educational videos/CDs, and games at the Inspiration Barber Shop. -27 children regularly engage in the Inspiration Barber Shop literacy extension program --32 books and 6 free haircuts were distributed --Older siblings, parents, and grandparents appeared more intentional in reading as they waited for haircuts. This led to plans for a community discussion with African American men and boys. -32 students initially enrolled in fall 2013 at the center; by spring 2014, 12 students consistently attended. Fall 2014 attendance consistently averages 20 students with a waiting list. --Approximately 60% were successfully matched with big brothers/sisters --Children also participate in various field trips and enrichment activities --90% of parents attended follow-up progress meetings with the director --COLLABORATIONS-Big Brother/Big Sister and St. Mary's College of Social Work; community volunteers and guest celebrity readers --OUTCOMES: From March-April, 2014, students read 351 books; comprehension scores averaged 54% B. Physical Health: Chronic Disease -BrainWorks encourages activities, nutrition, and socialization which support a life-time of brain health. -Childhood Obesity & Academic Performance -United Way of St. Joseph County convened this two-year project to address Childhood Obesity community-wide as a disease prevention model. The effort wanted to reduce childhood hunger, reduce childhood obesity, raise awareness of the effects of hunger on children and collaborate to implement programs designed to address childhood food inse |
| G. Violence/Safety | -The South Bend Group Violence Intervention (SBGVI) commissioned by South Bend Mayor, Pete Buttigieg, unites community leaders around a common goal: to stop gun violence and keep South Bend's highest risk citizens alive and out of prison. SBGVI is a partnership among South Bend law enforcement, government, education, civil service, health-care and faith-based agencies. SBGVI advocates direct, sustained engagement with street groups which cause the majority of South Bend's gun violence. The John Jay College strategy empowers community members to set clear moral standards against violence in their communities and reclaim a voice in the way they want to live. It coordinates the efforts of local, state and federal law enforcement to focus crime prevention efforts on the groups most associated with gun violence. SBGVI also draws on the expertise of social service providers to offer gang members a path away from violence. Three direct communications, or "call-ins," between the SBGVI coalition and street group members have been orchestrated. To date, a total of 66 men with criminal histories, representing at least 27 different gang associations, met with our community and law enforcement representatives to hear a simple message: "The violence must stop. We will help you if you let us. We will stop you if you make us." -OUTCOMES: --South Bend is adapting this strategy to a city our size and doing more with less --From May 15, 2013 to January 31, 2014 seventy one (71) people were criminally assaulted by being shot in the City of South Bend. During that same time period after the SBGVI strategy was introduced (from May 15, 2014 to January 31, 2015), 44 people have been criminally assaulted by being shot - a 38% decrease --More people are getting services to change their lifestyles --More collaborations have been built across all public safety groups --Trust is being built across races and ethnicity as groups put skepticism aside to engage and believe it's real --Needs and opportunities are better integrated --Panoramic perspectives are being developed H. Mental Health -Center for the Homeless: Genesis Center for Strength & Wellness is an on-site mental health counseling program available to all homeless individuals ages three and up, who are suffering from mental illness, addictions, and/or profound trauma and loss. The mental health needs of the homeless population are shifting toward higher levels of risk and symptom distress, and Genesis counselors are specifically trained to effectively address the intersection of mental health, trauma, addiction and homelessness. In 2014: --75 individuals received critical mental health, addiction, and trauma intervention services from January-September. --Counselors utilized Eye Movement Desensitization and Reprocessing (EMDR) for one year and provided anecdotal details about one client. --OUTCOMES: Of the clients, 65% increased their compliance with psychotropic medication, 83% reported improvements in daily functioning, and 92% indicated they are better able to express their thoughts and emotions -Eye Movement Desensitization and Reprocessing is an effective intervention used to relieve mental health symptoms associated with traumatic events. The training was provided to therapists and licensed community and hospital-based social workers in St. Joseph and Elkhart Counties. Non-profit agencies received a discount through a grant obtained from a national foundation. Fifty eight people were trained in EMDR during 2014. Additionally, 77 received training in A-Tip, a short-term intervention to help individuals become more stable and calm, diminishing the possibility of becoming traumatized. Some of the organizations represented included: Memorial, Youth Service Bureau, Oaklawn, Center for the Homeless, YWCA children's counseling, St. Margaret's House, Boys and Girls Clubs of St. Joseph County, Family and Children Services, the Samaritan Center, Department of Children's Services, HOPE Ministries, La Casa de Amistad, Bashor Children's Home, St. Adalbert's, Our Lady of Hungry Elementary Schools, and South Bend Career Academy. I. Economic Stability -Priority not receiving direct funding: The priority receiving the least resource investment was Economic Stability, detailed as Unemployment, Uninsured/Underinsured, Generational Poverty, and Affordable and Quality Housing. Memorial has an impact in these areas because we are the second largest employer of the City/County, behind the University of Notre Dame. The hospital has generated a number of career paths for employment in healthcare, beginning with Certified Nursing Assistant, Community Health Worker, Radiology Technician, Licensed Practical Nurse, Registered Nurse, Bachelor's and Master's Degrees in Nursing, and Advanced Practice Nurse. -To support the Indiana Health Plan, Marketplace Health Plans, and Medicaid coverage, 15 CHE associates successfully passed the Indiana Navigator training program and certification test. Affordable Care Act/Medicaid Enrollments are being facilitated in the community, as well as at the hospital. --State-certified Navigators enrolled 83 people in the first round of the Affordable Care Act. Indicator Framework: The framework for indicator selection within the Health category is based on the Health and Human Services' Healthy People initiative. "Healthy People 2020" establishes science-based objectives for improving the health of the nation. The initiative establishes benchmarks every ten years and tracks progress toward these achievable goals. This framework encourages collaboration across sectors and allows communities to track important health and quality of life indicators focusing on general health status, health-related quality of life and well-being, determinants of health, and disparities. Programming currently supported by Tithing will be enhanced and opened for additional partnership activities. Each priority will have an Aim Statement, with a logic chain analysis. Selected priorities for implementation will have multiple-actionable activities with a shared impact or outcome measurement. An Advisory Council composed of Board Members, system employees, and community residents has oversight of the Implementation Strategic process and accountability. Approval for St. Joseph Community Health Needs Assessment and Implementation Strategy: A Beacon to Health and Well-Being was given with a signed resolution by the Memorial Hospital Board on May 23, 2013. Implementation began immediately with a community-wide public event and announcement of a potential partnership. Shortly following the signing of the Implementation Strategy, the Beacon Health System Board signed a Policy confirming the financial commitment to Community Benefit Investment. The Implementation Plan continued through 2014. http://assets.thehcn.net/content/sites/qualityoflife/2013_TithingPolicy_Si gned.pdf Education and Research for a Healthy Future We consider education and research to be part of our mission. Each is vital to preparing the next generation of health care professionals to meet future health care demands. As our country ages, we will need more caregivers than ever before; at the same time, there is a shortage of new graduates in key clinical and technical positions. To ensure that we have the quality workforce we need to care for our patients in the future, we are committed to the education of current and future caregivers, and have partnered with local high schools, colleges, and universities including the Indiana University Medical School at Notre Dame. Preparing for tomorrow's health care needs requires a commitment to researching new and innovative treatments that battle tomorrow's health care challenges. Clinical research is a part of programming across the Health System. Physicians at Memorial participate in various research projects that are national in scope and are evaluated by FDA guidelines by Memorial's Institutional Review Board (IRB). Oncology and Pediatric clinical trials continue to be a significant portion of the protocols submitted to the IRB. Our medical and health care staff are working to find tomorrow's treatments and cures today. Research also evolves from the nursing, pre-medical, physical therapy and social service disciplines at the local post-secondary education institutions. The University of Notre Dame is a close partner in community-based research, which includes evaluating education curricula, and intervention modalities, using both quantitative analysis and qualitative research methods. Together, we offer a comprehensive learning experience for medical students, enabling interns, residents, and fellows to utilize our state-of-the-art training facilities and integrate advanced technology learned in the classroom directly with patient care. We utilize evidence from community-based research in addition to clinical research, particularly in the intersection of neuroscience and medical interventions. Evaluating how the |
| Part V, Section B Line 15e and 16i | FINANCIAL ASSISTANCE POLICY THE COLLECTION POLICY AND PROCEDURES RELATED TO PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE AS FOLLOWS: To ensure the Hospital fulfills its mission and commitment to the poor, the Hospital shall annually plan for and provide free and reduced health care and health-related services to the poor and qualified uninsured/underinsured. A patient is considered for Financial Assistance if all other State and Federal assistance opportunities have been exhausted and all other Third party payment sources have been exhausted. The Federal Income and Poverty Guidelines will serve as a guide in determining those patients that may qualify for Financial Assistance. All patients shall be treated consistently in the approval process including Medicare and non Medicare patients. PURPOSE: To provide financial assistance to those patients who cannot afford to pay and to provide discounted care to uninsured patients receiving medically necessary and/or emergent healthcare services from Memorial Hospital of South Bend. PROCEDURE: 1. Memorial Hospital will assist patients in making a determination regarding whether or not the patient may be able to qualify for some form of entitlement through a Federal or State Government program and complete the appropriate applications for assistance. It is required that the patient will assist in the determination and application process. If the patient does not qualify for any Federal or State Assistance, we will start the Financial Assistance Approval process. 2. The availability of financial assistance is publicized via signage posted in registration areas, by including information on every statement about financial assistance, and by publishing the policy on our website. 3. Identify patients potentially eligible for Financial Assistance through the pre-registration, admission, eligibility process, or through self pay account review and collection activities. 4. Provide to the patient a Financial Evaluation form. 5. Obtain or receive a signed, completed Financial Evaluation Form from the patient. 6. Determine eligibility by obtaining the following information from the patient: a) Gross income and most recent W-2 b) Prior years tax return (including all schedules) c) Last 3 pay stubs (if unemployed, Work One statement of earnings) d) Employment status and future earnings capacity e) Family size f) Medical expenses including drugs and medical supplies g) Last three bank statements If the patient does not have a prior year tax return, we will make our determination based on current income. A credit report may be run to substantiate documentation. There may be circumstances where a patient may not be able to provide all the above documentation needed to approve financial assistance. It will be up to the discretion of the Department Director and/or the CFO to grant approval in this circumstance. 7. Determine the amount of Financial Assistance by utilizing the Federal Poverty guidelines as a basis for qualification levels. Gross Annual income plus cash assets are used as the basis for income calculations. Patients may qualify for complete or partial financial assistance. The minimum amount billed to a patient who qualifies for financial assistance is limited to the amounts generally billed to those with insurance and this percentage was calculated based on the average discount amongst Medicare and Commercial payers. Financial Assistance will be granted for those patients who are homeless. If a patient is deceased and has no estate, we will grant charity on any outstanding self pay account balances. Documentation that an estate has not been filed will be attached to the Financial Assistance approval form. Presumptive Financial Assistance will be granted for those patients who are covered under a limited benefit Medicaid plan (i.e. Family Planning Medicaid, Emergency Only Medicaid, Pregnancy Only Medicaid, etc.) when the services are not covered under their policy. Note: Approval may be made based on Medical indigence. ie: Patients who have excessive pharmacy, oxygen, or ongoing medical expense. This amount would be deducted from their gross income. Financial Assistance will not be granted for non-medically necessary services. 8. Complete the Financial Assistance Approval form and forward to the Collection Coordinator. 9. The Collection Coordinator will review the Financial Assistance application to ensure that it is complete. The Coordinator will approve or deny the application before sending it to the Patient Account Manager for approval. Depending on the dollar amount of the financial assistance write-off, approval signatures are required. The approval guidelines are as follows: $1.00 to $2,500.00 Collection Coordinator $2,501.00 to $10,000.00 Patient Account Service Manager $10,001.00 to $25,000.00 Director, Patient Account Services $25,001.00 and above Vice President, CFO 10. After all the appropriate signatures have been obtained, the Financial Assistance write-off along with the corresponding documentation will be forwarded to Cash Application for write-off. 11. Send determination letter to notify patient of the approval for Financial Assistance. 12. Financial Assistance approvals will apply retroactively to all open accounts with existing balances (including accounts in collections) and will be active for 6 months following the date of approval. 13. The document will be placed in the Financial Assistance file drawer under the date the write off was posted. UNINSURED SELF PAY DISCOUNTS: For those patients who have no insurance and do not meet the above financial assistance guidelines, Memorial Hospital will provide a 35% uninsured discount. ANY EXCEPTIONS MUST BE APPROVED BY THE DEPARTMENT MANAGER OR DIRECTOR. |
| 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, 57%, by dividing (1) all claims allowed during the 12-month period from 1/1/2013 to 12/31/2013 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 I, line 3c Not applicable Part I, Line 6a Creating community health is at the core of Memorial Hospital of South Bend, Inc.'s ("Memorial", "the Hospital" or "We") mission. We view the promotion of community health as our social responsibility and a key to long-term cost effectiveness. We also define improving the health status of a community to be as much a social, economic and environmental issue, as a medical one. Our organization takes a broad approach to creating community health. This approach has included: ongoing education of board members, staff and local leaders through Community Plunges (experiential activities focused on the specific issues of community residents with a neighborhood-based agency), Community Foundation support, strategic allocation of tithing resources, a clear statement of vision and goals, a commitment to continuous quality improvement, and promotion of volunteer involvement and community partnerships. As a community not-for-profit organization, we take seriously our responsibility to invest our resources and energies into understanding and meeting the divergent health care needs of all; we strive to ensure that everyone, regardless of their ability to pay, receives the care they need. Memorial has long been recognized for the collaboration efforts which engage individuals and organizations with diverse socio-economic religious, ethnic, race, age, and gender identity characteristics. Our team of passionate and dedicated health care professionals, along with many partners throughout the Northern Indiana and Southern Michigan region (Michiana), helped us contribute significantly to the health and well-being of our community. For example, St. Joseph County public health system partners met in 2012; including more than 160 healthcare and social service agencies to support the residents of nine cities and towns and 13 townships. Public health system partners across the county are committed to enhancing systemic performance by engaging partnerships, support, and input, so that together we can better serve the residents of St. Joseph County. This is the foundation to strengthen local public health system infrastructure with the capacity and resources to improve quality and effectiveness of healthcare services in St. Joseph County. The Health Improvement Alliance's collaboration continues under the leadership of the St. Joseph County Health Department (SJCHD). A primary component of such a process includes a focus on partnerships and collaboration to ensure sustainability. Further, Memorial plays a key role in serving the community as a whole. Part I, Line 7, Column F BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES $35,599,378 Part I, Line 7B UNREIMBURSED MEDICAID AND OTHER MEANS TESTED GOVERNMENT PROGRAMS IN 2014, TOTAL OFFSETTING REVENUE FOR LINE 7B, MEDICAID DID NOT INCLUDE AMOUNTS THAT WERE RECEIVED IN 2014 THAT RELATED TO PRIOR YEARS. THOSE AMOUNTS ARE HOSPITAL ASSESSMENT FEE (HAF) RECEIPTS FOR 2013 IN THE AMOUNT OF 18,362,168, ALONG WITH HAF PAYMENTS MADE IN 2014 THAT RELATED TO 2013 IN THE AMOUNT OF 7,520,768 WHICH WAS EXCLUDED FROM THE COMPUTATIONS FOR WORKSHEET 2, COST TO CHARGE RATIO. COSTING METHODOLOGY PART I, LINE 7 DONATIONS - THE ACTUAL COST OF THE DONATION OR DEPARTMENTAL NET CONTRIBUTION, WHICHEVER IS APPROPRIATE, FROM GENERAL LEDGER RECORDS AND REPORTS ARE INCLUDED. IN-KIND/VOLUNTEER SERVICES - WHEN A SPECIFIC PERSON IS LISTED AS THE EVENT VOLUNTEER, THE YTD HOURLY WAGE IS PULLED FROM THE LABOR DISTRIBUTION REPORT FOR 12/31, MULTIPLIED BY THE NUMBER OF HOURS AT THE EVENT(S). WHEN A SPECIFIC JOB CLASS IS LISTED (I.E. "PEDS REHAB"), THE AVERAGE HOURLY WAGE IS COMPUTED FOR ALL EMPLOYEES IN THAT JOB CLASS AND DEPARTMENT AND USED IN THE SAME MANNER. BENEFITS ARE ADDED TO EACH AT A RATIO OF BENEFIT DOLLARS TO TOTAL SALARIES, MULTIPLIED BY TOTAL SALARIES CALCULATED FOR THE EVENT. Community Building Activities Part II Memorial has long been a supporter of leadership building. In 2014, community members attended multiple-day trainings at the Pfeil Innovation Center, hosting education forums, and inviting community members to leadership presentations. Memorial also has a history of supporting coalitions. In 2014, the Childhood Obesity program was convened by United Way of St. Joseph County. Seventeen agencies joined forces to develop and implement a collective impact strategy to reduce obesity among children. Partially funded by Memorial, this two-year project addresses Childhood Obesity community-wide, as a disease prevention model. Memorial has also been instrumental in supporting the Michiana Gerontological Institute, a collaborative of professionals providing research and services for the aging population. 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. 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 in the current year to determine amount attributable to the FAP. PART III, LINE 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS TAKING INTO CONSIDERATION THE TRENDS IN HEALTH CARE COVERAGE, HISTORICAL ECONOMIC TRENDS, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCES PERIODICALLY THROUGHOUT THE YEAR BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN UTILIZED TO MAKE MODIFICATIONS, AS NECESSARY, TO THE PROVISION FOR BAD DEBTS TO PROVIDE FOR AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT PART III, LINE 8 PARTICIPATION IN THE GOVERNMENTAL MEDICARE PROGRAM DOES NOT PROVIDE THE OPPORTUNITY FOR A HOSPITAL TO NEGOTIATE A REIMBURSEMENT RATE OR STRUCTURE THAT WOULD ALLOW THE HOSPITAL TO COVER THE COST OF THE MEDICAL SERVICE RENDERED TO THE PROGRAM PARTICIPANT, AS WOULD BE THE CASE IN CONTRACTUAL NEGOTIATIONS WITH COMMERCIAL INSURANCE COMPANIES. NOR IS THE HOSPITAL ALLOWED TO PROVIDE ONLY THE SERVICES FOR WHICH REIMBURSEMENT COVERS THE DIRECT COST OF CARE. THIS PRODUCES THE SAME SHORTFALL OUTCOME AS DOES THE PARTICIPATION IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM IS RECOGNIZED AS A COMMUNITY BENEFIT ON SCHEDULE H AND ON COMMUNITY BENEFIT REPORTS FOR MOST STATES. THE QUALITY AND COST OF THE PATIENT CARE IS THE SAME REGARDLESS OF PAYOR SOURCE. HENCE THE ACCEPTANCE OF MEDICARE REIMBURSEMENT REPRESENTS A REDUCTION OR RELIEF OF THE GOVERNMENT BURDEN TO PAY THE FULL COST OF CARE PROVIDED. FINANCIAL ASSISTANCE POLICY PART III, LINE 9B THE COLLECTION POLICY AND PROCEDURES RELATED TO PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE AS FOLLOWS: To ensure the Hospital fulfills its mission and commitment to the poor, the Hospital shall annually plan for and provide free and reduced health care and health-related services to the poor and qualified uninsured/underinsured. A patient is considered for Financial Assistance if all other State and Federal assistance opportunities have been exhausted and all other Third party payment sources have been exhausted. The Federal Income and Poverty Guidelines will serve as a guide in determining those patients that may qualify for Financial Assistance. All patients shall be treated consistently in the approval process including Medicare and non Medicare patients. PURPOSE: To provide financial assistance to those patients who cannot afford to pay and to provide discounted care to uninsured patients receiving medically necessary and/or emergent healthcare services from Memorial Hospital of South Bend. PROCEDURE: 1. Memorial Hospital will assist patients in making a determination regarding whether or not the patient may be able to qualify for some form of entitlement through a Federal or State Government program and complete the appropriate applications for assistance. It is required that the patient will assist in the determination and application process. If the patient does not qualify for any Federal or State Assistanc | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| NORTHEAST NEIGHBORHOOD REVITALIZATION ORGANIZATION | ||||||||
| 803 LINCOLNWAY WEST | SOUTH BEND | IN | 46616 | 352118149 | 501(C)(3) | $50,000 | CONTRIBUTION | |
| SJC BRIDGES OUT OF POVERTY INC | ||||||||
| 117 N LAFAYETTE BLVD | SOUTH BEND | IN | 46601 | 263195466 | 501(C)(3) | $32,000 | CONTRIBUTION | |
| MICHIANA PUBLIC BROADCASTING CORPORATION | ||||||||
| 300 W JEFFERSON | SOUTH BEND | IN | 46601 | 351155594 | 501(C)(3) | $90,000 | SPONSORSHIP | |
| COMMUNITY HEALTH PARTNERS OF SOUTH BEND | ||||||||
| 1010 N Bendix Drive | SOUTH BEND | IN | 46628 | 263051440 | 501(C)(3) | $191,706 | Contribution | |
| THE CENTER FOR THE HOMELESS | ||||||||
| 813 South Michigan | SOUTH BEND | IN | 46601 | 351768544 | 501(C)(3) | $103,500 | PEDS PROGRAM | |
| INDIANA UNIVERSITY SCHOOL OF MEDICINE | ||||||||
| 1234 Notre Dame Ave | SOUTH BEND | IN | 46617 | 356001673 | 501(C)(3) | $15,000 | SPONSORSHIP | Raclin-Carmichael HalL |
| UNIVERSITY OF NOTRE DAME | ||||||||
| MAIN BUILDING | Notre Dame | IN | 46556 | 350868188 | 501(c)(3) | $43,000 | CONTRIBUTION | |
| SOUTH BEND HERITAGE FOUNDATION INC | ||||||||
| 803 Lincolnway West | SOUTH BEND | IN | 46616 | 237394320 | 501(c)(3) | $18,500 | CONTRIBUTION | |
| UNITED WAY OF ST JOSEPH | ||||||||
| 3517 E Jefferson | SOUTH BEND | IN | 46660 | 351063368 | 501(c)(3) | $138,250 | CONTRIBUTION | |
| SOUTH BEND COMMUNITY SCHOOLS | ||||||||
| 215 S ST JOSEPH STREET | SOUTH BEND | IN | 46601 | 351076622 | 501(C)(3) | $6,500 | CONTRIBUTION | |
| COMMUNITY FOUNDATION OF STAINT JOSEPH COUNTY | ||||||||
| PO Box 837 | South Bend | IN | 46624 | 237365930 | 501(C)(3) | $100,000 | Contribution | |
| RIVERBEND CANCER SERVICES | ||||||||
| 919 E JEFFERSON BLVD | SOUTH BEND | IN | 46617 | 350872359 | 501(C)(3) | $30,277 | Contribution | |
| YMCA OF MICHIANA INC | ||||||||
| 1201 Northside Blvd | South Bend | IN | 46615 | 350868216 | 501(C)(3) | $35,000 | Contribution | |
| CENTER FOR HOSPICE CARE FOUNDATION | ||||||||
| 111 Sunnybrook Ct | South Bend | IN | 46637 | 300433147 | 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) | $37,500 | Contribution | |
| MORRIS PERFORMING ARTS CENTER | ||||||||
| Po Box 543 | South Bend | IN | 46624 | 351834689 | 501(C)(3) | $6,000 | CONTRIBUTION | |
| STANLEY CLARK SCHOOL | ||||||||
| 3123 Miami St | South Bend | IN | 46614 | 351019540 | 501(C)(3) | $7,500 | Contribution | |
| PROJECT IMPACT -SOUTH BEND INC | ||||||||
| 55501 MOSS RD | South Bend | IN | 46628 | 134331624 | 501(C)(3) | $26,450 | Contribution | |
| SAINT ADALBERTS PARISH | ||||||||
| 2505 Grace St | South Bend | IN | 46619 | 351095958 | 501(C)(3) | $30,575 | Contribution | |
| SOUTH BEND ALUMNI ASSOCIATION | ||||||||
| 215 S ST Joseph St | South Bend | IN | 46601 | 351674506 | 501(C)(3) | $15,000 | Contibution | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 20 | Total501c3OrgCnt |
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) |
|---|---|---|
| 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 | $377,534 | $0 | $147,084 | $0 | $28,522 | $0 | $138,880 | $0 | $19,868 | $0 | $711,888 | $0 | $0 |
| Robert Yount MD | ||||||||||||||
| Trustee; Employed Physician | $0 | $904,418 | $0 | $20,655 | $0 | $3,808 | $0 | $10,400 | $0 | $21,221 | $0 | $960,502 | $0 | $0 |
| Keith Sherry MD | ||||||||||||||
| Trustee Thru March 27 | $346,089 | $0 | $522 | $0 | $1,170 | $0 | $10,726 | $0 | $23,486 | $0 | $381,993 | $0 | $0 | $0 |
| Gerard Duprat MD | ||||||||||||||
| Trustee | $0 | $528,486 | $0 | $120,655 | $0 | $6,595 | $0 | $10,400 | $0 | $25,109 | $0 | $691,245 | $0 | $0 |
| Kreg Gruber | ||||||||||||||
| PRESIDENT | $189,751 | $189,752 | $66,692 | $66,693 | $6,905 | $6,905 | $63,778 | $63,778 | $11,604 | $11,605 | $338,730 | $338,733 | $0 | $0 |
| Cheryl Wibbens-Lesh MD | ||||||||||||||
| Asst. Secr./VP | $313,743 | $0 | $57,630 | $0 | $2,630 | $0 | $12,514 | $0 | $26,695 | $0 | $413,212 | $0 | $0 | $0 |
| Scott Thomas MD | ||||||||||||||
| Employed Physician | $409,404 | $37,927 | $261 | $0 | $104 | $84 | $10,595 | $0 | $5,553 | $835 | $425,917 | $38,846 | $0 | $0 |
| Thomas Sutula MD | ||||||||||||||
| Employed Physician | $240,337 | $0 | $23,670 | $0 | $1,980 | $0 | $15,327 | $0 | $20,751 | $0 | $302,065 | $0 | $0 | $0 |
| Dale A Patterson | ||||||||||||||
| Employed Physician | $307,905 | $0 | $25,161 | $0 | $670 | $0 | $10,400 | $0 | $22,741 | $0 | $366,877 | $0 | $0 | $0 |
| Anton J Crepinsek | ||||||||||||||
| Employed Physician | $243,097 | $0 | $21,021 | $0 | $8,850 | $0 | $10,400 | $0 | $25,405 | $0 | $308,773 | $0 | $0 | $0 |
| LINDA A MANSFIELD | ||||||||||||||
| EMPLOYED PHYSICIAN | $235,612 | $0 | $20,164 | $0 | $557 | $0 | $10,369 | $0 | $17,819 | $0 | $284,521 | $0 | $0 | $0 |
| STEPHEN M HUFFMAN | ||||||||||||||
| PRESIDENT | $135,475 | $135,475 | $48,204 | $48,204 | $3,300 | $3,301 | $25,133 | $25,134 | $11,518 | $11,518 | $223,630 | $223,632 | $0 | $0 |
| PHILLIP NEWBOLD | ||||||||||||||
| CEO | $0 | $708,507 | $0 | $335,650 | $0 | $204,080 | $0 | $163,973 | $0 | $20,081 | $0 | $1,432,291 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH. J - PART 1, 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 MEMORIAL'S HEALTH AND LIFESTYLE CENTER AND SPOUSAL TRAVEL. BEACON HEALTH SYSTEM ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. PART I, LINE 3 MEMORIAL HOSPITAL OF SOUTH BEND, INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION. SCH. J - PART 1, LINE 4B - EXECUTIVE RETENTION PLAN BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2014, REFLECTED IN COLUMN (B)(III): -PHIL NEWBOLD $154,765 IN MARCH 2014. THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2014 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: -PHIL NEWBOLD, $140,103 -JEFFREY COSTELLO, $71,368 -STEPHEN HUFFMAN, $38,213 -KREG GRUBER, $68,406. 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 2014 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: -JEFFREY COSTELLO, $48,750 -KREG GRUBER, $48,750 SCH. J - PART 1, LINE 7 - COMPENSATION CONTINGENT ON NET EARNINGS THE RELATED ORGANIZATION, BEACON HEALTH SYSTEM, HAS THREE INCENTIVE PLANS (EMPLOYEE, MANAGEMENT AND EXECUTIVE) WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR BEACON HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $4,500,000. THE PAYOUT AND AMOUNT OF THE PAYOUT FOR THE EMPLOYEE INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. THE MANAGEMENT INCENTIVE PLAN PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET OPERATING INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. THE PAYOUT OF THE MANAGEMENT INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP PLAN PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY | ||||||||
| A | 356311914 | 79061BCP8 | 2006-03-16 | $38,580,000 | REFUND BONDS ISSUED 12/12/2000 | false | false | false |
| HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY | ||||||||
| B | 356311914 | 79062WAA6 | 2013-05-21 | $45,523,353 | REFUND BONDS ISSUED 05/10/2007 | false | false | false |
| INDIANA FINANCE AUTHORITY | ||||||||
| C | 351602316 | 45471ALS9 | 2013-05-21 | $96,069,836 | REFUND BOND ISSD 2/3/98 & 10/22/08 | false | false | false |
| INDIANA FINANCE AUTHORITY | ||||||||
| D | 351602316 | 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 | $715,000 | $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 | false | Yes (true) |
| C | $7,712,973 | $0 | $96,069,836 | $0 | $0 | $0 | $764,791 | $0 | $0 | $0 | $95,305,045 | $0 | 2003 | Yes (true) | false | false | Yes (true) |
| D | $887,394 | $0 | $7,492,187 | $0 | $0 | $0 | $66,925 | $0 | $0 | $7,425,262 | $0 | $0 | 2013 | false | false | false | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Change In Use Bond Financed PropChangeInUseBondFinancedPropPct | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0.00000 | 0.00000 | 0.00000 | 0.00000 | |||||||||
| B | 0 | 0.00000 | false | false | Yes (true) | Yes (true) | false | false | false | false | Yes (true) | ||
| C | 0 | 0.00000 | false | false | Yes (true) | Yes (true) | false | false | false | false | Yes (true) | ||
| D | 0 | 0.00000 | false | false | false | false | false | false | false | Yes (true) |
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 | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) | |||
| 0 | |||||||||||||
| C | false | Yes (true) | false | false | false | false | false | 0 | false | Yes (true) | |||
| 0 | |||||||||||||
| D | false | Yes (true) | false | false | 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 |
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 2014, MEMORIAL HAD 503 VOLUNTEERS IN THIS PROGRAM WHO SERVED 45,900 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 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 395 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 SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT IN EARLY JANUARY, 2015 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2015, 21 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 INDEPENDANT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE 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. (66,532,647) Write off Inter company, Memorial Health Foundation, Inc. 37,466 Write off Inter company, Elkhart General Hospital, Inc. (11,435,037) Write off Inter company, Beacon Health System, Inc. (361,362,756) Change in interest in recipient org 2,643,404 Non cash donation from Memorial Health Foundation, Inc. (20,000) TOTAL (436,669,570) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FEES - PHYS TOTAL FEES:15078989 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:13128711 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB FEES TOTAL FEES:6672405 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:4604365 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION EXP TOTAL FEES:2911347 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:1741093 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TRNSCRPTN,P/S MEDICAL,RAD FEES TOTAL FEES:720529 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:REPAIR PARTS/MAINT. TOTAL FEES:676068 |
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 | MHSB | Yes (true) |
| BEACON HEALTH SYSTEM Inc | ||||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 453864076 | Parent Org. | IN | 501(C)(3) | 11a | 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 (14 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Beacon Health Ventures Inc | ||
| P | $4,322,551 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| Q | $2,250,000 | ACTUAL CHARGES |
| Beacon Health Ventures Inc | ||
| R | $721,390 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| B | $10,859,037 | writeoffinterco |
| Elkhart General Hospital Inc | ||
| P | $2,033,174 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| Q | $13,014,728 | ACTUAL CHARGES |
| Elkhart General Hospital Inc | ||
| R | $98,400 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| C | $646,131 | ACTUAL CHARGES |
| Memorial Health Foundation Inc | ||
| R | $64,547 | ACTUAL CHARGES |
| Beacon Medical Group Inc | ||
| J | $1,366,250 | writeoffinterco |
| Beacon Medical Group Inc | ||
| B | $66,532,648 | writeoffinterco |
| Beacon Medical Group Inc | ||
| Q | $55,000,000 | ACTUAL CHARGES |
| Beacon Medical Group Inc | ||
| P | $51,172,717 | writeoffinterco |
| Beacon Medical Group Inc | ||
| S | $66,492,733 | writeoffinterco |
Comments