2015-08-05T12:49:05-05:00 2014-09-30 351416669 LA ROSA & CO LLC 320 N MERIDIAN ST STE 328 INDIANAPOLIS IN 46204 990 2013-10-01 370661199 DECATUR MEMORIAL HOSPITAL DECA 2178762107 2300 N EDWARD ST DECATUR IL 625264163 AL NAQVI EXECUTIVE VICE PRESIDENT & CFO 2178762107 2015-05-14 true MICHAEL P MERKEL P00137280 3176348777 2015-05-14 2013 2016-04-25 22:37:26Z KEN SMITHMIER 2300 N EDWARD ST DECATUR IL 625264163 307313289 false X WWW.DMHCARES.ORG X 1916 IL DMH SERVES THE HEALTHCARE NEEDS OF THE PEOPLE OF CENTRAL ILLINOIS THROUGH OPERATION OF A 280-BED ACUTE CARE HOSPITAL AND RELATED FACILITIES PROVIDING COMPREHENSIVE INPATIENT, OUTPATIENT AND PHYSICIAN SERVICES. (SCHEDULE 0). 13 7 2431 352 4672960 707976 3280671 3574565 241842558 252800020 12422658 9197007 14653712 13405352 272199599 278976944 932272 1263671 0 135018427 131819160 0 0 121288590 133289463 257239289 266372294 14960310 12604650 391590668 369934112 80148738 79008802 311441930 290925310 X DMH SERVES THE HEALTHCARE NEEDS OF THE PEOPLE OF CENTRAL ILLINOIS THROUGH OPERATION OF A 280-BED ACUTE CARE HOSPITAL AND RELATED FACILITIES PROVIDING COMPREHENSIVE INPATIENT, OUTPATIENT AND PHYSICIAN SERVICES. (SCHEDULE 0). false false 113050707 1263671 160339734 OUTPATIENT SERVICES: DMH PROVIDES A FULL RANGE OF OUTPATIENT SERVICES (DIAGNOSTIC TESTS AND MEDICAL PROCEDURES NOT REQUIRING AN OVERNIGHT STAY). DMH DEPARTMENTS PROVIDING THE MOST SUBSTANTIAL SERVICES DURING THE YEAR INCLUDED CARDIOLOGY, LABORATORY, RADIOLOGY, ONCOLOGY, PHYSICAL THERAPY, SLEEP DISORDERS, SURGERY, GERIATRIC AND EMERGENCY MEDICINE. DURING THE FISCAL YEAR, PATIENTS MADE APPROXIMATELY 45,000 VISITS TO DMH'S EMERGENCY CARE CENTER AND RECEIVED APPROXIMATELY 252,000 OUTPATIENT TESTS. 48722989 69103779 INPATIENT SERVICES: WITH 280 BEDS CURRENTLY IN SERVICE,DMH PROVIDED 40,900 DAYS OF INPATIENT CARE DURING THE FISCAL YEAR. DMH'S INPATIENTS INCLUDED THE YOUNG (NEWBORN INFANTS IN THE LEVEL I OR LEVEL II NURSERY), THE OLD (FOR EXAMPLE, PERSONS RECEIVING CARE THROUGH DMH'S SENIOR HEALTH AND WELLNESS CENTER OF EXCELLENCE), AND THE IN-BETWEEN. AREAS OF INPATIENT SERVICE INCLUDED GENERAL MEDICAL, SURGERY, ORTHOPEDICS, CARDIOLOGY, GERIATRICS,PEDIATRICS, INTENSIVE CARE, DIALYSIS, OBSTETRICS AND GYNECOLOGY, NURSERY, LONG-TERM CARE, AND TELEMETRY MONITORING. INPATIENT CARE WAS PROVIDED BY DMH'S TEAM OF HIGHLY-QUALIFIED, TALENTED STAFF (TODAY NUMBERING OVER 2,000 IN ALL), INCLUDING HOSPITALISTS, NURSES, AIDES, DIETICIANS, CASE MANAGEMENT STAFF, SOCIAL WORKERS, AND CHAPLAINS. 47542010 31884244 PROFESSIONAL SERVICES: AS THE EMPLOYER OF APPROXIMATELY 58 PHYSICIANS PLUS A COMPLEMENT OF OTHER PROVIDERS (PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS), DMH OFFERS A WIDE RANGE OF PROFESSIONAL PATIENT CARE AT APPROXIMATELY 26 OFFICES LOCATED THROUGHOUT THE SERVICE AREA. THESE SITES INCLUDE THREE "EXPRESS CARE" LOCATIONS OFFERING CARE FOR CASES THAT ARE TIME-SENSITIVE BUT NOT LIFE-THREATENING OR EMERGENT. 180738 EDUCATION AND OUTREACH: DMH HAS CONCLUDED THAT, TO FULFILL ITS MISSION OF IMPROVING HEALTH, IT MUST BECOME INVOLVED IN THE EDUCATION, AWARENESS AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT HEALTH STATUS. IN AN EFFORT TO GIVE COMMUNITY RESIDENTS THE TOOLS NECESSARY TO MAKE HEALTHY LIFESTYLE DECISIONS, DMH SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE LOCAL COMMUNITY, THROUGH MEASURES RANGING FROM PROGRAMS FOR LOCAL SCHOOLS TO DMH'S POPULAR "PRIME TIME" PROGRAM FOR SENIORS. IN RECENT YEARS, DMH HAS PARTICIPATED IN VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES, AS A RESULT OF WHICH DMH HAS IDENTIFIED SIGNIFICANT CONCERNS SUCH AS ACCESS TO PRIMARY CARE PHYSICIANS AND SPECIALISTS; HEART, LUNG, & STROKE SCREENINGS; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; OBESITY; DIABETES; INDIGENT OUTPATIENT LONGITUDINAL CARE; ONCOLOGY SCREENINGS; WOMEN AND CHILDREN'S HEALTH; AND SENIOR HEALTH AND WELLNESS. WITH THE LEADERSHIP OF A MULTIDISCIPLINARY COMMUNITY BENEFITS COMMITTEE, INCLUDING PARTICIPATION BY A DIVERSE GROUP OF COMMUNITY REPRESENTATIVES, DMH HAS TAKEN A PRIMARY ROLE IN CONFRONTING THESE ISSUES. 180738 209496444 true true false true false false false false false true true false false false true true false true false false false false false false false false true true true false true true false false false false false false false true true true false false false false false true true true false false true 152 0 true 2431 true true true false false false false false false false false false X 13 7 true false false false true true true true true false false true true true true true true true true true true IL X DEBBIE BRAGG ACCOUNTING 2178762051 2300 N EDWARD ST DECATUR IL 625264163 KENNETH SMITHMIER DIRECTOR/PRE 10.00 30.00 X X 716504 0 17808 JACK O'RILEY DIRECTOR 2.00 X 0 0 0 WALTER SMITH DIRECTOR 2.00 X 0 0 0 JOHN W FUNK DIRECTOR 2.00 X 0 0 0 JONATHON T LOCKE MD DIRECTOR 2.00 X 0 0 0 ROY MOSSER JR DIRECTOR 2.00 X 0 0 0 THOMAS KOWA DIRECTOR 2.00 X 0 0 0 DAVID SMITH DIRECTOR 2.00 X 0 0 0 ROBIN KING DIRECTOR 2.00 X 0 0 0 BRAD WIKE DIRECTOR 2.00 X 0 0 0 DAVID TYROLT DIRECTOR 2.00 X 0 0 0 PAULA EISSFELDT DIRECTOR 2.00 X 0 0 0 EDWARD ELLIOT MD DIRECTOR 2.00 X 0 0 0 TIMOTHY D STONE JR EVP & ADMINI 40.00 0.00 X 417423 0 9580 MICHAEL ZIA MD VICE PRES. 40.00 0.00 X 301511 0 17655 JOHN RIDLEY SVP PROF. SE 40.00 2.00 X 253586 0 17981 LINDA FAHEY VP/CHIEF NUR 40.00 0.00 X 250843 0 4686 DEBBIE BRAGG SR. VP & CFO 40.00 3.00 X 219001 0 4195 KEVIN HORATH VP HUMAN RES 20.00 20.00 X 140299 0 16918 AL NAQVI EVP & CFO 20.00 30.00 X 38373 0 0 STEVEN SOBOL MD PHYSICIAN 40.00 X 1444659 0 18808 MARVIN DERRICK MD PHYSICIAN 40.00 X 859835 0 18808 MOHAMMED HASNAIN MD PHYSICIAN 40.00 X 859200 0 18808 ROBERT KRAUS JR MD PHYSICIAN 40.00 X 824601 0 18808 JOHN WATERS MD PHYSICIAN 40.00 X 818519 0 9580 7144354 173635 129 false true false DECATUR EMERGENCY MEDICAL SERVICES 334 W ELDORADO DECATUR IL 62522 PHYSICIAN FEES 1220000 DENMAN LINEN SERVICES 1801 N 43RD QUINCY IL 62305 LINEN SERVICES 1169246 CONSOCIATE GROUP PO 1068 DECATUR IL 62525 INSURANCE SERV 1079864 MIDWEST CREDIT 306 W ELDORADO PO BOX 445 DECATUR IL 62525 COLLECTIONS 993521 EXECUTIVE HEALTH RESOURCE PO BOX 822688 PHILADELPHIA PA 19182 CLAIMS REVIEW 801860 182 2289819 1284746 3574565 INPATIENT, OUTPATIENT, & PHYS 900099 252501866 252501866 DECATUR DIGESTIVE DISEASE CTR 621990 298154 298154 252800020 5108570 140961 4967609 840727 840727 840727 495111 345616 31139600 64018 27040702 74479 4098898 -10461 4088437 4088437 2349671 1221164 1128507 1128507 OTHER EXEMPT FUNCTION INC 900099 8527737 8527737 TAXABLE RELATED ENTITY INCOME 900099 1205164 1205164 WELLNESS & COSMETIC SERVICES 900099 817241 817241 885976 885976 11436118 278976944 261327757 4672960 9401662 1263671 1263671 2835597 2835597 4092652 4092652 102876083 86773343 16102740 1591558 1342438 249120 13550370 11429390 2120980 6872900 5797115 1075785 987458 987458 1008228 1008228 73931 73931 23649777 11742501 11907276 903055 548802 354253 48317284 45196318 3120966 5084689 4789679 295010 16495 16495 9967394 6238930 3728464 672937 519642 153295 440386 187307 253079 990854 620209 370645 19447853 11850911 7596942 3468141 978372 2489769 STATE MEDICAID TAX 14021413 14021413 MISCELLANEOUS EXPENSE 4239568 2087256 2152312 266372294 209496444 56875850 0 8700 8825 24054347 19528191 37962067 36616836 2000000 15800678 3071259 3042368 3526214 3782234 384485818 282935414 110268550 101550404 200205996 180621387 696017 942947 1042705 1042705 8754813 6997537 391590668 369934112 39514372 37506418 139553 826526 13311000 11475000 27183813 29200858 80148738 79008802 X 260167522 238706571 35917359 36797878 15357049 15420861 311441930 290925310 391590668 369934112 X 12604650 4077611 -37198881 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 23663 false true 50268 73931 false SCHEDULE C, PART II-B, LINE 1 A PORTION OF THE MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, THE ILLINOIS HOMECARE AND HOSPICE COUNCIL, AND THE ILLINOIS HOSPITAL ASSOCIATION ARE DESIGNATED AS LOBBYING EXPENSES. THE AMOUNT REPORTED ON SCHEDULE C, PART II-B, LINE 1I REPRESENTS THE AMOUNTS SO DESIGNATED. 15357049 983585 294026 625747 15420861 14608812 1893758 366193 779328 15357049 12369414 3817049 504333 1073318 14608812 11963360 406054 12369414 10910741 1977035 75407 849009 11963360 1.00000 true false 1337264 1337264 181320824 114088124 67232700 2280366 20154 2260212 191013290 163242626 27770664 8534074 5584510 2949564 101550404 CAPITAL LEASE OBLIGATIONS 12665263 MALPRACTICE INSURANCE 7562325 DEFERRED TRUST 5403898 PENSION LIABILITY 1971940 FUTURE RENT PAYMENTS 1001399 RETIREE HEALTH PLAN 596033 RESERVE FOR A/R NOT ON BOOKS 29200858 X SCHEDULE D, PAGE 2, PART V, LINE 4 THE ENDOWMENT FUNDS ARE USED FOR CAPITAL PURCHASES, SCHOLARSHIPS, AND ASSISTING INDIGENT PEOPLE WITH THEIR HOSPITAL BILLS. SCHEDULE D, PAGE 3, PART X THE SYSTEM HAD NO UNCERTAIN POSITIONS IN INCOME TAX LIABILITIES OR EXPENSES. true true X true X true X 6.000000000000 true true true false true true 17796311 17796311 0.06680 32394463 14545688 17848775 0.06700 50190774 14545688 35645086 0.13380 417338 417338 0.00160 993604 993604 0.00370 1247973 1247973 0.00470 14600 14600 0.00010 2673515 2673515 0.01000 52864289 14545688 38318601 0.14390 60000 60000 0.00020 850 850 46998 46998 0.00020 59039 59039 0.00020 166887 166887 0.00060 true 3814998 3804137 78033955 71874042 6159913 X true true DECATUR DIG DISEASE AMBULATORY ENDOSCOPY CENTER 0.50000 0.50000 1 1 DECATUR MEMORIAL HOSPITAL 2300 N EDWARD ST DECATUR IL 62526 X X X ACUTE CARE & LONG TERM CARE DECATUR MEMORIAL HOSPITAL 1 true X X X X X X X X X X 13 true false true X WWW.DMHCARES.ORG (SEE SECTION C) X X X X true false true true 200.000000000000 true 600.000000000000 true X X true true X X X X true false X X X X true X false false FACILITY 1, DECATUR MEMORIAL HOSPITAL - PART V, LINE 3 THE HOSPITAL HOSTED A COMMUNITY HEALTH NEEDS ASSESSMENT FOCUS GROUP WHERE THE FOLLOWING ATTENDEES PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS, AS WELL AS TOP HEALTH CONCERNS SEEN THROUGHOUT THE MACON COUNTY AREA. THESE INDIVIDUALS WERE CHOOSEN TO PARTICIPATE IN THE FOCUS GROUP BECAUSE OF THEIR INSIGHT TO THE COMMUNITY'S POPULATION, INCLUDING HEALTH NEEDS. TANYA ANDRICKS - ADMINISTRATIVE DIRECTOR DMH HOME HEALTH SERVICES JULIE BRILLEY - ADMINISTRATIVE DIRECTOR MEDICAL STAFF MIKE CASSELL - DMH DIRECTOR OF MARKETING NIKKI DAMERY - COORDINATOR, CANCER CARE INSTITUTE JULIE MOORE - DIRECTOR OF COMMUNITY RELATIONS FRANCES SPERRY - ANALYTICS AND PERFORMANCE MANAGER PAIGE TOTH - DIRECTOR OF LEGAL AFFAIRS PAUL STANZIONE - EXECUTIVE DIRECTOR, GREATER DECATUR YMCA JULIE MOORE - COUNCILWOMAN, CITY OF DECATUR RYAN MCCRADY - CITY MANAGER, CITY OF DECATUR BILL CLEVENGER, EXECUTIVE DIRECTOR, DECATUR PARK DISTRICT TINA CLONEY, R.D., PH.D. - PROFESSOR, MILLIKIN UNIVERSITY PATRICK HOBAN - VICE PRESIDENT, ECONOMIC DEVELOPMENT CORPORATION JULIE AUBERT - ADMINISTRATOR, MACON COUNTY HEALTH DEPARTMENT DANA RAY, M.D. - PHYSICAN, CHIC CLINIC LEE HALL, PSY.D. - CLINICAL PSYCHOLOGIST, PSYCHOLOGY SPECIALISTS MICHAEL ZIA M.D. - VP OF QUALITY & MEDICAL AFFAIRS, DMH LINDA FAHEY R.N. - VP AND CHIEF NURSING EXECUTIVE, DMH KAY GOWDAR M.D. - PEDIATRICIAN, DMH TIMOTHY STONE, JR - EXECUTIVE VP AND COO, DMH SIX ADDITIONAL COMMUNITY LEADERS WERE INVITED TO ATTEND THE FOCUS GROUP, BUT WERE UNABLE TO ATTEND. THESE INDIVIDUALS WERE ENCOURAGED TO COMPLETE A SHORT SURVEY OF TOP COMMUNITY HEALTH NEEDS. FACILITY 1, DECATUR MEMORIAL HOSPITAL - PART V, LINE 5C THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT HTTP://WWW.DMHCARES.ORG/PATIENT/ASSESSMENT/COMMUNITYHEALTHNEEDSASSESSMENT20 13-2015.PDF FACILITY 1, DECATUR MEMORIAL HOSPITAL - PART V, LINE 12I DMH USES INCOME LEVEL AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. THE MAXIMUM QUALIFYING INCOME LEVEL INCREASES WITH THE SIZE OF THE FAMILY. FACILITY 1, DECATUR MEMORIAL HOSPITAL - PART V, LINE 20D DMH COMPLIES WITH THE ILLINOIS HOSPITAL UNINSURED PATIENT DISCOUNT ACT AND 501(R) OF THE INTERNAL REVENUE CODE AS ENACTED BY SECTION 9007(A) OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT BY PROVIDING "FINANCIAL ASSISTANCE" (EITHER FREE CARE OR REDUCED PATIENT FINANCIAL OBLIGATIONS) FOR HOSPITAL SERVICES TO PATIENTS WHO: (I) ARE NOT COVERED UNDER A POLICY OF HEALTH INSURANCE AND ARE NOT BENEFICIARIES UNDER A PUBLIC OR PRIVATE HEALTH INSURANCE, HEALTH BENEFIT, OR OTHER COVERAGE PROGRAM, INCLUDING HIGH DEDUCTIBLE HEALTH INSURANCE PLANS, WORKERS' COMPENSATION, ACCIDENT LIABILITY INSURANCE, OR OTHER THIRD PARTY LIABILITY; (II) FAIL TO QUALIFY FOR GOVERNMENTAL ASSISTANCE (FOR EXAMPLE, MEDICARE OR MEDICAID); AND (III) COOPERATE WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION REGARDING INCOME, ASSETS AND RESIDENCY. 9 DMH MEDICAL GROUP 2300 N EDWARD ST DECATUR IL 62526 OUTPATIENT CLINICS SOUTH SHORES IMAGING CENTER 1689 S FRANKLIN ST DECATUR IL 62521 DIAGNOSTIC CENTER DMH SURGERY CENTER 304 W HAY SUITE 114 DECATUR IL 62526 AMBULATORY SURGERY CENTER FORSYTH IMAGING CENTER 389 W WEAVER ROAD FORSYTH IL 62535 DIAGNOSTIC CENTER DECATUR DIGESTIVE DISEASE CENTER 2 MEMORIAL DR PHYS PLAZA WEST SUITE 102 DECATUR IL 62526 AMBULATORY ENDOSCOPY CENTER DMH CORPORATE HEALTH SERVICES 2122 NORTH 27TH ST DECATUR IL 62526 OUTPATIENT CLINIC DMH HOME HEALTH CARE 3122 BRETTWOOD CIRCLE DECATUR IL 62526 HOME HEALTH AGENCY SPORTS PERFORMANCE ENHANCEMENT CTR 2122 NORTH 27TH ST DECATUR IL 62526 PHYSICAL THERAPY DMH HOSPICE 3122 BRETTWOOD CIRCLE DECATUR IL 62526 HOSPICE AGENCY PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE AS INDICATED, THE HOSPITAL USES FEDERAL POVERTY GUIDELINES. ADDITIONALLY, THERE MAY BE INSTANCES WHERE PATIENTS HAVE INCURRED A FINANCIAL HARDSHIP, BUT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE GUIDELINES. SUCH CASES ARE REVIEWED INDIVIDUALLY AND, WHERE DEEMED APPROPRIATE, EARNINGS ON RESTRICTED FUNDS ARE USED TO PAY THE PATIENT'S BILLS. PART I, LINE 6A - RELATED ORGANIZATION INFORMATION THE HOSPITAL PREPARES THE ANNUAL COMMUNITY BENEFIT REPORT UNDER ITS OWN NAME. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THE HOSPITAL DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE NONE. PER NEWLY ISSUED GAAP, DMH INCLUDES BAD DEBT EXPENSE AS PART OF PROGRAM SERVICE REVENUE ON PAGE 9, LINE 2A. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE HOSPITAL DERIVED ALL NUMBERS IN LINE 7 FROM THE APPLICABLE IRS WORKSHEETS, USING THE RATIO OF PATIENT COST-TO-CHARGES. PART II - COMMUNITY BUILDING ACTIVITIES PART VI, LINE 5 ECONOMIC DEVELOPMENT - DMH SUPPORTS THE ECONOMIC DEVELOPMENT CORPORATION OF DECATUR AND MACON COUNTY (EDC). EDC IS A NON-PROFIT PUBLIC-PRIVATE PARTNERSHIP RESPONSIBLE FOR NON-RETAIL BUSINESS ATTRACTION, EXPANSION AND RETENTION EFFORTS IN DECATUR & MACON COUNTY. COMPOSED OF A COMBINATION OF LEADING PRIVATE SECTOR EMPLOYERS, LABOR, EDUCATIONAL INSTITUTIONS AND A VARIETY OF GOVERNMENTAL BODIES, THE EDC IS UNIQUELY POSITIONED TO ADDRESS THE NEEDS OF MACON COUNTY'S EXISTING BUSINESS AND EMPLOYER BASE ALONG WITH PROSPECTIVE BUSINESSES LOOKING TO LOCATE IN AND AROUND THE DECATUR, ILLINOIS AREA. OFFICER TIM STONE IS CHAIRMAN OF THE EDC. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - DMH SUPPORTS A PROGRAM WHEREBY INDIGENT OR QUALIFYING PATIENTS WHO COULD NOT AFFORD TRANSPORTATION FOR HEALTH CARE ARE PROVIDED TAXI AND DECATUR AMBULANCE SERVICE TRANSPORTATION AT NO COST. COMMUNITY SUPPORT - DMH DONATED A DESK, TWO ROUND TABLES, AND FIFTEEN STACKABLE CHAIRS TO PASSING THE TORCH OF THE AFRICAN AMERICAN VOICE WHICH IS A COMMUNITY-DRIVEN NEWSPAPER THAT INFORMS, ENLIGHTENS, AND ENGAGES AFRICAN AMERICANS WITH STORIES AND PERSPECTIVES THAT APPEAL TO THEM AND SATISFIES THE DESIRE TO STAY CONNECTED WITH THE COMMUNITY. DMH DONATED A COPIER AND OFFICE FURNITURE TO EBENEZER BAPTIST CHURCH. OTHER - DMH SUPPORTS THE LOCAL HOMELESS SHELTER BY PROVIDING 56,175 IN FOOD CONTRIBUTIONS OVER THE FISCAL YEAR. DMH UNDERSTANDS THAT FEEDING THE HUNGRY SUPPORTS THE HEALTH OF THE INDIVIDUALS SERVED BY THE HOMELESS SHELTER. DMH PROVIDED 2,864 IN ASSISTANCE TO PATIENTS WITH GUARDIANSHIP ISSUES. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY FOOTNOTE DESCRIBING BAD DEBT (NOTE THAT THE AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A SEPARATE FOOTNOTE WHICH APPLIED SOLELY TO BAD DEBT. THE FOLLOWING IS AN EXCERPT FROM A BROADER FOOTNOTE CONTAINED IN THE FINANCIAL STATEMENTS): THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS CONSOLIDATED FINANCIAL STATEMENTS, INCLUDING PROVISIONS FOR BAD DEBT. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE, ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES, AND RECOMMENDATIONS MADE BY THE SYSTEM'S EXTERNAL ADVISORS AND ACTUARIES IN MAKING JUDGMENTS AND ESTIMATES. ACTUAL RESULTS COULD DIFFER FROM THOSE ESTIMATES. THE ABOVE WORDING CAN BE FOUND IN FOOTNOTE 1, USE OF ESTIMATES SUB TITLE, ON PAGE 8 AS NOTED AT THE BOTTOM OF THE PDF PAGE OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 2: LINE 2 OF PART III WAS CALCULATED USING THE HOSPITAL WIDE COST-TO-CHARGE RATIO FROM THE APPLICABLE IRS WORKSHEET. PROVISIONS FOR BAD DEBT EXPENSE ARE CALCULATED BY TAKING THE NET ACCOUNTS RECEIVABLE BY PAYOR CLASS WHICH IS SEGREGATED INTO 10 TIME PERIOD BUCKETS AND MULTIPLYING EACH BUCKET BY A CALCULATED PRIOR YEAR ACTUAL BAD DEBT EXPENSE PERCENT. PART III, LINE 3: LINE 3 OF PART III WAS CALCULATED AS FOLLOWS: THE HOSPITAL USED 2010-2014 AMERICAN COMMUNITY 5 YEAR ESTIMATES DATA FROM THE CENSUS BUREAU TO ESTIMATE THE PERCENTAGE OF ITS PATIENT POPULATION WHOSE HOUSEHOLD INCOME WAS UNDER ITS FULL CHARITY CARE ELIGIBILITY CRITERIA OF 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). THIS PERCENTAGE WAS THEN DECREASED BY THE PERCENTAGE OF ILLINOIS RESIDENTS WHO HAVE GAINED INSURANCE THROUGH THE AFFORDABLE CARE ACT. THIS ADJUSTED PERCENTAGE WAS APPLIED TO THE HOSPITAL'S CHARGES TO ESTIMATE THE AMOUNT OF GROSS CHARGES THAT MET ITS FINANCIAL ASSISTANCE GUIDELINES. THE HOSPITAL THEN SUBTRACTED THE CHARGES RELATED TO THE PATIENTS THAT WERE ELIGIBLE FOR GOVERNMENTAL ASSISTANCE PROGRAMS SUCH AS MEDICAID. HOSPITAL CHARITY CARE ADJUSTMENTS WERE ALSO REMOVED BECAUSE THEY TOO WOULD NOT HAVE RESULTED IN BAD DEBTS. THE REMAINING CHARGES RELATED TO UNINSURED PATIENTS WITH HOUSEHOLD INCOMES BELOW 200% OF FPG, AND IT IS REASONABLE TO ASSUME THAT THEY RESULTED IN BAD DEBTS. THIS TOTAL WAS THEN MULTIPLIED BY THE RATIO OF COSTS-TO-CHARGES FROM THE APPLICABLE IRS WORKSHEET TO CALCULATE THE COST OF PROVIDING THESE SERVICES. PART III, LINE 8 - MEDICARE EXPLANATION THE HOSPITAL USED THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT IN CALCULATING THE AMOUNT ON LINE 6 OF PART III. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE HOSPITAL WILL NOT SEND A PATIENT'S ACCOUNT TO A THIRD-PARTY COLLECTION AGENCY PRIOR TO MAKING GOOD FAITH EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE HOSPITAL WILL USE GOOD FAITH EFFORTS TO DETERMINE WHETHER A PATIENT IS INSURED PRIOR TO INITIATING ANY COLLECTION ACTION. THE HOSPITAL WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF BILLS FOR ANY PATIENT RECEIVING FINANCIAL ASSISTANCE SO LONG AS SUCH PATIENT IS MAKING PAYMENTS IN ACCORDANCE WITH HIS/HER ESTABLISHED PAYMENT PLAN AS SET FORTH IN A PAYMENT AGREEMENT. IN THE EVENT THE PATIENT IS UNABLE TO MAINTAIN SUCH PAYMENTS, THE HOSPITAL WILL CONTACT THE PATIENT TO DETERMINE WHETHER AN ADJUSTMENT IS APPROPRIATE. NOTWITHSTANDING THE FOREGOING, THE HOSPITAL MAY TAKE LEGAL ACTION AGAINST PATIENTS RECEIVING FINANCIAL ASSISTANCE TO ENFORCE THE TERMS OF AN EXISTING PAYMENT PLAN WHERE THERE IS EVIDENCE THAT THE PATIENT (OR HIS/HER FAMILY AND/OR GUARANTOR, IF APPLICABLE) HAS SUFFICIENT INCOME AND ASSETS TO MEET HIS/HER OBLIGATIONS UNDER THE EXISTING PAYMENT PLAN; PROVIDED HOWEVER, THE HOSPITAL WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST ANY PATIENT RECEIVING FINANCIAL ASSISTANCE WHO HAS CLEARLY DEMONSTRATED THAT SHE DOES NOT HAVE SUFFICIENT INCOME AND ASSETS TO MEET HIS/HER FINANCIAL OBLIGATIONS TO THE HOSPITAL. NOTWITHSTANDING THE FOREGOING, THE HOSPITAL'S DEBT COLLECTION POLICY PLACES A MAXIMUM AMOUNT, BASED UPON ANNUAL HOUSEHOLD PRE-TAX INCOME AND CASH BENEFITS FROM ALL SOURCES WITH CERTAIN ADJUSTMENTS, THAT THE HOSPITAL (OR ITS DESIGNATED THIRD-PARTY COLLECTION AGENCY) MAY COLLECT IN ANY TWELVE (12) MONTH PERIOD FOR HOSPITAL SERVICES FROM A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 2 - NEEDS ASSESSMENT DECATUR MEMORIAL HOSPITAL CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS TO EVALUATE THE HEALTH OF THE COMMUNITY, IDENTIFY HIGH PRIORITY HEALTH NEEDS, AND DEVELOP STRATEGIES TO ADDRESS THE NEEDS OF THE COMMUNITY. THE 2013-2015 COMMUNITY HEALTH NEEDS ASSESSMENT REPRESENT A COMBINATION OF QUANTITATIVE AND QUALITATIVE INFORMATION FROM REPUTABLE STATISTICAL SOURCES AND FOCUS GROUP FEEDBACK PROVIDED BY COMMUNITY LEADERS. THE ASSESSMENT PROCESS INCLUDED A COMBINATION OF SECONDARY DATA, INCLUDING IPLAN, U.S. CENSUS DATA, AND REFERENCE TO HEALTHY PEOPLE 2020, AMONG OTHER SOURCES. VALUABLE INPUT FROM FOCUS GROUP PARTICIPANTS PROVIDED PRIMARY DATA FOR THE ASSESSMENT. DECATUR MEMORIAL HOSPITAL UTILIZED THE SIX STEP ASSESSMENT PROCESS OUTLINED BELOW. STEP 1: ESTABLISHING THE ASSESSMENT INFRASTRUCTURE PARTICIPANTS IN THE ASSESSMENT INCLUDED DECATUR MEMORIAL HOSPITAL (DMH), MILLIKIN UNIVERSITY, MACON COUNTY HEALTH DEPARTMENT, DECATUR TRADES AND LABOR, PSYCHOLOGY SPECIALISTS, ECONOMIC DEVELOPMENT CORPORATION, CITY OF DECATUR, DECATUR CITY COUNCIL, DMH MEDICAL GROUP PHYSICIANS, CHIC CLINIC, CARPENTERS LOCAL UNION 742, AND DECATUR CHURCHES. DMH'S ROLE IN THE ASSESSMENT PROCESS WAS TO COORDINATE THE OVERALL ASSESSMENT PROCESS, PROVIDE MEETING SPACE, MOTIVATE COMMUNITY ORGANIZATIONS TO PARTICIPATE IN THE ASSESSMENT PROCESS, COLLECT AND ANALYZE SECONDARY DATA, CONDUCT A FOCUS GROUP TO COLLECT PRIMARY DATA, MOTIVATE COMMUNITY ORGANIZATIONS TO ACT ON THE IDENTIFIED PRIORITY HEALTH ISSUES, IDENTIFY PRIORITY HEALTH ISSUES, AND DEVELOP AND IMPLEMENT INITIATIVES TO ADDRESS PRIORITY ISSUES. PARTNERING ORGANIZATIONS PROVIDED FOCUS GROUP PARTICIPANTS AND INPUT. STEP 2: DEFINING PURPOSE AND SCOPE (DEFINING THE COMMUNITY) THE PURPOSE OF THE ASSESSMENT WAS TO EVALUATE THE CURRENT HEALTH NEEDS OF THE COMMUNITY, THE RESOURCES CURRENTLY IN PLACE TO MEET THOSE NEEDS AS WELL AS IDENTIFYING MAJOR GAPS BETWEEN THE TWO. DATA FROM THE ASSESSMENT IS USED TO DEVELOP AN ACTION PLAN TO BRIDGE THE GAP AND BETTER MEET THE HEALTH NEEDS OF THE COMMUNITY. THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT FOCUSES ON PRIMARY AND SECONDARY INFORMATION FOR MACON COUNTY, ILLINOIS, INCLUDING THE CITY OF DECATUR AND NEARBY TOWNS. THIS WAS DETERMINED BECAUSE THE MAJORITY OF PATIENTS RESIDE IN MACON COUNTY (MORE THAN 70% OF PATIENTS). IN SOME INSTANCES, DATA WAS NOT AVAILABLE FOR MACON COUNTY, SO CITY OF DECATUR DATA WAS USED. STEP 3: COLLECTING AND ANALYZING DATA PRIMARY DATA WAS COLLECTED ON SEPTEMBER 4, 2012 BY HOLDING A COMMUNITY HEALTH NEEDS ASSESSMENT FOCUS GROUP, WHERE COMMUNITY LEADERS PROVIDED INPUT REGARDING COMMUNITY HEALTH STRENGTHS AND CONCERNS, AS WELL AS TOP HEALTH CONCERNS SEEN THROUGHOUT THE MACON COUNTY AREA. THIS DIVERSE GROUP OF INDIVIDUALS WAS CHOSEN TO PARTICIPATE IN THE 2012 COMMUNITY HEALTH NEEDS ASSESSMENT FOCUS GROUP BECAUSE OF THEIR INSIGHT TO THE COMMUNITY'S POPULATION, INCLUDING HEALTH NEEDS. SECONDARY DATA WAS COLLECTED THROUGH SEVERAL SOURCES. THE ILLINOIS PROJECT FOR LOCAL ASSESSMENT OF NEEDS (IPLAN) IS A COMMUNITY HEALTH ASSESSMENT AND PLANNING PROCESS THAT IS CONDUCTED EVERY FIVE YEARS BY LOCAL HEALTH JURISDICTIONS IN ILLINOIS. BASED ON THE ASSESSMENT PROTOCOL FOR EXCELLENCE IN PUBLIC HEALTH (APEX-PH) MODEL, IPLAN IS GROUNDED IN THE CORE FUNCTIONS OF PUBLIC HEALTH AND ADDRESSES PUBLIC HEALTH PRACTICE STANDARDS. ADDITIONAL RESOURCES WERE UTILIZED THROUGHOUT THE PROCESS, INCLUDING BUT NOT LIMITED TO, U. S. CENSUS BUREAU AMERICAN FACT FINDER, SOCIAL IMPACT RESEARCH CENTER AT HEARTLAND ALLIANCE, ILLINOIS DISTRICT REPORT CARD, AND ILLINOIS COUNTY BEHAVIORAL RISK FACTOR SURVEY. STEP 4: SELECTING PRIORITIES THE FOCUS GROUP PARTICIPANTS DISCUSSED THE PRIORITY IN WHICH COMMUNITY HEALTH NEEDS SHOULD BE ADDRESSED AND DETERMINED IT BEST TO FOCUS ON SERVICES THAT IMPACTED THE COMMUNITY AS A WHOLE VS. PATIENT SPECIFIC SERVICES. STEP 5: DOCUMENTING AND COMMUNICATING RESULTS THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOCUS GROUP WAS RECORDED FOR FUTURE REFERENCE AND RESULTS WERE TALLIED TO DETERMINE THE AREA'S TOP STRENGTHS/VALUES, BARRIERS/CONCERNS, AND THE TOP 3 HEALTH NEEDS. THESE RESULTS WERE PRESENTED TO EACH FOCUS GROUP PARTICIPANT AS WELL AS DECATUR MEMORIAL HOSPITAL'S SENIOR LEADERSHIP TEAM. STEP 6: PLANNING FOR ACTION AND MONITORING PROGRESS FOLLOWING THE COMPLETION OF THE 2013-2015 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, AN IMPLEMENTATION PLAN WAS CREATED TO MEET THE APPLICABLE IDENTIFIED NEEDS. EFFORTS ARE MEASURED APPROPRIATELY AND PROGRESS WILL BE REPORTED REGULARLY. THE HEALTH ASSESSMENTS WE HAVE PERFORMED OVER THE PAST SEVERAL YEARS HAVE ALL INDICATED THE FOLLOWING SIGNIFICANT HEALTH CARE ACCESS AND PROVISION NEEDS WITHIN THE COMMUNITY. ACCESS TO PRIMARY CARE AND SPECIALISTS EVALUATION OF THE PHYSICIAN POPULATION RATIOS IN MACON COUNTY INDICATED THAT DECATUR WAS UNDERSERVED BOTH IN TERMS OF PRIMARY CARE PHYSICIANS AND SPECIALISTS. THE WAITING TIME FOR A NEW PATIENT TO SEE A PRIMARY CARE PHYSICIAN IN THE COMMUNITY WAS AS LONG AS TWO TO THREE MONTHS. BASED ON THIS INFORMATION, DECATUR MEMORIAL HOSPITAL (DMH) HAS RECRUITED, AND CONTINUES TO RECRUIT, PRIMARY AND SPECIALIST PHYSICIANS TO THE COMMUNITY. COSTS OF RECRUITMENT WERE GENERALLY BORN BY THE HOSPITAL AND AMOUNTED TO MORE THAN 600,000 DURING THE LAST FISCAL YEAR. DMH ALSO SIGNIFICANTLY SUPPORTS THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE FAMILY PRACTICE RESIDENCY PROGRAM, WHICH GRADUATES UP TO SIX FAMILY PRACTITIONERS PER YEAR. THE RETENTION RATE OF THE GRADUATES WITHIN CENTRAL ILLINOIS HAS BEEN VERY HIGH. SUPPORT FOR THE RESIDENCY PROGRAM COSTS IN EXCESS OF 3,000,000 A YEAR. OUR EMPLOYED PHYSICIANS CONTRIBUTE VOLUNTEER TEACHING HOURS TOWARDS RESIDENT TRAINING. IN ADDITION TO PHYSICIANS, IT HAS BECOME APPARENT THAT OTHER HEALTH CARE PROFESSIONALS ARE ALSO IN VERY SHORT SUPPLY. PROVISION OF ADEQUATE COMMUNITY HEALTH DEPENDS ON AN ADEQUATE SUPPLY OF SUCH PROFESSIONALS. AS SUCH, DECATUR MEMORIAL HOSPITAL (DMH) HAS VOLUNTEERED HOURS ON PLANNING AND CURRICULUM DESIGN AT OUR TWO NURSING SCHOOLS AND CONTRIBUTES MORE THAN 2,500 HOURS OF UNCOMPENSATED TEACHING AND CLINICAL EXPERIENCE TO NURSING STUDENTS IN THE DECATUR NURSING PROGRAMS. OUR MEDICAL STAFF AND PERSONNEL ALSO PARTICIPATE IN CLINICAL TRAINING AND SUPPORT FOR RESIDENT PHYSICIANS IN FAMILY MEDICINE AS WELL AS PHYSICIAN ASSISTANT STUDENTS. ADDITIONAL TRAINING PROGRAMS FOR OTHER ALLIED HEALTH PROFESSIONALS HAVE ALSO BEEN UNDERTAKEN AND SUPPORTED BY DMH. THE HOSPITAL ALSO SUPPORTS THE PARISH NURSE PROGRAM. THIS PROGRAM HAS SUBSTANTIALLY IMPROVED THE ABILITY OF COMMUNITY MEMBERS TO OBTAIN BASIC HEALTH INFORMATION AND SCREENING FROM TRAINED PARISH NURSES. HEART, LUNG AND STROKE RECOGNIZING THAT CORONARY HEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN MACON COUNTY, DECATUR MEMORIAL HOSPITAL (DMH) OFFERS FREE BLOOD PRESSURE SCREENINGS TO THE COMMUNITY. THE CARDIAC AND PULMONARY REHAB DEPARTMENT OFFERS A FREE MONTHLY EDUCATIONAL PROGRAM THAT IS OPEN TO THE PUBLIC. FURTHER TO ASSIST THOSE PATIENTS WHO ARE LIVING WITH THE DIAGNOSIS OF HEART FAILURE, DMH PROVIDES A FREE HEART FAILURE TELE-MONITORING PROGRAM. THIS PROGRAM ASSISTS PATIENTS AND THEIR CAREGIVERS IN MONITORING DAILY VITAL SIGNS OF HEART FAILURE PATIENTS ALLOWING THEM BETTER ONGOING STABILITY AND PROACTIVE MANAGEMENT OF THEIR CONDITION. DMH OFFERS CARDIAC INFORMATION AT HEALTH FAIRS. WE ALSO HAVE SPEAKERS AVAILABLE FOR EDUCATIONAL PROGRAMS. IDENTIFICATION OF THE NEED TO EDUCATE THE COMMUNITY WE SERVE ABOUT STROKE RISK FACTORS, OPTIONS FOR TREATMENT, AND INTERVENTIONS THAT WILL HELP TO MITIGATE LONG TERM DISABILITY AFTER STROKE, HAS RESULTED IN INCREASED EFFORTS TO PROVIDE INFORMATION REGARDING GOOD LIFE-STYLE AND TREATMENT CHOICES. INFORMATION IS PROVIDED AT HEALTH FAIRS ABOUT SMOKING CESSATION, HEALTHY DIET, DIABETES MONITORING, WEIGHT CONTROL, BLOOD PRESSURE CONTROL, ALONG WITH BLOOD PRESSURE SCREENING. ALL THIS COMES TOGETHER TO FORM A GOOD EDUCATIONAL FOUNDATION FOR PROMOTION OF HEALTHY LIFE-STYLE ADJUSTMENTS TARGETED AT DECREASING THE CHANCE OF STROKE. ADDITIONALLY, A "KIDS CAN BE HEROES" PROGRAM FOR 4-5-6 GRADERS TEACHES THESE CHILDREN ABOUT STROKE RISK FACTORS, AND THE FAST (FACE, ARM, SPEECH, TIME) ACRONYM, WHICH WILL HELP THEM TO IDENTIFY SYMPTOMS OF STROKE. THESE CHILDREN ARE GIVEN THE 'ASSIGNMENT' OF GOING HOME AND TEACHING TWO ADULTS WHAT THEY HAVE LEARNED. A COLORING BOOK WHICH TELLS THE STORY AND REINFORCES THE USEFULNESS OF THE FAST ACRONYM IS GIVEN TO EACH CHILD. TO DATE OVER 250 CHILDREN HAVE PARTICIPATED IN THIS PROGRAM. WORLD STROKE DAY IS AN ANNUAL EVENT IN OCTOBER. WE INVITE THE COMMUNITY TO HEAR EXPERTS SPEAK ABOUT STROKE. WE OFFER FREE ULTRASOUND SCREENING OF THE CAROTID ARTERIES AT THIS EVENT. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS THE THIRD LEADING CAUSE OF DEATH IN AMERICA. COPD IS A WIDELY UNDER DIAGNOSED ILLNESS AND, HOPING TO IMPROVE DIAGNOSIS AND TREATMENT, DECATUR MEMORIAL HOSPITAL OFFERS FREE S PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE DECATUR MEMORIAL HOSPITAL'S BUSINESS OFFICE HAS FIVE FINANCIAL COUNSELORS WHO REVIEW PATIENT ACCOUNTS FOR POSSIBLE CHARITY/FINANCIAL ASSISTANCE CONSIDERATION. THE HOME PAGE OF THE HOSPITAL'S WEBSITE, WWW.DMHCARES.COM, CONTAINS LINKS TO ALL INFORMATION CONCERNING THE CHARITY CARE / FINANCIAL ASSISTANCE PROGRAM, INCLUDING THE POLICIES AND PATIENT FINANCIAL APPLICATON FORMS. POSTERS ARE PLACED IN OUR PATIENT REGISTRATION AREA IN VISIBLE LOCATIONS WHERE PATIENTS AND THEIR FAMILIES CAN SEE THEM. THESE POSTERS ARE 24" BY 31". IN ADDITION TO OUR PATIENT REGISTRATION AREA IN KIRKLAND LOBBY, WE ALSO PLACED POSTERS IN OUR EMERGENCY CARE CENTER AND IN OUR IMAGING CENTERS IN SOUTH SHORES AND FORSYTH. TENT CARDS AND PATIENT BROCHURES ARE PLACED IN THE PATIENT REGISTRATION BOOTHS, ACCESSIBLE TO ALL PATIENTS AND THEIR FAMILIES. PATIENT ACCOUNT STATEMENTS INCLUDE THE PHONE NUMBER FOR "FINANCIAL ASSISTANCE." PART VI, LINE 4 - COMMUNITY INFORMATION PART VI, LINE 4 POPULATIONS AND COMMUNITIES SERVED -- DECATUR MEMORIAL HOSPITAL IS LOCATED IN DECATUR, ILLINOIS. THE CITY HAS A 2010 CENSUS POPULATION OF 76,000, WHICH REPRESENTS A POPULATION DECLINE OF 5.8% SINCE 2000. MACON COUNTY, WITHIN WHICH IT RESIDES, HAS A POPULATION OF APPROXIMATELY 110,750. THE OVERALL MARKET AREA FOR DECATUR MEMORIAL HOSPITAL INCLUDES APPROXIMATELY 250,000 RESIDENTS. THE DEMOGRAPHICS OF MACON COUNTY INDICATE AN AGING POPULATION. PROJECTIONS FOR THE NEXT TEN YEARS SUGGEST RELATIVELY FLAT POPULATION GROWTH WITH A CONTINUED GRADUAL INCREASE IN THE AGED POPULATION. THERE ARE APPROXIMATELY 20,000 MEDICAID RECIPIENTS LOCATED IN MACON COUNTY. MEDICARE IS THE LARGEST INPATIENT CARE PAYOR CATEGORY. THE UNEMPLOYMENT RATE IN THE DECATUR METRO AREA TENDS TO BE HIGHER THAN THE U.S. AVERAGE. RECENT JOB GROWTH WAS 1.43%. THE POVERTY RATE FOR MACON COUNTY IS 21.8% AND 23.1% FOR DECATUR. THE 2014 AVERAGE UNEMPLOYMENT RATE FOR DECATUR/MACON COUNTY WAS 9.9%, DOWN FROM 12.2% IN 2013. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH BACKGROUND -- DECATUR MEMORIAL HOSPITAL, SINCE IT'S INCEPTION IN 1916, HAS CONTINUOUSLY RESPONDED TO THE HEALTH CARE NEEDS OF COMMUNITIES IT SERVES. AS AN INDEPENDENT COMMUNITY HOSPITAL WITH A LOCAL BOARD OF DIRECTORS, THE HOSPITAL HAS ALWAYS HAD AS ITS PRIMARY FOCUS THE HEALTH CARE NEEDS OF DECATUR, MACON COUNTY AND SURROUNDING COUNTIES. AS PART OF ITS OVERALL MISSION, DECATUR MEMORIAL HOSPITAL HAS CONTINUOUSLY PROVIDED BOTH INTELLECTUAL AND FINANCIAL RESOURCES TO OUR COMMUNITIES FOR EXPERTISE AND ASSISTANCE IN ASSESSMENT OF HEALTH CARE NEEDS, SUPPORT OF VARIOUS COMMUNITY SERVICES AND AGENCIES IN ADDRESSING THE IDENTIFIED NEEDS, AND THE CONTINUAL HEALTH EDUCATION OF PATIENTS, THE COMMUNITY, AND THE OTHER RELEVANT PUBLICS. DECATUR MEMORIAL HOSPITAL HAS PARTICIPATED DIRECTLY IN CHARITY AND INDIGENT CARE FOR A SIGNIFICANT SEGMENT OF OUR COMMUNITY. GOALS AND OBJECTIVES FOR PROVIDING COMMUNITY BENEFITS -- DECATUR MEMORIAL HOSPITAL HAS EMBRACED THE PHILOSOPHY THAT TO IMPROVE THE HEALTH OF PEOPLE IN CENTRAL ILLINOIS, AN ORGANIZATION MUST BECOME INVOLVED IN THE EDUCATION, AWARENESS, AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT A PERSON'S HEALTH STATUS. WE STRIVE TO GIVE COMMUNITY RESIDENTS TOOLS TO EMPOWER THEM TO MAKE LIFESTYLE DECISIONS THAT WILL MAINTAIN AND ENHANCE A DESIRABLE QUALITY OF LIFE. TO HELP PEOPLE REACH THIS GOAL, DECATUR MEMORIAL HOSPITAL SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE COMMUNITY. WE ACTIVELY SUPPORT LOCAL HEALTH CARE EDUCATION PROGRAMS, HEALTH FAIRS, SCREENINGS, AND LOCAL ACCESS TO ADVANCED CARE. DECATUR MEMORIAL HOSPITAL IS, AND ALWAYS HAS BEEN, VERY MINDFUL OF ITS MISSION REGARDING CHARITY CARE. BY HOSPITAL POLICY, THE THRESHOLD FOR THE PROVISION OF CHARITY CARE IS VERY LIBERAL, AND WAS FURTHER EXPANDED IN FISCAL 2009 TO SIX TIMES THE FEDERAL POVERTY GUIDELINES. FOR PATIENTS WHOSE INCOME IS ABOVE THESE THRESHOLDS, WE REVIEW THE PERTINENT FACTORS INCLUDING THE MAGNITUDE OF THE BILL AND THE INDIVIDUAL'S FINANCIAL SITUATION, AND OFFER A SLIDING SCALE DISCOUNT AND EXTENDED PAYMENT TERMS TO THOSE INDIVIDUALS. APPROVAL OR DENIAL OF THESE GUIDELINES IS MADE WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, SEX OR AGE. THE HOSPITAL DOES NOT PLACE LIMITS ON THE AGGREGATE AMOUNTS OF CHARITY CARE PROVIDED IN ANY YEAR. SEE ALSO RESPONSE TO PART VI, LINE 2 ABOVE FOR EXAMPLES OF MANY WAYS IN WHICH THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM AS INDICATED, THE HOSPITAL AND ITS RELATED FACILITIES PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT AND PHYSICIAN SERVICES ALL OF WHICH BENEFIT AND PROMOTE THE HEALTH OF THE COMMUNITY. THE HOSPITAL IS AFFILIATED WITH ILLINOIS HEALTH AND SCIENCE WHICH SUPPORTS AND BENEFITS THE HOSPITAL BY PROVIDING FINANCIAL AND MANAGEMENT ASSISTANCE IN CONNECTION WITH THE ACTIVITIES OF THE HOSPITAL AND ITS AFFILIATES, AND BY HOLDING TITLE TO CERTAIN ASSETS USED IN CONNECTION WITH HOSPITAL ACTIVITIES. THE HOSPITAL IS ALSO AFFILIATED WITH DECATUR MEMORIAL FOUNDATION WHOSE MISSION IS TO SUPPORT AND BENEFIT THE HOSPITAL BY CONDUCTING FUND DEVELOPMENT ACTIVITIES, HOLDING TITLE TO CERTAIN ASSETS, AND OVERSEEING THEIR PRUDENT AND EFFECTIVE INVESTMENT AND MANAGEMENT. TOGETHER, THE ACTIVITIES OF THE HOSPITAL AND ITS AFFILIATES EFFECTIVELY AND EFFICIENTLY ADDRESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT ILLINOIS true SIU DECATUR FAMILY PRACTICE CENTER 250 W KENWOOD DECATUR IL 62526 376005961 501C3 1263671 GENERAL SUPPORT 1 SCHEDULE I, PAGE 1, PART I, LINE 2 SOUTHERN ILLINOIS UNIVERSITY (SIU) SCHOOL OF MEDICINE SPONSORS AN ACGME-ACCREDITED FAMILY RESIDENCY PROGRAM FOR WHICH DMH SERVES AS A PRIMARY PARTICIPATING INSTITUTION. AS PART OF THE PROGRAM, SIU OPERATES A FAMILY MEDICINE CLINIC ADJACENT TO THE DMH CAMPUS. THE EXISTENCE AND OPERATION OF THE CLINIC BENEFITS DMH AND ITS SERVICE AREA BY ENHANCING THE RECRUITMENT OF APPROPRIATELY-TRAINED PHYSICIANS TO THE COMMUNITY, ASSISTING DMH IN PROVIDING UNDERSERVED POPULATIONS WITH ACCESS TO PRIMARY CARE MEDICAL SERVICES, AND PROVIDING OTHER SERVICES TO AND FOR THE BENEFIT OF DMH'S PATIENT POPULATION. IN RECOGNITION OF THE ABOVE, DMH SUPPORTS THE PROGRAM BY PROVIDING A BUDGETED, AGREED-UPON AMOUNT FOR EACH ACADEMIC YEAR TO FUND MEDICAL EDUCATION AND RESEARCH THROUGH THE PROGRAM, INCLUDING COSTS INCURRED BY SIU TO SUPERVISE AND TEACH THE RESIDENTS ON-SITE AT THE CLINIC AND AT DMH. THE AMOUNT IS AGREED UPON PRIOR TO THE START OF EACH YEAR. UPON COMPLETION OF EACH ACADEMIC YEAR, SIU REPORTS BACK TO DMH REGARDING HOW FUNDS WERE ACTUALLY EXPENDED IN CONNECTION WITH THE PROGRAM. X X X X X true true X X X X false false false false false false false false false KENNETH SMITHMIER DIRECTOR/PRES & CEO 714350 2154 3825 13983 734312 TIMOTHY D STONE JR EVP & ADMINISTRATOR 417423 3825 5755 427003 MICHAEL ZIA MD VICE PRES. 301511 3825 13830 319166 JOHN RIDLEY SVP PROF. SERV. 202288 51298 3130 14851 271567 LINDA FAHEY VP/CHIEF NURSE EXEC 250843 3749 937 255529 DEBBIE BRAGG SR. VP & CFO 219001 3300 895 223196 KEVIN HORATH VP HUMAN RESOURCES 140299 2163 14755 157217 STEVEN SOBOL MD PHYSICIAN 995471 449188 3825 14983 1463467 MARVIN DERRICK MD PHYSICIAN 832335 27500 3825 14983 878643 MOHAMMED HASNAIN MD PHYSICIAN 544190 314260 750 3825 14983 878008 ROBERT KRAUS JR MD PHYSICIAN 618301 197700 8600 3825 14983 843409 JOHN WATERS MD PHYSICIAN 816919 1600 3825 5755 828099 SCHEDULE J, PAGE 1, PART I, LINE 1A DURING THE YEAR, DMH PAID FOR CHARTER TRAVEL IN ONE INSTANCE. DMH SHARED WITH ONE OTHER HOSPITAL THE COST OF A CHARTER PLANE HIRED TO PICK UP THEIR RESPECTIVE REPRESENTATIVES (IN DMH'S CASE, TIMOTHY STONE, JR.) TO TRAVEL TO A VHA BOARD MEETING IN KANSAS CITY, MO; THE DECISION TO USE THIS MEANS OF TRAVEL WAS BASED UPON COST AND AVAILABILITY OF COMMERCIAL FLIGHTS. DMH MAINTAINS A CORPORATE MEMBERSHIP IN THE DECATUR CLUB, IN THE NAME OF DMH. THE INVOICE FOR ANNUAL DUES IS SENT TO DMH. THE INVOICE FOR MONTHLY DUES IS SENT TO DMH, ATTN: KEN SMITHMIER (CEO). DMH PAYS THE MONTHLY DUES DIRECTLY. ALL USAGE OF THE DECATUR CLUB MEMBERSHIP IS FOR BUSINESS PURPOSES, WHETHER BY MR. SMITHMIER OR OTHER EXECUTIVES, WITH MONTHLY STATEMENTS DOCUMENTING ACTUAL USAGE. NEITHER MR. SMITHMIER NOR ANY OTHER DMH EXECUTIVE MAKE ANY PERSONAL USE OF THE DECATUR CLUB MEMBERSHIP. DMH PAID FOR AIRLINE TICKETS AND MEALS FOR ONE BUSINESS TRIP TAKEN BY MR. SMITHMIER, CEO, WHERE HE WAS ACCOMPANIED BY HIS SPOUSE. MR. SMITHMIER'S W-2 INCLUDED 2,154 RELATED TO HIS SPOUSE'S SHARE OF COST OF ATTENDING THE TRIP. DMH PAID HOUSING EXPENSES FOR THE FIRST SEVEN MONTHS OF EMPLOYMENT OF MR. NAQVI, EVP & CFO. MR. NAQVI'S 2013 W-2 INCLUDED 6,696 RELATED TO HIS HOUSING EXPENSES. AS A CONDITION OF MR. RIDLEY'S PROMOTION TO OFFICER, MR. RIDLEY AGREED TO OBTAIN AN ADVANCED DEGREE. IN EXCHANGE FOR MR. RIDLEY'S AGREEMENT, DMH AGREED TO PAY TUITION PLUS TAXES RELATED TO THE TUITION ON BEHALF OF MR. RIDLEY. MR. RIDLEY'S 2013 W-2 INCLUDED 51,298 OF GROSS UP PAYMENTS RELATED TO HIS TUITION ASSISTANCE. DMH DID EXEMPT 5,250 OF THE TUITION PAID ON MR. RIDLEY'S BEHALF BASED ON IRS ALLOWED EXEMPTIONS. A CITY OF DECATUR MACON COUNTY IL 376001308 2010-12-22 6280000 REFUND 1996 ISSUE false false false B CITY OF DECATUR MACON COUNTY IL 376001308 2010-12-22 5000000 REFUND 1996 ISSUE false false false C CITY OF DECATUR MACON COUNTY IL 376001308 2010-12-22 4405000 REFUND 1996 ISSUE false false false D CITY OF DECATUR MACON COUNTY IL 376001308 2010-12-22 2675000 REFUND 1996 ISSUE false false false A 2355000 6280000 6280000 true false true true B 1875000 5000000 5000000 true false true true C 1651875 4405000 4405000 true false true true D 1003125 2675000 2675000 true false true true A false false false false false false true B false false false false false false true C false false false false false false true D false false false false false false true A false false false false true false false false true B false false false false true false false false true C false false false false true false false false true D false false false false true false false false true SCHEDULE K - ADDITIONAL INFORMATION CITY OF DECATUR, MACON COUNTY, IL PART I, COLUMN C: NONE OF THE BOND ISSUES IN PART I HAD A CUSIP NUMBER AND, THEREFORE, THE RESPONSE IN COLUMN C FOR EACH IS "NONE" ACCORDING TO IRS INSTRUCTIONS. HOWEVER, ENTERING "NONE" IN COLUMN C CREATES AN E-FILE ERROR. THEREFORE, COLUMN C HAS BEEN LEFT BLANK, BUT AS INDICATED, SHOULD BE "NONE" FOR EACH ISSUE. SCHEDULE K - OTHER INFORMATION: AS INDICATED IN COLUMN G, EACH ISSUE IN PART I WAS A CURRENT REFUNDING ISSUE USED TO REFINANCE 1996 BONDS. ALL PROCEEDS OF EACH ISSUE WERE USED EXCLUSIVELY FOR THIS PURPOSE. HICKORY POINT BANK SEE PART V 2151 INTEREST INCOME false DUNN COMPANY SEE PART V 232664 ASPHALT SERVICES false CANCER CARE SPECIALISTS OF CENT IL SEE PART V 160576 MED SERVICES false CANCER CARE SPECIALISTS OF CENT IL SEE PART V 49694 EMR SUPPORT REV false BAKERS DOZEN LLC SEE PART V 594930 OFFICE SPACE RENTAL false PRAIRIE ONCOLOGY MANAGEMENT SERVICE SEE PART V 154399 SUPPLY SALES false ROY MOSSER SEE PART V 1693555 OFFICE SPACE RENTAL false HICKORY POINT BANK SEE PART V 494676 BANK FEES, INTEREST false FIRST BUSEY CORP SUBSIDIARIES SEE PART V 201124 BANK AND BOND FEES false FIRST BUSEY CORP SUBSIDIARIES SEE PART V 6316 INTEREST INCOME false SCHEDULE L, PART V PART IV, LINES 1(B)& 8(B): DIRECTOR KENNETH SMITHMIER IS ON THE HICKORY POINT BANK BOARD OF DIRECTORS. PART IV, LINE 2(B): DIRECTOR DAVID TYROLT OWNS DUNN COMPANY. PART IV, LINES 3(B), 4(B), 5(B), 6(B): DIRECTOR EDWARD ELLIOTT IS AN OWNER OF CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS, BAKER'S DOZEN, LLC., AND PRAIRIE ONCOLOGY MANAGEMENT SERVICES. PART IV, LINE 7(B): ROY MOSSER IS A DIRECTOR OF DMH. PART IV, LINE 9(B)& 10(B): DIRECTOR JOHN FUNK IS A DIRECTOR OF FIRSTECH, INC WHICH IS A SUBSIDIARY OF BUSEY BANK AND BUSEY BANK IS A SUBSIDIARY OF FIRST BUSEY CORPORATION. DIRECTOR DAVID TYROLT IS A DIRECTOR OF BUSEY WEALTH MANAGEMENT WHICH IS A SUBSIDIARY OF FIRST BUSEY CORPORATION. FORM 990 FORM 990, PART I, ITEM 1 AND FORM 990, PART III, ITEM 1: DMH'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE OF CENTRAL ILLINOIS, RELYING ON ITS CORE FOUNDATIONS OF COMMITTED PHYSICIANS, CONSTRUCTIVE CULTURE, RESPONSIBLE GOVERNANCE, PROCESS INNOVATION, MANAGERIAL COMPETENCE, AND ENGAGED EMPLOYEES. WITH A HISTORY DATING BACK TO 1916, DMH TODAY ENCOMPASSES TWELVE STATE-OF-THE-ART CENTERS OF EXCELLENCE WHICH FOCUS ON THE CUTTING EDGE OF MEDICINE TODAY AND PROVIDE THE COMMUNITY WITH AWARD-WINNING HEALTH CARE. APPROXIMATELY 250,000 PERSONS RESIDE IN DMH'S SERVICE AREA, INCLUDING SUBSTANTIAL NUMBERS OF MEDICARE AND MEDICAID BENEFICIARIES, AS WELL AS PERSONS WHO DO NOT QUALIFY FOR EITHER PROGRAM AND THUS SEEK CARE PURSUANT TO DMH'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM. THE LOCAL COMMUNITY HAS BEEN HIT HARD BY THE RECENT ECONOMIC DECLINES. IN RESPONSE TO THESE CONDITIONS, DMH HAS EXPANDED ITS THRESHOLD FOR PROVISION OF FINANCIAL ASSISTANCE TO SIX TIMES THE FEDERAL POVERTY GUIDELINES; FOR THESE AND OTHER PATIENTS, DMH OFFERS SLIDING SCALE DISCOUNTS AND EXTENDED PAYMENT TERMS IN AN EFFORT TO ENSURE THAT PATIENTS ARE ABLE TO OBTAIN NECESSARY MEDICAL CARE. DURING THE FISCAL YEAR, DMH PROVIDED SIGNIFICANT FREE OR DISCOUNTED SERVICES TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE AS WELL AS OTHER FORMS OF COMMUNITY BENEFIT PROGRAMS, GRANTS AND SERVICES. SEE SCHEDULE H FOR MORE DETAIL. FORM 990, PAGE 2, PART III, LINE 4D EDUCATION AND OUTREACH: DMH HAS CONCLUDED THAT, TO FULFILL ITS MISSION OF IMPROVING HEALTH, IT MUST BECOME INVOLVED IN THE EDUCATION, AWARENESS AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT HEALTH STATUS. IN AN EFFORT TO GIVE COMMUNITY RESIDENTS THE TOOLS NECESSARY TO MAKE HEALTHY LIFESTYLE DECISIONS, DMH SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE LOCAL COMMUNITY, THROUGH MEASURES RANGING FROM PROGRAMS FOR LOCAL SCHOOLS TO DMH'S POPULAR "PRIME TIME" PROGRAM FOR SENIORS. IN RECENT YEARS, DMH HAS PARTICIPATED IN VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES, AS A RESULT OF WHICH DMH HAS IDENTIFIED SIGNIFICANT CONCERNS SUCH AS ACCESS TO PRIMARY CARE PHYSICIANS AND SPECIALISTS; HEART, LUNG, & STROKE SCREENINGS; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; OBESITY; DIABETES; INDIGENT OUTPATIENT LONGITUDINAL CARE; ONCOLOGY SCREENINGS; WOMEN AND CHILDREN'S HEALTH; AND SENIOR HEALTH AND WELLNESS. WITH THE LEADERSHIP OF A MULTIDISCIPLINARY COMMUNITY BENEFITS COMMITTEE, INCLUDING PARTICIPATION BY A DIVERSE GROUP OF COMMUNITY REPRESENTATIVES, DMH HAS TAKEN A PRIMARY ROLE IN CONFRONTING THESE ISSUES. FORM 990, PAGE 6, PART VI, LINE 2 DAVID TYROLT ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS RELATIONSHIP DAVID TYROLT JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT JACK O'RILEY DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT JOHN RIDLEY DIRECTOR OFFICER BUSINESS RELATIONSHIP ROY MOSSER, JR. DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROY MOSSER, JR. TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS RELATIONSHIP ROY MOSSER, JR. JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROY MOSSER, JR. THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROY MOSSER, JR. KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROY MOSSER, JR. EDWARD ELLIOT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP PAULA EISSFELDT KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS RELATIONSHIP JOHN FUNK THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK EDWARD ELLIOT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP THOMAS KOWA DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP THOMAS KOWA ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP THOMAS KOWA TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS RELATIONSHIP THOMAS KOWA JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP THOMAS KOWA KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP TOMAS KOWA EDWARD ELLIOT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER PAULA EISSFELDT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER ROBIN KING DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER EDWARD ELLIOT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP EDWARD ELLIOT KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP EDWARD ELLIOT JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP EDWARD ELLIOT THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP EDWARD ELLIOT ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROBIN KING KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN RIDLEY DAVID TYROLT OFFICER DIRECTOR BUSINESS RELATIONSHIP JACK O'RILEY DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP TIMOTHY STONE, JR. JOHN FUNK OFFICER DIRECTOR BUSINESS RELATIONSHIP TIMOTHY STONE, JR. ROY MOSSER, JR. OFFICER DIRECTOR BUSINESS RELATIONSHIP TIMOTHY STONE, JR. THOMAS KOWA OFFICER DIRECTOR BUSINESS RELATIONSHIP TIMOTHY STONE, JR. EDWARD ELLIOTT, MD OFFICER DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS RELATIONSHIP TIMOTHY STONE, JR. DAVID TYROLT OFFICER DIRECTOR BUSINESS RELATIONSHIP TIMOTHY STONE, JR. KENNETH SMITHMIER OFFICER DIRECTOR BUSINESS RELATIONSHIP EDWARD ELLIOTT, MD TIMOTHY STONE, JR. DIRECTOR OFFICER BUSINESS REALTIONSHIP FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS ILLINOIS HEALTH AND SCIENCE, AN ILLINOIS NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS BEING DESCRIBED IN SEC. 501 (C)(3), IRC. FORM 990, PAGE 6, PART VI, LINE 7A AS THE SOLE CORPORATE MEMBER OF DMH, ILLINOIS HEALTH AND SCIENCE HAS THE RIGHT TO APPROVE ALL DIRECTORS OF DMH, AND TO REMOVE ANY DIRECTOR SO APPROVED. ALL DIRECTORS OF ILLINOIS HEALTH AND SCIENCE ARE ALSO DIRECTORS OF DMH. FORM 990, PAGE 6, PART VI, LINE 7B THE DMH BOARD OF DIRECTORS GENERALLY OVERSEES AND DIRECTS ALL ACTIVITIES, ASSETS AND OPERATIONS OF DMH, SUBJECT TO THE RIGHTS AND AUTHORITY SPECIFICALLY RESERVED TO ILLINOIS HEALTH AND SCIENCE, AS THE SOLE CORPORATE MEMBER, IN THE DMH BYLAWS. THESE RIGHTS PERTAIN TO THE APPOINTMENT AND REMOVAL OF DIRECTORS, ELECTION OF THE PRESIDENT AND TREASURER, NOMINATION OF OTHER OFFICERS, AMENDMENT OF ARTICLES AND BYLAWS, APPROVAL OF BUDGETS AND LONG RANGE PLANS, APPROVAL OF ANY MERGER OR CONSOLIDATION, APPROVAL OF SIGNIFICANT TRANSACTIONS, APPROVAL OF DISSOLUTION, CREATION OF ANY SUBSIDIARIES OR AFFILITATES, AND APPOINTMENT OF THE INDEPENDENT AUDITOR. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE ACCOUNTING DEPARTMENT OF THE HOSPITAL AND BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING. FURTHER, A COPY OF THE FORM 990, ALONG WITH AN EXPLANATORY NOTE, IS PROVIDED FOR REVIEW TO THE BOARD VIA AN INTRANET SITE. THE FORM 990 IS ALSO REVIEWED AND DISCUSSED AT A REGULARLY SCHEDULED BOARD MEETING PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CEO. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE FOR REFERENCE PRIOR TO EACH BOARD AND COMMITTEE MEETING. THE CFO'S OFFICE MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS OF ILLINOIS HEALTH AND SCIENCE (THE SOLE CORPORATE MEMBER OF DMH) HAS ADOPTED AN EXECUTIVE COMPENSATION POLICY AND PROCEDURE SETTING FORTH THE AUTHORITY AND PROCESS REGARDING COMPENSATION DETERMINATIONS FOR THE TOP EXECUTIVES OF DMH AND ITS AFFILIATES (THE CEO AND FIVE OTHER EXECUTIVES). PURSUANT TO THE POLICY, THE BOARD HAS DELEGATED TO THE EXECUTIVE COMMITTEE THE RESPONSIBILITY TO REVIEW INDEPENDENT MARKET DATA, ASSESS THE COMPARABILITY OF SUCH DATA, AND MAKE RECOMMENDATIONS TO THE BOARD REGARDING COMPENSATION PROPOSED TO BE PAID. IN CARRYING OUT THEIR RESPECTIVE COMPENSATION-RELATED RESPONSIBILITIES, THE BOARD AND EXECUTIVE COMMITTEE EXCLUDE ANY PERSON DEEMED TO HAVE A CONFLICT OF INTEREST WITHIN THE MEANING OF APPLICABLE TREASURY REGULATIONS (INCLUDING ANY PHYSICIANS EMPLOYED BY DMH OR ON ITS MEDICAL STAFF). AS PROVIDED IN THE POLICY, THE EXECUTIVE COMMITTEE CONDUCTS AN IN-DEPTH TOTAL COMPENSATION ANALYSIS USUALLY EVERY TWO YEARS WITH THE ASSISTANCE OF AN INDEPENDENT NATIONALLY-RECOGNIZED COMPENSATION CONSULTING FIRM. IN THE OFF-YEARS BETWEEN IN-DEPTH REVIEWS, THE COMMITTEE TYPICALLY HAS OBTAINED FROM ITS CONSULTING FIRM AN UPDATED ASSESSMENT TO CONFIRM CONTINUED COMPARABILITY WITH MARKET DATA. CONSISTENT WITH THE FOREGOING, IN AUGUST 2012, DMH OBTAINED SUCH AN UPDATE REPORT FROM ITS INDEPENDENT COMPENSATION CONSULTING FIRM, COVERING THE FOLLOWING INDIVIDUALS: SMITHMIER (CEO), STONE (COO), PEACOCK (FORMER CFO), ZIA (VPMA), FAHEY (CNO), AND RIDLEY (VPPS). ALL DETERMINATIONS OF THE BOARD AND EXECUTIVE COMMITTEE ARE THOROUGHLY AND TIMELY DOCUMENTED IN APPROPRIATE MINUTES AND SUPPORTING MATERIALS. FORM 990, PAGE 6, PART VI, LINE 15B SEE RESPONSE TO FORM 990, PART VI.B, LINE 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL INFORMATION OF DMH ARE AVAILABLE TO THE PUBLIC UPON SPECIFIC REQUEST TO DMH ADMINISTRATION. FORM 990, PART XI, LINE 9 BOOK/TAX DIFF. IN INC. FRM PARTNERSHIPS (INCREASE) 185,408 CHANGE IN VAL. OF ASSETS HELD IN TRUST (INCREASE) 552,474 TRANSFER OF CAPITAL FROM AFFILIATE (INCREASE) 39,903 TRANSFER OF CAPITAL FROM AFFILIATE (DECREASE) 36,831,437 TRANSFER OF CAPITAL FROM AFFILIATE (DECREASE) 295,000 CHANGE IN MINIMUM PENSION LIABILITY (DECREASE) 850,229 THE NET RESULT OF ALL OF THESE OTHER CHANGES IN NET ASSETS IS A DECREASE OF 37,198,881. FORM 990, PART XII DECATUR MEMORIAL HOSPITAL WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF ILLINOIS HEALTH AND SCIENCE AND AFFILIATED ORGANIZATIONS. ILLINOIS HEALTH AND SCIENCE 2300 N EDWARD ST DECATUR IL 625264163 371169606 SUPP. DMH IL 501C3 11A NA false DECATUR MEMORIAL FOUNDATION 2300 N EDWARD ST DECATUR IL 625264163 371169605 SUPP. DMH IL 501C3 11A NA false HEARTLAND RISK MANAGEMENT 2300 N EDWARD ST DECATUR IL 625264163 454256254 SUPP. DMH AZ 501C3 11A NA false DECATUR DIGESTIVE DISEASE CENTER 2 MEMORIAL DRIVE SUITE 102 DECATUR IL 62526 161678954 ENDOSCOPY IL DMH RELATED 298457 180891 false false 0.50000 DMH WORLDWIDE LTD 2300 N EDWARD ST DECATUR IL 62526 271901157 RADIOPHARM IL N/A true true true false true false false false true false true true true true true true false false false true DECATUR MEMORIAL FOUNDATION K 1495266 CASH PAYMENT DECATUR MEMORIAL FOUNDATION O 153893 CASH PAYMENT DECATUR DIGESTIVE DISEASE CENTER O 494402 CASH PAYMENT DMH WORLDWIDE LTD B 295000 CASH TRANSFER DECATUR DIGESTIVE DISEASE CTR LLC S 365000 CASH TRANSFER HEARTLAND RISK MANAGEMENT M 1914000 CASH PAYMENT ILLINOIS HEALTH AND SCIENCE B 36831437 CASH & SECURITIES DMH WORLDWIDE LTD A 773703 CASH PAYMENT DMH WORLDWIDE LTD O 1465933 CASH PAYMENT DMH WORLDWIDE LTD D 7457412 LOAN AMOUNT DMH WORLDWIDE LTD J 3081596 CASH PAYMENT DMH WORLDWIDE LTD H 1007160 CASH PAYMENT