2015-11-12T19:01:25-06:00 2014-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2014-01-01 350877574 Elkhart General Hospital Inc % JEFFREY COSTELLO ELKH 5745233208 600 EAST BLVD ELKHART IN 46514 JEFFERY COSTELLO CFO 2015-11-12 Angela Moore P00244342 3176817431 2014 2016-04-25 22:37:26Z GREGORY LOSASSO PRESIDENT 600 EAST BLVD ELKHART IN 46514 353426023 false X WWW.EGH.ORG X 1909 IN SEE SCHEDULE O 15 13 2426 244 679519 -129647 149782 141795 287755451 310651465 13598189 7414614 10164725 9069291 311668147 327277165 351361 394765 0 0 125018755 102961217 0 0 0 168491596 175787981 293861712 279143963 17806435 48133202 470365287 279639742 158809555 163724126 311555732 115915616 X TO CREATE A HEALTHIER COMMUNITY BY BEING A PREMIER PROVIDER OF HEALTHCARE; PROMOTING THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILIES BY PROVIDING EDUCATION THAT MAY AID IN DETECTION AND PREVENTION OF DISEASE; CONDUCTING OUR ACTIVITIES WITH COMPASSION AND RESPECT; ACTING WITH RECOGNITION THAT HEALTH IS HOLISTIC AND EMBRACES THE BODY, MIND, AND SPIRIT; SEEKING AND PARTNERING WITH THOSE WHO SHARE OUR MISSION; CONTINUOUSLY IMPROVING THE QUALITY AND COST-EFFECTIVENESS OF OUR SERVICES; MAINTAINING THE FINANCIAL VIABILITY OF THE HOSPITAL WHILE CONTINUING OUR CHARITABLE ROLE IN THE COMMUNITY. false true 242344764 394765 317367397 Elkhart General Hospital, Inc, has been providing comprehensive, advanced medical care primarily to Elkhart County and other contiguous counties in north central Indiana and south central Michigan for over 100 years. Elkhart General Hospital, Inc. consists of a 365-bed licensed hospital that provides services without regard to patient race, religion, national origin, economic status, or ability to pay. During 2014, the Hospital admitted 11,532 patients for a total of 48,694 inpatient days. Inpatient units consisted of medical, post-surgical, oncology, pediatric, critical care, cardiac care, behavioral health, rehabilitation, obstetric, and nursery intensive care. The Hospital also provided services for 193,995 of outpatient visits including 3,349 outpatient surgeries, 62,007 emergency room visits, and 128,639 visits for diagnostic services. During 2014, the unreimbursed cost of free or discounted medical care provided to patients that were deemed indigent under state, county, or internal guidelines was $6,836,884 which included $4,286,835 of traditional charity care and $2,550,049 in unpaid costs for Medicaid or other public programs for the poor. Elkhart General Hospital also provided $34,882,892 in unreimbursed care to the elderly covered by Medicare. Part of the mission of Elkhart General Hospital is to provide for a healthier community through medication assistance programs and community health education, the hospital incurred $530,000 in unbilled services to the poor and broader community. 242344764 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 136 0 true 2426 true true true false false false false false false false false false X 15 13 true false false false true true true true true false false true true true true true true false false true true IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 Pam Hluchota Treasurer 2.0 0.0 X X 0 0 0 Wilbur Bontrager VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 Mark Kaaseen MD Secretary 2.0 0.0 X X 0 0 0 Todd Martin VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 Linda Rothrock-Jurus VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 Frank Smole VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 Bruce Newswanger DO VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 John K Martin Chairman 2.0 2.0 X X 0 0 0 Matthew Pletcher VICE CHAIR 2.0 0.0 X X 0 0 0 Gregory Losasso President 50.0 0.0 X X 523848 0 145120 Laura Munkel Physician 1.0 50.0 X 17211 276771 30789 Leonard Kibiloski MD Volunteer Board Member 1.0 0.0 X 0 0 0 Kelly Puster MD Volunteer Board Member 1.0 0.0 X 0 0 0 Alex Strati Jr Volunteer Board Member 1.0 0.0 X 0 0 0 Tim Shelly VOLUNTEER BOARD MEMBER 1.0 0.0 X 0 0 0 Jeffrey P Costello CFO/Asst. Treasurer 1.0 46.0 X 0 553140 158748 Phillip A Newbold CEO 1.0 45.0 X 0 1248237 184054 GENEVIEVE A LANKOWICZ VP OF MEDICAL AFFAIRS 50.0 0.0 X 301692 0 19245 KARRA L HEGGEN VP OF NURSING 50.0 0.0 X 270638 0 11554 CINDIE L MCPHIE DIRECTOR 50.0 1.0 X 179146 0 8403 SUSAN G HAWES DIRECTOR 50.0 1.0 X 168845 0 13817 LIANG Q WANG SENIOR PHYSICIST 50.0 0.0 X 226739 0 29308 Gregory Lintjer FORMER OFFICER 0.0 0.0 X 6723419 0 0 KEVIN HIGDON FORMER OFFICER 0.0 0.0 X 450000 0 0 8861538 2078148 601038 59 true true false South Bend Medical Foundation 530 North Lafayette Blvd SOUTH BEND IN 46601 Lab Services 14088880 Northern Indiana Anesthesia Service 600 East Bvld ELKHART IN 46514 Anesthesia Services 3990287 Accretive Health Inc 401 N Michigan Ave Suite 2700 CHICAGO IL 60611 CONTRACT SERVICES 7429128 POWER CONSTRUCTION 8750 W BRYN MAWR CHICAGO IL 60631 CONSTRUCTION SERVICE 28898967 APOGEE PHYSICIANS 2525 E CAMELBACK RD PHOENIX AZ 85016 PHYSICIAN SERVICES 2681154 58 55144 70205 16446 141795 PATIENT SERVICE REVENUE 621110 306887525 306887525 OUTPATIENT PHARMACY 446110 2684758 215849 2468909 RENT FROM RELATED PARTIES 621110 1079182 1025429 53753 310651465 2034507 68 2034439 0 0 1657351 662144 995207 0 995207 995207 30849772 17049 25486714 5363058 17049 5380107 5380107 0 0 0 ELECTRONIC HEALTH RECORD IMPLEMENTATION 621110 2841180 2841180 CAFETERIA 722514 948303 948303 INTERCOMPANY CHARGEBACKS-MICHIANA LINEN 812300 1951467 1618597 332870 2333134 2256155 76979 8074084 327277165 314628886 679519 11826965 394765 394765 0 0 0 688452 688452 0 79357168 67656335 11700833 2664797 2363036 301761 13962283 11839837 2122446 6288517 5326374 962143 6292590 5329824 962766 253902 253902 152351 152351 7917 7917 0 569516 569516 30807429 26090249 4717180 27885 23619 4266 6961215 5893875 1067340 56337 47717 8620 0 3647278 3026912 620366 485187 410953 74234 0 81048 68648 12400 1121935 950279 171656 0 15806636 13377732 2428904 0 2003239 1696743 306496 PATIENT SUPPLIES, DRUGS 45747359 38748013 6999346 BAD DEBT EXPENSE 27111253 27111253 HOSPITAL ASSESSMENT FEE 16881340 16881340 CORPORATE ALLOCATION FEES 16401581 13892139 2509442 1371983 1215121 156862 279143963 242344764 36799199 0 13467 10454 28884387 46890254 0 0 42491354 43962066 0 0 0 0 834374 52198 6549354 7391912 1964431 1123100 296693298 133212580 139385007 163480718 243617201 6610979 0 0 1324980 749597 0 2640066 5300732 6728398 470365287 279639742 44403859 33086404 0 0 0 0 85675704 83053654 0 0 0 0 0 0 0 0 28729992 47584068 158809555 163724126 X 305277388 109305860 5878344 6209756 400000 400000 311555732 115915616 470365287 279639742 X 48133202 1899786 -245673104 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7917 7917 false Part II-B, Line 1i Elkhart General Hospital pays the dues for membership in the Indiana Hospital Association (IHA). The IHA has deemed that 22.8% of its dues are attributable to lobbying, thus the amount reported in Part II-B reflects total dues paid by Elhart General Hospital to IHA, multiplied by this percentage. 33921099 2833644 330764 714487 125000 17236 36228784 29895939 2180336 2985268 984717 125000 30727 33921099 26862451 1501904 2551948 923860 69000 27504 29895939 5017421 -201313 125000 27479 4663629 4520109 567312 70000 5017421 0.74560 0.01630 0.23810 false true true 4105180 4105180 174923155 85125176 89797979 78909068 48087404 30821664 38755895 38755895 163480718 0 ACCRUED PENSION LIABILITY 45213184 OTHER LIABILITIES 2370884 47584068 Supplemental Information SCH. D, 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. Schedule D, Part V, line 4 Permanently restricted net assets have been restricted by donors to be maintained by the Hospital and/or it's related entities, in perpetuity. In accordance with the restrictions, a majority of the investment income and investment gains or losses from permanently restricted net assets are to be reinvested with the principal and are therefore temporarily restricted. A specified portion of income earned by the temporarily restricted net assests is released from restriction and used for operations each year. The Hospital has one endowment fund established for patient care purposes with a value of $6,609,755. The Hospital has established investment and spending policies related to the appreciation of this endowment. Should the underlying assets fall below this targeted amount the Hospital pursues action consistent with established policies to return the endowment to the targeted amount. Based on these policies, endowment amounts are temporarily restricted until Board authorized release of funds for patient care purposes are approved. As a member organization of Beacon Health System, the Hospital also can benefit from endowment funds held by related entities, the value of which was $30,119,029 at 12/31/2014. In 2014, the Hospital received $0 from the related party endowment funds. FIN 48 DISCLOSURE ELKHART GENERAL HOSPITAL DID NOT HAVE A FOOTNOTE ADDRESSING FIN 48 (ASC 740) LIABILITIES FOR UNCERTAIN TAX POSITIONS IN ITS CONSOLIDATED FINANCIAL STATEMENTS. ELKHART GENERAL HOSPITAL DID NOT HAVE ANY UNCERTAIN TAX POSITIONS RECORDED DURING THE CURRENT TAX YEAR. true true X true X true X true true true false true true 3501548 3501548 0.01390 40476252 32556047 7920205 0.03140 43977800 32556047 11421753 0.04530 915484 304335 611149 0.00240 1042672 78725 963947 0.00380 1958156 383060 1575096 0.00620 45935956 32939107 12996849 0.05150 true 7710440 3855220 61929153 86522254 -24593101 X true true Riverpointe Surg Ctr Surgeries 0.40000 0.60000 Wakarusa Med Clin Medical Clinic Building 0.42000 0.58000 WaNee Walk-in Clinic Medical Clinic 0.50000 0.50000 1 1 Elkhart General Hospital Inc 600 East Blvd Elkhart IN 46514 www.egh.org 14-005017-1 X X X Elkhart General Hospital Inc 1 false false true X X X X X X X X X 12 true true false true X www.egh.org X X true 12 true www.egh.org false false true X 200. 350. X X X X X true true X X X X true X X X X X X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 ELKHART GENERAL HOSPITAL INCLUDED INPUT FROM HEART CITY HEALTH CENTER, MAPLE CITY HEALTH CENTER, AND THE CENTER FOR HEALING AND HOPE. IN ADDITION, ELKHART GENERAL HOSPITAL REACHED OUT TO THE ELKHART COUNTY MINORITY HEALTH COALITION, THE HISPANIC LATINO HEALTH COALITION OF NORTHERN INDIANA, AND THE INDIANA MINORITY HEALTH COALITION. PART V, SECTION B, LINE 6A OTHER HOSPITAL FACILITIES INCLUDED INDIANA UNIVERSITY HEALTH GOSHEN. PART V, SECTION B, LINE 7D ELKHART GENERAL HOSPITAL PROVIDED ELECTRONIC COPIES TO INDIVIDUAL EMAIL ADDRESSES UPON REQUEST. ELKHART GENERAL HOSPITAL STAFF ALSO PRESENTED THE RESULTS OF THE CHNA TO COMMUNITY GROUPS UPON REQUEST. PART V, SECTION B, LINE 11 The health priorities were identified through the community health needs assessment as obesity/diabetes; smoking; access to health care; and access to mental health services. The primary strategies for all priority areas are the prevention and earliest detection of disease with special focus on the medically underserved populations, and implemented through community-based screening, education, and resource referral. The hospital is addressing these significant needs through Population-Based Prevention Strategies, Disease Management Strategies, and Advocacy and Support Strategies. Population-Based Prevention Strategies are established through newly created efforts and focus on the prevention of adverse health outcomes and the promotion of healthy lifestyle behaviors. These strategies include broad-based community education through established communication venues, population-based health screenings, resource referral, and support services. Disease Management Strategies are established through EGH programs available to the community and within the Elkhart General organization. EGH focuses efforts on the management of known disease to reduce risk and to optimize the health status of the community members. These strategies include individualized and group educational support, integrated disease case management, and advocacy. Advocacy and Support Strategies are established through community-based initiatives with altruistic community health partners. EGH focuses efforts on reducing barriers to health care to improve the health status of Elkhart County residents. These strategies include ongoing and newly formed partnerships with local public health, minority health, community health, public assistance, health insurance advocacy, and emergency relief. Elkhart General Hospital remained committed to improving the community health status of Elkhart County as an organizational priority of EGH through its mission and through community identification. As a non-profit, charitable organization, we continue to expand our ambulatory health capabilities in the region. The Beacon Health System strategic plan calls for greater focus on health and wellness, and as a Beacon Health System partner, Elkhart General Hospital is implementing population-based health strategies with enhanced focus on community health and wellness. Ongoing support and enhanced focus on community health initiatives will occur through continued Community Benefit activities, with specific alignment with goals and objectives to achieve enhanced prevention and detection of disease at the earliest onset to avoid adverse health outcomes and maximize quality of life for all residents of Elkhart County. PART V, SECTION B, LINE 16I BROCHURES ARE PROVIDED TO PATIENTS EXPLAINING THE FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, THERE IS A MESSAGE INCLUDED IN EACH STATEMENT A PATIENT RECEIVED TELLING THEM IF THIS IS A HARDSHIP TO PLEASE CONTACT THE HOSPITAL BILLING DEPARTMENT FOR ASSISTANCE. PART V, LINE 22D When Elkhart General Hospital makes a determination that an individual is eligible for assistance under this financial assistance policy, Elkhart will not charge such individual more than the amounts generally billed (AGB) to individuals who have insurance covering emergency or other medically necessary care. Elkhart 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. Elkhart calculated its current AGB percentage, 60%, 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, Elkhart multiplies its gross charges for that care by the AGB percentage. Part I, Line 3c NOT APPLICABLE Part I, Line 6a COMMUNITY COLLABORATION INTRODUCTION CREATING COMMUNITY HEALTH IS AT THE CORE OF ELKHART GENERAL HOSPITAL'S MISSION. PROMOTION OF COMMUNITY HEALTH IS OUR SOCIAL RESPONSIBILITY AND A KEY TO LONG-TERM COST EFFECTIVENESS. IN ADDITION, IMPROVING THE HEALTH STATUS OF A COMMUNITY IS AS MUCH A SOCIAL, ECONOMIC AND ENVIRONMENTAL ISSUE, AS IT IS A MEDICAL ONE. CONSEQUENTLY, THE 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 TO INVOLVE THE 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. ELKHART GENERAL HOSPITAL TITHES 10% OF THE PREVIOUS YEAR'S INCOME FROM OPERATIONS AND TRANSFERS IT TO THE COMMUNITY BENEFIT FUND FOR INVESTMENT IN THE COMMUNITY. THIS INVESTMENT IS IN ADDITION TO THE HOSPITAL'S CHARITY CARE AND PREVENTION, AND EDUCATION ACTIVITIES SUPPORTED THROUGH ITS OPERATING BUDGET. THE COMMUNITY HEALTH ENHANCEMENT COMMITTEE OF THE BOARD MAKES ONGOING POLICY AND OVERSEES THE ADMINISTRATION OF THE FUND AND DETERMINES SPECIFIC INVESTMENT ALLOCATIONS BASED UPON THE ASSETS AND NEEDS OF THE COMMUNITY. VOLUNTEERS AND STAFF ARE COMMITTED TO PRUDENTLY INVESTING THESE RESOURCES IN AN ACCOUNTABLE MANNER. 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, AND ENSURE THAT EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY, RECEIVES THE CARE THEY NEED. ELKHART GENERAL HOSPITAL 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 (MICHIANA) REGION, HELPED US CONTRIBUTE SIGNIFICANTLY TO THE HEALTH AND WELL-BEING OF OUR COMMUNITY. FURTHER, ELKHART GENERAL HOSPITAL PLAYS A KEY ROLE IN SERVING THE COMMUNITY AS A WHOLE. Part I, Line 7 The costing methodology used to calculate Financial Assistance and Other Community Benefits was the cost-to-charge ratio. Part I, Line 7A and B 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) payments for 2013 in the amount of $10,500,000. Additionally, for 2014, HAF payments made in 2014 that related to 2013 in the amount of $5,837,759 were excluded from the computations for Worksheet 2, cost to charge ratio. Part I, Line 7 Column (f) Bad debt expense removed from total expenses 27,111,253. Part II COMMUNITY SUPPORT In 2014 Elkhart General Hospital provided community building activities that focused on child care, mentoring opportunities and support groups to the community's vulnerable populations, including low-income families, minorities, young teens, and at-risk youth. Elkhart General Hospital, in collaboration with the YMCA of Elkhart County, hosted an interactive health education series for at-risk female youth including topics of sexual abstinence and risk avoidance, healthy body image, and self-esteem. ELKHART GENERAL HOSPITAL continued its 17-year history of partnership with Elkhart and Baugo Schools Systems to provide the Peers Educating and Encouraging Relationship Skills (PEERS) Project, where EGH staff interviewed, recruited, and trained approximately 175 teen high-school mentors who in turn facilitated a five-session risk avoidance curriculum to 1,100 seventh and eight graders in Elkhart and Baugo Community Schools systems. The PEERS program curriculum focused on identifying consequences of risk behavior, and provided assertiveness training in abstaining from health risk behaviors of early sexual activity, alcohol, smoking, and drug use. The goals of the program are to optimize the opportunities for the community's youth to create a healthy and successful future, and to mitigate the mental health effects of the consequences of these behaviors. The high-schoolers completed a significant leadership peer mentor training prior to facilitating the classroom lessons to the underclassmen. In recognition of the importance of modeling the lifestyle being promoted, teen mentors signed a leadership agreement pledging to practice risk avoidance behaviors in their lifestyles. Elkhart General Hospital sponsored and helped facilitate four American Cancer Society "Look Good Feel Better" support groups for cancer patients. In these groups, cosmetologists trained in enhancing the appearance of persons undergoing chemotherapy or radiation treatment worked with cancer patients to improve their self-esteem and confidence regarding their physical appearance. Elkhart General Hospital continued to be actively engaged in community coalitions to improve the quality of life for Elkhart County residents both in leadership and committee level representation. Elkhart General Hospital representatives served on the boards or committees of the Elkhart County Board of Health, the Center for Healing and Hope, the Elkhart General Hospital Foundation, the Association for the Disabled of Elkhart county, and the Elkhart County Child Fatality Review Committee. Elkhart General Hospital provided leadership and representation on the National College Advisory Board, March of Dimes and American Heart Association Marketing Committees, Elkhart Area Career Center Advisory Board, Elkhart County United Way, the Midwest Cardiovascular Research and Education Foundation, the National College Medical Assistant Advisory Board, the Southwestern Michigan College School of Nursing Advisory Board, the Indiana Medical Group Management Association Education Committee, Elkhart County 4-H Fair Board, the Ivy Tech South Bend Respiratory Care Program Advisory Board, the Elkhart County Council on Aging Board, and the Catherine Kasper Life Center Board, the Elkhart County Homeless Coalition, the Downtown Churches Coalition, Ekhart County Covering Kids and Families Indiana Coalition, Tobacco Control of Elkhart County Advisory Board, the Elkhart Back2School Steering Committee, and the Elkhart County Safe Kids Coalition Board. Elkhart General Hospital provided staffing of the Elkhart County Healthy Schools Workgroup which provided support to school personnel and administration in addressing youth health. Specific focus of Workgroup activities has been in the prevention and reduction of childhood obesity, as well as nutrition education and physical activity opportunities. Elkhart General Hospital participated in the Coordinated School Health Committees of the Baugo, Middlebury and Goshen Community Schools systems. Elkhart General Hospital's Dame Tu Mano Hispanic Latino health outreach program has established a robust communication and advocacy network of over 40 Hispanic Latino-focused centric businesses, media, and social service organizations, and is regularly sought out to lead community health initiatives in the Hispanic Latino communities of Elkhart County. Elkhart General Hospital has continued to seek input from its minority health partners, including the Indiana Minority Health Coalition, the Northern Indiana Hispanic Health Coalition, Indiana Black Expo Elkhart, and the Minority Health Coalition of Elkhart County on potential ventures to reduce health disparities between cultures and races within the county. In 2014 Elkhart General Hospital continued its role in assisting with the establishment of a multidisciplinary coalition to address sexual assault. This effort, spearheaded by the YWCA of North Central Indiana, continues to plan for establishing a treatment center for Elkhart County victims of sexual assalt. Planned services include forensic examinations, investigative support, victim and family support, and hygiene amenities for adult and child victims of sexual assault. Elkhart General Hospital continued to participate in a public health-based coalition to identify trends in perinatal outcomes to ultimately reduce perinatal race disparity in the region. The partners in this effort with Elkhart General Hospital included Beacon Health System partner Memorial Hospital of South Bend, Indiana University Health Goshen Hospital, the health departments of Elkhart and St. Joseph Counties, minority health partners, and the Michiana Health Information Network. Perinatal outcomes are critical indicators of community health status, and this forum identifies opportunities to produce consistent perinatal risk reporting from the hospitals and the health informati Part III, Line 2,3 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. COSTING METHODOLOGY IS THE SAME AS TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE IS COST ADJUSTED BY NON-PATIENT ACTIVITY, EXPENSES, AND PATIENT CARE CHARGES. BAD DEBT EXPENSE WHICH IS ATTRIBUTABLE TO ELIGIBLE PATIENTS ARE CONSIDERED PART OF ELKHART GENERAL HOSPITAL'S COMMUNITY BENEFIT BECAUSE OF OUR MISSION TO CREATE A HEALTHIER COMMUNITY WHILE CONTINUING OUR CHARITABLE ROLE IN THE COMMUNITY. 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. PART III, LINE 8 RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. PARTICIPATION IN THE GOVERNMENTAL MEDICARE PROGRAM DOES NOT PROVIDE THE OPPORTUNITY FOR A HOSPITAL TO NEGOTIATE A REIMBURSEMENT RATE OR STRUCTURE THAT WOULD ALLOW THE HOSPITAL TO COVER THE COST OF THE MEDICAL SERVICE RENDERED TO THE PROGRAM PARTICIPANT, AS WOULD BE THE CASE IN CONTRACTUAL NEGOTIATIONS WITH COMMERCIAL INSURANCE COMPANIES. NOR IS THE HOSPITAL ALLOWED TO PROVIDE ONLY THE SERVICES FOR WHICH REIMBURSEMENT COVERS THE DIRECT COST OF CARE. THIS PRODUCES THE SAME SHORTFALL OUTCOME AS DOES THE PARTICIPATION IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM IS RECOGNIZED AS A COMMUNITY BENEFIT ON SCHEDULE H AND ON COMMUNITY BENEFIT REPORTS FOR MOST STATES. THE QUALITY AND COST OF THE PATIENT CARE IS THE SAME REGARDLESS OF PAYOR SOURCE. HENCE THE ACCEPTANCE OF MEDICARE REIMBURSEMENT REPRESENTS A REDUCTION OR RELIEF OF THE GOVERNMENT BURDEN TO PAY THE FULL COST OF CARE PROVIDED. THE SOURCE USED FOR THE COSTING METHODOLOGY FOR THE AMOUNT REPORTED ON LINE 6 WAS THE 2014 MEDICARE COST REPORT. PART III, LINE 9B COLLECTION 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 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. 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 HEALTHCARE SERVICES FROM ELKHART GENERAL HOSPITAL OF ELKHART. PROCEDURE: 1.ELKHART GENERAL 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.IDENTIFY PATIENTS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE PRE-REGISTRATION, ADMISSION, ELIGIBILITY PROCESS, OR THROUGH SELF PAY ACCOUNT REVIEW AND COLLECTION ACTIVITIES. 3.PROVIDE TO THE PATIENT A FINANCIAL EVALUATION FORM. 4.OBTAIN OR RECEIVE A SIGNED, COMPLETED FINANCIAL EVALUATION FORM FROM THE PATIENT. 5.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. 6.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. 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. NOTE: APPROVAL MAY BE MADE BASED ON MEDICAL INDIGENCE. I.E., 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. 7.COMPLETE THE FINANCIAL ASSISTANCE APPROVAL FORM AND FORWARD TO THE COLLECTION COORDINATOR. 8.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. 9. 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. 10.SEND DETERMINATION LETTER TO NOTIFY PATIENT OF THE APPROVAL FOR FINANCIAL ASSISTANCE. 11.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. 12.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, ELKHART GENERAL HOSPITAL WILL PROVIDE AN UNINSURED DISCOUNT BASED ON THE FOLLOWING TIERED STRUCTURE: 30% DISCOUNT IF ACCOUNT IS PAID WITHIN 30 DAYS FROM DATE OF SERVICE, 20% DISCOUNT IF ACCOUNT IS PAID WITHIN 90 DAYS FROM DATE OF SERVICE, 10% DISCOUNT IF PATIENT CHOOSES TO PARTICIPATE IN THE CAREPAYMENT FINANCING ANY EXCEPTIONS MUST BE APPROVED BY THE DEPARTMENT MANAGER OR DIRECTOR. 2. Needs Assessment Beginning in August 2011, Elkhart General Hospital and Indiana University Health Goshen jointly initiated an Elkhart County community health needs assessment (CHNA) as per federal law under the 2010 Patient Protection and Affordable Care Act. Elkhart County was defined as the community served, and staff from both hospitals consulted with numerous individuals representing the broad interests of the community to provide input during the course of the assessment. From these efforts, a Steering Committee was formed, comprised of community representatives from the public health, religious, education, minority advocacy, healthcare, social service, and private sectors. The hospitals contracted with Purdue University Healthcare Technical Assistance Program to facilitate the assessment process and to assist with data collection. The goal of the assessment was to identify and prioritize community health needs through data collected from a myriad of sources and from input from those representing the broad interests of the community, with the purpose of developing implementation strategies and a plan framework for the respective hospitals in their address of the community's priority health needs. Specific efforts were made to include local public health advocates, including Elkhart County Health Department, as well as other community entities that provide safety net health coverage for the community's most vulnerable populations. These entities included the two Federally Qualified Health Centers in Elkhart County, namely Heart City Health Center and Maple City Health Center, and the Center for Healing and Hope, an ecumenically-based volunteer health clinic. In addition, Elkhart General Hospital reached out to health advocacy entities conversant with local trends in racial health disparities and outcomes, including the Elkhart County Minority Health Coalition, the Hispanic Latino Health Coalition of Northern Indiana, and the Indiana Minority Health Coalition. Also invited to be part of the assessment process were those entities that represent marginalized populations within the county, including local relief agencies, and agencies representing child abuse prevention, elderly, homeless/transient, and the disabled populations within the county. The CHNA process included the analysis of priority health needs survey results submitted from 283 healthcare providers in the area. Data analyses and subsequent group discussion were solicited on multiple Elkhart County health indicators, including public health data, behavioral risk factor data, socioeconomic and crime statistics, and healthcare utilization indicators culled from local, regional, state, and national data sources. Both individual and group input were facilitated on community health needs, resulting in individual and collective weighted rankings of the needs. Through nominal rating, the community process identified Elkhart County's overall health needs of teen pregnancy, lack of social messaging for health promotion, diabetes, access to prescription medications, access to dental care, obesity, smoking, access to primary health care, and access to mental health services. Using a subsequent weighted ranking process to rate each health need based on the size of population impacted by the health need, the seriousness of the health need in the community and the effectiveness of known interventions in addressing the health need, the Steering Committee dialogue identified the community health needs as obesity/diabetes, smoking, access to primary health care, and access to mental health services. Elkhart General Hospital initiated dialogue with Indiana University Health Goshen Hospital beginning in 2011 to assess interest in partnering on a joint CHNA process. Both hospitals entered into an agreement to jointly complete the CHNA process. In May 2012 the CHNA report and the implementation strategies for addressing the community health needs were submitted to the Elkhart General Hospital Board of Directors for review and approval. Subsequent to the Board's June 2012 approval of the community health needs assessment and implementation strategies within the 2012 community health plan, these deliverables were made widely available to the community through posting on the Elkhart General Hospital website WWW.EGH.ORG UNDER THE ICON "ABOUT US, COMMUNITY HEALTH NEEDS ASSESSMENT." ALSO, hard copies ARE made available by request; through email transmission upon request; and through ongoing communication to the Elkhart County community by hospital representatives. Elkhart General Hospital staff also presented the results of the CHNA to community groups upon request. 3. Patient Education of Eligibility for Assistance WHEN UNINSURED PATIENTS PRESENT TO OUR HOSPITAL, THEY ARE OFFERED THE OPPORTUNITY TO MEET WITH OUR ELIGIBILITY SPECIALISTS. OUR ELIGIBILITY SPECIALISTS DISCUSS THE POTENTIAL ELIGIBILITY OF THE PATIENT FOR MULTIPLE ASSISTANCE PROGRAMS, INCLUDING OUR OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. OUR STATEMENTS ALSO INCLUDE A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS, AND THEY CAN CONTACT OUR CUSTOMER SERVICE GROUP FOR GUIDELINES. Patients are also made aware of our financial assistance program via telephone conversation with our Patient Accounts staff. Staff is particularly sensitive to address this program with anyone who indicates there might be a financial need. 4. Community Information Elkhart County, Indiana, was established in 1830, with the original county seat in Dunlap, which was later moved to Goshen. Today Elkhart County has three growing cities, four towns, and 16 townships. Elkhart County is located in northern Indiana and borders the state of Michigan. The County is approximately 463.91 square miles in size. Elkhart County lies halfway between Chicago and Cleveland and is conveniently located near Interstate 80/90 and the Indiana Toll Road. Elkhart County's service providers have a history of actively forming partnerships in an effort to meet the health needs of its residents. Elkhart County takes pride in offering its residents a great place to live and continually striving to establish new businesses and provide an entrepreneurial atmosphere. Elkhart County is considered to be Elkhart General Hospital's primary service area. According to the 2014 U.S. Census estimates, Elkhart County has a population of 201,971, up slightly from the 2013 estimate of 200,563 with a median household income of $46,123 and a per capita income of $36,229. The percentage of persons 65 years and older is estimated at 13.0%, and 7.5% were under five years of age. Census data showed that 76.3% of Elkhart County residents are white persons not of Hispanic descent; 14.9% are Hispanic/Latino; and 6.1% are black. Elkhart County's labor force was 94,513, of which 87,354 were employed and 7,159 persons, or 7.6% of the total labor force, were unemployed. In 2014, the County Health Rankings, sponsored by the Robert Wood Johnson Foundation, ranked Elkhart County as the 20th healthiest county in Indiana of all 92 counties for health outcomes (a gauge of the health status of a county) and 49th healthiest for health factors (those factors that influence the health of a county). The top five leading causes for Elkhart County are as follows: (1) Major Cardiovascular Disease, (2) Cancer, (3) Chronic Lower Respiratory Disease, (4) Motor Vehicle Accidents, and (5) Diabetes. 5. Promotion of Community Health The mission of Elkhart General Hospital, as a Beacon Health System partner, is to enhance the physical, mental, emotional and spiritual well-being of the communities we serve. Beacon Health System is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead the Health System to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both Beacon Health System and Elkhart General Hospital have community Boards of Directors, and consistently invest funds to improve the quality of life for our communities. Beacon Health System values reflect an unwavering commitment to the communities we serve. Elkhart General Hospital, as a Beacon Health System partner, has as its values: Patients are at the center - Patient needs, care and safety are our top priority. Trust - Our actions will firmly demonstrate reliability on our integrity, abilities and our character. Respect - We will treat our patients, community members and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. Integrity - We will continually do the right thing for our patients, associates and communities we serve. Compassion - We will demonstrate the emotional capacities of empathy and sympathy, and express the desire to help. Elkhart General seeks to promote the health and well being of Elkhart County residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community as a whole. A key mechanism by which this goal is carried out is Elkhart General Hospital's serious, consistent, deliberate search for and partnership with like-minded organizations. Elkhart General Hospital continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances included local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers. 6. Affiliated Health Care System Elkhart General Hospital's governing body is comprised of persons who reside in Elkhart County. The 15 member Board of Directors, who serve without pay, guides the system in its mission to provide high quality, affordable health care to the communities it serves. The Board's roles include guaranteeing fair and equal access, approving new medical staff members and approving long-term strategies for the continued success of the hospital. Additionally, Elkhart General Hospital extends medical staff privileges to all qualified physicians in our community. In 2011 Elkhart General Hospital affiliated with Memorial Hospital of South Bend, Indiana, under the name of Beacon Health System, Inc. Both organizations continue as full-care providers for their respective counties, and both organizations are committed to promoting the health of the communities they serve. 7. State Filing of Community Benefit Report Elkhart General Hospital, Inc., prepares a Community Benefit Report both for the State of Indiana and for the Annual Report, which is posted at www.egh.org. true RIBBON OF HOPE 600 EAST BOULEVARD ELKHART IN 46514 352118856 501(c)(3) 35000 CASH CANCER SUPPORT HEART REACH MICHIANA 500 ARCADE STREET SUITE 230 ELKHART IN 46514 202527524 501(c)(3) 10000 CASH SPONSORSHIP DOWNTOWN ELKHART INC 418 SOUTH MAIN STREET ELKHART IN 46516 311173964 501(c)(3) 10000 CASH Jazz Festival UNITED WAY OF ELKHART COUNTY 601 CR 17 ELKHART IN 46515 350953433 501(C)(3) 72000 CASH CORPORATE MATCH AMERICAN HEART ASSOCIATION PO BOX 681550 INDIANAPOLIS IN 46268 135613797 501(C)(3) 8500 CASH SPONSORSHIP INDIANA UNIVERSITY 1234 NOTRE DAME AVE SOUTH BEND IN 46617 356001673 501(C)(3) 15000 CASH SPONSORSHIP UNIVERSITY OF NOTRE DAME 1234 NOTRE DAME AVE SOUTH BEND IN 46617 350868188 501 (C)(3) 25000 CASH CANCER RESEARCH BOYS & GIRLS CLUB OF ELKHART CO PO BOX 614 GOSHEN IN 46527 351156334 501 (C)(3) 25000 CASH SPONSORSHIP 8 SCHEDULE I, PART II PART OF THE ORGANIZATION'S MISSION IS TO IMPROVE THE HEALTH OF ITS COMMUNITY. IN ORDER TO FULFILL THIS GOAL, OUR ADMINISTRATORS HAVE THE ABILITY TO MAKE DONATIONS TO ORGANIZATIONS THAT IMPROVE THE HEALTH AND WELL BEING OF OUR COMMUNITY. SINCE ALL PAYMENTS ARE MADE TO 501(C)(3) ENTITIES, THERE ARE NO PROCEDURES FOR MONITORING THE USE OF THE FUNDS. true true false false false false false true false Gregory Lintjer FORMER OFFICER 0 0 195033 0 6528386 0 0 0 0 0 6723419 0 5470272 0 Gregory Losasso President 351723 0 163545 0 8580 0 124391 20729 668968 0 28500 Laura Munkel Physician 16238 193038 923 83202 50 531 702 9698 1573 18816 19486 305285 Jeffrey P Costello CFO/Asst. Treasurer 0 377534 0 147084 0 28522 0 138880 0 19868 0 711888 0 Phillip A Newbold CEO 0 708507 0 335650 0 204080 0 163973 0 20081 0 1432291 0 154765 GENEVIEVE A LANKOWICZ VP OF MEDICAL AFFAIRS 262009 0 38822 0 861 0 10400 0 8845 0 320937 0 0 KARRA L HEGGEN VP OF NURSING 234060 0 35424 0 1154 0 10400 0 1154 0 282192 0 0 CINDIE L MCPHIE DIRECTOR 154675 0 18603 0 5868 0 0 0 8403 0 187549 0 0 SUSAN G HAWES DIRECTOR 153826 0 10460 0 4559 0 6222 0 7595 0 182662 0 0 LIANG Q WANG SENIOR PHYSICIST 217220 0 522 0 8997 0 8927 0 20381 0 256047 0 0 KEVIN HIGDON FORMER OFFICER 270000 0 0 0 180000 0 0 0 0 0 450000 0 0 0 Supplemental Compensation Information PART I, LINE 3 ELKHART GENERAL HOSPITAL , INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION. PART I, LINE 4A OTHER REPORTABLE COMPENSATION FOR MR. LINTJER INCLUDED $579,758 IN SEVERANCE PAYMENTS, $180,000 FOR DISPUTED SETTLEMENT, $195,033 FOR A FINAL PAYOUT FOR CAPITAL ACCUMULATION, AND $44,934 FOR OTHER BENEFITS. PART I, LINE 4B 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 DEFERRED PAYMENTS IN 2014 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: PHIL NEWBOLD $140,103 GREGORY LOSASSO $65,241. MR. LINTJER PARTICIPATED IN A SUPPLEMENTAL RETIREMENT PLAN, A FINAL PAYMENT OF $5,723,694 WAS PAID OUT IN 2014. Mr. Losasso received a payment of $28,512 from the Supplemental Retirement Plan in 2014. 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: GREGORY LOSASSO, $48,750. PART I, LINE 7 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-MANAGEMENT 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. PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. A HOSPITAL AUTHORITY OF ELKHART COUNTY 351657690 287468EM0 2008-12-09 47800000 REFUND BONDS ISSUED 04/02/2003 false false false B INDIANA FINANCE AUTHORITY 351602316 45471ALS9 2013-05-21 38582380 REFUND BONDS ISSUED 12/15/1998 false false false A 4830000 0 47800000 0 0 0 566012 33988 0 0 47200000 0 2004 true false true true B 3367027 0 38582380 0 0 0 307145 0 0 0 38275235 0 2000 true false false true A false true true true false 0.01900 0.01900 false false 0.00000 false true B 0 A false false true false true false 0 false 0 false true B false true true false false false 0 false 0 false true A true B true PART III, COLUMN B: COLUMN B IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND BONDS ISSUED BEFORE 01/01/2003. FORM 990, PART I, QUESTION 1 ELKHART GENERAL IS A NOT-FOR-PROFIT HOSPITAL GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY VOLUNTEERS. EMPHASIS IS PLACED ON ENSURING EVERYONE IN THE COMMUNITY RECEIVES THE HEALTH CARE THEY NEED. Form 990, Part III, Question 3 Physician Services previously reported on Elkhart General Hospital is now being reported on Beacon Medical Group which is an affiliate of Elkhart General Hospial and part of Beacon Health System,Inc., the parent organization. Form 990, Part VI, Question 2 John Martin and Todd Martin: Family Relationship Members of the Organization Form 990, Part VI, Question 6 Beacon Health System, Inc. is the sole corporate member of Elkhart General Hospital, Inc. ELECTION OF BOARD MEMBERS FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF ELKHART GENERAL HOSPITAL, INC. AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF ELKHART GENERAL HOSPITAL, INC. In the absence of such selection by the corporate member, or until the corporate member determines otherwise, Directors shall be selected as follows: Ten (10) directors shall be elected by the Elkhart General Hospital, Inc. Board from nominations proposed by the nominating committee pursuant to the following guidelines. Two (2) directors shall be representatives from the medical staff, elected by the board from recommendations submitted to the nominating committee by the medical staff. Two (2) directors shall be representatives from the United Labor Agency for Community Services, Inc. ("ULA") from recommendations submitted to the nomination committee from the ULA. Two (2) directors shall be representatives from the Elkhart General Foundation from recommendations by the Elkhart Foundation made to the nominating committee. One (1) director shall be the president of Elkhart General Hospital, Inc. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. Beacon Health System, the Sole Member of Elkhart General Hospital, has control over Elkhart General Hospital's operations. The following matters require the approval of Beacon Health System's Board: 1. Changes to the Articles of Incorporation or Bylaws of Elkhart General Hospital. 2. Appointing or removing with or without cause, the members of the Board, provided, however, that the process of appointment and removal of members of the Board of Elkhart General Hospital shall be as set forth in Elkhart General Hospital's Bylaws, and that appointment of members of the Board of Elkhart General Hospital shall be upon the recommendation of Beacon Health System's Nominating and Governance Committee. 3. The incurrence of debt of Elkhart General Hospital. 4. The sale, transfer or substantial change in use of all or substantially all of the assets of Elkhart General Hospital or the divestiture, dissolution, closure, merger, consolidation, change in corporate membership or ownership, or corporate reorganization of Elkhart General Hospital. 5. The formation of a subsidiary of Elkhart General Hospital, or the sale, transfer or substantial change in use of all or substantially all of the assets of a subsidiary of Elkhart General Hospital , or the divestiture, dissolution, closure, merger, consolidation or change in corporate membership or ownership of a subsidiary of Elkhart General Hospital. 6. The material transfer or encumbrance of the assets of Elkhart General Hospital or a subsidiary of Elkhart General Hospital. 7. The annual operating budget, capital plan, strategic plan, and business plan for Elkhart General Hospital and subsidiaries of Elkhart General Hospital. 8. The mission and vision statements for Elkhart General Hospital and subsidiaries of Elkhart General Hospital. 9. Any material transactions of Elkhart General Hospital or a subsidiary of Elkhart General Hospital which are not otherwise included in the approved operating or capital budgets of Elkhart General Hospital or a subsidiary of Elkhart General Hospital or as otherwise authorized in the bylaws or operating agreement of Elkhart General Hospital or a subsidiary of Elkhart General Hospital . 10. Resolving any issues between Elkhart General Hospital or a subsidiary of Elkhart General Hospital and other affiliates of Beacon Health System as to participation, or failure to participate in, specific managed care agreements, and the terms thereof. 11. Any management agreement for the management of all or any substantial part of Elkhart General Hospital or a subsidiary of Elkhart General Hospital operations. Describe the Process used by Management &/or Governing Body to Review 990 Form 990, Part VI, Question 11B 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. CONFLICT OF INTEREST STATEMENTS CORE FORM, PART VI, SECTION B, LINE 12C 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. 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 Chairman, 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. FORM 990, PART VI, SECTION B, LINE 15 AN EXTENSIVE EXAMINATION IS CONDUCTED USING COMPARABLE MARKET DATA AND IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD. PUBLIC AVAILABILITY FOR DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 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 BEACON HEALTH SYSTEM, INC. BONDS. Form 990, Part XI, line 9 Pension Liability - 20,783,334 Write off Intercompany Balances, Beacon Medical Group - 1,930,323 Write off Intercompany Balances, Memorial Hospital - (11,435,037) Write off Intercompany Balances, Beacon Health System - 234,394,484 Total - 245,673,104. AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO TH FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:1492857 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:521915 FORM 990 PART IX LINE 11G DESCRIPTION:RADIOLOGY FEES TOTAL FEES:14882 FORM 990 PART IX LINE 11G DESCRIPTION:LAB FEES TOTAL FEES:10661851 FORM 990 PART IX LINE 11G DESCRIPTION:BLOOD PRODUCTS TOTAL FEES:3013668 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:5271182 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:1939047 FORM 990 PART IX LINE 11G DESCRIPTION:REPAIR AND MAINTENANCE TOTAL FEES:2980476 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:4935366 FORM 990 PART IX LINE 11G DESCRIPTION:LESS RENTAL EXPENSE TOTAL FEES:-23815 COMMUNITY OCCUPATIONAL MEDICINE 22818 OLD US 20 ELKHART IN 46516 352073758 MEDICAL CENT IN 3922595 2899032 EGH Beacon Medical Group 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 PHY PRACTICES IN 501(C)(3) 9 BHS true MEMORIAL HEALTH FOUNDATION INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536129 FINANCIAL SUP IN 501(C)(3) 7 BHS true MEMORIAL ENDOWMENT FUND FOR MEMORIAL HOS PO BOX 1602 SOUTH BEND IN 46634 356068581 ENDOWMENT IN 501(C)(3) 11D III-O MHSB true BEACON HEALTH SYSTEM INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 PARENT ORG. IN 501(C)(3) 11A, TYPE I NA false Memorial Hospital of South Bend Inc 615 N Michigan Street South Bend IN 46601 350868132 Hospital IN 501(C)(3) 3 BHS true ELKHART GENERAL HOSPITAL FOUNDATION 600 EAST BLVD ELKHART IN 46514 356061200 CHAR SUPPORT IN 501(C)(3) 11B,TYPE II NA false ELKHART GENERAL HOSPITAL AUXILIARY 600 EAST BLVD ELKHART IN 46514 350938148 VOL SUPPORT IN 501(C)(3) 11B,TYPE II NA false WaNee Walk-In Cl 1028-A East Waterford St PO Box 3 Wakarusa IN 46573 272192375 Medical Clini IN EGH RELATED -17028 38583 false 0 true 0.50000 Beacon Health Ventures Inc 615 N Michigan St South Bend IN 46601 351901068 Home Medical IN C Beacon Health Ventures Michigan Inc 615 N Michigan St South Bend IN 46601 208259773 Home Medical MI C false true true false false false false false true true false false false false false true true false true Memorial Hospital of South Bend q 2033174 ACTUAL CHARGES Memorial Hospital of South Bend c 11435037 WRITEOFFINTERCO Memorial Hospital of South Bend p 13014728 ACTUAL CHARGES Memorial Hospital of South Bend s 98400 ACTUAL CHARGES Beacon Health Ventures j 85097 ACTUAL CHARGES Beacon Medical Group i 1426723 ACTUAL CHARGES Beacon Medical Group p 1731823 ACTUAL CHARGES Beacon Medical Group s 3500324 ACTUAL CHARGES Beacon Medical Group b 1930323 WRITEOFFINTERCO Beacon Medical Group j 1118187 ACTUAL CHARGES