MIDWEST MEDICAL CENTER: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MIDWEST MEDICAL CENTER (EIN 20-4560540)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-08-15
IRS object ID: 201402279349304015
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-08-15T14:37:31-05:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	390758449	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3703 OAKWOOD HILLS PARKWAY	AddressLine1
City	EAU CLAIRE	City
State	WI	State
ZIP Code	54701	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	204560540	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MIDWEST MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MIDW	NameControl
Phone	8157771340	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	GALENA	City
State	IL	State
ZIP Code	61036	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	TRACY BAUER	Name
Title	CEO	Title
Phone	8157771340	Phone
Date Signed	2014-08-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	HOLLY POKRANDT CPA	Name
PTIN	P00449155	PTIN
Phone	7158323407	Phone
Date Prepared	2014-08-13	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	TRACY BAUER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	GALENA	City
State	IL	State
ZIP Code	61036	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	18896833	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MIDWESTMEDICALCENTER.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2006	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CITY OF GALENA, ILLINOIS AND THE SURROUNDING AREA REGARDLESS OF A PATIENT'S ABILITY TO PAY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	226	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	30899	TotalGrossUBI
Net Unrelated Business Txbl Income	-6350	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	141373	ContributionsGrantsPriorYear
Contributions Grants Current Year	79512	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	18561798	ProgramServiceRevenuePriorYear
Program Service Revenue CY	18754974	ProgramServiceRevenueCY
Investment Income Prior Year	168942	InvestmentIncomePriorYear
Investment Income Current Year	35731	InvestmentIncomeCurrentYear
Other Revenue Prior Year	-54585	OtherRevenuePriorYear
Other Revenue Current Year	-61072	OtherRevenueCurrentYear
Total Revenue Prior Year	18817528	TotalRevenuePriorYear
Total Revenue Current Year	18809145	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	8523	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	7763	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	7830686	SalariesEtcPriorYear
Salaries Etc Current Year	7972988	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	12530635	OtherExpensePriorYear
Other Expenses Current Year	11757329	OtherExpensesCurrentYear
Total Expenses Prior Year	20369844	TotalExpensesPriorYear
Total Expenses Current Year	19738080	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1552316	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-928935	RevenuesLessExpensesCY
Total Assets BOY	47106686	TotalAssetsBOY
Total Assets EOY	45971126	TotalAssetsEOY
Total Liabilities BOY	50165610	TotalLiabilitiesBOY
Total Liabilities EOY	49958985	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-3058924	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	-3987859	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	12446528	Expense
Grants	7763	Grants
Revenue	13628682	Revenue
Description	MIDWEST MEDICAL CENTER OWNS AND OPERATES A 25-BED CRITICAL ACCESS HOSPITAL, AND LEADS IN THE DELIVERY OF HEALTHCARE SERVICES TO ITS REGION WITH OVER 200 ASSOCIATES, INCLUDING 17 PHYSICIANS AND ONE MID-LEVEL PRACTITIONER, WHICH COORDINATE PATIENT CARE AS AN INTEGRATED UNIT. THE HOSPITAL AND ITS ASSOCIATES WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE. THE ACCOMPLISHMENTS WHICH FOLLOW ARE ATTRIBUTABLE TO THE HOSPITAL AND ALL OF ITS DEPARTMENTS AS A WHOLE.REQUIREMENTS OF THE IRS COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT ORGANIZATIONS ARE A KEY COMPONENT TO THE ORGANIZATION'S LARGER CHARITABLE MISSION OF IMPROVING HEALTH AND QUALITY OF LIFE. SPECIFICALLLY, THE ORGANIZATION IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS, WHICH INCLUDES COMMUNITY LEADERS, CONSUMER REPRESENTATIVES, AND BUSINESS AND CLINICAL HEALTHCARE EXPERTS. THE BOARD OF DIRECTORS IS COMMITTED TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE SOLELY FOR THE BENEFIT OF THE COMMUNITY. DURING THE YEAR, THE BOARD WORKED WITH MANAGEMENT TO OVERSEE CRITICAL FUNCTIONS OF THE ORGANIZATION. FOR EXAMPLE:-THE COMPLIANCE COMMITTEE OF THE BOARD WAS ASSIGNED RESPONSIBILITY FOR OVERSIGHT OF THE CORPORATE COMPLIANCE PLAN AND FOR OVERSIGHT OF DEFINED COMPONENTS OF THE ORGANIZATION'S INTERNAL CONTROL FUNCTIONS.-POLICIES CURRENTLY EXIST THAT REGULATE DOCUMENT RETENTION/DESTRUCTION AND WHISTLEBLOWER PROTECTION.-POLICIES ON CONFIDENTIALITY OF PATIENT AND CORPORATE INFORMATION ARE REVIEWED ANNUALLY AS A COMPONENT OF MANDATORY EDUCATION, AND A CONFIDENTIALITY STATEMENT IS SIGNED ANNUALLY BY ALL EMPLOYEES AND BOARD MEMBERS.-THE ORGINAZATION'S CODE OF ETHICS/CODE OF CONDUCT IS PUBLISHED IN THE EMPLOYEE AND PHYSICIAN HANDBOOKS AND INCLUDED IN THE GENERAL ORIENTATION OF ALL NEW EMPLOYEES AND VOLUNTEERS. ALSO, AN ETHICS HOTLINE POLICY WAS IMPLEMENTED IN JANUARY 2013.THE HOSPITAL ALSO MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE REGION IT SERVES. THE HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAD OVER 3,800 EMERGENCY CENTER VISITS DURING FISCAL YEAR 2013. THE HOSPITAL PROVIDES CLINICAL AND ANCILLARY SERVICES REQUIRED TO SUPPORT THE EMERGENCY CENTER INCLUDING DIAGNOSTIC TESTING SUCH AS LABORATORY, RADIOLOGY, CT SCANNING, AND MRI SCANNING SERVICES. FULL-TIME ON-SITE EMERGENCY MEDICAL PHYSICIANS ARE PROVIDED THROUGH AN ARRANGEMENT WITH THE UNIVERSITY OF ILLINOIS-CHICAGO PHYSICIANS.IN ADDITION, MIDWEST MEDICAL CENTER PROVIDES NON-EMERGENCY SERVICES TO THE REGION IT SERVES. IT MAKES THESE SERVICES ACCESSIBLE TO THE REGION THROUGH PARTICIPATION IN GOVENMENT PROGRAMS LIKE MEDICARE AND MEDICAID AND BY OFFERING ASSISTANCE THROUGH THE HOSPITAL'S CHARITY CARE PROGRAM.THE HOSPITAL'S CHARITY CARE POLICY PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE HOSPITAL'S CHARITY CARE POLICY IS DESIGNED TO ENSURE THAT THE ENTIRE REGION IS SERVED BY THE HOSPITAL AND HAS ACCESS TO NEEDED HEALTHCARE SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS OVERSEES THE SERVICES DELIVERED UNDER THE HOSPITAL'S CHARITY CARE POLICY, INCLUDING ASSESSING HEALTH NEEDS OF THE REGION, APPROVING ELIGIBILITY CRITERIA, AND MONITORING THE EFFECTIVENESS OF THE PROGRAM IN PROVIDING REGIONAL ACCESS TO MEDICAL CARE.ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME LEVELS AND FAMILY SIZE. GENERALLY, INDIVIDUALS EARNING INCOME OF UP TO 300% OF THE FEDERAL POVERTY INCOME GUIDELINES ARE ELIGIBLE FOR VARYING LEVELS OF DISCOUNTS, INCLUDING FULL DISCOUNTS FOR CERTAIN INCOME LEVELS. IN ADDITION, AN AUTOMATIC DISCOUNT OF CHARGES IS PROVIDED TO ANY PATIENT THAT IS DETERMINED TO NOT HAVE INSURANCE OF ANY TYPE. APPLICATIONS FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY DESIGNATED HOSPITAL PATIENT REGISTRATION AREA OR BY CALLING THE HOSPITAL'S BUSINESS OFFICE.THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE PROVIDED UNDER THE CHARITY CARE PROGRAM. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE HOSPITAL REDUCED CHARGES TO PATIENTS UNDER THE CHARITY CARE PROGRAM FOR THE YEAR ENDED 2013 BY APPROXIMATELY $232,000. (SEE ADDITIONAL INFORMATION REGARDING THE COST OF PROVIDING CHARITY CARE IN SCHEDULE H TO THE FORM 990.)THE HOSPITAL TAKES ITS MISSION TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IT SERVES A STEP FURTHER BY REACHING OUT TO MEET THE BROAD HEALTH NEEDS OF THE REGION IT SERVES. THE HOSPITAL STRIVES TO IDENTIFY THE NEEDS OF THE REGION BEYOND BASIC HEALTHCARE, AND THEN RESPONDS TO THEM BY AIMING TO MAKE A POSITIVE, LIFE-ENHANCING DIFFERENCE IN THE REGION. THE HOSPITAL TAKES A STRATEGIC, REGIONAL NEEDS BASED APPROACH TO DELIVERING BENEFITS TO THE REGION. THE HOSPITAL HAS RESPONSIBILITY FOR LEADING THE ORGANIZATION TO ACHIEVE THESE OBJECTIVES:1. COLLABORATE WITH COMMUNITIES TO IDENTIFY UNMET COMMUNITY HEALTH NEEDS AND UNDERSERVED POPULATIONS.2. ADDRESS UNDERSERVED POPULATIONS AND UNMET NEEDS.3. IMPROVE THE HEALTH OF THE COMMUNITIES.THIS POSITION LINKS ALL COMMUNITY BENEFITS ACTIVITIES UNDER ONE MANAGEMENT UMBRELLA WITH A CONSISTENT CONTACT POINT. ORGANIZATIONAL FOCUS ON COMMUNITY BENEFIT HAS BEEN ELEVATED BY STRENGTHENING INFRASTRUCTURE TO SUPPORT AND COMMUNICATE COMMUNITY BENEFIT WORK.THE HOSPITAL DEMONSTRATES ITS COMMITMENT TO PROVIDING COMMUNITY BENEFIT THROUGH THE FOLLOWING SPECIFIC ACCOMPLISHMENTS:THE HOSPITAL IS A NON-PROFIT CORPORATION PROVIDING HEALTHCARE AND RESIDENTIAL SERVICES IN GALENA, ILLINOIS AND NEIGHBORING COMMUNITIES. ALL OF THESE SERVICES ARE OFFERED UNDER THE MISSION OF THE ORGANIZATION, WHICH STATES THAT "MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE." IN FISCAL YEAR 2013 THE HOSPITAL PROVIDED 415 ACUTE INPATIENT DAYS, 1,237 SWING BED DAYS, 3,812 EMERGENCY ROOM VISITS, 5,667 RADIOLOGY SERVICES, 91,373 LABORATORY TESTS, 8,552 PHYSICAL THERAPY TREATMENTS, AND 267 SURGICAL PROCEDURES AMONG MANY OF THE PATIENT SERVICES PROVIDED DURING THE YEAR.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	3172796	Expense
Revenue	3477822	Revenue
Description	MIDWEST MEDICAL CENTER RECOGNIZES THAT THE AGING AND DISABLED POPULATION OF PATIENTS ARE OFTEN AN UNDERSERVED DEMOGRAPHIC OF THE POPULATION AND TO MEET THE HEALTHCARE NEEDS OF THESE PATIENTS THE HOSPITAL OPERATES THE GALENA-STAUSS SENIOR CARE COMMUNITY. THIS SENIOR CARE CAMPUS PROVIDES SENIOR CARE SERVICES THROUGH ITS 57-BED LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY, AS WELL AS ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS PROVIDED 18,609 DAYS OF SKILLED NURSING AND INTERMEDIATE NURSING HOME CARE DAYS IN ADDITION TO THE ASSISTED LIVING AND ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS OFFERS SKILLED NURSING TO RESIDENTS AND PATIENTS IN BOTH SHORT TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY, WOUND CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED. THE SENIOR CARE CAMPUS OPERATES IN CONJUNCTION WITH THE MIDWEST MEDICAL CENTER HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN MIDWEST MEDICAL CENTER'S CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW COST CARE TO THE COMMUNITY.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	2684959	Expense
Revenue	1617571	Revenue
Description	MIDWEST MEDICAL CENTER ALSO OPERATES A PHYSICIAN CLINIC KNOWN AS THE MIDWEST HEALTH CLINIC. A TOTAL OF 9,924 CLINIC VISITS WERE PROVIDED DURING FISCAL YEAR 2013. THE CARE IN THE MIDWEST HEALTH CLINIC IS COORDINATED WITH THE CARE OF MIDWEST MEDICAL CENTER'S HOSPITAL IN AN EFFORT TO CONTINUE TO PROVIDE LOW COST AND HIGH QUALITY PATIENT CARE FOR THE RESIDENTS OF GALENA, ILLINOIS AND THE SURROUNDING AREAS. THE HEALTH CLINIC OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC TO MIDWEST MEDICAL CENTER'S HOSPITAL AND THE PRACTICE IS MADE UP OF THREE FAMILY PRACTICE PHYSICIANS, AN INTERNAL MEDICINE PHYSICIAN, AND ONE MID-LEVEL PRACTITIONER. ADDITIONAL SERVICES ARE ALSO PROVIDED IN THE CLINIC BY OUTREACH DOCTORS THAT PROVIDE SERVICES ON A LIMITED BASIS IN THE AREAS OF ORTHOPEDIC SURGERY, GENERAL SURGERY, PODIATRY, AND PLASTIC SURGERY.THE CLINIC PROVIDERS ALSO ENGAGE IN MANY ACTIVITIES WHICH PROMOTE THE WELL-BEING OF THE COMMUNITY AND PROVIDE HEALTH EDUCATION TO THE COMMUNITY. AN EXAMPLE OF THESE SERVICES IS DR. WELLS, WHO IS ON STAFF AT THE UNIVERSITY OF ILLINOIS ROCKFORD MEDICAL SCHOOL AND PROVIDES EDUCATIONAL EXPERIENCES AND TRAINING TO MEDICAL STUDENTS AT THE MIDWEST HEALTH CLINIC FOR THOSE STUDENTS INTERESTED IN LEARNING ABOUT RURAL MEDICINE. ANOTHER EXAMPLE IS DR. MATT GULLONE, WHO SPECIALIZES IN SPORTS MEDICINE AND PROVIDES FREE CARE TO LOCAL ATHLETES DURING SPORTING EVENTS. DR. BETH GULLONE AND PEG DITTMAR, ANP, ALSO PROVIDE BREAST CANCER EDUCATION TO SEVERAL GROUPS WITHIN JO DAVIESS COUNTY.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	18304283	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	1	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	37	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	226	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	TRACY BAUER	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	8157771340	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	GALENA	City
State	IL	State
ZIP Code	61036	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Average Hours Per Week RelatedAverageHoursPerWeekRelated	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
HELEN KILGORE
BOARD MEMBER	2.00	X	0	0	0
FRANK WAITES
BOARD MEMBER	2.00	X	0	0	0	0.50
VINCE TOEPFER
BOARD MEMBER	2.00	X	0	0	0
CAROL WRABL
BOARD MEMBER	2.00	X	0	0	0
ROY CLINGMAN
BOARD MEMBER	2.00	X	0	0	0
DAVID HEY
BOARD MEMBER	2.00	X	0	0	0
MARY ROONEY-SHEAHEN RN
CHAIR	2.00	X	0	0	0	0.50	X
CHERYL FARRUGGIA
VICE CHAIR	2.00	X	0	0	0	0.50	X
WILLIAM MORDEN
TREASURER	2.00	X	0	0	0	0.50	X
ROBERT MILLER
SECRETARY	2.00	X	0	0	0	0.50	X
TRACY BAUER
CEO	50.00		155411	0	34877		X
JENNIFER STEINES
CONTROLLER	50.00		89001	0	13660		X
DEBRA HOPPMAN
CNO	50.00		116058	0	4771			X
MICHAEL WELLS MD
PHYSICIAN	36.00		161678	0	33469			X
ELIZABETH GULLONE MD
PHYSICIAN	36.00		163999	0	26776			X
MATTHEW GULLONE MD
PHYSICIAN	36.00		172121	0	18696			X
DEBBIE CIHAK MD
PHYSICIAN	40.00		278511	0	26766			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1136779	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	159015	TotalOtherCompensation
Number Individuals GT100 K	6	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MICHAEL GREEN MD
1340 W NEWPORT	CHICAGO	IL	60657	ER PHYSICIAN COVERAGE	204816
BIKRAM DHILLON MD
432 JASON COURT	SCHAUMBURG	IL	60173	ER PHYSICIAN COVERAGE	183805
RALPH LOSEY MD
207 SOUTH PROSPECT STREET	GALENA	IL	61036	ER PHYSICIAN COVERAGE	166983
JOSEPH COLLA MD
41 EAST 8TH STREET APT 3304	CHICAGO	IL	60605	ER PHYSICIAN COVERAGE	123120
HINSHAW & CULBERTSON LLP
8142 SOLUTIONS CENTER DRIVE	CHICAGO	IL	60677	LEGAL	111456

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K
Fundraising Events	316	FundraisingEvents
Related Organizations	24522	RelatedOrganizations
Government Grants	46867	GovernmentGrants
All Other Contributions	7807	AllOtherContributions
Total Contributions	79512	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
HOSPITAL PATIENT REVENUE	621990	13278591	13278591
SENIOR CARE REVENUE	623000	3477822	3477822
CLINIC REVENUE	621110	1648470	1617571	30899
CAFETERIA REVENUE	621990	226173	226173
FITNESS CENTER REVENUE	621990	123918	123918

Field	Value	IRS element (for citing)
Total Program Service Revenue	18754974	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	34034	TotalRevenueColumn
Exclusion	$34,034	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	5824	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	78390	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-72566	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-72566	TotalRevenueColumn
Exclusion	-$72,566	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	1697	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	1697	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1697	TotalRevenueColumn
Exclusion	$1,697	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	20792	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	316	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	9298	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	11494	TotalRevenueColumn
Exclusion	$11,494	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	18809145	TotalRevenueColumn
Related Or Exempt Function Income	18724075	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	30899	UnrelatedBusinessRevenue
Exclusion	-$25,341	ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	7763	Total
Program Services	7763	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	275850	Total
Management And General	275850	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	6181883	Total
Program Services	5872723	ProgramServices
Management And General	309160	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	169505	Total
Program Services	161030	ProgramServices
Management And General	8475	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	912703	Total
Program Services	867068	ProgramServices
Management And General	45635	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	433047	Total
Program Services	395422	ProgramServices
Management And General	37625	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	111456	Total
Management And General	111456	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	1346211	Total
Program Services	1346211	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	968623	Total
Program Services	323027	ProgramServices
Management And General	645596	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3540621	Total
Program Services	3540621	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	78565	Total
Program Services	78565	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2281052	Total
Program Services	2281052	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	240542	Total
Program Services	240542	ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDICAL SUPPLIES	2344077	2344077
PROVISION FOR BAD DEBT	505327	505327
FOOD AND DIETARY SUPPLI	340855	340855

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	19738080	Total
Program Services	18304283	ProgramServices
Management And General	1433797	ManagementAndGeneral
Fundraising	0	Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1592769	BOY
EOY	1070433	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3269698	BOY
EOY	2461604	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	18684	BOY
EOY	24441	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	327426	BOY
EOY	314641	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	358154	BOY
EOY	319266	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	58880	BOY
EOY	79818	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	54829107	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	21698666	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	33118905	BOY
EOY	33130441	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	7536457	BOY
EOY	7611740	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	3256	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	822457	BOY
EOY	958742	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	47106686	BOY
EOY	45971126	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2778237	BOY
EOY	2774259	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	45485000	BOY
EOY	45135208	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
EOY	1955433	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1902373	BOY
EOY	94085	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	50165610	BOY
EOY	49958985	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-4512380	BOY
EOY	-5442756	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1254807	BOY
EOY	1256248	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	198649	BOY
EOY	198649	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-3058924	BOY
EOY	-3987859	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	47106686	BOY
EOY	45971126	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-928935	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$9,091	OtherActivitiesAmount
Total Lobbying Expenditures IIB	9091	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	MIDWEST MEDICAL CENTER PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE ORGANIZATIONS RECOGNIZE THAT A PORTION OF THE ACTIVITIES CONDUCTED BY BOTH IHA AND ICAHN ARE FUNDED IN CONJUNCTION WITH THE TOTAL ANNUAL DUES PAID. MIDWEST MEDICAL CENTER ESTIMATED THAT $9,091 OUT OF THE TOTAL DUES PAID TO IHA AND ICAHN WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	341497	BeginningOfYearBalance
Investment Earnings Or Losses	1696	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
End Of Year Balance	342693	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	342707	BeginningOfYearBalance
Investment Earnings Or Losses	650	InvestmentEarningsOrLosses
Grants Or Scholarships	1860	GrantsOrScholarships
End Of Year Balance	341497	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	345853	BeginningOfYearBalance
Investment Earnings Or Losses	439	InvestmentEarningsOrLosses
Grants Or Scholarships	3585	GrantsOrScholarships
End Of Year Balance	342707	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	354096	BeginningOfYearBalance
Investment Earnings Or Losses	1314	InvestmentEarningsOrLosses
Grants Or Scholarships	9557	GrantsOrScholarships
End Of Year Balance	345853	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	349405	BeginningOfYearBalance
Investment Earnings Or Losses	6191	InvestmentEarningsOrLosses
Grants Or Scholarships	1500	GrantsOrScholarships
End Of Year Balance	354096	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.57970	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.42030	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	559916	OtherCostOrOtherBasis
Book Value	559916	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	42874568	OtherCostOrOtherBasis
Depreciation	14412856	Depreciation
Book Value	28461712	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	9750113	OtherCostOrOtherBasis
Depreciation	7285810	Depreciation
Book Value	2464303	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1644510	OtherCostOrOtherBasis
Book Value	1644510	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	33130441	TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (4 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
BOARD DESIGNATED INVESTMENTS FOR CAP. IMPROVEMENTS	1153280	C
UNDER BOND AGREEMENT-RESERVE FUNDS	3420146	F
UNDER BOND AGREEMENT-PRINCIPAL/INTEREST FUNDS	1893850	F
DONOR RESTRICTED-MEDICAL SCHOLARSHIPS	1144464	C

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	7611740	TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	SECURITY DEPOSITS HELD	Description
Amount	$94,085	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	94085	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ENDOWMENTS CONSIST OF TWO DONOR-RESTRICTED FUNDS, WHICH WERE ESTABLISHED TO PROVIDE INVESTMENT INCOME FOR MEDICAL EDUCATION SCHOLARSHIPS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	THE SYSTEM AND ITS AFFILIATES ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM AND ITS AFFILIATES ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE SYSTEM IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). THE UBI IS NOT SIGNIFICANT. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE SYSTEM DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX BENEFITS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2013 OR 2012. FEDERAL TAX RETURNS FOR THE FISCAL YEARS SEPTEMBER 30, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	GOLF OUTING	NameOfEvent1
Gross Receipts Event1	21108	GrossReceiptsEvent1
Charitable Contributions Event1	316	CharitableContributionsEvent1
Gross Revenue Event1	20792	GrossRevenueEvent1
Non Cash Prizes Event1	900	NonCashPrizesEvent1
Rent Facility Costs Event1	3988	RentFacilityCostsEvent1
Food And Beverage Event1	2710	FoodAndBeverageEvent1
Other Direct Expenses Event1	1700	OtherDirectExpensesEvent1
Gross Receipts Total	21108	GrossReceiptsTotal
Charitable Contributions Total	316	CharitableContributionsTotal
Gross Revenue Total Events	20792	GrossRevenueTotalEvents
Non Cash Prizes Total Events	900	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	3988	RentFacilityCostsTotalEvents
Food And Beverage Total Events	2710	FoodAndBeverageTotalEvents
Other Direct Expenses Total Events	1700	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	9298	DirectExpenseSummaryEvents
Net Income Summary	11494	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent150	X	Pcent150
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	193153	TotalCommunityBenefitExpense
Net Community Benefit Expense	193153	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3383093	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1910632	DirectOffsettingRevenue
Net Community Benefit Expense	1472461	NetCommunityBenefitExpense
Percent Of Total Expense	0.07660	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3576246	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1910632	DirectOffsettingRevenue
Net Community Benefit Expense	1665614	NetCommunityBenefitExpense
Percent Of Total Expense	0.08660	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4997765	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3022921	DirectOffsettingRevenue
Net Community Benefit Expense	1974844	NetCommunityBenefitExpense
Percent Of Total Expense	0.10270	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10328	TotalCommunityBenefitExpense
Net Community Benefit Expense	10328	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5008093	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3022921	DirectOffsettingRevenue
Net Community Benefit Expense	1985172	NetCommunityBenefitExpense
Percent Of Total Expense	0.10320	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8584339	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4933553	DirectOffsettingRevenue
Net Community Benefit Expense	3650786	NetCommunityBenefitExpense
Percent Of Total Expense	0.18980	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$420,229	BadDebtExpenseAmount
Amount Attributable To	210114	AmountAttributableTo
Amount Reimbursed By Medicare	7945588	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	7973380	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-27792	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MIDWEST MEDICAL CENTER	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	ONE MEDICAL CENTER DRIVE	AddressLine1
City	GALENA	City
State	IL	State
ZIP Code	61036	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.MIDWESTMEDICALCENTER.ORG	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours
Other	PROVIDER BASED RURAL HEALTH CLINIC	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MIDWEST MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	150.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Lawsuit	X	PermitLawsuit
Permit Lien On Residence	X	PermitLienOnResidence
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Lawsuit	X	Lawsuit
Lien On Residence	X	LienOnResidence
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	GALENA-STAUSS SENIOR CARE CAMPUS	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	215 SUMMIT STREET	AddressLine1
City	GALENA	City
State	IL	State
ZIP Code	61036	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	SKILLED NURSING FACILITY, ASSISTED LIVING, AND ADULT DAY CARE	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanation	IdentifierIdentifier
PART I, LINE 3C: MIDWEST MEDICAL CENTER PRIMARILY USES FEDERAL POVERTY GUIDELINES TO ESTABLISH CHARITY OR DISCOUNTED CARE TO THOSE IN NEED OF CARE IN THE COMMUNITY, HOWEVER THERE ARE OTHER CONSIDERATIONS GIVEN TO PATIENTS TO AVOID HAVING PATIENTS BE IN FINANCIAL DISTRESS DUE TO CONCERNS OVER THEIR MEDICAL BILLS. BELOW ARE THE GENERAL GUIDELINES AS DEFINED IN MIDWEST MEDICAL CENTER'S CHARITY CARE POLICY WHICH ARE FOLLOWED BY THE ORGANIZATION:PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD WILL BE ELIGIBLE FOR 100% CHARITY CARE.PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME GREATER THAN 150%, BUT EQUAL TO OR LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD, WILL BE ELIGIBLE FOR PARTIAL FINANCIAL ASSISTANCE.PATIENT ACCOUNT GUARANTORS WITH INSUFFICIENT ASSETS TO PAY THE AMOUNT DUE, AND WHO DO NOT QUALIFY FOR CHARITY CARE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES, WILL BE ELIGIBLE FOR A CATASTROPHIC CHARITY ADJUSTMENT WHEN THE TOTAL AMOUNT DUE TO MIDWEST MEDICAL CENTER EQUALS AT LEAST 20% OF THE DEBTOR'S ADJUSTED GROSS INCOME. CATASTROPHIC CHARITY IS AN EIGHTY PERCENT (80%) ADJUSTMENT OFF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES.
PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES (EXCLUDING THE PROVISION FOR BAD DEBTS) DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. (THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE HOSPITAL.)
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT MIDWEST MEDICAL CENTER INCLUDES THE OPERATION OF SEVERAL DEPARTMENTS. THESE DEPARTMENTS AND SERVICES INCLUDE: THE ADULTS AND PEDIATRICS HOSPITAL INPATIENT UNIT AND THE EMERGENCY ROOM UNIT. A MAJORITY OF THESE DEPARTMENTS ARE OPERATED, OR ARE KEPT AT MINIMAL STAFFING LEVELS, IN ORDER TO PROVIDE ACCESS TO THE EMERGENCY ROOM OR EMERGENCY INPATIENT CARE OR CRITICAL CARE SERVICES WHICH SUPPLEMENT OTHER SERVICES AT THE HOSPITAL OR ARE BASED ON NEEDS IN THE COMMUNITY. THE EMERGENCY ROOM AND INPATIENT UNIT ARE STAFFED 24 HOURS PER DAY TO PROVIDE NEEDED ACCESS TO EMERGENCY CARE IN THE GALENA, ILLINOIS COMMUNITY OR AS REQUIRED BY REGULATIONS TO BE ON-CALL AND AVAILABLE TO PROVIDE ACCESS TO EMERGENCY INPATIENT CARE AS A PART OF OPERATING A HOSPITAL IN THE STATE OF ILLINOIS. THE INPATIENT UNIT ALSO PROVIDES CARE TO OVERNIGHT OBSERVATION PATIENTS WHICH ARE KEPT FOR OBSERVATION IN FOLLOW UP CARE FROM THE EMERGENCY ROOM AS WELL AS PROVIDING A SIGNIFICANT NUMBER OF SWING BED SERVICES. IN THE PAST, THERE WAS NO MEDICARE CERTIFIED NURSING HOME IN THE CITY OF GALENA, ILLINOIS OR IN THE IMMEDIATE SURROUNDING AREA AND AS OF FISCAL YEAR 2013 THERE ARE ONLY 5 MEDICARE CERTIFIED SKILLED NURSING BEDS IN JO DAVIESS COUNTY, ILLINOIS. IN RESPONSE TO THE NEED IN THE SURROUNDING AREA, THE HOSPITAL PARTICIPATES IN THE MEDICAL RURAL HOSPITAL SWING BED PROGRAM WHICH PROVIDES SKILLED NURSING CARE IN AVAILABLE BEDS IN THE HOSPITAL INPATIENT UNIT. IT IS THE GOAL OF MIDWEST MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART I, L7 COL(F): THE COSTING METHOD AND CALCULATIONS USED ON FORM 990 ARE BASED ON TOTAL OPERATING EXPENSES EXCLUDING BAD DEBT EXPENSE. THE COMMUNITY BENEFIT EXPENSE PERCENTAGES ARE CALCULATED BY DIVIDING THE COMMUNITY BENEFIT EXPENSE FOR EACH CATEGORY OF COMMUNITY SERVICES PROVIDED BY MIDWEST MEDICAL CENTER REPORTED IN THE TABLE ON LINE 7 PART I OF THE SCHEDULE H BY THE TOTAL OPERATING EXPENSES OF THE HOSPITAL LESS THE PROVISION FOR BAD DEBTS OF $505,327.
PART II: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. MIDWEST MEDICAL CENTER PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. MIDWEST MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY.
PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE ORGANIZATION HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE AND THE HOSPITAL HAS REFLECTED AN ESTIMATED AMOUNT OF THESE ADDITIONAL BAD DEBTS IN PART III OF SCHEDULE H OF THE 990.THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, RADIOLOGY PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT MIDWEST MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2013, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). MIDWEST MEDICAL CENTER ALSO SUFFERS A LARGER MEDICARE LOSS NOTED ON THE FORM 990 THAN MANY OTHER CRITICAL ACCESS HOSPITALS DUE TO A REGULATION WHICH AFFECTS LAB REIMBURSEMENT FOR CRITICAL ACCESS HOSPITALS. DUE TO THIS REGULATION, THE HOSPITAL DOES NOT RECEIVE THE FULL COST OF PROVIDING LAB SERVICES TO MEDICARE BENEFICIARIES.WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, MIDWEST MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S BUSINESS OFFICE OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM.
PART V, SECTION B, LINE 3: MIDWEST MEDICAL CENTER FORMED THREE FOCUS GROUPS COMPRISED OF AREA HEALTHCARE PROFESSIONALS/PARTNERS, LOCAL OFFICIALS, COMMUNITY LEADERS, AND COMMUNITY OFFICIALS. EACH FOCUS GROUP SESSION RESULTED IN A LIST OF PRIORITIZED HEALTH NEEDS AND ISSUES.	MIDWEST MEDICAL CENTER
PART V, SECTION B, LINE 7: THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY MIDWEST MEDICAL CENTER; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. THE ITEMS THAT WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA. ONE NEED THAT WAS IDENTIFIED BUT IS NOT BEING ADDRESSED INCLUDES IMPROVING ACCESS TO OUT OF AREA NON-EMERGENCY TRANSPORTATION. THIS NEED IS NOT CURRENTLY BEING ADDRESSED AS IT LIES BEYOND THE TRADITIONAL SCOPE OF CARE PROVIDED BY MIDWEST MEDICAL CENTER AND ITS MEDICAL STAFF.	MIDWEST MEDICAL CENTER
PART V, SECTION B, LINE 14G: THE POLICY IS OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARDS TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE.	MIDWEST MEDICAL CENTER
PART V, SECTION B, LINE 18E: PATIENTS ARE GIVEN THE OPPORTUNITY TO APPLY FOR CHARITY CARE PRIOR TO ANY COLLECTION PRACTICES NOTED EARLIER UNDER POLICIES OF MIDWEST MEDICAL CENTER. THE POLICY AND APPLICATION ARE OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARDS TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE.	MIDWEST MEDICAL CENTER
PART V, SECTION B, LINE 20D: THE HOSPITAL FOLLOWS ITS NORMAL PROCEDURES FOR COLLECTIONS OF THESE ACCOUNTS, INCLUDING DISCOUNTS BASED ON INCOME/ASSET LEVELS AND CATASTROPHIC CHARITY DISCOUNTS. PATIENT ACCOUNT GUARANTORS WITH INSUFFICIENT ASSETS TO PAY THE AMOUNT DUE, AND WHO DO NOT QUALIFY FOR CHARITY CARE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES, WILL BE ELIGIBLE FOR A CATASTROPHIC CHARITY ADJUSTMENT WHEN THE TOTAL AMOUNT DUE TO MIDWEST MEDICAL CENTER EQUALS AT LEAST 20% OF THE DEBTOR'S ADJUSTED GROSS INCOME. CATASTROPHIC CHARITY IS AN EIGHTY PERCENT (80%) ADJUSTMENT OFF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES. IN ADDITION, THE MEDICAL CENTER PROVIDES ADDITIONAL DISCOUNTS TO UNINSURED HOSPITAL PATIENTS UNDER THE HOSPITAL UNINSURED PATIENT DISCOUNT ACT AS REQUIRED BY ILLINOIS STATE LAW.	MIDWEST MEDICAL CENTER
PART VI, LINE 2: MIDWEST MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH MIDWEST MEDICAL CENTER'S MISSION IN THE COMMUNITY. MIDWEST MEDICAL CENTER ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND IT'S PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. DURING FISCAL YEAR 2013, MIDWEST MEDICAL CENTER COMPLETED A FORMALIZED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY.
PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH THE ORGANIZATION'S BUSINESS OFFICE EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. A HOSPITAL REPRESENTATIVE WILL EXPLAIN THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE ILLINOIS PUBLIC AID PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE.
PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR MIDWEST MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE HOSPITAL.
PART VI, LINE 5: MIDWEST MEDICAL CENTER IS AN INDEPENDENT COMMUNITY HOSPITAL GOVERNED BY A 10-MEMBER BOARD OF DIRECTORS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. SEE ADDITIONAL INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTH IN PART III, LINE 4A OF THE FORM 990.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	NOTES RECEIVABLE FOR SCHOLARSHIPS FORGIVEN	TypeOfGrant
Amount Of Non Cash Assistance	7763	AmountOfNonCashAssistance
Method Of Valuation	CURRENT NOTE RECEIVABLE BALANCE	MethodOfValuation
Description Of Non Cash Assistance	FORGIVENESS OF NOTES RECEIVABLE IS GOVERNED BY THE HOSPITAL'S MEDICAL EDUCATION SCHOLARSHIP PROGRAM AND FORGIVENESS IS GRANTED IF INDIVIDUALS FULFILL FUTURE SERVICE REQUIREMENTS WITH MIDWEST MEDICAL CENTER IN HEALTH PROFESSIONAL RELATED FIELDS. THE HOSPITAL TRACKS THIS INFORMATION ANNUALLY AND AWARDS THE FORGIVENESS BASED ON THE COMPLETION OF THE REQUIRED CRITERIA OF THE PROGRAM.	DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: MIDWEST MEDICAL CENTER TRACKS THE GRANTS PROVIDED THROUGH THE USE OF NOTES RECEIVABLE AS THE SCHOLARSHIP PROGRAMS ARE INTENDED TO SUPPLEMENT AND BE A FORM OF STUDENT LOANS FOR MEMBERS OF THE COMMUNITY PURSUING ADDITIONAL EDUCATION IN HEALTH RELATED FIELDS. PRIOR TO APPROVING A NOTE TO A PERSPECTIVE STUDENT, AN APPLICATION IS REVIEWED FOR APPROVAL BY THE HOSPITAL'S CONTROLLER TO ENSURE THAT ALL BACKGROUND INFORMATION ON THE CANDIDATE WAS PROVIDED. AFTER REVIEW BY THE CONTROLLER, THIS INFORMATION IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. EACH STUDENT MUST SIGN A PROMISSORY NOTE WITH MIDWEST MEDICAL CENTER THAT THEY COMMIT TO COMPLETE THE EDUCATIONAL PROGRAM AND THAT UPON GRADUATION THEY WILL PERFORM SERVICES FOR MIDWEST MEDICAL CENTER (PENDING AN AVAILABLE POSITION IN THE HOSPITAL AT THE TIME) OR THEY WILL REPAY THE NOTE WITH INTEREST. (THE REPAYMENT TERMS ENSURE THAT THE ENDOWED AND DONATED FUNDS ARE AVAILABLE IN FUTURE YEARS TO OTHER MEMBERS OF THE COMMUNITY OR THAT SERVICES ARE RETURNED TO THE COMMUNITY THROUGH SERVICE TO THE MEDICAL CENTER.) SERVICES PERFORMED AT MIDWEST MEDICAL CENTER RESULT IN FORGIVENESS OF NOTES RECEIVABLE AMOUNTS BASED ON HOURS WORKED.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Substantiation Required	1	SubstantiationRequired
Written Employment Contract	X	WrittenEmploymentContract
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TRACY BAUER
CEO	155411	0	0	0	0	0	6518	0	28359	0	190288	0	0	0
MICHAEL WELLS MD
PHYSICIAN	161678	0	0	0	0	0	5110	0	28359	0	195147	0	0	0
ELIZABETH GULLONE MD
PHYSICIAN	163999	0	0	0	0	0	6757	0	20019	0	190775	0	0	0
MATTHEW GULLONE MD
PHYSICIAN	172121	0	0	0	0	0	6698	0	11998	0	190817	0	0	0
DEBBIE CIHAK MD
PHYSICIAN	278511	0	0	0	0	0	4954	0	21812	0	305277	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	ILLINOIS FINANCE AUTHORITY	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	861091967	IssuerEIN
CUSIP Number	45200BJ66	CUSIPNumber
Date Issued	2006-10-01	DateIssued
Issue Price	45485000	IssuePrice
Description Of Purpose	CONSTRUCTION OF NEW HOSPITAL FACILITY	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Amount Retired	350000	AmountRetired
Total Proceeds	45485000	TotalProceeds
Amount In Reserve Fund	3420238	AmountInReserveFund
Issuance Costs From Proceeds	909700	IssuanceCostsFromProceeds
Capital Expenditures	41155062	CapitalExpenditures
Year Of Subst Completion	2007	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	0	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	0	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiled
Rebate Not Due Yet	1	RebateNotDueYet
Exception To Rebate	0	ExceptionToRebate
No Rebate Due	0	NoRebateDue
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	0	ProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Loan Table LoanTable

Field	Value	IRS element (for citing)
Name Person	TRACY BAUER	NamePerson
Relationship With Organization	CEO	RelationshipWithOrganization
Purpose Of Loan	EDUCATION LOAN	PurposeOfLoan
Loan From Organization	X	LoanFromOrganization
Original Principal	$25,937	OriginalPrincipalAmount
Balance Due	24441	BalanceDue
Default	0	Default
Approved By Board	1	ApprovedByBoard
Written Agreement	1	WrittenAgreement

Field	Value	IRS element (for citing)
Total Balance Due	24441	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
PAMELA SMITH
FAMILY MEMBER OF TRACY BAUER, CEO	33614	EMPLOYMENT COMPENSATION	0
PATRICIA BAUER
FAMILY MEMBER OF TRACY BAUER, CEO	20604	EMPLOYMENT COMPENSATION	0
CONNIE TRAVIS
FAMILY MEMBER OF TRACY BAUER, CEO	16592	EMPLOYMENT COMPENSATION	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 7B	THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER PREVIOUSLY ISSUED TAX-EXEMPT BONDS THROUGH THE ILLINOIS FINANCE AUTHORITY TO FINANCE THE CONSTRUCTION OF A REPLACEMENT HOSPITAL. UNDER THE TERMS OF THE BOND AGREEMENTS, THE ORGANIZATION IS LIMITED AS TO ISSUING NEW DEBT, PURCHASING SIGNIFICANT CAPITAL ASSETS, DISPOSING OF SIGNIFICANT ASSETS, AND/OR SETTING UP NEW CORPORATIONS OR SUBSTANTIALLY RESTRUCTURING THE CURRENT ORGANIZATION WITHOUT FIRST OBTAINING APPROVAL OF THE BOND TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11	THE BOARD OF DIRECTORS RECEIVED A COPY OF THE FINAL 990 FOR REVIEW AND APPROVAL THROUGH POSTING TO AN ELECTRONIC SECURE WEBSITE BY MANAGEMENT OF MIDWEST MEDICAL CENTER PRIOR TO ITS SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	SINCE MIDWEST MEDICAL CENTER IS PART OF A SMALL COMMUNITY, CONFLICTS OF INTEREST ARE GENERALLY KNOWN. THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUAL DISCLOSURE STATEMENTS. THESE ARE KEPT ON FILE AT THE HOSPITAL AND ALL MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING MANAGEMENT WHICH ATTEND MEETINGS, ARE TOLD OF THE CONFLICTS. ANY MEMBERS WITH KNOWN CONFLICTS ABSTAIN FROM VOTING ON THESE CONFLICTS DURING MEETINGS AND ENGAGE IN ONLY LIMITED DISCUSSIONS ON THESE TOPICS. THE BOARD AND MANAGEMENT HOLD EACH OTHER ACCOUNTABLE THROUGH OBSERVATION AND ENFORCEMENT OF THE POLICY DURING MEETINGS AND AT ORGANIZATION FUNCTIONS.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS REVIEWS EVALUATIONS FOR THESE INDIVIDUALS, COMPARES DATA TO COMPETITIVE MARKET DATA OBTAINED FROM SALARY SURVEYS, AND CONSULTS WITH OUTSIDE ORGANIZATIONS AS NEEDED IN REVIEWING CONTRACTS. LEGAL AND OUTSIDE VALUATION SERVICES ARE OBTAINED IN ENSURING THE KEY EMPLOYEES, EXECUTIVES, AND PHYSICIANS SALARIES ARE IN LINE WITH REASONABLE AND PRUDENT BUYER CONCEPTS AS WELL.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION A	THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER ALSO SERVES AS THE BOARD OF DIRECTORS FOR THE MIDWEST REGIONAL HEALTH SYSTEM. NO ADDITIONAL HOURS OF SERVICE ARE DEDICATED TO THE BOARD POSITIONS ON THE MIDWEST REGIONAL HEALTH SYSTEM. THE MIDWEST REGIONAL HEALTH SYSTEM WAS ORGANIZED TO SERVE AS A SUPPORTING ORGANIZATION FOR MIDWEST MEDICAL CENTER AND MIDWEST REGIONAL HEALTH FOUNDATION. ADDITIONALLY, SOME OFFICERS AND BOARD MEMBERS ALSO SERVE AS BOARD MEMBERS OF MIDWEST REGIONAL HEALTH FOUNDATION. THE HOURS OF SERVICE PROVIDED TO THIS ORGANIZATION IS REFLECTED ON LINE 2 OF COLUMN B.	EXPLANATION OF HOURS WORKED
FORM 990, PART XI, LINE 2C:	THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR SELECTION OF AN INDEPENDENT ACCOUNTANT, AND THE CEO OVERSEES THE AUDIT PROCESS. THE BOARD CHAIR TAKES TIME ANNUALLY TO MEET PRIVATELY WITH THE INDEPENDENT ACCOUNTANT WITHOUT MANAGEMENT PRESENT AND THE ENTIRE BOARD IS ALSO GIVEN THIS OPPORTUNITY DURING THE IN PERSON PRESENTATION OF THE AUDIT RESULTS BY THE INDEPENDENT ACCOUNTANT. NO CHANGES IN THE OVERSIGHT OR SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE OCCURRED IN THE PAST YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
MIDWEST REGIONAL HEALTH FOUNDATION
ONE MEDICAL CENTER DRIVE	GALENA	IL	61036	204560639	FUNDRAISING	IL	501(C)3	11 TYPE I	MIDWEST REGIONAL HEALTH SYSTEM	0
MIDWEST REGIONAL HEALTH SYSTEM
ONE MEDICAL CENTER DRIVE	GALENA	IL	61036	204560381	SUPPORTING ORGANIZATION	IL	501(C)3	11 TYPE III-FI		0	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg