2013-08-19T09:41:03-05:00 2012-09-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2011-10-01 370813229 OSF Healthcare System % MR DANIEL BAKER OSFH 3096552850 800 NE GLEN OAK AVENUE PEORIA IL 616033200 Daniel E Baker 3096552850 2013-08-14 KPMG LLP 6142492300 2011 2016-02-24 21:20:13Z Daniel E Baker 800 NE Glen Oak Avenue Peoria IL 61603 1877671105 false 0928 X www.osfhealthcare.org X 1880 IL OSF Healthcare System is a Catholic Integrated health care delivery system. During FY2012 osf operated 7 hospitals, 1 nursing home, 5 home health agencies, 4 hospices and employeed approximately 590 physicians 11 6 14993 1793 6000284 20962768 53637086 1679394636 1752743785 35856767 36513922 28146582 32275538 1764360753 1875170331 2211639 1895004 0 0 791991821 919657664 100336 0 4826047 857681591 796169733 1651985387 1717722401 112375366 157447930 2267817172 2418704402 1515029132 1693780438 752788040 724923964 X OSF HEALTHCARE SYSTEM IS A CATHOLIC INTEGRATED HEALTH CARE DELIVERY SYSTEM WHICH DURING ITS FISCAL YEAR 2012 OPERATED 7 HOSPITALS, 1 NURSING HOME until 2/1/13, 5 HOME HEALTH AGENCIES, 4 HOSPICES, AND EMPLOYED approximately 590 PHYSICIANS. ALL PATIENTS ARE ACCEPTED REGARDLESS OF THEIR ABILITY TO PAY. ALL FACILITIES, SERVICES, PHYSICIANS AND OTHER PROFESSIONAL STAFF OF OSF HEALTHCARE SYSTEM SERVE ALL PATIENTS WITHOUT REGARD TO RACE, RELIGION, AGE, SEX, NATIONAL ORIGIN, PAYER SOURCE OR ABILITY TO PAY. THE BOARD OF DIRECTORS HAS ADOPTED CHARITY CARE POLICIES AND PROCEDURES WHICH APPLY FOR ALL FACILITIES AND SERVICES OF THE CORPORATION. THE AVAILABILITY OF CHARITY CARE IS COMMUNICATED TO PATIENTS IN NUMEROUS WAYS, INCLUDING USE OF FINANCIAL COUNSELORS, PATIENT INFORMATION BROCHURES, AND NOTICES ON PATIENT BILLINGS. CHARITY CARE APPLICATIONS AND INSTRUCTIONS ARE AVAILABLE ON WEBSITES MAINTAINED BY THE CORPORATION AND UPON A REQUEST MADE TO ANY OF THE CORPORATION'S FACILITIES OR OFFICES. OSF false false 597321092 1800066 858564414 Inpatient services - SEE Schedule O 468492064 670837699 Outpatient Services - SEE Schedule O 240763556 88570927 Physician Services - SEE Schedule O 217340558 94938 163793268 1523917270 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true true true true true false false false false false false false false false false false false false true true true true false false true 700 0 true 14993 true true true false false false false false false false false false X 11 6 false false true false true true true true true true false true true true true true true true true true true IL X MR DANIEL BAKER 3096553638 800 NE GLEN OAK AVE PEORIA IL 61603 X GERALD J MCSHANE MD 40.0 X 523501 0 49298 JAMES W GIRARDY MD 3.0 X 26566 0 0 KEVIN D SCHOEPLEIN 40.0 X X 1014672 0 561494 SISTER AGNES JOSEPH WILLIAMS OSF 40.0 X X 0 4480 0 SISTER DIANE MARIE MCGREW OSF 40.0 X X 0 4480 0 SISTER JUDITH ANN DUVALL OSF 40.0 X X 0 4480 0 SISTER MARIA ELENA PADILLA OSF 40.0 X 0 0 0 SISTER ROSE THERESE MANN OSF 40.0 X 0 0 0 SISTER THERESA ANN BRAZEAU OSF 40.0 X X 0 4480 0 SUSAN CAMPBELL 40.0 X 286751 0 48635 VANCE C PARKHURST 40.0 X 357489 0 49710 DANIEL EBAKER 40.0 X 538332 0 222122 DANIEL R FASSETT MD 40.0 X 1551442 0 24043 FINN REIDER AMBLEMD 40.0 X 1040622 0 42216 JEFFREY D KLOPFENSTEIN MD 40.0 X 1339347 0 34680 SYED M HUSSAIN MD 40.0 X 1033643 0 37443 TRAVIS D RICHARDSON MD 40.0 X 1137689 0 24616 JAMES MOORE 0.1 X 1385662 0 0 10235716 17920 1094257 883 true true false UNIV OF IL COLLEGE OF MEDICINE PO BOX 4196 SPRINGFIELD IL 627084196 TEACHING PHYSICIANS 18817065 HINSHAW CULBERTSON LLP 8142 Solutions Center Dr CHICAGO IL 606778001 LEGAL 6802321 ASSOC ANESTHESIOLOGISTS SC 8600 N STATE RT 91 SUITE 250 PEORIA IL 616159452 Anesthesiology Svs 2777291 ROCKFORD ANESTHESIOLOGISTS ASSOC 2202 HARLEM RD STE 200 LOVES PARK IL 611112754 Anesthesiology Svs 1704850 CENTRAL IL PATHOLOGY SC PO BOX 9190 PEORIA IL 616129190 PATHOLOGY SERVICES 1349461 58 15571298 19604379 18461409 53637086 NET PATIENT SERVICE REVENUE 900099 1747157470 1747157470 LAB 621500 3915931 3915931 COLLECTION FEE 900099 4400 4400 AFFILIATED PURCHASING PROGRAM 561499 1575411 1575411 INTEREST 900099 41758 41758 48815 48815 1752743785 36453794 36453794 0 0 2365146 2500774 -135628 -135628 -135628 60128 60128 60128 60128 0 0 0 TUITION 900099 10211097 10211097 INCOME FROM JOINT VENTURES 900099 6120796 6120796 PHYSICIANS/RNS/STAFF CONTRACT SERVICES 900099 4391610 4391610 11687663 8299020 413969 2974674 32411166 1875170331 1776179993 6000284 39352968 1800066 1800066 94938 94938 0 0 3081090 3081090 0 711279464 649679710 60023732 1576022 52664123 46567799 6096324 104032672 96782784 7249888 48600315 44172500 4427815 0 3999961 2228259 1771702 535918 338200 197718 0 0 0 65903969 58331905 7571614 450 7225005 6870895 258406 95704 9840338 8811297 996188 32853 18497359 2623786 15873573 0 15321161 14639052 674629 7480 5743556 4524526 1199186 19844 0 2688391 1892853 776826 18712 42616001 247762 42368239 -63180731 -55412970 -7768111 350 76191295 62380358 13810937 20946488 20873918 72570 SUPPLIES 264392742 263653241 354789 384712 EQUIP RENTAL & MAINT 149390282 137226797 11787399 376086 BAD DEBT 82075923 82075923 MEDICAID FEES 34493208 34493208 59488867 39020463 18154570 2313834 1717722401 1523917270 188979084 4826047 X 1478645 1317714 159709 1222 0 0 105037151 88078588 7224184 9660264 332073347 437391995 0 0 0 0 0 0 19336204 20605960 6570936 6604229 1911724814 1089388655 812776075 822336159 627988373 687533607 0 0 39575545 35193736 6631798 6631798 310603559 304668066 2267817172 2418704402 137154631 150349952 0 0 0 0 832282449 845650526 0 0 0 0 0 0 0 0 545592052 697779960 1515029132 1693780438 X 693251306 683656289 47706091 28093608 11830643 13174067 752788040 724923964 2267817172 2418704402 X 157447930 -185312006 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false true false false true 601764 false false 601764 false false Mailing Expenses Part II-B, Line 1d The only cost of mailing related to lobbying expenses related to the cost of stamps. The total expenditures related to mailing is minor and the actual dollar amount is not readily available. Legislative Contacts Part II-B, Line 1g Schedule C, Part II-B, Line 1g includes lobbying expenses paid to various national health associations as part of dues and subscriptions in the amount of $161,764. It also includes direct contact with legislators, their staffs, government officials, and legislative bodies relating to physician payment reform, medicare rural extenders, hospital and home care protection, SGR issue resolution, and maintaining hospital reimbursement rates. This amounted to $440,000. 17139873 2735884 3093976 -71508 -33103 22865122 7390433 10371045 -557661 -63944 17139873 5655845 1551108 526674 -343194 7390433 2718442 2914621 32954 -10172 5655845 0.61580 0.35110 0.03310 false false 16688385 16688385 994939468 425668581 569270887 8164832 6602864 1561968 831058499 638915091 192143408 60873630 18202119 42671511 822336159 BOND INSURANCE FEES 7799280 WORKERS' COMP ESCROW DEPOSITS 5275012 THIRD PARTY WITHHOLDINGS 13637676 DUE FROM FOUNDATION 7372345 ASSETS - LIMITED OR RESTRICTED 41267674 FUNDS LIMITED AS TO USE 202836091 OTHER ACCOUNTS 26479988 304668066 0 ESTIMATED SELF INSURANCE LIABI 138324651 RETIRE OBLIG - ASBESTOS 2959600 ACCRUED PENSION LIABILITY 414264000 MARKET VALUATION OF SWAP 56932780 THIRD PARTY SETTLEMENT PAYABLE 82668563 DEFERRED COMPENSATION 2630366 697779960 SUPPLEMENTAL INFORMATION OSF adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an interpretation of FASB statment No. 109. The interpretation addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, OSF must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of September 30, 2011 and 2012, OSF does not have a liablity for unrecognized tax benefits. Part V, Line 4 The organization's endowment funds are used to provide scholarships to nursing students, acquire equipment and support programs of various medical departments of the OSF Healthcare System hospitals. true true X true X true X 600. true true true false true true 77457258 77457258 0.04740 257400636 221639700 35760936 0.02190 334857894 221639700 113218194 0.06930 1288193 117289 1170904 0.00070 54576370 21793030 32783340 0.02000 33807326 16124886 17682440 0.01080 1389616 128248 1261368 0.00080 1723692 1723692 0.00110 92785197 38163453 54621744 0.03340 427643091 259803153 167839938 0.10270 23621 23621 23621 23621 true 25002874 449317154 537565329 -88248175 X true true NONE 7 1 Saint Francis Medical Center

530 NE Glen Oak Avenue Peoria IL 61637

X X X X X X 2 St Anthony Medical Center

5666 East State Street Rockford IL 61108

X X X X X 3 St Joseph Medical Center

2200 East Washington Street Bloomington IL 61701

X X X 4 St Mary Medical Center

3333 North Seminary Street Galesburg IL 61401

X X X 5 St Francis Hospital

3401 Ludington Street Escanaba MI 49829

X X X 6 SAINT JAMES HOSPITAL

2500 W REYNOLDS STREET PONTIAC IL 61764

X X X 7 OSF HOLY FAMILY MEDICAL CENTER

1000 W HARLEM AVENUE MONMOUTH IL 61462

X X X Saint Francis Medical Center 1 true true 200. true 600. true X X X X X X true true X true false X X X X X true X true true St Anthony Medical Center 2 true true 200. true 600. true X X X X X true true X true false X X X X X true X true true St Joseph Medical Center 3 true true 200. true 600. true X X X X X X true true X true false X X X X X true X true true St Mary Medical Center 4 true true 200. true 350. true X X X X X X true true X true false X X X X X true X true true St Francis Hospital 5 true true 200. true 350. true X true true X true false X X X true X true true SAINT JAMES HOSPITAL 6 true true 200. true 350. true X X X X X X true true X true false X X X X X true X true true OSF HOLY FAMILY MEDICAL CENTER 7 true true 200. true 350. true X X X X X X true true X true false X X X X X true X true true 39 Glen Avenue Diagnostic Center

4911 Executive Drive Main Level S Peoria IL 61614

Maternal Fetal Diagnostics Outpatient Rehabilitation

Randolph Building Suite 100 NERan Peoria IL 61606

Rehab Outpatient Audiology

Randolph Building Suite 100 NERan Peoria IL 61606

Audiology PM&R Associates

Randolph Building Suite 100 NERan Peoria IL 61606

Rehab Center for Industrial Rehab

506 High Point Lane East Peoria IL 61611

Rehab Out Patient Rehabilitation

Pennsylvania Medical Building 200 E Peoria IL 61603

Rehab Pekin Cancer Treatment Center

603 Thirteenth Street Pekin IL 61554

EKG, Echo cardiology, Nuclear stress test, Vascular ultrasound, Treadmill stress T ObstetricsGynecology Clinic

320 E Armstrong Peoria IL 61603

OB/GYNE Services Internal Medicine

320 E Armstrong Peoria IL 61603

Ambulatory Internal Medicine Pediatric Ambulatory Clinic

320 E Armstrong Peoria IL 61603

Ambulatory Pediatric Medicine Saint Clare Family Health Center

10 Saint Clare Court Washington IL 61571

Lab, EKG, Radiology OSF Center for Health

8600-8800 Rt 91 North North Peoria IL 61615

Diagnostic Imaging/Lab/Voice & Swallowing Services OSF Saint Francis Riverplex

600 N E Water Street Peoria IL 61602

Rehab OSF Saint Francis Heart Hospital

5405 N Knoxville Avenue Peoria IL 61614

Nuclear Med, CT Scan, Vascular ultrasound, Echo cardiology, Chest X-Ray, Stress test OSF Heart Hospital Diagnostic Center

610 Park Avenue Pekin IL 615544650

EKG, Nuclear stress test, Vascular ultrasound, Echo cardiology, Chest X-Ray,Stress OSF SF Radiation Oncology

8948 N Wood Sage Road Peoria IL 61615

Radiation oncology OSF Saint Francis Morton Health Center

435 Maxine Dr Morton IL 61550

Radiology, Lab, EEG, EKG, Sleep lab Saint Francis Medical INI Rehabilitation

Five Points Washington 360 Wilmor R Washington IL 615711252

Rehab OSF Saint Francis Center for Health Glen

5114 Glen Park Place Peoria IL 616144686

Diagnostic Imaging/Lab Southridge Laboratory

4423 Manchester Drive Rockford IL 61109

Diagnostic Lab Outpatient Rehabilitation Services

5510 E State Street Rockford IL 61108

Rehab Diabetes Education Center

5510 E State Street Rockford IL 61108

Education Wound Healing Center State and Roxbury

5668 E State Street Rockford IL 61108

Hyperbaric Oxygen Therapy Rockford Cardiovascular Associates

444 Roxbury Road Rockford IL 61107

Cardiac and Pulmonary Rehab / Radiology and Diagnostic Services / Sleep Center OSF Center for Health-Rock Cut Crossing

9951 Rock Cut Crossing Loves Park IL 611111999

Diagnostic Imaging/Lab Illinois Neurological Institute at OSF

535 Roxbury Road Rockford IL 61108

No procedures are done at this location at this time OSF St Francis Hospital and Medical Gro

N 15995 Main St Powers MI 49870

Diagnostic Lab St Francis Hospital- Powers Clinic

N 15995 Main St Powers MI 49870

Diagnostic X-Ray OSF St Francis Hospital Medical Group

128 Michigan Gladstone MI 49837

Diagnostic X-Ray/Lab OSF St Francis Hospital Medical Group

3409 Ludington St Escanaba MI 49829

Diagnostic X-Ray/Lab St Francis Hospital- Rehab Services

704 Superior Avenue Gladstone MI 49837

Rehab OSF Saint James Rehabilitation

106 South First Street Fairbury IL 61739

Rehab OSF Saint James Rehabilitation

105 John Street Dwight IL 60420

Rehab Center for Health at Ft Jesse

2200 Ft Jesse Road Normal IL 61761

Physical Therapy; Occupational Therapy; Audiology; Industrial Rehab; Pain Clinic; Wound Care OSF St Joseph Medical Center-College Av

1701 East College Avenue Bloomington IL 61704

Diagnostic Imaging OSF St Joseph Medical Center - Rehabili

1701 East College Avenue Bloomington IL 61704

Rehab Eastland Medical Plaza I

1505 Eastland Avenue Bloomington IL 61704

Rehab OSF Holy Family Clinic

1000 West Harlem Ave Monmouth IL 61462

cardiology, general, neru, pediatric, podiatry sleep center Outpatient Medical Imaging

3375 North Seminary St Galesburg IL 61401

mammo, ultrasound, bone density, limited x-ray PART I, LINE 3C: THE CORPORATION PROVIDES FREE CARE AND DISCOUNTED CARE TO HOSPITAL PATIENTS AND ALL OTHER PATIENTS IN THE FOLLOWING WAYS: - FREE CHARITY CARE FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 200% OF FEDERAL POVERTY GUIDELINES (FPG) FOR THEIR FAMILY SIZE. - DISCOUNTED CHARITY CARE ON A SLIDING SCALE FOR PATIENTS WHOSE FAMILY INCOME IS BETWEEN 200% AND 600% OF FPG FOR THEIR FAMILY SIZE. - CATASTROPHIC CHARITY CARE REGARDLESS OF INCOME OR ASSET LEVELS FOR MEDICALLY NECESSARY SERVICES WHICH EXCEED 25% OF ANNUAL FAMILY INCOME. NO PATIENT PAYS MORE THAN 25% OF ANNUAL FAMILY INCOME IN A 12-MONTH PERIOD REGARDLESS OF INCOME OR ASSET LEVELS. - 20% DISCOUNT FOR ALL UNINSURED PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FREE, DISCOUNTED, OR CATASTROPHIC CHARITY CARE. - ALL PATIENTS RECEIVE THE GREATEST DISCOUNT AVAILABLE UNDER ANY OF THESE PROGRAMS. NO ASSET TESTS ARE USED. - EXCEPT AS OTHERWISE NOTED, THESE POLICIES APPLY BOTH TO UNINSURED PATIENTS AND TO INSURED PATIENTS WITH RESPECT TO THE PATIENT RESPONSIBILITY AMOUNT. PART I, LINE 7: COSTS REPORTED ON LINES 7 a, b, and c ARE CALCULATED USING THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2. COSTS REPORTED ON LINES 7 e,f,g,h, and i ARE COSTS DERIVED FROM GENERAL LEDGER ACCOUNTS AND HOSPITAL DEPARTMENT COST CENTER REPORTS WHICH INCLUDE BOTH DIRECT AND INDIRECT COSTS LESS REVENUE. LINE 7g REPRESENTS ALL PAYERS EXCLUDING MEDICARE, MEDCAID AND SELF-PAY. PART I, LINE 7G: NET COSTS (TOTAL EXPENSE LESS REVENUE) OF THIRTEEN PHYSICIAN CLINICS ARE INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7g. SUCH NET COSTS TOTAL $5,666,600. PART I, LINE 7, COLUMN F: BAD DEBT EXPENSE IN THE AMOUNT OF $82,075,923 IS INCLUDED ON FORM 990, PART IX, LINE 24c, COLUMN (A), BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN SCHEDULE H, PART I, LINE 7, COLUMN (F). PART III, LINE 4: IN GENERAL, AND IN ACCORDANCE WITH MEDICARE REGULATIONS, PATIENT ACCOUNT BALANCES ARE WRITTEN OFF TO BAD DEBT EXPENSE AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY OR LAW FIRM. Patients' accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectibility of patients' accounts receivable, OSF analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, OSF analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with patient responsibility(which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the patients are screened against the OSF charity care policy and uninsured discount policy. For any remaining patient responsibility balance, OSF records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates(or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Bad debt expense of $82,075,923 on Form 990, Part IX, Line 24c is based upon accrual accounting required by generally accepted accounting principles. This amount consequently differs from the bad debt expense of $25,002,874 on Schedule H, Part III, Line 2 which requires the organization to report aggregate bad debt at cost. BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS therefore CALCULATED BY MULTIPLYING GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE TIMES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2. DISCOUNTS, INCLUDING ANY APPLICABLE THIRD PARTY PAYER CONTRACTUAL ALLOWANCES AND ANY CHARITY CARE DISCOUNTS (VALUED AT GROSS CHARGES), ARE APPLIED TO PATIENT ACCOUNT GROSS CHARGES TO DETERMINE THE ACCOUNT BALANCE BEFORE PATIENT PAYMENTS. THE AGGREGATE AMOUNT OF ALL PATIENT PAYMENTS IS THEN APPLIED TO THE ACCOUNT BALANCE. WHEN DETERMINATION IS MADE THAT NO FURTHER AMOUNTS CAN BE COLLECTED IN ACCORDANCE WITH THE CORPORATION'S BAD DEBT POLICY, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. THE CORPORATION UTILIZES A PRESUMPTIVE CHARITY PROCEDURE FOR ALL PATIENTS WHO FAIL TO PROVIDE FINANCIAL INFORMATION NORMALLY CONSIDERED IN MAKING CHARITY ELIGIBILITY DETERMINATIONS BUT FOR WHOM THE CORPORATION IS ABLE TO OBTAIN COMPARABLE INFORMATION FROM INDEPENDENT SOURCES, INCLUDING CONTRACT SERVICE PROVIDERS WHO COMPILE CREDIT BUREAU AND OTHER INFORMATION. WHEN SUCH INDEPENDENT VERIFICATION OF A PATIENT'S FINANCIAL INFORMATION IS OBTAINED, THE CORPORATION APPLIES THE SAME CHARITY DISCOUNT IT WOULD HAVE PROVIDED IF THE PATIENT HAD COMPLETED A CHARITY APPLICATION AND SUBMITTED SUCH FINANCIAL INFORMATION. SUCH PRESUMPTIVE CHARITY DETERMINATIONS MAY BE MADE AT ANY TIME THE NECESSARY FINANCIAL INFORMATION BECOMES AVAILABLE TO THE CORPORATION, AND PATIENTS ARE NOTIFIED IN WRITING OF THE CHARITY DISCOUNT AMOUNTS SO DETERMINED AND APPLIED. THEREFORE, THE CORPORATION DOES NOT BELIEVE THAT BAD DEBT EXPENSE REPORTED ON PART III, LINE 3 INCLUDES ANY AMOUNTS THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY UNDER THE CORPORATION'S CHARITY CARE POLICY. PART III, LINE 8: 100% OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. OSF IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY MULTIPLYING MEDICARE CHARGES BY THE PATIENT CARE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UNREIMBURSED COSTS TO THE HEALTH SYSTEM FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY. PART III, LINE 9B THE CORPORATION HAS A FAIR BILLING/COLLECTION POLICY WHICH APPLIES FOR ALL PATIENTS. THE POLICY INCLUDES: - REQUIRED INFORMATION PROVIDED IN BILLS TO PATIENTS (INCLUDING A REQUIREMENT THAT INFORMATION BE PROVIDED ON HOW THE PATIENT MAY APPLY FOR CHARITY CARE). - PROCESS FOR PATIENTS TO INQUIRE ABOUT OR DISPUTE A BILL, INCLUDING TOLL-FREE TELEPHONE NUMBER, ADDRESS, CONTACT NAME, AND E-MAIL ADDRESS. - REQUIREMENTS FOR TIMELY RESPONSE TO PATIENT INQUIRIES. - CONDITIONS WHICH MUST BE SATISFIED AND VERIFIED BY AN AUTHORIZED HOSPITAL REPRESENTATIVE BEFORE THE ACCOUNT OF AN UNINSURED PATIENT MAY BE SENT TO A COLLECTION AGENCY OR ATTORNEY. - THE CORPORATION'S HOSPITALS ARE REQUIRED TO OFFER A REASONABLE PAYMENT PLAN (BASED ON STATE WAGE GARNISHMENT LIMITS) TO UNINSURED PATIENTS. - LEGAL ACTION FOR NON-PAYMENT OF A PATIENT BILL MAY NOT BE INITIATED UNTIL AN AUTHORIZED HOSPITAL OFFICIAL HAS DETERMINED THAT ALL CONDITIONS IN THE CORPORATION'S POLICY (INCLUDING ALL OF THE FOREGOING POLICY PROVISIONS) HAVE BEEN SATISFIED FOR INITIATING LEGAL ACTION. - LEGAL ACTION MAY NOT BE PURSUED AGAINST UNINSURED PATIENTS WHO HAVE DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS - EVEN IF SUCH PATIENTS ARE NOT ELIGIBLE FOR CHARITY CARE ASSISTANCE. - THE CORPORATION SHALL NOT FILE A JUDGMENT LIEN AGAINST THE PRIMARY RESIDENCE OF ANY DEBTOR (EXCEPTIONS MAY BE APPROVED IN RARE CASES BY SENIOR OFFICERS OF THE CORPORATION ONLY). - THE CORPORATION SHALL NOT OBTAIN A BODY ATTACHMENT AGAINST ANY PATIENT OR GUARANTOR. - THE CORPORATION SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS, SUCH AS SUBMITTING REPORTS TO CREDIT AGENCIES BEFORE REASONABLE ATTEMPTS TO DETERMINE ELIGIBILITY FOR CHARITY CARE ASSISTANCE HAVE BEEN COMPLETED. Explained the basis for calculating amounts charged to patients: Part V - LINE 11H Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: Please refer to the response to Schedule H, Part I, Line 3C for a description of how the above mentioned facilities explained the basis for calculating amounts charged to patients. Actions the hospital facility took before involving a collections agency Part V, Line 17E Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: Please refer to the response to Schedule H, Part III, Line 9B for a description of actions the above mentioned facilities took before initiating any of the collection actions checked in Schedule H, Part V, line 16. amounts billed to uninsured or underinsured individuals: part v, line 19d Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: THE HOSPITAL DETERMINED THE AMOUNTS BILLED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE FOLLOWING WAYS. THE AMOUNT BILLED TO THE INDIVIDUAL WAS THE LOWEST AMOUNT DETERMINED UNDER ANY OF THE FOLLOWING METHODS WHICH APPLY TO THE INDIVIDUAL: - FOR ILLINOIS RESIDENTS WHO INCUR GROSS CHARGES IN EXCESS OF $300 FOR ANY ONE INPATIENT ADMISSION OR OUTPATIENT ENCOUNTER, WHO APPLY FOR FINANCIAL ASSISTANCE, AND WHO'S FAMILY INCOME IS 600% OR LESS OF THE FEDERAL POVERTY GUIDELINE FOR THEIR FAMILY SIZE, THE AMOUNT BILLED IS CALCULATED BY MULTIPLYING GROSS CHARGES TIMES THE HOSPITAL'S COST TO CHARGE RATIO DETERMINED FROM ITS MOST RECENTLY FILED MEDICARE COST REPORT AND THEN MULTIPLYING THAT PRODUCT TIMES 135%. - THE AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY UNINSURED PATIENT WHO APPLIES AND DOES NOT OTHERWISE QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE IS LIMITED TO 80% OF GROSS CHARGES. - THE MAXIMUM AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY PATIENT WHO APPLIES FOR FINANCIAL ASSISTANCE DOES NOT EXCEED 25% OF FAMILY INCOME. -The maximum charge to any patient who qualifies for financial assistance under the hospital's charity policy will not exceed the average dollar amount which would be payable(including any patient or plan participant responsibility amount) for the same services under the terms of the three contracts in effect between the OSF facility providing medical care and private insurance companies on the first day of the fiscal year in which the patient's discharge occurs and which result in the lowest payment amounts. No insurance company contract which includes provisions for interim payments subject to later reconciliation shall be included in the calculation of the maximum charge. The amount billed to a patient eligible for charity assistance under this policy will be less than the amount of the gross charges. St. Francis Hospital: THE HOSPITAL DETERMINED THE AMOUNTS BILLED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE FOLLOWING WAYS. THE AMOUNT BILLED TO THE INDIVIDUAL WAS THE LOWEST AMOUNT DETERMINED UNDER ANY OF THE FOLLOWING METHODS WHICH APPLY TO THE INDIVIDUAL: - THE MAXIMUM AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY PATIENT WHO MEETS THE ELIGIBILITY CRITERIA OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DOES NOT EXCEED 25% OF FAMILY INCOME. DESCRIPTION AND REQUIRMENTS OF FINANCIAL ASSISTANCE POLICY ARE FOUND IN OSF HEALTHCARE SYSTEM POLICY AC-31. - THE AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY UNINSURED PATIENT WHO APPLIES BUT DOES NOT OTHERWISE QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE IS LIMITED TO 92.5% OF GROSS CHARGES. charges for medical care: part v, line 20 Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center, St. Francis Hospital: CHARGES TO PATIENTS WHO WERE ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WERE DETERMINED IN THE MANNERS DESCRIBED FOR PART I, LINE 3C AND PART V, LINE 19D ABOVE. IT IS POSSIBLE, ALTHOUGH UNUSUAL, THAT A PATIENT WHO WAS ELIGIBLE FOR FINANCIAL ASSISTANCE COULD HAVE BEEN CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE. patients charged amount equal to the gross charge for services provided: part v, line 21 Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: THE HOSPITAL CHARGED ITS PATIENTS AN AMOUNT EQUAL TO GROSS CHARGES IN THE FOLLOWING CIRCUMSTANCES: - PATIENTS RECEIVING ELECTIVE MEDICAL SERVICES OTHER THAN EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, SUCH AS ELECTIVE COSMETIC SURGERY PERFORMED TO IMPROVE ONE'S APPEARANCE AND NOT RELATED TO A TRAUMA OR DISFIGURATION. - UNINSURED PATIENTS WHO DID NOT QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE AND WHO FAILED TO REQUEST THE 20% DISCOUNT OFFERED BY THE HOSPITAL TO ALL SUCH PATIENTS WHO REQUEST THE DISCOUNT. [THE HOSPITAL'S BILLING SYSTEM IS NOT CAPABLE OF AUTOMATICALLY APPLYING THIS DISCOUNT]. - PATIENTS WHOSE MEDICAL BILLS ARE THE RESPONSIBILITY OF A THIRD PARTY PURSUANT TO A CLAIM BROUGHT BY THE PATIENT AGAINST THE THIRD PARTY, SUCH ANOTHER DRIVER IN AN AUTO ACCIDENT. St. Francis Hospital: THE HOSPITAL CHARGED ITS PATIENTS AN AMOUNT EQUAL TO GROSS CHARGES IN THE FOLLOWING CIRCUMSTANCES: - PATIENTS RECEIVING ELECTIVE MEDICAL SERVICES OTHER THAN EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, SUCH AS ELECTIVE COSMETIC SURGERY PERFORMED TO IMPROVE ONE'S APPEARANCE AND NOT RELATED TO A TRAUMA OR DISFIGURATION. - UNINSURED PATIENTS WHO DID NOT QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE AND WHO FAILED TO REQUEST THE 7.5% DISCOUNT OFFERED BY THE HOSPITAL TO ALL SUCH PATIENTS WHO REQUEST THE DISCOUNT. [THE HOSPITAL'S BILLING SYSTEM IS NOT CAPABLE OF AUTOMATICALLY APPLYING THIS DISCOUNT]. - PATIENTS WHOSE MEDICAL BILLS ARE THE RESPONSIBILITY OF A THIRD PARTY PURSUANT TO A CLAIM BROUGHT BY THE PATIENT AGAINST THE THIRD PARTY, SUCH ANOTHER DRIVER IN AN AUTO ACCIDENT. Schedule H - Part VI - 2 - Needs Assessment: The corporation commenced work during its fiscal year 2012 on conducting a community health needs assessment for each of its hospitals, as required by section 501(r)(3) of the code. That work effort continued into the corporation's fiscal year 2013. The final community health needs assessment for each of the corporation's hospitals was approved and adopted by the corporation's board of directors on July 29, 2013. Schedule H - Part VI - 3 - Patient Education of Eligibility for assistance THE CORPORATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE CORPORATION'S CHARITY ASSISTANCE POLICY IN THE FOLLOWING WAYS: - SIGNS ARE POSTED IN PATIENT REGISTRATION AREAS (INCLUDING EMERGENCY DEPARTMENT REGISTRATION) INFORMING PATIENTS OF THE AVAILABILITY OF CHARITY ASSISTANCE AND THE AVAILABILITY OF FINANCIAL ASSISTANCE REPRESENTATIVES. - PRINTED BROCHURES ARE DISTRIBUTED TO PATIENTS AT REGISTRATION INFORMING THEM OF THE AVAILABILITY OF CHARITY ASSISTANCE (FOR BOTH INSURED AND UNINSURED PATIENTS), FINANCIAL ASSISTANCE REPRESENTATIVES (INCLUDING CONTACT INFORMATION), AND UNINSURED PATIENT DISCOUNTS. - A NOTICE OF AVAILABILITY OF THE CORPORATION'S CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICIES IS PROMINENTLY AVAILABLE ON THE CORPORATION'S WEB SITE (AND SEPARATE WEB SITES OF ITS HOSPITAL FACILITIES). THE APPLICATION FORM WITH INSTRUCTIONS IS AVAILABLE FOR DOWNLOAD. - A NOTE REGARDING THE AVAILABILITY OF CHARITY AND FINANCIAL ASSISTANCE (TOGETHER WITH CONTACT PHONE NUMBERS) APPEARS ON EVERY PATIENT BILL AND STATEMENT. - FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND BY PHONE TO ASSIST PATIENTS IN COMPLETING CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS AND IN DETERMINING ELIGIBILITY AND APPLYING FOR GOVERNMENT PROGRAM BENEFITS, INCLUDING MEDICAID. - THE CORPORATION'S CHARITY CARE POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC. Schedule H - Part VI - 4 - Community Information Saint Francis Medical Center is located in Peoria County in Illinois and serves those in the counties of Peoria, Tazewell, and Woodford. Peoria County is a metropolitan statistical area and its population in 2010 was 186,494. For Peoria County, the median household income in 2010 was $49,819 and the percent of persons below poverty level was 15.4%. Tazewell County is a metropolitan statistical area and its population in 2010 was 135,394. For Tazewell County, the median household income in 2010 for was $54,078 and the percent of persons below poverty level was 8.5%. Woodford County is a metropolitan statistical area and its population in 2010 was 38,664. For Woodford County, the median household income in 2010 was $65,342 and the percent of persons below poverty level was 7.2%. Saint Anthony Medical Center is located in Winnebago County. Winnebago County is a metropolitan statistical area and its population in 2010 was 295,266. For Winnebago County, the median household income in 2010 was $45,611 and the percent of persons below poverty level was 12.7%. St. Joseph Medical Center is located in McLean County in Illinois. McLean County is a metropolitan statistical area and its population in 2010 was 169,572. For McLean County, the median household income in 2010 was $58,365 and the percent of persons below poverty level was 11%. Saint James-John W. Albrecht Medical Center is located in Livingston County in Illinois. Livingston County is a metropolitan statistical area and its population in 2010 was 38,950. For Livingston County, the median household income in 2010 was $53,745 and the percent of persons below poverty level was 11.0%. St. Mary Medical Center is located in Knox County in Illinois. Knox County is a metropolitan statistical area and its population in 2010 was 52,919. For Knox County, the median household income in 2010 was $38,535 and the percent of persons below poverty level was 15.5%. Holy Family Medical Center is located in Warren County in Illinois. Warren County is a metropolitan statistical area and its population in 2010 was 17,707. For Warren County, the median household income in 2010 was $42,773 and the percent of persons below poverty level was 13.4%. St. Francis Hospital is located in Delta County in Michigan. Delta County is a metropolitan statistical area and its population in 2010 was 37,069. For Delta County, the median household income in 2010 was $40,496 and the percent of persons below poverty level was 12.7%. COMMUNITY BUILDING ACTIVITIES: THE CORPORATION'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED IN THE FOLLOWING WAYS: - WELLNESS SCREENINGS AND FIRST AID STATIONS AT COMMUNITY EVENTS SUCH AS STATE FAIRS AND SENIORS CONVENTIONS. - CORPORATE EXECUTIVES VOLUNTEER TO SERVE ON BOARDS AND COMMITTEES OF COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY AND OTHERS. - TRANSPORTATION VOUCHERS ARE GIVEN TO INDIGENT PERSONS FOR THEIR PERSONAL TRANSPORTATION NEEDS (OTHER THAN TO OR FROM THE CORPORATION'S FACILITIES). Schedule H - Part VI - 5 - PROMOTION OF COMMUNITY HEALTH: THE CORPORATION'S SPONSORING ORGANIZATION IS A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS. IN ACCORDANCE WITH CANON LAW OF THE ROMAN CATHOLIC CHURCH AND FEDERAL TAX LAW APPLICABLE TO SUPPORTING ORGANIZATIONS, A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION ARE PROFESSED MEMBERS OF THE SPONSORING RELIGIOUS CONGREGATION. EACH HOSPITAL OPERATED BY THE CORPORATION HAS A COMMUNITY ADVISORY BOARD CONSISTING OF MEMBERS OF THE COMMUNITY WHO ARE NOT DIRECTORS, OFFICERS, OR CONTRACTORS OF THE CORPORATION. EXCEPT FOR HOSPITAL DEPARTMENTS WHICH HAVE BEEN CLOSED, OR IN WHICH CLINICAL PRIVILEGES HAVE BEEN RESTRICTED, FOR CLINICAL OR QUALITY OF CARE REASONS BY ACTIONS OF THE HOSPITAL'S MEDICAL STAFF AND THE BOARD OF DIRECTORS, THE CORPORATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE CORPORATION'S SURPLUS FUNDS WERE USED DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2012 FOR IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH IN THE FOLLOWING WAYS: - CAPITAL EXPENDITURES OF APPROXIMATELY $98,753,262 WERE MADE DURING THE FISCAL YEAR FOR CONSTRUCTION AND RENOVATION OF PATIENT CARE FACILITIES AND ACQUISITION OF MEDICAL EQUIPMENT AND OTHER EQUIPMENT USED IN PATIENT CARE AND RELATED SUPPORT SERVICES. - THE CORPORATION INCURRED NET COSTS (EXPENSES MINUS REVENUES) OF APPROXIMATELY $26,131,047 DURING THE FISCAL YEAR FOR ACCREDITED PHYSICIAN RESIDENCY PROGRAMS AND NET COSTS OF APPROXIMATELY $5,216,791 FOR UNDERGRADUATE AND GRADUATE NURSING EDUCATION PROGRAMS. SEE SCHEDULE O, FORM 990, PART III, LINE 4D FOR A DESCRIPTION OF SUCH PROGRAMS. - THE CORPORATION INCURRED NET COSTS (EXPENSES MINUS REVENUES) OF APPROXIMATELY $1,261,367 DURING THE FISCAL YEAR FOR CLINICAL RESEARCH PROGRAMS AND ACTIVITIES. ALL OF THE CORPORATION'S HOSPITALS MEET THE REQUIREMENTS OF REVENUE RULING 69-545 BY: - OPERATING EMERGENCY DEPARTMENTS WHICH ARE STAFFED 24 HOURS PER DAY BY QUALIFIED PHYSICIANS AND OTHER MEDICAL PERSONNEL AND WHICH ARE OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY. - HAVING MEDICAL STAFFS WHICH ARE OPEN TO ALL QUALIFIED PHYSICIANS, MID-LEVEL PROVIDERS, PODIATRISTS, AND DENTISTS IN THE COMMUNITY (EXCEPT WHERE RESTRICTED IN RARE CASES FOR CLINICAL QUALITY REASONS BY ACTION OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS). - ACCEPTING MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAM PATIENTS. - ACCEPTING ALL PATIENTS, INCLUDING UNINSURED PATIENTS, WITHOUT REGARD TO THEIR ABILITY TO PAY. - USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. THE FOLLOWING PROVIDES A SUMMARY OF SERVICES FOR EACH OSF HOSPITAL: Saint Francis Medical Center ("Saint Francis Medical Center") is a 609 licensed bed tertiary acute care teaching hospital located near downtown Peoria, Illinois. Saint Francis Medical Center operates several hospital-based outpatient facilities in and around Peoria, Illinois. In addition to its regular hospital accreditation, Saint Francis Medical Center has received disease specific certification from The Joint Commission for its primary stroke network and its myocardial infarction and acute coronary syndrome programs. The University of Illinois College of Medicine at Peoria, founded in 1970, maintains its primary teaching affiliation with Saint Francis Medical Center and has established 11 fully accredited residency programs and 2 fully accredited fellowship programs at Saint Francis Medical Center. Currently, 196 residents and fellows are in training at Saint Francis Medical Center. In addition to providing the full range of primary, secondary and tertiary services, Saint Francis Medical Center provides certain specialized services, including Level I (highest level) trauma services, life flight helicopter transport services (using the helicopters owned by OSF Aviation), adult and pediatric open heart surgery, pancreas and kidney transplantation services, neurosurgery and neurology, Level III (highest level) perinatal services, radiation oncology (including gamma knife and the Varian Trilogy unit), and specialized services of the Children's Hospital of Illinois (which is operated as a part of Saint Francis Medical Center). Saint Anthony Medical Center ("Saint Anthony") is a 254 licensed bed acute care hospital located on the east side of Rockford, Illinois. Saint Anthony provides primary, secondary and tertiary care. Saint Anthony provides certain specialized services, including Level 1(highest level) Trauma services, helicopter services (using helicopters owned by OSF Aviation), adult open heart surgery, a regional burn unit, neurosurgery, and neurology, and radiation oncology (including varian true beam and stereotactic radio-surgery). St. Joseph Medical Center ("St. Joseph") in Bloomington, Illinois, and OSF Saint James-John W. Albrecht Medical Center ("Saint James") in Pontiac, Illinois are located approximately 35 miles apart and serve partially overlapping markets. St. Joseph is a 137 licensed acute care bed and 12 bed skilled nursing care hospital located on the east side of Bloomington, Illinois. St. Joseph provides primary, secondary and tertiary care, including open heart surgery. Saint James has 42 licensed acute care beds which are also Medicare swing bed approved. This hospital facility is located on the west side of Pontiac, Illinois, near Interstate 55. Saint James is the only acute care hospital located in Livingston County, Illinois. St. Mary Medical Center ("St. Mary") in Galesburg, Illinois, and OSF Holy Family Medical Center ("Holy Family") in Monmouth, Illinois are located approximately 19 miles apart and serve partially overlapping markets. Residents of Monmouth and its surrounding areas frequently travel to Galesburg to receive health care services. St. Mary is a 90 licensed bed acute care hospital located on the northeast side of Galesburg, Illinois. In addition to primary and secondary care, including diagnostic cardiac catheterization services, St. Mary has designations from the State of Illinois as a Level II Trauma Center, a Trauma Network Resource Hospital, a Level II perinatal center and a Hemophilia Emergency Treatment Center. Holy Family is a 23 licensed acute bed facility located in Monmouth, Illinois. All of its acute beds are also Medicare approved swing beds. St. Francis Hospital ("St. Francis Hospital") is a 25 licensed bed critical access hospital located on the west side of Escanaba, Michigan. As the only hospital in Delta County, Michigan, St. Francis Hospital provides a range of inpatient and outpatient hospital, diagnostic, therapeutic and ancillary services. AFFILIATED HEALTH CARE SYSTEM ROLES: THE CORPORATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM (THE "OSF SYSTEM") WHICH PROVIDES INTEGRATED HEALTH CARE SERVICES THROUGHOUT CENTRAL ILLINOIS, PARTS OF NORTHERN ILLINOIS, AND PARTS OF THE UPPER PENNINSULA OF MICHIGAN. THE OSF SYSTEM INCLUDES THE OTHER CORPORATIONS LISTED BELOW, ALL OF WHICH ARE CONTROLLED, DIRECTLY OR INDIRECTLY, BY THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS (THE "CONGREGATION"). ALL AFFILIATED CORPORATIONS (WHETHER TAXABLE OR EXEMPT) APPLY AND FOLLOW THE CHARITY CARE POLICY OF THE CORPORATION AND ARE OPERATED IN FURTHERANCE OF THE MISSION OF THE CONGREGATION TO PROVIDE COMPREHENSIVE, INTEGRATED, QUALITY CARE, INCLUDING PREVENTIVE, PRIMARY, ACUTE, CONTINUOUS AND REHABILITATIVE HEALTH SERVICES TO THE COMMUNITIES SERVED BY THE CORPORATION AND THE OSF SYSTEM. SPECIAL EMPHASIS IS PLACED ON MEETING THE PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL NEEDS OF EVERYONE WHO IS CARED FOR IN THE OSF SYSTEM REGARDLESS OF RACE, COLOR, RELIGION AND ABILITY TO PAY. THE AFFILIATED CORPORATIONS ARE: - THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, WHICH HOLDS THE ASSETS OF THE RELIGIOUS CONGREGATION AND DIRECTS ALL OTHER CORPORATIONS IN THE AFFILIATED HEALTH CARE SYSTEM THROUGH BOARD REPRESENTATION AND THE EXERCISE OF RESERVED POWERS. - OSF SAINT FRANCIS, INC., WHICH PROVIDES HOME INFUSION AND DURABLE MEDICAL EQUIPMENT SERVICES, MOBILE MEDICAL IMAGING SERVICES, MEDICAL EQUIPMENT MAINTENANCE AND REPAIR SERVICES, MEDICAL STAFFING SERVICES, BILLING SERVICES, AND OTHER SERVICES IN SUPPORT OF THE AFFILIATED HEALTH CARE SYSTEM. - OSF AVIATION, LLC, WHICH IS AN FAA PART 135 CERTIFIED CARRIER PROVIDING EMS HELICOPTER SERVICES THROUGHOUT CENTRAL ILLINOIS AND PARTS OF NORTHERN ILLINOIS. - OSF LIFELINE AMBULANCE, LLC, WHICH PROVIDES GROUND AMBULANCE TRANSPORTATION SERVICES IN PARTS OF NORTHERN ILLINOIS. - OSF MULTISPECIALTY GROUP - PEORIA, LLC, WHICH PROVIDES PEDIATRIC CARDIOLOGY PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - ILLINOIS NEUROLOGICAL INSTITUTE - PHYSICIANS, LLC, WHICH PROVIDES PHYSICIAN NEUROSURGERY SERVICES IN CENTRAL ILLINOIS. - HEARTCARE MIDWEST, LTD., WHICH PROVIDES CARDIOLOGY AND CARDIOVASCULAR SURGERY PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - CARDIOVASCULAR INSTITUTE AT OSF, LLC, WHICH PROVIDES CARDIOLOGY AND CARDIOVASCULAR SURGERY PHYSICIAN SERVICES IN PARTS OF NORTHERN ILLINOIS. - OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC, WHICH PROVIDES PRIMARY AND SPECIALTY PHYSICIAN SERVICES IN PARTS OF CENTRAL ILLINOIS. - ILLINOIS PATHOLOGIST SERVICES, LLC, WHICH PROVIDES PROFESSIONAL PATHOLOGY SERVICES IN PARTS OF NORTHERN ILLINOIS. - ILLINOIS SPECIALTY PHYSICIAN SERVICES AT OSF, LLC, WHICH PROVIDES PULMONOLOGY AND CRITICAL CARE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - OSF PERINATAL ASSOCIATES, LLC, WHICH PROVIDES MATERNAL FETAL MEDICINE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - OSF MULTISPECIALTY GROUP - WESTERN REGION, LLC, WHICH PROVIDES PRIMARY AND SPECIALTY PHYSICIAN SERVICES IN WESTERN ILLINOIS. - OSF CHILDREN'S MEDICAL GROUP- CONGENITAL HEART CENTER, LLC WHICH PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESSES IN NORTHERN ILLINOIS. - PREFERRED EMERGENCY PHYSICIANS OF ILLINOIS, LLC WHICH PROVIDES PHYSICIAN COVERAGE FOR EMERGENCY DEPARTMENTS. - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC, WHICH PROVIDES AMBULATORY SURGERY SERVICES IN CENTRAL ILLINOIS. - EASTLAND MEDICAL PLAZA SURGICENTER, LLC, WHICH PROVIDES AMBULATORY SURGERY SERVICES IN CENTRAL ILLINOIS. - FORT JESSE IMAGING CENTER, LLC, WHICH PROVIDES MEDICAL IMAGING SERVICES IN CENTRAL ILLINOIS. - SLEEP CENTER OF CENTRAL ILLINOIS, LLC, WHICH PROVIDES MEDICAL TREATMENT FOR SLEEP DISORDERS IN CENTRAL ILLINOIS. ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: IL, MI true Heartland Community Health 1701 W Garden Street Peoria IL 61605 371270794 501(c)(3) 750000 support of clinic operations Quality Quest for Heart of Illinois 416 Main St Ste 717 Peoria IL 61602 263896631 501(c)(3) 200000 SUPPORT OF ORG OPERATIONS Five Points Washington 360 N Wilmor Road Washington IL 61571 364141385 501(c)(3) 100000 SUPP EFFORT TO INC WELLNESS Peoria Riverfront Museum 1125 West Lake Avenue Peoria IL 61614 272920016 501(c)(3) 500000 SUPPORT OPER FOR COMM EDU Illinois Heart & Lung Foundation 1302 Franklin Ave Normal IL 61761 371400057 501(c)(3) 6000 SUPP WOMMENS HEALTH NIGHT PROG Catholic Charities USA PO Box 7044 ROCKFORD IL 61125 362181998 501(C)(3) 50000 SUPP FEEDING CHILDREN PROG Peoria Park District 2218 N Prospect Road Peoria IL 61603 371368760 501(C)(3) 100000 SUPP PROG TO ENCOURAGE EXERCISE 7 0 SCHOLARSHIPS 88 94938 SUPPLEMENTAL INFORMATION Procedures for Monitoring Grants Part I, Line 2 THE CORPORATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES IN A VARIETY OF WAYS. FOR EDUCATIONAL SCHOLARSHIPS, THE CORPORATION TRACKS AND REVIEWS THE STUDENT'S GRADES AND SUCCESSFUL COURSE COMPLETION EACH SEMESTER. IN SOME CASES, THE CORPORATION'S CHIEF FINANCIAL OFFICER OR OTHER REPRESENTATIVE OF THE CORPORATION SERVES ON THE BOARD OF DIRECTORS OR ON THE FINANCE COMMITTEE OF THE GRANTEE ORGANIZATION AND RECEIVES DIRECT INFORMATION REGARDING USE OF GRANT FUNDS IN SUCH CAPACITY. IN OTHER CASES, THE CORPORATION RECEIVES WRITTEN REPORTS AND/OR FINANCIAL STATEMENTS FROM THE GRANTEE ORGANIZATION WHICH INCLUDE INFORMATION REGARDING USE OF GRANT FUNDS. Requirements for Saint Francis Medical Center Scholarship All scholarships are approved by the scholarship committee. Nursing Minimum Requirements: - GPA 2.5/4.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center RN staff position within 60 days of graduation and remain employed in a 72-80 hours/pay for two years following completion of the 90 day unit nursing orientation. Radiology, Radiation Therapist & Sonography Minimum Requirements: - GPA 2.5/4.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center Diagnostic Radiology Technologist staff position within 30 days of graduation and remain employed for two years following completion of the department orientation. Pharmacy Minimum Requirements: - Interview - GPA 2.5/4.0 or 3.125/5.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center R.Ph. position within 30 days of graduation and remain employed for two years or three years, depending on the monies received, following completion of the Pharmacy orientation. Respiratory Therapy Minimum Requirements: For External Candidates: - Meet all Illinois Central College's (ICC) minimum requirements for admission - GPA 3.0/4.0 scale - Pass a Wonderlic Test score of a 3 on the verbal section and a 2 on the math portion - Two favorable academic references from clinical instructors - Two favorable employer references - A brief 1-2 page typed essay explaining interest and desire to enroll the scholarship program - Interview For OSF Saint Francis Medical Center Employees: - Meet all Illinois Central College's (ICC) minimum requirements for admission - GPA 3.0/4.0 scale - Pass a Wonderlic Test score of a 3 on the verbal section and a 2 on the math portion - Must not be on any current formal levels of discipline - Two favorable supervisor/manager or director references - A brief 1-2 page typed essay explaining interest and desire to enroll the scholarship program - Interview Merit Scholarship Requirement: - GPA 3.4/4.0 scale - Dean's List in the semester previous to posting on students account Institutional Scholarship Requirement: - College of Nursing student in good academic standing and in financial need President's Scholarship Requirement: - GPA 3.55/4.0 scale Requirements for Saint Anthony Medical Center Scholarships Scholarships are awarded based on 50% academics, 30% financial need, and 20% community service. The awards are approved by the Saint Anthony College of Nursing Financial Aid Committee. The Alumni Memorial Scholarship are awarded based on 60% academics, 30% financial need, and 10% community service. Minimum requirements for all scholarships: - GPA 2.5/4.0 scale - Resume - Two favorable letters of recommendation, at least one from a clinical instructor - A brief typed essay explaining interest and desire to enroll the scholarship program Requirements for Holy Family Medical Center Scholarships - Application for assistance from OSF Holy Family Medical Center signifies a desire to work at OSF HFMC at the completion of the educational course work. - Meeting deadlines is the responsibility of the applicant. All application materials must reach OSF HFMC by April 1. Awards will be made by May 31. - Funds may only be used for health care-related coursework at the bachelor's degree level or below. - Recipients must reside in Warren or Henderson County, Illinois, be employees of OSF Holy Family Medical Center, or related to employees of OSF HFMC. - The maximum available amount of educational assistance is $3,500 annually. This amount will be distributed for tuition, books, and lab fees. Funds may not be used for living expenses or transportation - Each disbursement of funds requires the recipient sign a "Student Loan Promissory Note" which is forgiven when the student borrower becomes employed at OSF HFMC at completion of the educational program within specified time constraints. This means each request for funds requires a personal appearance by the student. (According to tax law, disbursements are taxable income.) - When funds have been distributed for a given semester, additional funds will not be paid until OSF HFMC has been furnished with a copy of prior semester grades, giving proof of successful completion of course work. A cumulative 3.0 grade point average or higher is required. - Recipients must reapply annually if they desire funds for subsequent years. While funds for subsequent years are not guaranteed, serious consideration will be given to those students who have excelled academically. - Receipt of educational assistance does not guarantee the recipient will be offered employment at the completion of the educational program. An appropriate position may not be available at that time. If an appropriate position is available, the recipient must accept the position or be prepared to repay any funds received. - With mutual agreement, the requirement to accept a position at OSF HFMC may be met by accepting employment at other OSF facilities. X true true X X X X X false true false false false false false false false DANIEL R FASSETT MD 473500 0 1060907 0 17035 0 24043 0 12 0 1575497 0 0 0 FINN REIDER AMBLEMD 698447 0 305000 0 37175 0 27004 0 15230 0 1082856 0 0 0 GERALD J MCSHANE MD 395061 0 68673 0 59767 0 37500 0 11877 0 572878 0 0 0 JAMES MOORE 111824 0 1179429 0 94409 0 0 0 0 0 1385662 0 0 0 JEFFREY D KLOPFENSTEIN MD 473501 0 851648 0 14198 0 20000 0 14692 0 1374039 0 0 KEVIN D SCHOEPLEIN 774705 0 141989 0 97978 0 545173 0 16373 0 1576218 0 0 0 SUSAN CAMPBELL 205606 0 28687 0 52458 0 37282 0 11405 0 335438 0 0 SYED M HUSSAIN MD 297846 0 685844 0 49953 0 22763 0 14691 0 1071097 0 0 TRAVIS D RICHARDSON MD 684759 0 416879 0 36051 0 15008 0 9620 0 1162317 0 0 VANCE C PARKHURST 268667 0 35015 0 53807 0 38357 0 11432 0 407278 0 0 DANIEL EBAKER 410341 0 51874 0 76117 0 208368 0 13806 0 760506 0 0 0 Schedule J, Part I, Line 1a THE CORPORATION REIMBURSES CERTAIN EXECUTIVES FOR SOCIAL CLUB DUES PAID BY SUCH EXECUTIVES. ELIGIBILITY FOR CLUB DUES REIMBURSEMENT IS DETERMINED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS AND IS TAKEN INTO CONSIDERATION BY THE COMMITTEE IN DETERMINING FAIR MARKET COMPENSATION. SEE FORM 990 - SCHEDULE O - PART VI - LINES 15A AND 15B FOR AN EXPLANATION OF THE ROLE OF THE HUMAN RESOURCES COMMITTEE AND THE MANNER IN WHICH FAIR MARKET COMPENSATION IS DETERMINED. CLUB DUES ARE NOT ELIGIBLE FOR REIMBURSEMENT IF THE CLUB IN QUESTION DISCRIMINATES ON THE BASIS OF RACE, RELIGION, SEX, NATIONAL ORIGIN, OR OTHER PROHIBITED FACTORS. DUES REIMBURSEMENT IS TREATED AND REPORTED AS TAXABLE COMPENSATION. Schedule J, Part I, Line 3 See explanation in Schedule O, Part VI, Line 15a for details regarding the process to establish the compensation of the organization's CEO. Schedule J, Part I, Line 4b OSF healthcare System has a deferred compensation plan for select key executives. This plan was developed to assist with attracting and retaining certain key executives in the corporation. The plan is designed to encourage the participants to stay until a certain retirement date. If the participants terminate prior to their target retirement date, they forfeit what is in the plan. Illinois Finance Authority 861091967 45200B8E1 2007-08-29 461801780 See Schedule O false false false Illinois Finance Authority 861091967 45200FWD7 2009-03-31 249074230 See Schedule O false false false Illinois Finance Authority 861091967 2009-08-18 70000000 See Schedule O false false false Illinois Finance Authority 861091967 45200f3r8 2010-06-29 158535888 SEE SCHEDULE O false false false 0 0 461801780 24898348 0 127425737 12165772 0 0 285706088 0 0 2010 true false true true 0 0 249074230 12276530 0 233334384 3240846 0 0 0 0 0 true false true true 0 0 70000000 0 0 0 0 0 0 70000000 0 0 2010 false false true true 0 0 158535888 15337813 0 115936745 2080292 0 0 28000000 0 0 2010 true false true true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false true true Merrill Lynch false true false 0 true false false true false 0 false 0 false false false true false 0 false 0 false false false false false 0 false 0 false false X FORM 990 - PART III - LINE 4A: INPATIENT SERVICES: OSF HEALTHCARE SYSTEM OWNS AND OPERATES ACUTE CARE HOSPITALS IN ESCANABA, MICHIGAN; ROCKFORD, ILLINOIS; PONTIAC, ILLINOIS; BLOOMINGTON, ILLINOIS; PEORIA, ILLINOIS; GALESBURG, ILLINOIS; AND MONMOUTH, ILLINOIS; AND OWNed AND OPERATEd ONE LONG-TERM CARE FACILITY IN PEORIA HEIGHTS, ILLINOIS until it was sold on February 1, 2013. AS OF THE CLOSE OF THE REPORTING PERIOD ON SEPTEMBER 30, 2012, THESE EIGHT FACILITIES HAD A COMBINED TOTAL OF 1,396 LICENSED INPATIENT AND RESIDENT BEDS AND OPERATED A COMBINED TOTAL OF 1,363 STAFFED INPATIENT AND RESIDENT BEDS. THEY HAD COMBINED TOTALS OF 60,044 INPATIENT AND RESIDENT DISCHARGES AND 307,806 INPATIENT AND RESIDENT DAYS, INCLUDING 10,077 NEWBORN INPATIENT DAYS. THE SEVEN ACUTE CARE HOSPITALS COLLECTIVELY SERVED 48 COUNTIES. THEY HAD A COMBINED TOTAL OF APPROXIMATELY 2,133 PHYSICIANS ON THEIR MEDICAL STAFFS; INCLUDING APPROXIMATELY 1,271 PHYSICIANS ON THEIR ACTIVE OR ASSOCIATE MEDICAL STAFFS. TWO OF THE HOSPITALS ARE SOLE COMMUNITY HOSPITALS AND two are CRITICAL ACCESS HOSPITALs. THE CORPORATION'S HOSPITALS OFFER A BROAD RANGE OF INPATIENT SERVICES. THREE OF THE HOSPITALS PROVIDE OPEN HEART SURGERY SERVICES, TWO OFFER LEVEL II NEONATAL SERVICES, ONE OFFERS LEVEL III NEONATAL SERVICES (HIGHEST LEVEL), AND ONE OFFERS KIDNEY AND PANCREAS ORGAN TRANSPLANT SERVICES. THE CORPORATION HAS ORGANIZED AND OPERATES COMPREHENSIVE CARDIAC AND STROKE CARE NETWORKS IN CENTRAL AND NORTHERN ILLINOIS AND OPERATES THE ONLY COMPREHENSIVE CHILDREN'S HOSPITAL IN CENTRAL ILLINOIS FORM 990 - PART III - LINE 4B: OUTPATIENT SERVICES: THE SEVEN ACUTE CARE HOSPITALS OWNED AND OPERATED BY OSF HEALTHCARE SYSTEM COLLECTIVELY PROVIDED 1,009,030 OUTPATIENT VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012, INCLUDING 50,937 OUTPATIENT SURGERY VISITS BUT EXCLUDING EMERGENCY DEPARTMENT VISITS. THE CORPORATION'S HOSPITALS OFFER A BROAD RANGE OF OUTPATIENT THERAPEUTIC AND DIAGNOSTIC SERVICES, INCLUDING OUTPATIENT SURGERY AND ADVANCED MEDICAL IMAGING. FORM 990 - PART III - LINE 4C: Physcian Services PHYSICIANS EMPLOYED BY OSF HEALTHCARE SYSTEM PROVIDED 967,351 OFFICE VISITS (NOT INCLUDING SERVICES PROVIDED TO HOSPITAL INPATIENTS AND OUTPATIENTS) AT OFFICES IN 74 SEPARATE LOCATIONS THROUGHOUT CENTRAL AND NORTHERN ILLINOIS AND THE UPPER PENINSULA OF MICHIGAN. FORM 990 - PART III - LINE 4D: Home Health Services: (EXPENSES $48,589,211 INCLUDING GRANTS OF $NONE)(REVENUE $43,818,098) THE five HOME HEALTH AGENCIES OWNED AND OPERATED BY THE CORPORATION COLLECTIVELY SERVE 32 COUNTIES IN ILLINOIS AND MICHIGAN, ENROLLED 24,518 HOME HEALTH PATIENTS, AND PROVIDED 179,135 HOME HEALTH VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. THE Four HOSPICE PROGRAMS OWNED AND OPERATED BY THE CORPORATION COLLECTIVELY SERVE 35 COUNTIES IN ILLINOIS AND MICHIGAN, ENROLLED 1,862 HOSPICE PATIENTS, AND PROVIDED 94,474 HOSPICE DAYS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. FORM 990 - PART III - LINE 4D: EMERGENCY DEPARTMENT SERVICES: (EXPENSES $73,333,883 INCLUDING GRANTS OF $ NONE) (REVENUE $88,819,744) ALL OF THE SEVEN ACUTE CARE HOSPITALS OF THE CORPORATION PROVIDE 24-HOUR EMERGENCY DEPARTMENT SERVICES. ALL ARE STAFFED BY PHYSICIANS WHO ARE PREDOMINANTLY (BUT NOT ENTIRELY) CERTIFIED IN EMERGENCY MEDICINE BY NATIONAL SPECIALTY BOARDS. THE EMERGENCY DEPARTMENTS OF THE CORPORATION'S ACUTE CARE HOSPITALS PROVIDED 207,850 PATIENT VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. FORM 990 - PART III - LINE 4D: RESIDENCY PROGRAMS: (EXPENSES $42,368,717 INCLUDING GRANTS OF $ NONE) (REVENUE $100,324) OSF HEALTHCARE SYSTEM HAS ENTERED INTO A MAJOR AFFILIATION AGREEMENT WITH THE UNIVERSITY OF ILLINOIS PROVIDING SIGNIFICANT FINANCIAL AND TEACHING SUPPORT FOR PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS SPONSORED BY THE UNIVERSITY. THE CORPORATION EMPLOYED 201 RESIDENTS AND FELLOWS IN THESE PROGRAMS DURING THE REPORTING PERIOD. FORM 990 - PART III - LINE 4D: COLLEGES OF NURSING PROGRAMS: (EXPENSES $11,270,296 INCLUDING GRANTS OF $94,938) (REVENUE $10,611,057) TWO OF THE CORPORATION'S HOSPITALS OPERATE ACCREDITED COLLEGES OF NURSING WHICH AWARD BACCALAUREATE, MASTERS, AND DOCTORATE DEGREES. THERE WERE 2,013 ENROLLEES IN THESE PROGRAMS DURING THE THREE SEMESTERS FALLING WITHIN THE REPORTING PERIOD (FALL 2011, SPRING 2012, AND SUMMER 2012) FORM 990 - PART III - LINE 4D: TRAUMA SERVICES (LEVEL 1): (EXPENSES $8,751,802 INCLUDING GRANTS OF $ NONE) (REVENUE $1,232,982) TWO OF THE CORPORATION'S SEVEN HOSPITALS HAVE BEEN DESIGNATED AS LEVEL I (HIGHEST LEVEL) TRAUMA CENTERS, AND TWO HAVE BEEN DESIGNATED AS LEVEL II TRAUMA CENTERS. LEVEL I TRAUMA CENTERS ARE CONTINUOUSLY STAFFED WITH IN-HOUSE TRAUMA SURGEONS, ANESTHESIA PROVIDERS, AND OTHER SPECIALIZED HEALTH CARE PROFESSIONALS IN ORDER TO PROVIDE IMMEDIATE TRAUMA SURGERY AND OTHER TREATMENT SERVICES TO TRAUMA PATIENTS. THE EXPENSES ABOVE REFLECT THESE STAFFING COSTS. LEVEL I TRAUMA CENTERS ALSO HAVE SPECIAL RESPONSIBILITIES FOR FORMING AND CARRYING OUT AREA-WIDE DISASTER PREPAREDNESS AND EMERGENCY RESPONSE PLANS AND FOR COORDINATING AREA-WIDE TRAUMA SERVICES IN THE EVENT OF MAJOR DISASTERS. FORM 990 - PART III - LINE 4D: EMS FLIGHT & GROUND TRANSPORT SERVICES: (EXPENSES $19,464,792 INCLUDING GRANTS OF $ NONE) (REVENUE $12,869,567) THE CORPORATION PROVIDES EMERGENCY HELICOPTER TRANSPORT SERVICES TO PATIENTS IN NORTHERN AND CENTRAL ILLINOIS USING A FLEET OF FOUR EMS CONFIGURED HELICOPTERS. 2,396 EMS HELICOPTER PATIENT TRANSPORTS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. A SUBSIDIARY OF THE CORPORATION PROVIDES GROUND AMBULANCE PATIENT TRANSPORT SERVICES IN NORTHERN ILLINOIS. 7,810 GROUND AMBULANCE PATIENT TRANSPORTS PLUS 3,334 WHEELCHAIR PATIENT TRANSPORTS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. FORM 990 - PART III - LINE 4D: COMMUNITY CLINIC, Outreach, and Other Educational PROGRAMS: (EXPENSES $6,679,145 INCLUDING GRANTS OF $ NONE) (REVENUE $2,284,015) OSF COMMUNITY PRENATAL CLINIC - BLOOMINGTON, ILLINOIS: THIS CLINIC SERVES UNINSURED AND UNDERINSURED PREGNANT WOMEN IN THE BLOOMINGTON-NORMAL, ILLINOIS COMMUNITIES AND SURROUNDING AREA. THE CLINIC PROVIDES SPANISH-SPEAKING STAFF TO ASSIST PATIENTS WHO HAVE LANGUAGE BARRIERS. PRENATAL SERVICES AND DELIVERIES WERE PROVIDED TO 48 WOMEN DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. OSF SISTERS COMMUNITY HEALTHCARE CLINICS - PEORIA, ILLINOIS: THIS CLINIC IS A PRIMARY CARE HOSPITAL BASED RESIDENCY CLINIC WHERE UNINSURED AND UNDERINSURED PATIENTS OF ALL AGES ARE SEEN BY RESIDENT PHYSICIANS UNDER THE DIRECTION OF AN ATTENDING PHYSICIAN. PROFESSIONAL SERVICES INCLUDE ADULT INTERNAL MEDICINE, PEDIATRIC AMBULATORY CARE, AND OBSTETRICS/GYNECOLOGY. OTHER SERVICES INCLUDE X-RAY, LABORATORY, SONOGRAPHY, COUMADIN MANAGEMENT, ADULT AND PEDIATRIC SOCIAL SERVICES, AND FINANCIAL ADVISORY SERVICES. 23,332 PATIENT VISITS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. PARISH NURSING PROGRAM - PEORIA, ILLINOIS: THIS PROGRAM PROVIDES PROFESSIONAL SUPERVISION AND CLINICAL SUPPORT FOR VOLUNTEER NURSES WHO FURNISH MEDICAL SCREENING, EDUCATION AND NURSING SERVICES TO MEMBERS OF CHURCH CONGREGATIONS IN AND AROUND PEORIA, ILLINOIS. PERINATAL OUTREACH PROGRAM - PEORIA, ILLINOIS: THIS PROGRAM PROVIDES PROFESSIONAL EDUCATION AND TRAINING TO CLINICIANS IN COMMUNITY HOSPITALS THROUGHOUT CENTRAL ILLINOIS REGARDING CLINICALLY APPROPRIATE MANAGEMENT AND REFERRAL OF WOMEN WITH HIGH RISK PREGNANCIES. 1,038 HOURS OF EDUCATION AND TRAINING WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2012. COMMUNITY TRAINING CENTER - ROCKFORD, ILLINOIS AND PEORIA, ILLINOIS: THE COMMUNITY TRAINING CENTERS PROVIDE TRAINING TO THE PUBLIC SO THEY ARE PREPARED TO DO BASIC LIFE SUPPORT IN AN EMERGENCY. CLASSES INCLUDE CPR CERTIFICATION AND TRAINING FOR THE AMERICAN HEART ASSOCIATION CERTIFICATIONS SUCH AS BASIC LIFE SUPPORT AND ADVANCED LIFE. PARAMEDICAL EDUCATION - ROCKFORD, ILLINOIS: THIS PROGRAM PROVIDES BASIC AND CONTINUING EDUCATION AT VARIOUS EMERGENCY MEDICAL TECHNICIAN (EMT) LEVELS TO OVER 2,500 EMTS WHO SERVE IN THEIR HOME COMMUNITIES. EMT EDUCATION - PEORIA, ILLINOIS: THIS INCLUDES CLASSES PROVIDED TO THE AMBULANCE AND RESCUE SQUADS OF THE CENTRAL ILLINOIS AREA FOR THE TRAINING AND UPDATING OF THE EMPLOYEES AND VOLUNTEERS OF THE SQUADS. THIS SERVICE PROVIDES HUNDREDS OF HOURS OF ONGOING TRAINING THROUGHOUT THE REGION TO FIRST RESPONDERS. MEDICAL TECH EDUCATION - ROCKFORD, ILLINOIS AND PEORIA, ILLINOIS: AT PEORIA THIS IS A YEAR LONG PROGRAM FOR SCIENCE MAJOR STUDENTS THAT WILL BECOME TECHNICIANS IN A HOSPITAL LAB. THIS IS A REQUIRED PROGRAM FOR THE STUDENTS TO COMPLETE THE BACHELOR'S DEGREE AND BE ABLE TO FUNCTION IN THE LAB. THERE ARE USUALLY TEN STUDENTS PER YEAR. ROCKFORD'S CLINICAL LAB HAS AN EXCLUSIVE AFFILIATION WITH THE NORTHERN ILLINOIS UNIVERSITY CLINICAL LABORATORY SCIENCE PROGRAM. THE LAB SERVES AS A CLINICAL TRAINING SITE FOR FOUR STUDENTS ANNUALLY WHO COMPLETE A 33-WEEK CLINICAL ROTATION WHERE THEY ARE ONSITE FOR 24 HOURS EACH WEEK. RADIOLOGY TECH EDUCATION - PEORIA, ILLINOIS: THIS IS A TWO YEAR PROGRAM FOR STUDENTS THAT WISH TO BECOME IMAGING TECHNICIANS IN ANY OF SEVERAL AREAS (DIAGNOSTIC, MRI, CT, SONS, ETC). UPON GRADUATION THE STUDENT IS ABLE TO PROVIDE THE PROCEDURES IN A CLINICAL SETTING. THERE ARE APPROXIMATELY TWENTY STUDENTS PER YEAR. DIETETIC EDUCATION - PEORIA, ILLINOIS: THIS IS A YEAR LONG PROGRAM THAT IS REQUIRED FOR A STUDENT TO BECOME A REGISTERED DIETITIAN. THE STUDENTS ARE PROVIDED TRAINING IN THE PREPARATION OF DIETS, COUNSELING, RESEARCH, AND EXPOSURE TO THE OPERATIONS OF A FOOD SERVICE AREA. THERE ARE APPROXIMATELY TEN STUDENTS PER YEAR. OTHER PROGRAM SERVICES (EXPENSES $6,882,712 INCLUDING GRANTS OF $ NONE) (REVENUE $4,057,481) Form 990 - Part VI - Line 1a: By adopting certain provisions of the corporate bylaws, the board of directors has delegated broad authority to the executive committee of the board. The bylaws provide that the executive committee shall be authorized to take such action as may be necessary on behalf of the corporation during periods when the board of directors is not in session. FORM 990 - PART VI - LINE 4 On April 30, 2012, OSF Healthcare System (OSF) became the sole corporate member of Ottawa Regional Hospital & Healthcare Center d/b/a OSF Saint Elizabeth Medical Center (SEMC) an Illinois not-for-profit corporation. SEMC owns all of the capital stock of Ottawa Regional Healthcare Affiliates, Inc. and Ottawa Regional Hospital Auxiliary. SEMC is the sole member of Ottawa Regional Hospital Foundation and has a 57% ownership in Radiation Oncology of Northern Illinois, LLC (RONI). RONI is consolidated by SEMC. Ottawa Regional Healthcare Affiliates, Inc. (ORHA) is an Illinois for-profit corporation, was incorporated in 2008, and is wholly owned by SEMC. ORHA is a holding company and does not itself operate any businesses. ORHA is the sole stockholder of Ottawa Regional Medical Center, Inc. (ORMC) and Ottawa Regional Cardinal Sleep Center, LLC (ORCSC) and 50% owner of Ottawa Regional DMC, LLC (DME). ORHA has not made any initial capital contributions to ORCSC and DME and there have been no operations within these entities at September 30, 2012. FORM 990 - PART VI - LINE 6 & 7A: OSF HEALTHCARE SYSTEM HAS NO CORPORATE STOCK OR STOCKHOLDERS. ITS SOLE MEMBER IS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, AN ILLINOIS NOT FOR PROFIT CORPORATION, WHICH IS CONTROLLED BY MEMBERS OF A RELIGIOUS CONGREGATION OF THE CATHOLIC CHURCH ALSO KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS. THE GOVERNING BOARD OF THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, AN ILLINOIS NOT FOR PROFIT CORPORATION AND THE SOLE MEMBER OF OSF HEALTHCARE SYSTEM, HOLDS RESERVED POWERS TO ELECT AND REMOVE ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS OF OSF HEALTHCARE SYSTEM. FORM 990 - PART VI - LINE 7B: AS GOVERNED BY CANONICAL AND CIVIL GUIDELINES PERTAINING TO ROMANCATHOLIC CHURCH PROPERTIES AND AS PROVIDED IN THE BYLAWS, CERTAIN TRANSACTIONS OF OSF HEALTHCARE SYSTEM MAY BE AUTHORIZED ONLY BY VOTE OF THE GOVERNING BOARD OF THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, WHICH VOTE IS TO BE TAKEN ONLY AFTER CONSIDERING THE ADVICE OF THE BOARD OF DIRECTORS OF OSF HEALTHCARE SYSTEM. THESE TRANSACTIONS ARE AS FOLLOWS: - TO ESTABLISH THE PHILOSOPHY AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. - TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. - TO ELECT AND REMOVE WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION. - TO MERGE OR DISSOLVE THE CORPORATION. - TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE REAL PROPERTY OF THE CORPORATION. - TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. - TO APPROVE ANY BORROWING OR DEBT FINANCING IN EXCESS OF A SPECIFIED LIMIT (CURRENTLY $1,000,000) ESTABLISHED BY RESOLUTION OF THE MEMBER. - TO APPOINT (OR APPROVE THE APPOINTMENT OF) OR REMOVE THE CORPORATION'S CHAIRPERSON, CHIEF EXECUTIVE OFFICER, PRESIDENT, REGIONAL PRESIDENT/CHIEF EXECUTIVE OFFICERS, AND THE LOCAL PRESIDENT/CHIEF EXECUTIVE OFFICER OF EACH HEALTH CARE FACILITY AND OPERATING DIVISION OWNED, OPERATED OR CONTROLLED BY THE CORPORATION. - TO APPROVE STRATEGIC PLANS, MANAGEMENT OBJECTIVES AND CAPITAL ANDOPERATING BUDGETS OF THE CORPORATION. - TO APPROVE ANY PURCHASE OR OTHER ACQUISITION IN EXCESS OF A SPECIFIED LIMIT (CURRENTLY $1,000,000) ESTABLISHED BY RESOLUTION OF THE MEMBER. - TO REQUIRE A CERTIFIED AUDIT OF THE CORPORATION'S FINANCES AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. - TO APPROVE THE ENGAGEMENT OF ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS AND THE DISMISSAL OF ANY CURRENT LEGAL COUNSEL REPRESENTING THE CORPORATION ON A REGULAR BASIS. - TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WILL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY. FORM 990 - PART VI - LINE 9: JAMES W. GIRARDY, M.D. 5666 East State Street ROCKFORD, IL 61108 JAMES MOORE 4405 W. LONGMEADOW CT. PEORIA, IL 61615 FORM 990 - PART VI - LINE 11B: THE INITIAL DRAFT FORM 990 AND ALL REQUIRED SCHEDULES ARE PREPARED USING A MULTI-DISCIPLINARY PROCESS WHICH INCLUDES CORPORATE FINANCE AND ACCOUNTING, CORPORATE LEGAL, CORPORATE COMPLIANCE, AND CORPORATE MARKETING AND COMMUNICATIONS PERSONNEL WHO FOCUS INITIALLY ON SPECIFIC PORTIONS OF THE RETURN. THE COMPLETED DRAFT FORM 990 AND ALL SCHEDULES ARE THEN REVIEWED BY THIS SAME MULTI-DISCIPLINARY TEAM TO ENSURE ACCURACY AND INTEGRATION OF THE INDIVIDUAL PARTS AND SCHEDULES. IN ADDITION, THE INFORMATION AND SCHEDULES OF THE RETURN ARE SENT TO THE CORPORATION'S OUTSIDE AUDITORS, KPMG LLP FOR REVIEW AND COMMENT. KPMG REVIEWS THE INFORMATION AND SCHEDULES AND PREPARES AND SIGNS THE FINAL RETURN. COMMENTS FROM THE MULTI-DISCIPLINARY TEAM AND FROM THE AUDITORS ARE INCORPORATED INTO A PROPOSED FINAL VERSION OF FORM 990 AND ALL SCHEDULES. THIS PROPOSED FINAL VERSION IS THEN SENT VIA E-MAIL TO ALL OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES FOR FILING. FORM 990 - PART VI - LINE 12C: DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTING DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION ABOUT THE INTEREST. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANAGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM. FORM 990 - PART VI - LINE 15A: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE CHIEF EXECUTIVE OFFICER ("CEO") IS NOT A MEMBER OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITTEE. THE COMMITTEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS THE BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. FORM 990 - PART VI - LINE 15B: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. SOME KEY EMPLOYEES LISTED IN PART VII ARE PRACTICING PHYSICIANS WHO ARE LISTED AS KEY EMPLOYEES AS A RESULT OF THE COMPENSATION THEY RECEIVE AND NOT DUE TO ANY EXECUTIVE OR MANAGEMENT POSITION WHICH THEY HOLD. SUCH PHYSICIANS GENERALLY ARE NOT PARTICIPANTS IN THE EXECUTIVE COMPENSATION PLAN, AND THEIR COMPENSATION, INCLUDING BASE SALARY, BENEFITS, AND ANY APPLICABLE BONUS OR INCENTIVE COMPENSATION, IS ESTABLISHED IN ACCORDANCE WITH NATIONALLY RECOGNIZED PHYSICIAN COMPENSATION SURVEYS AND IS SET FORTH IN WRITTEN EMPLOYMENT AGREEMENTS WHICH ARE APPROVED BY THE BOARD OF DIRECTORS OR ITS EXECUTIVE COMMITTEE. FORM 990 - PART VI - LINE 18: OSF HEALTHCARE SYSTEM MAKES ITS FORM 990, ITS FORM 990-T, AND DOCUMENTATION OF ITS EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE CODE AVAILABLE FOR PUBLIC INSPECTION AND COPYING UPON REQUEST IN ACCORDANCE WITH SECTION 6104 OF THE INTERNAL REVENUE CODE. NAMES AND ADDRESSES OF CONTRIBUTORS ARE NOT DISCLOSED. REQUESTS MAY BE MADE IN PERSON, IN WRITING, OR BY TELEPHONE. REQUESTS MADE IN PERSON ARE ACCEPTED AT THE CORPORATE OFFICE AND AT EACH HOSPITAL FACILITY OF THE CORPORATION. REQUESTS MADE IN WRITING OR BY TELEPHONE TO ANY FACILITY OR LOCATION OF THE CORPORATION ARE FORWARDED TO THE CORPORATE FINANCE AND ACCOUNTING DIVISION, WHICH THEN PROVIDES COPIES OF THE REQUESTED DOCUMENTS IN THE MANNER REQUESTED (IF SUCH DELIVERY METHOD IS AVAILABLE TO THE CORPORATION). FORM 990 - PART VI - LINE 19: THE CORPORATION MAKES ITS ARTICLES OF INCORPORATION, CORPORATE BYLAWS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. ALL REQUESTS ARE FORWARDED TO THE CORPORATE LEGAL DIVISION, WHICH THEN PROVIDES COPIES OF THE REQUESTED DOCUMENTS IN THE MANNER REQUESTED (IF SUCH DELIVERY METHOD IS AVAILABLE TO THE CORPORATION). IN ADDITION, THE CORPORATION'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE FROM THE OFFICE OF THE ILLINOIS SECRETARY OF STATE OR FROM THE RECORDER OF DEEDS IN WOODFORD COUNTY, ILLINOIS, SITE OF THE CORPORATION'S REGISTERED OFFICE. FINANCIAL STATEMENTS OF THE CORPORATION ARE PUBLICLY AVAILABLE ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE OF THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB)AND FROM THE ILLINOIS ATTORNEY GENERAL AS PART OF THE CORPORATIONS COMMUNITY BENEFIT REPORT. FORM 990 - PART VII - Section A: Reportable compensation in Part VII was determined from a review of payroll queries from the Organization's and related organization's payroll and general ledger modules, yearly payroll reports, and W-2 filings. FORM 990 - PART XI - LINE 5: OTHER CHANGES IN FUND BALANCE INCLUDE: CHANGE IN UNREALIZED MARKET VALUE OF SWAPS (4,017,477) NET ASSETS RELEASED FROM RESTRICTION (29,093,369) UNREALIZED GAIN/LOSS 45,222,754 UNREALIZED GAIN/LOSS - RESTRICTED 1,842,997 INCREASE IN PERMANETLY RESTRICTED ASSETS 9,005,812 REVERSAL OF MINIMUM PENSION LIABILITY (130,781,385) SFI & SUBSIDIAIRY INCOME (407,191) CHANGE IN MARKET VALUE OF TRUSTEE ACCOUNTS 4,163,325 MINORiTY INTEREST (2,823,822) INVESTMENT IN HEALTHCARE MIDWEST (17,227,232) EQUITY TRANSFERS (37,337,192) EARLY EXTINGUISHMENT OF DEBT (11,340,591) TRANSFER TO PARENT (200,000) TRANSFER TO OTTAWA (12,318,635) ------------ TOTAL CHANGES IN NET ASSETS OR FUND BALANCE (185,312,006) SCHEDULE K - PART I - BOND ISSUES ILLINOIS FINANCE AUTHORITY - 08/29/2007 Cusip# 45200B8E1 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2007 BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, INCLUDING PROCEEDS FROM THE SALE OF THE AUCTION BONDS AND THE variable RATE BONDS, TO (I) FINANCE OR REFINANCE THE COST OF THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF THE PROJECT; (II) PAY CAPITALIZED INTEREST WITH RESPECT TO A PORTION OF THE SYSTEMWIDE BONDS; (III) FUND DEBT SERVICE RESERVE FUNDS FOR CERTAIN OF THE SYSTEMWIDE BONDS; (IV) REFINANCE THE PRIOR INDEBTDEDNESS DESCRIBED BELOW AND (V) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 03/31/2009 Cusip# 45200FWD7, 4500FWG0, 45200FWE5, 45200FWF2 THE CORPORATION USED THE PROCEEDS OF THE SYSTEMWIDE BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (I) REFINANCE AND REDEEM THE PRIOR BONDS DESCRIBED BELOW; (II) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2009 BONDS; AND (III) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 08/18/2009 NO CUSIP# THE CORPORATION USED THE PROCEEDS OF THE SERIES 2009EFG TO PAY OR REIMBURSE THE CORPORATION FOR THE PROJECTS. ILLINOIS FINANCE AUTHORITY - 06/29/2010 CUSIP# 45200F3R8 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2010A BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (i) REFINANCE AND REDEEM ON OR ABOUT AUGUST 2, 2010, THE ILLINOIS HEALTH FACILITY AUTHORITY VARIABLE DEMAND REVENUE BONDS, SERIES 1985B (REVOLVING FUND POOLED FINANCING PROGRAM) AND ILLINOIS FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2001 IN THE AMOUNT OF $75,000,000 AND $46,050,000, RESPECTIVELY, ON OR ABOUT SEPTEMBER 17, 2010, THE ILLINOIS FINANCE AUTHORITY REVENUE BONDS, SERIES 2007D IN THE AMOUNT OF $20,050,000; (ii) PAY OR REIMBURSE THE CORPORATION FOR THE PROJECT; (iii) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2010A BONDS; AND PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2010A BONDS AND THE REFINANCING OF THE SERIES 1985B BONDS, THE SERIES 2001 BONDS AND THE SERIES 2007D BONDS. The Corporation used the proceeds of the Series 2012 bonds to (i) pay or reimburse the corporation or ottawa regional hospital & healthcare center for the costs of the project, (ii) advance refund all of the illinois finance authority revenue bonds, series 2004, (iii) current refund a portion of the illinois finance authority insured variable rate demand revenue bonds, series 2007f, (iv) currently refund all of the illinois finance authority variable rate demand revenue bonds, series 2007g, (v) advance refund a portion of the illinois finance authority revenue bonds, series 2009a, (vi) currently refund all of the illinois finance authority revenue bonds, series 2009f, (vii) refinance the pnc bank loan, and (viii) pay certain expenses incurred in connection with the issuance of the bonds and the refunding of the prior bonds and pnc bank loan. SCHEDULE K - PART II - LINE 7 BOND ISSUANCE COSTS BOND ISSUANCE COST CREDIT ENHANCEMENT TOTAL A $3,319,397 $8,846,375 $12,165,772 B $3,114,169 $126,677 $3,240,846 C $0 $0 $0 D $2,080,292 $0 $2,080,292 E $2,402,586 $0 $2,402,586 SCHEDULE R - PART I - (B) PRIMARY ACTIVITY: OSF LIFELINE AMBULANCE, LLC OWNS ten AMBULANCES AND FOUR WHEEL CHAIR VANS CONFIGURED AND EQUIPPED FOR PATIENT TRANSPORT AND PROVIDES GROUND AMBULANCE SERVICES IN NORTHERN ILLINOIS. SCHEDULE R - PART II - (B) PRIMARY ACTIVITY: THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS IS THE SOLE MEMBER OF THE CORPORATION AND IS ENGAGED IN ACTIVITIES RELATED TO GOVERNANCE OF THE CORPORATION. OSF HEALTHCARE FOUNDATION RAISES FUNDS TO SUPPORT THE ACTIVITIES OF THE CORPORATION. St. Francis Community clinic provides free comprehensive health care services to the indigent population of the area. Ottawa regional hospital & healthcare center operates an acute care hospital in Ottawa that provides efficient and quality healthcare services consistent with the needs of the commnunity. Ottawa regional hospital foundation supports and encourages healthcare services in furtherance of the support of and in assistance to Ottawa Regional Hospital & Healthcare Center through providing financial and fundraising assistance. Ottawa regional hospital auxiliary operates to promote and advance the welfare of Ottawa regional hospital & healthcare center. Ottawa regional hospital & healthcare liability loss fund provides a vehicle for self-insuring risks arising from the operation and maintenance of the Ottawa regional hospital & healthcare center. OSF multi-specialty group has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to comprehensive inpatient and outpatient care. it has not yet commenced operations. OSF Heart & Vascular Institute has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to cardiovascular care and treatment. It has not yet commenced operations. Children's hospital of Illinois Medical group has been organized to support the mission of OSF healthcare system in future years through the provision of quality of healthcare services related to comprehensive inpatient and outpatient care for children. It has not yet commenced operations. Illinois Neuroscience Institute has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to research center for diagnosis and treatment of brain disorders. it has not yet commenced operations. SCHEDULE R - PART III - (B) PRIMARY ACTIVITY: CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC OPERATES AMULTISPECIALTY AMBULATORY SURGICAL CENTER IN PEORIA, ILLINOIS. STATE AND ROXBURY, LLC OPERATES A REAL ESTATE MANAGEMENT ORGANIZATION IN ROCKFORD, ILLINOIS. EASTLAND MEDICAL PLAZA SURGICENTER, LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY TREATMENT CENTER IN BLOOMINGTON, ILLINOIS. FORT JESSE IMAGING CENTER, LLC OPERATES A STAND-ALONE MEDICAL IMAGING CENTER IN BLOOMINGTON, ILLINOIS. SLEEP CENTER OF CENTRAL ILLINOIS, LLC OPERATES A STAND-ALONE SLEEP DISORDER DIAGNOSTIC CENTER IN BLOOMINGTON, ILLINOIS. Radiation Oncology of Northern Illinois, LLC operates a radiation oncology center. Ottawa regional cardinal sleep center, LLC was created to be a sleep diagnostic center. It has not yet commenced operations. SCHEDULE R - PART IV - (B) PRIMARY ACTIVITY: OSF SAINT FRANCIS, INC. PROVIDES HEALTHCARE RELATED SERVICES SUCH AS MEDICAL PRACTICE MANAGEMENT, RETAIL PHARMACIES, MOBILE MEDICAL SYSTEMS, DURABLE MEDICAL EQUIPMENT, HOME THERAPEUTICS, REAL ESTATE RENTAL AND EQUIPMENT TECHNOLOGY SERVICES. HEARTCARE MIDWEST, LTD. IS A PHYSICIAN GROUP OF CARDIOVASCULAR SPECIALISTS SERVING CENTRAL ILLINOIS. CARDIOVASCULAR INSTITUTE AT OSF, LLC IS A PHYSICIAN GROUP OF CARDIOVASCULAR SPECIALISTS SERVING NORTHERN ILLINOIS. ILLINOIS PATHOLOGIST SERVICES, LLC PROVIDES PATHOLOGY SERVICES INNORTHERN ILLINOIS. OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC IS A MULTISPECIALTY CLINIC SERVING EASTERN ILLINOIS, OFFERING SERVICES IN ADULT MEDICINE, BEHAVIORAL FAMILY MEDICINE, GENERAL SURGERY, NEUROLOGY, OBSTETRICS, GYNECOLOGY, PEDIATRICS, PHYSIATRY, PULMONOLOGY, RADIOLOGY AND UROLOGY. OSF MULTISPECIALTY GROUP - PEORIA, LLC PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESSES. ILLINOIS NEUROLOGICAL INSTITUTE - PHYSICIANS, LLC PROVIDES A FULL SPECTRUM OF ADULT AND PEDIATRIC CARE FOR ILLNESSES AFFECTING THE BRAIN, SPINAL CORD, AND PERIPHERAL NERVES. ILLINOIS SPECIALTY PHYSICIAN SERVICES AT OSF, LLC PROVIDES PULMONOLOGY AND CRITICAL CARE SERVICES IN CENTRAL ILLINOIS. OSF PERINATAL ASSOCIATES, LLC PROVIDES MATERNAL FETAL MEDICINE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. OSF Multispecialty group - western region, LLC is a multispecialty clinic serving western Illinois, offering services in a wide variety of general and specialty medical categories. OSF CHILDREN'S MEDICAL GROUP - CONGENITAL HEART CENTER, LLC PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESS IN NORTHERN ILLINOIS. PREFERRED EMERGENCY PHYSICIANS OF ILLINOIS, LLC PROVIDES PHYSICIAN COVERAGE FOR EMERGENCY DEPARTMENTS. Ottawa regional healthcare affiliates, inc. is a holding company for Ottawa regional cardinal sleep centr, llc and ottawa regional medical center, inc. Ottawa regional medical center, inc. provides outpatient medical and diagnostic services. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GERALD J. MCSHANE, M.D. TITLE:Pres/CEO OSFMG, board member HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN D SCHOEPLEIN TITLE:Vice Chairperson; CEO HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER AGNES JOSEPH WILLIAMS, OSF TITLE:Assistant Secretary HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER DIANE MARIE MCGREW, OSF TITLE:PRESIDENT/TREASURER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER JUDITH ANN DUVALL, OSF TITLE:Chairperson HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER ROSE THERESE MANN, OSF TITLE:Board Member HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SISTER THERESA ANN BRAZEAU, OSF TITLE:Secretary HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:VANCE C. PARKHURST TITLE:Senior Vice President HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DANIEL E.BAKER TITLE:Senior VP, Board Member HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DANIEL R. FASSETT, MD ** TITLE:Physician, Neurosurgery HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FINN REIDER AMBLE,MD ** TITLE:Physician, Neurosurgery HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFFREY D. KLOPFENSTEIN, MD ** TITLE:Physician, Neurosurgery HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SYED M. HUSSAIN, MD ** TITLE:Physician, Vascular Surgery HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAMES MOORE TITLE:Vice Chairperson; CEO Retired HOURS: OSF Lifeline Ambulance LLC 318 Roxbury Road Rockford IL 61107 200080542 Schedule O IL -1119546 948611 OSF Sisters of The Third order of St Franci 800 NE Glen OAK Ave Peoria IL 61603 371259286 Schedule O IL 501(c)(3) Ln11 TypeII NA false OSF Healthcare Foundation 800 NE Glen OAk Ave Peoria IL 61603 371259284 Schedule O IL 501(c)(3) Ln11 TypeII NA false St Francis Community Clinic 530 NE Glen Oak Ave Peoria IL 61603 370661235 Schedule O IL 501(c)(3) Ln7 sis 3rd osf false Ottawa Regional Hospital & Healthcare Ce 1100 East Norris Drive Ottawa IL 61350 362604009 Schedule O IL 501(c)(3) Ln3 OSF false Ottawa Regional Hospital Foundation 1100 East Norris Drive Ottawa IL 61603 364007569 Schedule O IL 501(c)(3) LN11A TYPE1 orhhc false Ottawa Regional Hospital Auxiliary 1100 East Norris Drive Ottawa IL 61603 363854788 Schedule O IL 501(c)(3) LN11C Tpiii NA false Ottawa Regional Hospital & Healthcare Ce 1100 East Norris Drive Ottawa IL 61603 360361265 Schedule O IL 501(c)(3) LN11A TYPE1 orhhc false OSF Multi-Specialty Group 800 NE Glen Oak Avenue Peoria IL 61603 383852646 Schedule O IL 501(c)(3) LN11A TYPE1 OSF false OSF Heart & Vascular Institute 800 NE Glen Oak Avenue Peoria IL 61603 352422385 Schedule O IL 501(c)(3) LN11A TYPE1 OSF false Children's Hospital of Illinois Medical 800 NE Glen Oak Avenue Peoria IL 61603 320353954 Schedule O IL 501(c)(3) LN11A TYPE1 OSF false Illinois Neuroscience Institute 800 NE Glen Oak Avenue Peoria IL 61603 364709999 Schedule O IL 501(c)(3) LN11A TYPE1 OSF false Center for Health Ambulatory Surgery Cen 8800 Route 91 North Peoria IL 61615 205557171 Schedule O IL OSF Related 2791115 2265027 false false 0.60250 State and Roxbury LLC 5668 E State Street Rockford IL 61108 261728983 Schedule O IL OSF Related -56238 1872798 false false 0.51000 Eastland Medical Plaza Surgicenter LLC 1505 Eastland Drive Bloomington IL 61701 371400643 Schedule O IL OSF Related 3434227 5753329 false false 0.50000 Fort Jesse Imaging Center LLC 220 Ft Jesse Road Suite B Normal IL 61761 460515604 Schedule O IL OSF Related 303558 232943 false false 0.50100 Sleep Center of Central Illinois LLC 2204 Eastland Drive Suite 100 Bloomington IL 61704 810581886 Schedule O IL OSF Related 263464 205345 false false 0.50050 Radiation Oncology of Northern Illinois 1200 Starfire Drive Ottawa IL 61350 753247165 Schedule O IL ORHHC Related 455880 1173554 false false 0.57000 Ottawa Regional Cardinal Sleep Center 1601 Mercury Circle Suite 2 Ottawa IL 61350 Schedule O IL ORHHC Related 0 0 false false 1.00000 OSF Saint Francis Inc 800 NE Glen Oak Ave Peoria IL 61603 363484677 Schedule O IL OSF C 312355 144307094 1.00000 Heartcare Midwest LTD 5405 N Knoxville Avenue Peoria IL 61614 370996868 Schedule O IL OSF c -17227232 5758710 1.00000 Cardiovascular Institute at OSF LLC 444 Roxbury Road Rockford IL 61107 264225726 Schedule O IL OSF C -7594715 2243688 1.00000 Illinois Pathologist Services LLC 5666 East State Street Rockford IL 61108 800439081 Schedule O IL OSF C 165715 434835 1.00000 OSF Multispecialty Group-Eastern Region 1701 E College Avenue Bloomington IL 61704 300561892 Schedule O IL OSF C -12929274 3686709 1.00000 OSF Multispecialty Group-Peoria LLC 530 NE Glen Oak Avenue Peoria IL 61637 262800379 Schedule O IL OSF C 2566953 219464 1.00000 Ill Neurological Institute-Phy LLC 719 N William Kumpf Blvd Peoria IL 61605 263109118 Schedule O IL OSF C -4988556 699144 1.00000 Ill Spec Phy Svcs at OSF LLC 1001 Main Street Suite 200 Peoria IL 61606 800462209 Schedule O IL OSF C -3461233 320429 1.00000 OSF Perinatal Associates LLC 4911 Executive Drive Suite 200 Peoria IL 61614 800498373 Schedule O IL OSF C -1678863 77 1.00000 OSF Multispecialty Group-Western Region 3315 North Seminary Street Galesburg IL 61401 800608541 Schedule O IL OSF C -5959111 752174 1.00000 OSF Children's Medical Group - 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