2013-11-14T14:54:41-06:00 2012-12-31 CROWE HORWATH LLP 330 E Jefferson Blvd PO Box 7 South Bend IN 466240007 990 2012-01-01 350868178 SOUTH BEND MEDICAL FOUNDATION INC SOUT 5742045291 530 North Lafayette Blvd South Bend IN 46601 ANN M SULLIVAN 2013-11-14 true KENNETH J KEBER P00240883 5742323992 2012 2016-02-25 16:41:14Z ROBERT TOMEC MD 530 North Lafayette Blvd South Bend IN 46601 100278370 false X WWW.SBMF.ORG X 1946 IN SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. 11 10 872 14 0 0 0 429028 97034819 99026282 80602 140634 585608 391040 97701029 99986984 2374760 2710438 0 0 46509524 46930111 0 57197 57197 46468237 48795997 95352521 98493743 2348508 1493241 53629071 52639511 46010216 47569581 7618855 5069930 X SOUTH BEND MEDICAL FOUNDATION EXISTS FOR THE PURPOSE OF PROVIDING QUALITY AND COST EFFECTIVE LABORATORY AND BLOOD BANKING SERVICES TO HOSPITALS, PHYSICIANS, AND PATIENTS. (CONTINUED IN SCHEDULE O). false false 82010136 2710438 99477727 SOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 750 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O) 82010136 true true false false false false false false false true false false false true true true false false false false false false true true false false true true true false false false false false false false true false false false false false false false false false false true 77 0 true 872 true false false false false false true true false false false false X 11 10 true false false false false false false true true false false true true true true true true true true true true IN X James B Myers 5742045206 118 W Edison Road Mishawaka IN 46545 BILAL ANSARI MD 1.00 X X 250 0 0 CHARLES E PETERSON MD 1.00 X X 250 0 0 ALAN B ENGEL MD 1.00 X 250 0 0 BARBARA L WILLIAMS MD 1.00 X 250 0 0 BRIAN SUCHARETZA MD 1.00 X 250 0 0 FREDERICK J FERLIC MD 1.00 X 200 0 0 HENRY KIM MD 1.00 X 250 0 0 JOHN T RICE MD 1.00 X 250 0 0 KURT H STIVER 1.00 X 200 0 0 MICHELLE A MIGLIORE DO 1.00 X 250 0 0 SAMUEL BORRELLI MD 1.00 X 250 0 0 SLOAN S SHAH MD 1.00 X 250 0 0 STARLA D GRABER MD 1.00 X 250 0 0 STEPHEN F MITROS MD 1.00 X 200 0 0 ANN SULLIVAN 40.00 X 232773 0 42832 DIANE JANOWIAK 40.00 X 233474 0 29004 JAMES FRAIN 40.00 X 232993 0 42092 ROBERT KING 40.00 X 273442 0 34446 ROBERT TOMEC MD 40.00 X 385680 0 35498 WILLIAM KALINEY MD 40.00 X 384015 0 36598 ALFONSO CARDENAS MD 40.00 X 363033 0 39273 AMOBI EZENEKWE MD 40.00 X 248662 0 45410 BLAIR CHRENKA MD 40.00 X 232078 0 41510 BOBBIE SUTTON MD 40.00 X 285108 0 31021 C K KIM MD 40.00 X 366137 0 42073 DAVID JENTZ MD 40.00 X 364018 0 34223 DERRICK FORCHETTI MD 40.00 X 261709 0 36522 FRANCISCO DEOGRACIAS MD 40.00 X 353125 0 35601 FRED BUSSE MD 40.00 X 259123 0 35325 JAMES DYER MD 40.00 X 248548 0 19286 JOHN LANDGRAF MD 40.00 X 260223 0 33425 JOSEPH PRAHLOW MD 40.00 X 266461 0 38655 JOYCE SIMPSON MD 40.00 X 164462 0 15733 KRISTEN JACOBS MD 24.00 X 571092 0 37994 LUIS GALUP MD 40.00 X 362643 0 46064 NICOLE ANEST MD 40.00 X 226510 0 32264 NITA GERIG MD 32.00 X 285075 0 41887 ODETA LAPKUS MD 40.00 X 254100 0 34260 RICKY HOOVER MD 40.00 X 345369 0 43567 CARRIE ROBINSON 40.00 X 106412 0 33879 DEBORAH SUN 40.00 X 108217 0 14633 JANET AGLER 40.00 X 102033 0 28629 KAY BEAM 40.00 X 105866 0 5300 PRENTISS JONES 40.00 X 145530 0 26223 8031261 0 1013227 31 true true false ASSOC REG AND UNIV PATHOLOGISTS PO BOX 27964 SALT LAKE CITY UT 84127 REFERENCE LAB 2386480 THERMO ASSET MANAGEMENT SERVICES INC PO BOX 712224 CINCINNATI OH 452712224 EQUIPMENT MAINTENANCE / REPAIR 906100 MICHIANA HEALTH INFORMATION NETWORK 220 W COLFAX AVENUE SUITE 300 SOUH BEND IN 46601 COMMUNITY BASED CLINICAL INFO SYSTEM 776723 CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 64141 EQUIPMENT MAINTENANCE / REPAIR 694128 PARKVIEW PROFESSIONAL PROGRAMS PO BOX 2504 FORT WAYNE IN 468012504 REFERENCE LAB 585269 16 414927 14101 429028 NET OPERATING REVENUES 621500 99026282 99026282 0 0 0 0 0 0 0 0 99026282 123674 123674 0 0 0 0 0 31865 14905 0 16960 16960 16960 45980 414927 276481 -230501 -230501 0 0 CLINICAL PATHOLOGY FEES 621500 451445 451445 TEACHING FEES 611430 76407 76407 0 93689 0 0 93689 621541 99986984 99477727 0 80229 204633 204633 2505805 2505805 0 0 8151161 6652667 1498494 0 27679891 21979761 5700130 1073129 852172 220957 7726682 6135758 1590924 2299248 1833006 466242 0 56835 56835 81481 81481 0 57197 57197 0 1950240 1045591 904649 0 0 2930381 1470067 1460314 0 0 1887456 1789097 98359 121545 65077 56468 0 0 658845 15256 643589 0 3510158 3078042 432116 729599 99151 630448 MEDICAL LAB 22653885 21870965 782920 REFERENCE LAB 4431550 4431550 BAD DEBT 3635498 3635498 BUILDING EQUIPMENT/MAINTENANCE 3635083 2431096 1203987 2513441 1914944 598497 0 98493743 82010136 16426410 57197 0 850 841 11644739 9566851 11361378 11110618 0 0 1756111 2117948 1240012 1566976 92583163 65020370 26980187 27562793 0 0 490286 571791 155508 141693 53629071 52639511 8208104 9693485 11565000 10615000 0 26237112 27261096 46010216 47569581 X 7618855 5069930 7618855 5069930 53629071 52639511 X 1493241 374373 -4416539 X false true X true false X 429028 429028 92391025 94545973 94079057 97034819 99026282 477077156 193765 238981 195040 169918 170096 967800 0 0 92584790 94784954 94274097 97204737 99625406 478473984 0 0 0 0 15082 15082 0 0 0 0 0 0 0 0 0 0 15082 15082 478458902 60887 -108281 -69086 60573 123674 67767 0 60887 -108281 -69086 60573 123674 67767 0 353784 334004 338675 415690 497425 1939578 92999461 95010677 94543686 97681000 100246505 480481329 0.99580 0.99430 0.00010 0.00170 X OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 353784, COLUMN B - 334004, COLUMN C - 338675, COLUMN D - 415690, COLUMN E - 451445, COLUMN F - 1893598; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 0, COLUMN E - 45980, COLUMN F - 45980;, RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1115907 1115907 43197792 25593551 17604241 807978 791390 16588 46245230 38635429 7609801 1216256 1216256 27562793 0 ACCRUED PENSION AND POSTRETIREMENT BENEFITS 25183732 FAIR VALUE OF INTEREST RATE SWAP 1964673 CAPITAL LEASE OBLIGATION 112691 27261096 X FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THE FOUNDATION'S FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES FOR THE YEARS ENDED DECEMBER 31, 2009 THROUGH 2012. THE FOUNDATION FOLLOWS GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD WITH RESPECT TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. A TAX POSITION IS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. MANAGEMENT HAS DETERMINED THAT THERE IS NO LIABILITY FOR UNCERTAIN TAX POSITIONS AND DOES NOT EXPECT THIS TO CHANGE OVER THE NEXT 12 MONTHS. X true DONNA KYLE 21556 LAKE STREET CASSOPOLIS MI 49031 FUNDRAISING EVENT CONSULTING & SOLICIATION false 460907 52197 408710 LOU BEHRE 1660 SIGNAL POINT DRIVE NILES MI 49120 FUNDRAISING EVENT COORDINATOR false 5000 -5000 460907 57197 403710 IN 100TH ANNIVERSARY GALA 460907 414927 45980 276481 0 0 460907 414927 45980 0 0 0 0 0 276481 276481 -230501 true THE FOUNDATION OF ST JOSEPH REGIONAL MEDICAL CENTER 837 EAST CEDAR STREET SUITE 350 SOUTH BEND IN 466172069 351654543 501(C)(3) 10000 0 N/A N/A GENERAL SUPPORT BOYS AND GIRLS CLUB OF ST JOSEPH COUNTY 1411 LINCOLNWAY W MISHAWAKA IN 46544 351329625 501(C)(3) 11000 0 N/A N/A GENERAL SUPPORT NORTHERN INDIANA HISTORICAL SOCIETY 808 W WASHINGTON ST SOUTH BEND IN 46601 351124156 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT INDIANA UNIVERSITY FOUNDATION PO BOX 500 BLOOMINGTON IN 47204 356018940 501(C)(3) 10000 0 N/A N/A GENERAL SUPPORT - IU SCHOOL OF MEDICINE - SOUTH BEND LAKELAND HEALTH FOUNDATION NILES 1234 NAPIER AVE ST JOSEPH MI 49085 383130558 501(C)(3) 5035 0 N/A N/A GENERAL SUPPORT MARCH OF DIMES - INDIANA CHAPTER 136 EAST MARKET STREET SUITE 500 INDIANAPOLIS IN 46204 131846366 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT MEMORIAL HOSPITAL OF SOUTH BEND 615 N MICHIGAN STREET SOUTH BEND IN 46601 350868132 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT UNITED WAY OF ST JOSEPH COUNTY 3517 E JEFFERSON BLVD SOUTH BEND IN 46615 351063368 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT O'HANA HERITAGE FOUNDATION DBA A ROSIE PLACE 53131 QUINCE ROAD SOUTH BEND IN 46628 371523448 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT MEDICAL EDUCATION FOUNDATION PO BOX 4394 SOUTH BEND IN 46634 351291588 501(C)(3) 5000 0 N/A N/A GENERAL SUPPORT - IUSB CLINICAL TRAINING LOGAN COMMUNITY RESOURCES 2505 E JEFFERSON BLVD SOUTH BEND IN 46615 350965639 501(C)(3) 5500 0 N/A N/A GENERAL SUPPORT COMMUNITY FOUNDATION OF ST JOSEPH COUNTY PO BOX 837 SOUTH BEND IN 46624 237365930 501(C)(3) 75540 0 N/A N/A GENERAL SUPPORT CENTER FOR HOSPICE 111 SUNNYBROOK CT SOUTH BEND IN 46637 310952866 501(C)(3) 5140 0 N/A N/A GENERAL SUPPORT 13 0 PATIENT MEDICAL ASSISTANCE 0 1919979 BOOK VALUE FREE OR REDUCED MEDICAL CARE TIME OF SERVICE DISCOUNTS 0 585826 BOOK VALUE DISCOUNT PROVIDED AT TIME OF PAYMENT NUMBER OF RECIPIENTS SCHEDULE I, PART III, COLUMN (B) CURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS. Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 SOUTH BEND MEDICAL FOUNDATION (SBMF) PROVIDES FUNDING TO OTHER COMMUNITY NOT-FOR-PROFIT ORGANIZATIONS. GENERALLY, THESE ARE UNRESTRICTED CONTRIBUTIONS THAT THE RECEIVING ORGANIZATION CAN USE TO FURTHER THEIR MISSION AND PROGRAMS AT THEIR DISCRETION. THE USE OF THESE CONTRIBUTIONS IS NOT MONITORED. SBMF ALSO PROVIDES ASSISTANCE TO INDIVIDUALS IN THE FORM OF FREE OR REDUCED FEE MEDICAL CARE AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITIES SERVED. THESE INDIVIDUALS MEET SBMF'S CHARITY CARE ELIGIBILITY REQUIREMENTS, OR THE REQUIREMENTS OF THE REFERRING HEALTH CARE PROVIDER. DETERMINATION AND MONITORING OF CHARITY CARE IS PERFORMED ON A CASE-BY-CASE BASIS. SBMF ALSO PROVIDES DISCOUNTS FOR PAYMENT AT TIME OF SERVICE TO PATIENTS WHO DO NOT HAVE GOVERNMENT PROVIDED INSURANCE COVERAGE OR DO NOT WISH TO HAVE A CLAIM FILED WITH THEIR COMMERCIAL INSURANCE CARRIER. THERE IS NO ACTUAL EXCHANGE OF FUNDS, AS THE DISCOUNTS ARE CREDITED DIRECTLY TO THE PATIENTS' ACCOUNTS. TIME OF SERVICE DISCOUNTS ARE MONITORED AT THE ORGANIZATION LEVEL, IN THE AGGREGATE. X true true X X X X false true false false false false false false false ALFONSO CARDENAS MD 362982 0 51 0 0 0 7350 0 31923 0 402306 0 0 0 AMOBI EZENEKWE MD 245633 0 73 0 2956 0 7350 0 38060 0 294072 0 0 0 BLAIR CHRENKA MD 229422 0 203 0 2453 0 4752 0 36758 0 273588 0 0 0 BOBBIE SUTTON MD 285035 0 73 0 0 0 7350 0 23671 0 316129 0 0 0 C K KIM MD 362916 0 73 0 3148 0 7350 0 34723 0 408210 0 0 0 DAVID JENTZ MD 360819 0 51 0 3148 0 7350 0 26873 0 398241 0 0 0 DERRICK FORCHETTI MD 261641 0 68 0 0 0 7350 0 29172 0 298231 0 0 0 FRANCISCO DEOGRACIAS MD 349926 0 51 0 3148 0 7350 0 28251 0 388726 0 0 0 FRED BUSSE MD 239114 0 53 0 19956 0 7350 0 27975 0 294448 0 0 0 JAMES DYER MD 245633 0 73 0 2842 0 4793 0 14493 0 267834 0 0 0 JOHN LANDGRAF MD 250977 0 51 0 9195 0 7350 0 26075 0 293648 0 0 0 JOSEPH PRAHLOW MD 263491 0 73 0 2897 0 7350 0 31305 0 305116 0 0 0 JOYCE SIMPSON MD 164462 0 0 0 0 0 6541 0 9192 0 180195 0 0 0 KRISTEN JACOBS MD 214547 0 51 0 356494 0 6594 0 31400 0 609086 0 353882 0 LUIS GALUP MD 359070 0 73 0 3500 0 7350 0 38714 0 408707 0 0 0 NICOLE ANEST MD 222550 0 68 0 3892 0 5433 0 26831 0 258774 0 0 0 NITA GERIG MD 265347 0 70 0 19658 0 7350 0 34537 0 326962 0 0 0 ODETA LAPKUS MD 254032 0 68 0 0 0 4900 0 29360 0 288360 0 0 0 RICKY HOOVER MD 342170 0 51 0 3148 0 7350 0 36217 0 388936 0 0 0 ROBERT TOMEC MD 364977 0 51 0 20652 0 7350 0 28148 0 421178 0 0 0 ROBERT KING 270165 0 68 0 3209 0 7350 0 27096 0 307888 0 0 0 WILLIAM KALINEY MD 363477 0 51 0 20487 0 7350 0 29248 0 420613 0 0 0 DIANE JANOWIAK 232699 0 73 0 702 0 6981 0 22023 0 262478 0 0 0 ANN SULLIVAN 229171 0 68 0 3534 0 6721 0 36111 0 275605 0 0 0 JAMES FRAIN 230171 0 68 0 2754 0 6981 0 35111 0 275085 0 0 0 PRENTISS JONES 145462 0 68 0 0 0 4447 0 21776 0 171753 0 0 0 Health or social club dues or initiation fees Schedule J, Part I, Line 1a THE ORGANIZATION INCLUDES THE PERSONAL USE OF SOCIAL CLUB DUES IN TAXABLE COMPENSATION FOR THE ORGANIZATION'S VICE PRESIDENT OF FINANCE AND VICE PRESIDENT OF CENTRAL LAB OPERATIONS. PERSONAL USE IS DETERMINED BY SIGNED ACKNOWLEDGEMENT OF EACH OFFICER. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE ORGANIZATION HAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THAT WAS DESIGNED TO REPLACE RETIREMENT BENEFITS LOST BY INDIVIDUALS DUE TO 1998 CHANGES IN PENSION LAWS AND A REDESIGN OF THE PENSION PLAN TO MAXIMIZE BENEFITS FOR LOWER COMPENSATED EMPLOYEES. THE ORGANIZATION'S BOARD OF DIRECTORS ELECTED TO FREEZE THIS PLAN, AND THEREFORE NO BENEFITS WERE PROVIDED DURING 2012. MICHIANA HEALTH INFORMATION NETWORK LLC (MHIN) R. KING & R. TOMEC (SBMF OFFICERS) ARE MHIN BOARD MEMBERS 803564 SEE PART V false MICHIANA HEMATOLOGY ONCOLOGY PC (MHO) B. ANSARI (SBMF BOARD MEMBER) IS AN OFFICER/DIRECTOR OF MHO. 110053 SEE PART V false DESCRIPTION OF TRANSACTION (MHIN) SCHEDULE L, PART IV, COLUMN (D) SBMF OWNS AN INTEREST IN MHIN, A JOINT VENTURE THAT MAINTAINS A COMMUNITY-BASED MEDICAL INFORMATION SYSTEM AND CLINICAL DATA REPOSITORY. SBMF PURCHASED SERVICES AT FMV FROM MHIN AGGREGATING $756,000 DURING 2012. IN ADDITION, MHIN PURCHASED CERTAIN SERVICES AT FMV FROM SBMF AMOUNTING TO $47,564 DURING 2012. DESCRIPTION OF TRANSACTION (MHO) SCHEDULE L, PART IV, COLUMN (D) SBMF MADE $110,053 IN PAYMENTS (AT FMV) TO MHO FOR RENTAL OF SPACE. ORGANIZATION'S MISSION (CONTINUED FROM PART III) FORM 990, PART III, LINE 1 TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT. PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) FORM 990, PART III, LINE 4A THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $881,500 FOR THE YEAR ENDED DECEMBER 31, 2012. Delegate broad authority to a committee Form 990, Part VI, Section A, Line 1a THE ADMINISTRATIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION. SUBJECT TO THE CONTROL OF THE BOARD OF DIRECTORS, THE ADMINISTRATIVE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT FOR AND ON BEHALF OF THE CORPORATION AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS THAT MAY BE LAWFULLY DELEGATED BY SUCH BOARD TO SUCH COMMITTEE EXCEPT, HOWEVER, THE ADMINISTRATIVE COMMITTEE SHALL HAVE NO POWER TO DONATE ANY PART OF THE ASSETS OF THE CORPORATION. THE ADMINISTRATIVE COMMITTEE SHALL RECEIVE STATUS REPORTS ON OTHER COMMITTEE ACTIVITIES AND DISCUSS ITEMS OF INTEREST TO THE GROUP AS A WHOLE OR TO INDIVIDUAL OFFICERS FOR THE PERFORMANCE OF THEIR DUTIES. THE ADMINISTRATIVE COMMITTEE SHALL KEEP MINUTES OF ITS MEETINGS. Family/business relationships amongst interested persons Form 990, Part VI, Section A, Line 2 BOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - BUSINESS RELATIONSHIP, ANA CARDENAS (WIFE OF ALFONSO CARDENAS) AND JOHN JACOBS (HUSBAND OF KRISTEN JACOBS) - BUSINESS RELATIONSHIP, FREDERICK J. FERLIC, M.D. AND HENRY KIM, M.D. - BUSINESS RELATIONSHIP Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b PRIOR TO NOVEMBER 15, 2013, EACH BOARD MEMBER WAS PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW AND INSTRUCTED TO SUBMIT ANY QUESTIONS OR COMMENTS TO THE VP OF FINANCE. AFTER COMMENTS AND QUESTIONS ARE REVIEWED, THE RETURN WAS COMPLETED AND FILED WITH THE IRS ON OR BEFORE NOVEMBER 15, 2013. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETED BY ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THE ORGANIZATION'S VICE PRESIDENT OF FINANCE AND TAX ADVISERS REVIEW ALL RESPONSES TO DETERMINE WHETHER OR NOT A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, PERSONS WITH A CONFLICT ARE RECUSED FROM VOTING ON THE CONFLICTING ISSUE. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a ON AN ANNUAL BASIS, THE ORGANIZATION'S COMPENSATION COMMITTEE REVIEWS AND APPROVES COMPENSATION FOR THE PRESIDENT/EXECUTIVE VICE PRESIDENT, AS WELL AS OTHER OFFICERS, ADMINISTRATORS, AND PROFESSIONAL STAFF, INCLUDING KEY EMPLOYEES. THE COMMITTEE REVIEWS CURRENT SALARIES AND PAY STRUCTURES AGAINST VARIOUS SOURCES OF COMPARABILITY DATA, INCLUDING: THE COLLEGE OF AMERICAN PATHOLOGY PATHOLOGISTS COMPENSATION SURVEY; PATHOLOGY COMPENSATION DATA FOR PATHOLOGISTS, WHICH OUTLINES PATHOLOGY AND PHYSICIAN SALARIES BY SPECIALTY, PROVIDED FROM MERRITT HAWKINS AND ASSOCIATES; THE GUIDESTAR NATIONAL COMPENSATION REPORT; AND COMPENSATION REPORTED ON LOCAL AREA HOSPITALS' FORMS 990. AFTER REVIEWING THE COMPARABILITY DATA, THE COMMITTEE DISCUSSES THE CURRENT ECONOMY AND FINANCIAL POSITION OF THE ORGANIZATION TO DETERMINE THE AMOUNT OF ANY COMPENSATION INCREASES AND/OR DECREASES, IF ANY, THAT WILL BE GIVEN. THIS PROCESS IS DOCUMENTED IN THE COMPENSATION COMMITTEE'S MEETING MINUTES. THE COMPENSATION REVIEW COMMITTEE MET APRIL 26, 2012 AND REPORTED AT THE MAY BOARD OF DIRECTOR'S MEETING. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b SEE NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 WHEN REQUESTS FOR THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE, THE DATA IS PROVIDED ON SITE. WHEN REQUESTS FOR THE ORGANIZATION'S GOVERNING DOCUMENTS ARE MADE, THE PERSON IS REFERRED TO WWW.IRS.GOV, WHERE COPIES ARE AVAILABLE. THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC ON SITE. Other changes in net assets or fund balances Form 990 , Part XI, Line 9 PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -4313414; GALA 2013 RECEIPTS - -103125;