BEACON HEALTH FOUNDATION INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BEACON HEALTH FOUNDATION INC (EIN 35-1536129)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201233199349306513
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T16:38:34-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351536129EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JEFFREY COSTELLOInCareOfName
Name ControlMEMONameControl
Phone5746473549Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1615 N Michigan StreetAddressLine1
CitySouth BendCity
StateINState
ZIP Code46601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEFFREY COSTELLOName
TitleCFOTitle
Date Signed2012-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPhilip NewboldNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1615 N Michigan StreetAddressLine1
CitySouth BendCity
StateINState
ZIP Code46601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2593905GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.qualityoflife.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionMEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members23NbrIndependentVotingMembers
Total Nbr Employees5TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1436553ContributionsGrantsPriorYear
Contributions Grants Current Year2225724ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year101731InvestmentIncomePriorYear
Investment Income Current Year203953InvestmentIncomeCurrentYear
Other Revenue Prior Year97OtherRevenuePriorYear
Other Revenue Current Year-1208OtherRevenueCurrentYear
Total Revenue Prior Year1538384TotalRevenuePriorYear
Total Revenue Current Year2428469TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4223295GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1238765GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year606847SalariesEtcPriorYear
Salaries Etc Current Year560314SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year415759TotalFundrsngExpCurrentYear
Other Expense Prior Year899097OtherExpensePriorYear
Other Expenses Current Year721413OtherExpensesCurrentYear
Total Expenses Prior Year5729239TotalExpensesPriorYear
Total Expenses Current Year2520492TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4190855RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-92023RevenuesLessExpensesCY
Total Assets BOY22902442TotalAssetsBOY
Total Assets EOY22210857TotalAssetsEOY
Total Liabilities BOY1176625TotalLiabilitiesBOY
Total Liabilities EOY123796TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY21725817NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY22087061NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1450454Expense
Grants1258492Grants
Revenue268Revenue
DescriptionMemorial Health System, Inc. (the "Corporation") was established as the parent corporation of Memorial Hospital of South Bend, Inc. (the "Hospital") in 1981 to develop a full spectrum of health-related services for North Central Indiana and Southwestern Michigan. The Corporation is community-owned and not-for-profit. Along with its subsidiaries, the Corporation serves the greater community throughout the continuum of care from health promotion and sickness prevention to diagnosis, inpatient, outpatient and home health services. It controls the Hospital, Memorial Health Foundation, the Hospital's philanthropic arm, and Memorial Home Care, Inc., collectively referred to as the "System". Memorial Health Foundation, Inc., (MHF) a tax-exempt foundation, was established in 1982 to provide philanthropic support to the Hospital and the Corporation through contributions and management of endowment funds. Memorial Health Foundation's mission is to support the work of Memorial Hospital & Health System by inspiring generosity and commitment to our cause. MHF exists to allow people to generously support Memorial in a way that connects them with the impact they are having on Memorial's work in the community. Memorial Health Foundation works to support Memorial Hospital & Health System in three key ways: - Creating relationships - Inspiring generosity - Stewarding resources Creating Relationships Every day, Memorial cares for those most in need of high quality, specialized medical care. From infants born four months early, to children with cancer, to mothers, fathers, sisters, brothers and friends who have faced a serious injury, Memorial is always here for every member of our community. Memorial Health Foundation (MHF) raises funds for Memorial Hospital & Health System. Our job is to ensure that charitable support for Memorial is used to create the most significant impact possible at Memorial in a way that is most meaningful to each donor. We build relationships with those who want to make a difference and connect them with a cause at Memorial that inspires them. Memorial is reliant on the support of our community to ensure that we are always able to provide the highest quality services for every patient. At Memorial Health Foundation, every gift matters and is an investment into our mission and our community. We treat that investment with the same level of care and concern that Memorial shows each one of its patients. Inspiring Generosity: In 2011, fund raising at Memorial Health Foundation focused upon the following areas: - Corporate Fundraising - Grant Writing, focusing on private, corporate, and family foundations - Online Giving - Major gift fundraising, focusing on: - Memorial Children's Hospital - The Memorial Neighborhood Health Centers - Memorial HealthWorks! Kids' Museum - Spiritual Care Services - Staff Education - Direct Mail Fundraising Funds available at MHF to support Memorial's mission as of December 31, 2011: Memorial Hospital & Health System $1,309,913 Memorial Children's Hospital $2,242,496 Stewarding Resources In 2011, funds from Memorial Health Foundation went to support the following areas at Memorial: Memorial Hospital & Health System Memorial BrainWorks $ 89,567.52 Memorial Regional Cancer Center $ 59,544.24 Community Health Enhancement $ 66,600.36 Family Medicine Residency Program $ 5,000.00 Family Psychosocial Support (Chaplaincy, Social Services, etc.) $ 5,914.49 Pfeil Innovation Center $ 48,553.75 Reach Out Club $ 82,103.71 Staff Education $ 38,969.02 Sunburst Races $ 35,500.00 Areas of Greatest Need at Memorial $ 12,661.52 Other Community Initiatives $ 20,919.72 Memorial Children's Hospital Memorial Children's Hospital $ 18,243.14 Pediatric Psychosocial Support (Child Life, Social Services, etc.) $ 5,125.17 Developmental Pediatrics $219,856.01 HealthWorks! Kids' Museum $188,102.26 Newborn Intensive Care Unit $ 49,922.94 Patient Family Support $ 25,670.00 Pediatric Hematology Oncology $ 10,203.52Description
Total Program Service Expense1450454TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees5NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members23NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJEFFREY COSTELLONamePerson
Telephone Number5746473549TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 N MICHIGAN STREETAddressLine1
CitySouth BendCity
StateINState
ZIP Code46601ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Leland R Kaiser PhD
Director2.0X000
Carmi Murphy
Director thru March 20112.0X000
Olubunmi A Okanlami MD
Director thru March 20112.0X039580823721
Jan R Reineke MD
Director thru March 20112.0X000
James F Keenan
Chair thru March 20112.0X000X
John C Kerr
VICE Chair2.0X399000X
Najeeb A Khan
Chair2.0X000X
Terri T Kosik
Director2.0X000
John T Phair
Director2.0X186600
Peter Veldman
Director2.0X284400
Louis M Nanni
Director2.0X207300
Christopher Chocola
Director thru March 20112.0X000
James Laing
Director2.0X000
Michael Vogel
Director thru March 20112.0X000
Mary Jo Halbritter
Secretary2.0X000X
William Schmuhl Jr
Director2.0X168600
Maggie Kernan
Director2.0X235500
Leigh Morris
Treasurer2.0X000X
Timothy Griffin
Director thru March 20112.0X000
Charles Simon
Director2.0X000
Deborah Barton-Grant
Director2.0X305100
Deborah Cafiero
Director2.0X000
Delores Wilmoski
Director2.0X000
Otha Reese
Director2.0X168600
Sandra Brown MD
Director2.0X199900
Shannon Cullinan
Director2.0X305100
Greta Roemer Lewis
Director2.0X365800
Colleen Morrison MD
Director2.0X019684325921
Michael Steinberg MD
Director2.0X0540131243
Katie Toothaker
Director2.0X106800
Emerson Spartz
Director2.0X000
Christopher Hickey
Director2.0X279700
David Hornback MD
Director2.0X070495134245
Philip A Newbold
CEO/President2.00167563742358X
Jeffrey Costello
CFO/Asst. Treasurer2.0060804932936X
Kellie Porter
Asst. Secretary40.0142057024892X
FieldValueIRS element (for citing)
Total Reportable Comp From Org174181TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3635301TotalReportableCompFrmRltdOrgs
Total Other Compensation185316TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events9345FundraisingEvents
All Other Contributions2216379AllOtherContributions
Noncash Contributions69012NoncashContributions
Total Contributions2225724TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column195423TotalRevenueColumn
Exclusion$195,423ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities170535Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities162005Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities8530Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column8530TotalRevenueColumn
Exclusion$8,530ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events1955GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events9345CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses3431FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-1476TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER INCOME - TIMELESS SETTLEMENT611600187187
OTHER INCOME - MISC CLASS ACT REVENUE6116005757
OTHER INCOME - SPIRO SETTLEMENT6116002424
FieldValueIRS element (for citing)
Total Other Revenue268TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2428469TotalRevenueColumn
Related Or Exempt Function Income268RelatedOrExemptFunctionIncome
Exclusion$203,953ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1181553Total
Program Services1181553ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total57212Total
Program Services57212ProgramServices

Foreign Grants ForeignGrants

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Total0Total

Benefits To Members BenefitsToMembers

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Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total174182Total
Program Services14206ProgramServices
Management And General117359ManagementAndGeneral
Fundraising42617Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total317566Total
Program Services92339ProgramServices
Management And General95732ManagementAndGeneral
Fundraising129495Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total37990Total
Program Services3757ProgramServices
Management And General22962ManagementAndGeneral
Fundraising11271Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total30576Total
Program Services6625ProgramServices
Management And General13250ManagementAndGeneral
Fundraising10701Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1737Total
Management And General1737ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12299Total
Management And General10938ManagementAndGeneral
Fundraising1361Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total46852Total
Management And General28544ManagementAndGeneral
Fundraising18308Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total14582Total
Management And General14582ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total29245Total
Management And General16178ManagementAndGeneral
Fundraising13067Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total12000Total
Management And General1272ManagementAndGeneral
Fundraising10728Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total945Total
Management And General523ManagementAndGeneral
Fundraising422Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total29200Total
Management And General29200ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total49027Total
Management And General49027ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total32465Total
Management And General32465ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CORPORATE ALLOCATION43736594762189525153078
CIRCLES OF EXCELLENCE296821642013262
DUES/SUBSCRIPTIONS913150514080
RECOGNITION290216051297

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total13981Total
Management And General7909ManagementAndGeneral
Fundraising6072Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2520492Total
Program Services1450454ProgramServices
Management And General654279ManagementAndGeneral
Fundraising415759Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3718038BOY
EOY3579430EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY88300BOY
EOY100265EOY

Accounts Receivable AccountsReceivable

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BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

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BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1925BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis416856LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec297238LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY137852BOY
EOY119618EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY18956327BOY
EOY18411544EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22902442BOY
EOY22210857EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8967BOY
EOY47675EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY1057398BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY110260BOY
EOY76121EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1176625BOY
EOY123796EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY17986961BOY
EOY17413169EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3738856BOY
EOY4483222EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY190670EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21725817BOY
EOY22087061EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22902442BOY
EOY22210857EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-92023ReconcilationRevenueExpenses
Reconcilation Other Changes453267ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1695500CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1532816CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1334217CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1436553CurrentTaxYearMinus1Year
Current Tax Year2225724CurrentTaxYear
Total8224810Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years207590CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years142561CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years127810CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year100CurrentTaxYearMinus1Year
Current Tax Year268CurrentTaxYear
Total478329Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1903090CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1675377CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1462027CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1436653CurrentTaxYearMinus1Year
Current Tax Year2225992CurrentTaxYear
Total8703139Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years984449CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years121124CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years133141CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year67601CurrentTaxYearMinus1Year
Current Tax Year370311CurrentTaxYear
Total1676626Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years984449CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years121124CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years133141CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year67601CurrentTaxYearMinus1Year
Current Tax Year370311CurrentTaxYear
Total1676626Total
FieldValueIRS element (for citing)
Public Support Total5097026513PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1922402CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years402683CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years201715CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year113552CurrentTaxYearMinus1Year
Current Tax Year195423CurrentTaxYear
Total2835775Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13960CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18314CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10410CurrentTaxYearMinus2Years
Total42684Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1936362CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years420997CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years212125CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year113552CurrentTaxYearMinus1Year
Current Tax Year195423CurrentTaxYear
Total2878459Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year1955CurrentTaxYear
Total1955Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3839452CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2096374CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1674152CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1550205CurrentTaxYearMinus1Year
Current Tax Year2423370CurrentTaxYear
Total11583553Total
FieldValueIRS element (for citing)
Public Support Percentage5090.60659PublicSupportPercentage509
Prior Year Support Percentage0.51786PriorYearSupportPercentage
Investment Income Percentage0.24849InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.27267PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance21769701BeginningOfYearBalance
Contributions2155236Contributions
Investment Earnings Or Losses-543657InvestmentEarningsOrLosses
Grants Or Scholarships1182458GrantsOrScholarships
End Of Year Balance22198822EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance22665989BeginningOfYearBalance
Contributions1296194Contributions
Investment Earnings Or Losses1929600InvestmentEarningsOrLosses
Grants Or Scholarships4122082GrantsOrScholarships
End Of Year Balance21769701EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance20595396BeginningOfYearBalance
Contributions1076924Contributions
Investment Earnings Or Losses3137353InvestmentEarningsOrLosses
Grants Or Scholarships2143683GrantsOrScholarships
End Of Year Balance22665990EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance28741974BeginningOfYearBalance
Contributions1278996Contributions
Investment Earnings Or Losses-6927657InvestmentEarningsOrLosses
Grants Or Scholarships2497917GrantsOrScholarships
End Of Year Balance20595396EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.78950BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00850PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.20200TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis416856OtherCostOrOtherBasis
Depreciation297238Depreciation
Book Value119618BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings119618TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USE OF ENDOWMENT FUNDSIdentifier
Return ReferenceSch. D, Part V, Line 4ReturnReference
ExplanationBoard Designated Endowment - The second amendment, dated July 27, 1995, provides Board direction to utilize each year the income, revenues, and profits arising and accruing from the endowment, in defraying cost associated with the trust and the remainder for support, betterment, improvement, upkeep, expansion, and replacement of Memorial Health System, Inc. and its corporate affiliates. Term endowments, which are the Temporarily restricted net assets are used as designated by the donor. The permanent endowment provides income to be used for health care educational purposes.Explanation

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted
Total Expenditures2429699TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent2429699SubtotalAmountSpent
Total Amount Spent2429699TotalAmountSpent
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
Memorial Hospital of South Bend Inc
615 N Michigan StreetSouth BendIN46601350868132501(c)(3)6392878600FMVEXERCISE EQUIPGeneral Support
Memorial Health System Inc
615 N Michigan StreetSouth BendIN46601351536132501(c)(3)514674General support
University of Notre Dame
Athletic Dept/Bus OffNotre DameIN465565678350868188501(c)(3)5500TEG/ER ResearchJoyce Center
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantGrants for ChildrenTypeOfGrant
Amount Of Non Cash Assistance57212AmountOfNonCashAssistance
Method Of ValuationFMVMethodOfValuation
Description Of Non Cash Assistancegift cardsDescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGRANT MONITORING PROCEDURESIdentifier
Return ReferenceSchedule I, Part IReturnReference
ExplanationThe organization has numerous temporarily restricted funds, from which the distributions are considered grants. In general the grants are to provide scholarships and/or are distributions for the purpose of the specific fund. All distributions of the funds are supported by evidence that the expenditure meets the donor's intent. For scholarships the individual must meet several requirements to qualify. In order to qualify for a scholarship the individual must (1)Apply on-line (intranet) and within the acceptable time parameters for the semester of funds being requested, (2) Maintain a grade of C or better,(3)Pay for tuition/books and submit corresponding original receipts for reimbursement. Reimbursed up to the amount awarded by the scholarship committee. (4) Meet any additional requirements of the specific scholarship fund, and (5) Meet eligibility requirements which include: (A) Employed by Memorial Health System, Inc. (B) Enrolled in a qualified program; (C) Submitted a positive recommendation each semester from the immediate supervisor; and (D) Submitted a positive recommendation each semester from the school.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Philip A Newbold
055921908915630224855022046020312017179950448804
Olubunmi A Okanlami MD
03944280001380010468013253041952900
Jeffrey Costello
0282072030318602279101740201553406409850203250
Colleen Morrison MD
019646900037402760023161022276400
David Hornback MD
059546108310202638809800024445073919600
Kellie Porter
1318220010235018670230250166949000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AHEALTH CLUB AND SPOUSAL TRAVELMEMORIAL HEALTH SYSTEM, INC. (MHS) REIMBURSES TRUSTEES FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS FOR HEALTH CLUB MEMBERSHIP, WITH MHS'S HEALTH AND LIFESTYLE CENTER, AND SPOUSAL TRAVEL. THIS REPORTING IMPACTS 14 CURRENT BOARD MEMBERS. MHS ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. SPOUSAL TRAVEL WAS INCLUDED IN TAXABLE COMPENSATION FOR 1 EMPLOYEE (PHILIP NEWBOLD). CHARTER TRAVEL WAS PROVIDED FOR INVESTMENT COMMITTEE MEMBERS TO TRAVEL TO THE INVESTMENT ADVISOR, LOCATED IN MINNEAPOLIS, MN. THE CHARTER TRAVEL ALLOWED THE ORGINIZATION TO REDUCE THE OVERALL COST OF TRAVEL, BY ELIMINATING THE NEED FOR OVERNIGHT ACCOMIDATIONS. THE CHARTER TRAVEL ALSO REDUCED THE TIME UNPAID BOARD MEMBERS HAD TO COMMIT. CHARTER TRAVEL WAS PROVIDED FOR 5 INDIVIDUALS LISTED ON PART VII, SECTION LINE 1A (JEFFREY COSTELLO, JAMES KEENAN, JOHN KERR, LEIGH MORRIS, AND KELLIE PORTER).
PART 1, LINE 3COMPENSATION REVIEW PROCESSMEMORIAL HEALTH FOUNDATION, INC. USES A RELATED ORGANIZATION'S (MEMORIAL HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. IN WHICH, AN EXTENSIVE EXAMINATION IS CONDUCTED USING COMPARABLE MARKET DATA AND IT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION.
PART I, LINE 4BSUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (457(F))RELATED ORGANIZATION (MEMORIAL HEALTH SYSTEM, INC.) EMPLOYEE 2011 EARNED VESTED 457(f): EMPLOYEE 2011 EARNED 457(f) PHILIP NEWBOLD $191,729 MEMORIAL HEALTH SYSTEM PROVIDED A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) TO CERTAIN EXECUTIVES. THE PURPOSE OF THE PLAN WAS TO PROVIDE AN ADDED RETIREMENT BENEFIT OVER THE QUALIFIED RETIREMENT PROGRAM. QUALIFIED INDIVIDUALS WERE ELIGIBLE TO RECEIVE A BENEFIT, IN THE FORM OF AN AFTER TAX LUMP SUM WHICH WAS THE ACTUARIAL EQUIVALENT OF AN ANNUITY, EQUAL TO 65% OF THE AVERAGE OF THEIR LAST FIVE YEARS OF PRERETIREMENT EARNINGS, OR 70% WITH MORE THAN 25 YEARS OF SERVICE, WITH OFFSETS FOR THE VALUE OF SOCIAL SECURITY AND QUALIFIED RETIREMENT PLAN BENEFITS. PARTICIPANTS WERE VESTED INTO THE SERP AFTER FIVE YEARS OF SERVICE. THE INCREASE IN VALUE OF THE BENEFIT EACH YEAR WAS INCLUDED IN THE TAXABLE COMPENSATION OF VESTED SERP PARTICIPANTS. SUCH AMOUNTS WERE INCLUDED IN PART II COLUMN (b)(iii). IF A VESTED EMPLOYEE LEAVES EMPLOYMENT, THE ANNUAL VALUE OF THE BENEFIT IS CONVERTED TO A LUMP SUM AND PAID TO THE PARTICIPANT AFTER FULFILLING THE TERMS OF THEIR NON-COMPETE AGREEMENT. THE PLAN WAS TERMINATED ON 12/31/2011.
PART I, LINE 6A & 6BCOMPENSATION CONTINGENT ON NET EARNINGSTHE RELATED ORGANIZATION HAS TWO INCENTIVE PLANS (EMPLOYEE AND MANAGEMENT) WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR MEMORIAL HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES, WHICH INCLUDES MEMORIAL HOSPITAL OF SOUTH BEND, INC. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $2,500,000. THE MANAGEMENT INCENTIVE PLAN PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET OPERATING INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. The CEO is covered under a deferred compensation plan. The Plan sets aside half of the CEO's annual bonus award as deferred compensation to be paid in future years at a rate of 20% per year plus accrued interest. In order to receive the future benefits under the Plan, the CEO must continue to remain employed by the organization. The Plan was terminated and benefits under the Plan were paid in full on 12/31/11.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F9901200NoncashContribsRptdF990
Method Of Determining RevenuesCost Donated PropMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XToys, stuffed animals, books and electronics222128762Cost Donated Propert
XHosting/sponsoring events137700Cost Donated Propert
XGift cards, coupons, etc.45522750Cost Donated Propert
XExcercise Equipment18600Cost Donated Propert
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierGIFT ACCEPTANCE AND REVIEWIdentifier
Return ReferenceSch. M, Question 31ReturnReference
ExplanationMemorial Health Foundation has a written process for review of all gifts, it does not speak specifically to non-standard gifts, however there is a review process in place.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (20 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EMPLOYEES OF THE ORGANIZATIONCore Form, Part V, Question 2aEmployees are paid by Memorial Health System, Inc.(EIN 35-1536132) and expensed to Memorial Health Foundation through contract labor.
MEMBERS OF THE ORGANIZATIONCore Form, Part VI, Section A, Question 6Membership in the Corporation shall be divided into two classes: Corporate and Personal. The Corporate Member shall be the Memorial Health System, Inc. The Personal Members shall be the directors of the Corporation.
ELECTION OF BOARD MEMBERSCore Form, Part VI, Section A, Question 7aThe Corporate Member shall appoint the Board of Directors of the Corporation and shall have such powers of advance approval regarding Corporate actions as are delineated in the By-laws of the Corporation.
DECISIONS OF THE BOARD OF DIRECTORSCore Form, Part VI, Section A, Question 7bDecisions of the Board of Directors must be approved by the Corporate Member.
REVIEW PROCESSCore Form, Part VI, Section B, Line 11BThe organization incorporates numerous parties in the production and review of the Form 990 and associated schedules. Senior accounting staff and management, complete the Form 990 and schedules. The forms and schedules are reviewed by the Controller and CFO. Subsequent to those steps, the organization engaged Ernst & Young to review the completed Form 990 and appropriate schedules. Prior to filing the return, the compensation committee of the organization and the CEO conduct a general overview of the form 990, including applicable compensation schedules. In addition, the Board of Directors and the audit committee will receive a copy of the Form 990 prior to filing.
CONFLICT OF INTEREST STATEMENTSCore Form, Part VI, Section B, Line 12cThere are three separate forms that are sent out through the Internal Audit Department to Key Employees or Board Members regarding Conflict of Interest. They are as follows: 1. The first is a Conflict of Interest Statement that is sent to Senior level Administration, Management, and select staff such as Purchasing Department employees. The purpose of the Statement is to require these employees to disclose any potential conflict of interests they may have. The Statements are sent in January of each year and we pursue the replies to get a 100% response rate. In the current year we sent out over 250 Statements and did achieve a 100% response rate. Each response is reviewed by the Director of Internal Audit and the results are reported to the CEO of Memorial as well as the Audit Committee of the Board of Directors. 2. The second Statement is the Board Duality of Interest Statement that is sent to current Board Members, former Board Members from the last five years, the five highest compensated employees from the previous year, employees that are on Grant and Scholarship Committees, and Other Key Employees. The Duality of Interest Statement was sent out in June, 2011. The replies are reviewed by the Director of Internal Audit who summarizes the results, which are reviewed by an independent party. results are reported to the CEO of Memorial and the Audit Committee of the Board of Directors. 3. The third Statement is entitled "Code of Ethics for Senior Financial Officers". The Statement requires an acknowledgement form to be signed by Memorial's Key Financial Employees that Memorial's financial information is to the best of their knowledge true and accurate. This Statement was sent out in early January, 2011 and the signed acknowledgements are kept by the Director of Internal Audit. In 2011, twelve designated employees were requested to sign the form and we had a 100% compliance rate. Any potential conflicts of interests are reviewed by independent parties both internal and external to the organization, and if necessary, corrective action would be taken to resolve a true conflict. The individual with the potential conflict of interest is excluded from all review proceedings.
COMPENSATION REVIEWCore Form, Part VI, Line 15a & 15bAn extensive examination is conducted using comparable market data and it is then reviewed by an independant consultant hired by, and reporting to, the Board of Directors. Recommendations are presented to the Board for deliberation and final decision. Deliberation and final decision are performed by the independent members of the Board.
AVAILABILITY OF GOVERNING DOCUMENTSCore Form 990, Part VI, Section C, Line 19The governing documents and conflict of interest policy are not made available to the public. The financial statements are distributed quarterly to the Electronic Municipal Market Access (EMMA) website as part of the continuing disclosures for the Memorial Health System, Inc. bonds.
CHANGE IN FUND BALANCECore Form, Part XI, Line 5Other changes in fund balance: Writeoff of Intercompany MHS $1,043,051 Writeoff of Intercompany MHSB (43,495) Unrealized gain/loss on investments (508,549) Change in Grube Trust (37,740) Total $453,267
BUSINESS RELATIONSHIPSForm 990, Schedule L, Part IVJohn Phair is president of Holladay Properties from which Memorial Health Foundation, Inc. rents property for values less than the reporting thresholds.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Olubunmi A. Okanlami, MD TITLE:Director thru March 2011 HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:James F. Keenan TITLE:Chair thru March 2011 HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Najeeb A. Khan TITLE:Chair HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Timothy Griffin TITLE:Director thru March 2011 HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Delores Wilmoski TITLE:Director HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Colleen Morrison, MD TITLE:Director HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Michael Steinberg, MD TITLE:Director HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:David Hornback, MD TITLE:Director HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Philip A. Newbold TITLE:CEO/President HOURS:42
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Jeffrey Costello TITLE:CFO/Asst. Treasurer HOURS:42

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Memorial Health System Inc
615 N Michigan StSouth BendIN46601351536132Corp ServicesIN501(c)(3)9BEACONtrue
Memorial Hospital of South Bend Inc
615 N Michigan StSouth BendIN46601350868132HospitalIN501(c)(3)3BEACONtrue
ELKHART GENERAL HOSPITAL
600 EAST BOULEVARDELKHARTIN46514350877574HOSPITALIN501(C)(3)3BEACONtrue
BEACON HEALTH SYSTEM INC
600 EAST BOULEVARDELKHARTIN46514453864076Parent OrgIN501(c)(3)11C III-FINAfalse
MEMORIAL ENDOWMENT FUND FOR MEMORIAL HOS
PO BOX 1602SOUTH BENDIN46634356068581ENDOWMENTIN501(C)(3)11D III-OMEM HOSPITALtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Memorial Home Care IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1615 N Michigan StAddressLine1
CitySouth BendCity
StateINState
ZIP Code46601ZIPCode
FieldValueIRS element (for citing)
EIN351901068EIN
Primary ActivityHome MedicalPrimaryActivity
Legal Domicile StateINLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Memorial Hospital of South Bend Inc
K647887DIST TO MHSB
Memorial Hospital of South Bend Inc
R62479CASH TRANSFER

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