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        <City>Woodstock</City>
        <State>IL</State>
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        <Explanation>As part of our payment of Illinois Hospital Association dues, approximately 34% are allocable to lobbying activities. As part of our payment of Metropolitan Chicago Healthcare Council dues, approximately 25% are allocable to lobbying activities.</Explanation>
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        <Identifier>Part X</Identifier>
        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>ASC Topic 740, Income Taxes, 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 Topic 740, the Health System 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 fifty percent likelihood of being realized upon ultimate settlement. ASC Topic 740 also provides guidance on derecognition, classification, interest and penalties on income taxes, accounting in interim periods and requires increased disclosures. At the date of adoption, and as of June 30, 2010, the organization does not have a liability for unrecognized tax benefits. The adoption of ASC Topic 740 had no impact on the consolidated financial statements of the Health System.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH" softwareId="09000047" softwareVersion="2009v1.7">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <DiscountedOther>
        <Other>X</Other>
        <DiscountedOtherPercentage>600.000000000</DiscountedOtherPercentage>
      </DiscountedOther>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>2896279</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>2896279</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02210</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>14229682</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>8909402</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>5320280</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04060</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>17125961</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>8909402</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8216559</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05720</PercentOfTotalExpense>
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      <CommunityHealthServices>
        <NumberOfActivitiesOrPrograms>29</NumberOfActivitiesOrPrograms>
        <PersonsServed>7696</PersonsServed>
        <TotalCommunityBenefitExpense>28110</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>28110</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <NumberOfActivitiesOrPrograms>4</NumberOfActivitiesOrPrograms>
        <PersonsServed>176</PersonsServed>
        <TotalCommunityBenefitExpense>196718</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>300</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>196418</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00150</PercentOfTotalExpense>
      </HealthProfessionsEducation>
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        <NumberOfActivitiesOrPrograms>1</NumberOfActivitiesOrPrograms>
        <PersonsServed>63</PersonsServed>
        <TotalCommunityBenefitExpense>6786</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>6786</NetCommunityBenefitExpense>
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      <CashAndInKindContributions>
        <NumberOfActivitiesOrPrograms>4</NumberOfActivitiesOrPrograms>
        <PersonsServed>47</PersonsServed>
        <TotalCommunityBenefitExpense>1140</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>180</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>960</NetCommunityBenefitExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <NumberOfActivitiesOrPrograms>38</NumberOfActivitiesOrPrograms>
        <PersonsServed>7982</PersonsServed>
        <TotalCommunityBenefitExpense>232754</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>480</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>232274</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00160</PercentOfTotalExpense>
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      <TotalCommunityBenefits>
        <NumberOfActivitiesOrPrograms>38</NumberOfActivitiesOrPrograms>
        <PersonsServed>7982</PersonsServed>
        <TotalCommunityBenefitExpense>17358715</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>8909882</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>8448833</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05880</PercentOfTotalExpense>
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        <TotalCommunityBuildingExpense>1771</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>1771</NetCommunityBuildingExpense>
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      <CommunitySupport>
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        <PersonsServed>14000</PersonsServed>
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        <NetCommunityBuildingExpense>642892</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00490</PercentOfTotalExpense>
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        <PersonsServed>676</PersonsServed>
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        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
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        <PersonsServed>1315</PersonsServed>
        <TotalCommunityBuildingExpense>35775</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>35775</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00030</PercentOfTotalExpense>
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        <NumberOfActivitiesOrPrograms>27</NumberOfActivitiesOrPrograms>
        <PersonsServed>15991</PersonsServed>
        <TotalCommunityBuildingExpense>687831</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>687831</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00480</PercentOfTotalExpense>
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      <BadDebtExpenseAmount>4404276</BadDebtExpenseAmount>
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      <AmountReimbursedByMedicare>35293423</AmountReimbursedByMedicare>
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      <MedicareSurplusOrShortfall>-8730986</MedicareSurplusOrShortfall>
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        <CostToChargeRatio>X</CostToChargeRatio>
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      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
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          <City>Huntley</City>
          <State>IL</State>
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          <City>Huntley</City>
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        <Other>Laboratory and Medical Imaging Services</Other>
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          <City>Woodstock</City>
          <State>IL</State>
          <ZIPCode>60098</ZIPCode>
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        <BadDebtFootnote>The estimated amount of bad debt expense (at cost) which could be reasonably attributable to patients who would likely qualify for financial assistance under the organizations charity care policy if sufficient information had been available to make a determination of their eligibility was based on the self pay patient accounts which were written off as bad debts. These amounts were then multiplied by the cost to charge ratio. Any payments received during the fiscal year on these accounts were deducted from the cost.</BadDebtFootnote>
        <ShortfallAsCommunityBenefit>The amount shown in line 6 represents the actual costs incurred to treat Medicare patients and is calculated by applying the Medicare cost-to-charge ratio. Therefore, the entire amount of line 7 constitutes a community benefit.</ShortfallAsCommunityBenefit>
        <DebtCollectionPolicy>If a patient qualifies for a 100% charity/financial assistance discount, collection of the account is not pursued as a bad debt. The account is written off in full at the time of the decision. If a patient receives a partial discount for Financial Assistance, any remaining balances will be treated in accordance with the Financial Policy regarding self pay balances and may be offered a payment plan option. The payment plan is in installments ($25 minimum), with the first payment due at discharge. Payment plans are not to exceed 36 months without documentation or verbal communication of ability to pay. Documentation may include a completed financial statement. Patients who have not completed arrangements for one of the payment options within 120 days of the billing date will be automatically turned over to a collection agency. Patients with delinquent payments, 15 or more days late, will be turned over to a collection agency. After insurance processing, patients who have not made payments or enrolled in one of the payment options for co-insurance and deductible amounts within 120 days of insurance payment will be turned over to a collection agency. As an exception, the Director of Patient Financial Services may review and recommend further discounts. No interest charges will accrue on account balances in which payments are being made.</DebtCollectionPolicy>
        <NumberOfFacilityTypeExpln>Memorial Medical Center is comprised of one licensed hospital, one center housing laboratory and medical imaging services and one center housing a rehabilitation and sports medicine clinic.</NumberOfFacilityTypeExpln>
        <GeneralExplanation>Part I, Line 7The amounts in Lines 7a-7d were calculated by applying the Medicare cost-to-charge ratio to the net patient revenue for each category. The amounts in Lines 7e-7k were calculated based on actual expenses for each community benefit activity category.Part I, Line 7, Column (f)Form 990, Part IX, line 25 includes $12,840,456 for Bad Debt Expense. This amount cannot be subtracted from total expenses in order to calculate the column (f) percentages in lines 7a-7k due to software limitations.</GeneralExplanation>
        <NeedsAssessment>Centegra Health System worked with the McHenry County Department of Public Health and other participating organizations to conduct a community health assessment and identify leading indicators to help highlight the health needs of the county. Those indicators identified include percentage of physically inactive people, percentage of obese people, percentage of current smokers over the age of 18, percentage of binge drinkers, reported new aids cases, suicide rate, mortality rate from unintentional injuries, firearm-related mortality rate, homicide rate, percentage of children with elevated lead levels age 1-6, percentage of children 19 to 35 months of age in full immunization compliance, percentage of people with no health insurance, and percentage of pregnant women who begin prenatal care in the 1st trimester. Centegra Health System has been an active participant in the McHenry County Health Department's MAPP process (Mobilizing for Action through Planning &amp; Partnerships), which is an ongoing effort: Phase 1: Organize for Success/ Partnership Development; Phase 2: Vision, Value Statements; Phase 3: Conducting MAPP Assessments; Phase 4: Identify Strategic Issues; Phase 5: Formulate Goals and Strategies; Phase 6: Action Cycle (current stage). MAPP priorities have been defined as: 1) Increase Access to Medical, Dental and Mental Health care: Goal 1: Provide increased access to follow up care (medical, dental, mental) for the under/uninsured residents of McHenry County; Goal 2: Increase access to (medical, dental, mental) prevention, education, and screening programs available for all residents of McHenry County; 2) Information &amp; Referral: Goal 1: Centralize and update Information and Referral located on Crisis Services web site; Goal 2: Market Crisis Line #/Web site (future 2-1-1) to community to increase visibility; Goal 3: 2-1-1 Information and Referral System; 3) Cardiovascular Care: Goal: By 2017, reduce the death rate from cardiovascular disease by 20%. Centegra's initiatives will target the following defined community needs as priorities: Access to Care, Information &amp; Referral Services, and Clinical Areas of Cardiovascular and Cancer-related programs and services. Centegra's Community Benefits programming will continue to target: community wellness and prevention programs, community health education, community health advocacy and assistance, clinical education, community collaborations, and community-based clinical initiatives.</NeedsAssessment>
        <PatientEducationAssistance>1. Uninsured patients arriving at our emergency department and/or direct admits are screened at time of service by either an Emergency Department Financial Counselor or the health system's In-Patient Financial Counseling Team, Public Aid Representatives and a Medication Assistance Coordinator to identify eligibility guidelines for federal, state and local government programs as well as charity care. Centegra Health System's Self Pay Process includes a screening which is completed by using hospital form C910050 03-09 prompting an interview offering payment options and eligibility guidelines. It is at this time that a patient becomes aware of the Hospital Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, Section 1011, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time lines for completing application processes at time of service in person. Appropriate scripting is followed by Centegra Health System (CHS) Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by Centegra Health System Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid.2. Uninsured patients opting for elective services are contacted by phone prior to their date of service by the CHS Out-Patient Financial Counseling Team. CHS's Self Pay Process is followed and includes a screening for federal, state and local government programs as well charity care. An interview offering payment options and eligibility guidelines using hospital form C910050 03/09 prompts a quick eligibility determination. It is at this time that a patient becomes aware of the Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, Section 1011, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time lines for completing application processes prior to their elective services via phone. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid.3. Our health system's web site offers FAQ's and answers as well as encourages patients to contact our Customer Service Team when they are unable to pay for services.4. Our health system's statements also identify detailed account and billing information encouraging the patient to contact our Customer Service Team and inquire about Financial Assistance options.5. Documentation is essential in effective communication. Follow up teams will then move forward in a timely manner with the appropriate actions to insure all necessary documents (if applicable) are received for eligibility determinations.6. CHS advertises a Price Line encouraging patients to inquire about estimated costs for future services. The Price Line is manned by our Out-Patient Financial Counselors from 8:00am - 7:00pm. When calls are returned with estimated costs, a conversation ensues to identify a possible financial hardship. Our Self Pay Process is put into effect at this time.7. Site Registrars will notify the CHS Financial Counseling Team when a financial hardship is identified.8. Emergency Department Financial Counseling positions were created this year and will be rolled out 12/1/09 to meet the needs of our ED patients. In addition to these new roles, a full time Financial Counselor position was created to meet the special needs of our cancer patients.9. A Financial Assistance Coordinator reviews all financial applications, gathers needed documents, determines financial assistance and prepares each patient file for leadership approval.</PatientEducationAssistance>
        <CommunityInformation>Centegra Health System defines its primary service area as Greater McHenry County, an area of approximately 612 square miles and 341,000 residents. This county is among the fastest growing counties in Illinois with growth seen in all age categories. The population is projected to increase by 13% over the next 5 years. For 2007, the age distribution of the population is as follows: 27% 0-17, 38% 18-44, 25% 45-64, and 10% 65+. McHenry County has a relatively high socioeconomic status compared to the rest of Illinois. Median household income for 2007 was 52% higher than the rest of the state. The 2006 annual average unemployment rate was 24% below the state average. The percentage of families below the poverty level for 2006 was 52% below the rest of the state. For 2006, the percentage of the county's population holding a high school diploma was 7% greater than rest of the state, while the percentage holding a bachelor's degree or higher was 6% higher and the rest of the state.</CommunityInformation>
        <CommunityBuildingActivities>Representatives of Memorial Medical Center participated in many different community groups and committees, such as the Fire/EMS Chief Association, the Police Chief Association, the Health and Human Services Network, the Child Advocacy Board, and the Family Violence Coordinating Council. Through these meetings, representatives of Memorial Medical Center can promote the health system's role in improving the health of the individuals that these different groups serve. Also included Part II are expenses related to our Spanish language interpreters. Hispanics comprise 11.3% of the population of McHenry County and our Spanish language interpreters are imperative to the effort to improve the health of this traditionally underserved population.</CommunityBuildingActivities>
        <OtherInformation>See Schedule O for response to Form 990, Part III, Line 4a.</OtherInformation>
        <AffiliatedHealthCareSystem>See Schedule O for response to Form 990, Part III, Line 4a.</AffiliatedHealthCareSystem>
        <ReportsFiledWithStates>IL</ReportsFiledWithStates>
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      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
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        <TotalCompensationFilingOrg>157196</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Joseph P Hurshe</NamePerson>
        <CompBasedOnRelatedOrgs>223391</CompBasedOnRelatedOrgs>
        <DeferredCompRelatedOrgs>751</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>5939</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>230081</TotalCompensationRelatedOrgs>
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    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="09000047" softwareVersion="2009v1.7">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Carey Electric</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Director</Relationship>
        <AmountOfTransaction>35507</AmountOfTransaction>
        <DescriptionOfTransaction>Electrical Contractor</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>American Community Bank</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Vice Chairman</Relationship>
        <AmountOfTransaction>100000</AmountOfTransaction>
        <DescriptionOfTransaction>Certificate of Deposit</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
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      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>American Community Bank</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Director</Relationship>
        <AmountOfTransaction>100000</AmountOfTransaction>
        <DescriptionOfTransaction>Certificate of Deposit</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
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      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Home State Bank</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Director</Relationship>
        <AmountOfTransaction>100000</AmountOfTransaction>
        <DescriptionOfTransaction>Certificate of Deposit</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
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      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Home State Bank</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Treasurer</Relationship>
        <AmountOfTransaction>100000</AmountOfTransaction>
        <DescriptionOfTransaction>Certificate of Deposit</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
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    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="09000047" softwareVersion="2009v1.7">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>All documents are available upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>The Board of Directors of Centegra Health System, through the Compensation Committee comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organization's approved compensation philosophy and strategy: The Committee is comprised of members of the Board of Directors, who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with Centegra.The Chief Executive Officer's compensation is determined by the Compensation Committee in relation to appropriate comparability data. Compensation for other members of the executive staff are developed by the CEO, reviewed by the Committee, evaluated against market data, and approved by the Committee. The Committee approves all compensation decisions in advance of their implementation and documents its determinations and discussions. Its decisions and deliberations are thoroughly documented and meeting minutes are kept and distributed to the Committee members (for historical reference). The Compensation Committee uses a number of external resources and comparisons, and their review includes total compensation (cash compensation, plus benefits provided by Centegra) in relation to organizational performance and prevailing industry practices of comparably-sized organizations. They have engaged the services of a compensation consulting firm (Sullivan Cotter) specializing in the not-for-profit sector that has worked with Centegra and reports directly to the Compensation Committee.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>Continued from above. 6. A voting member of any committee whose jurisdiction includes compensation matters and who receives compensation, directly or indirectly, from Centegra for services is precluded from voting on matters pertaining to that member's compensation, Physicians who receive compensation, directly or indirectly, from Centegra, whether as employees or independent contractors, are precluded from membership on any committee whose jurisdiction includes compensation matters and in which such physician may have a direct or indirect interest. 7. Each director, principal officer, and member of a committee with board-delegated powers shall annually sign a statement which affirms that such person has received a copy of the conflicts of interest policy; has read and understands the policy; has agreed to comply with the policy; and understands that Centegra is a charitable organization and that in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish one or more of its tax exempt purposes. 8. To ensure that Centegra operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted by the Governors Affairs Committee of Centegra. The periodic reviews shall, at a minimum, include the following subjects: Whether acquisition of physician practices and other provider services result in inurement or impermissible private benefit. Whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payment for goods and services, further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether agreements to provide healthcare and agreements with other healthcare providers, employees, and third party payors further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether business transactions on behalf of Centegra or an entity controlled by it are the result of arms-length dealing and are no less advantageous than competitively available goods and services of like grade and quality. 9.In conducting the periodic reviews provided for in Article VII, Centegra may, but need not, use outside advisors. If outside experts are used, their use shall not relieve the board of its responsibility for ensuring that periodic reviews are conducted.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>The review process for the 990 included review by the Director of Accounting and Chief Financial Officer. The 990 also was sent to an outside auditor for review before submission to the IRS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</ReturnReference>
        <Explanation>Centegra Health System has a single class of members.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 3</Identifier>
        <ReturnReference>Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company</ReturnReference>
        <Explanation>Management companies were used for the daily operations and management of the following services for the health system. Sodexho was used for Food &amp; Nutrition, Plant Operations and Maintenance, and Environmental Services work. Dell Marketing LP was used for the management of the Information Systems area. Professional Business Consultants is used for the management of the Managed Care department.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 2</Identifier>
        <ReturnReference>Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et</ReturnReference>
        <Explanation>Memorial Medical Center, (MMC), adopted specific conflict of interest policies for its governing and management staff. The policy includes, but is not limited to, when an individual, governor, committee member, officer, agent or employee believes that he or she, or member of his or her immediate family might have or does have a real or apparent conflict, he or she should in addition to filing the disclosure notice required, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of MMC. Not with standing, it is realized that both real and apparent conflicts of interest sometimes naturally occur in the course of conducting daily affairs. Conflicts occur because the many persons associated with MMC should be expected to have, and do in fact generally have multiple interests and affiliations, and various positions of responsibility with the community. The long-range interests of MMC do not require the termination of an association with persons who have real or apparent conflicts, if an effective method can render such conflicts harmless to all concerned. During fiscal year 2010, MMC purchased certain goods and/or services from organizations with director's affiliation. All transactions were competitively bid and conducted at arms length. The fees paid were at fair market value. Rachel Sebastian, Vice President, is the daughter of Michael Eesley, President and CEO. Director Kathy Powell is an employee and vice president of Home State Bank. Director Patrick Morehead is on the Board of Directors and a 1% owner of Home State Bank. Vice Chairman Charie Zanck is a Director of American Community Bank &amp; Trust. Director Charles Ruth is the Board Chairman of American Community Bank &amp; Trust. Director Tom Carey is the Vice President and Majority Owner of Carey Electric.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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          <BusinessNameLine1>Centegra Insurance Services LTD</BusinessNameLine1>
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          <PostalCode>KY1-1102</PostalCode>
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        <PrimaryActivities>Malpractice Insurance Provider</PrimaryActivities>
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          <BusinessNameLine1>DIS Holdings LLC</BusinessNameLine1>
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          <ZIPCode>60012</ZIPCode>
        </AddressUS>
        <EIN>364085398</EIN>
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      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
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      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
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      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
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      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
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      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
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