DEACONESS MEMORIAL MEDICAL CENTER INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- DEACONESS MEMORIAL MEDICAL CENTER INC (EIN 35-0985964)
- Tax period
- 2024-10-01 to 2025-09-30
- Filed
- 2026-08-17
- IRS object ID
- 202632309349302403
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-08-17T17:48:43-05:00 | ReturnTs |
| Tax Period End | 2025-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N MERIDIAN ST SUITE 200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350985964 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS MEMORIAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DEAC | BusinessNameControlTxt |
| Phone | 8124822345 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 WEST NINTH STREET | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47546 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH MILLER | PersonNm |
| Person Title | CAO | PersonTitleTxt |
| Phone | 8124822345 | PhoneNum |
| Signature | 2026-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EMILIE M KNIERIEM CPA | PreparerPersonNm |
| PTIN | P01330194 | PTIN |
| Phone | 3176334705 | PhoneNum |
| Preparation | 2026-08-17 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Change | Yes (X) | NameChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL & HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEITH MILLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 WEST NINTH STREET | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $400,829,448 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SEE SCHEDULE O | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTH SERVICES CONSISTENT WITH THE NEEDS OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 2073 | TotalEmployeeCnt |
| Total Volunteers | 163 | TotalVolunteersCnt |
| Total Gross UBI | $28,223 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $6,856 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $252,023 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,314,420 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,383,448 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $288,391,134 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,090,762 | PYInvestmentIncomeAmt |
| CY Investment Income | $12,001,449 | CYInvestmentIncomeAmt |
| PY Other Revenue | $834,020 | PYOtherRevenueAmt |
| CY Other Revenue | $4,241,065 | CYOtherRevenueAmt |
| PY Total Revenue | $74,560,253 | PYTotalRevenueAmt |
| CY Total Revenue | $306,948,068 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $14,456 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,746,463 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $131,904,352 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,240,156 | PYOtherExpensesAmt |
| CY Other Expenses | $148,203,688 | CYOtherExpensesAmt |
| PY Total Expenses | $72,001,075 | PYTotalExpensesAmt |
| CY Total Expenses | $280,108,040 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,559,178 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $26,840,028 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $375,527,229 | TotalAssetsBOYAmt |
| Total Assets EOY | $403,731,135 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $104,135,811 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $101,385,062 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $271,391,418 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $302,346,073 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE, THE BOARD, PHYSICIANS, STAFF, VOLUNTEERS AND AUXILIARY OF MEMORIAL HOSPITAL AND HEALTH CARE CENTER WILL PROVIDE EXCELLENT HEALTH CARE SERVICES TO THE PEOPLE OF THE COMMUNITIES WE SERVE. WE WILL PLEDGE OURSELVES TO CARE FOR EACH INDIVIDUAL IN A MANNER THAT REFLECTS THE PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL HEALING MINISTRY OF JESUS CHRIST. WE WILL WORK TOGETHER TO CREATE AN ATMOSPHERE OF MUTUAL RESPECT, DIGNITY, COMPASSION AND JOY. WE WILL EFFECTIVELY AND EFFICIENTLY UTILIZE OUR RESOURCES IN PROVIDING HEALTH CARE. WE WILL BE GUIDED BY THE NEEDS OF THOSE WE SERVE AND AS NEEDS CHANGE, WE WILL CHANGE. WE WILL "BE FOR OTHERS!" | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $248,502,433 | ExpenseAmt |
| Revenue | $291,878,541 | RevenueAmt |
| Desc | GENERAL PRIMARY ACUTE CARE HOSPITAL EXPENSES INCURRED IN PROVIDING EXCELLENT HEALTH CARE SERVICES CONSISTENT WITH THE NEEDS OF THE COMMUNITY. SEE FORM 990, SCHEDULE H FOR ADDITIONAL SERVICES PROVIDED TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $248,502,433 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 158 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2073 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH MILLER | PersonNm |
| Phone | 8129960506 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 WEST NINTH STREET | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| KEITH MILLER | |||||||||
| CAO & INDIANA REGION PRES. | 40.00 | 5.00 | Yes (X) | Yes (X) | $287,654 | $0 | $41,313 | ||
| JIM HUEBNER | |||||||||
| BOARD CHAIRPERSON | 5.00 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRENT STERNBERG | |||||||||
| BOARD TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SR RENEE CUNNINGHAM | |||||||||
| BOARD SECRETARY | 30.00 | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DONNA BALKA | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTIAN BLOME | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| TONYA HEIM | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL KERN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY KEEPES MD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SHERRIL LUEKEN | |||||||||
| BOARD MEMBER PARTIAL TERM | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SHAWN MCCOY | |||||||||
| BOARD MEMBER | 1.00 | 60.00 | Yes (X) | $0 | $2,016,238 | $361,449 | |||
| KRISTI NORD MD | |||||||||
| MED. STAFF PRES. | 51.00 | 0.00 | Yes (X) | $363,083 | $0 | $39,340 | |||
| SOHAIL QADIR MD | |||||||||
| BOARD MEMBER | 51.00 | 0.00 | Yes (X) | $640,356 | $0 | $38,703 | |||
| LYNN LINGAFELTER | |||||||||
| BOARD MEMBER | 1.00 | 65.00 | Yes (X) | $0 | $1,072,960 | $198,379 | |||
| JAMES PORTER MD | |||||||||
| BOARD MEMBER | 1.00 | 60.00 | Yes (X) | $0 | $1,073,178 | $187,360 | |||
| NICK WERNE MD | |||||||||
| BOARD MEMBER | 51.00 | 0.00 | Yes (X) | $483,444 | $0 | $37,941 | |||
| BRENDA STALLINGS | |||||||||
| BOARD TREASURER PARTIAL TERM | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDWARD W MILLER | |||||||||
| VP FINANCE/CFO | 40.00 | 0.00 | Yes (X) | $699,942 | $0 | $12,731 | |||
| GEOFFREY DAY MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,362,411 | $0 | $40,284 | Yes (X) | |||
| MATTHEW DODARO | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,414,703 | $0 | $40,284 | Yes (X) | |||
| JOSHUA LEONARD MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,309,715 | $0 | $39,806 | Yes (X) | |||
| ADAM DAWKINS MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,291,520 | $0 | $39,067 | Yes (X) | |||
| JONATHAN DAY MD | |||||||||
| PHYSICIAN | 50.00 | 0.00 | $1,186,230 | $0 | $56,920 | Yes (X) | |||
| E KYLE BENNETT | |||||||||
| FORMER PRES./CEO | 0.00 | 0.00 | $1,245,859 | $0 | $25,569 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $10,284,917 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,162,376 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,159,146 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 218 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| IVORY COAST ANESTHESIA | |||||
| 1765 E NINE MILE RD SUITE 1-229 | PENSACOLA | FL | 32514 | ANESTHESIOLOGY | $6,087,128 |
| MEMORIAL HOSPITAL OUTPATIENT SURGERY CTR | |||||
| 600 W 13TH STREET SUITE 100 | JASPER | IN | 47546 | OUTPATIENT SURGERY | $4,268,468 |
| CHG COMPANIES INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | HEALTHCARE STAFFING & RECRUITING | $1,721,465 |
| INDIANA UNIVERSITY | |||||
| DEPT 78920 PO BOX 78000 | DETROIT | MI | 48278 | MEDICAL & HEALTHCARE PAYMENTS | $1,399,477 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | LOCUM PHYSICIANS | $1,299,488 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 43 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,203,518 | RelatedOrganizationsAmt |
| Government Grants | $228,176 | GovernmentGrantsAmt |
| All Other Contributions | $882,726 | AllOtherContributionsAmt |
| Total Contributions | $2,314,420 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $288,391,134 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $288,391,134 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $288,391,134 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,267,433 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $20,330 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,247,103 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $433,356 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $182,916 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $250,440 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $250,440 | TotalRevenueColumnAmt |
| Exclusion | $250,440 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $99,432,480 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $93,698,464 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,734,016 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,734,016 | TotalRevenueColumnAmt |
| Exclusion | $5,734,016 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| CAFETERIA REVENUE | 722514 | $476,908 | $476,908 | ||
| LAB REVENUE | 541380 | $7,893 | $7,893 | ||
| GAIN/LOSS ON JOINT VENTURE | 900099 | -$303,665 | -$303,665 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,809,489 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,791,072 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $18,417 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,990,625 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $306,948,068 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $291,878,541 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $28,223 | UnrelatedBusinessRevenueAmt |
| Exclusion | $12,726,884 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,399,597 | TotalAmt |
| Program Services | $102,631,480 | ProgramServicesAmt |
| Management And General | $10,768,117 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,411,982 | TotalAmt |
| Program Services | $2,061,036 | ProgramServicesAmt |
| Management And General | $350,946 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,553,301 | TotalAmt |
| Program Services | $8,163,287 | ProgramServicesAmt |
| Management And General | $1,390,014 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,539,472 | TotalAmt |
| Program Services | $5,587,973 | ProgramServicesAmt |
| Management And General | $951,499 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,344 | TotalAmt |
| Program Services | $63,842 | ProgramServicesAmt |
| Management And General | $5,502 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,100 | TotalAmt |
| Management And General | $6,100 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,531,708 | TotalAmt |
| Program Services | $37,321,136 | ProgramServicesAmt |
| Management And General | $3,210,572 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,981 | TotalAmt |
| Program Services | $119,160 | ProgramServicesAmt |
| Management And General | $13,821 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,012,695 | TotalAmt |
| Program Services | $13,892,135 | ProgramServicesAmt |
| Management And General | $120,560 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,260,552 | TotalAmt |
| Program Services | $14,335,951 | ProgramServicesAmt |
| Management And General | $8,924,601 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502,366 | TotalAmt |
| Program Services | $450,153 | ProgramServicesAmt |
| Management And General | $52,213 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,393 | TotalAmt |
| Program Services | $83,686 | ProgramServicesAmt |
| Management And General | $9,707 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,974,881 | TotalAmt |
| Program Services | $1,163,495 | ProgramServicesAmt |
| Management And General | $811,386 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,443,942 | TotalAmt |
| Program Services | $9,153,188 | ProgramServicesAmt |
| Management And General | $4,290,754 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,469 | TotalAmt |
| Program Services | $526,411 | ProgramServicesAmt |
| Management And General | $61,058 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| HOSPITAL SUPPLIES | $37,300,439 | $36,979,527 | $320,912 |
| HAF EXPENSE | $13,229,674 | $13,229,674 | |
| DUES & SUBSCRIPTIONS | $854,596 | $765,775 | $88,821 |
| LICENSES & TAXES | $146,639 | $131,398 | $15,241 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,056,909 | TotalAmt |
| Program Services | $1,843,126 | ProgramServicesAmt |
| Management And General | $213,783 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,108,040 | TotalAmt |
| Program Services | $248,502,433 | ProgramServicesAmt |
| Management And General | $31,605,607 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,031,777 | BOYAmt |
| EOY | $40,536,878 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,255,814 | BOYAmt |
| EOY | $28,051,624 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $32,500 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,592,821 | BOYAmt |
| EOY | $1,203,304 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,722,988 | BOYAmt |
| EOY | $5,537,843 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,482,178 | BOYAmt |
| EOY | $2,774,513 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $161,547,733 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,018,001 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,750,501 | BOYAmt |
| EOY | $139,529,732 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,791,551 | BOYAmt |
| EOY | $177,714,082 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $799,226 | BOYAmt |
| EOY | $289,044 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,100,373 | BOYAmt |
| EOY | $8,061,615 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $375,527,229 | BOYAmt |
| EOY | $403,731,135 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,604,679 | BOYAmt |
| EOY | $27,149,618 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,055,000 | BOYAmt |
| EOY | $56,255,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $761,228 | BOYAmt |
| EOY | $689,205 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,714,904 | BOYAmt |
| EOY | $17,291,239 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,135,811 | BOYAmt |
| EOY | $101,385,062 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,391,418 | BOYAmt |
| EOY | $302,346,073 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,391,418 | BOYAmt |
| EOY | $302,346,073 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $375,527,229 | BOYAmt |
| EOY | $403,731,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $26,840,028 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,114,627 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,411 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,411 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS MEMORIAL MEDICAL CENTER AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,505,629 | OtherCostOrOtherBasisAmt |
| Book Value | $1,505,629 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $104,646,762 | OtherCostOrOtherBasisAmt |
| Depreciation | $309,372 | DepreciationAmt |
| Book Value | $104,337,390 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,395,342 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,708,629 | DepreciationAmt |
| Book Value | $33,686,713 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $139,529,732 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RIGHT OF USE LIABILITY | $2,333,825 |
| RELATED PARTY PAYABLE | $14,957,414 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $17,291,239 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2025 AND 2024, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE REMAINING CONSOLIDATED SUBSIDIARIES ARE ORGANIZED AS LIMITED LIABILITY COMPANIES, WHEREBY NET TAXABLE INCOME IS TAXED DIRECTLY TO THE MEMBERS OF THE LIMITED LIABILITY COMPANIES. THUS, THE CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR FEDERAL OR STATE INCOME TAXES RELATED TO THESE ENTITIES. THESE ENTITIES HAVE FILED THEIR FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH THEIR MOST RECENT FISCAL YEAR ENDS (PRIMARILY DECEMBER 31, 2024). THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,097,657 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,097,657 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $39,867,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,533,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,334,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03690 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,965,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,533,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,432,297 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04080 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,023,549 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,023,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00720 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,653,213 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,653,213 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,400,127 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,400,127 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01570 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,076,889 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,076,889 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,042,458 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,533,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,509,186 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07320 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,759,244 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $114,735,410 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $131,222,701 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$16,487,291 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 MEMORIAL OUTPATIENT SURGERY CENTER LLC | |||
| HEALTHCARE | 0.40000 | 0.00000 | 0.07500 |
| 2 DUBOIS PSYCH PROPERTIES LLC | |||
| HEALTHCARE | 0.50000 | 0.00000 | 0.50000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS MEMORIAL MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 W 9TH ST | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47546 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.DEACONESSMEMORIAL.COM | WebsiteAddressTxt |
| State License | 26-005102-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEACONESS MEMORIAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 23 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.DEACONESS.COM/CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.DEACONESS.COM/CHNA | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DEACONESS MEMORIAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: ADVISORY COUNCILS: ADVISORY COUNCILS WERE DEVELOPED AND IMPLEMENTED IN 2014 AS A WAY FOR DEACONESS MEMORIAL MEDICAL CENTER TO STAY CONNECTED WITH EACH COUNTY OUTSIDE OF DUBOIS COUNTY. IT WAS IDENTIFIED THERE WERE SEVERAL NEEDS THAT WERE SPECIFIC FOR EACH COUNTY. MEMBERS OF THE DEACONESS MEMORIAL MEDICAL CENTER MANAGEMENT TEAM ARE ASSIGNED TO A COUNTY TO CONTINUE THE COLLABORATION AND TO RECEIVE ONGOING FEEDBACK ON NEEDS AND WHERE DEACONESS MEMORIAL MEDICAL CENTER IS ABLE TO PROVIDE ASSISTANCE. PARTICIPATING IN THESE COUNCILS ARE ECONOMIC DEVELOPMENT DIRECTORS, COUNTY HEALTH NURSES, CHAMBER OF COMMERCE LEADERS, EDUCATORS, EXECUTIVES, PASTORS, EMS, LAW ENFORCEMENT, BUSINESS OWNERS, OTHER HEALTH CARE ORGANIZATION LEADERS, ETC. WITH THE ONGOING ADVISORY COUNCILS, WE ARE ABLE TO PROVIDE QUICK SOLUTIONS FOR EACH AREA. WE CONTINUE TO GATHER FEEDBACK AND NEEDS AND WORK TO ADDRESS EACH COUNTY SPECIFICALLY IN OUR PSA. |
| DEACONESS MEMORIAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: DEACONESS MEMORIAL MEDICAL CENTER CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2023, IDENTIFYING FIVE PRIORITY AREAS: MENTAL HEALTH, ACCESS TO HEALTHCARE, DIVERSITY/EQUITY AND INCLUSION, COMMUNITY-FOCUSED HEALTHCARE EDUCATION, AND TRANSPORTATION. THE FOLLOWING DESCRIBES ACTIONS TAKEN IN 2025 TO ADDRESS THESE NEEDS IN ALIGNMENT WITH THE HOSPITAL'S ADOPTED IMPLEMENTATION STRATEGY.PRIORITY 1: MENTAL HEALTHTHE 2023 CHNA IDENTIFIED INCREASED NEED FOR MENTAL HEALTH RESOURCES AS THE TOP COMMUNITY PRIORITY, WITH FOCUS GROUP PARTICIPANTS CITING LACK OF TIMELY TREATMENT AND INSUFFICIENT BEHAVIORAL HEALTH SERVICES ACROSS THE REGION.-CONTINUED PARTNERSHIP WITH IU SCHOOL OF PUBLIC HEALTH TO EXPAND URGENT AND EMERGENT MENTAL HEALTH SERVICES INTO MARTIN, ORANGE, AND PERRY COUNTIES THROUGH IN-OFFICE VISITS AND TELEHEALTH, WITH FUNDING SECURED THROUGH 2029 TO SUPPORT ONGOING EXPANSION INTO ADDITIONAL RURAL AREAS.-WORKED WITH THE DUBOIS COUNTY COMMUNITY FOUNDATION TO SECURE FUNDING THROUGH THE LILLY GIFT VIII, SUPPORTING CONSTRUCTION OF A PARTIAL HOSPITALIZATION PROGRAM SPACE SCHEDULED TO OPEN IN OCTOBER 2026, PROFESSIONAL DEVELOPMENT FOR MENTAL HEALTH PROFESSIONALS, AND A COMMUNITY MENTAL HEALTH FIRST AID TRAINING PROGRAM DELIVERED BY TRAINED WELLNESS COACHES.-COLLABORATED WITH LIFESPRINGS TO SUPPORT THEIR CERTIFICATION AS A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CENTER AND EXPAND THEIR MOBILE CRISIS TEAM INTO DUBOIS AND SURROUNDING COUNTIES, BROADENING ACCESS TO CRISIS SERVICES.-DEVELOPED A CARE TEAM MODEL IN THE EMERGENCY DEPARTMENT TO PROVIDE 24/7 EVALUATION AND ACCESS FOR PATIENTS PRESENTING IN BEHAVIORAL HEALTH CRISIS, AND PARTNERED WITH DUBOIS COUNTY COMMUNITY CORRECTIONS TO PROVIDE URGENT AND EMERGENT OUTPATIENT MENTAL HEALTH ACCESS.-MAINTAINED CO-CHAIR ROLE ON THE DUBOIS COUNTY MENTAL HEALTH COMMITTEE AND SUSTAINED ACTIVE PARTICIPATION IN THE DUBOIS COUNTY PUBLIC HEALTH PARTNERSHIP, SUPPORTING REGIONAL COORDINATION AND COMMUNITY EDUCATION ON ACCESSING EMERGENCY MENTAL HEALTH SERVICES.PRIORITY 2: ACCESS TO HEALTHCARETHE 2023 CHNA IDENTIFIED ACCESS TO PRIMARY CARE AND SPECIALTY CARE AS A SIGNIFICANT COMMUNITY NEED, NOTING LONG WAIT TIMES AND PHYSICIAN SHORTAGES ACROSS DUBOIS, MARTIN, PIKE, AND SPENCER COUNTIES.-ADDED TWO FULL-TIME PRIMARY CARE PHYSICIANS, DR. ZACH CRABTREE AND DR. KENEDI DIVINE, TO MEMORIAL'S SERVICE AREA, DIRECTLY INCREASING PRIMARY CARE CAPACITY FOR PATIENTS ACROSS THE REGION.-EXPANDED OUTPATIENT MENTAL HEALTH ACCESS THROUGH ADDITIONAL FTE ADDITIONS, REDUCING WAIT TIMES AND INCREASING AVAILABILITY OF BEHAVIORAL HEALTH SERVICES.-CONTINUED DEPLOYMENT OF TELEHEALTH SERVICES TO EXTEND CARE ACCESS INTO RURAL AND UNDERSERVED AREAS OF THE PRIMARY SERVICE AREA, CONSISTENT WITH THE IMPLEMENTATION STRATEGY'S FOCUS ON IMPROVING HEALTHCARE ACCESSIBILITY.-SUSTAINED THE IU FAMILY MEDICINE RESIDENCY PROGRAM AS A LONG-TERM PIPELINE STRATEGY FOR GROWING PRIMARY CARE CAPACITY IN SOUTHWESTERN INDIANA.PRIORITY 3: DIVERSITY, EQUITY AND INCLUSIONTHE 2023 CHNA IDENTIFIED GAPS IN CULTURAL COMPETENCY, LANGUAGE ACCESS, AND INCLUSION OF DIVERSE POPULATIONS, WITH FOCUS GROUP PARTICIPANTS NOTING LANGUAGE BARRIERS AND A LACK OF DIVERSE CULTURAL UNDERSTANDING AMONG STAFF AND IN SERVICE DELIVERY.-CONTINUED OFFERING INTERPRETER SERVICES AND ACCESS TO TRANSLATION LANGUAGE LINE ACROSS CLINIC LOCATIONS TO SUPPORT PATIENTS WITH LIMITED ENGLISH PROFICIENCY, CONSISTENT WITH THE LANGUAGE ACCESS RESOURCES NOTED IN APPENDIX D OF THE 2023 CHNA.-PROVIDED CULTURAL COMPETENCY TRAINING OR EDUCATION FOR STAFF TO STRENGTHEN THE ORGANIZATION'S ABILITY TO SERVE A GROWING AND DIVERSE PATIENT POPULATION, INCLUDING THE EXPANDING HISPANIC/LATINO COMMUNITY IN DUBOIS COUNTY.-PROVIDED FINANCIAL SUPPORT TO ALASI (ASOCIACIN LATINOAMERICANA DEL SUR DE INDIANA), A LOCAL NONPROFIT WORKING TO REMOVE BARRIERS FOR LATINO AND IMMIGRANT COMMUNITIES IN DUBOIS COUNTY, SUPPORTING THE HOSPITAL'S EFFORTS TO ADDRESS LANGUAGE ACCESS AND CULTURAL INCLUSION NEEDS-TRAINED STAFF IN AVADE NONVIOLENT CRISIS INTERVENTION, SUPPORTING EQUITABLE AND TRAUMA-INFORMED CARE FOR BEHAVIORAL HEALTH PATIENTS ACROSS ALL BACKGROUNDS.PRIORITY 4: COMMUNITY-FOCUSED HEALTHCARE EDUCATIONTHE 2023 CHNA IDENTIFIED A NEED FOR GREATER COMMUNITY OUTREACH, HEALTH EDUCATION, AND COLLABORATION WITH COMMUNITY PARTNERS TO IMPROVE AWARENESS OF AVAILABLE SERVICES AND SUPPORT POPULATION WELLNESS.-DELIVERED COMMUNITY EDUCATIONAL OFFERINGS TO A BROAD RANGE OF COMMUNITY PARTNERS ACROSS THE PRIMARY SERVICE AREA, SUPPORTING HEALTH LITERACY AND AWARENESS OF AVAILABLE CARE.-PARTICIPATED IN OR SPONSORED COMMUNITY HEALTH EVENTS, SCREENINGS, OR WELLNESS PROGRAMS TO PROMOTE PREVENTIVE CARE AND HEALTHY BEHAVIORS IN THE COMMUNITIES SERVED.-COLLABORATED WITH AREA EMPLOYERS, SCHOOLS, OR FAITH COMMUNITIES TO DELIVER HEALTH EDUCATION PROGRAMMING ALIGNED WITH IDENTIFIED COMMUNITY PRIORITIES SUCH AS CARDIOVASCULAR HEALTH, CANCER SCREENING, AND DIABETES PREVENTION.-SUPPORTED COMMUNITY AWARENESS OF EMERGENCY MENTAL HEALTH SERVICES AVAILABLE THROUGH DEACONESS MEMORIAL MEDICAL CENTER AND THE CARE TEAM MODEL, IN PARTNERSHIP WITH BUSINESS DEVELOPMENT AND COMMUNITY EDUCATION EFFORTS.PRIORITY 5: TRANSPORTATIONTHE 2023 CHNA IDENTIFIED TRANSPORTATION AS A BARRIER TO CARE, PARTICULARLY FOR PATIENTS FOLLOWING DISCHARGE OR TRANSFER AND FOR THOSE IN RURAL AREAS OF THE PRIMARY SERVICE AREA.-CONTINUED TO CONNECT PATIENTS WITH AVAILABLE TRANSPORTATION RESOURCES AND COMMUNITY PROGRAMS TO SUPPORT ACCESS TO FOLLOW-UP CARE AND OUTPATIENT SERVICES.-COORDINATED WITH COMMUNITY PARTNERS, INCLUDING COUNTY AGENCIES OR SOCIAL SERVICES, TO IDENTIFY AND ADDRESS TRANSPORTATION BARRIERS FOR PATIENTS WITH LIMITED MOBILITY OR IN RURAL AREAS.-LEVERAGED TELEHEALTH SERVICES AS A STRATEGY TO REDUCE TRANSPORTATION BURDEN FOR PATIENTS IN OUTLYING COUNTIES, INCLUDING MARTIN, PIKE, SPENCER, ORANGE, AND PERRY COUNTIES. |
| DEACONESS MEMORIAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 15E: WELL FUND IS AVAILABLE TO DEACONESS HEALTH SYSTEM PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS. |
| DEACONESS MEMORIAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 16J: DEACONESS MEMORIAL MEDICAL CENTER SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS MEMORIAL MEDICAL CENTER SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. |
| DEACONESS MEMORIAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 24: GROSS CHARGES FOR NON-MEDICALLY NECESSARY SERVICES (ELECTIVE SERVICES) INCLUDING COSMETIC, SURGICAL WEIGHT LOSS, EXPERIMENTAL (NON-FDA APPROVED DEVICES) PROCEDURES, SPECIALTY REPLACEMENT LENSES, HEARING AIDS, SERVICES DENIED BY INSURANCE FOR NO PRIOR AUTHORIZATION OR NON-EMERGENCY SERVICES PROVIDED AS A RESULT OF BEING OUT-OF-NETWORK ARE NOT ELIGIBLE FOR DISCOUNTED CHARGES OR FINANCIAL ASSISTANCE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 22 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - DEACONES CLINIC FAMILY MEDICINE BRISTOW | ||||
| 26020 STATE ROAD 145 | BRISTOW | IN | 47515 | HEALTHCARE |
| 2 - DEACONESS CLINIC & REHAB SERVICES | ||||
| 695 WEST 2ND AVENUE | JASPER | IN | 47546 | ORTHOPAEDIC, OCCUPATIONAL HEALTH, REHABILITATION |
| 3 - DEACONESS CLINIC EAR NOSE AND THROAT | ||||
| 251 S TRUMAN RD | JASPER | IN | 47546 | EAR, NOSE, THROAT |
| 4 - DEACONESS CLINIC FAMILY MEDICINE | ||||
| 1950 ST CHARLES STREET SUITE 4 | JASPER | IN | 47546 | PRIMARY CARE |
| 5 - DEACONESS CLINIC FAMILY MEDICINE & SPECIAL | ||||
| 5066 NORTH 900 EAST | MONTGOMERY | IN | 47558 | HEALTHCARE |
| 6 - DEACONESS CLINIC FAMILY MEDICINE 9TH ST | ||||
| 751 WEST 9TH STREET | JASPER | IN | 47546 | FAMILY MEDICINE |
| 7 - DEACONESS CLINIC FAMILY MEDICINE DALE | ||||
| 4 WEST VINE STREET PO BOX 599 | DALE | IN | 47523 | FAMILY MEDICINE |
| 8 - DEACONESS CLINIC FAMILY MEDICINE FERDINAND | ||||
| 115 SOUTH MAIN STREET PO BOX 280 | FERDINAND | IN | 47532 | FAMILY MEDICINE |
| 9 - DEACONESS CLINIC FAMILY MEDICINE FRENCH LI | ||||
| 679 HIGHWAY 145 | FRENCHLICK | IN | 47432 | FAMILY MEDICINE |
| 10 - DEACONESS CLINIC FAMILY MEDICINE HOLLAND | ||||
| 303 MERIDIAN STREET PO BOX 212 | HOLLAND | IN | 47541 | FAMILY MEDICINE |
| 11 - DEACONESS CLINIC FAMILY MEDICINE HUNTINGBU | ||||
| 407 EAST 22ND STREET | HUNTINGBURG | IN | 47542 | HEALTHCARE |
| 12 - DEACONESS CLINIC FAMILY MEDICINE LOOGOOTEE | ||||
| 105 COOPER STREET PO BOX 401 | LOOGOOTEE | IN | 47553 | FAMILY MEDICINE |
| 13 - DEACONESS CLINIC FAMILY MEDICINE PETERSBUR | ||||
| 1003 EASTI LLINOIS STREET PO BOX 66 | PETERSBURG | IN | 47567 | FAMILY MEDICINE |
| 14 - DEACONESS CLINIC FAMILY MEDICINE RESIDENCY | ||||
| 966 BARTLEY STREET | JASPER | IN | 47546 | FAMILY MEDICINE |
| 15 - DEACONESS CLINIC FAMILY MEDICINE SANTA CLA | ||||
| 92 WEST CHRISTMAS BOULEVARD | SANTACLAUS | IN | 47579 | FAMILY MEDICINE |
| 16 - DEACONESS CLINIC FAMILY MEDICINE WASHINGTO | ||||
| 600 SOUTH STATE ROAD 57 | WASHINGTON | IN | 47501 | HEALTHCARE |
| 17 - DEACONESS CLINIC HEART & VASCULAR JASPER | ||||
| 440 SCOTT ROLEN DRIVE | JASPER | IN | 47546 | CARDIOLOGY |
| 18 - DEACONESS CLINIC HUNTINGBURG | ||||
| 507 EAST 19TH STREET | HUNTINGBURG | IN | 47542 | WOUND CARE & URGENT CARE |
| 19 - DEACONESS CLINIC JASPER | ||||
| 600 WEST 13TH STREET | JASPER | IN | 47546 | OUTPATIENT SURGERY, UROLOGY, NEUROLOGY |
| 20 - DEACONESS CLINIC JASPER | ||||
| 721 WEST 13TH STREET | JASPER | IN | 47546 | AUDIOLOGY, BEHAVIORAL, GASTRO, SURGERY, PED., SLEEP, PULMONARY, NEPHRO, PAIN |
| 21 - DEACONESS CLINIC ORTHOPAEDICS ST CHARLES | ||||
| 1900 ST CHARLES STREET | JASPER | IN | 47546 | ORTHOPAEDICS |
| 22 - MARTIN COUNTY HEALTH CENTER | ||||
| 229 HIGHSTREET PO BOX 480 | SHOALS | IN | 47581 | HEALTHCARE |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | A PATIENT MAY QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE IF THE PATIENT'S HOUSEHOLD INCOME IS BETWEEN 200% AND 350% OF THE FEDERAL POVERTY GUIDELINES. PRESUMPTIVE ELIGIBILITY FOR FREE CARE WITH REQUIRED VERIFICATION IS AVAILABLE FOR DECEASED INDIVIDUALS WITH NO ESTATE AND NO SURVIVING SPOUSE; AND, FOR INDIVIDUALS IN HOMELESS SITUATIONS RECEIVING ASSISTANCE FROM SUPPORTIVE SERVICES SUCH AS GOVERNMENTAL, RELIGIOUS OR COMMUNITY SERVICES. |
| PART I, LINE 7: | DEACONESS MEMORIAL MEDICAL CENTER CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS, USING THE COST-TO-CHARGE RATIO DERIVED FROM SCHEDULE H, WORKSHEET 2, RATIO OF PATIENT CARE COST-TO- CHARGES. OTHER BENEFIT AMOUNTS REPORTED ON LINE 7 WERE CALCULATED USING COSTS CHARGED DIRECTLY TO THE INDIVIDUAL PROGRAMS VIA THE FINANCIAL ACCOUNTING SYSTEM. |
| PART I, LINE 7G: | $1,714,460 OF LOSSES FROM RURAL HEALTH CLINICS OPERATED BY DEACONESS MEMORIAL MEDICAL CENTER ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES. |
| PART III, LINE 2: | DEACONESS MEMORIAL MEDICAL CENTER'S ANALYSIS AND ASSESSMENT OF THE BAD DEBT EXPENSE IS BASED ON THE EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. |
| PART III, LINE 3: | NO OTHER BAD DEBT AMOUNTS HAVE BEEN INCLUDED AS COMMUNITY BENEFIT. THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY AND EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON, THE ORGANIZATION BELIEVES IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. |
| PART III, LINE 4: | SEE PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS FOOTNOTE 1 UNDER HEADING "PATIENT SERVICE REVENUE." |
| PART III, LINE 8: | THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED SEPTEMBER 30, 2025: HOSPITAL STATEMENT OF REIMBURSABLE COST. |
| PART III, LINE 9B: | THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY INCLUDES PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED DURING THE FOLLOW-UP PERIOD AFTER A PATIENT IS DISCHARGED AND INCLUDES SPECIFIC INSTRUCTIONS FOR SELF-PAY WHO MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | ADVISORY COUNCILS: ADVISORY COUNCILS WERE DEVELOPED AND IMPLEMENTED IN 2014 AS A WAY FOR DEACONESS MEMORIAL MEDICAL CENTER TO STAY CONNECTED WITH EACH COUNTY OUTSIDE OF DUBOIS COUNTY. IT WAS IDENTIFIED THERE WERE SEVERAL NEEDS THAT WERE SPECIFIC FOR EACH COUNTY. MEMBERS OF THE DEACONESS MEMORIAL MEDICAL CENTER MANAGEMENT TEAM ARE ASSIGNED TO A COUNTY TO CONTINUE THE COLLABORATION AND TO RECEIVE ONGOING FEEDBACK ON NEEDS AND WHERE DEACONESS MEMORIAL MEDICAL CENTER IS ABLE TO PROVIDE ASSISTANCE. PARTICIPATING IN THESE COUNCILS ARE ECONOMIC DEVELOPMENT DIRECTORS, COUNTY HEALTH NURSES, CHAMBER OF COMMERCE LEADERS, EDUCATORS, EXECUTIVES, PASTORS, EMS, LAW ENFORCEMENT, BUSINESS OWNERS, OTHER HEALTH CARE ORGANIZATION LEADERS, ETC. WITH THE ONGOING ADVISORY COUNCILS, WE ARE ABLE TO PROVIDE QUICK SOLUTIONS FOR EACH AREA. WE CONTINUE TO GATHER FEEDBACK AND NEEDS AND WORK TO ADDRESS EACH COUNTY SPECIFICALLY IN OUR PSA. |
| PART VI, LINE 3: | THIS IS LISTED ON OUR WEBSITE AT HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE AND IS POSTED IN EVERY CLINIC OFFICE AND FACILITY. |
| PART VI, LINE 4: | DEACONESS MEMORIAL MEDICAL CENTER DEFINES ITS COMMUNITY AS INDIVIDUALS RESIDING IN DUBOIS, MARTIN, PIKE, AND SPENCER COUNTIES IN INDIANA. THE SERVICE AREA HAD AN ESTIMATED POPULATION OF APPROXIMATELY 85,509 BASED ON 2020 U.S. CENSUS DATA AND ENCOMPASSES APPROXIMATELY 1,494 SQUARE MILES, WITH A POPULATION DENSITY OF APPROXIMATELY 57 PERSONS PER SQUARE MILE. THE AREA IS PREDOMINANTLY RURAL. THE POPULATION IS GENERALLY EVENLY DIVIDED BETWEEN MALES AND FEMALES.THE COMMUNITY INCLUDES RESIDENTS ACROSS ALL AGE GROUPS; APPROXIMATELY 19.3% OF RESIDENTS ARE AGE 65 OR OLDER, AND APPROXIMATELY 23.1% ARE UNDER AGE 18. THE POPULATION IS PREDOMINANTLY WHITE (APPROXIMATELY 91.8%), WITH RESIDENTS REPRESENTING OTHER RACIAL BACKGROUNDS AND PERSONS REPORTING MORE THAN ONE RACE. APPROXIMATELY 6.0% OF THE POPULATION IDENTIFIES AS HISPANIC OR LATINO. THESE GEOGRAPHIC AND DEMOGRAPHIC CHARACTERISTICS WERE CONSIDERED IN IDENTIFYING AND ADDRESSING THE HEALTH NEEDS OF THE COMMUNITY SERVED. |
| PART VI, LINE 5: | DEACONESS PROMOTED SERVICES AND INFORMATION THAT HELPED US ADDRESS THE GREATEST HEALTH NEEDS OF THE COMMUNITY AS DEFINED BY OUR MOST RECENT CHNA, AS WELL AS ENCOURAGE PEOPLE TO GET THE PREVENTIVE SCREENINGS THEY NEED.DEACONESS HOSTED AND ATTEND PUBLIC EVENTS, SUCH AS OUR ANNUAL ORAL, HEAD AND NECK CANCER SCREENINGS; COLON CANCER SCREENINGS, LOW DOSE CT SCREENINGS AND MORE OUTLINED BELOW. ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND HEALTH CONCERNS FOR OUR COMMUNITY.SOCIAL MEDIA POSTS:BREAST CANCER AWARENESS 10/1/2024WISE CHOICE 10/8/2024MENTAL HEALTH AWARENESS 10/10/2024PRIMARY CARE WEEK 10/11/2024GLOBAL HANDWASHING DAY 10/15/2024NATIONAL MAMMOGRAPHY DAY 10/18/2024MEGA BREAST TOUR 10/18/2024BREAST CANCER SURVIVOR TESTIMONY 10/25/2024BREAST CANCER SURVIVOR TESTIMONY 10/31/2024LUNG CANCER AWARENESS 11/1/2024LUNG CANCER SCREENING 11/8/2024WORLD DIABETES DAY 11/14/2024GREAT AMERICAN SMOKEOUT 11/24/2024WORLD AIDS DAY SCREENING 11/22/2024NO SHAVE NOVEMBER 11/22/2024SAFE TOYS AND GIFTS MONTH 12/2/2024SAFESITTER 12/4/2024HAND HYGIENE 12/6/2024ANXIETY 12/6/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/10/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/18/2024CROHN'S DISEASE AWARENESS 12/19/2024WHOOPING COUGH (PERTUSSIS) VACCINE AWARENESS 12/23/2024ANXIETY 1/3/2025WINTER STORM PREPAREDNESS 1/5/2025SLEDDING SAFETY 1/10/2025WEIGHT LOSS 1/10/2025HEAD AND NECK CANCER AWARENESS 1/15/2025LUNG DISEASE SUPPORT 1/16/2025FROSTBITE/HYPOTHERMIA AWARENESS 1/20/2025MOBILE MAMMOGRAM 1/29/2025GO RED FOR WOMEN (HEART DISEASE) 1/31/2025GO RED FOR WOMEN (HEART DISEASE) 2/1/2025AMERICAN HEART MONTH 2/3/2025GO RED FOR WOMEN (HEART DISEASE) 2/5/2025GO RED FOR WOMEN (HEART DISEASE) 2/6/2025HEART ATTACK SIGNS AND SYMPTOMS 2/8/2025IMPELLA HEART PUMP 2/11/2025CARDIAC REHAB 2/15/2025WINTER WEATHER SAFETY 2/18/2025NATIONAL CAREGIVERS DAY 2/21/2025COLON CANCER SCREENING 3/3/2025MEDICARE SEMINAR 3/3/2025NATIONAL KIDNEY MONTH 3/6/2025COLON CANCER AWARENESS MONTH 3/6/2025COLONOSCOPY AWARENESS 3/7/2025KIDNEY HEALTH 3/11/2025WORLD KIDNEY DAY / CHRONIC KIDNEY DISEASE 3/13/2025PULMONARY REHAB EDUCATION 3/15/2025FLU SEASON AWARENESS 3/18/2025KIDNEY DISEASE AWARENESS 3/20/2025AMERICAN DIABETES ALERT DAY 3/20/2025KIDNEY HEALTH 3/25/2025COLON CANCER SCREENING 3/26/2025HEAD AND NECK CANCER AWARENESS 4/1/2025HEAD AND NECK CANCER SCREENINGS 4/7/2025HEAD AND NECK CANCER SCREENINGS 4/15/2025STRESS AND ALCOHOL USE 4/18/2025STROKE AWARENESS MONTH 5/1/2025SPOT A STROKE F.A.S.T. 5/2/2025WORLD OVARIAN CANCER DAY 5/8/2025MENTAL HEALTH AND NURSING 5/9/2025SANE EDUCATION 5/9/2025SKIN CANCER AWARENESS 5/14/2025F.A.S.T. EXPERIENCE 5/14/2025STROKE AWARENESS MONTH 5/21/2025MENTAL HEALTH FOR WOMEN 5/22/2025BLOOD DONATION 5/24/2025CANCER SURVIVORSHIP 6/1/2025MEN'S HEALTH AWARENESS MONTH 6/2/2025MEN'S HEALTH AWARENESS MONTH 6/4/2025MEN'S HEALTH AWARENESS MONTH 6/9/2025MEN'S HEALTH AWARENESS MONTH 6/11/2025MEN'S HEALTH AWARENESS MONTH 6/12/2025MEN'S HEALTH AWARENESS MONTH 6/12/2025WORLD BLOOD DONATION DAY 6/14/2025HEAT SAFETY AWARENESS 6/23/2025MEN'S CANCERS 6/24/2025MEN'S HEALTH AWARENESS MONTH 6/27/2025SUMMER SAFETY 6/28/2025MEN'S HEALTH AWARENESS MONTH 6/30/2025FIREWORKS SAFETY 7/2/2025SKIN HEALTH AWARENESS 7/17/2025PEDIATRIC PHYSICAL THERAPY 7/18/2025HEALTH SAFETY 7/19/2025BLOOD DONATION 7/21/2025INFANT MORTALITY 7/23/2025UV SAFETY AWARENESS 7/25/2025BACK-TO-SCHOOL HEALTH 7/28/2025PEDIATRIC PHYSICAL THERAPY 7/30/2025BACK-TO-SCHOOL HEALTH 7/30/2025WORLD LUNG CANCER DAY 8/1/2025NATIONAL BREASTFEEDING MONTH 8/16/2025BITE THERAPY 9/4/2025WORLD SEPSIS DAY 9/13/2025TIF PROCEDURE FOR GERD 9/17/2025BLOOD DONATION 9/17/2025BREAST CANCER AWARENESS 9/19/2025PROSTATE CANCER DETECTION 9/23/2025COCHLEAR IMPLANTS 9/26/2025MAMMOGRAMS 9/29/2025MEDICATION ASSISTANCE AND FAMILY MEDICINE RESIDENCY CLINIC DEACONESS PROVIDES FREE AND REDUCED CARE WITHIN OUR HOSPITAL BUILDINGS. THROUGH OUR MEDICATION ASSISTANCE PROGRAM (MAP) AND OUR FAMILY PRACTICE RESIDENCY CLINIC, PATIENTS CAN ACCESS THE HIGH QUALITY HEALTH CARE THEY NEED IN CONVENIENT LOCATIONS AND AT A PRICE THEY CAN AFFORD. SIMILARLY, THE MAP FOR DEACONESS MEMORIAL MEDICAL CENTER ASSISTED 963 PATIENTS WITH $5,818,823.94 IN MEDICATION ASSISTANCE.LOCAL SPONSORSHIPSAS A SYSTEM IN FY 24-25, DEACONESS SPONSORED PROGRAMS AND ACTIVITIES FOR MORE THAN 170,000 PEOPLE, CONTRIBUTING $2.1 MILLION IN SUPPORT OF CLUBS, GROUPS, SOCIAL SERVICE ORGANIZATIONS, AND OTHERS STRIVING TO MAKE OUR COMMUNITY A BETTER PLACE. |
| PART VI, LINE 6: | DEACONESS MEMORIAL MEDICAL CENTER IS AFFILIATED WITH DEACONESS HEALTH SYSTEM, COOPERATING TO PROVIDE HEALTH CARE SERVICES TO THEIR COMMUNITIES. ADDITIONALLY, THE HOSPITAL DOES PARTICIPATE IN SEVERAL COALITIONS AND COOPERATIVES WITH OTHER PROVIDERS AND OFTEN COLLABORATES WITH THE LARGER SYSTEM IN THE EVANSVILLE AREA TO PROVIDE ACCESS TO SERVICES THE HOSPITAL CANNOT PROVIDE SUCH AS CARDIAC AND NEUROLOGICAL SURGERY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHAWN MCCOY | ||||||||||||||
| BOARD MEMBER | $0 | $1,238,547 | $0 | $457,318 | $0 | $320,373 | $0 | $316,483 | $0 | $44,966 | $0 | $2,377,687 | $0 | $313,370 |
| MATTHEW DODARO | ||||||||||||||
| PHYSICIAN | $806,756 | $0 | $595,642 | $0 | $12,305 | $0 | $6,900 | $0 | $33,384 | $0 | $1,454,987 | $0 | $0 | $0 |
| GEOFFREY DAY MD | ||||||||||||||
| PHYSICIAN | $905,895 | $0 | $455,886 | $0 | $630 | $0 | $6,900 | $0 | $33,384 | $0 | $1,402,695 | $0 | $0 | $0 |
| JOSHUA LEONARD MD | ||||||||||||||
| PHYSICIAN | $886,787 | $0 | $421,962 | $0 | $966 | $0 | $6,900 | $0 | $32,906 | $0 | $1,349,521 | $0 | $0 | $0 |
| ADAM DAWKINS MD | ||||||||||||||
| PHYSICIAN | $869,346 | $0 | $421,544 | $0 | $630 | $0 | $6,900 | $0 | $32,167 | $0 | $1,330,587 | $0 | $0 | $0 |
| E KYLE BENNETT | ||||||||||||||
| FORMER PRES./CEO | $346,259 | $0 | $557,501 | $0 | $342,099 | $0 | $5,775 | $0 | $19,794 | $0 | $1,271,428 | $0 | $0 | $0 |
| LYNN LINGAFELTER | ||||||||||||||
| BOARD MEMBER | $0 | $694,891 | $0 | $216,135 | $0 | $161,934 | $0 | $162,333 | $0 | $36,046 | $0 | $1,271,339 | $0 | $158,553 |
| JAMES PORTER MD | ||||||||||||||
| BOARD MEMBER | $0 | $682,862 | $0 | $213,203 | $0 | $177,113 | $0 | $160,685 | $0 | $26,675 | $0 | $1,260,538 | $0 | $173,123 |
| JONATHAN DAY MD | ||||||||||||||
| PHYSICIAN | $589,958 | $0 | $595,642 | $0 | $630 | $0 | $6,900 | $0 | $50,020 | $0 | $1,243,150 | $0 | $0 | $0 |
| EDWARD W MILLER | ||||||||||||||
| VP FINANCE/CFO | $383,209 | $0 | $314,307 | $0 | $2,426 | $0 | $6,900 | $0 | $5,831 | $0 | $712,673 | $0 | $0 | $0 |
| SOHAIL QADIR MD | ||||||||||||||
| BOARD MEMBER | $609,750 | $0 | $28,800 | $0 | $1,806 | $0 | $6,900 | $0 | $31,803 | $0 | $679,059 | $0 | $0 | $0 |
| NICK WERNE MD | ||||||||||||||
| BOARD MEMBER | $308,731 | $0 | $174,083 | $0 | $630 | $0 | $5,682 | $0 | $32,259 | $0 | $521,385 | $0 | $0 | $0 |
| KRISTI NORD MD | ||||||||||||||
| MED. STAFF PRES. | $344,042 | $0 | $18,621 | $0 | $420 | $0 | $6,529 | $0 | $32,811 | $0 | $402,423 | $0 | $0 | $0 |
| KEITH MILLER | ||||||||||||||
| CAO & INDIANA REGION PRES. | $274,802 | $0 | $11,670 | $0 | $1,182 | $0 | $7,569 | $0 | $33,744 | $0 | $328,967 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | SOCIAL CLUB DUES ARE PAID FOR SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEES. |
| PART I, LINE 3 | THE FOLLOWING METHODS WERE USED BY DEACONESS HEALTH SYSTEM, A RELATED NON-PROFIT ORGANIZATION, TO DETERMINE THE COMPENSATION FOR THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION STUDY OR SURVEY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | SEVERANCE PAYMENTS: E. KYLE BENNETT $339,602 EDWARD MILLER $53,612 NONQUALIFIED PAYMENTS: SHAWN MCCOY $23,000 LYNN LINGAFELTER $23,000 DR. JAMES PORTER $23,000 LYNN LINGAFELTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $150,258 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $158,553 SHAWN MCCOY: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $304,408 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $313,370 JAMES PORTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $148,610 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $173,123 |
| PART I, LINE 6 | COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANIZATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. |
| PART I, LINE 7 | PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A CALENDAR YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE CALENDAR YEAR MULTIPLIED BY THE INCENTIVE RVU PAYMENT. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR MATTHEW DODARO | PersonNm |
| Relationship With Org | TOP 5 HIGHEST COMPENSATED EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | SB&A LOAN | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Balance Due | $32,500 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $32,500 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRENDA STALLINGS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | $2,569,050 | TransactionAmt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | A) NAME OF PERSON: BRENDA STALLINGS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE HOSPITAL: BRENDA STALLINGS, MEMORIAL HOSPITAL BOARD MEMBER, IS THE PRESIDENT OF MATRIX INTEGRATION.(D) DESCRIPTION OF TRANSACTION: MATRIX INTEGRATION PROVIDES PROFESSIONAL INFORMATION TECHNOLOGY (IT) SERVICES TO MEMORIAL HOSPITAL. THE HOSPITAL PAID $2,569,050 FOR SERVICES TO MATRIX INTEGRATION IN THE CURRENT YEAR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, SECTION J | WWW.DEACONESS.COM/INDIANA/DEACONESS-MEMORIAL-MEDICAL-CENTER |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS DEACONESS HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | DIRECTORS APPOINTED TO THE BOARD ARE SUBJECT TO THE APPROVAL OF THE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | EACH OF THE FOLLOWING MATTERS SHALL REQUIRE THE SPECIFIC APPROVAL OF THE MEMBER, WHICH MAY BE EXERCISED UPON THE MEMBER'S INITIATIVE (EITHER BY ACTION OF THE BOARD OF DIRECTORS OF THE MEMBER OR VIA APPROVED MANAGEMENT AUTHORITY (E.G., VIA AUTHORITY SET FORTH IN THE DIVISION CHARTER, SUBJECT TO APPLICABLE PARAMETERS)) OR BY APPROVAL OF A RECOMMENDATION FROM THE BOARD OF THE CORPORATION: (A) ADOPTION BY THE CORPORATION OF ANNUAL OR LONG-TERM STRATEGIC PLANS, BUSINESS PLANS, CAPITAL BUDGETS AND OPERATING BUDGETS AND, THEREAFTER, ANY ACTION WHICH WILL RESULT IN A SUBSTANTIAL CHANGE IN ANY SUCH PLAN OR BUDGET OR IN THE EXPENDITURES OR REVENUE FORECAST IN ANY SUCH PLAN OR BUDGETS IN EXCESS OF THE APPLICABLE PARAMETERS; (B) ANY CREATION OR SUBSTANTIVE AMENDMENT OF A CONTRACT, LEASE OR OTHER AGREEMENT TO WHICH THE CORPORATION IS A PARTY WHICH INVOLVES AN OBLIGATION, OR A POTENTIAL OBLIGATION, ON THE PART OF THE CORPORATION IN EXCESS OF THE APPLICABLE PARAMETERS; INVOLVES A STRATEGIC AFFILIATION BY THE CORPORATION WITH ONE OR MORE OTHER ENTITIES; OR RELATES TO THE PURCHASE OF INSURANCE OR RELATED ISSUES INVOLVING A MATERIAL CHANGE IN INSURANCE LIMITS, DEDUCTIBLES, COINSURANCE OR OTHER ISSUES INVOLVING THE NATURE OF ANY TYPE OF INSURANCE OR THE CORPORATION'S PROGRAM OF INSURANCE IN EACH CASE EXCEPT WITH RESPECT TO TRANSACTIONS CONSISTENT WITH APPROVED BUDGETS OR APPLICABLE POLICIES; (C) ANY PURCHASE, LEASE AS LESSEE, OR OTHER ACQUISITION BY THE CORPORATION OF ANY BUSINESS, ASSET OR ASSETS AT AN AGGREGATE PRICE IN EXCESS OF THE APPLICABLE PARAMETERS, IN EACH CASE EXCEPT WITH RESPECT TO TRANSACTIONS CONSISTENT WITH APPROVED BUDGETS OR APPLICABLE POLICIES; (D) ANY SALE, LEASE AS LESSOR, EXCHANGE, GIFT, MORTGAGE, ENCUMBRANCE, OPTION OR OTHER DISPOSITION BY THE CORPORATION OF: ANY REAL PROPERTY OR INTEREST THEREIN WITH A VALUE IN EXCESS OF THE APPLICABLE PARAMETERS; OR ANY OTHER ASSET WITH A VALUE IN EXCESS OF THE APPLICABLE PARAMETERS, EXCEPT WITH RESPECT TO TRANSACTIONS CONSISTENT WITH APPROVED BUDGETS OR APPLICABLE POLICIES; (E) ANY RELEASE OR CANCELLATION BY THE CORPORATION OF A CLAIM OR RIGHT OF ACTION AGAINST ANOTHER PARTY IN ANY AMOUNT, OR ANY SETTLEMENT OF LITIGATION, ARBITRATION OR OTHER PROCEEDINGS, IN EXCESS OF THE APPLICABLE PARAMETERS; (F) ANY PLAN OF CONSTRUCTION OR REMODELING INVOLVING AN EXPENDITURE BY THE CORPORATION IN EXCESS OF THE APPLICABLE PARAMETERS; (G) ANY BORROWING BY THE CORPORATION IN EXCESS OF THE APPLICABLE PARAMETERS; (H) ANY LOAN MADE BY THE CORPORATION TO ANOTHER PARTY THAT WOULD CAUSE THE AGGREGATE OF ALL LOANS MADE BY SUCH ENTITY AND ITS SUBSIDIARIES THEN OUTSTANDING TO EXCEED THE APPLICABLE PARAMETERS; (I) ADOPTION BY THE CORPORATION OF ANY INVESTMENT POLICIES, AND ANY MAKING, RETENTION OR DISPOSITION OF AN INVESTMENT BY THE CORPORATION INCONSISTENT WITH SUCH POLICIES; J) ANY SELECTION, REMOVAL, OR CHANGE IN THE COMPENSATION OR OTHER TERMS OF EMPLOYMENT OF THE CAO OR THE OFFICERS OF THE CORPORATION (WITH COMPENSATION FOR INDIVIDUALS SERVING IN EXECUTIVE ROLES FOR THE CORPORATION AT ALL TIMES BEING SUBJECT TO REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS OF THE MEMBER); (K) ANY SUBSTANTIAL CHANGE IN THE EMPLOYEE FRINGE BENEFITS OR PERSONNEL POLICIES OF THE CORPORATION; (I) ANY GENERAL PLAN FOR THE SOLICITATION BY THE CORPORATION OF CHARITABLE CONTRIBUTIONS, OR THE SOLICITATION OR ACCEPTANCE AS A GIFT BY THE CORPORATION OF ANY REAL PROPERTY OR ANY INTEREST THEREIN, EXCEPT FOR ROUTINE FUNDRAISING ACTIVITIES CONTEMPLATED BY A FUNDRAISING PROGRAM PREVIOUSLY APPROVED BY THE MEMBER; (M) ANY REPORT OR APPLICATION TO A PUBLIC OR QUASI-PUBLIC AGENCY OR THIRD PARTY PAYER BY THE CORPORATION; (N) ANY AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION, BYLAWS, OR OTHER ORGANIZATIONAL DOCUMENTS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (SUBJECT TO THE RESTRICTIONS CONTAINED IN ARTICLE XII HEREOF). (O) ANY MERGER, REORGANIZATION, CONSOLIDATION, CHANGE OF CONTROL, OR DISSOLUTION INVOLVING THE CORPORATION, OR ANY ACTION RELATED TO BANKRUPTCY OR INSOLVENCY INVOLVING THE CORPORATION; (P) ANY AGREEMENT TO INDEMNIFY A PERSON OR PERSONS BY THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; (Q) ANY TRANSACTION BY THE CORPORATION INVOLVING A DUALITY OF INTEREST; (R) ANY ACTION OR INACTION BY THE CORPORATION AT VARIANCE WITH THE POLICIES OF THE MEMBER; (S) ANY AGREEMENTS OR AFFILIATIONS INVOLVING THE CORPORATION AND ANY OTHER HOSPITALS OR HEALTH CARE SYSTEMS INVOLVING FINANCIAL COMMITMENTS IN EXCESS OF THE APPLICABLE PARAMETERS; (T) FORMATION OF ANY NEW ENTITY BY THE CORPORATION INVOLVING FINANCIAL COMMITMENTS IN EXCESS OF THE APPLICABLE PARAMETERS; (U) ANY ACQUISITION OF EQUITY OR MEMBERSHIP INTEREST BY THE CORPORATION IN ANOTHER ENTITY INVOLVING FINANCIAL COMMITMENTS IN EXCESS OF THE APPLICABLE PARAMETERS; (V) ANY ISSUANCE OF EQUITY OR MEMBERSHIP INTEREST BY THE CORPORATION WITH A VALUE IN EXCESS OF THE APPLICABLE PARAMETERS; (W) THE CORPORATION ENTERING A NEW LINE OF BUSINESS, OR CEASING OR MATERIALLY ALTERING ANY EXISTING LINE OF BUSINESS, IN EACH CASE INVOLVING A FINANCIAL IMPACT OR COMMITMENT IN EXCESS OF THE APPLICABLE PARAMETERS; (X) HIRING OR CHANGING OUTSIDE FINANCIAL AUDITORS BY THE CORPORATION; (Y) CREATING COMMITTEES OF THE GOVERNING BOARD OF THE CORPORATION OR CHANGING THE PURPOSES, AUTHORITY, SIZE OR COMPOSITION OF ANY EXISTING COMMITTEES; (Z) GUARANTEEING ANY OBLIGATIONS OF ANY OTHER PERSON OR ENTITY BY THE CORPORATION INVOLVING POTENTIAL FINANCIAL OBLIGATIONS IN EXCESS OF THE APPLICABLE PARAMETERS; (AA) ADOPTION OF ANY CHANGES TO THE CHARITY CARE POLICY OF THE CORPORATION EXCEPT TO THE EXTENT CONSISTENT WITH POLICIES PREVIOUSLY APPROVED BY THE MEMBER; (BB) ANY OTHER MATTERS INVOLVING THE CORPORATION AS MAY BE REQUIRED BY LAW TO BE SUBMITTED TO THE MEMBER OR AS TO WHICH THE GOVERNING BOARD OF THE CORPORATION DETERMINES BY RESOLUTION THAT SUBMISSION IS ADVISABLE; AND (CC) SUCH OTHER MATERIAL MATTERS RELATED TO THE CORPORATION AS MAY BE DETERMINED APPROPRIATE FROM TIME TO TIME BY RESOLUTION OF THE BOARD OF THE MEMBER OR BY INCLUSION IN THE CHARTER OF AN OPERATING DIVISION COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE IRS FORM 990 IS PRESENTED TO DHS CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW AND ALL QUESTIONS HAVE BEEN ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM PRIOR TO FILING. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FILING OF THE FORM IS COMPLETED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HEALTH'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND ANNUALLY THEREAFTER, OFFICERS, TRUSTEES, DIRECTORS, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE THE CONFLICTS OF INTEREST AND/OR THE DISCLOSURE QUESTIONNAIRE. THESE DOCUMENTS SERVE TO ENSURE THAT INTERESTED PERSONS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS ON A PERIODIC BASIS. REVIEWS OCCUR TO ENSURE DEACONESS MEMORIAL MEDICAL CENTER OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS DEACONESS MEMORIAL MEDICAL CENTER UTILIZES THE DEACONESS HEALTH COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS OF DEACONESS HEALTH AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE IRS. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1) ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION 2) MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES 3) OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4) REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS 5) RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICER COMPENSATION 6) SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS 7) OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS 8) APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS 9) MAKE REGULAR REPORTS TO THE BOARD |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII & SCHEDULE J, PART II: | WE DO NOT USE A COMMON PAYMASTER. ALL SHARED STAFF AND DUAL-OFFICERS ARE PAID AND W-2'D SOLELY BY DHS. DEACONESS MEMORIAL MEDICAL CENTER REPORTS ALL SUCH COMPENSATION AS RELATED ORGANIZATION COMPENSATION IN PART VII COL (E) AND SCHEDULE J ROW (II). THE INTERCOMPANY ALLOCATION AND SUBSIDY ARE REPORTED AS OPERATIONAL TRANSFERS/ALLOCATIONS, NOT AS DIRECT COMPENSATION BY THE SUBSIDIARY. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 37,321,136. MANAGEMENT AND GENERAL EXPENSES 3,210,572. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,531,708. |
| FORM 990, PART XI, LINE 9: | INTERCOMPANY TRANSFER 4,114,627. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 800 WEST NINTH STREET | JASPER | IN | 47546 | 351359445 | BENEFIT DEACONESS MEMORIAL MEDICAL CENTER | IN | 501(C)(3) | LINE 12A, I | DEACONESS MEMORIAL MEDICAL CENTER | Yes (1) | |
| DEACONESS CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 263083364 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH KENTUCKY INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 830966826 | HEALTHCARE | KY | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS HEALTH SYSTEM INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 351532889 | HEALTHCARE | IN | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| DEACONESS HOSPITAL INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 350593390 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS SPECIALTY PHYSICIANS INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 824503095 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS UNION COUNTY HOSPITAL INC | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 862614124 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY INC | 0 | |
| DEACONESS VNA PLUS LLC | |||||||||||
| 611 HARRIET STREET | EVANSVILLE | IN | 47710 | 465223267 | HEALTHCARE | IN | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| METHODIST HEALTH INC | |||||||||||
| PO BOX 48 | HENDERSON | KY | 42419 | 610461753 | HEALTHCARE | KY | 501(C)(3) | LINE 3 | DEACONESS HEALTH KENTUCKY INC | 0 | |
| UNION COUNTY METHODIST HOSPITAL FOUNDATION | |||||||||||
| 4604 US HWY 60 WEST | MORGANFIELD | KY | 42437 | 611230297 | SUPPORT METHODIST HOSPITAL | KY | 501(C)(3) | LINE 10 | DEACONESS HEALTH KENTUCKY INC | 0 | |
| DEACONESS ILLINOIS SPECIALTY CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920904755 | HEALTHCARE | IL | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS ILLINOIS CLINIC INC | |||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 920574205 | HEALTHCARE | IL | 501(C)(3) | LINE 10 | DEACONESS HEALTH SYSTEM INC | 0 | |
| DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA LLC | |||||||||||
| 4199 GATEWAY BLVD | NEWBURG | IN | 47630 | 352062016 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
| GIBSON GENERAL HOSPITAL | |||||||||||
| 1808 SHERMAN DR | PRINCETON | IN | 47670 | 350877575 | HEALTHCARE | IN | 501(C)(3) | LINE 3 | DEACONESS HEALTH SYSTEM INC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (18 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DUBOIS PSYCH PROPERTIES LLC | |||||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47710 | 992349209 | MENTAL HEALTH SERVICES | IN | N/A | RELATED | -$766,918 | $40,994 | 0 | 0 | 0.50000 |
| VASCMED LLC | |||||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 472578168 | VASCULAR SERVICES | IN | N/A | 0 | 0 | ||||
| TRI-STATE HEALTHCARE CONSULTANTS LLC | |||||||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 922120911 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| PROGRESSIVE HEALTH OF INDIANA LLC | |||||||||||||
| 150 N ROSENBERGER | EVANSVILLE | IN | 47712 | 208480988 | OUTPATIENT | IN | N/A | 0 | 0 | ||||
| ORTHOPRIME LLC | |||||||||||||
| 600 MARY STREET | EVANSVILLE | IN | 47747 | 993575306 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| ORTHOALIGN LLC | |||||||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 812816013 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| MEMORIAL HOSPITAL OUTPATIENT SURGERY CENTER LLC | |||||||||||||
| 600 WEST 13TH STREET | JASPER | IN | 47546 | 274828606 | OUTPATIENT | IN | RELATED | $346,400 | $410,329 | 0 | 0 | 0.40000 | |
| MAINSPRING MANAGERS LLC | |||||||||||||
| 4011 GATEWAY BLVD | NEWBURGH | IN | 47630 | 464601001 | NEUROLOGY SERVICES | IN | N/A | 0 | 0 | ||||
| LOFIELD DIALYSIS LLC | |||||||||||||
| PO BOX 4388 | FEDERAL WAY | WA | 98063 | 812592834 | HEALTHCARE | WA | N/A | 0 | 0 | ||||
| INNOVATIVE HEALTHCARE COLLABORATIVE OF INDIANA LLC | |||||||||||||
| 7330 SHADELAND STATION STE 200 | INDIANAPOLIS | IN | 46256 | 833592473 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| EVANSVILLE SURGERY SERVICES LLC | |||||||||||||
| 520 MARY STREET | EVANSVILLE | IN | 47747 | 994656829 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| ENCOMPASS HEALTH DEACONESS REHABILIATION | |||||||||||||
| 9001 LIBERTY PARKWAY | BIRMINGHAM | AL | 35242 | 721375246 | OUTPATIENT | AL | N/A | 0 | 0 | ||||
| DEACONESS HOME HEALTH LLC | |||||||||||||
| 6281 TRI RIDGE BLVD STE 300 | LOVELAND | OH | 45140 | 843167946 | HEALTHCARE | OH | N/A | 0 | 0 | ||||
| DEACONESS HEALTH PLANS LLC | |||||||||||||
| 7100 EAGLE CREST BLVD | EVANSVILLE | IN | 47715 | 383492529 | PREFERRED PROVIDER NETWORK | IN | N/A | 0 | 0 | ||||
| BURKHARDT CANCER CENTER LLC | |||||||||||||
| 4972 LINCOLN AVENUE STE 100 | EVANSVILLE | IN | 47715 | 300256432 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
| BAPTIST HEALTH DEACONESS LLC | |||||||||||||
| 1901 CAMPUS PLACE | LOUISVILLE | KY | 40299 | 872361058 | HEALTHCARE | KY | N/A | 0 | 0 | ||||
| TRI-STATE RADIATION ONCOLOGY CENTERS LLC | |||||||||||||
| PO BOX 819067 TAX DEPT | DALLAS | TX | 75381 | 263706834 | OUTPATIENT | DE | N/A | 0 | 0 | ||||
| BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL | |||||||||||||
| 4199 GATEWAY BLVD | NEWBURGH | IN | 47630 | 455549778 | HEALTHCARE | IN | N/A | 0 | 0 | ||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSSROADS HEALTH SERVICES RECIPROCAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 BANK STREET SUITE 500 | AddressLine1Txt |
| City | BURLINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 814762330 | EIN |
| Primary Activities | INDUSTRIAL INSURANCE RECIPROCAL REINSURANCE | PrimaryActivitiesTxt |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $1,203,518 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Comments