COMMUNITY HOSPITAL OF BREMEN INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOSPITAL OF BREMEN INC (EIN 35-0835006)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-10
IRS object ID: 202343149349304979
Schema version: 2022v5.0
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 I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-10T16:23:06+00:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	462045100	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	350835006	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Community Hospital of Bremen Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	COMM	BusinessNameControlTxt
Phone	5745462211	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1020 HIGH ROAD	AddressLine1Txt
City	BREMEN	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46506	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JEFFREY COSTELLO	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2023-11-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	JEFFREY	PersonFirstNm
Person Last	COSTELLO	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	Yes (true)	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Jennifer D Rhoderick	PreparerPersonNm
PTIN	P00395735	PTIN
Phone	3176817000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DAVID BAILEY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1020 HIGH ROAD	AddressLine1Txt
City	BREMEN	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46506	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$23,907,545	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BEACONHEALTHSYSTEM.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1948	FormationYr
Legal Domicile State	IN	LegalDomicileStateCd
Activity Or Mission	WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	35	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,964	PYContributionsGrantsAmt
CY Contributions Grants	$557,605	CYContributionsGrantsAmt
PY Program Service Revenue	$24,167,675	PYProgramServiceRevenueAmt
CY Program Service Revenue	$23,076,532	CYProgramServiceRevenueAmt
PY Investment Income	$46,386	PYInvestmentIncomeAmt
CY Investment Income	$73,632	CYInvestmentIncomeAmt
PY Other Revenue	$185,929	PYOtherRevenueAmt
CY Other Revenue	$193,211	CYOtherRevenueAmt
PY Total Revenue	$24,404,954	PYTotalRevenueAmt
CY Total Revenue	$23,900,980	CYTotalRevenueAmt
PY Grants And Similar Paid	$5,360	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$10,875	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$10,747,484	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$12,945,189	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$13,741,223	PYOtherExpensesAmt
CY Other Expenses	$12,841,743	CYOtherExpensesAmt
PY Total Expenses	$24,494,067	PYTotalExpensesAmt
CY Total Expenses	$25,797,807	CYTotalExpensesAmt
PY Revenues Less Expenses	-$89,113	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,896,827	CYRevenuesLessExpensesAmt
Total Assets BOY	$20,113,950	TotalAssetsBOYAmt
Total Assets EOY	$19,854,519	TotalAssetsEOYAmt
Total Liabilities BOY	$18,473,843	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$11,197,968	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,640,107	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$8,656,551	NetAssetsOrFundBalancesEOYAmt
Mission	WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$23,494,401	ExpenseAmt
Grant	$10,875	GrantAmt
Revenue	$23,136,290	RevenueAmt
Desc	FOUNDED IN 1948, COMMUNITY HOSPITAL OF BREMEN, INC. (CHB) IS A NOT-FOR-PROFIT, 24-BED CRITICAL ACCESS HOSPITAL SERVING THE HEALTHCARE NEEDS OF BREMEN AND THE SURROUNDING COMMUNITIES. WITH THE PRIMARY PHYSICIAN MEDICAL STAFF BASE, CHB EMBRACES A HOLISTIC APPROACH TO PATIENT CARE. INPATIENT SERVICES INCLUDE MEDICAL/SURGICAL, OBSTETRICS, PHYSICAL AND OCCUPATIONAL THERAPY, AND SWING BED/SKILLED NURSING. OUTPATIENT SERVICES INCLUDE MEDICAL/SURGICAL AND PHYSICAL AND OCCUPATION THERAPY. SERVICES IN THE EMERGENCY DEPARTMENT ARE AVAILABLE 24 HOURS PER DAY. A FULL SERVICE CAP ACCREDITED LABORATORY AND COMPREHENSIVE RADIOLOGY DEPARTMENT MEETS THE DIAGNOSTIC TESTING NEEDS OF INPATIENTS AND OUTPATIENTS. THE PHYSICIANS ALSO PROVIDE PRIMARY CARE AND SPECIALTY CARE SERVICES SUCH AS PAIN MANAGEMENT, CARDIOLOGY, ORTHOPEDICS, UROLOGY, GYNECOLOGY, PODIATRY, AND MORE THROUGH HOSPITAL-BASED OUTPATIENT CLINICS. IN ADDITIONAL, THE HOSPITAL PROVIDES THE FOLLOWING PROGRAMS: - FREE CARE AND/OR SUBSIDIZED CARE - CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT/OR BELOW COST - OTHER HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY SUCH AS WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.	Desc
Total Program Service Expenses	$23,494,401	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	40	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFREY COSTELLO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5746473549	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	615 N MICHIGAN STREET	AddressLine1Txt
City	SOUTH BEND	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46601	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 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
Carol Hochstetler
Chair	2.0	0	Yes (X)	Yes (X)	$150	$0	$0
Jason Marker MD
Vice Chair/Chief Med Officer	2.0	40.0	Yes (X)	Yes (X)	$0	$299,271	$34,822
Jeffrey Brinkman
Secretary/Treasurer	2.0	0	Yes (X)	Yes (X)	$150	$0	$0
Alfred Alvarado
Director	2.0	0	Yes (X)		$150	$0	$0
Anthony Wagner
Director (Beg 3/2022)	2.0	0	Yes (X)		$150	$0	$0
Bill Davis
Director	2.0	0	Yes (X)		$150	$0	$0
Greg Miller
Director	2.0	0	Yes (X)		$150	$0	$0
Pheanis Wickey
Director	2.0	0	Yes (X)		$150	$0	$0
Trend Weldy
Director	2.0	0	Yes (X)		$150	$0	$0
David H Bailey
President	40.0	0.0		Yes (X)	$0	$442,401	$55,095
Jeffrey P Costello
CFO	2.0	50.0		Yes (X)	$0	$878,794	$126,495
Kreg R Gruber
CEO	2.0	50.0		Yes (X)	$0	$1,543,364	$221,266

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,200	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,163,830	TotReportableCompRltdOrgAmt
Total Other Compensation	$437,678	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SOUTH BEND EMERGENCY PHYSICIANS
615 N MICHIGAN ST	SOUTH BEND	IN	46601	PHYSICIAN SERVICES	$1,521,250
MIDWEST HOSPITALISTS LLC
50593 ARBORWOOD COURT	GRANGER	IN	46530	PHYSICIAN SERVICES	$856,350
JEBS ANESTHESIA CONSULTANTS LLC
PO BOX 591	GRANGER	IN	46530	Anesthesia services	$435,164
LABORATORY CORPORATION OF AMERICA HOLDINGS
PO Box 8014	BURLINGTON	NC	272168014	Contract services	$199,856
Better Nights Diagnostic Sleep Services
10257 Copper Chase Dr	GRANGER	IN	46530	Phy services	$106,540

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$3,308	RelatedOrganizationsAmt
Government Grants	$554,297	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$557,605	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
LAB NET PATIENT REVENUE	622110	$4,803,711	$4,803,711	$0	$0
SURGERY NET PATIENT REVENUE	622110	$4,842,747	$4,842,747	$0	$0
RADIOLOGY NET PATIENT REVENUE	622110	$4,449,593	$4,449,593	$0	$0
OTHER NET PATIENT REVENUE	622110	$8,858,537	$8,858,537	$0	$0
AFFILIATE RENTAL REVENUE	532000	$110,040	$110,040	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,904	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,904	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$23,076,532	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$70,632	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$70,632	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$33,985	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$6,565	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$27,420	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$27,420	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$27,420	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$3,000	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$3,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,000	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$3,000	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
CAFETERIA SALES	561499	$106,033	$0	$0	$106,033
ANESTHESIA COLLECTIONS	621500	$30,932	$30,932	$0	$0
INSURANCE CLAIMS	561499	$17,082	$17,082	$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,744	TotalRevenueColumnAmt
Related Or Exempt Func Income	$11,744	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$165,791	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$23,900,980	TotalRevenueColumnAmt
Related Or Exempt Func Income	$23,136,290	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$207,085	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$10,875	TotalAmt
Program Services	$10,875	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,699,204	TotalAmt
Program Services	$9,616,013	ProgramServicesAmt
Management And General	$1,083,191	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,505,015	TotalAmt
Program Services	$1,352,647	ProgramServicesAmt
Management And General	$152,368	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$740,970	TotalAmt
Program Services	$665,954	ProgramServicesAmt
Management And General	$75,016	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$24,720	TotalAmt
Program Services	$22,217	ProgramServicesAmt
Management And General	$2,503	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$22,500	TotalAmt
Management And General	$22,500	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,336	TotalAmt
Program Services	$2,100	ProgramServicesAmt
Management And General	$236	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$27,982	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$27,982	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,362,670	TotalAmt
Program Services	$3,921,228	ProgramServicesAmt
Management And General	$441,442	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,232	TotalAmt
Program Services	$1,107	ProgramServicesAmt
Management And General	$125	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$766,961	TotalAmt
Program Services	$689,314	ProgramServicesAmt
Management And General	$77,647	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$429,299	TotalAmt
Program Services	$385,837	ProgramServicesAmt
Management And General	$43,462	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$3,294	TotalAmt
Program Services	$2,961	ProgramServicesAmt
Management And General	$333	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,064	TotalAmt
Program Services	$956	ProgramServicesAmt
Management And General	$108	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$152,934	TotalAmt
Program Services	$137,451	ProgramServicesAmt
Management And General	$15,483	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$936,443	TotalAmt
Program Services	$841,637	ProgramServicesAmt
Management And General	$94,806	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$104,512	TotalAmt
Program Services	$93,931	ProgramServicesAmt
Management And General	$10,581	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
CORPORATE ALLOCATION	$2,622,692	$2,622,692	$0	$0
MEDICAL SUPPLIES	$2,465,761	$2,216,127	$249,634	$0
HOSPITAL ASSESSMENT FEE	$551,116	$551,116	$0	$0
BAD DEBT EXPENSE	$307,066	$307,066	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$59,161	TotalAmt
Program Services	$53,172	ProgramServicesAmt
Management And General	$5,989	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$25,797,807	TotalAmt
Program Services	$23,494,401	ProgramServicesAmt
Management And General	$2,303,406	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,050	BOYAmt
EOY	$1,250	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,934,089	BOYAmt
EOY	$2,111,386	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,648,445	BOYAmt
EOY	$4,181,520	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$53,621	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$282,421	BOYAmt
EOY	$368,049	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$49,609	BOYAmt
EOY	$19,826	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$15,457,544	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$4,631,781	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$10,802,234	BOYAmt
EOY	$10,825,763	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,759,124	BOYAmt
EOY	$1,759,124	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$636,978	BOYAmt
EOY	$533,980	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,113,950	BOYAmt
EOY	$19,854,519	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$902,864	BOYAmt
EOY	$839,521	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$382,497	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$11,040,296	BOYAmt
EOY	$9,978,878	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,148,186	BOYAmt
EOY	$379,569	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$18,473,843	BOYAmt
EOY	$11,197,968	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	$1,640,107	BOYAmt
EOY	$8,656,551	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,640,107	BOYAmt
EOY	$8,656,551	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$20,113,950	BOYAmt
EOY	$19,854,519	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,896,827	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$8,913,271	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

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	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$2,336	OtherActivitiesAmt
Total Lobbying Expenditures	$2,336	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	COMMUNITY HOSPITAL OF BREMEN APPLIED A CONSERVATIVE ESTIMATE OF 35% TO ALL PAYMENTS THAT CHB WAS UNABLE TO ASCERTAIN ALLOCATION OF DUES ATTRIBUTED TO LOBBYING.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$42,986,124	BeginningYearBalanceAmt
Contributions	$3,689,060	ContributionsAmt
Investment Earnings Or Losses	-$4,645,970	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$3,270,255	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$38,758,959	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$37,554,313	BeginningYearBalanceAmt
Contributions	$3,126,708	ContributionsAmt
Investment Earnings Or Losses	$3,841,751	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,536,648	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$42,986,124	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$34,924,914	BeginningYearBalanceAmt
Contributions	$1,692,784	ContributionsAmt
Investment Earnings Or Losses	$2,289,915	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,353,300	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$37,554,313	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$30,834,712	BeginningYearBalanceAmt
Contributions	$2,588,247	ContributionsAmt
Investment Earnings Or Losses	$3,242,314	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$1,740,359	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$34,924,914	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$34,205,140	BeginningYearBalanceAmt
Contributions	$1,352,757	ContributionsAmt
Investment Earnings Or Losses	-$2,479,196	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$2,243,989	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$30,834,712	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.7587	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.0	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.2413	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$779,000	OtherCostOrOtherBasisAmt
Book Value	$779,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,990,782	OtherCostOrOtherBasisAmt
Depreciation	$1,806,864	DepreciationAmt
Book Value	$8,183,918	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,680,962	OtherCostOrOtherBasisAmt
Depreciation	$2,824,917	DepreciationAmt
Book Value	$1,856,045	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,800	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$6,800	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$10,825,763	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
LEASE LIABILITIES	$379,569
Due to third party

Field	Value	IRS element (for citing)
Total Liability	$379,569	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4 Intended uses of endowment funds

NET ASSETS WITH DONOR RESTRICTIONS CONSIST OF ASSETS WHOSE USE IS LIMITED BY DONOR IMPOSED, TIME AND/OR PURPOSE RESTRICTIONS. SOME NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY THE CORPORATION IN PERPETUITY. IN ACCORDANCE WITH THE RESTRICTION, A MAJORITY OF THE INVESTMENT INCOME AND INVESTMENT GAINS OR LOSSES FROM THESE NET ASSETS ARE RESTRICTED BY THE DONOR FOR A SPECIFIC PURPOSE. A SPECIFIED PORTION OF INCOME EARNED BY THE NET ASSETS IS RELEASED FROM RESTRICTION AND USED FOR OPERATIONS EACH YEAR AND, THEREFORE, IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS OTHER REVENUE. THE BOARD HAS DISCRETION TO UTILIZE EACH YEAR THE INCOMES, REVENUES AND PROFITS ARISING AND ACCRUING FROM THE ENDOWMENTS IN DEFRAYING COSTS ASSOCIATED WITH THE TRUST AND THE REMAINDER FOR SUPPORT, BETTERMENT, IMPROVEMENT, UPKEEP, EXPANSION AND REPLACEMENT OF BEACON HEALTH SYSTEM, INC. AND ITS CORPORATE AFFILIATES.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

ASC 740, INCOME TAXES, REQUIRES THAT REALIZATION OF AN UNCERTAIN INCOME TAX POSITION IS MORE LIKELY THAN NOT (I.E., GREATER THAN 50% LIKELIHOOD OF RECEIVING A BENEFIT) BEFORE IT IS RECOGNIZED IN THE FINANCIAL STATEMENTS AS THE AMOUNT MOST LIKELY TO BE REALIZED ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. THIS INTERPRETATION ALSO CLARIFIES THE FINANCIAL STATEMENT CLASSIFICATION OF TAX-RELATED PENALTIES AND INTEREST AND SETS FORTH NEW DISCLOSURES REGARDING UNRECOGNIZED TAX BENEFITS. NO AMOUNT WAS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2022 OR 2021.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent350	Yes (X)	Percent350Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,058	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$61,058	NetCommunityBenefitExpnsAmt
Total Expense	0.0024	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,593,507	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$985,972	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,607,535	NetCommunityBenefitExpnsAmt
Total Expense	0.1023	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,654,565	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$985,972	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,668,593	NetCommunityBenefitExpnsAmt
Total Expense	0.1047	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$33,272	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,970	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,302	NetCommunityBenefitExpnsAmt
Total Expense	0.0010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,994,655	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,220,682	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,773,973	NetCommunityBenefitExpnsAmt
Total Expense	0.0696	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,027,927	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,229,652	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,798,275	NetCommunityBenefitExpnsAmt
Total Expense	0.0705	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$6,682,492	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,215,624	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,466,868	NetCommunityBenefitExpnsAmt
Total Expense	0.1752	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$143,952	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$5,260,401	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$6,351,072	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,090,671	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
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	COMMUNITY HOSPITAL OF BREMEN INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1020 HIGH ROAD	AddressLine1Txt
City	BREMEN	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46506	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.BEACONHEALTHSYSTEM.ORG	WebsiteAddressTxt
State License	22-005097-01	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL OF BREMEN INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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	21	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://IMPACT.BEACONHEALTHSYSTEM.ORG/CHNA	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://IMPACT.BEACONHEALTHSYSTEM.ORG/CHNA	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	350.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.	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
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	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 (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. Beginning in January 2021, Beacon Health System undertook completing a Community Health Needs Assessment (CHNA). Our approach utilizes both quantitative data (secondary data, key informant survey) and qualitative data (focus groups, open-ended responses). Once the results of the survey were determined, a qualitative approach was used to gather richer insight into the main issues faced by the community. Therefore, the methodology followed for this needs assessment consists of three steps: 1) Identify needs; 2) Analyze the links between the needs and the information required to make decisions; 3) Make recommendations that guide decision-making. The data collection and analysis process started in January 2021 and concluded in November 2021. The key findings were consolidated in one report which provided a snapshot of the three-county overall health status. The Key Informant Survey collected information from February 2021 through May 2021. Focus Groups launched in August 2021 and concluded in October 2021. This assessment focused on creating a better understanding of the health needs of the Beacon Community (Elkhart, LaPorte, Marshall, and St. Joseph counties) and the response necessary to address the need. Data was collected through secondary data collection, a key informant survey, and community focus groups on a variety of topics centered on health indicators and social determinants of health. The goal of the CHNA is to provide Beacon Health System with a clear picture of Elkhart, LaPorte, Marshall, and St. Joseph County, which constitutes the service areas of Elkhart General Hospital, Memorial Hospital of South Bend, and Community Hospital of Bremen. The findings from the assessment will be used by Beacon Health System to prioritize health issues in the community. The research took the following approach to better understand the community health needs: Key Informant Survey - A survey was provided to community leaders and those knowledgeable about the communities' health issues. The list of key informants was developed by Beacon Community Impact staff along with input from a variety of key stakeholders. Two hundred and seven completed responses were collected and analyzed. Secondary Data Research - information related to the current state of the communities' economic, social and health status published by established sources. Data, when possible, was collected for a three-year period in order to establish a trend. Over 1,000 data points were collected and analyzed, encompassing more than 80 best practice indicators. Data from Beacon Health System's electronic health record (EHR) were also used as a secondary data source. The secondary data reviewed so far has all been aggregated at the county level, and does not reveal when there are differences in indicators based on race, ethnicity, age, neighborhood, or socio-economic status. When stratified by these categories, publically available sources and data from Beacon's electronic health record (EHR) from late 2020 - early 2021, demonstrate disparities in both health outcomes and social determinants of health. Community Focus Groups - groups of 3 - 18 individuals were engaged in conversations about the current health needs of the community. Beacon Community Impact utilized Stanford's Focus Group Guide and conducted three focus groups per county (Elkhart, Marshall, and St. Joseph). Staff conducted at least two English and one Spanish focus group per county. Each focus group was recorded for continuity. Focus group recordings were transcribed and de-identified using a professional transcription service and qualitative research software tools were utilized to analyze the transcripts for common themes. Staff then engaged in an interrater reliability check to ensure accuracy of identified themes. For the purpose of the Community Health Needs Assessment (CHNA), the community served is defined as those persons residing in Elkhart, Marshall, and St Joseph Counties, who were program participants. Beacon Community Impact makes a special effort to focus on populations with the highest unmet needs, specifically those persons who are known as vulnerable, through chronic diseases, lower-income and poverty, members of a minority population and/or the uninsured. Stakeholders in the community participated and represented a broad knowledge of interests, including public health, and minority, cultural, and underserved populations. Through the following organizations Beacon ensured that under-represented populations (Medically Underserved, Low-Income, and Minority Populations) were engaged in the consultation process, actively reaching out to them, ensuring that needs and perceptions from a wide range of demographic and socioeconomic groups were taken into consideration in the definition of top community health issues. The following organizations helped increase the reach of the survey, hence solicited in order for Beacon to take into account input received from persons who represent the broad interests of the community it serves: AIDS Ministries, American Cancer Society, American University Beirut , Baugo Community Schools, Beacon Cancer Care, Beacon Community Impact, Beacon Health System, Pokagon Health Services, IU School of Medicine - South Bend, Beacon Medical Group, Beacon Pediatric Specialty, Beacon - North Central Indiana Sickle Cell Initiative, Big Brothers Big Sisters Southern Lake Michigan,, Region, Bowen Center, Boys & Girls Club of St. Joseph County, Bremen Public Schools, CAPS, Catholic Charities, Center for Civic Innovation, Center for Healing & Hope, Center for the Homeless, Child and Parent Services, Inc. , City of South Bend, Community Hospital of Bremen, Crossroads United Way, Cultivate Food Rescue, David's Courage, Division of Family Resources, Elkhart Community Schools, Elkhart County Health Department, Elkhart Education Foundation, Elkhart General Hospital, enFocus, Inc., Goodwill Industries of Michiana, Inc., Goshen Family Physicians, Greenspire Solutions, Harper Cancer Research Institute, Health Improvement Alliance of St. Joseph County, Healthlinc, HealthMarkets, Horizon Education Alliance, Elkhart City Council, Imani Unidad, Indiana University Indiana University South Bend, Indiana University South Bend - Elkhart Center, Ivy Tech Community College, Junior Achievement, La Casa de Amistad, Marshall County Project HOPE, Marshall County, Board of Health, Marshall County Community Foundation, Memorial Hospital of South Bend, Mental Health Awareness of Michiana, Michiana Area Council of Governments, Michiana Health Information, Network/Indiana Health Information Exchange, Middlebury Community Schools, Minority Health, Coalition Elkhart County, Near Northwest Neighborhood, Northern Indiana Hispanic Health Coalition, Oaklawn Psychiatric Center, OI, Partnership for Drug-Free St. Joseph County, Purdue Extension - St. Joseph County, REAL Services, Reins of Life, Inc., Ribbon of Hope, Inc., RiverBend Cancer Services, Robinson Community Learning Center, Saint Joseph Health System, School City of Mishawaka, Shaw Center for Children and Families at the University of Notre Dame, SJC Cares, Smoke Free St. Joe, South Bend Adult Education, South Bend Common Council, South Bend Community School Corporation, South Bend Elkhart Regional Partnership, South Bend Heritage Foundation, South Bend Regional Chamber, Spiritual & Personal Adjustments - Women's Ministry Homes, St. Joseph County Department of Health, St. Joseph County Public Library, St. Vincent de Paul Society, The Community Foundation of Elkhart County, The Jewish Community, The LGBTQ Center, The Michiana Athletic and Recreation Association, United Health Services Suicide Prevention Center, United Way of LaPorte County, United Way of Marshall County, United Way of St. Joseph County, Unity Gardens Inc., University of Notre Dame, Upper Room Recovery Community, WIC, YMCA of Greater Michiana, Youth Service Bureau of St. Joseph County, YWCA North Central Indiana. The assessment process identified two health priorities that can be streamlined into the essential components of Beacon Health System's mission. Priority Areas - Healthcare Access (Health Literacy) and Mental Health provide a framework for the alignment of intervention strategies with BHS mission and values that aim for 1) providing information and enhance skills to patients/practitioners/community; 2) improving equitable access to health and wellness; 3) leveraging incentives for long-term behavioral change; and 4) improving and strengthening the social and healthcare systems in the three-county area.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. COMMUNITY HOSPITAL OF BREMEN CONDUCTED THE 2021 MARSHALL COUNTY CHNA IN PARTNERSHIP WITH MEMORIAL HOSPITAL OF SOUTH BEND AND ELKHART GENERAL HOSPITAL.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. COMMUNITY HOSPITAL OF BREMEN CONDUCTED THE 2021 MARSHALL COUNTY CHNA IN PARTNERSHIP WITH MEMORIAL HOSPITAL OF SOUTH BEND AND ELKHART GENERAL HOSPITAL.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. The Community Health Needs Assessment (CHNA) was made widely available to the community through posting on the CHB website at beaconhealthsystem.org/CHNA and through email transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. Beacon Health System's 2021 Community Health Needs Assessment identified two top health priorities: Mental Health and Healthcare Access. These were common across all three counties where Beacon operates a hospital. Our approach to Community Benefit includes addressing these health needs from three angles. With each approach, both internal programs and externally funded partners are required to report on common metrics. This allows Beacon to focus its resources to achieve and demonstrate a deeper impact in our priority health areas. Beacon Community Impact provided community resources to 45,750 individuals across our service area - Elkhart, Marshall, and St. Joseph, IN Counties. In 2022, we first recognized the importance of partnering with other organizations who are experts in what they do, Beacon funds community non-profits who have boots on the ground in the most vulnerable neighborhoods in our service area, and with more diverse populations. Each of our funded partners who are addressing one of the tactics outlined on the Implementation Strategy are responsible for reporting both the number of participants they serve and one or more outcome metric in the priority areas of Mental Health or Healthcare Access. In addition, in 2022, Beacon Health System funded three partners to help them build capacity to serve more people or develop an infrastructure to make their service more effective or collect data that demonstrate their impact. Beacon's second angle of evaluating Community Benefit is to provide client programming through the Community Impact department - services are provided by the Early Childhood Services team. Programs include the St. Joseph County WIC program, two Sickle Cells programs, and our Perinatal Care Coordination (PNCC) program. Overall, the focus of these groups is to improve the health status of women, infants, and young families, particularly those who are underserved. Our Community Health Services team focuses on preventive services through community health educators with school curricula delivered throughout the three-county area in middle and high schools. Summer programming shifts to health-related day camps and participation at community health fairs. Though it may not be their primary focus, these community health teams screen for and provide referrals for clients experiencing mental health challenges. Likewise, they emphasize the importance of trusted adults as protective factors for youth. Finally, Beacon administers state and federal grants as the fiscal agent and to deliver direct programming funded by the grants. In 2022, we were involved with grants from the Health Resources and Services Administration (HRSA) under the U. S. Dept. of Health and Human Services. These grants funded two programs to provide education about COVID vaccines and provide the vaccines themselves. 2022 was also the second year of administering Project HOPE, and the first year for Support and Safe Psychostimulant also funded by HRSA, which established a coalition of organizations to address opioid use in Marshall County. Similarly, Beacon Community Impact provides services and collaborates with outside organizations with funding from a State of Indiana Safety Pin grant. Finally, Beacon functions as the fiscal agent for programming run by Oaklawn, the local outpatient mental health provider, to build crisis response teams. Mental Health Strategy - Provide wrap-around mental health support with a multidisciplinary team from various referral sources. - Partner on the development of a Self-Healing Community to build resilience and relieve stress on the traditional mental health care system. - Drive the rollout of Trauma-Informed Care throughout Beacon and the community. - Health and Wellness Team - provide evidence-based community and school education. - Community Health Workers (CHWs) on the Early Childhood Services and Community Health Services teams provide peer-led education to address mental wellness and resilience. Healthcare Access Strategy - Embed in Beacon Medical Group practices to work with pregnant women with adverse childhood experiences and social determinants of health needs. - Have a community health worker at Community Hospital of Bremen. - Grow and standardize the use of community health workers for scaling out in the future. - Implement experts in navigating the healthcare system. - Educate patients to optimize their use of the health system. - Refer to insurance navigators for insurance enrollment. - Build organizational health literacy between Beacon and Community Impact departments. Mental Health Metrics % of the population with frequent mental health distress % of the population with two or more trusted support people Healthcare Access Metrics % of the population with health insurance (adults < 65 and children) % of adults who reported their healthcare providers always involved them in decisions about their care, as much as they wanted. NEEDS NOT BEING ADDRESSED: By overlapping the top identified needs from the Key Informants, Secondary Data, and Focus Groups, we see that Mental Health, Chronic Disease, and Healthcare Access are the top health issues identified by all data sources combined. Other issues may have ranked higher by just one source, but not all three. Notably, sexually transmitted disease, immunization and infectious disease, and injury and violence prevention were among the top issues according to secondary data, but among the lowest rated issues according to key informants and focus groups. Overweight / obesity is also a top health issue according to secondary data; it ranked as a moderate health issue according to the other sources, just not at the top. Community Gaps Key Informants provided many ideas on areas of improvement. Most commonly, is the concern about the lack of mental health providers in the area. "From my experience, our biggest challenge stems from workforce shortages in mental health. If we could hire the amount of staff we need, our capacity would be much greater. It has been very difficult to find a competent and caring staff that can maintain a career in mental health and substance use." More specifically, the area needs more programs and/or services around pediatric mental health. As one Key Informant stated, "Mental health issues have drastically increased in our K-12 student population. We need to empower more school personnel to help students with these issues, and we need more mental health professionals in our school systems." Accessing mental health and more broadly, health services, is increasingly hard for low-income individuals. Focus group participants and Key Informants noted how navigating the healthcare system is too complex. Health insurance navigators and additional community resources are needed to ensure everyone can get to the appointments they need to get to and are informed. "I believe we need more outreach efforts. I think Beacon has the ability to meet families where they are-- whether it's at the childcare provider or a place of employment. We need to make healthcare more accessible." Another Key Informant went on to mirror these thoughts, "I think our wellness system is still not accessible to everyone. Self-advocacy, tenacity, and resilience are necessary to access health systems and to navigate social support systems. We need ways to reach people by attraction and positive experiences without screening highest need which causes further barriers." Community Strengths Key informants identified collaboration among non-profit service providers, agencies addressing food insecurity, and the public parks system, particularly South Bend's Venues Parks and Arts, as strengths in the community. They identified a number of organizations who do quality work to improve the health of the community. These include medical providers who serve low-income or the uninsured population, multiple organizations who provide emergency food access, some who serve specific populations such as homeless individuals, people with cancer, children, or people with substance use disorder. Again, collaborative efforts were noticed by the key informants.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. FINANCIAL ASSISTANCE CRITERIA THE POLICY ALLOWS FOR PATIENTS TO QUALIFY FOR ASSISTANCE BY TWO MEANS: FINANCIAL OR CATASTROPHIC. THE FINANCIAL ASSISTANCE PROGRAM ALSO ALLOWS FOR PARTIAL ASSISTANCE OR FULL ASSISTANCE BASED ON ELIGIBILITY CRITERIA IN THIS POLICY. FINANCIAL ASSISTANCE 1. A PATIENT QUALIFYING FOR FINANCIAL ASSISTANCE IS A PERSON WHO IS UNINSURED OR UNDERINSURED, RECEIVES CARE AND UNABLE TO PAY THEIR BILL. 2.TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE GUIDELINES, A PERSON'S INCOME SHALL BE AT OR BELOW A PERCENTAGE OF THE FEDERAL POVERTY LEVEL (FPL) AS DETERMINED BY FEDERAL POVERTY GUIDELINES. HOUSEHOLD SIZE AND INCOME DETERMINES THE % OF FPL. COMMUNITY HOSPITAL OF BREMEN, OR ITS DESIGNEE, MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. 3. COMMUNITY HOSPITAL OF BREMEN WILL USE THE MOST CURRENT POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE POVERTY INCOME GUIDELINES ARE PUBLISHED ANNUALLY IN THE FEDERAL REGISTER AND FOR THE PURPOSES OF THIS POLICY WILL BECOME EFFECTIVE THE FIRST DAY OF THE MONTH FOLLOWING THE MONTH OF PUBLICATION. 4. TO QUALIFY UNDER THE FINANCIAL ASSISTANCE PORTION OF THIS POLICY, A COMPLETED, SIGNED FINANCIAL ASSISTANCE APPLICATION MUST BE SUBMITTED AND PROOF OF INCOME, PROOF OF LACK OF FINANCIAL ASSETS AND OTHER REQUIRED DOCUMENTS MUST ACCOMPANY THE APPLICATION. CATASTROPHIC ASSISTANCE CRITERIA 1. A PATIENT QUALIFYING FOR CATASTROPHIC ASSISTANCE IS A PERSON WHOSE HOSPITAL BILLS EXCEED A SPECIFIED PERCENTAGE OF THE PERSON'S ANNUAL GROSS INCOME AS SET FORTH IN THE POLICY AND WHO IS UNABLE TO PAY THE REMAINING BILL. 2. TO BE ELIGIBLE FOR CATASTROPHIC ASSISTANCE THE AMOUNT OWED BY THE PATIENT MUST EXCEED ONE HUNDRED FIFTY (150) PERCENT OF THE PATIENT'S ANNUAL GROSS INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. COMMUNITY HOSPITAL OF BREMEN MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ABILITY TO PAY. 3. IF A DETERMINATION IS MADE THAT A PATIENT HAS THE ABILITY TO PAY THE REMAINDER OF THE BILL, SUCH A DETERMINATION DOES NOT PREVENT A REASSESSMENT OF THE PATIENT'S ABILITY TO PAY AT A LATER DATE SHOULD THEIR FINANCIAL CIRCUMSTANCES CHANGE. 4. AFTER ELIGIBILITY IS DETERMINED UNDER THIS PROVISION, ASSISTANCE WILL BE PROVIDED TO DISCOUNT THE BILL BY 75% OF THE CURRENT BALANCE. 5. IF A PATIENT HAS CASH ASSETS, THOSE ASSETS WILL BE ADDED TO THEIR INCOME WHEN DETERMINING ELIGIBILITY FOR ASSISTANCE.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part VI, Line 7 State Filing of community benefit report	COMMUNITY HOSPITAL OF BREMEN PREPARES THE COMMUNITY BENEFIT REPORT BOTH FOR THE STATE OF INDIANA AND FOR THE ANNUAL REPORT, WHICH IS POSTED AT BEACONHEALTHSYSTEM.ORG/CHNA.
Schedule H, Part I, Line 3c Factors to be considered for financial assistance	HOUSEHOLD SIZE AND INCOME THE FOLLOWING FACTORS MAY BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR ASSISTANCE AND MUST BE PROVIDED BY ALL INCOME EARNING RESIDENTS IN THE COUNTABLE HOUSEHOLD UNIT UNLESS THEY ARE NOT DEPENDENTS BASED ON IRS GUIDELINES FOR DETERMINING WHETHER A HOUSEHOLD MEMBER CAN BE CONSIDERED A DEPENDENT. 1. INDIANA WORKFORCE WAGE REPORT FOR LAST 2 QUARTERS (UNEMPLOYMENT INCOME). 2. LAST 3 PAY STUBS OR A LETTER OR PRINTOUT FROM EMPLOYER(S) PROVIDING VERIFICATION OF GROSS INCOME IF CURRENTLY EMPLOYED. THIS DOCUMENTATION SHOULD NOT BE MORE THAN 30 DAYS OLD FROM DATE OF ISSUE AND INCLUDE YEAR-TO-DATE INFORMATION. 3. LAST 3 BANK STATEMENTS (INCLUDING EXPLANATIONS OF REGULAR DEPOSITS NOT EXPLAINED BY PAY STUBS). 4. SOCIAL SECURITY AWARD OR ENTITLEMENT LETTER OR OTHER PROOF OF GROSS MONTHLY AWARD. 5. RETIREMENT INCOME. 6. INVESTMENT INCOME. 7. STATEMENT FROM PERSON(S) THAT ARE PROVIDING DIRECT SUPPORT. 8. NUMBER OF DEPENDENTS. 9. MOST RECENT TAX RETURN (INCLUDING W2 AND ALL SUPPORTING SCHEDULES). 10. OTHER FINANCIAL OBLIGATIONS. 11. THE AMOUNT AND FREQUENCY OF HOSPITAL/MEDICAL BILLS. 12. OTHER FINANCIAL RESOURCES THAT PRODUCE INCOME. 13. IF SELF-EMPLOYED, GROSS INCOME LESS COST OF GOODS SOLD AND EMPLOYEE SALARIES. FINANCIAL CAPACITY 1. INDIVIDUALS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE MAY BE REQUIRED TO PURCHASE AND WILL BE PROVIDED ACCESS TO MEET WITH AN INDIANA CERTIFIED NAVIGATOR AS A MEANS OF ASSURING ACCESS TO HEALTHCARE SERVICES, FOR THEIR OVERALL PERSONAL HEALTH, AND FOR THE PROTECTION OF THEIR INDIVIDUAL ASSETS. 2. INDIVIDUALS FOUND TO BE INELIGIBLE FOR MEDICAID OR OTHER AFFORDABLE HEALTH CARE COVERAGE MUST PROVIDE PROOF OF DENIAL. 3. FOOD STAMPS OR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) WILL NOT BE COUNTED AS INCOME. 4. COSMETIC SERVICES ARE NOT ELIGIBLE FOR ANY TYPE OF ASSISTANCE AND CANNOT BE INCLUDED IN THE AMOUNT OF HOSPITAL/MEDICAL BILLS OWED.
Schedule H, Part I, Line 6a Name of Related Org that prepare the Community benefit report	BEACON HEALTH SYSTEM (EIN: 45-3864076) PREPARED THE ANNUAL COMMUNITY BENEFIT REPORT.
Schedule H, Part I, Line 7 Costing Methodology used for calculating line 7 table	THE COSTING METHOD USED TO CALCULATE FINANCIAL ASSISTANCE REPORTED ON LINES 7 A THROUGH D WAS THE COST-TO-CHARGE RATIO. ALL OTHER COMMUNITY BENEFITS WERE CALCULATED USING DIRECT COSTS. PART I, LINE 7 COLUMN (F) BAD DEBT EXPENSE OF $307,066 WAS REMOVED FROM TOTAL EXPENSES.
Schedule H, Part II Describe how Community building activities promote the health of the community	Project HOPE is a consortium of 25 plus organizations, led by Beacon Health System in Marshall County, that provide comprehensive and coordinated access to substance use prevention, treatment and recovery services in Marshall County. The consortium formally began in 2019 when Beacon was awarded a Planning Grant from HRSA. Dr. Jason Marker successfully led the consortium through that initial phase. In September 2020, the consortium was awarded a HRSA 3-year, $1,000,000 Implementation grant.
Schedule H, Part I, Line 7g Subsidized health services	COMMUNITY HOSPITAL OF BREMEN CHANGED THE WAY WE CALCULATED THE COMMUNITY BENEFIT RELATED TO SUBSIDIZED HEALTH SERVICES IN 2019. IN PRIOR YEARS THE COST TO CHARGE RATIO WAS USED FROM THE COST REPORT BUT FOR A MORE ACCURATE REPRESENTATION OF CHB'S EMERGENCY ROOM WE USED AN ALLOCATION OR SPECIFIC EXPENSES AS WELL AS THE EXPENSES ALLOCATED DIRECTLY TO THE ER. NO PHYSICIAN CLINIC COSTS WERE INCLUDED IN THE SUBSIDIZED HEALTH SERIVCES.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	307066
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE CORPORATION EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYOR CLASS, AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. THE COSTING METHODOLOGY IS THE SAME AS THE TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE COST IS ADJUSTED BY NON-PATIENT ACTIVITY EXPENSES, AND PATIENT CARE CHARGES. THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 IS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO, AS DETERMINED BY WORKSHEET 2, TO TOTAL BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	CHB DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THEREFORE, NO PORTION OF BAD DEBT IS CONSIDERED A COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS TAKING INTO CONSIDERATION THE TRENDS IN HEALTH CARE COVERAGE, HISTORICAL ECONOMIC TRENDS, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCES PERIODICALLY THROUGHOUT THE YEAR BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN UTILIZED TO MAKE MODIFICATIONS, AS NECESSARY, TO THE PROVISION FOR BAD DEBTS TO PROVIDE FOR AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT PARTICIPATION IN THE GOVERNMENTAL MEDICARE PROGRAM DOES NOT PROVIDE THE OPPORTUNITY FOR A HOSPITAL TO NEGOTIATE A REIMBURSEMENT RATE OR STRUCTURE THAT WOULD ALLOW THE HOSPITAL TO COVER THE COST OF THE MEDICAL SERVICE RENDERED TO THE PROGRAM PARTICIPANT, AS WOULD BE THE CASE IN CONTRACTUAL NEGOTIATIONS WITH COMMERCIAL INSURANCE COMPANIES. NOR IS THE HOSPITAL ALLOWED TO PROVIDE ONLY THE SERVICES FOR WHICH REIMBURSEMENT COVERS THE DIRECT COST OF CARE. THIS PRODUCES THE SAME SHORTFALL OUTCOME AS DOES THE PARTICIPATION IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM IS RECOGNIZED AS A COMMUNITY BENEFIT ON SCHEDULE H AND ON COMMUNITY BENEFIT REPORTS FOR MOST STATES. THE QUALITY AND COST OF THE PATIENT CARE IS THE SAME REGARDLESS OF PAYOR SOURCE. HENCE THE ACCEPTANCE OF MEDICARE REIMBURSEMENT REPRESENTS A REDUCTION OR RELIEF OF THE GOVERNMENT BURDEN TO PAY THE FULL COST OF CARE PROVIDED.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	COLLECTIONS PRACTICES PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE FOLLOW THE SAME COLLECTION POLICY AS ALL INDIVIDUALS WITH BALANCES REMAINING AFTER APPLICATION OF FINANCIAL ASSISTANCE. CREDIT AND COLLECTIONS POLICY: COMMUNITY HOSPITAL OF BREMEN RELIES ON TIMELY PAYMENT OF PATIENT ACCOUNTS RECEIVABLE TO ALLOW THE HOSPITAL TO CONTINUE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND TO SECURE THE LATEST IN HEALTH CARE TECHNOLOGY FOR ITS PATIENTS. COMMUNITY HOSPITAL OF BREMEN, RECOGNIZING THE BURDEN THAT UNEXPECTED HEALTH CARE EXPENSES CAN PLACE ON PATIENTS AND THEIR FAMILIES, WILL ASSIST PATIENTS TO RESOLVE OPEN ACCOUNTS FOR HOSPITAL SERVICES BY WORKING WITH THIRD PARTY PAYERS TO ADJUDICATE PATIENT'S INSURANCE CLAIMS AND BY PROVIDING ALTERNATIVE PAYMENT PLANS FOR PATIENTS. THE HOSPITAL ALSO PROVIDES SUBSIDIZED CARE FOR THOSE PATIENTS WHO QUALIFY. HOWEVER, WITH THE EXCEPTION OF SOME GOVERNMENT AND CONTRACTED CARE PLANS, ULTIMATE RESPONSIBILITY FOR RESOLUTION OR PAYMENT OF ACCOUNTS RESTS WITH THE PATIENT. PATIENTS ARE EXPECTED TO WORK WITH HOSPITAL PERSONNEL TO RESOLVE ACCOUNTS WITH THEIR INSURANCE COMPANIES AND/OR EMPLOYERS AS APPROPRIATE. WHERE THERE IS AN ESTIMATED SELF-PAY BALANCE DUE, COMMUNITY HOSPITAL OF BREMEN WILL ASK NON-EMERGENCY PATIENTS TO PAY THAT BALANCE PRIOR TO OR AT THE TIME OF ADMISSION/REGISTRATION 1. IF A PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND DOES NOT PAY THEIR ACCOUNT ACCORDING TO THE OPTIONS PROVIDED, THEN THE PATIENT'S ACCOUNT WILL BE PROCESSED ACCORDING TO THE BAD DEBT WRITE OFF POLICY. 2. IF A PATIENT HAS BEGUN MAKING PAYMENTS BUT THEN IS LATER DETERMINED TO QUALIFY UNDER THE FAP, COMMUNITY HOSPITAL OF BREMEN WOULD ISSUE A REFUND TO THE PATIENT FOR ANY AMOUNT THAT HAS BEEN DETERMINED TO EXCEED THEIR NEWLY DETERMINED FINANCIAL RESPONSIBILITY. 3. COMMUNITY HOSPITAL OF BREMEN MAY REQUEST AND COLLECT A DEPOSIT, BASED ON THE PATIENT'S TOTAL ESTIMATED PORTION OF A BILL, FROM APPROPRIATE NON EMERGENCY INPATIENT ADMISSIONS, SAME DAY SURGERY PATIENTS, AND PATIENTS SCHEDULED FOR HIGH-DOLLAR OUTPATIENT PROCEDURES PRIOR TO OR AT THE TIME OF ADMISSION OR REGISTRATION. IN THE EVENT THAT A REQUEST FOR PAYMENT IS NOT MADE PRIOR TO OR AT THE TIME OF THE PATIENT'S ARRIVAL, A FINANCIAL COUNSELOR MAY CALCULATE THE ESTIMATED DEPOSIT AMOUNT AND CONFER WITH THE PATIENT/GUARANTOR FOR PAYMENT FOLLOWING THE ADMISSION OR REGISTRATION PROCESS VIA A FINANCIAL INTERVIEW. (IN SOME INSTANCES, THIS COULD OCCUR WHILE THE PATIENT IS IN HIS/HER ASSIGNED ROOM.) AT THE TIME OF DISCHARGE, EMERGENCY PATIENTS MAY BE REQUESTED TO PAY ANY CO-PAY OR DEDUCTIBLE. 4. WHERE APPROPRIATE, COMMUNITY HOSPITAL OF BREMEN WILL IDENTIFY, AND REQUEST PAYMENT OF, AGED PATIENT BALANCES AS PART OF THE REQUEST FOR DEPOSIT. PAYMENT FOR OPEN PRIOR BALANCES WILL NOT DELAY CARE FOR EMERGENCY OR MEDICALLY NECESSARY CARE. AGED OPEN PRIOR BALANCES WILL BE CONSIDERED BY THE COLLECTION STAFF IN PATIENT ACCOUNT SERVICES WHENEVER PAYMENT ARRANGEMENTS OR AN ALTERNATIVE PAYMENT PROGRAM IS DEVELOPED FOR A PATIENT. 5. UNINSURED PATIENTS ARE GIVEN A 35% DISCOUNT FROM GROSS CHARGES. 6. COMMUNITY HOSPITAL OF BREMEN WILL CONDUCT FINANCIAL INTERVIEWS WITH PATIENTS AND/OR GUARANTORS WHEN NECESSARY. ALL FINANCIAL INTERVIEWS WILL BE CONDUCTED IN AN ENVIRONMENT THAT IS BOTH PRIVATE AND PROFESSIONAL. 7. IN ADDITION TO CASH, CHECK, AND CREDIT CARDS, THE APPROVED PAYMENT ARRANGEMENT METHODS MIGHT INCLUDE: A. HOSPITAL PAYMENT PLAN - A PAYMENT PLAN WITH THE HOSPITAL IS NOT TO EXCEED THREE MONTHS. EXCEPTIONS MUST BE APPROVED BY THE MANAGER OF PATIENT ACCOUNT SERVICES OR REVENUE CYCLE DIRECTOR. PATIENTS MAY BE REQUIRED TO SIGN A PROMISSORY NOTE BASED ON THE AGREED UPON PAYMENT ARRANGEMENT. B. CAREPAYMENT - AN EXTENDED PAYMENT PLAN WHICH ALLOWS THE PATIENT AN EXTENDED PERIOD NOT TO EXCEED 36 MONTHS AT 0% INTEREST TO PAY THEIR BALANCE BETWEEN $100 AND $15,000. PATIENTS MAY BE AUTOMATICALLY ENROLLED IN THE CAREPAYMENT PLAN IF THEIR ACCOUNT HAS NOT BEEN PAID IN FULL 2 MONTHS AFTER THEIR FIRST STATEMENT. ALL PATIENTS ARE ELIGIBLE PROVIDED THAT THEY PROVIDE A VALID SOCIAL SECURITY NUMBER, ARE OVER 18 AND HAVE NOT PREVIOUSLY DEFAULTED ON THEIR CAREPAYMENT ACCOUNT. C. MEDICAID/HIP - PATIENTS WHO DO NOT HAVE COVERAGE WHEN THEY PRESENT TO THE HOSPITAL FOR TREATMENT WILL BE SCREENED FOR OTHER COVERAGE THROUGH STATE ASSISTANCE PROGRAMS. AN ELIGIBILITY SPECIALIST WILL ASSIST THE PATIENT/GUARANTOR TO COMPLETE AND SUBMIT ALL NECESSARY FORMS REQUIRED BY THE INDIANA DEPARTMENT OF PUBLIC AID FOR THESE TYPES OF PROGRAMS. D. HOSPITAL FINANCIAL ASSISTANCE (UNCOMPENSATED CARE) - REASONABLE EFFORTS WILL BE MADE TO DETERMINE IF PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ALL FINANCIAL ASSISTANCE MUST BE APPROVED ACCORDING TO THE FAP FOR THE HOSPITAL. (REFER TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY) 8. EXTRAORDINARY COLLECTION ACTIONS WILL NOT BE TAKEN UNTIL AFTER COMMUNITY HOSPITAL OF BREMEN HAS MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT WILL QUALIFY FOR FINANCIAL ASSISTANCE. EXTRAORDINARY COLLECTION ACTIONS INCLUDE SUIT, WAGE GARNISHMENT, LIEN OR ADVERSE CREDIT BUREAU REPORTING.
Schedule H, Part V, Section B, Line 16a FAP website	- COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16a URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.;
Schedule H, Part V, Section B, Line 16b FAP Application website	- COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16b URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16c URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.;
Schedule H, Part VI, Line 2 Needs assessment	Beacon Community Impact formed the first Community Health Advisory Council in 2016. Still operating on an as needed basis today the Council consists of representation from Community Hospital of Bremen, Elkhart General Hospital, and Memorial Hospital of South Bend. The council is made up of individuals from Beacon Health System and Community stakeholders - i.e. Council at Large, Public School Systems, other Health Care entities, Indiana University South Bend, University of Notre Dame, Ivy Tech Community College, community organizations, local churches, community persons, etc.). The Advisory Council will meet 2-4 times per year to learn about community health, the CHNA process, and to review local hospital and community data collected regarding health in our community; there are periodic email communications as well. The Advisory Council provides input on the health priority areas, offers best practices, identifies areas of opportunities, and monitors progress on addressing health needs.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	WHEN PATIENTS PRESENT TO OUR HOSPITAL, THEY ARE OFFERED THE OPPORTUNITY TO MEET WITH OUR ELIGIBILITY SPECIALISTS. OUR ELIGIBILITY SPECIALISTS DISCUSS THE POTENTIAL ELIGIBILITY OF THE PATIENT FOR MULTIPLE ASSISTANCE PROGRAMS, INCLUDING OUR OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. OUR STATEMENTS ALSO INCLUDE A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS, AND THEY CAN CONTACT OUR CUSTOMER SERVICE GROUP FOR GUIDELINES. PATIENTS ARE ALSO MADE AWARE OF OUR FINANCIAL ASSISTANCE PROGRAM VIA TELEPHONE CONVERSATION WITH OUR PATIENT ACCOUNTS STAFF. STAFF IS PARTICULARLY SENSITIVE TO ADDRESS THIS PROGRAM WITH ANYONE WHO INDICATES THERE MIGHT BE A FINANCIAL NEED.
Schedule H, Part VI, Line 4 Community information	Established In 1836, Marshall County Indiana is the 31st largest county in the state of Indiana. The county spans 443.62 Square Miles, which includes a comfortable mix of rural cultural heritage and urban amenities. Marshall County has a population of 46,332 according to the U.S. Census Bureau. Located south of St. Joseph County and at the junction of US 30 and US 31, Marshall County is home to many small towns and Indiana's second largest natural lake, Lake Maxinkuckee. Due to low tax rates in the county, nearly a hundred manufacturers are present, six of whom are international companies and nine corporate headquarters. Marshall County boasts low crime rates and safe, high performing schools, including the world premier college preparatory school, Culver Academies, with students from around the world. Elkhart, Marshall and St. Joseph Counties are all located in Northern Indiana. They have a total of 6 cities and 16 towns with a combined population of 525,456. St. Joseph is the largest and Marshall the smallest, which is classified as rural. Although each varies in population density, they are closer in geographic size (SJC-457 square miles, Elkhart-463, Marshall-443). The median household income (2017-2021) is comparable in Marshall and St. Joseph ($58,296; $58,599), but higher in Elkhart county -$61,182 where 11.3 % of people live in poverty compared to the higher rate of 14.3% in St. Joseph and a lower rate of 8.6% in Marshall. Elkhart's RV industry is a multi-billion-dollar industry and nearly 1,000 RV manufacturers are located there. Marshall County has become one of the leading agricultural counties in Indiana. St. Joseph is the regional center for higher education, with more than eight colleges and universities. These campuses have shifted the county's focus from manufacturing to health, education, and customer services.
Schedule H, Part VI, Line 5 Promotion of community health	In partnership with Beacon Health System (BHS), the mission of Community Hospital of Bremen (CHB) is to deliver outstanding care, inspire health and connect with heart. BHS is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead BHS to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both BHS and CHB consistently invest funds to improve the quality of life for our communities. BHS values reflect an unwavering commitment to the communities we serve. MHSB has as its values: Patients are at the center - Patient needs, care and safety are our top priority. - Trust - Our actions will firmly demonstrate our integrity, abilities and our character. - Respect - We will treat our patients, community members, and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. - Integrity - We will continually do the right thing for patients, associates, and communities we serve. - Compassion - We will appropriately demonstrate empathy and sympathy, and express the desire to help. CHB seeks to promote the health and well-being of St. Joseph (SJC) residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community as a whole. A key mechanism by which this goal is carried out is MHSB's serious, consistent, and deliberate search for and partnership with like-minded organizations. MHSB continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances include local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers. Beacon recognizes that participating in volunteerism enriches the lives of the workforce as well as the community. Community Service through "Beacon's Helping Hands" encourages Beacon associates to participate in community activities aligned with Beacon's Mission and Values. To support community involvement, Associates who volunteer with a 501c3 charitable organization whose activities align with the Mission and Values of Beacon Health System may be compensated for their Community Service. Full-time associates are compensated for up to 4 hours a year and part-time associates are compensated up to 2 hours per year. In 2022, Beacon associates collectively logged 430.9 hours of helping charitable organizations in their community and living the Beacon mission of connecting with heart. As we continue to adjust from meeting emergent needs brought on by COVID, we look forward to uplifting the community through individual volunteer service.
Schedule H, Part VI, Line 6 Affiliated health care system	In 2018, Community Hospital of Bremen affiliated with Memorial Hospital of South Bend and Elkhart General Hospital, under the name Beacon Health System. In October 2021, Beacon Health System affiliated with Three Rivers Health System. All organizations continue as full-care providers for their respective Counties, and they are committed to promoting the health of the communities they serve. The Beacon Health System Board of Directors consists of 14 voting board members.
Schedule H, Part VI, Line 7 State filing of community benefit report	IN

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Cultivate Food Rescue	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1403 Prairie Ave	AddressLine1Txt
City	South Bend	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46613	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	813306113	RecipientEIN
IRC Section	501 (C) (3)	IRCSectionDesc
Cash Grant	$10,000	CashGrantAmt
Valuation Method Used	Cash	ValuationMethodUsedDesc
Purpose Of Grant	Sponsor Programs	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	FormAndLineReferenceDesc
Explanation	Part of Community Hospital of Bremen's mission is to improve the health of its community. In order to fulfill this goal, our administrators have the ability to make donations to organizations that improve the health and well being of our community. Since the grant to the organization is made to a 501 (C) (3) entity, there are no procedures for monitoring the use of the funds.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
Jason Marker MD
Vice Chair/Chief Med Officer	$0	$266,611	$0	$15,952	$0	$16,708	$0	$11,592	$0	$23,230	$0	$334,093	$0	$0
Kreg R Gruber
CEO	$0	$994,922	$0	$261,341	$0	$287,101	$0	$194,557	$0	$26,709	$0	$1,764,631	$0	$83,287
Jeffrey P Costello
CFO	$0	$602,522	$0	$122,536	$0	$153,736	$0	$110,781	$0	$15,714	$0	$1,005,289	$0	$77,367
David H Bailey
President	$0	$243,124	$0	$49,316	$0	$149,961	$0	$53,515	$0	$1,581	$0	$497,496	$0	$120,943

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

COMMUNITY HOSPITAL OF BREMEN, INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION.

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2022, REFLECTED IN COLUMN (B)(III): * KREG GRUBER, $146,136 * JEFFREY COSTELLO, $116,448 * DAVID BAILEY, $122,330 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2022 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: * KREG GRUBER, $182,357 * JEFFREY COSTELLO, $98,581 * DAVID BAILEY, $41,315

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Wagner & Wagner LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	Board Member Greater than 35% ownership	RelationshipDescriptionTxt
Transaction	$183,932	TransactionAmt
Transaction	Collection Services	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part V, Line 2a EMPLOYEE COMPENSATION	EMPLOYEES ARE PAID BY MEMORIAL HOSPITAL OF SOUTH BEND. (EIN 35-0868132) AND EXPENSED TO COMMUNITY HOSPITAL OF BREMEN, INC. THROUGH CONTRACT LABOR.
Form 990, Part VI, Line 15a & 15b - Compensation Process	BEACON HEALTH SYSTEM, INC., THE PARENT COMPANY OF COMMUNITY HOSPITAL OF BREMEN, CONDUCTS THE REVIEW OF ALL COMPENSATION. VICE PRESIDENT AND HIGHER COMPENSATION IS DETERMINED AFTER AN EXTENSIVE EXAMINATION IS CONDUCTED USING COMPARABLE MARKET DATA AND THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. HUMAN RESOURCES CONDUCTS THE ANALYSIS AND MAKES RECOMMENDATIONS TO THE CEO WHO THEN MAKES THE RECOMMENDATIONS TO THE BOARD FOR APPROVAL. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD.
Form 990, Part VI, Line 6 Classes of members or stockholders	MEMBERS OF THE ORGANIZATION BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF COMMUNITY HOSPITAL OF BREMEN, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	ELECTION OF BOARD MEMBERS THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF BREMEN AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF COMMUNITY HOSPITAL OF BREMEN.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	DECISIONS OF THE BOARD OF DIRECTORS DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. BEACON HEALTH SYSTEM, INC., THE SOLE MEMBER OF COMMUNITY HOSPITAL OF BREMEN HAS THE SOLE POWER WITH RESPECT TO THE FOLLOWING MATTERS: 1. SELECTION AND RETENTION OF AUDITORS. 2. APPROVAL OF ALL CONTRACTS, POLICIES, OR PROGRAMS OF INSURANCE ESTABLISHING THE TYPES OF INSURANCE COVERAGE REQUIRED AS WELL AS THE COVERAGE LEVELS. 3. THE NOMINATION, ELECTION AND REMOVAL OF MEMBERS OF THE BOARD OF THE CORPORATION. 4. THE APPOINTMENT AND EVALUATION OF THE PRESIDENT OF THE CORPORATION. 5. COMPENSATION OF EXECUTIVE MANAGEMENT OF THE CORPORATION. 6. OTHER MATTERS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	PREPARATION & REVIEW OF FORM 990 THE ORGANIZATION INCORPORATES NUMEROUS PARTIES IN THE PRODUCTION AND REVIEW OF THE FORM 990 AND ASSOCIATED SCHEDULES. SENIOR ACCOUNTING STAFF AND MANAGEMENT COMPLETE THE FORM 990 AND SCHEDULES. SOME FORMS AND SCHEDULES ARE REVIEWED BY THE CONTROLLER. SUBSEQUENT TO THOSE STEPS, THE ORGANIZATION ENGAGED ERNST & YOUNG TO REVIEW THE COMPLETED FORM 990 AND APPROPRIATE SCHEDULES. PRIOR TO FILING THE RETURN, THE CFO, THE COMPENSATION COMMITTEE OF THE ORGANIZATION, AND THE CEO CONDUCT A GENERAL OVERVIEW OF THE FORM 990, INCLUDING APPLICABLE COMPENSATION SCHEDULES. IN ADDITION, EACH BOARD MEMBER RECEIVES NOTIFICATION OF THE IRS FORM 990 PLACEMENT ON THE ORGANIZATION'S BOARD PORTALS WHICH ALLOWS FOR BOARD MEMBER REVIEW PRIOR TO FILING THE RETURN.
Form 990, Part VI, Line 12c Conflict of interest policy	THERE ARE THREE SEPARATE FORMS THAT ARE SENT OUT THROUGH THE INTERNAL AUDIT DEPARTMENT TO KEY EMPLOYEES OR BOARD MEMBERS REGARDING CONFLICT OF INTEREST. THEY ARE AS FOLLOWS: 1. THE FIRST IS A CONFLICT OF INTEREST STATEMENT THAT IS SENT TO SENIOR LEVEL ADMINISTRATION, MANAGEMENT, AND SELECT STAFF SUCH AS PURCHASING DEPARTMENT EMPLOYEES. THE PURPOSE OF THE STATEMENT IS TO REQUIRE THESE EMPLOYEES TO DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS THEY MAY HAVE. THE STATEMENTS ARE SENT IN JANUARY OF EACH YEAR FOR THE PREVIOUS YEAR ACTIVITIES WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT 376 STATEMENTS AND ARE WORKING TO ACHIEVE A 100% RESPONSE RATE. EACH RESPONSE IS REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT AND THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AS WELL AS THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 2. THE SECOND STATEMENT IS THE BOARD DUALITY OF INTEREST STATEMENT THAT IS SENT TO CURRENT BOARD MEMBERS, FORMER BOARD MEMBERS FROM THE LAST FIVE YEARS, AND OTHER KEY EMPLOYEES. THE DUALITY OF INTEREST STATEMENT IS SENT USING A WEB BASED SURVEY TOOL PROVIDED BY ERNST & YOUNG. THE REPLIES ARE REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT. THE RESULTS OF THE SURVEYS ARE SUMMARIZED USING THE WEB BASED TOOL, AND ARE REVIEWED BY ERNST & YOUNG IN COMPLETING THE 990. The RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 3. THE THIRD STATEMENT IS ENTITLED "CODE OF ETHICS FOR SENIOR FINANCIAL OFFICERS". THE STATEMENT REQUIRES AN ACKNOWLEDGEMENT FORM TO BE SIGNED BY BEACON HEALTH SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT ON JANUARY 12, 2023 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2022, 22 DESIGNATED EMPLOYEES WERE REQUESTED TO SIGN THE FORM AND WE HAD A 100% COMPLIANCE RATE. ANY POTENTIAL CONFLICTS OF INTERESTS ARE REVIEWED BY INDEPENDENT PARTIES BOTH INTERNAL AND EXTERNAL TO THE ORGANIZATION, AND IF NECESSARY, CORRECTIVE ACTION WOULD BE TAKEN TO RESOLVE A TRUE CONFLICT. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT OF INTEREST WOULD BE EXCLUDED FROM ALL REVIEW PROCEEDINGS.
Form 990, Part VI, Line 19 Required documents available to the public	AVAILABILITY OF INFORMATION THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR BEACON HEALTH SYSTEM, INC. BONDS.
Form 990, Part VIII, Line 2f Other Program Service Revenue	All other program service revenue - Total Revenue: 11904, Related or Exempt Function Revenue: 11904, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	- Total Revenue: 11744, Related or Exempt Function Revenue: 11744, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	P/S MEDICAL - Total Expense: 645662, Program Service Expense: 580295, Management and General Expenses: 65367, Fundraising Expenses: ; PHYSCIAN FEES - Total Expense: 2633516, Program Service Expense: 2366898, Management and General Expenses: 266618, Fundraising Expenses: ; SERVICE CONTRACTS - Total Expense: 431326, Program Service Expense: 387658, Management and General Expenses: 43668, Fundraising Expenses: ; LAB FEES - Total Expense: 174734, Program Service Expense: 157280, Management and General Expenses: 17454, Fundraising Expenses: ; OTHER P/S - Total Expense: 336340, Program Service Expense: 302289, Management and General Expenses: 34051, Fundraising Expenses: ; REPAIR/MAINTENANCE - Total Expense: 100072, Program Service Expense: 89941, Management and General Expenses: 10131, Fundraising Expenses: ; CONSULTING - Total Expense: 3485, Program Service Expense: 3132, Management and General Expenses: 353, Fundraising Expenses: ; BLOOD SUPPLY - Total Expense: 28665, Program Service Expense: 25763, Management and General Expenses: 2902, Fundraising Expenses: ; COLLECTION EXPENSE - Total Expense: 4510, Program Service Expense: 4053, Management and General Expenses: 457, Fundraising Expenses: ; RADIOLOGY FEES - Total Expense: 1140, Program Service Expense: 1025, Management and General Expenses: 115, Fundraising Expenses: ; TRANSCRIPTIONS - Total Expense: 3220, Program Service Expense: 2894, Management and General Expenses: 326, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Write off Intercompany - 8913271;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
COMMUNITY HOSPITAL OF BREMEN AUXILLARY
PO BOX 8	BREMEN	IN	46506	351467691	FIN SUPPORT	IN	501(c)(3)	10	N/A	false
BEACON MEDICAL GROUP INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	351536132	PHY PRACTICES	IN	501(c)(3)	10		Yes (true)	BHS
BEACON HEALTH FOUNDATION INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	351536129	FIN SUPPORT	IN	501(c)(3)	7		Yes (true)	BHS
ELKHART GENERAL HOSPITAL INC
600 EAST BOULEVARD	ELKHART	IN	46514	350877574	HOSPITAL	IN	501(c)(3)	3		Yes (true)	BHS
BEACON HEALTH SYSTEM INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	453864076	PARENT ORG	IN	501(c)(3)	Type III-FI		false	NA
MEMORIAL HOSPITAL OF SOUTH BEND INC
615 N MICHIGAN STREET	SOUTH BEND	IN	46601	350868132	HOSPITAL	IN	501(c)(3)	3		Yes (true)	BHS
THREE RIVERS HEALTH FOUNDATION
701 SOUTH HEALTH PARKWAY	THREE RIVERS	MI	49093	201384776	FOUNDATION	MI	501(c)(3)	Type I		Yes (true)	TRH
THREE RIVERS HEALTH SYSTEM
701 SOUTH HEALTH PARKWAY	THREE RIVERS	MI	49093	451257972	HOSPITAL	MI	501(c)(3)	3		Yes (true)	BHS

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
BEACON HEALTH VENTURES INC
615 N MICHIGAN ST	SOUTH BEND	IN	46601	351901068	HOME MEDICAL	IN	NA	C Corporation	false
BEACON HEALTH VENTURES MICHIGAN INC
615 N MICHGIAN ST	SOUTH BEND	IN	46601	208259773	HOME MEDICAL	MI	NA	C Corporation	false
INTEGRATED HEALTH SYSTEMS INC
701 SOUTH HEALTH PARKWAY	THREE RIVERS	MI	49093	383134384	PERSONNEL MGMT	MI	TRH	C Corporation	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	Yes (true)	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MEMORIAL HOSPITAL OF SOUTH BEND
P	$12,520,398	ACTUAL CHARGES
MEMORIAL HOSPITAL OF SOUTH BEND
R	$13,514,828	CASH
MEMORIAL HOSPITAL OF SOUTH BEND
Q	$69,124	ACTUAL CHARGES
BEACON MEDICAL GROUP
R	$104,953	CASH
BEACON MEDICAL GROUP
J	$105,060	ACTUAL CHARGES
ELKHART GENERAL HOSPITAL
Q	$62,540	ACTUAL CHARGES
ELKHART GENERAL HOSPITAL
R	$62,661	CASH