2022-08-15T07:33:45-05:00 2021-09-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2020-10-01 263083364 DEACONESS CLINIC INC DEAC 8124503296 600 MARY STREET EVANSVILLE IN 47747 BRADLEY SCHEU MD VICE PRESIDENT 8124503296 2022-08-15 1 BRADLEY SCHEU MD 999009999 CARRIE A MERRILL CPA P00832283 3176334705 2022-08-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BRADLEY SCHEU MD 421 CHESTNUT STREET EVANSVILLE IN 47713 130819888 0 X DEACONESS.COM X 2008 IN SEE SCHEDULE O 16 1 1341 0 0 0 2274671 2100000 103481417 127724385 -127242 32639 304173 623211 105933019 130480235 0 0 0 0 117058987 138146652 0 0 0 44141241 51216433 161200228 189363085 -55267209 -58882850 91384879 96808507 83175864 92147048 8209015 4661459 X SEE SCHEDULE O 0 0 164609854 126359224 PATIENT SERVICES REVENUE-DEACONESS CLINIC IS A MAJOR SOURCE OF MEDICAL SERVICES WHICH ENCOMPASSES A BROAD SPECTRUM OF EXPERTISE, REPRESENTING MORE THAN 20 MEDICAL AND SURGICAL SPECIALTIES. DEACONESS CLINIC EMPLOYS 150 PHYSICIANS, 150 MIDLEVEL PROVIDERS AND 707 FULL TIME NURSING AND ADMINISTRATIVE FULL TIME EQUIVALENTS. DEACONESS CLINIC SERVES A 25-COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY, AND SOUTHEASTERN ILLINOIS. THE CLINIC AND ITS FACILITIES HAVE LOCATIONS IN EVANSVILLE, NEWBURGH, MT. VERNON, PETERSBURG, FT. BRANCH, PRINCETON, OAKLAND CITY, BOONVILLE, AND REO IN INDIANA. THE CLINIC ALSO HAS LOCATIONS IN HENDERSON, MORGANFIELD AND OWENSBORO, KENTUCKY. THE CLINICS SERVED 929,289 PATIENT VISITS FROM OCTOBER 1, 2020 THROUGH SEPTEMBER 2021. 1378403 1365161 THE DEACONESS RESEARCH INSTITUTE ASSISTS THE DEACONESS HEALTH SYSTEM THROUGH ITS 9 HOSPITAL LOCATIONS, HUNDREDS OF CLINICS & AMBULATORY FACILITIES, AND VARIOUS COMMUNITY PARTNERS IN THE TRI-STATE AREA IN GAINING ACCESS TO LEADING EDGE MEDICAL SCIENCE AND NEW TREATMENTS FOR ACUTE AND CHRONIC ILLNESSES. THE INSTITUTE WAS AWARDED 12 NEW AND EXPANDED CLINICAL RESEARCH GRANTS THIS YEAR TO STUDY INVESTIGATIONAL DRUGS AND DEVICES ACROSS 10 FIELDS OF MEDICINE INCLUDING, BUT NOT LIMITED TO, NEW TREATMENTS FOR HEART DISEASE, DIABETES, COVID-19, ATOPIC DERMATITIS, CHRONIC MIGRAINES, INFANT NUTRITION, AND NEW DIAGNOSTIC TECHNOLOGY FOR COLORECTAL CANCER. THE NEW RESEARCH CONTRACTS PROVIDED TREATMENT OR TESTING OPPORTUNITIES AND PREVENTATIVE HEALTH SERVICES FOR THOUSANDS OF PATIENTS. IN ALL, THE NEWLY AWARDED GRANTS AND CONTRACTS THIS YEAR TOTALED $1.48 MILLION TO COVER THE COSTS ASSOCIATED WITH THE CONDUCT OF THE CLINICAL TRIALS WITHIN THE REGION. 388 PATIENTS WERE SCREENED FOR CLINICAL TRIAL QUALIFICATION THROUGHOUT THE YEAR, WITH 359 NEW PATIENTS ENROLLED ONTO CLINICAL PROTOCOLS, RESULTING IN 2,815 RESEARCH RELATED PATIENT VISITS. 165988257 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 97 0 1 1341 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X KYLE DILLMAN 8124507399 600 MARY STREET EVANSVILLE IN 47747 STEPHEN TITZER CHAIRMAN 1.00 0.00 X X 2800 0 0 CHERYL WATHEN SECRETARY/TREASURER 3.00 53.00 X X 0 790019 179947 BRADLEY SCHEU MD NON-VOTING DIRECTOR/CMO & VP 50.00 5.00 X X 566054 6248 54498 MAQBOOL AHMED MD DIRECTOR 50.00 5.00 X 842877 153360 18046 CHRIS CHACKO MD DIRECTOR 50.00 0.00 X 379127 0 18051 RENEE GALEN MD DIRECTOR 50.00 0.00 X 331867 0 37054 MIA HINDI MD DIRECTOR 50.00 5.00 X 1208642 306300 41045 GARY KEEPES MD DIRECTOR 50.00 0.00 X 514013 0 49460 JOSEPH KLINK MD DIRECTOR 50.00 0.00 X 1103632 0 40624 MAJED KOLEILAT MD DIRECTOR 50.00 0.00 X 895873 0 45268 GARRETT KOON MD DIRECTOR 50.00 0.00 X 122059 164355 483 SNESHA MODI MD DIRECTOR 50.00 0.00 X 292631 0 9253 BARRY PHILLIPS MD DIRECTOR 50.00 0.00 X 421193 11000 48715 JAMES PORTER MD DIRECTOR 3.00 50.00 X 0 1127023 189162 ASHLEY RICHESON MD DIRECTOR 50.00 0.00 X 238611 7838 39843 WILLIAM SMITH MD DIRECTOR 50.00 0.00 X 312892 27521 22640 JOANN WOOD MD DH CHIEF MEDICAL OFFICER & VP 3.00 50.00 X X 0 156101 22198 JULIE DINGMAN OPERATIONS ADMINSTRATOR 50.00 0.00 X 227824 0 52666 JON DAVIS MD PHYSICIAN 50.00 0.00 X 2261062 0 40850 MIR FAHAD FAISAL MD PHYSICIAN 50.00 0.00 X 1667969 14400 27983 MANGA KODALI MD PHYSICIAN 50.00 0.00 X 1431626 360 13976 CHRISTOPHER BRADEN MD PHYSICIAN 50.00 0.00 X 1149978 360 40733 ADAM BECKER MD PHYSICIAN 50.00 0.00 X 1139209 0 36713 LINDA WHITE FORMER DIRECTOR 5.00 55.00 X 0 180735 7461 W ALLEN WHITE MD FORMER DIRECTOR/CPAO 50.00 4.00 X 399997 145714 140305 15509936 3091334 1176974 236 1 1 0 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PHYSICIAN SERVICES 1553405 SCRIBE AMERICA LLC 1200 E LOS OLAS BLVD SUITE 1 201 FT LAUDERDALE FL 33001 SCRIBE PROGRAM 624468 MED CLEAN SERVICE PO BOX 8142 EVANSVILLE IN 47716 CLEANING 622226 COMPHEALTH 2815 MERCIER ST KANSAS CITY MO 64108 PHYSICIAN SERVICES 542256 INDIANA UNIVERSITY PO BOX 7237 INDIANAPOLIS IN 46204 PHYSICIAN SERVICES 247057 13 2100000 2100000 NET PATIENT REVENUE 621110 126359224 126359224 NET RESEARCH REVENUE 621110 1365161 1365161 127724385 32639 32639 309255 339653 -30398 -30398 -30398 USI CAPITATION 900099 551609 551609 EHR 900099 102000 102000 653609 130480235 127724385 0 655850 8245830 7751080 494750 109737879 103075180 6662699 6421224 6106180 315044 7851998 7466756 385242 5889721 5600754 288967 2800 2800 487319 487319 12000 12000 15069222 5041728 10027494 612741 307449 305292 13064129 13064129 1545160 1496763 48397 16139485 12766285 3373200 178283 152106 26177 492705 492705 1495727 1427304 68423 2116862 1239838 877024 189363085 165988257 23374828 0 11949415 13134587 4356671 5054669 724077 549028 21190694 8977384 10447184 12213310 59343356 59138630 4564176 6718283 91384879 96808507 31899854 43161468 51276010 48985580 83175864 92147048 X 8209015 4661459 8209015 4661459 91384879 96808507 X -58882850 55335294 X X 0 1 X 1 0 X SCHEDULE A, LINE 3: DEACONESS CLINIC HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARILY RECOGNIZED BY A STATE AS A HOSPITAL IS REQUIRED TO COMPLETE THE SCHEDULE. THE CLINIC IS NOT LICENSED AS A HOSPITAL FOR THE STATE OF INDIANA. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12000 12000 0 PART II-B, LINE 1: LOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS CLINIC AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT. 10488870 3681711 6807159 9739656 5295673 4443983 962168 962168 12213310 INVESTMENTS IN JOINT VENTURES 834554 INTANGIBLES 336478 457 PLAN 3887838 MISC AR NOT PATIENT RELATED 1659413 6718283 OPERATING LEASE 48985580 48985580 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE COMPANY AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI AND XII: SECTIONS ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENT IS AUDITED BY AN INDEPENDENT ACCOUNTING FIRM AND IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. X 1 1 X X X X X X 0 1 0 0 0 1 1 0 0 CHERYL WATHEN SECRETARY/TREASURER 0 537700 0 139230 0 113089 0 140101 0 39846 0 969966 0 100563 BRADLEY SCHEU MD NON-VOTING DIRECTOR/CMO & VP 354827 0 178517 6248 32710 0 20434 0 34064 0 620552 6248 0 0 MAQBOOL AHMED MD DIRECTOR 789016 0 46412 0 7449 153360 17292 0 754 0 860923 153360 0 0 CHRIS CHACKO MD DIRECTOR 290763 0 53813 0 34551 0 8646 0 9405 0 397178 0 25940 0 RENEE GALEN MD DIRECTOR 211116 0 111730 0 9021 0 17292 0 19762 0 368921 0 0 0 MIA HINDI MD DIRECTOR 1059796 0 139778 0 9068 306300 12969 0 28076 0 1249687 306300 0 0 GARY KEEPES MD DIRECTOR 327555 0 184103 0 2355 0 23398 0 26062 0 563473 0 0 0 JOSEPH KLINK MD DIRECTOR 998969 0 95778 0 8885 0 12969 0 27655 0 1144256 0 0 0 MAJED KOLEILAT MD DIRECTOR 797426 0 88544 0 9903 0 17292 0 27976 0 941141 0 0 0 GARRETT KOON MD DIRECTOR 108308 139277 6262 0 7489 25078 483 0 0 0 122542 164355 0 0 SNESHA MODI MD DIRECTOR 193265 0 98543 0 823 0 8646 0 607 0 301884 0 0 0 BARRY PHILLIPS MD DIRECTOR 336635 0 82316 0 2242 11000 22822 0 25893 0 469908 11000 0 0 JAMES PORTER MD DIRECTOR 0 614578 0 189484 0 322961 0 153695 0 35467 0 1316185 0 316206 ASHLEY RICHESON MD DIRECTOR 177278 0 41390 0 19943 7838 6817 0 33026 0 278454 7838 0 0 WILLIAM SMITH MD DIRECTOR 212785 0 91378 27521 8729 0 12969 0 9671 0 335532 27521 0 0 JOANN WOOD MD DH CHIEF MEDICAL OFFICER & VP 0 128892 0 24802 0 2407 0 15621 0 6577 0 178299 0 0 JULIE DINGMAN OPERATIONS ADMINSTRATOR 197635 0 28638 0 1551 0 30154 0 22512 0 280490 0 0 0 JON DAVIS MD PHYSICIAN 1882928 0 370208 0 7926 0 12969 0 27881 0 2301912 0 0 0 MIR FAHAD FAISAL MD PHYSICIAN 1560287 0 92110 0 15572 14400 0 0 27983 0 1695952 14400 0 0 MANGA KODALI MD PHYSICIAN 1383134 0 40692 0 7800 360 12969 0 1007 0 1445602 360 0 0 CHRISTOPHER BRADEN MD PHYSICIAN 1072832 0 69389 0 7757 360 12969 0 27764 0 1190711 360 0 0 ADAM BECKER MD PHYSICIAN 1040990 0 96307 0 1912 0 8646 0 28067 0 1175922 0 0 0 LINDA WHITE FORMER DIRECTOR 0 159920 0 16535 0 4280 0 2457 0 5004 0 188196 0 0 W ALLEN WHITE MD FORMER DIRECTOR/CPAO 343979 28546 133 96096 55885 21072 107370 0 30873 2062 538240 147776 53372 16478 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR LINDA WHITE FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEE. PART I, LINE 4B SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED CHERYL WATHEN $ -0- $ 19,500 $ -0- W. ALLEN WHITE, MD 0 19,500 0 MAQBOOL AHMED, MD 0 19,500 0 MAJED KOLEILAT, MD 0 19,500 0 JAMES PORTER, MD 0 19,500 0 MIA HINDI, MD 0 19,500 0 MANGA KODALI, MD 0 19,500 0 JON DAVIS, MD 0 19,500 0 ADAM BECKER, MD 0 19,500 0 GARY KEEPES, MD 0 19,500 0 SNESHA MODI, MD 0 16,516 0 BRADLEY SCHEU, MD 0 19,500 0 SEVERANCE NONQUALIFIED EQUITY-BASED JOSEPH KLINK, MD $ -0- $ 19,500 $ -0- PART 1, LINE 4B: CHERYL WATHEN: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $100,293 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $100,563 JAMES PORTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $122,390 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $316,206 W. ALLEN WHITE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $60,509 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $9,341 JOANN WOOD: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $15,621 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $0 BRADLEY SCHEU: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $23,441 SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $0 PART I, LINE 6 COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANZIATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS CLINIC'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. JUNG WOOK KANG SMITH FAMILY OF BD MBR 250230 COMPENSATION 0 SCH L, PART IV DR. JUNG WOOK KANG SMITH IS MARRIED TO DR. WILLIAM SMITH, A BOARD MEMBER OF DEACONESS CLINIC, INC. SHE IS AN EMPLOYED PHYSICIAN AT DEACONESS CLINIC, INC. FORM 990, PART I, LINE 1 AND PART III, LINE 1: ORGANIZATION'S MISSION: DEACONESS CLINIC WAS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATION, AND SCIENTIFIC PROGRAM PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE IRS CODE WHICH INCLUDES (AMONG OTHERS): TO DELIVER HEALTH CARE TO THE PUBLIC; TO CARRY OUT SCIENTIFIC RESEARCH AND RESEARCH PROJECTS IN THE PUBLIC INTEREST IN THE FIELDS OF MEDICAL SCIENCES, MEDICAL ECONOMICS, PUBLIC HEALTH, SOCIOLOGY, AND RELATED AREA; TO IMPROVE AND DEVELOP THE CAPABILITIES OF INDIVIDUALS AND INSTITUTIONS STUDYING, TEACHING, AND PRACTICING MEDICINE AND OTHER HEALTH OCCUPATIONS; TO PROVIDE HEALTH CARE AND HEALTH-RELATED EDUCATION FOR THE BENEFIT OF THE COMMUNITY IN A SYSTEMATIC, INTEGRATED AND COORDINATED FASHION WITH THE DEACONESS HEALTH SYSTEM AND DEACONESS HOSPITAL, INC. AND THEIR AFFILIATES. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC., A TAX EXEMPT 501(C)(3) ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF DEACONESS CLINIC, INC. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THEIR RIGHTS: DEACONESS HEALTH SYSTEM, INC. MUST APPROVE THE CHOSEN DEACONESS CLINIC VICE PRESIDENT. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS SUBJECT TO APPROVAL OF MEMBERS: APPOINTMENT OF VICE PRESIDENT REQUIRES APPROVAL OF THE MEMBER. CHANGES TO PHYSICIAN COMPENSATION PLAN REQUIRES THE APPROVAL OF THE MEMBER THOUGH ITS COMPENSATION COMMITTEE WHICH IS COMPRISED OF INDEPENDANT MEMBERS OF THE DEACONESS HEALTH SYSTEM BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS THAT DEACONESS CLINIC UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE CONTROLLER, CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT, AND ANNUALLY THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE AND/OR THE "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS CLINIC OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: SALARIES AND BENEFITS OF OFFICERS AND PHYSICIANS AT DEACONESS CLINIC ARE APPROVED BY THE DEACONESS HEALTH SYSTEM COMPENSATION COMMITTEE. DEACONESS CLINIC BOARD CAN ONLY MAKE RECOMMENDATION TO THE DEACONESS HEALTH SYSTEM COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM INC. AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW, APPROVE, AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE VICE PRESIDENT AND EACH OTHER EXECUTIVE OFFICERS ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS. 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, VICE PRESIDENT OR EXECUTIVE OFFICE COMPENSATION. 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN-RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DEACONESS CLINIC'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. AS REQUIRED BY LAW, DEACONESS CLINIC SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART XI, LINE 9: FUNDING 55,335,294. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. DEACONESS HEALTH SYSTEM INC 600 MARY STREET EVANSVILLE IN 47747 351532889 HEALTHCARE IN 501(C)(3) LINE 12A, I N/A 0 DEACONESS HOSPITAL INC 600 MARY STREET EVANSVILLE IN 47747 350593390 HEALTHCARE IN 501(C)(3) LINE 3 DEACONESS HEALTH SYSTEM INC 0 DEACONESS REGIONAL HEALTHCARE SERVICES 600 MARY STREET EVANSVILLE IN 47747 810693478 HEALTHCARE IN 501(C)(3) LINE 10 DEACONESS HEALTH SYSTEM INC 0 DEACONESS VNA PLUS LLC 610 E WALNUT ST EVANSVILLE IN 47713 465223267 HEALTHCARE IN 501(C)(3) LINE 10 DEACONESS HEALTH SYSTEM INC 0 DEACONESS SPECIALTY PHYSICIANS INC 600 MARY STREET EVANSVILLE IN 47747 824503095 HEALTHCARE IN 501(C)(3) LINE 3 DEACONESS HEALTH SYSTEM INC 0 DEACONESS HEALTH KENTUCKY INC 600 MARY STREET EVANSVILLE IN 47747 830966826 HEALTHCARE IN 501(C)(3) LINE 10 DEACONESS HEALTH SYSTEM INC 0 METHODIST HEALTH INC PO BOX 48 HENDERSON KY 42419 610461753 HEALTHCARE KY 501(C)(3) LINE 3 DEACONESS HEALTH SYSTEM INC 0 DEACONESS GIBSON HOSPITAL 1808 SHERMAN DR PRINCETON IN 47670 350877575 HEALTHCARE IN 501(C)(3) LINE 3 DEACONESS HEALTH SYSTEM INC 0 HENDERSON REGIONAL HOSPITAL FOUNDATION 1305 NORTH ELM ST HENDERSON KY 42420 610944432 SUPPORT METHODIST HEALTH KY 501(C)(3) LINE 10 N/A 0 UNION COUNTY METHODIST HOSPITAL FOUNDATION 4604 US HWY 60 WEST MORGANFIELD KY 42437 611230297 SUPPORT METHODIST HEALTH KY 501(C)(3) LINE 10 N/A 0 GIBSON GENERAL HEALTH FOUNDATION INC 1808 SHERMAN DR PRINCETON IN 47670 350950175 SUPPORT DEACONESS GIBSON HOSPITAL IN 501(C)(3) LINE 12A, I DEACONESS GIBSON HOSPITAL 0 HEALTHCARE RESOURCE SOLUTIONS LLC 600 MARY STREET EVANSVILLE IN 47747 833275390 HEALTHCARE IN N/A 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0