MEMORIAL HOSPITAL OF SOUTH BEND: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL OF SOUTH BEND (EIN 35-0868132)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-12
- IRS object ID
- 202223169349301907
- Schema version
- 2021v4.2
- 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 K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-12T13:27:41-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 SUITE 4000 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 350868132 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Memorial Hospital of South Bend Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JEFFREY COSTELLO | InCareOfNm |
| Business Name Control | MEMO | BusinessNameControlTxt |
| 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 |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Costello | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5746473549 | PhoneNum |
| Signature | 2022-11-11 | 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 |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER D RHODERICK | PreparerPersonNm |
| PTIN | P00395735 | PTIN |
| Phone | 3176817445 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Larry Tracy | PrincipalOfficerNm |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $682,388,849 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | beaconhealthsystem.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1923 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | We deliver outstanding care, inspire health and connect with heart. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 3984 | TotalEmployeeCnt |
| Total Volunteers | 186 | TotalVolunteersCnt |
| Total Gross UBI | $185,803 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $50,995 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $14,630,567 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,347,561 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $595,563,105 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $656,274,620 | CYProgramServiceRevenueAmt |
| PY Investment Income | $636,105 | PYInvestmentIncomeAmt |
| CY Investment Income | -$28,873 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,304,755 | PYOtherRevenueAmt |
| CY Other Revenue | $18,707,957 | CYOtherRevenueAmt |
| PY Total Revenue | $624,134,532 | PYTotalRevenueAmt |
| CY Total Revenue | $682,301,265 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,186,324 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $445,939 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $198,306,152 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $243,034,492 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $306,274,088 | PYOtherExpensesAmt |
| CY Other Expenses | $327,822,196 | CYOtherExpensesAmt |
| PY Total Expenses | $505,766,564 | PYTotalExpensesAmt |
| CY Total Expenses | $571,302,627 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $118,367,968 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $110,998,638 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $574,259,157 | TotalAssetsBOYAmt |
| Total Assets EOY | $567,070,116 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $264,036,621 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $253,927,832 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $310,222,536 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $313,142,284 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $136,476,085 | ExpenseAmt |
| Revenue | $365,492,203 | RevenueAmt |
| Desc | Ancillary Services offers the following services for patients and facilities: - Imaging Services - Outpatient Physical, Occupational and Speech Therapy - Infusion Treatments - Radiation Oncology Therapy - Cancer Research - Cardiac Cath Lab - Sleep Lab - Interventional Radiology - Environmental Services - Nutritional Services - Pharmacy Services - Laboratory. 2021 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 651,623 INPATIENT PROCEDURES - 486,609 OUTPATIENT PROCEDURES - 1,160 INPATIENT CATHS - 1,381 OUTPATIENT CATHS - 1,721 OUTPATIENT VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $144,041,109 | ExpenseAmt |
| Revenue | $167,903,321 | RevenueAmt |
| Desc | Patient Care Unit Services provides a wide variety of hospital services including: - Inpatient rehabilitation CARF (Commission on Accreditation of Rehabilitation Facilities) accredited - Medical - Post surgical - Orthopedic - Oncology - Intensive and intermediate - Heart and Vascular - Mother and Child - Special Care Obstetrics - Neonatal Intensive Care Level III - Emergency - Trauma Level II - Pediatrics - Pediatric Intensive Care - Pediatric Hematology Oncology - Medical Flight program - Pediatric Intensive Care Transports. 2021 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 98,029 PATIENT DAYS - 11,731 INPATIENT ER VISITS - 58,774 OUTPATIENT ER VISITS - 2,610 BIRTHS - 16,655 OBSERVATION STAYS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $63,178,751 | ExpenseAmt |
| Revenue | $134,900,961 | RevenueAmt |
| Desc | Surgical Services provides the following services: - General Surgery - Vascular Surgery - Cardiac Surgery - Orthopedic Surgery - Gynecological Surgery - Trauma Surgery - GI Labs - Pulmonary Services - Pain Center - DaVinci Robotic Surgery. 2021 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 8,064 INPATIENT PROCEDURES - 413 OPEN HEART PROCEDURES - 17,851 OUTPATIENT PROCEDURES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $187,451,817 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $445,939 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $531,147,762 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| 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 | Yes (true) | 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 | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | Yes (true) | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | Yes (true) | 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 |
| IRP Document | 186 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 3984 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFREY COSTELLO | PersonNm |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| Kreg Gruber | |||||||||
| CEO | 2.0 | 50.0 | Yes (X) | $0 | $1,487,125 | $206,853 | |||
| Jeffrey P Costello | |||||||||
| CFO | 2.0 | 50.0 | Yes (X) | $0 | $952,112 | $130,897 | |||
| Larry Tracy | |||||||||
| President | 40.0 | 0.0 | Yes (X) | $650,274 | $0 | $121,874 | |||
| Dale A Patterson | |||||||||
| Employed Physician | 40.0 | 0.0 | $446,924 | $0 | $35,925 | Yes (X) | |||
| Cheryl Wibbens-Lesh MD | |||||||||
| Asst. Secr./VP | 0.0 | 40.0 | $0 | $415,862 | $31,436 | Yes (X) | |||
| KRISTEN JENNINGS | |||||||||
| DIR OF MED RESIDENCY PROGRAM | 40.0 | 0.0 | $329,250 | $0 | $35,949 | Yes (X) | |||
| Linda A Mansfield | |||||||||
| EMPLOYED PHYSICIAN | 40.0 | 0.0 | $312,586 | $0 | $33,524 | Yes (X) | |||
| Marion Mahone | |||||||||
| EMPLOYED PHYSICIAN | 40.0 | 0.0 | $315,289 | $0 | $19,001 | Yes (X) | |||
| Matthew R Reed | |||||||||
| EMPLOYED PHYSICIAN | 40.0 | 0.0 | $315,537 | $0 | $18,709 | Yes (X) | |||
| BRAD TOOTHAKER | |||||||||
| Chair | 2.0 | 0.0 | Yes (X) | $1,308 | $0 | $0 | Yes (X) | ||
| HUGH HEDMAN MD | |||||||||
| Director | 2.0 | 0.0 | $948 | $0 | $0 | Yes (X) | |||
| Linda Paskiewicz | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| KAREN BARNETT | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Ronald Nelson MD | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| MARK HARMAN | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| THOMAS HAUCH MD | |||||||||
| Vice Chair | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Stephanie Steele | |||||||||
| Secretary | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Martha Smith | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| John Callaghan MD | |||||||||
| Director | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,372,116 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,855,099 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $634,168 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 295 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 | SOUTH BEND | IN | 46601 | PHYSICIAN SERVICES | $3,894,680 |
| SOUTH BEND MEDICAL FOUNDATION | |||||
| 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 46601 | LAB SERVICES | $3,352,948 |
| METRO AVIATION INC | |||||
| 1214 HAWN AVENUE | SHREVEPORT | LA | 71107 | MEDICAL FLIGHTS | $2,240,290 |
| GIBSON LEWIS LLC | |||||
| 1001 W 11TH STREET | MISHAWAKA | IN | 46544 | construction service | $2,293,343 |
| PEDIATRIX MEDICAL GROUP of INDIANA | |||||
| POBOX 281034 | ATLANTA | GA | 30384 | PHYSICIAN SERVICES | $2,078,622 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 32 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $715,945 | RelatedOrganizationsAmt |
| Government Grants | $6,631,616 | GovernmentGrantsAmt |
| Total Contributions | $7,347,561 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $653,274,458 | $653,274,458 |
| AFFILIATE RENTAL REVENUE | 532000 | $2,308,349 | $2,308,349 |
| JOINT VENTURE ACTIVITY | 561499 | $545,897 | $545,897 |
| AMBULANCE SUPPLY | 621910 | $138,406 | $138,406 |
| MEDICAL EDUCATION REVENUE | 561499 | $7,510 | $7,510 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $656,274,620 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,328 | TotalRevenueColumnAmt |
| Exclusion | $32,328 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $997,292 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $26,383 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $970,909 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $970,909 | TotalRevenueColumnAmt |
| Exclusion | $970,909 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,552 | SecuritiesAmt |
| Other | $50,649 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$10,552 | SecuritiesAmt |
| Other | -$50,649 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$61,201 | TotalRevenueColumnAmt |
| Exclusion | -$61,201 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| 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 |
| 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 |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| OUTPATIENT PHARMACY | 561499 | $8,318,271 | $8,318,271 | |
| GAIN ON BOND REFUNDING | 523000 | $3,535,250 | $3,535,250 | |
| QUALITY INCENTIVE | 561499 | $1,441,020 | $1,441,020 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,442,507 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,262,574 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $185,803 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,994,130 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $17,737,048 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $682,301,265 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $668,296,485 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $185,803 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,471,416 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,939 | TotalAmt |
| Program Services | $445,939 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,148 | TotalAmt |
| Management And General | $772,148 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,302,536 | TotalAmt |
| Program Services | $175,298,165 | ProgramServicesAmt |
| Management And General | $21,004,371 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,781,908 | TotalAmt |
| Program Services | $5,163,244 | ProgramServicesAmt |
| Management And General | $618,664 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,610,099 | TotalAmt |
| Program Services | $24,655,818 | ProgramServicesAmt |
| Management And General | $2,954,281 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,567,801 | TotalAmt |
| Program Services | $11,223,046 | ProgramServicesAmt |
| Management And General | $1,344,755 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,442,414 | TotalAmt |
| Program Services | $1,288,076 | ProgramServicesAmt |
| Management And General | $154,338 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,345 | TotalAmt |
| Management And General | $83,345 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,716 | TotalAmt |
| Management And General | $292,716 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,412 | TotalAmt |
| Program Services | $5,726 | ProgramServicesAmt |
| Management And General | $686 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,817 | TotalAmt |
| Management And General | $15,817 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,696,086 | TotalAmt |
| Program Services | $40,601,989 | ProgramServicesAmt |
| Management And General | $2,094,097 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,547 | TotalAmt |
| Program Services | $17,455 | ProgramServicesAmt |
| Management And General | $2,092 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,357,463 | TotalAmt |
| Program Services | $1,212,214 | ProgramServicesAmt |
| Management And General | $145,249 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,441 | TotalAmt |
| Program Services | $23,612 | ProgramServicesAmt |
| Management And General | $2,829 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,545,002 | TotalAmt |
| Program Services | $5,844,687 | ProgramServicesAmt |
| Management And General | $700,315 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,916 | TotalAmt |
| Program Services | $373,199 | ProgramServicesAmt |
| Management And General | $44,717 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,231 | TotalAmt |
| Program Services | $29,675 | ProgramServicesAmt |
| Management And General | $3,556 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,444,107 | TotalAmt |
| Program Services | $4,861,588 | ProgramServicesAmt |
| Management And General | $582,519 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,646,289 | TotalAmt |
| Program Services | $25,581,136 | ProgramServicesAmt |
| Management And General | $3,065,153 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,397,506 | TotalAmt |
| Program Services | $3,033,973 | ProgramServicesAmt |
| Management And General | $363,533 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $116,263,059 | $116,263,059 | |
| BAD DEBT EXPENSE | $41,571,079 | $41,571,079 | |
| CORPORATE ALLOCATION | $53,441,311 | $47,723,091 | $5,718,220 |
| HOSPITAL ASSESSMENT FEE | $24,333,076 | $24,333,076 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,789,379 | TotalAmt |
| Program Services | $1,597,915 | ProgramServicesAmt |
| Management And General | $191,464 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,302,627 | TotalAmt |
| Program Services | $531,147,762 | ProgramServicesAmt |
| Management And General | $40,154,865 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,526 | BOYAmt |
| EOY | $19,526 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,169,388 | BOYAmt |
| EOY | $16,600,012 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $539,124 | BOYAmt |
| EOY | $706,610 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,175,183 | BOYAmt |
| EOY | $134,539,398 | 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 | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,679,323 | BOYAmt |
| EOY | $17,996,119 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,895,868 | BOYAmt |
| EOY | $2,377,934 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $802,956,508 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $450,546,246 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $353,093,898 | BOYAmt |
| EOY | $352,410,262 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,920,607 | BOYAmt |
| EOY | $2,895,264 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,050 | BOYAmt |
| EOY | $284,447 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,171,474 | BOYAmt |
| EOY | $1,171,474 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,213,716 | BOYAmt |
| EOY | $38,069,070 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,259,157 | BOYAmt |
| EOY | $567,070,116 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,735,841 | BOYAmt |
| EOY | $58,465,468 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,373 | BOYAmt |
| EOY | $19,485 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,904,144 | BOYAmt |
| EOY | $131,029,097 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,376,263 | BOYAmt |
| EOY | $64,413,782 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,036,621 | BOYAmt |
| EOY | $253,927,832 | 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 | $302,758,044 | BOYAmt |
| EOY | $303,747,363 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,464,492 | BOYAmt |
| EOY | $9,394,921 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,222,536 | BOYAmt |
| EOY | $313,142,284 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,259,157 | BOYAmt |
| EOY | $567,070,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $110,998,638 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,720,030 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$109,798,920 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| 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 | $6,412 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,412 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHED C, PART IV | FormAndLineReferenceDesc |
| Explanation | MEMORIAL HOSPITAL PAID DUES TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE AMOUNT OR PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: AAFP (AMERICAN ACADEMY OF FAMILY PHYSICIANS) - 8% AMA (American Medical Association) - 50% APTA (American Physical Therapy Association) - 28% ACHE (American College of Healthcare Executives) - 1% ASHP (American Society of Health-System Pharmacists) - 20% ATS (American Trauma Society) - 20% APA (American Psychological Association)-15% CAP (College of American Pathologists) - 35% ACS (American College of Surgeons) - 4% ENA (EMERGENCY NURSES ASSOCIATION) - 22% NACH (National Association of Children's Hospitals) - 25% ACCC (Association of Community Cancer Centers) - 1% MEMORIAL HOSPITAL OF SOUTH BEND, INC. PAYS DUES TO SOME ADDITIONAL ORGANIZATIONS NOT LISTED ABOVE, WHICH DO NOT SPECIFY A PERCENTAGE FOR LOBBYING, FOR THESE ORGANIZATIONS THAT WE ARE UNABLE TO ASCERTAIN ALLOCATION OF DUES ATTRIBUTED TO LOBBYING A CONSERVATIVE ESTIMATE OF 20% IS APPLIED. MEMORIAL HOSPITAL PAID National Association of Children's Hospital Dues $10,000 during 2021, comparing to the dues paid in 2020's $ 26,700, which totally decreased Lobby expense (25%) approximately $4,000 for 2021. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| 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 |
| End Year Balance | $42,986,124 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 |
| End Year Balance | $37,554,313 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 |
| End Year Balance | $34,924,914 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
| End Year Balance | $30,834,712 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $33,854,961 | BeginningYearBalanceAmt |
| Contributions | $2,155,261 | ContributionsAmt |
| Investment Earnings Or Losses | $2,479,263 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,284,345 | GrantsOrScholarshipsAmt |
| End Year Balance | $34,205,140 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.78150 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.21850 | 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 | $26,898,864 | OtherCostOrOtherBasisAmt |
| Book Value | $26,898,864 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $520,374,937 | OtherCostOrOtherBasisAmt |
| Depreciation | $243,840,601 | DepreciationAmt |
| Book Value | $276,534,336 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $324,743 | OtherCostOrOtherBasisAmt |
| Depreciation | $324,743 | DepreciationAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $243,140,057 | OtherCostOrOtherBasisAmt |
| Depreciation | $205,180,398 | DepreciationAmt |
| Book Value | $37,959,659 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,217,907 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,200,504 | DepreciationAmt |
| Book Value | $11,017,403 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $352,410,262 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM 3RD PARTY PAYORS | $21,487,896 |
| INT IN NET ASSETS OF REC ORG | $9,394,921 |
| INTEREST RECEIVABLE - SWAP | $0 |
| OTHER RECEIVABLES | $3,672,579 |
| 2016 BOND FUND | $11,579 |
| AFFILIATE INTERCO | $1,013,350 |
| RIGHT OF USE FINANCING ASSET | $2,488,745 |
| SWAP MTM RECEIVABLE | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $38,069,070 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| INTEREST RATE SWAP | $16,883,539 |
| ASSET RETIREMENT OBLIGATION | $5,211,251 |
| IBNR | $3,162,751 |
| DUE TO THIRD PARTY | $36,636,892 |
| FINANCING LEASE LIABILITY | $2,519,349 |
| OTHER LONG TERM LIABILITIES | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $64,413,782 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4 | 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. |
| PART X, LINE 2 | 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, 2021 OR 2020. |
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 | $1,618,874 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,618,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $125,772,742 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $146,542,507 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $127,391,616 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $146,542,507 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,618,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,541,175 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,276,167 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,265,008 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,258,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,343,112 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,915,393 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $424,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $65,165 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $359,332 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $766,525 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $766,525 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,990,702 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,684,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,306,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01760 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $140,382,318 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $150,226,951 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,925,132 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02070 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $50,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $50,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,364,863 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $5,182,432 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $79,528,608 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $111,431,322 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$31,902,714 | 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 | MEMORIAL HOSPITAL OF SOUTH BEND INC | BusinessNameLine1Txt |
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 | 46545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.BeaconHealthSystem.org | WebsiteAddressTxt |
| State License | 21-005053-1 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Research Facility | Yes (X) | ResearchFacilityInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL OF SOUTH BEND 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 | www.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 | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.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. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350. | 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 | See Section C for full URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Section C for full URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Section C for full URL | 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, Section B, Line 5 | Input from persons who represent the community: 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, publicly 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 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. Part V, Section B, Line 6a & 6b Memorial Hospital of South Bend (MHSB) developed the 2021 St. Joseph County CHNA in partnership with Elkhart General Hospital and Community Hospital of Bremen, Beacon Health System (BHS) Care Partners. Part V, Section B, Line 7D The Community Health Needs Assessment (CHNA) was made widely available to the community through po |
| Part V, Section B, Line 11 | In 2021 Beacon Community Impact provided community resources to 40,242 individuals in the priority areas of Health Body, Healthy Families, Healthy Mind, and Healthy Spirit. Healthy Mind had the largest number of participants. Similar to the year before, Healthy Spirit had the lowest number of participants as we continue to grow our newest program to address the identified needs. The priority is making steady progress with the number of organizations who are willing to work collaboratively to address substance use prevention, treatment, and recovery. St. Joseph County had the greatest number of participants served, followed by Elkhart County and then Marshall County. The goal for 2021 was to serve 55% participants in St. Joseph County, 40% in of participants in Elkhart County and 5% of participants in Marshall County. Prioritization and description of the significant community health needs Implementation Strategies - As a general rule, the implementation strategies will take into consideration the following approaches: 1) the program should address discrete factors, such as knowledge, beliefs and skills, at individual and family levels; and 2) the program should address context factors such as social support, available resources and services, and access barriers to financial/physical/information resources, at family and community levels. By addressing risk and protective factors in a comprehensive way, BHS acknowledges the fact that comorbidities are very likely to happen to chronic disease patients, because different health issues or disorders share the same risk factors, so the interventions addressing such factors are reasonably expected to reduce the prevalence of these multiple conditions. Defining Mental Health: Conditions like depression, anxiety, bipolar disorder, or schizophrenia, among many others, may occur occasionally or over a long period, affecting people's ability to have a normal social life and be functional on a daily basis. Mental illness, especially depression, increases the risk for many types of physical health problems, particularly long-lasting conditions like stroke, type 2 diabetes, and heart disease. Similarly, the presence of chronic conditions can increase the risk for mental illness. Several factors can contribute to risk for mental illness, such as Adverse Child Experiences (ACEs), other forms of trauma, experiencing other acute or chronic medical conditions, use of alcohol or drugs, and being/feeling lonely or isolated. The County Health Rankings model examines quality of life and can tell us a lot about how people perceive their health - whether they feel healthy and satisfied. When communities have higher rates of those who do not feel healthy, it can influence other factors of health including mortality rates, unemployment, poverty, and the percentage of adults who did not complete high school. Getting this sense of the physical and mental health of a community can also bring to light inequities and help monitor trends, as well as identify risk factors and policies to address those risk factors. Given this definition and risk factors for poor mental health, we identify two key metrics associated with this implementation strategy. Outcome Metric #1: % of population with frequent mental health distress. Outcome Metric #2: % of the population with at least one caring and competent adult connection. In order to impact these metrics, we will implement the following strategies: Strategy #1: Build a Self-Healing Community in Michiana with regional community partners using a shared ownership model. Strategy #2: Improve the show rate at behavioral health outpatient follow-up appointments after inpatient stays in partnership with regional stakeholders. Defining Healthcare Access: Increasing healthcare access, quality, and equity implies addressing all major social, economic, environmental and behavioral factors that enable individuals and communities to make healthy choices and enjoy a long, healthy life. Beacon Health System will leverage its Community Benefit programs to close health gaps, through increased awareness, knowledge and referral of under-served/underinsured residents to insurance providers. Additionally, as found in the CHNA research, individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider. Healthy People 2030 has defined health literacy as personal and organizational health literacy. Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. The burden of disease and disease management is shared by patients, families, communities and health services. As a result, financial resources and social networks benefit from improved management practices that reduce the risk of disease, while increasing capacities at individual, family, community and organizational levels to manage poor health and access to care. By aligning with Healthy People 2030 we: - Emphasize people's ability to use health information rather than just understand it - Focus on the ability to make "well-informed" decisions rather than "appropriate" ones - Incorporate a public health perspective - Acknowledge that organizations have a responsibility to address health literacy Outcome Metric #1: % of population with health insurance (Adults < 65 and children) Outcome Metric #2: % of adults who reported that their healthcare providers always involved them in decisions about their health care as much as they wanted. In order to impact these metrics, we will implement the following strategies: Strategy #3: Build a strong Community Health Worker presence in the Beacon Service Area, with Early Childhood Services and the Health & Wellness Team. Strategy #4: Increase Health Literacy in the Michiana Area, through the work of Early Childhood Services, the Health & Wellness Team, and community partners. Community Health Needs Not Being Directly Addressed and Rationale - BHS is focusing in the most pressing community health needs identified in the CHNA Report. In order to avoid overlapping with other organizations and use the limited resources available strategically, it is worth acknowledging that gaps in community health are not isolated, and that oftentimes they reinforce each other, or coexist in the form of comorbidities, as medical research evidence suggest: Overweight / Obesity - 2nd highest priority according to secondary data, ranks below economic stability, chronic disease and access for key informants - Three focus groups listed it in their top three issues - St. Joseph County Health Department-Obesity Coalition Injury and Violence Prevention - Tied to mental health - Goodwill funded by the Community Foundation of St. Joseph County-SAVE-Stand Against Violence Everyday - SBGVI group violence initiative Immunization and Infectious Disease - County Health Departments are addressing this issue Sexually Transmitted Disease - County Health Departments are addressing this issue |
| Part V, Section B, Line 13h | 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. Memorial Hospital of South Bend, or its designee, may consider other financial assets and liabilities of the person when determining eligibility. 3. Memorial Hospital of South Bend 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 no 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. Memorial Hospital of South Bend 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. |
| Part V, Section B, Line 16 a, b, & c | The Financial Assistance Policy, application and plain language summary can all be found at: beaconhealthsystem.org/patients-and-visitors/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MEMORIAL SLEEP DISORDER CENTER | ||||
| 53990 CARMICHAEL DRIVE | SOUTH BEND | IN | 46601 | OUTPATIENT CLINIC PROVIDING SLEEP RELATED DIAGNOSIS AND TREATMENT |
| MEMORIAL HEALTH PLEX | ||||
| 111 W JEFFERSON ST | SOUTH BEND | IN | 46601 | OUTPATIENT REHABILITATION FACILITY AND FITNESS FACILITY |
| MEMORIAL BREAST CARE CENTER | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL CHILDREN'S THERAPY CENTER | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL RADIOLOGY | ||||
| 100 NAVARRE PLACE | SOUTH BEND | IN | 46601 | OUTPATIENT DIAGNOSIS AND TREATMENT |
| MEMORIAL LIGHTHOUSE PHYSICAL THERAPY | ||||
| 6913 N MAIN STREET | GRANGER | IN | 46530 | OUTPATIENT DIAGNOSIS AND TREATMENT |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part VI, Descriptions for Part I, Line 3c | FormAndLineReferenceDesc |
| Explanation | 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. 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 have been found they are 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. Part VI, Descriptions for Part I, Line 6a Beacon Health System, Inc, EIN 45-3864076, prepares the annual community benefit reporting for Memorial Hospital of South Bend, Inc. Part VI, Descriptions for Part I, Line 7b In 2021, due to the fact that MHSB received a large Medicaid Disproportionate Share Hospital (DSH) payment that included payments related to prior years. The total DSH payment received was $44,527,223, which includes approximately 25,444,430 related to years prior to 2021. Without the DSH payments related to prior years, the net community benefit expense would have been $4,674,665, 0.818% percent of total expense. Part VI, Descriptions for Part I, Line 7, Column F BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES $41,571,029 Part VI, Descriptions for Part I, Line 7 COSTING METHODOLOGY The costing method used to calculate financial assistance reported on lines 7 a through d was the cost-to-charge ratio as derived on TAX FORM 990, SCHEDULE H, WORKSHEET 2. All other community benefits were calculated using direct costs. PART VI, Descriptions for Part II, Community Building Activities Coalition Building - participation in community coalitions and other collaborative efforts with the community to address health and safety issues In 2017 The Executive Director of Beacon Community Impact was asked to represent Beacon Health System as one of six anchor organizations. Currently the director maintains this seat. This group, now recognized as the St. Joseph County Health Improvement Alliance Group, has met several times since the original assessment. Together the group worked on a vision, mission, and direction for the group. As a result of these brainstorming sessions, the group decided to focus on our stakeholders top priorities in order to increase public health infrastructure and ultimately improve the community's health. The ultimate goal is to improve the health of our community by collaboratively working together to decrease duplication of services and increase the utilization of existing services and resources. The Director of Community Impact participates on the executive team of the St. Joseph County System of Care. This group is a network of services and supports that identify and meet the needs of families, youth, and children so they may define and reach their potential. Part VI, Descriptions for Part III, Line 2 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. Part VI, Descriptions for Part III, Line 3 Bad debt attributable to the FAP is estimated based on the historical trend of the sources of the bad debt. The majority of bad debt is attributable to uninsured patients which represent the majority of the population that would fall under the FAP. We have applied the historical estimate 50% to the total bad debt expense to determine the amount attributable to the FAP. Part VI, Descriptions for Part III, Line 4 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. Part VI, Descriptions for Part III, Line 8 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. Part VI, Descriptions for Part III, Line 9b 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: Memorial Hospital of South Bend 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. Memorial Hospital, 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, Memorial Hospital 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. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| 100 BLACK MEN OF GREATER SOUTH BEND INC | ||||||||
| 2043 South Bend Ave | SOUTH BEND | IN | 46637 | 270295842 | 501(c)(3) | $15,000 | General Support | |
| UNITED WAY OF ST JOSEPH | ||||||||
| 3517 E Jefferson | SOUTH BEND | IN | 46660 | 351063368 | 501(c)(3) | $125,000 | Corporate Sponsor | |
| INDIANA UNIVERSITY FOUNDATION | ||||||||
| PO Box 7072 | Indianapolis | IN | 46207 | 356018940 | 501(C)(3) | $20,000 | EVENT Sponsorship | |
| RIVERBEND CANCER SERVICES | ||||||||
| 919 E JEFFERSON BLVD | SOUTH BEND | IN | 46617 | 350872359 | 501(C)(3) | $20,000 | PROGRAM SPONSORSHIP | |
| Beacon Medical Group INC | ||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 351536132 | 501(C)(3) | $41,518 | General Support | |
| Venues Parks and Arts Foundation | ||||||||
| 321 E WALTER STREET | South Bend | IN | 46614 | 273843043 | 501(C)(3) | $25,000 | project sponsor | |
| PLAY LIKE A CHAMPION TODAY EDUCATION SERVICES | ||||||||
| PO BOX 72 | NOTRE DAME | IN | 46556 | 813305202 | 501(C)(3) | $20,000 | PROGRAM SPONSOR | |
| IMANI UNIDAD | ||||||||
| 234 Chapin St | South Bend | IN | 46616 | 810615463 | 501(C)(3) | $20,000 | General Support | Suite B |
| MENTAL HEALTH AWARENESS OF MICHIANA | ||||||||
| 3220E Jefferson BLVD | South Bend | IN | 46615 | 824359500 | 501(C)(3) | $27,500 | General Support | |
| SOUTH BEND HERITAGE FOUNDATION INC | ||||||||
| 803 Lincolnway West | South Bend | IN | 46616 | 237394320 | 501(C)(3) | $20,000 | General Support | |
| CENTER FOR THE HOMELESS | ||||||||
| 813 South Michigan | South Bend | IN | 46601 | 351768544 | 501(C)(3) | $10,000 | General Support | |
| LACASA DE AMISTADINC | ||||||||
| 746S Meade St | South Bend | AK | 46619 | 351350013 | 501(C)(3) | $16,000 | General Support | |
| OAKLAWN PSYCHIATRIC CENTER INC | ||||||||
| PO BOX 809 | GOSHEN | IN | 46527 | 351070041 | 501(C)(3) | $20,000 | ||
| REINS OF LIFE INC | ||||||||
| 55200 Quince Rd | South Bend | IN | 46619 | 310945572 | 501(C)(3) | $12,500 | ||
| LGBTQ RESOURCE CENTER | ||||||||
| 251 East Sample St Suite 10 | South Bend | IN | 46601 | 203906347 | 501(C)(3) | $15,000 | ||
| ROBINSON COMMUNITY LEARNING CENTER | ||||||||
| 1004 N Eddy St | South Bend | IN | 46617 | 350868188 | 501(C)(3) | $20,000 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 16 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | GRANT MONITORING PROCEDURES | FormAndLineReferenceDesc |
| Explanation | Sch I, PART I, QUESTION 2 Donations and grants given to organizations that improve the health and well-being of our community are monitored through Outcome Measurement Reports that are provided to Memorial by the various organizations. These reports inform us of how the donations and grants were used. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| 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 |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffrey P Costello | ||||||||||||||
| CFO | $0 | $575,796 | $0 | $193,976 | $0 | $182,340 | $0 | $115,848 | $0 | $15,049 | $0 | $1,083,009 | $0 | $74,414 |
| Kreg Gruber | ||||||||||||||
| CEO | $0 | $947,095 | $0 | $389,336 | $0 | $150,694 | $0 | $187,021 | $0 | $19,832 | $0 | $1,693,978 | $0 | $84,167 |
| Cheryl Wibbens-Lesh MD | ||||||||||||||
| Asst. Secr./VP | $0 | $349,166 | $0 | $62,736 | $0 | $3,960 | $0 | $11,600 | $0 | $19,836 | $0 | $447,298 | $0 | $0 |
| Dale A Patterson | ||||||||||||||
| Employed Physician | $382,708 | $0 | $62,736 | $0 | $1,480 | $0 | $11,600 | $0 | $24,325 | $0 | $482,849 | $0 | $0 | $0 |
| Larry Tracy | ||||||||||||||
| President | $478,172 | $0 | $163,222 | $0 | $8,880 | $0 | $97,267 | $0 | $24,607 | $0 | $772,148 | $0 | $0 | $0 |
| Linda A Mansfield | ||||||||||||||
| EMPLOYED PHYSICIAN | $283,862 | $0 | $28,034 | $0 | $690 | $0 | $11,600 | $0 | $21,924 | $0 | $346,110 | $0 | $0 | $0 |
| Marion Mahone | ||||||||||||||
| EMPLOYED PHYSICIAN | $287,227 | $0 | $27,792 | $0 | $270 | $0 | $11,600 | $0 | $7,401 | $0 | $334,290 | $0 | $0 | $0 |
| Matthew R Reed | ||||||||||||||
| EMPLOYED PHYSICIAN | $287,475 | $0 | $27,792 | $0 | $270 | $0 | $11,600 | $0 | $7,109 | $0 | $334,246 | $0 | $0 | $0 |
| KRISTEN JENNINGS | ||||||||||||||
| DIR OF MED RESIDENCY PROGRAM | $284,449 | $0 | $29,531 | $0 | $15,270 | $0 | $11,600 | $0 | $24,349 | $0 | $365,199 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHED J, PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | MEMORIAL HOSPITAL OF SOUTH BEND, INC. OFFERS COMPLIMENTARY HEALTH CLUB MEMBERSHIP TO BEACON HEALTH SYSTEM'S HEALTH AND LIFESTYLE CENTER, A RELATED PARTY. HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: BRAD TOOTHAKER AND HUGH HEDMAN. PART I, LINE 3 MEMORIAL HOSPITAL OF SOUTH BEND, 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. SCH. J - PART 1, LINE 4B - EXECUTIVE RETENTION 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 2021, REFLECTED IN COLUMN (B)(III): . KREG GRUBER, $141,814 . JEFFREY COSTELLO, $146,062 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2021 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: . KREG GRUBER, $175,421 . JEFFREY COSTELLO, $104,248 . LARRY TRACY, $85,667 SCH. J - PART 1, LINE 7 - INCENTIVE PLANS THE ORGANIZATION HAS THREE INCENTIVE PLANS (EMPLOYEE, MANAGEMENT AND EXECUTIVE) WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR BEACON HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $4,500,000. THE PAYOUT AND AMOUNT OF THE PAYOUT FOR THE EMPLOYEE INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. THE MANAGEMENT INCENTIVE PLAN IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE MANAGEMENT INCENTIVE IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| Indiana Finance Authority | ||||||||
| A | 351602316 | 45471AQL9 | 2017-09-08 | $37,240,000 | REFUND BONDS ISSUED 03/16/2006 | false | false | false |
| HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY | ||||||||
| B | 911914363 | 79062WAA6 | 2013-05-21 | $45,523,353 | REFUND BONDS ISSUED 05/10/2007 | false | false | false |
| INDIANA FINANCE AUTHORITY | ||||||||
| C | 351602316 | 45471ALS9 | 2013-05-21 | $96,069,836 | REFUND BOND ISSD 2/3/98 & 10/22/08 | Yes (true) | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $960,000 | $0 | $37,240,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $37,240,000 | $0 | 2000 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $0 | $0 | $45,523,353 | $0 | $0 | $0 | $511,271 | $0 | $0 | $0 | $45,012,082 | $0 | 2009 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $32,598,478 | $37,637,250 | $96,069,836 | $0 | $0 | $0 | $764,791 | $0 | $0 | $0 | $95,305,045 | $0 | 2003 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Private Bus Use By OthersPrivateBusUseByOthersPct | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | |||||||||
| B | 0 | false | false | Yes (true) | Yes (true) | false | false | false | false | Yes (true) |
| C | 0 | false | false | Yes (true) | Yes (true) | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WELLS FARGO NA | |||||||||||||
| A | false | false | Yes (true) | false | Yes (true) | Yes (true) | 21.7 | false | false | false | 0 | false | Yes (true) |
| 0 | |||||||||||||
| B | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
| 0 | |||||||||||||
| C | false | false | false | Yes (true) | false | false | false | 0 | false | Yes (true) | |||
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, COLUMN A | FormAndLineReferenceDesc |
| Explanation | COLUMN A IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND, THROUGH A SERIES OF 2006 REFUNDINGS, BONDS ISSUED BEFORE 01/01/2003. PART IV, LINE 2C, COLUMN B-D THE DATE THE REBATE COMPUTATION WAS PERFORMED ON THE HOSPITAL AUTHORITY OF SANT JOSEPH COUNTY AND INDIANA FINANCE AUTHORITY WAS 5/18/2018. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STANZ FOOD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BD MBR GREATER THAN 35% | RelationshipDescriptionTxt |
| Transaction | $402,242 | TransactionAmt |
| Transaction | PURCHASED SERVICES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART I, LINE 1 | We deliver outstanding care, inspire health and connect with heart. CORE FORM, PART I, LINE 6 VOLUNTEERS - MEMORIAL HOSPITAL OF SOUTH BEND HAS A DEPARTMENT CALLED AMBASSADOR AND CUSTOMER SERVICES. IT IS THE RESPONSIBILITY OF THIS DEPARTMENT TO RECRUIT, ORIENT, PROCESS AND PLACE NEW AMBASSADORS IN APPROXIMATELY 30 SERVICE AREAS OF THE HOSPITAL. IT IS ALSO THE RESPONSIBILITY OF THE DEPARTMENT TO FOLLOW UP, SCHEDULE AND RECOGNIZE AMBASSADORS. SOME OF THE AREAS OF SERVICE INCLUDE A MAJOR SURGERY WAITING ROOM, PATIENT ESCORTS, FLOWER DELIVERY, MAIL DELIVERY, LIVING HISTORY PROGRAM, EMERGENCY DEPARTMENT VOLUNTEERS AND COOKIE BAKERS. IN 2021, MEMORIAL HAD 186 VOLUNTEERS IN THIS PROGRAM WHO SERVED 8,147 HOURS. CORE FORM, PART III, LINE 4D OTHER PROGRAM SERVICES OTHER PROGRAM SERVICES INCLUDE PSYCHIATRIC DEPARTMENTS, SOCIAL SERVICES, COMMUNITY OUTREACH PROGRAMS, TITHING, GRANTS, AND SUPPORTING SERVICES SUCH AS ADMINISTRATION, FINANCE, PAYROLL, PATIENT ACCOUNTING, LAUNDRY SERVICES, HEALTH AND LIFESTYLE CENTER, AND MEDICAL RECORDS. DUE TO THE NON-REVENUE GENERATING OR COMMUNITY INVESTMENT NATURE OF MANY OF THE PROGRAMS, THEY OPERATE AT A LOSS. SEE SCHEDULE H FOR DETAILS ON THE HOSPITALS TITHING AND COMMUNITY OUTREACH REPRESENTED IN OTHER PROGRAM SERVICES. CORE FORM, PART VI, SECTION A, LINE 4 MEMORIAL HOSPITAL, INC. UPDATED THEIR BYLAWS IN 2021. 1. The powers of the board were updated to include: a) oversee patient satisfaction outcomes. b) Oversee Employee and Medical Staff Engagement. c) Oversee the Community Health Needs Assessment Results and Action Plans. d) Interact and provide counsel to Administration and Medical Staff regarding Operations. 2. SELECTION OF DIRECTORS, TERMS, STAGGERED BOARD TERMS, AND ATTENDANCE WERE UPDATED. 3. BOARD OF DIRECTOR MEETINGS WERE UPDATED TO INCULDE MEETINGS BY INTERNET APPLICATIONS. CORE FORM, PART VI, SECTION A, QUESTION 6 MEMBERS OF THE ORGANIZATION - BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF MEMORIAL HOSPITAL OF SOUTH BEND, INC. CORE FORM, PART VI, SECTION A, QUESTION 7A ELECTION OF BOARD MEMBERS THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF MEMORIAL HOSPITAL OF SOUTH BEND AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF MEMORIAL HOSPITAL OF SOUTH BEND. CORE FORM, PART VI, SECTION A, QUESTION 7B DECISIONS OF THE BOARD OF DIRECTORS DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. BEACON HEALTH SYSTEM, THE SOLE MEMBER OF MEMORIAL HOSPITAL OF SOUTH BEND, HAS CONTROL OVER MEMORIAL HOSPITAL OF SOUTH BEND'S OPERATIONS. THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF BEACON HEALTH SYSTEM'S BOARD: 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 CORPORAION 4. OTHER MATTERS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS CORE FORM, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS 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. CORE FORM, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURE 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 AND WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT OVER 364 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 SURVEY 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 25, 2022 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2021, 23 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. CORE FORM, PART VI, SECTION B, LINE 15A & 15B COMPENSATION DETERMINATION PROCESS MEMORIAL HOSPITAL OF SOUTH BEND'S PARENT, BEACON HEALTH SYSTEM, INC. HAS AN EXTENSIVE EXAMINATION THAT IS CONDUCTED, FOR VICE PRESIDENT AND HIGHER, USING COMPARABLE MARKET DATA THAT IS 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 FOR ALL OTHER EXECUTIVES/OFFICERS TO THE BOARD FOR APPROVAL. THE INDEPENDENT CONSULTING GROUP SEPARATELY MAKES THE RECOMMENDATIONS REGARDING THE CEO'S COMPENSATION 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. CORE FORM, PART VI, SECTION C, LINE 19 AVAILABILITY OF ORGANIZATIONAL DOCUMENTS 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 THE BEACON HEALTH SYSTEM, INC. BONDS. AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR THE BEACON HEALTH SYSTEM, INC. BONDS. |
| PART XI, LINE 9 | Other Changes in the net assets of Fund Balances Write off Inter company, Beacon Health System, Inc. - (111,729,352) Change in interest in recipient org - 1,930,429 Rounding - 3 TOTAL - (109,798,920) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Beacon Medical Group Inc | ||||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351536132 | PHY PRACTICES | IN | 501(C)(3) | 10 | BHS | Yes (true) |
| Beacon Health Foundation Inc | ||||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351536129 | Financial Sup | IN | 501(C)(3) | 7 | BHS | Yes (true) |
| Elkhart General Hospital Inc | ||||||||||
| 600 East Boulevard | Elkhart | IN | 46514 | 350877574 | Hospital | IN | 501(C)(3) | 3 | BHS | Yes (true) |
| MEMORIAL ENDOWMENT FUND FOR MEM HOS | ||||||||||
| PO BOX 1602 | SOUTH BEND | IN | 46634 | 356068581 | ENDOWMENT | IN | 501(C)(3) | 12D | MHSB | Yes (true) |
| BEACON HEALTH SYSTEM Inc | ||||||||||
| 615 N MICHIGAN STREET | SOUTH BEND | IN | 46601 | 453864076 | Parent Org | IN | 501(C)(3) | 12C | NA | false |
| COMMUNITY HOSPITAL OF BREMEN INC | ||||||||||
| 1020 HIGH RD | BREMEN | IN | 46506 | 350835006 | HOSPITAL | IN | 501(C)(3) | 3 | BHS | Yes (true) |
| COMMUNITY HOSPITAL OF BREMEN FOUNDATION | ||||||||||
| 1020 HIGH RD | BREMEN | IN | 46506 | 351813755 | FINANCIAL SUP | IN | 501(C)(3) | 12B, 11 | CHB | Yes (true) |
| Three River Health System | ||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 451257972 | HOSPITAL | MI | 501(C)(3) | 3 | BHS | Yes (true) |
| THREE RIVERS HEALTH FOUNDATION | ||||||||||
| 701 S HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 201384776 | FINANCIAL SUP | MI | 501(C)(3) | 12A | TRH | Yes (true) |
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 |
|---|---|---|---|---|---|---|---|---|
| BEACON HEALTH VENTURES INC | ||||||||
| 615 N Michigan Street | South Bend | IN | 46601 | 351901068 | Home Medical | IN | NA | C |
| BEACON HEALTH VENTURES MICHIGAN INC | ||||||||
| 615 N MICHIGAN ST | SOUTH BEND | IN | 46601 | 208259773 | HOME MEDICAL | MI | NA | C |
| Integrated Health Systems Inc | ||||||||
| 701 SOUTH HEALTH PARKWAY | THREE RIVERS | MI | 49093 | 383134384 | PERSONNEL MGMT | MI | TRH | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | 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 | false | 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 | Yes (true) | 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 (15 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BEACON MEDICAL GROUP | ||
| O | $994,828 | ACTUAL CHARGES |
| BEACON MEDICAL GROUP | ||
| P | $12,505,507 | ACTUAL CHARGES |
| BEACON MEDICAL GROUP | ||
| Q | $10,307,978 | ACTUAL CHARGES |
| BEACON MEDICAL GROUP | ||
| J | $1,776,327 | ACTUAL CHARGES |
| BEACON MEDICAL GROUP | ||
| R | $2,078,507 | CASH |
| BEACON MEDICAL GROUP | ||
| S | $620,958 | CASH |
| BEACON HEALTH VENTURES | ||
| P | $726,266 | ACTUAL CHARGES |
| ELKHART GENERAL HOSPITAL | ||
| P | $1,386,513 | ACTUAL CHARGES |
| ELKHART GENERAL HOSPITAL | ||
| Q | $2,603,329 | ACTUAL CHARGES |
| BEACON HEALTH VENTURES | ||
| Q | $245,046 | ACTUAL CHARGES |
| COMMUNITY HOSPITAL OF BREMEN | ||
| Q | $10,414,070 | ACTUAL CHARGES |
| COMMUNITY HOSPITAL OF BREMEN | ||
| S | $10,346,711 | CASH |
| ELKHART GENERAL HOSPITAL | ||
| S | $729,568 | CASH |
| ELKHART GENERAL HOSPITAL | ||
| R | $487,248 | CASH |
| BEACON HEALTH FOUNDATION | ||
| C | $715,945 | ACTUAL CHARGES |