2020-11-15T14:59:06-06:00 2019-12-31 ERNST & YOUNG US LLP 155 N WACKER DRIVE 20 FLOOR CHICAGO IL 60606 990 2019-01-01 350868132 Memorial Hospital of South Bend Inc % JEFFREY COSTELLO MEMO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 JEFFREY COSTELLO CFO 5746473549 2020-11-13 true JACOB ZEHNDER P01564049 3128792702 104.187.159.70 36964520203205000020 2020-11-15 P 1DB21BA5E43097C511A7D1ADC50EBB96669EB973 08EA3ABC02870A03E2977DCD2F85AD881E89FD8E 2019 2021-01-29 14:40:06Z Larry Tracy 615 N MICHIGAN STREET SOUTH BEND IN 46601 605839935 false X beaconhealthsystem.org X 1923 IN SEE SCHEDULE O 8 6 4150 441 184425 91975 4212683 3624914 588328326 580204402 289708 236908 12403981 21363371 605234698 605429595 2391343 2269667 0 0 193387208 206896415 0 0 0 289795056 300860109 485573607 510026191 119661091 95403404 538957796 554946020 220825979 214953940 318131817 339992080 X BEACON HEALTH SYSTEM, INC. IS COMMITTED TO ENHANCING THE PHYSICAL, MENTAL, AND EMOTIONAL AND SPIRITUAL WELL-BEING OF THE COMMUNITIES WE SERVE AS THE COMMUNITY'S PROVIDER OF OUSTANDING QUALITY, SUPERIOR VALUE AND COMPREHENSIVE HEALTH CARE SERVICES. false false 118638257 0 313182649 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. 2019 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 567,311 INPATIENT PROCEDURES - 472,019 OUTPATIENT PROCEDURES - 1,158 INPATIENT CATHS - 1,667 OUTPATIENT CATHS. 113510284 0 149324294 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. 2019 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 94,418 PATIENT DAYS - 11,194 INPATIENT ER VISITS - 52,957 OUTPATIENT ER VISITS - 2,360 BIRTHS - 18,879 OBSERVATION STAYS. 61283199 0 129553731 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. 2018 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 9,382 INPATIENT PROCEDURES - 402 OPEN HEART PROCEDURES - 20,286 OUTPATIENT PROCEDURES. 185922223 2269667 0 479353963 true true false true false false false false false true true false false true true true false true false false false false false false true false true true true false true true false false false false false false false true false false false false false false false true true true false false true 280 0 true 4150 true true true false false false false false false false false false false false X 8 6 false false true false true true true true true false false true true true true true true false false true true IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 X Kreg Gruber CEO 2.0 48.0 X 0 1670567 203973 Jeffrey P Costello CFO 2.0 48.0 X 0 1208925 131675 BRYAN BOYER Trustee/Employed Physician 2.0 40.0 X 0 851880 34035 Larry Tracy President 40.0 0.0 X 596664 0 113993 BRANT SANDERS EMPLOYED PHYSICIAN 0.0 40.0 X 577575 0 11596 Dale A Patterson Employed Physician 40.0 0.0 X 453066 0 34356 JAMES LOWE EMPLOYED PHYSICIAN 0.0 40.0 X 436896 0 32138 RANDELL COULTER EMPLOYED PHYSICIAN 0.0 40.0 X 454630 0 11596 Cheryl Wibbens-Lesh MD Asst. Secr./VP 0.0 40.0 X 0 400443 35716 KRISTEN JENNINGS DIR OF MED RESIDENCY PROGRAM 40.0 0.0 X 313744 0 34405 Peter Baranay Chair 2.0 0.0 X X 1308 0 0 BRAD TOOTHAKER Vice Chair 2.0 0.0 X X 1248 0 0 HUGH HEDMAN MD TRUSTEE 2.0 0.0 X 948 0 0 KAREN BARNETT CHAIR 2.0 0.0 X X 0 0 0 TIM DURHAM Trustee 2.0 0.0 X 0 0 0 MARK HARMAN Trustee 2.0 0.0 X 0 0 0 THOMAS HAUCH MD SECRETARY 2.0 0.0 X X 0 0 0 2836079 4131815 643483 150 true true false SOUTH BEND EMERGENCY PHYSICIANS 615 N MICHIGAN SOUTH BEND IN 46601 PHYSICIAN SERVICES 3721955 SOUTH BEND MEDICAL FOUNDATION 530 N LAFAYETTE BLVD SOUTH BEND IN 46601 LAB SERVICES 4979581 GIBSON LEWIS LLC 1001 W 11TH STREET MISHAWAKA IN 46544 CONSTRUCTION 3615287 METRO AVIATION INC 1214 HAWN AVENUE SHREVEPORT LA 71107 MEDICAL FLIGHTS 2025547 PANZICA2 A JOINT VENTURE 416 EAST MONROE ST SUITE 320 SOUTH BEND IN 46601 CONSTRUCTION 13521072 142 1321013 2303901 3624914 NET PATIENT REVENUE 622110 576998736 576998736 AFFILIATE RENTAL REVENUE 532000 2094658 2094658 JOINT VENTURE ACTIVITY 561499 918679 918679 AMBULANCE SUPPLY 621910 107274 107274 CASH DISCOUNTS 611710 52541 52541 32514 32514 580204402 147467 147467 31 31 0 1293944 14075 1279869 0 1279869 1279869 0 130289 7531 33348 -7531 96941 89410 89410 264276 355386 -91110 -91110 0 0 0 0 0 0 HLC ATHLETIC CLUB 713940 5999920 5966319 33601 OUTPATIENT PHARMACY 561499 5933335 5933335 VENDOR REBATES 713940 1591732 1591732 6649625 4298221 184425 2166979 20174612 605429595 592060674 184425 9559582 2269667 2269667 0 0 0 714161 714161 0 164575771 149434800 15140971 5479564 4975444 504120 25341807 23010361 2331446 10785112 9792882 992230 245013 222472 22541 131382 131382 277553 277553 17044 15476 1568 0 21924 21924 41209528 39378987 1830541 203681 184942 18739 4420908 4014184 406724 61086 55466 5620 0 6125181 5561664 563517 793748 720723 73025 0 62061 56351 5710 5185562 4708490 477072 0 30322914 27533206 2789708 3218888 2922750 296138 MEDICAL SUPPLIES 103400803 103400803 BAD DEBT EXPENSE 37156745 37156745 CORPORATE ALLOCATION 41723640 37885065 3838575 HOSPITAL ASSESSMENT FEE 23793725 23793725 2488723 2259760 228963 510026191 479353963 30672228 0 20401 19526 -3714006 11957914 596814 422142 98674931 107763356 0 0 0 0 0 0 17813996 17209333 1773700 2015306 864871820 489636532 364408738 375235288 2718128 2824030 0 0 261355 270034 1171474 1171474 55232265 36057617 538957796 554946020 44212885 41553003 0 0 144305 21288 148972182 143661411 0 0 0 0 296473 107637 0 0 27200134 29610601 220825979 214953940 X 312373852 333014441 5757965 6977639 318131817 339992080 538957796 554946020 X 95403404 394943 -73938084 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 17044 17044 false false SCHED C, PART IV 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) - 60% APTA (American Physical Therapy Association) - 23% ANFP (Association of Nutrition & Foodservice Professionals) - 1% ACHE (American College of Healthcare Executives) - 1% ASHP (American Society of Health-System Pharmacists) - 19% CAP (College of American Pathologists) - 35% ACS (American College of Surgeons) - 4% AND (Academy of Nutrition and Dietetics) - 13% NACH (National Association of Children's Hospitals) - 25% APA (American Psychiatry Association) - 14% 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. 30834712 2588247 3242314 1740359 34924914 34205140 1352757 -2479196 2243989 30834712 33854961 2155261 2479263 4284345 34205140 26556022 9605449 339397 2645907 33854961 29619029 4093832 -1367472 5789367 26556022 0.80030 0.00210 0.19760 false true true 21501410 21501410 528305464 223563929 304741535 851999 851999 0 309524546 263996152 45528394 4688401 1224452 3463949 375235288 DUE FROM 3RD PARTY PAYORS 20000382 INT IN NET ASSETS OF REC ORG 6977639 INTEREST RECEIVABLE - SWAP 129936 OTHER RECEIVABLES 5591860 2016 BOND FUND 11573 AFFILIATE INTERCO 770228 RIGHT OF USE FINANCING ASSET 2253391 SWAP MTM RECEIVABLE 322608 36057617 0 INTEREST RATE SWAP 14884451 ASSET RETIREMENT OBLIGATION 4896702 IBNR 3212580 DUE TO THIRD PARTY 4356727 CAPITAL LEASE PAYABLE 1 29610601 X 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, 2019 or 2018. MARATHON 264276 264276 2700 584 5558 346544 0 264276 264276 2700 584 5558 346544 355386 -91110 Part II Event #1 Memorial Hospital of South Bend facilitates an annual sunburst marathon by collecting registration payment and organizing the event. All contributions are directed to and recorded by Beacon Health Foundation. It is common for the event to be run at a loss as all the sponsorship and contribution income is recorded by Beacon Health Foundation. true true X true X true X true true false true true 2696536 2696536 0.00570 106185824 81793284 24392540 0.05160 0 0 0 0.00000 108882360 81793284 27089076 0.05730 4628220 2131693 2496527 0.00530 7907296 1680788 6226508 0.01320 0 0 0 0.00000 507617 391730 115887 0.00020 332128 0 332128 0.00070 13375261 4204211 9171050 0.01940 122257621 85997495 36260126 0.07670 27851 142 27709 0.00010 27851 142 27709 0.00010 true 9107118 4553559 85892296 119798847 -33906551 X true true 1 1 MEMORIAL HOSPITAL OF SOUTH BEND INC 615 N MICHIGAN STREET SOUTH BEND IN 46545 www.BeaconHealthSystem.org 16-005053-1 X X X X X X MEMORIAL HOSPITAL OF SOUTH BEND INC 1 false false true X X X X X X X X X 18 true true true true X www.beaconhealthsystem.org/chna X X true 19 true www.beaconhealthsystem.org/chna false true X 200. 350. X X X true true X X X true X See Section C for full URL X See Section C for full URL X See Section C for full URL X X X X X X true X false X X X X true X false false PART V, Section B, Line 5 The data collection and analysis process started in February and concluded on September 2018. The key findings were consolidated in two reports: the first provided a snapshot of the three-county overall health status, and the second focused on the health needs of children in Elkhart, St. Joseph and Marshall counties. The Key Informant Survey collected information from March 28th to August 20th, 2018. The Community Survey was launched on May 7th and was closed on August 20th, 2018. The methodology followed for the needs assessment was based on 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. Since community engagement and feedback are essential to the integrity and validity of the CHNA process, input was actively solicited and secured from three sources (elaborated below) to understand community health needs. To ensure a representative sample of the community completed the community survey, a special effort was made to get feedback from hard to reach and minority populations. In addition to the survey being pushed out through digital platforms and listservs in both English and Spanish, the Beacon Community Impact/enFocus team (which is an organization that assisted with the community health needs assessment) partnered with 35 different organizations to collect feedback and attended 8 community events (listed below) to directly target individuals who typically do not complete community surveys. Beacon Community Impact's partner organizations provided recommendations and restrictions for creating a variety of strategies to engage these harder-to reach samples within the tri-county population. 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 along with enFocus also 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: St. Joseph County: - 100 Black Men of SJC - Center for the Homeless - Community Foundation of St. Joseph County - Goodwill Industries - Hope Ministries - Imani Unidad - IUSB Division of Health Sciences - IUSB School of Nursing - Ivy Tech Community College - La Casa de Amistad - The LGBTQ Center - Notre Dame - South Bend Community School Corporation - South Bend-Elkhart Regional Partnership - South Bend Heritage Foundation - South Bend Veterans Center - St. Joseph County Public Library - St. Margaret's House - TREES, Inc - United Church of Christ - United Religious Community - United Way of St. Joseph County - Youth Service Bureau South Bend. Elkhart County: - Community Foundation of Elkhart County - Church Community Services - Elkhart County Public Library - Faith Mission of Elkhart - Greater Elkhart Chamber of Commerce - Heart City Health - Mosaic Health & Healing Arts - Minority Health Coalition - Northern Indiana Hispanic Health Coalition - RETA: Reason Enough to Act - Ribbon of Hope Cancer Support - United Health Services. Marshall County: -Bowen Center - Marshall County System of Care - United Way of Marshall County (Trustees at Purdue University) - Marshall County. Additional efforts were made to reach the at-risk individuals in the community. Beacon and enFocus solicited and received input from the vulnerable and broader community by attending the following community events. Community Outreach Events: - Faith Mission of Elkhart - Elkhart County Public Library - Best Week Ever - St. Joseph County Public Library - Minority Health Coalition - Northern Indiana Hispanic Health Coalition - Center for the Homeless - Heart City Health The assessment process identified four health priorities that can be streamlined into the essential components of Beacon Health System's mission. The Healthy Mind, Healthy Body, Healthy Spirit and Healthy Families pillars 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 2018 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 posting on the MHSB website at BeaconHealthSystem.org/CHNA and through email transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums. Part V, Section B, Line 11 Overall In 2019, Beacon Community Impact provided community resources to 40,168 individuals in the priority areas of Healthy Body, Healthy Families, Healthy Mind, and Healthy Spirit. Healthy Mind had the largest number of participants, which includes the department's ACE Interface Initiative. Healthy Spirit had the lowest number of participants, but it is also the department's newest priority. The department plans to see a greater number of participants in subsequent years as programming develops around substance use issues. St. Joseph County had the greatest number of participants served, followed by Elkhart and then Marshall County. Similar to the Healthy Spirit priority, Marshall County is Beacon Community Impact's newest service area and has the smallest number of residents. The goal for 2019 was to service 55% of participants in St. Joseph County, 40% of participants in Elkhart County and 5% of participants in Marshall County. Implementation Strategies - As a general rule, the implementation of any of the four 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. Healthy Body - Obesity/ Overweight The Healthy Body priority is aimed at reducing obesity in youth and adults through increased physical activity and improved nutrition. In 2019, Beacon Community Impact engaged with six programs in this priority, serving a total of 7,228 people. Most participants engaged with the Healthy Body priority through health education and awareness activities, while a small percentage of the programs were geared towards Action (behavior change). Compared to the previous year, Beacon Community Impact saw a 130% increase in Healthy Body participants. Indicators: Youth leisure time, Adult leisure time, Adult BMI, and Youth BMI Programs: Achieve, Dame tu Mano Class, Dame tu Mano Radio, Diabetes Alliance Program Healthy Hearts and Women, Infant and Children Current Gap: - Obesity rates in 2017 for EC (14.5%), MC (15.2%) and SJC (14.3%) are higher than IN. - 1 in 3 children ages 10-17 are overweight or obese (33.9%), - According to WIC, by 2017, 13.5% of children between 2-5 years of age who were part of the program were obese. Intended Health Outcome: - By the end of the program cycle, obesity and overweight rates are reduced through the adoption of individual habits of healthier nutrition and increased physical activity. Behavioral Objective: - By the end of the program cycle, participants are consuming enough healthier food to cover their caloric needs and are engaged in regular physical activity, in accordance to attitudes and practices promoted by BHS. Rationale: - Obesity results from a combination of causes and contributing factors, including individual factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. - Obesity is often associated with poorer mental health outcomes, reduced quality of life, and the leading causes of death in the U.S. and worldwide, including diabetes, heart disease, stroke, and some types of cancer. Healthy Mind - Mental Health The Healthy Mind priority is aimed at improving the mental and behavioral health of the community. It also houses the department's ACE Interface initiative, which is geared towards breaking the cycle of trauma and supporting safe communities. In 2019, Healthy Mind supported 17 programs in providing mental health resources to 18,721 community members. Indicators: Youth who were electronically bullied, Youth with an adult in their lives with whom they can talk to about their health, Adults with an adult in their lives with whom they can talk to about their health Programs: ACE Interface, ACT-Embrace, ADAP (Adolescent Depression Awareness Program), ATIP-EMD, Digital Citizenship, Draw the Line/Respect the Line, Healthy Boundaries (Stress Happens) - KOHLS BE A HERO, Horizon Education Alliance-PAX Elkhart, County Health Department, Horizon Education Alliance, Elkhart Education Foundation Kindness to Prevent Blindness, Leighton Lecture Impact Series, PEERS Project, QPR Suicide Prevention Training, Ribbon of Hope, RiverBend Cancer Services, YWCA Take Charge, United Health Services, Yellow Ribbon Suicide Prevention Program Current Gap: - The prevalence estimates for the IN North Central Region show that 4.7% of resident adults have suffered from a serious mental illness (diagnoses resulting in serious functional impairment). - EC and SJC averaged 4.2 days of poor mental in the past 30 days before being surveyed. Intended Health Outcome: - By the end of the program cycle, participants are better able to cope with mental and emotional distress through enhanced community capacities (ability to provide mental health services). Behavioral Objective: - By the end of the program cycle, participants' socioemotional competences to reduce mental and emotional distress are strengthened. Rationale: - 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), experiencing other chronic medical conditions (such as cancer or diabetes), biological factors, use of alcohol or drugs, and being/feeling lonely or isolated. Healthy Spirit - Substance Abuse The Healthy Spirit priority, new as of this current CNHA cycle, aims at reducing substance abuse and tobacco use. In 2019 there were six programs aimed at substance abuse that served a total of 770 community members. Moving forward, Community Impact will focus on increasing resources to address this issue. The Department is laying the foundation for increasing impact by growing the network of partners, increasing the number of programs, and securing additional funding through state, federal, and private grants. Indicators: Adults who use tobacco, Youth who use tobacco, Non-fatal ER visits due to opioid overdose Programs: Opioid Public Health Crisis, SB Heritage Foundation- Oliver Apartments, South Bend Group Violence Intervention Call-In, SPA (Spiritual & Personal Adjustments) Women's Ministry Homes, This is (Not) About Drugs (TINAD) Current Gap: - Drug overdose mortality rates have increased from 2014 to 2016 in all three counties (SJC, from 13.5% to 22.3%; EC, from 11.9% to 12.3%; and MC, from 7.8% to 9.3%). - Excessive Drinking rates have increased from 2014 to 2016 in all three counties (SJC, from 15.6% to 19.5%; EC, from 15.5% to 15.7%; and MC, from 16.2% to 17.2%). Intended Health Outcome: - By the end of the program cycle, participants are better able to cope with substance use disorder (SUD) by strengthening their socioemotional competencies. Behavioral Objective: - By the end of the program cycle, participants' socioemotional competences to reduce exposure to SUDs are strengthened. Rationale: - Excessive drinking is a risk factor for a number of adverse health outcomes, such as alcohol poisoning, hypertension, acute myocardial infarction, sexually transmitted infections, unintended pregnancy, fetal alcohol syndrome, sudden infant death syndrome, suicide, interpersonal violence, and motor vehicle crashes. - Drug use is also a risk factor for respiratory conditions and cancer. - Substance use disorders can be fatal to the user or others, by causing drunk driving fatalities and drug overdoses. - Mental illnesses and substance use disorders often occur together (sometimes as a contributing factor to the other, or by making it worse). Healthy Families - Maternal/Infant Health The Healthy Family priority services families with the goal of reducing infant mortality, improving outcomes in maternal health and offering resources for child development. In 2019, Beacon Community Impact served a total of 13,389 participants compared to 11,667 served in 2018. The bulk of these participants came from the Action (behavior change) category, though in general th 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. 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/assist 6 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 Part VI, Descriptions for Part I, Line 3c Factors to be considered for Financial Assistance Household Size and Income The following factors may be considered in determining the eligibility of the patient for assistance and must be provided by all income earning residents in the countable household unit unless they are not dependents based on IRS guidelines for determining whether a household member can be considered a dependent. 1. Indiana workforce wage report for last 2 quarters (unemployment income) 2. Last 3 pay stubs or a letter or printout from employer(s) providing verification of gross income if currently employed. This documentation should not be more than 30 days old from date of issue and include year-to-date information. 3. Last 3 bank statements (including explanations of regular deposits not explained by pay stubs) 4. Social Security award or entitlement letter or other proof of gross monthly award. 5. Retirement income. 6. Investment income. 7. Statement from person(s) that are providing direct support. 8. Number of dependents. 9. Most recent tax return (including W2 and all supporting schedules). 10. Other financial obligations. 11. 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 7, Column F BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES $37,156,745 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, Line 6 In 2017 The Executive Director of Beacon Community Impact was asked to represent Beacon Health System as one of six anchor organizations. She currently 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 (50%). 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 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. 2. If a patient has begun making payments but then is later determined to qualify under the FAP, Memorial Hospital would issue a refund to the patient for any amount that has been determined to exceed their newly determined financial responsibility. 3. Memorial Hospital of South Bend may request and collect a deposit, based on the patient's total estimated portion of a bill, from appropriate non-emergency inpatient admissions, same day surgery patients, and patients scheduled for high-dollar outpatient procedures prior to or at the time of admission or registration. In the event that a request for payment is not made prior to o true THE CENTER FOR THE HOMELESS 813 South Michigan SOUTH BEND IN 46601 351768544 501(C)(3) 16000 auction sponsor UNIVERSITY OF NOTRE DAME MAIN BUILDING Notre Dame IN 46556 350868188 501(c)(3) 7500 Research Donation SOUTH BEND HERITAGE FOUNDATION INC 803 Lincolnway West SOUTH BEND IN 46616 237394320 501(c)(3) 27500 project sponsor UNITED WAY OF ST JOSEPH 3517 E Jefferson SOUTH BEND IN 46660 351063368 501(c)(3) 50000 Corporate Sponsor ENFOCUS INC 506 W South St South Bend IN 46601 455638209 501(C)(3) 10000 Contribution INDIANA UNIVERSITY FOUNDATION PO Box 7072 Indianapolis IN 46207 356018940 501(C)(3) 10000 EVENT Sponsorship RIVERBEND CANCER SERVICES 919 E JEFFERSON BLVD SOUTH BEND IN 46617 350872359 501(C)(3) 20000 PROGRAM SPONSORSHIP Beacon Medical Group INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 501(C)(3) 1831850 CONTRIBUTION FOR CLINICS ST JOSEPH COUNTY HEALTH DEPARTMENT 227 W JEFFERSON BLVD SOUTH BEND IN 46601 356000194 501(C)(3) 21250 project sponsor YWCA 1102 S FELLOWS ST SOUTH BEND IN 46617 350868226 501(C)(3) 30500 program sponsor CITY OF SOUTH BEND 321 E WALTER ST SOUTH BEND IN 46614 273843043 501(C)(3) 45000 EVENT SPONSORSHIP SOUTH BEND EDUCATION FOUNDATION 215 S ST JOSEPH ST SOUTH BEND IN 46624 351959196 501(C)(3) 30000 CORPORATE SPONSORSHIP ELKHART EDUCATION FOUNDATION 2746 OLD US 20 WEST STE B ELKHART IN 46514 463429545 501(C)(3) 20000 PROGRAM SPONSORSHIP NEAR NORTHWEST NEIGHBORHOOD PO BOX 1132 SOUTH BEND IN 46624 237414729 14500 PROJECT SPONSORSHIP MICHIANA VEGFEST 125 E POKAGON SOUTH BEND IN 46617 830797029 501(C)(3) 11000 PROJECT SPONSORSHIP FOUNDATION FOR THE CENTER FOR HOSPICE 111 SUNNYBROOK CT SOUTH BEND IN 46637 300433147 501(c)(3) 10000 CAMPAIGN PLEDGE UNITED HEALTH SERVICES 6910 N MAIN STREET BLDG 9 MAIL UNIT 10 GRANGER IN 46530 351118647 501(C)(3) 10000 EVENT SPONSORSHIP PLAY LIKE A CHAMPION TODAY EDUCATION SERVICES PO BOX 72 NOTRE DAME IN 46556 813305202 501(C)(3) 7500 PROGRAM SPONSOR GENTLEMAN AND SCHOLARS INC 1412 W WASHINGTON ST SOUTH BEND IN 46601 465141303 501(C)(3) 6000 EVENT SPONSORSHIP GOODWILL INDUSTRIES PO BOX 3846 SOUTH BEND IN 46619 530196588 501(C)(3) 6000 LITTLE LIBRARY SPONSORSHIP 19 1 GRANT MONITORING PROCEDURES 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. X true true false true false false false false false true false Jeffrey P Costello CFO 0 536899 0 213297 0 458729 0 112590 0 19085 0 1340600 0 380118 Kreg Gruber CEO 0 792493 0 435000 0 443074 0 172991 0 30982 0 1874540 0 377156 Cheryl Wibbens-Lesh MD Asst. Secr./VP 0 328039 0 68750 0 3654 0 11200 0 24516 0 436159 0 0 Dale A Patterson Employed Physician 360191 0 61875 0 31000 0 11200 0 23156 0 487422 0 0 0 BRYAN BOYER Trustee/Employed Physician 0 824983 0 25229 0 1668 0 11200 0 22835 0 885915 0 0 Larry Tracy President 418010 0 170100 0 8554 0 89867 0 24126 0 710657 0 0 0 BRANT SANDERS EMPLOYED PHYSICIAN 547485 0 1136 0 28954 0 11200 0 396 0 589171 0 0 0 RANDELL COULTER EMPLOYED PHYSICIAN 414967 0 568 0 39095 0 11200 0 396 0 466226 0 0 0 JAMES LOWE EMPLOYED PHYSICIAN 411706 0 568 0 24622 0 11200 0 20938 0 469034 0 0 0 KRISTEN JENNINGS DIR OF MED RESIDENCY PROGRAM 267559 0 30915 0 15270 0 11200 0 23205 0 348149 0 0 0 SCHED J, PART I, LINE 1A MEMORIAL HOSPITAL OF SOUTH BEND, INC. OFFERS COMPLIMENTARY HEALTH CLUB MEMBERSHIP TO BEACON HEALTH SYSTEM'S HEALTH AND LIFESTYLE CENTER, A RELATED PARTY. MEMORIAL HOSPITAL OF SOUTH BEND INC. REIMBURSES DIRECTORS FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS FOR SPOUSAL TRAVEL. MEMORIAL HOSPITAL OF SOUTH BEND INC. ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: PETER BARANAY, THOMAS HAUCH, BRAD TOOTHAKER, KAREN BARNETT, 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 2019, REFLECTED IN COLUMN (B)(III): . KREG GRUBER, $106,338 . JEFFREY COSTELLO, $99,427 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2019 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: . KREG GRUBER, $161,791 . JEFFREY COSTELLO, $101,390 . LARRY TRACY, $78,667 BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE LONGEVITY BONUS PLAN FOR THE PURPOSE OF PROVIDING A LONGEVITY BONUS FOR ITS DESIGNATED EXECUTIVES. THIS UNFUNDED PLAN WAS EFFECTIVE APRIL 1, 2014. THE PARTICIPANTS MUST REMAIN IN AN ACTIVE EMPLOYMENT STATUS WITH BEACON FOR A PERIOD OF 5 CONSECUTIVE YEARS FROM THE EFFECTIVE DATE TO BE ELIGIBLE TO RECEIVE THE FULL LONGEVITY BONUS AMOUNT AT WHICH TIME VESTING IS 100%. VESTING PRIOR TO THE 5 YEARS IS AT 0%. THE MAXIMUM BONUS AWARD AT 100% VESTING IS $325,000. THE FOLLOWING INDIVIDUALS EARNED THESE AMOUNTS IN 2019 TOWARDS THE LONGEVITY BONUS PLAN: . KREG GRUBER, $16,250 . JEFFREY COSTELLO, $16,250 THE LONGEVITY BONUS PLAN BECAME FULLY VESTED IN 2019 AND WAS PAID OUT TO THE FOLLOWING INDIVIDUALS, REFLECTED IN COLUMN B(III): . KREG GRUBER, $325,000 . JEFFREY COSTELLO, $325,000 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 PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET OPERATING INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. THE PAYOUT OF THE MANAGEMENT INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP PLAN PAYS A SLIDING PERCENTAGE OF BASE COMPENSATION IF THE NET OPERATING INCOME IS EQUAL TO OR GREATER THAN 80% OF THE BUDGETED NET INCOME. THE SLIDING SCALE CAPS WHEN OPERATING INCOME REACHES 120% OF THE BUDGETED OPERATING INCOME. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. A Indiana Finance Authority 351602316 45471AQL9 2017-09-08 37240000 REFUND BONDS ISSUED 03/16/2006 false false false B HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 911914363 79062WAA6 2013-05-21 45523353 REFUND BONDS ISSUED 05/10/2007 false false false C INDIANA FINANCE AUTHORITY 351602316 45471ALS9 2013-05-21 96069836 REFUND BOND ISSD 2/3/98 & 10/22/08 false false false D INDIANA FINANCE AUTHORITY 351602316 000000000 2013-04-29 7492187 URGENT CARE HELICOPTER false false false A 460000 0 37240000 0 0 0 0 0 0 0 37240000 0 2000 true false true true B 0 0 45523353 0 0 0 511271 0 0 0 45012082 0 2009 true false true true C 25101913 0 96069836 0 0 0 764791 0 0 0 95305045 0 2003 true false true true D 7121328 0 7492187 0 0 0 66925 0 0 7425262 0 0 2013 false false true true A 0 B false false true true false 0 false false false true C false false true true false 0 false false false true D false false false 0 false false false true A false false true false true true WELLS FARGO NA 21.7 false false false 0 false true B false false false true false false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true false false 0 false 0 false true A true B true C true D true PART III, COLUMN A 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. STANZ FOOD BOARD MEMBER GREATER THAN 35% OWNERSHIP 251578 PURCHASED SERVICES false CORE FORM, PART I, LINE 1 BEACON HEALTH SYSTEM, INC. IS COMMITTED TO ENHANCING THE PHYSICAL, MENTAL, AND EMOTIONAL AND SPIRITUAL WELL-BEING OF THE COMMUNITIES WE SERVE AS THE COMMUNITY'S PROVIDER OF OUSTANDING QUALITY, SUPERIOR VALUE AND COMPREHENSIVE HEALTH CARE SERVICES. 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 2019, MEMORIAL HAD 441 VOLUNTEERS IN THIS PROGRAM WHO SERVED 34,258 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. FORM 990, PART VI, SECTION A, LINE 4 MEMORIAL HOSPITAL OF SOUTH BEND, INC. UPDATED THEIR CORPORATE BYLAWS IN 2019 TO ALIGN THE AFFILIATE ENTITIES BYLAWS WITH THE PARENT COMPANY, BEACON HEALTH SYSTEM. CHANGES INCLUDED: 1. THE TREASURER OFFICER POSITION WAS ELIMINATED 2. TERM LIMITS FOR DIRECTORS WAS INCREASED FROM TWO TERMS TO THREE CONSECTUIVE TERMS 3. THE ATTENDANCE POLICY WAS UPDATED TO REQUIRE DIRECTORS TO ATTEND AT LEAST 75% OF BOARD MEETINGS (UPDATED FROM 50%) 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. NOMINATION AND ELECTION OF BOARD MEMBERS, 4. APPOINTMENT AND EVALUATION OF THE PRESIDENT OF MEMORIAL HOSPITAL OF SOUTH BEND, AND 5. EXECUTIVE COMPENSATION. 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 356 STATEMENTS AND ARE WORKING TO ACHIEVE A 100% RESPONSE RATE. EACH RESPONSE IS REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT AND THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AS WELL AS THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 2. THE SECOND STATEMENT IS THE BOARD DUALITY OF INTEREST STATEMENT THAT IS SENT TO CURRENT BOARD MEMBERS, FORMER BOARD MEMBERS FROM THE LAST FIVE YEARS, AND OTHER KEY EMPLOYEES. THE DUALITY OF INTEREST STATEMENT IS SENT USING A WEB BASED SURVEY TOOL PROVIDED BY ERNST & YOUNG. THE REPLIES ARE REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT. THE RESULTS OF THE SURVEYS ARE SUMMARIZED USING THE WEB BASED TOOL, AND ARE REVIEWED BY ERNST & YOUNG IN COMPLETING THE 990. THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 3. THE THIRD STATEMENT IS ENTITLED "CODE OF ETHICS FOR SENIOR FINANCIAL OFFICERS". THE STATEMENT REQUIRES AN ACKNOWLEDGEMENT FORM TO BE SIGNED BY BEACON HEALTH SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT ON JANUARY 24, 2020 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2020, 20 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. PART XI, LINE 9 Other Changes in the net assets of Fund Balances Write off Inter company, Beacon Health System, Inc. - (75,157,766) Change in interest in recipient org - 1,219,674 Rounding - 7 TOTAL - (73,938,085) Beacon Medical Group Inc 615 N Michigan Street South Bend IN 46601 351536132 PHY PRACTICES IN 501(C)(3) 10 BHS true Beacon Health Foundation Inc 615 N Michigan Street South Bend IN 46601 351536129 Financial Sup IN 501(C)(3) 7 BHS true Elkhart General Hospital Inc 600 East Boulevard Elkhart IN 46514 350877574 Hospital IN 501(C)(3) 3 BHS true MEMORIAL ENDOWMENT FUND FOR MEM HOS PO BOX 1602 SOUTH BEND IN 46634 356068581 ENDOWMENT IN 501(C)(3) 12D MHSB true BEACON HEALTH SYSTEM Inc 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 Parent Org IN 501(C)(3) 12A NA false COMMUNITY HOSPITAL OF BREMEN INC 1020 HIGH RD BREMEN IN 46506 350835006 HOSPITAL IN 501(C)(3) 3 BHS true COMMUNITY HOSPITAL OF BREMEN FOUNDATION 1020 HIGH RD BREMEN IN 46506 351813755 FINANCIAL SUP IN 501(C)(3) 12B, 11 CHB true 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 true true true false false false false false false false false false true true true true true true true BEACON MEDICAL GROUP B 1831850 ACTUAL CHARGES BEACON MEDICAL GROUP O 1805459 ACTUAL CHARGES BEACON MEDICAL GROUP P 5513688 ACTUAL CHARGES BEACON MEDICAL GROUP Q 4753267 ACTUAL CHARGES BEACON MEDICAL GROUP A 1498892 ACTUAL CHARGES BEACON HEALTH VENTURES P 530993 ACTUAL CHARGES BEACON HEALTH VENTURES Q 229818 ACTUAL CHARGES BEACON HEALTH VENTURES R 283347 CASH ELKHART GENERAL HOSPITAL P 1622500 ACTUAL CHARGES ELKHART GENERAL HOSPITAL Q 1435722 ACTUAL CHARGES BEACON HEALTH FOUNDATION C 1321013 ACTUAL CHARGES COMMUNITY HOSPITAL OF BREMEN Q 10720954 ACTUAL CHARGES COMMUNITY HOSPITAL OF BREMEN S 9862878 CASH COMMUNITY HOSPITAL OF BREMEN A 1043 ACTUAL CHARGES