ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-0661244)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-15
IRS object ID: 201841359349303379
Schema version: 2016v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-15T10:00:57-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE HORWATH LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	225 West Wacker Drive Suite 2600	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606061224	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	370661244	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	St Mary's Hospital Decatur of the Hospital Sisters of the Third Order of St	BusinessNameLine1Txt
Business Name Line2	Francis	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	STMA	BusinessNameControlTxt
Phone	2174642966	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1800 E LAKE SHORE DRIVE	AddressLine1Txt
City	Decatur	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62521	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Joan Coffman	PersonNm
Person Title	Chief Executive Officer	PersonTitleTxt
Signature	2018-05-11	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RACHEL SPURLOCK	PreparerPersonNm
PTIN	P00520729	PTIN
Phone	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Joan Coffman	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1800 E LAKE SHORE DRIVE	AddressLine1Txt
City	Decatur	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62521	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$147,708,968	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STMARYSDECATUR.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1878	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	TO PARTICIPATE IN THE HEALTH CARE MINISTRY OF THE CHURCH AND PROVIDE A FAMILY-CENTERED APPROACH IN MEETING THE COMMUNITY'S HEALTH CARE NEEDS REGARDLESS OF ABILITY TO PAY.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	1260	TotalEmployeeCnt
Total Volunteers	350	TotalVolunteersCnt
Total Gross UBI	$55,673	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$43,977	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$418,671	PYContributionsGrantsAmt
CY Contributions Grants	$283,469	CYContributionsGrantsAmt
PY Program Service Revenue	$146,568,604	PYProgramServiceRevenueAmt
CY Program Service Revenue	$145,272,433	CYProgramServiceRevenueAmt
PY Investment Income	$41,528	PYInvestmentIncomeAmt
CY Investment Income	$3,450	CYInvestmentIncomeAmt
PY Other Revenue	$250,306	PYOtherRevenueAmt
CY Other Revenue	-$94,939	CYOtherRevenueAmt
PY Total Revenue	$147,279,109	PYTotalRevenueAmt
CY Total Revenue	$145,464,413	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$55,405,642	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$57,120,563	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$83,836,356	PYOtherExpensesAmt
CY Other Expenses	$86,859,099	CYOtherExpensesAmt
PY Total Expenses	$139,241,998	PYTotalExpensesAmt
CY Total Expenses	$143,979,662	CYTotalExpensesAmt
PY Revenues Less Expenses	$8,037,111	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,484,751	CYRevenuesLessExpensesAmt
Total Assets BOY	$136,787,360	TotalAssetsBOYAmt
Total Assets EOY	$141,330,225	TotalAssetsEOYAmt
Total Liabilities BOY	$88,723,714	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$96,407,928	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$48,063,646	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$44,922,297	NetAssetsOrFundBalancesEOYAmt
Mission	THE MISSION OF ST. MARY'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$74,031,770	ExpenseAmt
Revenue	$146,031,806	RevenueAmt
Desc	SEE SCHEDULE O - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Desc
Total Program Service Expenses	$74,031,770	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
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	392	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1260	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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SHANE KITCHENS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	2174642590	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1800 E LAKE SHORE DRIVE	AddressLine1Txt
City	DECATUR	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62521	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DANIEL PERRYMAN
Chief Executive Officer, President	60.0	0.0	Yes (X)	Yes (X)	$0	$345,849	$37,222
EVERT J KUIPER
CEO CENTRAL ILLINOIS DIV/Interim Pres	18.0	42.0	Yes (X)	Yes (X)	$0	$814,237	$169,389
Bob Wiesemann
Chair, Board Member	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Lori Kerans
Vice Chair, Board Member	1.0	0	Yes (X)	Yes (X)	$0	$0	$0
Kevin Breheny
2017 Secretary	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
SR Helen Marie Plummer OSF
2016 Secretary	1.0	3.0	Yes (X)	Yes (X)	$0	$0	$0
MATT Bennett
Board Member	1.0	0	Yes (X)		$0	$0	$0
Gary Birschbach
Board Member	1.0	0	Yes (X)		$0	$0	$0
MARK CHEVIRON
BOARD MEMBER	1.0	0	Yes (X)		$0	$0	$0
MICHAEL W COTTRELL
Board Member	1.0	59.1	Yes (X)		$0	$877,154	$229,172
Pat Dawson
Board Member	1.0	0	Yes (X)		$0	$0	$0
Alan Frigy MD
Board Member	1.0	0	Yes (X)		$0	$0	$0
SR BERNADINE GUTOWSKI OSF
Board Member	1.0	4.0	Yes (X)		$0	$0	$0
Claudia Madding
Board Member	1.0	0	Yes (X)		$0	$0	$0
Joseph Molloy Rev
Board Member	1.0	0	Yes (X)		$0	$0	$0
Mary Walker
Board Member	1.0	0	Yes (X)		$0	$0	$0
ANN M CARR
TREASURER	0.0	59.6		Yes (X)	$0	$359,960	$312,526
SHERRI A GREENWOOD
DIVISION CHIEF NURSING OFFICER	5.0	0.0		Yes (X)	$0	$84,867	$0
REBECCA PUCLIK
DIVISIONAL CHIEF PEOPLE OFFICER	10.0	50.0		Yes (X)	$0	$244,372	$90,654
STEVEN UMLAND
CHIEF FINANCIAL OFFICER - CENTRAL IL DIVISION	16.0	45.0		Yes (X)	$0	$443,765	$94,472
MARY HARTMAN
CRNA	40.0	0			$284,825	$0	$188,363	Yes (X)
Deanna Y Hitchens
CRNA	40.0	0			$233,823	$0	$94,594	Yes (X)
Sheila A Holliden
CRNA	40.0	0			$237,288	$0	$199,941	Yes (X)
Roberta S McBride
CRNA	40.0	0			$251,191	$0	$266,870	Yes (X)
Beth A McCoy
CRNA	40.0	0			$304,628	$0	$173,682	Yes (X)
Lauren R Remley
CRNA	40.0	0			$224,353	$0	$42,064	Yes (X)
DAVID OLEJNICZAK
Former Interim CEO	0.0	60.0			$0	$530,943	$117,219		Yes (X)
THERESA J RUTHERFORD
Former COO	0.0	60.0			$0	$409,764	$194,158		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,536,108	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,110,910	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,210,326	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	41	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
SODEXO
488 PAYSPHERE CIRCLE	DECATUR	IL	60674	FOOD SERVICE/EVS MANAGEMENT	$1,784,830
Infinity Meds LLP
111 E Wisconsin Ave	Milwaukee	WI	53202	EMERGENCY ROOM SERVICES	$1,693,408
PRAIRIE CARDIOVASCULAR CONSULTING
PO BOX 19420	SPRINGFIELD	IL	627949420	CONSULTANTS	$1,677,708
ST JOHNS HOSPITAL
800 E CARPENTER STREET	SPRINGFIELD	IL	62769	SHARED SERVICES/DIVISIONAL FEE	$1,600,064
Focus One Solution
PO BOX 3037	OMAHA	NE	681030037	contract Labor	$1,291,095

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	32	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$283,469	RelatedOrganizationsAmt
Total Contributions	$283,469	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Program Service Revenue	900099	$131,227,971	$131,227,971
Medicaid Assessment	900099	$14,044,462	$14,044,462

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

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

Field	Value	IRS element (for citing)
Total Program Service Revenue	$145,272,433	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,980	TotalRevenueColumnAmt
Exclusion	$13,980	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,184,518	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,244,555	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$1,060,037	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$1,060,037	TotalRevenueColumnAmt
Exclusion	-$1,060,037	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	-$10,533	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$10,533	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$10,530	TotalRevenueColumnAmt
Exclusion	-$10,530	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Reference Lab	621500	$26,082	$26,082
Physician Answering Service	621500	$29,591	$29,591
Gift Shop Revenue	900099	$150,052		$150,052

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$759,373	TotalRevenueColumnAmt
Related Or Exempt Func Income	$759,373	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$965,098	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$145,464,413	TotalRevenueColumnAmt
Related Or Exempt Func Income	$146,031,806	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$55,673	UnrelatedBusinessRevenueAmt
Exclusion	-$906,535	ExclusionAmt

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$44,749,848	TotalAmt
Program Services	$39,580,312	ProgramServicesAmt
Management And General	$5,169,536	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$680,348	TotalAmt
Management And General	$680,348	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$8,635,654	TotalAmt
Management And General	$8,635,654	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,054,713	TotalAmt
Management And General	$3,054,713	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$215,158	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$215,158	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$28,116	TotalAmt
Management And General	$28,116	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$1,897	TotalAmt
Management And General	$1,897	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$16,627,568	TotalAmt
Program Services	$9,601,803	ProgramServicesAmt
Management And General	$7,025,765	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$429,157	TotalAmt
Management And General	$429,157	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$120,247	TotalAmt
Program Services	$78,818	ProgramServicesAmt
Management And General	$41,429	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$6,602,826	TotalAmt
Management And General	$6,602,826	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,517,264	TotalAmt
Program Services	$215,337	ProgramServicesAmt
Management And General	$1,301,927	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$108,313	TotalAmt
Program Services	$42,702	ProgramServicesAmt
Management And General	$65,611	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$162,532	TotalAmt
Management And General	$162,532	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$11,848,873	TotalAmt
Management And General	$11,848,873	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,849,076	TotalAmt
Management And General	$8,849,076	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,135,533	TotalAmt
Management And General	$3,135,533	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Management And GeneralManagementAndGeneralAmt	Program ServicesProgramServicesAmt
Bad Debt	$1,582,224	$1,582,224
Medicaid Tax Assessment	$5,872,720	$5,872,720
Supplies	$21,842,892	$651,396	$21,191,496
Minor Equipment	$160,892	$42,113	$118,779

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,753,811	TotalAmt
Program Services	$3,202,523	ProgramServicesAmt
Management And General	$4,551,288	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$143,979,662	TotalAmt
Program Services	$74,031,770	ProgramServicesAmt
Management And General	$69,947,892	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,031,840	BOYAmt
EOY	$1,854,206	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$31,847,687	BOYAmt
EOY	$40,340,172	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)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,037,024	BOYAmt
EOY	$2,536,452	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,905,358	BOYAmt
EOY	$1,776,265	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$221,022,085	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$135,788,034	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$89,800,181	BOYAmt
EOY	$85,234,051	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$7,438,982	BOYAmt
EOY	$9,072,660	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$545,594	BOYAmt
EOY	$373,823	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$180,694	BOYAmt
EOY	$142,596	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$136,787,360	BOYAmt
EOY	$141,330,225	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$16,059,536	BOYAmt
EOY	$17,037,586	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$32,589,310	BOYAmt
EOY	$31,154,079	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$6,553,419	BOYAmt
EOY	$25,500,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,521,449	BOYAmt
EOY	$22,716,263	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$88,723,714	BOYAmt
EOY	$96,407,928	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$40,624,664	BOYAmt
EOY	$35,849,637	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,237,958	BOYAmt
EOY	$7,871,592	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,201,024	BOYAmt
EOY	$1,201,068	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$48,063,646	BOYAmt
EOY	$44,922,297	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$136,787,360	BOYAmt
EOY	$141,330,225	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,484,751	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$73,671	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$4,699,771	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$28,116	OtherActivitiesAmt
Total Lobbying Expenditures	$28,116	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

ST. MARY'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES. A PART OF THESE DUES IS ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 21.78% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.76% LOBBYING EXPENSE - ILLINOIS HOSPITAL ASSOCIATION ("IHA") AT 31.00% LOBBYING EXPENSE - NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE AT 15.00% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,295,160	OtherCostOrOtherBasisAmt
Book Value	$3,295,160	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$98,863,306	OtherCostOrOtherBasisAmt
Depreciation	$46,853,933	DepreciationAmt
Book Value	$52,009,373	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$41,830,063	OtherCostOrOtherBasisAmt
Depreciation	$27,549,535	DepreciationAmt
Book Value	$14,280,528	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$76,629,702	OtherCostOrOtherBasisAmt
Depreciation	$61,178,033	DepreciationAmt
Book Value	$15,451,669	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$403,854	OtherCostOrOtherBasisAmt
Depreciation	$206,533	DepreciationAmt
Book Value	$197,321	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$85,234,051	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
RETIRE OBLIGATION - ASBESTOS	$1,888,414
ACCRUED BENEFIT LIABILITY	$20,827,849

Field	Value	IRS element (for citing)
Total Liability	$22,716,263	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501 (c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2017 and 2016 in the accompanying consolidated financial statements due to the uncertainty of realization. Hshs recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2017 and 2016, HSHS does not have any liabilities for unrecognized tax benefits.	ExplanationTxt

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	600	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
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	$2,475,459	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,475,459	NetCommunityBenefitExpnsAmt
Total Expense	0.0174	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$130,169,105	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$119,284,494	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,884,611	NetCommunityBenefitExpnsAmt
Total Expense	0.0764	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$132,644,564	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$119,284,494	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,360,070	NetCommunityBenefitExpnsAmt
Total Expense	0.0938	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,261,992	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,261,992	NetCommunityBenefitExpnsAmt
Total Expense	0.0089	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$99,725	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$99,725	NetCommunityBenefitExpnsAmt
Total Expense	0.0007	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,316,948	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,316,948	NetCommunityBenefitExpnsAmt
Total Expense	0.0092	TotalExpensePct

Research ResearchGrp

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

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$238,234	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$238,234	NetCommunityBenefitExpnsAmt
Total Expense	0.0017	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,916,899	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,916,899	NetCommunityBenefitExpnsAmt
Total Expense	0.0205	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$135,561,463	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$119,284,494	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,276,969	NetCommunityBenefitExpnsAmt
Total Expense	0.1143	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

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

Economic Development EconomicDevelopmentGrp

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

Community Support CommunitySupportGrp

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

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

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

Coalition Building CoalitionBuildingGrp

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

Health Improvement Advocacy HealthImprovementAdvocacyGrp

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

Workforce Development WorkforceDevelopmentGrp

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

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

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

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,582,224	BadDebtExpenseAmt
Reimbursed By Medicare	$46,533,969	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$49,165,881	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,631,912	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (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	ST MARY'S HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1700 E LAKE SHORE DR	AddressLine1Txt
City	DECATUR	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62521	ZIPCd

Field	Value	IRS element (for citing)
Website Address	https://www.stmarysdecatur.com/	WebsiteAddressTxt
State License	0905-2097	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST MARY'S HOSPITAL	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	14	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.stmarysdecatur.com/Community-Connection/Community-Partnerships	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	https://www.stmarysdecatur.com/Community-Connection/Community-Partnerships	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	600.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
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	https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx	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
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - HSHS St. Mary's Hospital. HSHS St. Mary's Hospital undertook an eight-month planning and implementation effort to develop the CHNA, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. As part of this process, St. Mary's leveraged existing relationships that provided diverse input for a comprehensive review and analysis of community health needs in the hospital's service area. HSHS St. Mary's Hospital (SMD) worked collaboratively with the Macon County Health Department (MCHD) to complete the Macon County Health Needs Assessment. The above organizations agreed to work in collaboration with an External Advisory Council to narrow health focus areas and develop implementation strategies around addressing the health focus area during the next three years. The CHNA Core Group was made up of representatives from St. Mary's Hospital and the Macon County Health Department. Both organizations serve and represent the broad interests of the community. The Core Group included a Masters of Public Health from the Health Department who specialized in Community and Public Health Education.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - ST. MARY'S HOSPITAL, DECATUR. Members of the CHNA External Advisory Council were chosen based on their unique expertise and experience, informed perspectives and involvement with the community. The CHNA external Advisory Council members were responsible for: Offering insight into issues affecting existing data; Identifying local community assets and gaps; and Offering advice on which issues are the highest priority. * Jeff Abbot: Decatur Fire Department * Tanya Andricks: Community Health Improvement Center (CHIC, the FQHC) * Brandi Binkley: Macon County Health Department * Debbie Bogle: United Way of Decatur and Mid-Illinois * Julie Brilley, MPH: Decatur Memorial Hospital * Reverend Stacy Brohard: Good Samaritan Inn * Laura Brown: St. Mary's Hospital * Dr. Jo Carter: Millikin University School of Nursing * Dennis Crowley: Macon County Mental Health Board * Jim Alpi: Decatur Housing Authority * Diane Drew: Community Home Environmental Learning Project * Linda Fasick, RN, BSN: Community Health Improvement Center (CHIC, the FQHC) * Angela Foulke: Decatur Family YMCA * Vivian Goodman: Decatur Community Partnership * Mart Hart: St. Mary's Decatur * Dianna Heyer, RN, BSN: Macon County Health Department * Patrick Hoban: City of Decatur * Caitlin Huth: University of Illinois Extension Office * James Keith: United Way of Decatur and Mid-Illinois * Diana Knaebe: Hertiage Behavioral Health Center * BJ Leonard: First Christian Church * Terri Luckenbill: Decatur Public Schools District 61 * Robin McCoy: Workforce Investment Solutions * Bruce Nims: Grow Decatur * Elizabeth Rawls: National Association for the Advancement of Colored People (NAACP) * Mirinda Rothrock: Greater Decatur Chamber of Commerce * Tom Schneider: Macon County Sheriff's Department * Karen Schneller, RN: Decatur Memorial Hospital * Carol Smith, RN: Parish Nurses * Leslie Stanberry: Decatur Macon County Senior Center * Brad Sweeney: Decatur Police Department * Corey Walker: Decatur Black Chamber of Commerce * Angie Wetzel: Decatur Public Schools District 61 * Matt Whitehead: YMCA
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HSHS St. Mary's Hospital. ACCESS TO HEALTH CARE: Dental Voucher Program: HSHS St. Mary's Hospital partnered with 12 dentist offices and Catholic Charities to implement the Dental Voucher Program in FY17. The program was launched in September 2016 and since then we have assisted 42 clients in getting cleanings, x-rays, fillings and simple or surgical extractions for problem teeth. This program was developed in response to a lack access to dental care primarily due to insurance and cost. Our clients receive a voucher for the services mentioned above in order to receive dental care specific to problem teeth. ACCESS TO CARE AND MENTAL HEALTH: HSHS St. Mary's Hospital also developed the Pre-Term Home Visitation program which was launched at the end of FY17. This program connects a highly skilled NICU nurse with families who delivered babies at or less than 32-weeks. The nurse meets with the family in the NICU and will follow-up in the home for 18-months following delivery. Ninety percent of our NICU babies are born into high-risk, vulnerable situations (extreme poverty, single-parent homes, homelessness, food / housing insecurities; to name a few). These babies face a greater risk for poor health and mental health outcomes due to lack of access to basic health care services in addition to decreased neurodevelopment. By connecting these babies and families with a highly-trained nurse, in their home, we will work with the families to meet basic needs, provide timely health care, and engage families and babies in activities proven to stimulate healthy brain development. MENTAL HEALTH AND UNMANAGED CHRONIC CONDITIONS: HSHS St. Mary's Hospital is partnering with Catholic Charities and Crossings Healthcare, local FQHC, to launch the 'Hospital Transition Program' (HTP). This program was developed in FY17 and will be launched in FY18. This program works to identify unattached and complex patients in the Emergency Department and connect them with basic health care needs. Each patient identified will meet with a multi-disciplinary team comprised of Emergency Providers, Behavioral Health Specialist, Primary Care and a Care Coordinator. Patients will receive a Social Determinants of Health screening, health assessment, and review of medical history. The team will identify a care coordination plan to address basic health care needs. The patient and care coordinator will work closely together to ensure the patient's needs are met outside of the Emergency Department in a way that promotes self-sufficiency and long-term improved health outcomes. Needs not selected: As an outcome of the prioritization process, seven of the ten health focus areas ranked by the community and Internal Advisory Council were not identified as ranking high against the defined criteria, and therefore they were not advanced for inclusion in the Implementation Plan. In some cases, the focus area is currently being addressed by another organization in the community or there is another organization within the community better equipped to address the need. While the list below will not be areas of primary focus for St. Mary's, the hospital will continue to participate in efforts with other organizations as appropriate and where the hospital can lend support. 1. Child Abuse * The Macon County Child Advocacy Center (MCCAC) and Safe from the Start advocate for child abuse prevention. The Center serves Macon and Piatt Counties, and partners with the Illinois Department of Children and Family Services (IDCFS), the Illinois Attorney General Violent Crimes Victim Assistance program, the Mental Health Board (708) of Macon County, the National Children's Alliance, the Illinois Violence Prevention Authority, and the Circuit Clerks of Macon and Piatt Counties. * Macon County CASA (Court Appointed Special Advocates) provides court-appointed volunteers to advocate for abused, neglected and/or dependent children who are involved in the Macon County juvenile court system. 2. Nutrition * HSHS St. Mary's Hospital continues to support and donate to the annual WSOY community food drive, as well as nutrition-related community benefit initiatives. * Several organizations provide nutrition and healthy eating education and information to the local area including the University of Illinois Extension of DeWitt, Macon and Piatt Counties, the Senior Nutrition Program at the Decatur-Macon County Opportunities Corporation, Macon Resources' Bright Start program, Meals on Wheels of Macon County and the Macon County Health Department. 3. Obesity * The Obesity Prevention Coalition is a collaboration of county-wide health care organizations to promote healthy nutrition and physical activity awareness through education and advocacy to prevent obesity and obesity-related conditions. HSHS St. Mary's Hospital is represented on and sponsors this coalition. 4. Sexually Transmitted Infections * The Macon County Health Department offers confidential testing on a walk-in basis each week. The health department also provides counseling and referrals for treatment. 5. Teen Birth * Teen births in Macon County are on the decline. The Macon County Teen Health Coalition and the Macon County Health Department work to educate young people. * HSHS St. Mary's Hospital's Prenatal Clinic provides prenatal care to all women, regardless of ability to pay. 6. Teen Substance Abuse * The Macon County Mental Health Board works with local non-profits, governmental entities and schools to provide prevention, education and treatment resources for young people. * HSHS St. Mary's Hospital is the only inpatient adolescent behavioral health provider in Macon County. The hospital, along with Heritage Behavioral Health Center, provide outpatient services for youth. * Juvenile Justice programs based upon evidence-based restorative justice principles such as Macon County Redeploy from the Illinois Department of Human Services (IDHS) and Macon County Teen Court, seek to reduce recidivism and to deter non-offenders. 7. Cancer * The Affordable Care Act expanded coverage for preventive screenings, including recommended cancer screenings. * HSHS St. Mary's Hospital partners with Decatur Memorial Hospital and Cancer Care Specialists of Illinois to sponsor events related to cancer awareness. The hospital promotes recommended screenings for cancer and steps to prevent throughout the year. Patients can obtain screenings through primary care providers. * The Macon County Health Department also provides screening resources to the public.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - HSHS St. Mary's Hospital. 7. Cancer * The Affordable Care Act expanded coverage for preventive screenings, including recommended cancer screenings. * HSHS St. Mary's Hospital partners with Decatur Memorial Hospital and Cancer Care Specialists of Illinois to sponsor events related to cancer awareness, and promotes recommended screenings for cancer and steps to prevention throughout the year. Patients can obtain screenings through primary care providers. * The Macon County Health Department also provides screening resources to the general public.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - St. Mary's Hospital (SMD). Presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 7. Wisconsin Department of Health Services Housing Assistance Program 8. Participation in Women, Infants and Children programs (WIC); 9. Supplemental Nutrition Assistance Program (SNAP) eligibility; 10. Illinois Free Lunch and Breakfast Program; 11. Wisconsin Free Lunch Program; 12. Low Income Home Energy Assistance Program (LIHEAP); 13. Wisconsin Home Energy Assistance Program (WHEAP); 14. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 15. Receipt of grant assistance for medical services
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - St. Mary's Hospital (SMD). HSHS provids a written notice about upcoming ECAs at least 30 days prior to initiating ECAs. This statement is included on a patient billing statement prior to placement with an agency. Additionally, a message about the availability of financial assistance is included on the statement, but it was not a separate summary document.

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Supplemental Information Detail SupplementalInformationDetail (19 entries)

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Schedule H, Part VI, Line 6 Description of Affiliated Group (continued A)	HSHS Good Shepherd Hospital in Shelbyville, Illinois increases access to mammograms, diagnostic screenings and breast cancer treatments for women through the hospital's Pink Ribbon Program and Vicky Wagner Breast Cancer Assistance Fund. The Pink Ribbon Program covers the costs of mammograms or diagnostic screenings for women living in rural areas who are under or uninsured. The Vicky Wagner Breast Cancer Assistance Fund assists women living in Shelby County who are receiving treatment for breast cancer with out of pocket expenses such as wigs, transportation to treatment appointments, child care, meals or other expenses that insurance doesn't cover. In southwest Illinois, HSHS St. Joseph's Hospital in Highland provides enhanced offerings for senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital is the lead collaborator in the Highland Area Meals on Wheels Program. In April 1977, the hospital partnered with the now defunct Highland Area Council of Churches to introduce the Meals on Wheels program. Today, St. Joseph's partners with the civic organization Highland Area Meals on Wheels Program to prepare and deliver nutritious meals to the elderly, those who are recuperating from illness or hospital stays, or anyone wishing to participate in the program within a 15-mile radius (cumulative population 20,000+) of the hospital. Annually, approximately 16,896 meals are delivered in eight communities. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified to offer a 45 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 HSHS hospitals conducted Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS Good Shepherd Hospital in Shelbyville, Illinois who affiliated with HSHS in January 2017, conducted its most recent CHNA in FY2016. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Priority health care needs were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. Under the umbrella of 3D Community Health, the hospitals led suicide prevention activities across multiple sectors in collaboration with the Chippewa Health Improvement Partnership in FY2017. Strategies included community trainings of an evidence-based suicide prevention program, QPR (question, persuade & refer), and a variety of events, activities and displays pertaining to suicide prevention. Efforts are measured by the county suicide rate, inventory of change in community knowledge, stigma and behaviors, as well as participation in the county suicide death review team to monitor for potential trends and respond accordingly. 3D formed a suicide death review team in both Eau Claire and Chippewa Counties. These teams review details of each suicide to look for trends and key pieces of information that may guide efforts in targeting certain geographic areas, certain age or gender, etc. 3D is also focused on increasing community awareness and knowledge of the factors that offer protection from suicidal behaviors and that promote wellness and recovery in collaboration with multiple community partners on an ongoing basis. One strategy is to promote effective programs and practices i.e. adverse childhood experiences (ACEs) that increase protection from suicidal risk and promote connectedness among residents of Chippewa and Eau Claire Counties. At the Children, Health and Family Summit that 3D Community Health coordinated in partnership with the County Department of Human Services in FY2017, 99 of the 190 attendees took a pre-and- post-event survey about ACEs and brain development. There was a 24% increase in the percentage who strongly agreed that exposing infants to stress can actually cause them to develop a smaller brain post-event compared to pre-event survey. HSHS Holy Family Hospital in Greenville, Illinois has sponsored a multi-faceted health fair for decades, one of the largest Health Fairs in the east St. Louis metropolitan area. The event provides many free health tests in addition to five, low-cost comprehensive blood tests. In FY2017, more than 2,000 blood tests were performed as part of the hospital's annual Health Fair. Participants could choose from a comprehensive blood test, prostate specific antigen blood test (PSA), Hemoglobin A1-C, Vitamin D blood test, Colovantage or a combination of the five blood tests. The cost incurred by HSHS Holy Family Hospital for offering these discounted services was $1,431,105. In addition to the services provided on the day of the Health Fair, the hospital also performs the low-cost blood tests at several off-site locations including area schools, businesses, and manufacturers. Through the years, life-threatening and serious medical conditions have been discovered through testing performed in association with the Health Fair. Mary's Garden is a community teaching garden located on the campus of HSHS St. Mary's Hospital in Decatur, Illinois. The goals of the community garden are to improve community health and food accessibility for those in need, teach the younger generation sustainable gardening and offer a comprehensive, place-based approach to community health improvement. In FY2017 Mary's Garden became a living classroom for Eisenhower High School students who use the garden for interactive instruction on health and nutrition, science, mathematics, ecology and agriculture. Mary's Garden also provided opportunities for two apprentices to develop competencies and self-confidence to move into rural and urban farming/gardening leadership roles and launched a community-supported agriculture (CSA) program for colleagues. This created two jobs and is providing a model for turning dilapidated city lots into urban gardens. The hospital has engaged City officials about a job creation program and neighborhood revitalization.
Schedule H, Part VI, Line 6 Description of Affiliated Group (continued B)	Mission-driven and strategically implemented Community Benefit is an integral part of Hospital Sisters Health System's Mission. Our commitment to Community Benefit arises from our Catholic identity, Mission and Core Values shared by 14,000 colleagues across Illinois and Wisconsin. Through our work to improve access to health care services, enhance community health, advance medical knowledge, and relieve or reduce the burden of government, we believe we have made a positive difference in the quality of lives of tens of thousands of people in Illinois and Wisconsin in FY2016. As a Catholic health care ministry, HSHS is concerned with the dignity of all persons, the common good, and the stewardship of resources. We advocate for health care for all and work to improve social conditions that lead to improved health and well-being. We engage partners in our communities to improve health and quality of life and to reduce duplication. Working side by side with many faith communities, HSHS remains dedicated to our common purpose of compassionate care for all people.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	1582224
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	To determine the actual cost of these services, the hospital uses a cost-to-charge ratio based on our audited financial statements to calculate the amounts reported on Lines 7a through 7i.
Schedule H, Part II Community Building Activities	HSHS St. Mary's Hospital partners with local providers to promote the Central Illinois Sportsmen for Outdoor Accessibility. The goal of this group is to promote and support accessibility and participation in outdoor recreation experiences, such as hunting, boating, fishing, camping and shooting, for persons with disabilities of all ages in Central Illinois. This group explores ways to improve accessibility, to encourage active recruitment of eligible participants, to solicit grants to assist in funding to improve accessibility and to offer educational seminars to inform individuals of resources available to them. HSHS St. Mary's Hospital also partners with the YMCA to offer the YMCA Health Jam program. This program provides health careers education to students in grades 4 & 5 from Garfield School and Johns Hill School to encourage kids to stay in school. This program works with high risk students to teach skills needed for a successful education and future career. HSHS St. Mary's Hospital partners with Big Brothers Big Sisters to provide mentors to high school students. Mentors work with students weekly via the internet and meet one-on-one monthly. HSHS St. Mary's Hospital partnered with Good Samaritan Inn, Mercy Gardens and Eisenhower High School to develop a teaching garden on hospital property. This program provides food for the Good Samaritan Inn feeding program, has been written into the horticulture curriculum at the high school and provides training opportunities and jobs for individuals working with Mercy Gardens. Without HSHS St. Mary's Hospital's leadership in the community, these Community Building Activities would not occur. These activities promote the overall health and quality of life for the individuals they serve.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors that do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	HSHS St. Mary's Hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The text of the footnote to the organization's financial statements that describes bad debt expense can be found on pages 21 of the HSHS Consolidated Audit Report.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	HSHS St. Mary's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, St. Mary's Hospital is relieving the burdens of the government. Accordingly, this shortfall restricts St. Mary's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2017 was $13,753,208
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	The hospital's policy on account resolution outlines the procedures to be followed when collecting balances on outstanding patient bills. Besides addressing the procedures and follow-up for accounts covered by insurance or governmental programs, the policy discusses situations where the patient may be eligible for financial assistance through our charity care program. If a patient is deemed eligible, reference is made to the hospital's charity care policy. Even with the best intentions, patients cannot always meet their responsibility to pay for the care they receive. For a number of reasons, from the loss of a job to temporary hardships, this leaves the hospital to cover the unpaid balance or even the entire bill, an expense for the hospital referred to as "bad debt." In fiscal year ended June 30, 2017, bad debt expense less recoveries was $987,883 with no outside source of funding to help compensate for the expense. The cost, after applying the cost to charge ratio, was $251,910 This is a growing problem.
Schedule H, Part V, Section B, Line 16a FAP website	- ST MARY'S HOSPITAL: Line 16a URL: https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx;
Schedule H, Part V, Section B, Line 16b FAP Application website	- ST MARY'S HOSPITAL: Line 16b URL: https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- ST MARY'S HOSPITAL: Line 16c URL: https://stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance.aspx;
Schedule H, Part VI, Line 2 Needs assessment	As indicated in Part V, Section C, the hospital conducted a Community Health Needs Assessment in FY2015. In addition to conducting a Community Health Needs Assessment (CHNA) triennially per the provisions in the Affordable Care Act, the hospital routinely assesses the health care needs of the communities it serves in a variety of ways, including reviewing the health needs assessments of other health care organizations in our service area as well our local and state health departments and the United Way. We continually review primary data such as hospital and emergency department utilization and patient surveys as well as secondary data from our county and state public health departments, the Centers for Disease Control, County Health Rankings, and the Behavioral Risk FS Survey to name a few. On occasion, we will also collect primary data through telephone and electronic survey instruments. In addition to ongoing primary and secondary data collection and analysis, the hospital regularly assesses the health care needs of the communities it serves through feedback received from its internal assessment team, assessment advisory team, hospital leadership, Strategy department and hospital Board members. As part of the three-year Implementation Plan, the hospital shares its progress toward achieving its short and long term indicators in various community venues such as town hall meetings, community forums, and Chamber of Commerce. Also through volunteer and board service with other local health care, social service agencies, law enforcement task forces, and area schools, hospital colleagues gather ongoing information on the health care needs of the communities it serves.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	The Registration Department provides brochures to patients upon registration regarding the Payment Assistance Program available to them at HSHS St. Mary's Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. The brochures include contact information for several community agencies that help patients determine their eligibility for assistance under federal, state or local government programs. The brochures also provide information on how to read and understand HSHS St. Mary's Hospital's billing information. HSHS St. Mary's website provides an explanation of Medicare forms at https://www.stmarysdecatur.com/Patient-Guest/Patient-Financial-Services/Financial-Assistance. The hospital has a representative on site to assist patients who may be eligible for Medicaid assistance through the Illinois Department of Public Assistance. They work with patients to determine if they may be eligible, and if so, assist in pulling together the necessary application for submission. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A system called Search America is now being utilized after failed attempts made by the hospital and our law firm to work out payment arrangements. That system accesses credit and other information and allows us to see the probability of a patient being able to pay their bill. After assessing that information, the hospital determines whether to grant charity care or continue collection efforts.
Schedule H, Part VI, Line 4 Community information	HSHS St. Mary's Hospital, located in Decatur, Illinois serves not only Macon County but also parts of the surrounding counties (DeWitt, Moultrie, Christian and Shelby). The total primary and secondary service area of the hospital has a population of 142,986 people, 109,281 people from Macon County and 33,705 people from the surrounding counties. Aside from the city of Decatur, the economy of St. Mary's secondary service area is primarily rural and is supported by small businesses, industries, mining and agriculture. Decatur, on the other hand, is an urban area supported by large businesses, such as Archer Daniels Midland and Caterpillar. Based on 2014 population estimates derived from the 2010 census, Macon County's population of 109,281 people is comprised of 78.69% Caucasians, 16.61% African-Americans, 0.22% American Indians/Alaska Natives, 1.13% Asians, 0.04% Native Hawaiians/Other Pacific Islanders, 0.72% people stating another race, and 2.6% people stating two or more races. Thirty-three percent of Macon County's residents have a high school diploma, 6.64% hold an Associate Degree, 14.39% have a Bachelor's Degree, 5.87% hold a Master's Degree, and 2.18% have a Professional School Degree or Doctorate Degree. As of January 2015, unemployment rate of Macon County is 8%, according to the US Bureau of Labor Statistics, and the median household income is $46,559. HSHS St. Mary's secondary service area is comprised of 33,705 people, of whom 83.08% are Caucasian, 12.82% are African-American, 0.21% are American Indian/Alaska Native, 0.95% are Asian, 0.03% are Native Hawaiian/Other Pacific Islander, 0.69% state another race, and 2.22% state two or more races. Educational levels of this population reflect that 35.7% graduated high school, 6.77% graduated with an Associate Degree, 12.85% graduated with a Bachelor's Degree, 5.27% graduated with a Master's Degree and 1.92% graduated with either a Professional School Degree or a Doctorate Degree. The average unemployment rate of the combined counties is 6.6% and the median household income is $47,313. Within the report area 17.6% or 19,233 individuals are living in households with income below the Federal Poverty Level (FPL). This is higher than the statewide poverty levels of 15%. This indicator is relevant because poverty creates barriers to access including health services, nutritional food and other necessities that contribute to poor health status. HSHS St. Mary's Hospital's service area is comprised of approximately 580.69 square miles with a population of approximately 142,986 and a population density of 190.80 per square mile. The service area consists of 3-cities, 16-townships, 9-villages and 2-unincorporated communities. The hospital does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area.
Schedule H, Part VI, Line 5 Promotion of community health	As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St. Mary's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded more than 140 years ago to bring a healing presence and improve the health of our community, especially for those persons who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Decatur and surrounding areas. The hospital is governed by a Board of Directors, the majority of whom reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St. Mary's Hospital is responding to community need. In FY2015, for example, the Board reviewed the Community Health Needs Assessment and approved an Implementation Plan for addressing selected health focus areas Consistent with its exempt purpose, HSHS St. Mary's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an Emergency Department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Mary's Hospital reinvests surplus funds to support the mission of the organization and health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. HSHS St. Mary's Hospital also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In FY 2017, HSHS St. Mary's provided more than $16,200,670 in Community Benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2017, St. Mary's provided <$X.X>million (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than< $XX>million (at cost) in excess of Medicare payment for health care services. HSHS St. Mary's provides a range of Community Benefit activities and programs that furthers our mission and long-standing commitment to our community. In many cases, these Community Benefit initiatives would not exist without the leadership role played by HSHS St. Mary's Hospital and they often relieve a burden that would otherwise be carried by government. The hospital's FY2015 Community Health Needs Assessment (CHNA) identified the following health focus areas to be addressed by the hospital in collaboration with other hospitals and community organizations: Unmanaged Chronic Conditions, Access to Care, and Mental Health. Unmanaged Chronic Conditions: Mary's Garden is a community teaching garden located on HSHS St. Mary's Hospital's campus. The mission of the garden is to improve community health and food accessibility for those in need and teach a younger generation sustainable gardening. The purpose of this garden is to offer a comprehensive, place-based approach to community health improvement. In FY17 Mary's Garden: * Became a living classroom for Eisenhower High School students who use the garden for interactive instruction on health and nutrition, science, mathematics, ecology and agriculture. The garden manager worked closely with the Horticulture instructor and class in school-year 2016-2017 to make Mary's Garden part of the core curriculum. This past school year, Mary's Garden launched a dual credit program between Eisenhower High School's horticulture class and Richland Community College. This program provides a college credit for high school students in horticulture or agriculture classes who utilize Mary's Garden as a living classroom. * Apprentice/mentor program: Mary's Garden offered opportunities for two apprentices to develop competencies and self-confidence to move into rural and urban farming/gardening leadership roles. * Community development: Mary's Garden launched a community-supported agriculture (CSA) program for colleagues. This created two jobs and is providing a model for turning dilapidated city lots into urban gardens. We have engaged the city in discussions around a job creation program and neighborhood revitalization. Other Community Benefit Activities and Programs Naloxone Program - Heroin overdose is a recent epidemic in central and southern Illinois. A heroin overdose causes one to stop breathing which, without immediate intervention, will lead to death. An antidote to heroin overdose is Naloxone, a medication that immediately reverses the effect of the heroin and can save someone's life if given soon enough. The legal system has put in place provisions to allow first responders to administer the medication. The heroin epidemic is so great in our community that more people die from opiate-related deaths than car accidents. The Emergency Services team uses Naloxone, an opiate antidote, in the event of an overdose. The patient is then referred to the right treatment resources, including the hospital's treatment center. In recent months, the hospital used Naloxone more than 65 times in the community and more than 20 times in the Emergency Department. The community benefits from the hospital storing the antidote and through the quality care for patients and their families who need treatment for substance abuse. Without the Naloxone program at HSHS St. Mary's Hospital, there are many people who would not be alive today. In response, the hospital expanded its detox program to allow for medical detoxification services. Medical detoxification allows the person to get through withdrawals from the drug and get treatment-an intervention that is beneficial to the individual, their loved ones and the community. Every day, the colleagues of the treatment center witness the effect of addiction and know how important it is to ensure we continue to provide services to help them. School-Based Mental Health - HSHS St. Mary's Hospital is a distinguished center for children who are suffering emotionally. We partner with the Decatur Public School District to provide school teachers for two hours per day. With the parent's permission, school representatives are kept aware of the child's progress and stability in the adolescent unit, so they know how to best work with the child academically while they are in our care. The partnership limits the amount of school time missed during an otherwise strenuous time. We also have substance abuse counselors that speak about alcohol and drug abuse in county schools to both students and faculty. Fostering a Sense of Comfort in the Adolescent Unit - At Christmas time, children in our adolescent unit are provided socks, undergarments and soft tops. This partnership with the HSHS St. Mary's Auxiliary increases the child's likelihood of receiving a gift at Christmas time. As some family members live far away, this program provides children with fresh clothing they might not otherwise have. Lastly, the Linus Ladies make soft blankets and donate them to the children; the blankets are a source of comfort and security. Food Drive: SMD recognizes food insecurity in our community and how the lack of healthy foods contributes to identified community health needs including cardiovascular/heart disease, diabetes, high blood pressure and high cholesterol. One in six Americans faces hunger and Macon County has a food insecurity rate of 17.8 percent, or nearly 20,000 people. In October 2016, St. Mary's Hospital supported a week-long collection of non-perishable food items and monies to support the annual WSOY Community Food Drive. The hospital made a $5,000 contribution toward the drive. The hospital, together with colleagues, raised more than 15,000 dollars/pounds to distribute to local food pantries.
Schedule H, Part VI, Line 6 Affiliated health care system	HSHS St. Mary's Hospital is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 15 hospitals, numerous community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high-quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2017, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2017, HSHS collectively provided $197.6 million in Community Benefit (9.2% of total hospital expenses). This amount included $26.0 million provided for Financial Assistance (a.k.a. Charity Care) and $128.6 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $205.9 million. HSHS hospitals also recorded $40.9 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Improve access to health care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2017, HSHS and our 15 hospitals dedicated Community Benefit resources to educate uninsured persons about enrollment opportunities in affordable health care coverage and to facilitate the enrollment process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their service areas, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or by helping them to obtain coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville is committed to improving access to health care services by assisting eligible patients to enroll in health care plans. In FY2017, more than 3,200 patients were screened and 74% met eligibility criteria and were enrolled in Medicaid. Access to health care is not limited to insurance coverage and access to primary care providers. In FY2017, the hospital assisted patients with access to medications, durable medical equipment, and transportation including more than $5,600 in cab and bus tickets for patients and $14,000 for patients who needed transfer by ambulance. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first three years, the program has realized 93% engagement of 300 clients. Services rendered include basic needs and health care access. Sixteen formally homeless individuals or families were placed in affordable, safe housing. Of the 35 parolees in the program, the recidivism rate was only 18% compared to 60% nationwide. The only reason participating parolees went back to prison was because of lack of a job or housing. One-hundred percent of our clients saw a primary care provider and 84% were connected to a medical home. This program is being replicated in a second location in Sangamon County's eastside where our most vulnerable, low-income and underserved populations exist. Through the support of HSHS St. Mary's Hospital Medical Center and St. Vincent Hospital in Green Bay, the Oral Health Partnership (OHP) continues to expand to communities throughout Brown County, providing dental care to 0 - 19 year olds who are uninsured or underinsured. In FY2017, more than 12,000 general dentistry procedures, including exams, X-rays, cleanings, fillings, and crowns, were completed for youth in Brown County's smaller, less urban communities, and more than 1,300 preventative sealants were applied. OHP serves more than 9,000 kids each year through three fixed-site clinics and the traveling school-based program. In January 2017, OHP's West location was opened in response to data showing an unmet need of medical assistance children in the Ashwaubenon area. This clinic, along with the traveling school-based team, will help OHP and HSHS reach the goal of expanding services to a wider population of Brown County children in need. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues has decreased from 2.2% in 2011 to .95% in 2016 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2017, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 246 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DANIEL PERRYMAN
Chief Executive Officer, President	$0	$239,894	$0	$32,233	$0	$73,722	$0	$11,332	$0	$25,890	$0	$383,071	$0	$62,663
EVERT J KUIPER
CEO CENTRAL ILLINOIS DIV/Interim Pres	$0	$598,790	$0	$166,274	$0	$49,173	$0	$141,971	$0	$27,418	$0	$983,626	$0	$0
MICHAEL W COTTRELL
Board Member	$0	$617,558	$0	$139,028	$0	$120,568	$0	$199,280	$0	$29,892	$0	$1,106,326	$0	$83,663
DAVID OLEJNICZAK
Former Interim CEO	$0	$284,473	$0	$39,706	$0	$206,764	$0	$91,915	$0	$25,304	$0	$648,162	$0	$0
THERESA J RUTHERFORD
Former COO	$0	$301,923	$0	$50,518	$0	$57,323	$0	$173,895	$0	$20,263	$0	$603,922	$0	$37,545
ANN M CARR
TREASURER	$0	$251,800	$0	$39,616	$0	$68,544	$0	$291,816	$0	$20,710	$0	$672,486	$0	$31,485
REBECCA PUCLIK
DIVISIONAL CHIEF PEOPLE OFFICER	$0	$224,195	$0	$20,133	$0	$44	$0	$77,756	$0	$12,898	$0	$335,026	$0	$0
STEVEN UMLAND
CHIEF FINANCIAL OFFICER - CENTRAL IL DIVISION	$0	$371,859	$0	$50,483	$0	$21,423	$0	$66,667	$0	$27,805	$0	$538,237	$0	$0
MARY HARTMAN
CRNA	$284,825	$0	$0	$0	$0	$0	$172,759	$0	$15,604	$0	$473,188	$0	$0	$0
Deanna Y Hitchens
CRNA	$233,823	$0	$0	$0	$0	$0	$80,741	$0	$13,853	$0	$328,417	$0	$0	$0
Sheila A Holliden
CRNA	$237,288	$0	$0	$0	$0	$0	$191,075	$0	$8,866	$0	$437,229	$0	$0	$0
Roberta S McBride
CRNA	$251,191	$0	$0	$0	$0	$0	$251,345	$0	$15,525	$0	$518,061	$0	$0	$0
Beth A McCoy
CRNA	$304,628	$0	$0	$0	$0	$0	$153,045	$0	$20,637	$0	$478,310	$0	$0	$0
Lauren R Remley
CRNA	$224,353	$0	$0	$0	$0	$0	$28,292	$0	$13,772	$0	$266,417	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part II, Column (C) DEFINED BENEFIT PLAN	THE ACTUARY COMPUTES THE DEFINED BENEFIT AMOUNT FOR ALL OF THE DISCLOSURES. THE REDUCTION DIRECTLY RELATES TO THE IMPROVEMENT IN THE DISCOUNT RATE.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $31,564 Michael Cottrell -- $94,085 Evert Kuiper -- $94,865 Daniel Perryman -- $43,848 Theresa Rutherford -- $35,788 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $31,485 Michael Cottrell -- $83,663 Daniel Perryman -- $62,663 Theresa Rutherford -- $37,545

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4a STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	ST. MARY'S HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF ST. MARY'S HOSPITAL, IT IS RECONGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE NECESSARY MEDICAL SERVICES. INHERENT TO OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION PROGRAMS, WELLNESS PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FISCAL YEAR 2017, ST. MARY'S HOSPITAL PROVIDED 33,958 ADULT AND DAYS OF CARE AND 164,800 OUTPATIENT REGISTRATIONS DURING THE SAME TIME PERIOD. ST. MARY'S HOSPITAL PROVIDES BOTH BENEFITS TO THE POOR AND TO THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED ON THE FORM OF TRADITIONAL CHARITY CARE FOR THOSE WHO CANNOT AFFORD TO PAY, UNPAID COSTS OF PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF, NONBILLED SERVICES FOR THE POOR AND MANY IN-KIND DONATIONS. THE TOTAL VALUES OF THESE UNREIMBURSED BENEFITS FOR THE POOR WERE $16,253,543 IN FISCAL YEAR 2017. ST. MARY'S HOSPITAL PROVIDES NUMEROUS BENEFITS TO THE BROADER COMMUNITY. THIS IS CARRIED OUT THROUGH OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE, AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN TOTALED $13,753,208 DURING FISCAL YEAR 2017. ALL OTHER NONBILLED SERVICES PROVIDED TO THE COMMUNITY AND SERVICES PROVIDED AT LOW OR NEGATIVE MARGINS TOTALED $16,276,969 FOR THE YEAR ENDED 6/30/2017. BELOW ARE SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: THROUGH THE OPERATION OF ITS PRENATAL CLINIC, THE HOSPITAL PROVIDES BOTH PRE AND POST NATAL CARE TO THE POOR. THE HOSPITAL ROUTINELY DONATES FOOD TO LOCAL FOOD PANTRIES. OBSOLETE EQUIPMENT IS ALSO OCCASIONALLY DONATED TO LOCAL AGENCIES. PROVIDE TRAINING TO THE LOCAL PARAMEDICS, FIRST RESPONDER GROUPS, AND FIRE DEPARTMENTS. IN ADDITIONAL, AREA ORGANIZATIONS RECEIVE CPR TRAINING THROUGH THE HOSPITAL'S EMS DEPARTMENT. THE HOSPITAL PARTICIPATES IN THE SECONDARY TRANSITIONAL EXPERIENCE PROGRAM BY PROVIDING EMPLOYMENT OPPORTUNITIES TO HANDICAPPED STUDENTS. PASTORAL CARE AND SOCIAL SERVICE DEPARTMENTS PROVIDE ASSISTANCE FOR PATIENT AND FAMILY NEEDS. EMPLOYEES SERVE AS SPEAKERS AT HEALTH FAIRS, SCHOOLS, AND A VARIETY OF AREA ORGANIZATIONS. ASSIST THE UNITED WAY CAMPAIGN BY HAVING STAFF MEMBERS ORGANIZE THE HOSPITAL'S ANNUAL FUND DRIVE. PROVIDE A VARIETY OF HEALTH SCREENINGS TO THE PUBLIC IN DIFFERENT LOCATIONS THROUGHOUT THE COMMUNITY.
Form 990, Part IV, Line 24a TAX EXEMPT BONDS	ST. MARY'S DECATUR HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY	PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
Form 990, Part VI, Line 16b JOINT VENTURES	HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. MARY'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. MARY'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. MARY'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL DECATUR(THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY- SYSTEM OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE COMPENSATION COMMITTEE ("COMMITTEE") IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES (IHS), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A.
Form 990, Part VI, Line 19 Required documents available to the public	BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Billing Service Revenue - Total Revenue: 395247, Related or Exempt Function Revenue: 395247, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; State (late pay) revenue - Total Revenue: 190311, Related or Exempt Function Revenue: 190311, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Adult Day Care - Total Revenue: 12642, Related or Exempt Function Revenue: 12642, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Answering Service - Total Revenue: 27870, Related or Exempt Function Revenue: 27870, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Senior Center - Total Revenue: 79568, Related or Exempt Function Revenue: 79568, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Laundry Service - Total Revenue: 8237, Related or Exempt Function Revenue: 8237, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; All Other Revenue - Total Revenue: 45498, Related or Exempt Function Revenue: 45498, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Other Purchased Services - Total Expense: 6937717, Program Service Expense: 3175680, Management and General Expenses: 3762037, Fundraising Expenses: ; Professional Fees - Total Expense: 6426123, Program Service Expense: 6426123, Management and General Expenses: 0, Fundraising Expenses: ; SHARED SERVICE FEE - Total Expense: 3263728, Program Service Expense: , Management and General Expenses: 3263728, Fundraising Expenses: ;
Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT	ST. MARY'S HOSPITAL CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM (HSHS). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 124, "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CHANGE IN FAIR VALUE OF INTEREST RATE SWAP - 22846; SWAP PAYMENTS - 1629; PENSION - 3964834; TRANSFER FROM AFFLIATES - -10257046; CHANGE IN TEMP RESTRICTED NET ASSETS - 1567966;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
KIARA CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	261417684	HEALTHCARE	IL	-$1,762,307	$6,257,513	HSSI
PHYSICIAN CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371668647	HEALTHCARE	IL	-$950,689	$8,580,781	KCIN
HSHS ACO LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	320465666	HEALTHCARE & SOCIAL ASSISTANCE	IL	-$515,297	$146,855	KCIN

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 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
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371058692	HEALTHCARE	IL	501(c)(3)	Type III-FI	NA	false
HOSPITAL SISTERS OF ST FRANCIS FOUNDATION
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371186514	HEALTHCARE	IL	501(c)(3)	7	HSHS	Yes (true)
HSHS SELF INSURANCE TRUST
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371120626	INSURANCE	IL	501(c)(3)	Type I	HSHS	Yes (true)
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY 1	CHIPPEWA FALLS	WI	54729	510157933	HEALTHCARE	WI	501(c)(3)	Type I	HSSI	Yes (true)
SACRED HEART HOSPITAL
990 WEST CLAIREMONT AVENUE	EAU CLAIRE	WI	54701	390807060	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
ST ANTHONY'S HOSPITAL
503 N MAPLE STREET	EFFINGHAM	IL	62401	370661233	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREET	BELLEVILLE	IL	62220	370663567	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUE	SHEBOYGAN	WI	53081	390808480	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	370661238	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANE	BREESE	IL	62230	371208459	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1	CHIPPEWA FALLS	WI	54729	390810545	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
ST MARY'S HOSPITAL
111 SPRING STREET	STREATOR	IL	61364	362169181	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST MARY'S MEDICAL CENTER
1762 SHAWANO AVENUE	GREEN BAY	WI	54303	390818682	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
ST VINCENT HOSPITAL
835 S VAN BUREN	GREEN BAY	WI	51301	390817529	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
12866 TROXLER AVENUE	HIGHLAND	IL	62249	370663568	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVE	LITCHFIELD	IL	62056	370661236	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163402	HEALTHCARE	IL	501(c)(3)	Type III-FI	HSHS	Yes (true)
HSHS MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE	SPRINGFIELD	IL	62703	263956318	HEALTHCARE	IL	501(c)(3)	Type III-FI	HSSI	Yes (true)
HSHS WISCONSIN MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE	SPRINGFIELD	IL	62703	264515959	HEALTHCARE	WI	501(c)(3)	Type III-FI	HSSI	Yes (true)
ORANGE CROSS AMBULANCE INC
919 ASHLAND AVENUE	SHEBOYGAN	WI	53081	391860942	HEALTHCARE	WI	501(c)(3)	10	ST NICHOLAS	Yes (true)
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	HEALTHCARE	WI	501(c)(3)	10	HSSI	Yes (true)
PRAIRIE EDUCATION & RESEARCH COOPERATIVE
317 NORTH 5TH STREET	SPRINGFIELD	IL	62701	371157915	HEALTHCARE	IL	501(c)(3)	4	HSSI	Yes (true)
ST CLARE MEMORIAL HOSPITAL
855 S MAIN STREET	OCONTO FALLS	WI	54154	390848401	HEALTHCARE	WI	501(c)(3)	3	HSSI	Yes (true)
HSHS HOLY FAMILY HOSPITAL
200 HEALTHCARE DRIVE	GREENVILLE	IL	62246	370792770	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)
UTLAUT MEMORIAL FOUNDATION
200 HEALTHCARE DRIVE	GREENVILLE	IL	62246	371140166	FUNDRAISING	IL	501(c)(3)	Type II	HSSI	Yes (true)
SHELBY MEMORIAL HOSPITAL FOUNDATION INC
200 SOUTH CEDAR STREET	SHELBYVILLE	IL	62565	371294401	FUNDRAISING	IL	501(c)(3)	Type I	HSSI	Yes (true)
HSHS GOOD SHEPHERD HOSPITAL INC
200 SOUTH CEDAR STREET	SHELBYVILLE	IL	62565	370512290	HEALTHCARE	IL	501(c)(3)	3	HSSI	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Address Line2USAddress/AddressLine2Txt
MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER
4000 NORTH ILLINOIS STREET	SWANSEA	IL	62226	371312961	HEALTHCARE	IL	ST ELIZABETH'S	Related	$674,729	$4,464,307	false	false	0.5
PRAIRIE HEART INSTITUTE ST JOHN'S
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	371321197	HEALTHCARE	IL	HSHS	Related	$0	$8,000	false	false	1
PAIN CENTER OF WISCONSIN
4131 W LOOMIS ROAD	GREENFIELD	WI	53221	263155343	HEALTHCARE	WI	ST VINCENT	Related	$527,290	$608,459	false	false	0.5	SUITE 300
PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC
4131 W LOOMIS ROAD	GREENFIELD	WI	53221	364717036	HEALTHCARE	WI	ST CLARE	Related	$82,878	$213,434	false	false	0.5	SUITE 300
CARPENTER STREET HOTEL LLC
525 NORTH SIXTH STREET	SPRINGFIELD	IL	62702	364128127	HOTEL	IL	LASANTE INC	N/A					0
SPRINGFIELD URGENT CARE REAL ESTATE LLC
PO BOX 19456	SPRINGFIELD	IL	62794	030413258	RENTAL REAL ESTATE	IL	LASANTE INC	N/A					0
PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	261479945	MEDICAL	IL	HSHS	Related	-$7,119	$10,276	false	Yes (true)	1

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
KIARA INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163401	HEALTHCARE	IL	HSHS	C Corporation	-$32,734,440	$34,421,714	1	Yes (true)
LASANTE WISCONSIN INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	391572196	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
LASANTE INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163400	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
PRAIRIE CARDIOVASCULAR
619 EAST MASON SUITE 4P57	SPRINGFIELD	IL	62701	371071858	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
PREVEA HEALTH SERVICES INC
2710 EXECUTIVE DRIVE	GREEN BAY	WI	54304	391839351	HEALTHCARE	WI	HSSI	C Corporation	$260,762	$45,933,122	0.5	Yes (true)
PREVEA CLINIC INC
2710 EXECUTVE DRIVE	GREEN BAY	WI	54304	391839349	HEALTHCARE	WI	PHSI	C Corporation				Yes (true)
RENAISSANCE QUALITY INSURANCE LTD
				980669953	INSURANCE		HSSI	C Corporation	$0	$120,349,324	1	Yes (true)	PO BOX 1159	GRAND CAYMAN	CJ	KY11102	CJ
OJV INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	460873384	HEALTHCARE	IL	LASANTE INC	C Corporation				Yes (true)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	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	Yes (true)	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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ORGANIZATIONS	FormAndLineReferenceDesc
Explanation	THE TRANSACTIONS REPORTED ON LINE 1 AND NOT SPECIFICALLY IDENTIFIED ON LINE 2 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES. ACCORDINGLY THEY ARE NOT REPORTED IN THIS SECTION.	ExplanationTxt