2025-11-14T14:13:09-06:00 2024-12-31 420714325 RSM US LLP 30 South Wacker Dr Suite 3300 Chicago IL 606063392 990 2024-01-01 350868132 Memorial Hospital of South Bend Inc MEMO 5746473549 615 N Michigan Street South Bend IN 46601 Jeffrey Costello CFO 5746473549 2025-11-07 1 1 Rebekuh Eley P01247672 3126343400 2025-11-07 2024 2025-03-06 01:10:19Z Larry Tracy 615 N Michigan Street South Bend IN 46601 749364383 0 X beaconhealthsystem.org X 1923 IN We deliver outstanding care, inspire health and connect with heart. 9 5 3795 348 -128890 0 5467805 7224114 702912880 713570432 980489 4668388 21181074 21334820 730542248 746797754 391700 551678 0 0 245500017 243670377 0 0 0 345904362 401686351 591796079 645908406 138746169 100889348 668333733 677976847 285895745 331926867 382437988 346049980 X We deliver outstanding care, inspire health and connect with heart. 0 0 152781217 0 408514218 Ancillary Services offers the following services for patients and facilities: - Imaging services - Outpatient physical, occupational and speech therapy - Infusion treatments - Radiation oncology therapy - Cancer research - Cardiac cath lab - Sleep lab - Interventional radiology - Environmental services - Nutritional services - Pharmacy services - Laboratory2024 statistics for this service unit include: - 729,811 inpatient procedures - 576,738 outpatient procedures - 1,491 inpatient caths - 1,216 outpatient caths - 1,864 outpatient visits 137625579 0 176092253 Patient care unit services provides a wide variety of hospital services including: - Inpatient rehabilitation CARF (commission on accreditation of rehabilitation facilities) accredited - Medical - Post surgical - Orthopedic - Oncology - Intensive and intermediate- Heart and vascular - Mother and child - Special care obstetrics- Neonatal intensive care level III - Emergency - Trauma level II- Pediatrics - Pediatric intensive care - Pediatric hematology oncology - Medical flight program - Pediatric intensive care transports2024 statistics for this service unit include: - 85,170 patient days - 11,505 inpatient ER visits - 67,767 outpatient ER visits - 2,608 births - 24,909 observation stays 67447370 0 145396861 Surgical Services provides the following services: - General surgery - Vascular surgery - Cardiac surgery - Orthopedic surgery- Gynecological surgery - Trauma surgery - GI labs - Pulmonary services - Pain center - DaVinci robotic surgery2024 statistics for this service unit include: - 7,952 inpatient procedures - 458 open heart procedures - 17,247 outpatient procedures 223540673 551678 0 Other program services include psychiatric departments, social services, community outreach programs, tithing, grants, and supporting services such as administration, finance, payroll, patient accounting, laundry services, health and lifestyle center, and medical records. Due to the non-revenue generating or community investment nature of many of the programs, they operate at a loss. See Schedule H for details on the hospitals tithing and community outreach represented in other program services. 223540673 551678 0 581394839 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 181 0 1 3795 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 IN X Jeffrey Costello 5746473549 615 N Michigan Street South Bend IN 46601 Ronald Nelson MD Secretary 2.00 40.00 X X 0 19344 4085 John Callaghan MD Chair 2.00 0.00 X X 200 0 0 Martha Smith Vice Chair 2.00 0.00 X X 1220 0 0 Stephanie Steele Vice Chair thru 5/31/24 2.00 0.00 X X 0 0 0 Daniel Adams Director thru 3/31/24 2.00 2.00 X 0 0 0 Peter Baranay Director thru 11/30/24 2.00 2.00 X 0 0 0 Raquel Buari JD Director 2.00 0.00 X 200 0 0 Tim Durham MD Director 2.00 0.00 X 200 0 0 Renee Fleming Director 2.00 0.00 X 1130 0 0 Bethany Hartley Director 2.00 0.00 X 860 0 0 Linda Paskiewicz Director 2.00 0.00 X 200 0 0 Tim Weber Director 2.00 0.00 X 200 0 0 Kreg R Gruber CEO 2.00 50.00 X 0 1848714 287708 Jeffrey P Costello CFO 2.00 50.00 X 0 1077612 188598 Larry A Tracy President 40.00 0.00 X 0 807555 177573 Michelle A Thompson VP Medical Affairs 40.00 0.00 X 475895 0 73709 Linda A Mansfield Dir of Sports Medicine 40.00 0.00 X 349571 0 75197 Kristine E Jennings Dir of Med Residency Program 40.00 0.00 X 349938 0 68099 Matthew R Reed Employed Physician 40.00 0.00 X 349893 0 56865 Marion Mahone Assoc. Dir Resident Program 40.00 0.00 X 349125 0 49194 1878632 3753225 981028 460 0 1 0 Walsh Construction Company 929 W Adams St Chicago IL 60607 Construction services 38583886 South Bend Medical Foundation 530 N Lafayette Blvd South Bend IN 46601 Lab services 3947263 South Bend Emergency Physicians 615 N Michigan St South Bend IN 46601 Physician services 3857669 Gibson Lewis LLC 1001 W 11th St Mishawaka IN 46544 Building contractor services 2900419 Metro Aviation Inc 1214 Hawn Ave Shreveport LA 71107 Medical flights 2560246 33 1236977 5987137 7224114 Net Patient Revenue 622110 710950118 710950118 Affiliate Rental Rev 532000 2388836 2388836 Ambulance Supply 621910 159117 159117 Medical Education Rev 561499 108100 108100 Joint Venture Activity 561499 -35739 -35739 713570432 3601377 -128890 3730267 966419 20558 945861 945861 945861 3613082 1500 2544571 -1500 1068511 1067011 1067011 Outpatient Pharmacy 561499 12946382 12946382 Cafeteria Sales 561499 1573259 1573259 Quality Incentive 561499 1189868 1189868 4679450 2296650 2382800 20388959 746797754 730003332 -128890 9699198 X 516015 516015 35663 35663 989338 989338 194057137 166306966 27750171 6716148 5755739 960409 28235281 24197636 4037645 13672473 11717309 1955164 805685 690472 115213 41506 41506 207424 207424 11924 10219 1705 75646 75646 61849601 53005108 8844493 20703 17742 2961 1645531 1410220 235311 18044 15464 2580 7032752 6027068 1005684 672606 576423 96183 38727 33189 5538 9121165 7816838 1304327 26147289 22408227 3739062 3767313 3228587 538726 Medical Supplies 129921984 129921984 Corporate Allocation 85709478 73453023 12256455 Bad Debt Expense 39664964 39664964 Hospital Assessment Fee 32500248 32500248 2433761 2085735 348026 645908406 581394839 64513567 0 20766 21106 21510137 11688920 573139 688960 136256547 121403211 248 0 20100045 22615435 733635 1571288 914091418 517174684 369019545 396916734 2853422 2965937 1999203 1999839 1171474 1171474 114095572 116933943 668333733 677976847 47259588 47489851 2540 452 222735475 264897768 15898142 19538796 285895745 331926867 X 371605031 346049980 10832957 0 382437988 346049980 668333733 677976847 X 100889348 -2108146 -135169210 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 11924 11924 0 Part II-B, Line 1: Memorial Hospital paid dues to the following organizations for which the amount or percentage listed was attributed to lobbying: AAFP (American Academy of Family Physicians) - 20% AASM (American Academy of Sleep Medicine) - 2% ACC (American College of Cardiology) - 13.89% ACHE (American College of Healthcare Executives) - 1% ACS (American College of Surgeons) - 4% AHA (American Hospital Association) - 32% AMA (American Medical Association) - 75% AND (Academy of Nutrition and Dietetics) - 10% AORN (Association of Peri-Operative Registered Nurses) - 25.46% APA (American Psychiatric Association) - 12% APTA (American Physical Therapy Association) - 28% ASHE (American Society for Health Care Engineering) - 32% ASHP (American Society of Health-System Pharmacists) - 19% CAP (College of American Pathologists) - 35% ENA (Emergency Nurses Association) - 22% ISMA (Indiana State Medical Association) - 24% NACHRI (National Association of Children's Hospitals and Related Institutions) - 25% NAEMSP (National Association of EMS Physicians) - 28% STFM (Society of Teachers of Family Medicine) - 10% When unable to ascertain allocation of dues attributed to Lobbying, a conservative estimate of 20% is applied. 42456771 9625097 2320861 4428203 49974526 38758960 2440358 2682416 1424963 42456771 42986124 3689060 -4645969 3270255 38758960 37554313 3126708 3841751 1536648 42986124 34924914 1692784 2289915 1353300 37554313 0.67190 0.00000 0.32810 0 1 1 24870122 24870122 521485761 280830358 240655403 324743 324743 0 264886186 231610541 33275645 102524606 4409042 98115564 396916734 Due from Third-Party Payors 30625695 Interest Receivable - Swap 291550 Other Receivables 6007671 2016 Bond Fund 11581 Right of Use Financing Asset 347688 2022 US Bank Bond Fund 77188658 GLC Parking Garage 2461100 116933943 Interest Rate Swap 8208779 Asset Retirement Obligation 5742715 IBNR 3125956 Due to Third-Party Payors 2035649 Financing Lease Liability 353775 Due to Affiliates 71922 19538796 X Part V, Line 4: Net assets with donor restrictions consist of assets whose use is limited by donor imposed, time and/or purpose restrictions. In accordance with the restriction, a majority of the investment income and investment gains or losses from these net assets are restricted by the donor for a specific purpose. A specified portion of income earned by the net assets is released from restriction and used for operations each year and, therefore, is included in the consolidated statements of operations and changes in net assets as other revenue. The board has discretion to utilize each year the incomes, revenues and profits arising and accruing from the endowments in defraying costs associated with the trust and the remainder for support, betterment, improvement, upkeep, expansion and replacement of Beacon Health System, Inc. and its corporate affiliates. Part X, Line 2: ASC 740, income taxes, requires that realization of an uncertain income tax position be more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it is recognized in the consolidated financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the years ended December 31, 2024 or 2023. 1 1 X 1 X 1 X 1 1 0 1 1 1920952 0 1920952 0.00320 139384824 129605507 9779317 0.01610 141305776 129605507 11700269 0.01930 4771808 3069719 1702089 0.00280 9670632 1710760 7959872 0.01310 464542 173713 290829 0.00050 823377 0 823377 0.00140 15730359 4954192 10776167 0.01780 157036135 134559699 22476436 0.03710 13840 0 13840 0.00010 13840 13840 0.00010 1 8942032 4471016 82730239 120865205 -38134966 X 1 1 1 1 Memorial Hospital of South Bend Inc 615 N Michigan Street South Bend IN 46545 www.beaconhealthsystem.org 23-005053-1 X X X X X X Memorial Hospital of South Bend Inc 1 0 0 1 X X X X X X X X X 24 1 1 0 1 X https://impact.beaconhealthsystem.org/chna X X 1 22 1 https://impact.beaconhealthsystem.org/chna 0 1 X 200.000000000000 350.000000000000 X X X 1 1 X X X 1 X www.beaconhealthsystem.org/patients-and-visitors X www.beaconhealthsystem.org/patients-and-visitors X www.beaconhealthsystem.org/patients-and-visitors X X X X X X 1 X 0 X X X X 1 X 0 0 Memorial Hospital of South Bend, Inc. Part V, Section B, Line 5: Beacon Health System's 2024 Community Health Needs Assessment (CHNA) represents more than just a regulatory requirement for non-profit hospitals. The organization views it as a valuable opportunity to engage with communities across their four-county service area (St. Joseph County IN, Elkhart County, Marshall County, and St. Joseph County MI) to understand health and social needs of community members.The assessment follows the MAPP 2.0 framework (Mobilizing for Action through Planning and Partnerships) developed by the National Association of County & City Health Officials. This community-driven assessment and planning process is designed to support health equity while focusing on strategic, prioritized needs. The framework helps recognize and align resources across integrated sectors by emphasizing diverse and inclusive assessment activities.The CHNA is structured around three primary assessment components:Community Status Assessment (CSA) - Provides a foundation of secondary research data about demographics, health status, health inequities, and social drivers of health. This helps identify communities at greater risk of poor health outcomes and understand which groups may need more services.Community Partner Assessment (CPA) - Reviews existing resources, systems, processes, and capacities, both individually and collectively as a network of community partners. This component recognizes that community partnerships form the required network of support for public health improvement, as rarely can a single agency address all interrelated needs.Community Context Assessment (CCA) - Collects and analyzes qualitative data through community engagement. This component captures the lived experiences of community members, providing insights about helpful resources, organizational strengths, cultural nuances, and priorities.The assessment methodology employed a mixed methods approach between January and September 2024, including secondary research, community surveying, resource guide reviews, access audits, qualitative interviews, focus groups, and a needs prioritization process. Throughout the process, Beacon utilized:A Multi-Sector Health Advisory Council with a total of 23 representatives from across the four-county service area who received MAPP 2.0 training and met monthly throughout the project. Eight Equity Champions representing diverse communities helped ensure the needs of underrepresented or historically marginalized communities were understood. Beacon Health System is dedicated to understanding health equity and disparities within the communities it serves. Equity Champions participated in a stakeholder interview, participated in a focus group or helped host and recruit community members for a focus group, and participated in the prioritization process. The Equity Champions met regularly throughout the CHNA process.The research engaged many participants throughout the four-county region. 150 participants were for the focus groups and stakeholder interviews. We had 1,513 individuals complete our community survey. 49 partners completed the partner survey. We completed an access audit/mystery shopper with 25 facilities across the region. Community members participated in focus groups that explored local health needs and how these intersect with individual health experiences. Meanwhile, professionals and community leaders contributed their expertise through both focus groups and stakeholder interviews to provide insights into the broader health landscape. The participants represented diverse sectors that influence community health, including healthcare professionals, government representatives, faith-based organizations, community-based organizations, educational institutions, and social service providers. This multi-sector approach ensured a well-rounded understanding of health needs from various perspectives, combining both personal experiences and professional knowledge.Collectively with the health advisory council, health equity champions, the community survey, key informant interviews, and focus groups to took into account input received from persons who represent the broad interests of the community served. Secondary data provides an essential framework from which to better understand the fabric of the community. This analysis highlights sociodemographic factors, social drivers of health (SDOH), behavioral health risk factors, and other key indicators to further guide the development of effective strategies to meet evolving needs. In addition to collecting key demographic secondary data, research also focused on the SDOH. The SDOH includes a wide range of factors, including, but not limited to, income, education, job security, food security, housing, basic amenities, the environment, social inclusion and non-discrimination, and access to quality affordable health care.The top priority was identified through the modified delphi technique with our advisory council and internal leaders. The assessment identified 49 community needs, with "Access to Providers" emerging as the top priority area. This includes several subcategories:- Shortages of various provider types (primary care, specialists like endocrinology, OBGYN, pediatrics, rheumatology, neurology, podiatry)- Need for community health workers and peer support specialists- Improving cultural competency of providers- Addressing community mistrust of providersThe report defines "providers" broadly to include anyone within the health system who interacts with patients or community members (nurses, front desk staff, cafeteria workers, environmental). Memorial Hospital of South Bend, Inc. Part V, Section B, Line 6a: Memorial Hospital of South Bend (MHSB) developed the 2024 St. Joseph County CHNA in partnership with Elkhart General Hospital, Community Hospital of Bremen, and Three Rivers Health, Beacon Health System (BHS) care partners. Memorial Hospital of South Bend, Inc. Part V, Section B, Line 7d: The Community Health Needs Assessment (CHNA) was made widely available to the community through posting on the Beacon Health System website at: https://impact.beaconhealthsystem.org/chna and through email transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums. Memorial Hospital of South Bend, Inc. Part V, Section B, Line 11: Beacon Health System completed a Community Health Needs Assessment (CHNA) in 2021 to better understand and prioritize the health needs of the communities we serve in Indiana (Elkhart, LaPorte, Marshall, and St. Joseph counties). The CHNA process included secondary data collection, a key informant survey and focus groups throughout Beacon's core service area in Indiana. Executive leaders approved mental health and healthcare access as the top priorities after analysis of the data collected. Three Rivers Health, which serves St. Joseph County in Michigan, joined the Beacon family after the completion of the 2021 CHNA. They participated in their local health department's CHNA, which found mental health and resource accessibility to be among the top three health needs, which aligns with our priority areas and implementation strategy. Beacon's implementation strategy (2022 -2024) aligns with our mission and values by enhancing the skills of patients, practitioners and the community. Over the past three years, Beacon prioritized expanding mental health services and improving healthcare access to better serve our communities. Beacon worked with community partners and internal programs to improve access to health and wellness services by improving and strengthening local social and healthcare systems. Mental illness, especially depression, increases the risk for many types of adverse physical health outcomes, particularly long-lasting conditions like type 2 diabetes and heart disease. Similarly, the presence of chronic conditions can increase the risk for mental illness. Robert Wood Johnson's County Health Rankings model examines quality of life and tells us a lot about how people perceive their health whether they feel healthy and satisfied. When communities have higher rates of those who do not feel healthy, it can influence other factors of health, including mortality rates, unemployment and poverty. Increasing healthcare access, quality and equity addresses all major social, economic, environmental and behavioral factors that enable individuals and communities to make healthy choices and enjoy a long, healthy life. Additionally, our 2021 CHNA research indicated that individuals with low health literacy were significantly more likely to delay or forgo needed care or to report difficulty finding a provider, compared with individuals who have adequate health literacy.Mental Health Metrics % of the population with frequent mental health distress % of the population with two or more trusted support people Healthcare Access Metrics % of the population with health insurance (adults < 65 and children) % of adults who reported their healthcare providers always involved them in decisions about their care, as much as they wanted. Beacon Community Impact provided community resources to 59,738 individuals across our service area Elkhart, Marshall, and St. Joseph, IN Counties and St Jospeh County, Michigan in 2024. Within Beacon Health System, the Beacon Community Impact Department leads efforts impact our priority areas of mental health and healthcare access using a combination of internal programs and collaborative partnerships. Our implementation strategy incorporates a three-pronged approach:We provide direct services to clients through Beacon's Early Childhood Services and Community Health Services teams. Early Childhood Services include the St. Joseph County (Ind.) WIC program, two sickle cell programs and our Family & Infants Support Program. These programs focus on the health status of women, infants and young families, particularly the most vulnerable in Beacon's service area. Our Community Health Services team focuses on prevention through community health educators with school curricula delivered throughout middle and high schools in the three Indiana counties we serve. Summer programming shifts to health-related day camps and participation at community health fairs. Though it may not be their primary focus, these community health teams screen for and provide referrals for clients experiencing mental health challenges. Likewise, they emphasize the importance of trusted adults as protective factors for youth.We fund local community organizations with expertise in their service areas. These organizations are community nonprofits with boots-on-the-ground services in the most vulnerable neighborhoods and more diverse populations. Each of the funded partners addresses the top two health priorities and reports on the number of participants and on an outcome metric for either mental health or healthcare access. In addition, Beacon partnered with the local health department in Three Rivers, Michigan, to support building out their Community Health Worker Program to increase services addressing healthcare access and mental health. Participating organizations Community partners- Center for Healing and Hope - diabetes support program- Child and Parent Services, Inc. (CAPS) - maternal and infant health support- Healthy Beginnings (Elkhart County Health Department) - maternal and infant health support- Mental Health Awareness of Michiana (MHAM) - behavioral and mental health- United Health Services - healthcare navigation- La Casa de Amistad - social service support- Maple City Health Care - maternal infant health support- Transformation Ministries - youth advocacy and support- Gentleman and Scholars, Inc. - youth advocacy and support- Imani Unidad - health literacy and case management- Horizon Education Alliance - health literacy and case management- Branch-Hillsdale-St. Joseph Community Health Agency, Health Department Beacon Community Impact Programs- Beacon Health Navigator- Family and Infant Support Program (FISP)- Health and Wellness Programs- Sickle Cell Infant Screening- Sickle Cell Broadscope- Women, Infants and Children (WIC) Clinic Memorial Hospital of South Bend, Inc. Part V, Section B, Line 13h: The policy allows for patients to qualify for assistance by two means: financial or catastrophic. The financial assistance program also allows for partial assistance or full assistance based on eligibility criteria in this policy.Financial assistance1. A patient qualifying for financial assistance is a person who is uninsured or underinsured, receives care and unable to pay their bill.2. To be eligible for assistance under the financial assistance guidelines, a person's income shall be at or below a percentage of the federal poverty level (FPL) as determined by federal poverty guidelines. Household size and income determines the % of FPL. Memorial Hospital of South Bend, or its designee, may consider other financial assets and liabilities of the person when determining eligibility.3. Memorial Hospital of South Bend will use the most current poverty income guidelines issued by the U.S. Department of Health and Human Services to determine an individual's eligibility for financial assistance. The poverty income guidelines are published annually in the federal register and for the purposes of this policy will become effective the first day of the month following the month of publication.4. To qualify under the financial assistance portion of this policy, a completed, signed financial assistance application must be submitted and proof of income, proof of no income, proof of lack of financial assets and other required documents must accompany the application. Catastrophic assistance criteria1. A patient qualifying for catastrophic assistance is a person whose hospital bills exceed a specified percentage of the person's annual gross income as set forth in the policy and who is unable to pay the remaining bill.2. To be eligible for catastrophic assistance the amount owed by the patient must exceed one hundred fifty (150) percent of the patient's annual gross income and the patient must be unable to pay the remaining bill. Memorial Hospital of South Bend may consider other financial assets and liabilities of the person when determining ability to pay.3. If a determination is made that a patient has the ability to pay the remainder of the bill, such a determination does not prevent a reassessment of the patient's ability to pay at a later date should their financial circumstances change.4. After eligibility is determined under this provision, assistance will be provided to discount the bill by 75% of the current balance.5. If a patient has cash assets, those assets will be added to their income when determining eligibility for assistance. 6 1 - Memorial Sleep Disorder Center 53990 Carmichael Drive South Bend IN 46601 Outpatient Clinic Providing Sleep-Related Diagnosis And Treatment 2 - Memorial Breast Care Center 100 Navarre Place South Bend IN 46601 Outpatient Diagnosis And Treatment 3 - Memorial Children'S Therapy Center 100 Navarre Place South Bend IN 46601 Outpatient Diagnosis And Treatment 4 - Memorial Radiology 100 Navarre Place South Bend IN 46601 Outpatient Diagnosis And Treatment 5 - Memorial Lighthouse Physical Therapy 6913 N Main Street Granger IN 46530 Outpatient Diagnosis And Treatment 6 - Memorial Health Plex 111 W Jefferson St South Bend IN 46601 Outpatient Rehabilitation Facility And Fitness Facility Part I, Line 3c: Household size and incomeThe following factors may be considered in determining the eligibility of the patient for assistance and must be provided by all income earning residents in the countable household unit unless they are not dependents based on IRS guidelines for determining whether a household member can be considered a dependent.1. Indiana workforce wage report for last 2 quarters (unemployment income).2. Last 3 pay stubs or a letter or printout from employer(s) providing verification of gross income if currently employed. This documentation should not be more than 30 days old from date of issue and include year-to-date information. 3. Last 3 bank statements (including explanations of regular deposits not explained by pay stubs).4. Social Security award or entitlement letter or other proof of gross monthly award.5. Retirement income.6. Investment income.7. Statement from person(s) that are providing direct support.8. Number of dependents.9. Most recent tax return (including W2 and all supporting schedules).10. Other financial obligations.11. Amount and frequency of hospital/medical bills.12. Other financial resources that produce income.13. If self-employed, gross income less cost of goods sold and employee salaries.Financial capacity1. Individuals with the financial capacity to purchase health insurance coverage through the health insurance marketplace may be required to purchase and will be provided access to meet with an Indiana certified navigator as a means of assuring access to healthcare services, for their overall personal health, and for the protection of their individual assets.2. Individuals have been found they are ineligible for Medicaid or other affordable health care coverage must provide proof of denial.3. Food stamps or supplemental nutrition assistance program (SNAP) will not be counted as income.4. Cosmetic services are not eligible for any type of assistance and cannot be included in the amount of hospital/medical bills owed. Part I, Line 6a: Creating community health is at the core of Memorial Hospital of South Bend's mission. Promotion of community health is our social responsibility and a key to long-term cost effectiveness. In addition, improving the health status of a community is as much a social, economic and environmental issue as it is a medical one. Consequently, the organization takes a broad approach to creating community health. This approach has included: ongoing education of board members, staff and local leaders through community plunges, experimental activities to involve the community residents with a neighborhood-based clear statement of vision and goals, a commitment to continuous quality improvement and promotion of volunteer involvement and community partnerships. Memorial Hospital of South Bend invests in the community. This investment is in addition to the hospital's financial assistance and prevention, and education activities supported through its operating budget. The Beacon community impact advisory council makes ongoing policy and oversees the administration of the fund and determines specific investment allocations based upon the assets and needs of the community. Staff are committed to prudently investing these resources in an accountable manner. As a community not-for-profit organization, we take seriously our responsibility to invest our resources and energies into understanding and meeting the divergent health care needs of all and ensure that everyone, regardless of their ability to pay, receives the care they need. Memorial Hospital of South Bend has long been recognized for the collaboration efforts which engage individuals and organizations with diverse socio-economic religious, ethnic, race, age, and gender identity characteristics. Our team of passionate and dedicated health care professionals, along with many partners throughout the northern Indiana and southern Michigan (Michiana) region, helped us contribute significantly to the health and well-being or our community. Further, Memorial Hospital of South Bend plays a key role in serving the community as a whole. Beacon Health System, Inc. (EIN 45-3864076), prepares the annual community benefit reporting for Memorial Hospital of South Bend. Part I, Line 7: Costing MethodologyThe costing method used to calculate financial assistance reported on lines 7 a through d was the cost-to-charge ration as derived on tax form 990, Schedule H, worksheet 2. All other community benefits were calculated using direct costs. The bad debt expense removed from total expenses in 2024: $39,664,964. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 39,664,964. Part II, Community Building Activities: In 2017 The Executive Director of Beacon Community Impact was asked to represent Beacon Health System as one of six anchor organizations. We currently maintain this seat. This group, now recognized as the St. Joseph County Health Improvement Alliance, has met several times since the original assessment. Together the group worked on a vision, mission, and direction for the group. As a result of these brainstorming sessions, the group decided to focus on our stakeholders' top priorities to increase public health infrastructure and improve the community's health. The goal is to improve the health of our community by collaboratively working together to decrease duplication of services and increase the utilization of existing services and resources. Part III, Line 2: The corporation evaluates the collectability of its accounts receivable based on the length of time the receivable is outstanding, payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for doubtful accounts when they are deemed uncollectible. The costing methodology is the same as the tax form 990, Schedule H, worksheet 2 methodology. Patient care cost is adjusted by non-patient activity expenses, and patient care charges. The amount of bad debt reported on Part III, Line 2 is calculated by applying the cost-to-charge ratio, as determined by worksheet 2, to total bad debt expense per the audited financial statements. Part III, Line 3: Bad debt attributable to the FAP is estimated based on the historical trend of the sources of the bad debt. The majority of bad debt is attributable to uninsured patients which represent the majority of the population that would fall under the FAP. We have applied the historical estimate 50% to the total bad debt expense to determine the amount attributable to the FAP. Part III, Line 4: The provision for bad debts is based upon management's assessment of historical and expected net collections taking into consideration the trends in health care coverage, historical economic trends, and other collection indicators. Management assesses the adequacy of the allowances periodically throughout the year based upon historical write-off experience by major payor category. The results of the review are then utilized to make modifications, as necessary, to the provision for bad debts to provide for an appropriate allowance for uncollectable accounts. A significant portion of the corporation's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the corporation records a significant provision for bad debts related to uninsured patients in the period the services are provided. Part III, Line 8: Participation in the governmental Medicare program does not provide the opportunity for a hospital to negotiate a reimbursement rate or structure that would allow the hospital to cover the cost of the medical service rendered to the program participant, as would be the case in contractual negotiations with commercial insurance companies. Nor is the hospital allowed to provide only the services for which reimbursement covers the direct cost of care. This produces the same shortfall outcome as does the participation in the Medicaid program. The Medicaid program is recognized as a community benefit on Schedule H and on community benefit reports for most states. The quality and cost of the patient care is the same regardless of payor source. Hence the acceptance of Medicare reimbursement represents a reduction or relief of the government burden to pay the full cost of care provided. Part III, Line 9b: Collections practicesPatients known to qualify for financial assistance follow the same collection policy as all individuals with balances remaining after application of financial assistance.Credit and collections policy:Memorial Hospital of South Bend relies on timely payment of patient accounts receivable to allow the hospital to continue to provide high-quality medical care and to secure the latest in health care technology for its patients. Memorial Hospital, recognizing the burden that unexpected health care expenses can place on patients and their families, will assist patients to resolve open accounts for hospital services by working with third party payers to adjudicate patient's insurance claims and by providing alternative payment plans for patients. The hospital also provides subsidized care for those patients who qualify. However, with the exception of some government and contracted care plans, ultimate responsibility for resolution or payment of accounts rests with the patient. Patients are expected to work with hospital personnel to resolve accounts with their insurance companies and/or employers as appropriate. Where there is an estimated selfpay balance due, Memorial Hospital will ask non-emergency patients to pay that balance prior to or at the time of admission/registration.1. If a patient does not qualify for financial assistance and does not pay their account according to the options provided, then the patient's account will be processed according to the bad debt write off policy.2. If a patient has begun making payments but then is later determined to qualify under the FAP, Memorial Hospital would issue a refund to the patient for any amount that has been determined to exceed their newly determined financial responsibility.3. Memorial Hospital of South Bend may request and collect a deposit, based on the patient's total estimated portion of a bill, from appropriate non-emergency inpatient admissions, same day surgery patients, and patients scheduled for high-dollar outpatient procedures prior to or at the time of admission or registration. In the event that a request for payment is not made prior to or at the time of the patient's arrival, a financial counselor may calculate the estimated deposit amount and confer with the patient/guarantor for payment following the admission or registration process via a financial interview. (in some instances, this could occur while the patient is in his/her assigned room.) At the time of discharge, emergency patients may be requested to pay any co-pay or deductible.4. Where appropriate, Memorial Hospital of South Bend will identify, and request payment of, aged patient balances as part of the request for deposit. Payment for open prior balances will not delay care for emergency or medically necessary care. Aged open prior balances will be considered by the collection staff in patient account services whenever payment arrangements or an alternative payment program is developed for a patient.5. Uninsured patients are given a 35% discount from gross charges.6. Memorial Hospital of South Bend will conduct financial interviews with patients and/or guarantors when necessary. All financial interviews will be conducted in an environment that is both private and professional.7. In addition to cash, check, and credit cards, the approved payment arrangement methods might include:A. Hospital payment plan - a payment plan with the hospital is not to exceed three months. Exceptions must be approved by the manager of patient account services or revenue cycle director. Patients may be required to sign a promissory note based on the agreed upon payment arrangement.B. Carepayment - an extended payment plan which allows the patient an extended period not to exceed 36 months at 0% interest to pay their balance between $100 and $15,000. Patients may be automatically enrolled in the carepayment plan if their account has not been paid in full 2 months after their first statement. All patients are eligible provided that they provide a valid social security number, are over 18 and have not previously defaulted on their carepayment account.C. Medicaid/HIP - patients who do not have coverage when they present to the hospital for treatment will be screened for other coverage through state assistance programs. An eligibility specialist will assist the patient/guarantor to complete and submit all necessary forms required by the Indiana Department of Public Aid for these types of programs.D. Hospital financial assistance (uncompensated care)- reasonable efforts will be made to determine if patients are eligible for financial assistance through the hospital financial assistance program. All financial assistance must be approved according to the FAP for the hospital. (Refer to the hospital's financial assistance policy).8. Extraordinary collection actions will not be taken until after Memorial Hospital has made reasonable efforts to determine if a patient will qualify for financial assistance. Extraordinary collection actions include suit, wage garnishment, lien or adverse credit bureau reporting. Part VI, Line 2: Beacon Community Impact formed the first Community Health Advisory Council in 2016. Still operating on an as needed basis today the Council consists of representation from Community Hospital of Bremen, Elkhart General Hospital, Memorial Hospital of South Bend, and Three Rivers Health. The council is made up of individuals from Beacon Health System and Community stakeholders i.e. Council at Large, Public School Systems, other Health Care entities, Indiana University South Bend, University of Notre Dame, Ivy Tech Community College, community organizations, local churches, community persons, etc.). The Advisory Council met monthly in 2024 following the MAPP 2.0 training during the Community Health Needs Assessment (CHNA) procedures and will meet 2-4 times per year to learn about community health, the CHNA process, and to review local hospital and community data collected regarding health in our community; there are periodic email communications as well. The Advisory Council provides input on the health priority areas, offers best practices, identifies areas of opportunities, and monitors progress on addressing health needs. Part VI, Line 3: When patients present to our hospital, they are offered the opportunity to meet with our eligibility specialists. Our eligibility specialists discuss the potential eligibility of the patient for multiple assistance programs, including our own internal financial assistance program. Our statements also include a notice that financial assistance is available to patients, and they can contact our customer service group for guidelines. Patients are also made aware of our financial assistance program via telephone conversation with our patient accounts staff. Staff is particularly sensitive to address this program with anyone who indicates there might be a financial need. Part VI, Line 4: Established in 1830, St. Joseph County Indiana has become the fourth largest county in the state of Indiana. The county spans 457.78 square miles, which includes a comfortable mix of rural cultural heritage and urban amenities. St. Joseph County is also the regional center for higher education, with more than eight colleges and universities with a population of 272,843 according to the U.S. Census Bureau (year 2023). Through the years, the environment of South Bend, the largest city in St. Joseph County, has changed from a focus on manufacturing (Studebaker, Bosch, and Uniroyal) to health, education and customer services.Elkhart, Marshall and St. Joseph Counties are all located in Northern Indiana. They have a total of 6 cities and 16 towns with a combined population of 525,609. St. Joseph is the largest and Marshall the smallest, which is classified as rural. St. Joseph County, Michigan borders Elkhart County, Indiana and is similar in rural classification as Marshall County. Although each varies in population density, they are closer in geographic size (SJC, IN-457 square miles, Elkhart-463, Marshall-443, SJC, MI-521). The median household income (2018-2022) is comparable across Beacon's service area counties, with Marshall County leading at $66,016, followed by Elkhart County at $63,978, St. Joseph County, MI at $62,281, and St. Joseph County, IN at $61,877 - all below the U.S. median of $75,149. Poverty rates vary, with St. Joseph County, IN experiencing the highest rate at 14.4%, followed by St. Joseph County, MI at 12.9%, Elkhart County at 12.0%, and Marshall County with the lowest at 10.8%. Elkhart County remains the "RV Capital of the World," with the industry generating over $32.4 billion in annual economic impact nationwide and supporting over 18,000 local jobs. Marshall County continues as one of Indiana's agricultural leaders, with over 219,000 acres of farmland generating $171 million in agricultural products. St. Joseph County, IN serves as the regional center for higher education, home to institutions like Notre Dame, Indiana University South Bend, and Saint Mary's College, which have helped transform the local economy from manufacturing to health, education, and service sectors. St. Joseph County, MI maintains its natural beauty with numerous lakes and woodlands, including over 42 lakes and Sturgeon Lake, which spans 220 acres. Part VI, Line 5: In partnership with Beacon Health System (BHS), the mission of Memorial Hospital of South Bend (MHSB) is to deliver outstanding care, inspire health and connect with heart. BHS is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead BHS to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both BHS and MHSB consistently invest funds to improve the quality of life for our communities.BHS values reflect an unwavering commitment to the communities we serve. MHSB has as its values:- Patients are at the center - Patient needs, care and safety are our top priority. - Trust - Our actions will firmly demonstrate our integrity, abilities and our character.- Respect - We will treat our patients, community members, and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. - Integrity - We will continually do the right thing for patients, associates, and communities we serve. - Compassion - We will appropriately demonstrate empathy and sympathy and express the desire to help.MHSB seeks to promote the health and well-being of St. Joseph (SJC) residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community. A key mechanism by which this goal is carried out is MHSB's serious, consistent, and deliberate search for and partnership with like-minded organizations. MHSB continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances include local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers.Memorial Hospital South Bend's governing body is comprised of persons who reside in St. Joseph County. Board of Directors, who serve without pay, guides the system in its mission to provide high quality, affordable health care to the communities it serves. The Board's roles include guaranteeing fair and equal access, approving new medical staff members and approving long-term strategies for the continued success of the hospital. Additionally, Memorial Hospital South Bend extends medical staff privileges to all qualified physicians in our community.Beacon Health System welcomed Three Rivers Health in Three Rivers, Michigan, to the Beacon family in September 2021. In 2023, Community Impact established a working relationship with the local health department, Branch-Hillsdale-St. Joseph Community Health Agency, to address the top needs in the community. Beacon Health System employs a comprehensive approach to health promotion across its four-county service area, focusing on two priority areas: healthcare access and mental health. This integrated strategy works through community partnerships and internal programs to address social determinants of health and build healthier communities.Beacon's healthcare access work aims to decrease the number of uninsured individuals and increase patients' confidence in communicating with healthcare providers. Key programs include:- The Beacon Health Navigator program, which helps connect people to appropriate health resources and insurance options, preventing situations like fraudulent insurance schemes- Cultural and language-appropriate services for diverse populations- Targeted support for uninsured individuals through community partnerships- Specialized outreach to underserved communities through partners like La Casa de AmistadBeacon's mental health initiatives focus on reducing mentally unhealthy days and increasing social support systems for both youth and adults. Activities include:- Suicide prevention training (safeTALK) that provides education and emotional healing- Culturally-responsive mental health support for diverse populations- Programming that connects isolated individuals with supportive communities- Trauma-informed approaches to mental health careRecognizing maternal and infant health as a critical indicator of community wellbeing, Beacon has implemented:- A comprehensive maternal health strategy with care coordination between clinical providers and community programs- Dedicated care teams including doulas, community health workers, nurses, and social workers- The Family Journey initiative, funded by a $5.4 million federal grant, to improve birth outcomes and eliminate health disparities- Remote patient monitoring for pregnant patients with hypertension- Sickle cell screening and education for newborns and parents- B.A.B.E. stores providing essential supplies to new parents who earn "coupons" through healthy behaviors- WIC nutritional support programs with successful breastfeeding promotion initiativesBeacon extends its health promotion work through:- Street Medicine South Bend to improve care for those experiencing homelessness- Food pantry services at the Family Medicine Residency Clinic- The Beacon School of Nursing partnership with Ivy Tech to address nursing shortages- Associate volunteer programs encouraging community service- Annual Sunburst races promoting physical activity while supporting Beacon Children's Hospital- Continuing education for healthcare providers on community health issuesThis multi-faceted approach demonstrates Beacon's commitment to improving health outcomes by addressing both clinical care and underlying social determinants of health throughout their service area. Part VI, Line 6: In 2011, MHSB affiliated with Elkhart General Hospital of Elkhart, Indiana, under the name of Beacon Health System. In 2018, Beacon Health System affiliated with Community Hospital of Bremen. In October 2021, Beacon Health System affiliated with Three Rivers Health System. All organizations continue as full-care providers for their respective Counties, and they are committed to promoting the health of the communities they serve. The Memorial Hospital South Bend board of directors consists of 9 voting board members. The Beacon Health System Board of Directors consists of 14 voting board members. Part VI, Line 7, Reports Filed With States IN 1 Cultivate Culinary School & Catering Inc 1403 Prairie Ave South Bend IN 46613 813306113 501(c)(3) 6000 0 General Support Cultivating Life Inc 1042 W Western Ave South Bend IN 46601 461656925 501(c)(3) 30000 0 General Support Downtown South Bend Inc 217 S Michigan St South Bend IN 46601 351546291 501(c)(6) 20000 0 General Support Gentlemen and Scholars Inc 1412 W Washington St South Bend IN 46601 465141303 501(c)(3) 25000 0 General Support Imani Unidad Inc 234 Chapin St Ste B South Bend IN 46616 810615463 501(c)(3) 30000 0 General Support Indiana University Foundation IUSM-SB 1234 Notre Dame Ave Racin-Carmichae Hall South Bend IN 46617 356018940 501(c)(3) 12500 0 General Support IYSA Indiana Youth Services Association 303 N Alabama Ste 210 Indianapolis IN 46201 351481092 501(c)(3) 18000 0 General Support Lacasa de Amistad Inc 746S Meade St South Bend IN 46619 351350013 501(c)(3) 25000 0 General Support LGBTQ Resource Center 251 East Sample St Ste 10 South Bend IN 46601 203906347 501(c)(3) 25000 0 General Support Logan Community Resource 2505 E Jefferson Blvd South Bend IN 46615 350965639 501(c)(3) 5170 0 General Support Mental Health Awareness of Michiana 3220 E Jefferson Blvd South Bend IN 46615 824359500 501(c)(3) 20000 0 General Support Oaklawn Psychiatric Center Inc PO Box 809 Goshen IN 46527 351070041 501(c)(3) 40000 0 General Support Play Like A Champion Today Ed Services PO Box 72 Notre Dame IN 46556 813305202 501(c)(3) 25000 0 Program Sponsor REAL Services Inc PO Box 1835 South Bend IN 46634 351157606 501(c)(3) 7099 0 General Support Transformation Ministries Inc 1519 Portage Ave South Bend IN 46616 823641234 501(c)(3) 34000 0 General Support United Health Services 6910 N Main St Bldg 9 Mail Unit 10 Granger IN 46530 351118647 501(c)(3) 12800 0 General Support United Way of St Joseph County IN 3517 E Jefferson South Bend IN 46660 351063368 501(c)(3) 20000 0 Corporate Sponsor Venues Parks and Arts Foundation 301 S St Louis Blvd South Bend IN 46617 273843043 501(c)(3) 5750 0 Event Sponsorship Vibes Music Festival Inc 408 W Western Ave Apt 2104 South Bend IN 46601 921035774 501(c)(3) 7500 0 Event Sponsorship WNIT-TV Channel 34 300 West Jefferson South Bend IN 46601 351155594 501(c)(3) 7750 0 Event Sponsorship YMCA of Greater Michiana 905 N Front St Niles MI 49120 381358236 501(c)(3) 15784 0 General Support YWCA 1102 S Fellows St South Bend IN 46601 350868226 501(c)(3) 5258 0 General Support 21 1 Scholarship 1 33163 Part I, Line 2: Donations and grants given to organizations that improve the health and well-being of our community are monitored through outcome measurement reports that are provided to Memorial by the various organizations. These reports inform us of how the donations and grants were used. Part III: Number of recipients for scholarship assistance is estimated based on the number of invoices from outside organizations for other assistance made for the benefit of individual recipients. X 1 1 0 1 0 0 0 0 0 1 0 Kreg R Gruber CEO 0 1081233 0 557131 0 210350 0 259693 0 28015 0 2136422 0 64523 Jeffrey P Costello CFO 0 626239 0 261724 0 189649 0 166583 0 22015 0 1266210 0 61622 Larry A Tracy President 0 515206 0 216036 0 76313 0 141988 0 35585 0 985128 0 62479 Michelle A Thompson VP Medical Affairs 390736 0 83227 0 1932 0 39861 0 33848 0 549604 0 0 0 Linda A Mansfield Dir of Sports Medicine 310219 0 38662 0 690 0 44300 0 30897 0 424768 0 0 0 Kristine E Jennings Dir of Med Residency Program 311607 0 38031 0 300 0 34702 0 33397 0 418037 0 0 0 Matthew R Reed Employed Physician 312382 0 37211 0 300 0 36800 0 20065 0 406758 0 0 0 Marion Mahone Assoc. Dir Resident Program 310886 0 37211 0 1028 0 36800 0 12394 0 398319 0 0 0 Part I, Line 1a Memorial Hospital of South Bend, Inc. offers complimentary health club membership to Beacon Health System's Health and Lifestyle Center, a related party. Health or social club dues for the following individuals was included in taxable compensation: Ronald Nelson, Bethany Hartley, Martha Smith and Renee Fleming. Part I, Line 3 Memorial Hospital of South Bend, Inc. uses a related organization's (Beacon Health System, Inc.) compensation review process. This review process includes an extensive examination using comparable market data that is then reviewed by an independent consultant hired by, and reporting to, the board of directors. Recommendations are presented to the board for deliberation and final decision. Part I, Line 4b Beacon Health System implemented an executive retention plan to attract and retain key employees by providing additional deferred compensation. The Chief Executive Officer will participate in the plan and will select other participants pursuant to the guidelines set by the employer's board of directors. The employer may make contributions under the plan and has sole discretion over whether to make a contribution. Vesting occurs on January 1 of the fifth year for which such contributions are made for participants who have been continuously employed. The plan also allows vesting to occur if the participant attains the age of 62. The following individuals received vested payments in 2024, reflected in column (b)(iii): Kreg Gruber, $198,816 Jeffrey Costello, $130,545 Larry Tracy $65,201 The following individuals received deferred payments in 2024 that will vest in future years, which are reflected in column c: Kreg Gruber, $215,393 Jeffrey Costello, $122,283 Larry Tracy, $97,688 Part I, Line 7 The Organization has three incentive plans (employee, management and executive) which have a net operating income to budget measurement for the payout threshold. The employee plan shares the excess over budget net operating income with the non-management employees for Beacon Health System, Inc. and the affiliated entities. The employee incentive has a maximum cap of $4,500,000. The payout and amount of the payout for the employee incentive plan is made at the discretion of the board. The management incentive plan is funded when operating income is equal to or greater than 50% of the budgeted net operating income. Reward amounts are based on a balanced score card methodology utilizing Beacon's strategic imperatives and measured using selected metrics set on a sliding scale defined as threshold 50%, target 100%, and maximum 150%. The strategic imperatives are clinical excellence, great workplace, customer-driven culture, smart growth, and financial sustainability. Each imperative carries a default weight of 20%. The payout of the management incentive is made at the discretion of the board. Executives are covered under the Beacon Health System executive short-term incentive plan (ESTIP). The ESTIP is funded when operating income is equal to or greater than 50% of the budgeted net operating income. Reward amounts are based on a balanced score card methodology utilizing Beacon's strategic imperatives and measured using selected metrics set on a sliding scale defined as threshold 50%, target 100%, and maximum 150%. The strategic imperatives are clinical excellence, great workplace, customer-driven culture, smart growth, and financial sustainability. Each imperative carries a default weight of 20%. The payout of the ESTIP is made at the discretion of the board. A INDIANA FINANCE AUTHORITY 351602316 000000000 2017-09-08 37240000 REFUND BONDS ISSUED 03/16/2006 0 0 0 B HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 911914363 79062WAA6 2013-05-21 45523353 REFUND BONDS ISSUED 05/10/2007 0 0 0 C HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 911914363 000000000 2022-05-19 150000000 CONSTRUCT TOWER ON MEMORIAL HOSPITAL 0 0 0 D INDIANA FINANCE AUTHORITY 351602316 000000000 2023-06-16 40658950 REFUND TAXABLE BONDS ISSUED ON 9/21/2021 0 0 0 A 1775000 37240000 37240000 2000 1 0 1 1 B 45523353 511271 45012082 2009 1 0 1 1 C 150000000 175395 76233740 73590865 0 0 0 1 D 6196175 40658950 95083 40563867 2003 0 1 1 1 B 0 0 1 1 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 1 1 0 0 0 1 A 0 0 1 1 1 1 Wells Fargo NA 21.700000000000 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part III - Column a Column a is not completed because such bonds were issued after 12/31/2002. To refund, through a series of 2006 refundings, bonds issued before 01/01/2003. Schedule K, Part IV, Line 2c - Column b The date the rebate computation was performed on the Hospital Authority of Saint Joseph County was 4/29/23. Schedule K, Part IV, Line 2c - Column a The date the rebate computation was performed on the Indiana Finance Authority was 9/8/22. Katharine Callaghan Board member is their father 178519 Compensation 0 Dominique Fleming Board member is their mother 14750 Compensation 0 Part I, Line 6: Volunteers - Memorial Hospital of South Bend has a department called Ambassador and Customer Services. It is the responsibility of this department to recruit, orient, process and place new ambassadors in approximately 30 service areas of the hospital. It is also the responsibility of the department to follow up, schedule and recognize ambassadors. Some of the areas of service include a major surgery waiting room, patient escorts, flower delivery, mail delivery, living history program, emergency department volunteers and cookie bakers. In 2024, Memorial had 348 volunteers in this program. Form 990, Part VI, Section A, line 6 Members of the Organization Beacon Health System, Inc. is the sole corporate member of Memorial Hospital of South Bend, Inc. Form 990, Part VI, Section A, line 7a Election of Board Members The Corporate Member shall appoint the board of directors of Memorial Hospital of South Bend and shall have such powers of advance approval regarding corporate actions as are delineated in the bylaws of Memorial Hospital of South Bend. Form 990, Part VI, Section A, line 7b Decisions of the Board of Directors Decisions of the board of directors must be approved by the Corporate Member. Beacon Health System, the sole member of Memorial Hospital of South Bend, has control over Memorial Hospital of South Bend's operations. The following matters require the approval of Beacon Health System's board: 1. Selection and retention of auditors 2. Approval of all contracts, policies, or programs of insurance establishing the types of insurance coverage required as well as the coverage levels 3. The nomination, election and removal of members of the board of the corporation 4. Other matters determined from time to time by the member, or as provided in the bylaws or other governing documents Form 990, Part VI, Section B, line 11b Form 990 Review Process The Organization incorporates numerous parties in the production and review of the form 990 and associated schedules. Senior accounting staff and management complete information for the form 990 and related schedules. Some forms and schedules are reviewed by the controller. Subsequent to those steps, the organization engaged RSM to prepare form 990 and appropriate schedules. Prior to filing the return, the CFO, the audit committee of the organization, and the CEO, conduct a general overview of the form 990, including applicable compensation schedules. In addition, each board member receives notification of the IRS form 990 placement on the organization's board portals which allows for board member review prior to filing the return. Form 990, Part VI, Section B, line 12c Conflict of Interest Disclosure There are three separate forms that are sent out through the internal audit department to key employees or board members regarding conflict of interest. They are as follows: 1. The first is a conflict of interest statement that is sent to senior level administration, management, and select staff, such as purchasing department employees. The purpose of the statement is to require these employees to disclose any potential conflict of interests they may have. The statements are sent in January of each year for the previous year activities and we pursue the replies to get a 100% response rate. In the current year, we sent out 372 statements and are working to achieve a 100% response rate. Each response is reviewed by the director of internal audit and the results are reported to the CEO of Beacon Health System, the audit committee chairman, as well as the audit committee of the board of directors. 2. The second statement is the board duality of interest statement that is sent to current board members, former board members from the last five years, and other key employees. The duality of interest statement is sent using a web based survey tool provided by RSM. The replies are reviewed by the director of internal audit. The results of the surveys are summarized using the web based tool and are reviewed by RSM in completing the 990. The results are reported to the CEO of Beacon Health System, the audit committee chairman, and the audit committee of the board of directors. 3. The third statement is entitled "Code of Ethics for Senior Financial Officers". The statement requires an acknowledgement form to be signed by Beacon Health System's key financial employees that Beacon's financial information is to the best of their knowledge true and accurate. This statement was sent out on March 4, 2025, and the signed acknowledgements are kept by the director of internal audit. In 2024, 31 designated employees were requested to sign the form and we had a 100% compliance rate. Any potential conflicts of interests are reviewed by independent parties both internal and external to the organization, and if necessary, corrective action would be taken to resolve a true conflict. The individual with the potential conflict of interest would be excluded from all review proceedings. Form 990, Part VI, Section B, line 15 Compensation Determination Process Memorial Hospital of South Bend's parent, Beacon Health System, Inc. has a comprehensive process in place for reviewing and approving compensation of the executive leadership team. This review compares the total compensation provided to each executive to that provided to functionally similar positions in similarly situated organizations. This review is conducted regularly by the board compensation committee in consultation with an independent compensation advisor who is hired by and reports to the board compensation committee. Based on the advice of the compensation advisor and comparable and appropriate market data reported in third-party compensation surveys, and applying the organization's executive compensation philosophy, the board compensation committee makes compensation recommendations regarding the CEO's compensation to the board of directors for approval and the CEO makes compensation recommendation regarding all other members of the executive leadership team to the board compensation committee for approval. Deliberations and final decisions are contemporaneously documented. The annual compensation review was completed by the board compensation committee in March 2025 and the independent compensation advisor provided a statement of reasonableness of the compensation provided to the CEO and executive leadership team members. Form 990, Part VI, Section C, line 19 Availability of Organizational Documents The governing documents and conflict of interest policy are not made available to the public. The financial statements are distributed quarterly to the Electronic Municipal Market Access (EMMA) website as part of the continuing disclosures for the Beacon Health System, Inc. bonds available to the public. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 53,005,108. Management and general expenses 8,844,493. Fundraising expenses 0. Total expenses 61,849,601. Form 990, Part XI, line 9: Write Off Intercompany Balances -135,169,210. Beacon Medical Group Inc 615 N Michigan St South Bend IN 46601 351536132 Physician Practices IN 501(c)(3) Line 10 Beacon Health System Inc 1 Beacon Health Foundation Inc 615 N Michigan St South Bend IN 46601 351536129 Financial Support IN 501(c)(3) Line 7 Beacon Health System Inc 1 Elkhart General Hospital Inc 600 East Blvd Elkhart IN 46514 350877574 Hospital IN 501(c)(3) Line 3 Beacon Health System Inc 1 Memorial Endowment Fund for Memorial Hospital PO Box 1602 South Bend IN 46634 356068581 Endowment IN 501(c)(3) Line 12d, III-O Memorial Hospital of South Bend Inc 0 Beacon Health System Inc 615 N Michigan St South Bend IN 46601 453864076 Parent Organization IN 501(c)(3) Line 12c, III-FI N/A 0 Community Hospital of Bremen Inc 1020 High Road Bremen IN 46506 350835006 Hospital IN 501(c)(3) Line 3 Beacon Health System Inc 1 Three Rivers Health System 701 S Health Parkway Three Rivers MI 49093 451257972 Hospital MI 501(c)(3) Line 3 Beacon Health System Inc 1 South Bend Specialty Surgery Center LLC 335 Florence Ave 1B Granger IN 46530 460571418 Ambulatory Surgery Center IN N/A 0 0 Beacon Health Ventures Inc 615 N Michigan St South Bend IN 46601 351901068 Home Medical IN Beacon Health System Inc C 0 Beacon Health Ventures Michigan 615 N Michigan St South Bend IN 46601 208259773 Home Medical MI Beacon Health System Inc C 0 LaSalle Square Inc 615 N Michigan St South Bend IN 46601 383955333 Low Income Housing Project IN Memorial Hospital of South Bend Inc C 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 Beacon Health Foundation Inc C 1236977 Actual charges Beacon Medical Group Inc J 1856380 Actual charges Beacon Health Ventures Inc P 1167100 Actual charges Beacon Medical Group Inc P 34294272 Actual charges Community Hospital of Bremen Inc P 1034640 Actual charges Elkhart General Hospital Inc P 1188283 Actual charges Beacon Health Ventures Inc Q 518613 Actual charges Beacon Medical Group Inc Q 8424622 Actual charges Community Hospital of Bremen Inc Q 13077669 Actual charges Elkhart General Hospital Inc Q 1836293 Actual charges Three Rivers Health System Q 65954 Actual charges Beacon Health Foundation Inc R 127767 Cash Beacon Health Ventures Inc R 142280 Cash Beacon Medical Group Inc R 6319297 Cash Community Hospital of Bremen Inc R 10017075 Cash Elkhart General Hospital Inc R 371686 Cash Three Rivers Health System R 61929 Cash Beacon Health Foundation Inc S 127882 Cash Beacon Health Ventures Inc S 467485 Cash Community Hospital of Bremen Inc S 2025954 Cash Beacon Medical Group Inc S 17709886 Cash Elkhart General Hospital Inc S 276323 Cash