PROTESTANT MEMORIAL MEDICAL CENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: PROTESTANT MEMORIAL MEDICAL CENTER (EIN 37-0635502)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-13
IRS object ID: 201533179349302053
Schema version: 2014v5.0
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 K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-13T08:31:08-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	211 N BROADWAY SUITE 600	AddressLine1Txt
City	ST LOUIS	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	631022733	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	370635502	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Protestant Memorial Medical Center Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% MEMORIAL HOSPITAL - CONTROLL	InCareOfNm
Business Name Control	PROT	BusinessNameControlTxt
Phone	6182575602	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4500 Memorial Drive	AddressLine1Txt
City	Belleville	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	622265399	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOE LANIUS	PersonNm
Person Title	VP FINANCE	PersonTitleTxt
Phone	6182575602	PhoneNum
Signature	2015-11-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Donna J Larson	PreparerPersonNm
PTIN	P00043751	PTIN
Phone	3142315544	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Mark J Turner President	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4500 Memorial Drive	AddressLine1Txt
City	Belleville	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	622265399	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$266,283,993	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.memhosp.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1947	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	2724	TotalEmployeeCnt
Total Volunteers	323	TotalVolunteersCnt
Total Gross UBI	$133,364	TotalGrossUBIAmt
PY Contributions Grants	$186,420	PYContributionsGrantsAmt
CY Contributions Grants	$87,600	CYContributionsGrantsAmt
PY Program Service Revenue	$252,678,468	PYProgramServiceRevenueAmt
CY Program Service Revenue	$257,400,765	CYProgramServiceRevenueAmt
PY Investment Income	$1,726,809	PYInvestmentIncomeAmt
CY Investment Income	$953,390	CYInvestmentIncomeAmt
PY Other Revenue	$3,886,245	PYOtherRevenueAmt
CY Other Revenue	$4,100,754	CYOtherRevenueAmt
PY Total Revenue	$258,477,942	PYTotalRevenueAmt
CY Total Revenue	$262,542,509	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$138,681,634	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$127,784,757	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$116,440,853	PYOtherExpensesAmt
CY Other Expenses	$111,556,129	CYOtherExpensesAmt
PY Total Expenses	$255,122,487	PYTotalExpensesAmt
CY Total Expenses	$239,340,886	CYTotalExpensesAmt
PY Revenues Less Expenses	$3,355,455	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$23,201,623	CYRevenuesLessExpensesAmt
Total Assets BOY	$193,664,592	TotalAssetsBOYAmt
Total Assets EOY	$219,188,493	TotalAssetsEOYAmt
Total Liabilities BOY	$78,172,900	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$80,527,360	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$115,491,692	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$138,661,133	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MEMORIAL IS COMMITTED TO BEING THE HEALTHCARE PROVIDER OF CHOICE BY DELIVERING EXTRAORDINARY CARE AND COMPASSIONATE SERVICE TO PATIENTS OF SOUTHWEST ILLINOIS THROUGH EXPANDED SERVICES, PHYSICAL FACILITIES, AND ADVANCED TECHNOLOGY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$199,384,372	ExpenseAmt
Revenue	$247,601,599	RevenueAmt
Desc	GENERAL SHORT TERM ACUTE CARE HOSPITAL: 316 BEDS, 15,403 PATIENTS ADMITTED, 64,238 PATIENT DAYS, 68,063 EMERGENCY ROOM VISITS, 30,460 MEDICARE PATIENT DAYS, 348,620 OUTPATIENT DEPARTMENT VISITS, AND 12,921 MEDICAID PATIENT DAYS. SEE SCHEDULE O FOR ADDITIONAL STATISTICS AND VALUE OF COMMUNITY BENEFITS PROVIDED DURING 2014.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$9,075,047	ExpenseAmt
Revenue	$10,273,149	RevenueAmt
Desc	SKILLED NURSING FACILITY-MEMORIAL CARE CENTER: 108 BEDS, 1,025 PATIENTS ADMITTED, 22,895 PATIENT DAYS, 15,294 MEDICARE PATIENT DAYS, 52 MEDICAID PATIENT DAYS.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$208,459,419	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	Yes (true)	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	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	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	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	false	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	192	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	2724	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	14	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	MEMORIAL HOSPITAL - CONTROLL	PersonNm
Phone	6182575602	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4500 MEMORIAL DRIVE	AddressLine1Txt
City	BELLEVILLE	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62226	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
R BRAD RINGHOFER MD
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
LESLIE MEHRTENS
DIRECTOR	0.5	0.8	Yes (X)	$0	$0	$0
EDWARD HOERING
DIRECTOR	0.5	1.2	Yes (X)	$0	$0	$0
LARY ECKERT
DIRECTOR	0.5	1.2	Yes (X)	$0	$0	$0
THOMAS LIPPERT
DIRECTOR	0.5	0.8	Yes (X)	$0	$0	$0
EDWARD ROSE MD
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
ROLAND THOUVENOT
CHAIRMAN, DIRECTOR	0.5	0.85	Yes (X)	$0	$0	$0
ROBERT WANLESS MD
DIRECTOR	0.5	0.5	Yes (X)	$0	$288,124	$26,226
SCOTT GIVENS
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
MARQUITA WILEY
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
JEFFRY LUTZ
DIRECTOR	0.5	1.2	Yes (X)	$0	$0	$0
REV ROB DYER
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
ROBERT GRAEBE
DIRECTOR	0.5	0.5	Yes (X)	$0	$0	$0
KEITH COOK
DIRECTOR	0.5	0.85	Yes (X)	$0	$0	$0
MARK TURNER
PRESIDENT	55.0	5.62		$544,046	$0	$137,324	Yes (X)
JOE LANIUS
VP FINANCE	23.0	37.62		$0	$310,394	$45,486	Yes (X)
NANCY WESTON
VP NURSING SERVICES	65.0	0.0		$326,236	$0	$35,380	Yes (X)
RUTH HOLMES
ADMINISTRATOR MEMORIAL EAST	10.0	60.0		$0	$202,212	$33,668	Yes (X)
CHERYL CREASY
VP RISK MANAGEMENT	49.0	1.0		$145,105	$0	$28,424	Yes (X)
JAMES DAVIS
VP PHYSICIAN SERVICES	1.0	59.0		$0	$179,367	$31,213	Yes (X)
WILLIAM CASPERSON MD
VP MEDICAL AFFAIRS	60.0	0.0		$329,374	$0	$61,039	Yes (X)
AMY THOMAS
VICE PRESIDENT FINANCE	60.0	0.0		$203,590	$0	$33,226	Yes (X)
JOHN ZIEGLER
VP HUMAN RESOURCES	55.0	5.0		$182,719	$0	$31,673	Yes (X)
MICHAEL MCMANUS
CHIEF OPERATING OFFICER	55.0	0.0		$279,423	$0	$40,608	Yes (X)
LINDA FRITSCHE
TELEMETRY NURSE	60.0	0.0		$135,115	$0	$19,706		Yes (X)
MARIA GHORMLEY
EMERGENCY NURSE	60.0	0.0		$149,525	$0	$16,363		Yes (X)
STARLA ELLER
DIRECTOR SURGICAL SERVICES	60.0	0.0		$180,855	$0	$17,484		Yes (X)
JENNIFER MEINKOTH
DIRECTOR INFORMATION TECHNOLOG	55.0	0.0		$189,817	$0	$27,296		Yes (X)
GLEN KOHNZ
DIRECTOR PHARMACY	60.0	0.0		$145,727	$0	$14,946		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,811,532	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$980,097	TotReportableCompRltdOrgAmt
Total Other Compensation	$600,062	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	65	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	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
CALIFORNIA EMERGENCY PHYSICIANS
2100 POWELL ST	EMERYVILLE	CA	94608	PHYSICIAN SERVICES	$3,824,475
CROTHALL HEALTHCARE
13028 COLLECTION CTR DR	CHICAGO	IL	60693	CONSULTING SERVICES	$3,584,347
ANESTHESIA ASSOCIATES
4500 MEMORIAL DR	BELLEVILLE	IL	62226	ANESTHESIA SERVICES	$3,106,982
HURON CONSULTING SERVICES
550 W VAN BUREN	CHICAGO	IL	60607	CONSULTING SERVICES	$2,416,440
ARUP LABORATORIES
500 CHIPETA WAY	SALT LAKE CITY	UT	84108	LAB TEST SERVICES	$963,552

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	73	CntrctRcvdGreaterThan100KCnt
Related Organizations	$87,600	RelatedOrganizationsAmt
Total Contributions	$87,600	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES -
ACUTE CARE HOSP.	621110	$247,127,616	$246,994,252	$133,364
PATIENT SERVICES -
SKILLED NURS. FAC	621110	$10,273,149	$10,273,149

Field	Value	IRS element (for citing)
Total Program Service Revenue	$257,400,765	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$937,156	TotalRevenueColumnAmt
Exclusion	$937,156	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$49,056	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$49,056	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$49,056	TotalRevenueColumnAmt
Exclusion	$49,056	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$3,757,718	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$3,741,484	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$16,234	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,234	TotalRevenueColumnAmt
Exclusion	$16,234	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA/COFFEE SHOP SALES	722210	$1,573,801	$1,573,801
VHA PATRONAGE PROG	621110	$473,983		$473,983
EMR INCENTIVE PAYMENT	900099	$1,596,119	$1,596,119

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$407,795	TotalRevenueColumnAmt
Exclusion	$407,795	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$4,051,698	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$262,542,509	TotalRevenueColumnAmt
Related Or Exempt Func Income	$257,741,384	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$133,364	UnrelatedBusinessRevenueAmt
Exclusion	$4,580,161	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,378,167	TotalAmt
Management And General	$2,378,167	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$38,605	TotalAmt
Program Services	$38,605	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$90,495,886	TotalAmt
Program Services	$83,007,377	ProgramServicesAmt
Management And General	$7,488,509	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$3,105,945	TotalAmt
Program Services	$2,777,164	ProgramServicesAmt
Management And General	$328,781	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$24,756,291	TotalAmt
Program Services	$22,135,705	ProgramServicesAmt
Management And General	$2,620,586	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$7,009,863	TotalAmt
Program Services	$6,267,832	ProgramServicesAmt
Management And General	$742,031	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$373,630	TotalAmt
Management And General	$373,630	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$94,024	TotalAmt
Management And General	$94,024	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$25,198,927	TotalAmt
Program Services	$17,902,993	ProgramServicesAmt
Management And General	$7,295,934	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,054,968	TotalAmt
Management And General	$1,054,968	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$41,794,452	TotalAmt
Program Services	$41,127,783	ProgramServicesAmt
Management And General	$666,669	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,988,184	TotalAmt
Program Services	$3,566,013	ProgramServicesAmt
Management And General	$422,171	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$97,411	TotalAmt
Program Services	$54,512	ProgramServicesAmt
Management And General	$42,899	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,151,695	TotalAmt
Management And General	$1,151,695	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$14,736,720	TotalAmt
Program Services	$13,204,489	ProgramServicesAmt
Management And General	$1,532,231	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,299,763	TotalAmt
Program Services	$1,995,659	ProgramServicesAmt
Management And General	$304,104	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
REPAIRS & MAINTENANCE	$7,595,442	$5,366,171	$2,229,271
ASSOCIATION DUES	$315,112		$315,112
MICROFILMING	$42,000		$42,000
MEDICAL WASTE DISPOSAL	$285,569	$285,569

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,528,232	TotalAmt
Program Services	$10,729,547	ProgramServicesAmt
Management And General	$1,798,685	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$239,340,886	TotalAmt
Program Services	$208,459,419	ProgramServicesAmt
Management And General	$30,881,467	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,200	BOYAmt
EOY	$4,200	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$9,781,616	BOYAmt
EOY	$30,783,994	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$47,450,427	BOYAmt
EOY	$44,254,007	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,882,714	BOYAmt
EOY	$2,834,468	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,405,134	BOYAmt
EOY	$3,543,952	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$236,543,632	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$175,641,838	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$67,789,386	BOYAmt
EOY	$60,901,794	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$31,115,810	BOYAmt
EOY	$33,316,897	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$12,110,181	BOYAmt
EOY	$13,131,080	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$19,125,124	BOYAmt
EOY	$30,418,101	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$193,664,592	BOYAmt
EOY	$219,188,493	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$45,778,407	BOYAmt
EOY	$48,004,576	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$15,586,237	BOYAmt
EOY	$15,350,155	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$16,808,256	BOYAmt
EOY	$17,172,629	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$78,172,900	BOYAmt
EOY	$80,527,360	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$103,381,511	BOYAmt
EOY	$125,530,053	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,110,181	BOYAmt
EOY	$13,131,080	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$115,491,692	BOYAmt
EOY	$138,661,133	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$193,664,592	BOYAmt
EOY	$219,188,493	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$23,201,623	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$301,571	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$269,389	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)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$88,570	OtherActivitiesAmt
Total Lobbying Expenditures	$88,570	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	PROTESTANT MEMORIAL MEDICAL CENTER, INC. PAID MEMBERSHIP DUES TO ILINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THESE ORGANIZATIONS ESTIMATED EXPENSES ALLOCATED TO LOBBYING ACTIVITIES TO BE 39.5% OF MEMBERSHIP DUES. PROTESTANT MEMORIAL MEDICAL CENTER, INC. ENGAGED AND PAID KANE CONSULTING $48,000 TO ASSIST MEMORIAL HOSPITAL WORKING WITH THE ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES (DHFS) ON THE MEDICAL CENTER'S MEDICAID REIMBURSEMENTS.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,486,451	OtherCostOrOtherBasisAmt
Book Value	$1,486,451	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,670,663	OtherCostOrOtherBasisAmt
Depreciation	$30,779,881	DepreciationAmt
Book Value	$6,890,782	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,097,425	OtherCostOrOtherBasisAmt
Depreciation	$3,985,294	DepreciationAmt
Book Value	$1,112,131	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$191,416,169	OtherCostOrOtherBasisAmt
Depreciation	$140,876,663	DepreciationAmt
Book Value	$50,539,506	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$872,924	OtherCostOrOtherBasisAmt
Book Value	$872,924	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$60,901,794	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

Field	Value	IRS element (for citing)
Desc	NET ASSETS OF MEMORIAL FOUNDAT	Desc
Book Value	$13,131,080	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$13,131,080	TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
AUXILIARY OTHER ASSETS	$151,498
DUE FROM AFFILIATED CORPS	$13,093,974
DUE FROM INSURANCE AFFILIATE	$17,172,629

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$30,418,101	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ESTIMATED PROFESSIONAL LIABILI	Desc
Amt	$17,172,629	Amt

Field	Value	IRS element (for citing)
Total Liability	$17,172,629	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$262,404,076	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$425,764	NetUnrealizedGainsInvstAmt
Other Revenue	$287,331	OtherRevenueAmt
Revenue Not Reported	-$138,433	RevenueNotReportedAmt
Revenue Subtotal	$262,542,509	RevenueSubtotalAmt
Total Revenue Per Form990	$262,542,509	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$242,285,977	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$2,945,091	OtherExpensesIncludedAmt
Expenses Not Reported	$2,945,091	ExpensesNotReportedAmt
Expenses Subtotal	$239,340,886	ExpensesSubtotalAmt
Total Expenses Per Form990	$239,340,886	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V	SCHEDULE D, PART V HAS NOT BEEN COMPLETED. THE ORGANIZATION ONLY REPORTS SUCH FUNDS ON THE BALANCE SHEET DUE TO AN AUDIT REQUIREMENT THAT THE INTEREST IN A RELATED FOUNDATION BE RECOGNIZED ON THE BOOKS. THE FUNDS HAVE BEEN ANALYZED ON FORM 990 OF MEMORIAL FOUNDATION, INC. (EIN#37-1186034).
PART X, LINE 2-FIN 48	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
PART XI, LINE 2D	$287,331 OF INVESTMENT INCOME OF MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND (EIN#37-1064809), A RELATED 501(C)(3) ORGANIZATION IS INCLUDED ON THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC.
PART XII, LINE 2D	$219,181 OF EXPENSES OF MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND (EIN#37-1064809), A RELATED 501(C)(3) ORGANIZATION ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. $2,725,910 OF INSURANCE EXPENSES ON THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. ARE INCLUDED IN OTHER CHANGES IN NET ASSETS ON THIS FORM 990 PART XI LINE 9 AND REPRESENT AN INSURANCE RELATIONSHIP WITH MEMORIAL CAPTIVE INSURANCE COMPANY (EIN#98-1082415), A RELATED ORGANIZATION.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	249.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent350	Yes (X)	Percent350Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,521,442	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,521,442	NetCommunityBenefitExpnsAmt
Total Expense	0.01050	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,628,737	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,334,047	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,294,690	NetCommunityBenefitExpnsAmt
Total Expense	0.04300	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$32,150,179	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,334,047	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,816,132	NetCommunityBenefitExpnsAmt
Total Expense	0.05350	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,260,615	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,260,615	NetCommunityBenefitExpnsAmt
Total Expense	0.00530	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$271,944	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$271,944	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,532,559	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,532,559	NetCommunityBenefitExpnsAmt
Total Expense	0.00640	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$33,682,738	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,334,047	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,348,691	NetCommunityBenefitExpnsAmt
Total Expense	0.05990	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$11,276,742	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,691,511	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$86,531,071	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$95,958,249	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$9,427,178	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	MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4500 MEMORIAL DRIVE	AddressLine1Txt
City	BELLEVILLE	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	62226	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MEMHOSP.COM	WebsiteAddressTxt
State License	0001461	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	MEMORIAL 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
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SCHEDULE H, PART V, SECTION C	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SCHEDULE H, PART V, SECTION C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
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	249.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	350.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
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	X	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	X	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	X	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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 5	PERSONS WHO REPRESENT THE COMMUNITY THE MAPP ASSESSMENT TEAMS CONDUCTED A COMPREHENSIVE ASSESSMENT OF THE ENTIRE POPULATION THROUGH THE USE OF COMMUNITY SURVEYS, A REVIEW OF POPULATION TRENDS, HEALTH OUTCOMES AND BEHAVIORS OVER THE LAST 5 YEARS. SECONDARY ASSESSMENTS OCCURRED AMONG KEY INFORMANTS AND FOCUS GROUPS FOR SELECT SEGMENTS OF THE POPULATION REPRESENTED BY PARTICIPATING HEALTH AND HUMAN SERVICE ORGANIZATIONS (I.E. THE HOMEBOUND ELDERLY, PERSONS WITH DISABILITIES, SENIOR CITIZENS, RESIDENTS OF COUNTY HOUSING AUTHORITIES, THE FAITH COMMUNITY, HEALTH ADVOCACY GROUPS, MEDICALLY MANAGED INDIVIDUALS AND THOSE PERSON WITH SERIOUS MENTAL ILLNESS). SEE COMMUNITY HEALTH NEEDS ASSESSMENT FOR LISTING OF HEALTHCARE COMMISSION MEMBERS AND AFFILIATES CONSULTED.
PART V, SECTION B, LINE 7, 10, 11	CHNA MADE WIDELY AVAILABLE THE HOSPITAL FACILITY POSTS THE CHNA, ALONG WITH ITS IMPLEMENTATION STRATEGY AT THE FOLLOWING SITE: http://memhosp.com.jtsite.com/media/uploads/Patient-Visitor/community_heal th_needs_assessment_2012.pdf THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA AND HOW THEY ARE BEING MET ARE DESCRIBED IN THE IMPLEMENTATION STRATEGY. THE ORGANIZATION DOES NOT HAVE ANY IDENTIFIED NEEDS THAT ARE NOT BEING ADDRESSED.
PART V, SECTION B, LINE 22D	ATTACHMENT A TO THE FINANCIAL ASSISTANCE POLICY DESCRIBED IN THE NOTE FOR PART I, LINE 3, AND THE UNINSURED DISCOUNT POLICY FOUND IN PART VI, PROVIDE THE FACTORS FOR DETERMINING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE PATIENTS.
PART V, SECTION B, LINES 16A-C	ACCESS THE FOLLOWING WEBSITE FOR THE THREE QUESTIONS LISTED ABOVE: HTTP://MEMHOSP.COM.JTSITE.COM/FINANCIAL-ASSISTANCE

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
MEMORIAL CARE CENTER
4315 MEMORIAL DRIVE	BELLEVILLE	IL	62226	SKILLED NURSING FACILITY
BELLEVILLE HEALTH & SPORTS CENTER
1001 SOUTH 74TH STREET	BELLEVILLE	IL	62223	SPORTS FACILITY

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C	FINANCIAL ASSISTANCE (CHARITY CARE) I. PURPOSE To describe the guidelines and process by which Memorial will grant charity care to patients. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. Individuals who need financial assistance and do not possess sufficient resources to pay all or a portion of Memorial's bill may be eligible for charity care according to the guidelines set forth in this policy. Charity care is available for all services provided by Memorial with the exception of the following: 1. Elective cosmetic surgery, elective sterilization and reverse sterilization procedures and screening tests 2. Any services not covered by Medicare. 3. Memorial Care Center services for long-term residential care. 4. Services not billed by Memorial (e.g., ambulance services, physician services, etc.) Patients who do not qualify for assistance pursuant to this policy may be eligible for discounts pursuant to AP 740 (Uninsured Patient Discount Policy). III. GUIDELINES 1. Eligibility for financial assistance will be based upon income guidelines approved by the Board of Directors, as well as the size of the patient's bill relative to the patient's household income. A. Eligibility based on income. Eligibility for financial assistance will be based upon income guidelines approved by the Memorial Board of Directors, based on federal poverty guidelines published by the United States Department of Health & Human Services ("Income Eligibility"). The Income Eligibility Guidelines, as amended from time to time by the Board of Directors, are set forth in Attachment A to this policy. B. Eligibility based on catastrophic medical expenses. Eligibility for financial assistance also will be based on the size of the patient's bill relative to the patient's household income. Payment responsibility for patients qualifying for Income Eligibility will be capped at ten percent (10%) of annual family income, as determined in the application process. Uninsured patients who face extraordinary medical expenses and who do not qualify for charity care based on Income Eligibility will qualify for financial assistance if their self-pay balances exceed ten percent (10%) of annual family income ("Medical Expense Eligibility"). Patients eligible on the basis of Medical Expense Eligibility will be responsible for the portion of the self-pay balance up to 10% of annual family income. Charity care will be granted to cover the excess amount. C. Eligibility based on Presumptive Mandated Categories. Eligibility for financial assistance also will be based on the following presumptive categories: Homelessness; deceased with no estate; mental incapacitation with no one to act on behalf; Medicaid eligibility, but not covered on date of service or non-covered service; Women, Infants, Children (WIC); Supplemental Nutrition Assistance Program (SNAP); Free Lunch and Breakfast Program; Low Income Home Energy Assistance Program (LIHEAP); Grant assistance for medical services; and Community medical care programs to low income. 2. Memorial will identify patients requiring financial assistance either prior to or and at any time during the billing and collection process. Memorial's Point of Service program will help to identify patients qualifying for financial assistance prior to service. Patients in the presumptive mandated categories may also be identified as eligible prior to receiving services. In addition, circumstances relating to a patient's (or a responsible party's) ability to pay may change subsequent to the rendering of medical services. Accordingly, a charity care determination can be made for a patient prior to, at the time of service or at any time during the billing and collection process. 3. The availability of charity care will be communicated to patients through a variety of means to ensure that Memorial's policy reaches persons in need of assistance. Communications to patients regarding the availability of charity care will be clear and concise and will include, but not be limited to, information provided by registration personnel, statements included on consent forms and patient statements, patient handbooks, signage within the hospital and publication on Memorial's website. Copies of Memorial's Application for Financial Assistance form ("Application Form") will be available for distribution in the Patient Access & Financial Services Department. Recognizing the sensitivity of patients and their families regarding the need for charity, all publications, forms, etc. will use the term "financial assistance" in lieu of "charity care" or "charity assistance." 4. Patients' specific questions about financial assistance should be directed to the Revenue Cycle Director or his/her designee. 5. All patients seeking financial assistance will be requested to complete an Application Form except for the patients in the presumptive financial categories (see section III Ic). Each patient or a patient representative will be requested to complete the Application Form in order for Memorial to determine eligibility for financial assistance on the basis of either Income Eligibility or Medical Expense Eligibility, provided that patients who demonstrate eligibility for any of the presumptive financial categories will be deemed eligible for charity assistance without an Application Form. It is the responsibility of the person seeking assistance to provide Memorial with sufficient and complete financial information to evaluate any request for charity care. Memorial personnel are available to assist with completion of the Application Form by telephone or in person. If translation is needed to facilitate completion of applications, it will be provided. Confidentiality of information and preservation of privacy shall be maintained for all patients who seek charity care. No information obtained in the application process will be released to third parties without the patient's written consent. 6. The patient or responsible party must apply to any local, state or federal government program for which the patient may be eligible for medical payment assistance when applicable. Memorial personnel will assist the patient or responsible party in the completion of any required application(s). A government application form may be substituted for the Application Form. 7. Any insurance benefit or third party obligation that is available for covering the cost of Memorial's services must be considered prior to the determination of charity care. This includes any medical liability, no-fault or insurance benefits. Memorial reserves the right to recover any amount previously approved for charity care that is subsequently paid by such insurance benefit or third party. 8. Memorial may consider the availability of liquid assets in determining charity care. In determining whether a patient qualifies for charity care, Memorial may also consider the extent to which the person has liquid assets (cash and investments) that could be used to meet the financial obligation. The patient's primary residence, automobile, pension assets and other personal property are specifically exempted from consideration in the determination of financial need. 9. A determination of the patient's eligibility for charity care will be made within fifteen (15) business days from the receipt of a completed Application Form, and collection efforts will be suspended pending such determination and otherwise in compliance with AP 730 (Billing and Collections Policy). Patients will be notified in writing of Memorial's decision to grant or to deny financial assistance. Charity care will be extended for any open account at the time of application and may continue for a period of six (6) months unless a change in patient financial status is determined. 10. Memorial offers payment plan options to patients eligible for charity care to successfully retire self-pay balances. Charity care patients are offered interest free payment plans to assist them in retiring their outstanding hospital bills. 11. Memorial will offer patients the opportunity to apply for charity care prior to referring an outstanding hospital bill to collection. Memorial will offer to conduct a financial assessment or will arrange for an alternative payment plan prior to sending a bill to collection. (Refer to AP 730 Billing and Collections Policy). 12. Memorial will train its Patient Access and Financial Services Department staff with regard to the availability of financial assistance under this policy. 13. Memorial will periodically evaluate its charity care program and will file annual reports as appropriate. Management will make periodic reports to the Board of Directors regarding charity care. This policy will be reviewed periodically by senior managers for possible revision. Any revisions recommended by management will be submitted to the Board of Direct
PART I, LINE 6A	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT FILED WITH ILLINOIS OFFICE OF ATTORNEY GENERAL PREPARED BY PMMCI
PART I, LINE 7, COLUMN (F)	THE COST OF CHARITY AND OTHER COMMUNITY BENEFITS WERE DIVIDED BY ORGANIZATION'S TOTAL OPERATING EXPENSES, WHICH DID NOT INCLUDE BAD DEBT EXPENSE.
PART I, LINE 7	CHARITY CARE AND OTHER COMMUNITY BENEFITS WERE CALCULATED IN ACCORDANCE WITH STATE OF ILLINOIS REQUIREMENTS FOR COMMUNITY BENEFITS REPORT. THE MEDICARE COST TO CHARGE RATIO WAS USED FROM THE MEDICARE COST REPORT.
PART III, LINE 4	THE AMOUNT ON LINE 2 REPRESENTS THE AMOUNT WRITTEN OFF TO BAD DEBT EXPENSE DURING 2014. THE ORGANIZATION DID NOT EMPLOY A METHODOLOGY TO ITS ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE AS THERE ARE NO SUPPORTING STATISTICS AVAILABLE. RATHER, THE AMOUNT INCLUDED ON LINE 3 REPRESENTS AN ESTIMATED 15% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2. FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: "ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."
PART III, LINE 8	MEDICARE COST REPORT IS FILED FOLLOWING COST REPORT GUIDELINES. MEDICARE PAYMENT SHORTFALLS SHOULD BE REFLECTED AS COMMUNITY BENEFIT AS THE FEDERAL GOVERNMENT PROSPECTIVELY SETS THE HOSPITAL PAYMENT RATES; THE RATES ARE NOT NEGOTIABLE AND CONSEQUENTLY NO LONGER COVER THE HOSPITAL'S COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES.
PART III, LINE 9B	BILLING AND COLLECTIONS I. PURPOSE To insure billing and collection efforts are fair, consistent and in accordance with applicable law. II. POLICY Memorial Hospital and Memorial Care Center (collectively, "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. Accordingly, Memorial shall pursue patient accounts fairly and consistently pursuant to the law and only after offering patients the opportunity to apply for charity care pursuant to AP 700 ("Financial Assistance Policy") and/or applying a discount pursuant to AP 740 ("Uninsured Patient Discount Policy"). III. GUIDELINES 1. Bill Information. When Memorial bills a patient for health care services, it shall provide the following information: (a) the date or dates that health care services were provided to the patient; (b) a brief description of the services; (c) the amount owed for services; (d) contact information for addressing billing inquiries to Memorial; (e) notice that the patient may obtain an itemized bill upon request; and (f) a statement regarding how an uninsured patient may apply for consideration under the Financial Assistance Policy on or with each Memorial bill sent to an uninsured patient. 2. Bill Inquiries. Memorial will provide patients with a telephone number to inquire about or dispute a bill. Memorial will return calls made by patients promptly, and in any case no later than two business days after receipt. If Memorial receives correspondence from the patient regarding a bill, Memorial will respond within ten business days of receipt. 3. Collections; Limitation on Collections. (a) In General. Memorial and its agents will not pursue a collection action against a patient until the patient has had the opportunity to assess the accuracy of the bill and apply for financial assistance under the Financial Assistance Policy or establish a reasonable payment plan under the Financial Assistance Policy or this policy. (b) Approval of Collection Actions. Memorial will not refer an account to collections, and will not permit any collection agency, law firm or individual to initiate legal action for non-payment of a hospital bill against a patient, without the written approval of the Revenue Cycle Director or his/her designee. Such action will only be approved if it is reasonably believed that the conditions for pursuing the action under this Policy are met. (c) Special Considerations for Uninsured Patients. An uninsured patient will have sixty days following the date of discharge or receipt of care or thirty days following the initial bill (whichever is longer) to submit an application for financial assistance or to request a reasonable payment plan. Thereafter, Memorial may pursue collection action against an uninsured patient only when: (i) the patient has not paid his or her bill (as adjusted pursuant to the Uninsured Patient Discount Policy) during such time and has not contacted Memorial about payment; (ii) the patient has informed Memorial that he or she has applied for a government sponsored healthcare program but the patient's application has been denied; (iii) the patient has agreed to a reasonable payment plan with Memorial and the patient has failed to make payments in accordance with that reasonable payment plan; or (iv) the patient requests a reasonable payment plan but fails to agree to a plan within thirty days of that request. (d) Other Considerations. (i) Memorial will not pursue legal action for non-payment of bills against patients who qualify for financial assistance and who have clearly demonstrated that they have neither sufficient income nor assets to meet their financial obligation. (ii) Legal action may be taken by Memorial to enforce the terms of the payment plan when there is evidence that the responsible party has sufficient income and/or assets to meet his or her financial obligation. (iii) Memorial will not place a lien on the primary residence of a patient receiving financial assistance unless the value of the property clearly indicates an ability to assume significant financial obligations. Further, Memorial will not execute a lien by forcing the sale or foreclosure of the primary residence of a patient receiving financial assistance to pay for an outstanding medical bill. (iv) Memorial will not use body attachment to require any person, whether receiving financial assistance or not, to appear in court. (e) Adoption of Standards by Collection Agencies. Memorial will ensure that the guidelines outlined above are adhered to by any external collection agency, law firm or individual engaged to assist in obtaining payment on outstanding bills from patients. 4. Periodic Review. Memorial will review this policy periodically for compliance with the federal Fair Debt Collection Practices Act, the Illinois Fair Patient Billing Act and the Illinois Hospital Uninsured Patient Discount Act.
PART V	1 HOSPITAL & 1 SKILLED NURSING FACILITY ILLINOIS
NEEDS ASSESSMENT	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT REGARDING COMMUNITY NEEDS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	FINANCIAL ASSISTANCE IS COMMUNICATED VIA SIGNS POSTED THROUGHOUT THE HOSPITAL, NEWSPAPER, BROCHURES, WEBSITE, AND PATIENT BILLING STATEMENTS.
COMMUNITY INFORMATION	SEE SCHEDULE O - COMMUNITY BENEFIT REPORT FOR DESCRIPTION OF THE GEOGRAPHIC AND DEMOGRAPHIC PROFILES OF PATIENTS SERVED.
PROMOTION OF COMMUNITY HEALTH	SEE SCHEDULE O - COMMUNITY BENEFIT REPORT REGARDING SUBSIDIZED COMMUNITY OUTREACH, COMMUNITY EDUCATION, SUPPORT GROUPS AND SCREENINGS
OTHER INFORMATION REQUIRED	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT FOR A DESCRIPTION OF ACTIVITIES THAT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. ADDITIONALLY, THE FOLLOWING IS THE UNINSURED PATIENT DISCOUNT POLICY: UNINSURED PATIENT DISCOUNT I. PURPOSE To describe the guidelines and process by which Memorial will grant uninsured patients a discount from billed charges. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. In an effort to provide affordable health care services, patients who lack private or public health insurance will receive an automatic discount from Memorial's billed charges. Memorial will discuss financial responsibility with patients prior to services being provided pursuant to the Point of Service Policy (AP 750). The uninsured patient discount is available for all services provided by Memorial with the exception of the following: 1. Elective cosmetic surgery, elective sterilization and reverse sterilization procedures and procedures or other services not covered by Medicare. 2. Memorial Care Center services for long-term residential care. 3. Non-medical services (e.g., social and vocational services). 4. Services not billed by Memorial (e.g., ambulance services, physician services etc.) This policy will be interpreted and applied in a manner consistent with the Illinois Hospital Uninsured Patient Discount Act. III. GUIDELINES 1. Eligibility for the discount. An "uninsured patient" is defined as: Any patient who is not covered under a policy of health insurance and is not a beneficiary under a public or private health insurance, health benefit, or other health coverage program, including high deductible health insurance plans, workers' compensation, accident liability insurance or other third party liability or no fault insurance. Patients that are insured but not covered for a particular service do not qualify for the uninsured patient discount. The availability of the uninsured discount is contingent upon the uninsured patient applying, at Memorial's request, for coverage under public programs (i.e., Medicare, Medicaid, etc.) if Memorial determines there is a basis to believe the patient may be eligible for such programs. 2. Calculation of the discount. The discount is calculated as the difference between billed charges and one hundred thirty-five percent (135%) of cost, using the total cost-to-charge ratio from Memorial's most recently filed Medicare cost report (Worksheet C, Part I). 3. Maximum annual collection. The maximum amount collected from an eligible patient in a twelve-month period is twenty-five percent (25%) of the family's annual household income. The twelve-month period begins as of the first date of service eligible for discount. For subsequent services to be counted toward the maximum, the patient must inform Memorial that he/she had received prior discounted services from Memorial. The annual cap is applicable only to services provided at Memorial and does not include services provided at other hospital facilities. 4. Communication to Patients. Memorial will include a statement on all patient bills that financial assistance may be available on the remaining account balance, pursuant to AP 700 (Financial Assistance Policy). POINT OF SERVICE I. PURPOSE To describe the guidelines and process by which Memorial will collect patient payments prior to service. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. As healthcare continues to evolve it is necessary to educate patients regarding their financial liability prior to service. Discussing financial responsibility before service is provided will improve the patient experience as well as increase revenue and reduce costs for the organization. III. GUIDELINES 1. Patient responsibility will be determined using payment estimation software or communication (online or phone call) to the patient's benefit administrator. 2. Guidelines for the payment of the patient's responsibility are based on estimated amount due. a. All patients will be asked to pay 100% of estimated balance due. b. Patients that pay their total estimated amount due prior to service being rendered will receive a 10% prompt pay discount. c. Patients with an estimated balance due of $100.00 or less and who do not pay 100% will be asked to establish a payment plan of at least $25.00 per month until the balance is paid in full. d. Patients whose estimated balance due is more than $100.00 and who cannot pay 100% will be asked to pay 50% with an automated payment plan for the remaining balance not to exceed 12 months. e. Patients whose estimated balance due is more than $100.00 and who cannot pay 100% or 50% will set up an automated payment plan for the entire estimated balance not to exceed 12 months. 3. Patients will be offered payment options of cash, check, credit/debit card, or electronic funds transfer. 4. Patients will be pre-screened for financial assistance based on information they provide to staff regarding income and presumptive eligibility per Financial Assistance Charity Care Policy (AP700). 5. Uninsured patients will receive up-front estimates of patient liability per Uninsured Patient Discount Policy (AP 740). 6. Patients that refuse to either pay their estimated balance or fail to cooperate in establishing a payment plan within the above guidelines will be notified that their test may be postponed. a. An exception to postponement will be made if the ordering physician determines that a delay in testing would be harmful to the patient's health. b. Emergency services will not be delayed based on a patient's ability to pay. 7. Patients will be billed per the collection guidelines included in the Billing and Collections Policy (AP 730). 8. If the actual patient responsibility is less than the original estimate the patient paid, the patient will be refunded if there are no other outstanding accounts. Otherwise, the credit will be applied towards any outstanding balance(s).
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
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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 (16 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
MARK TURNER
PRESIDENT	$526,546	$0	$0	$0	$17,500	$0	$117,420	$0	$19,904	$0	$681,370	$0	$0	$0
JOE LANIUS
VP FINANCE	$0	$292,894	$0	$0	$0	$17,500	$0	$29,320	$0	$16,166	$0	$355,880	$0	$0
NANCY WESTON
VP NURSING SERVICES	$308,736	$0	$0	$0	$17,500	$0	$24,610	$0	$10,770	$0	$361,616	$0	$0	$0
RUTH HOLMES
ADMINISTRATOR MEMORIAL EAST	$0	$195,368	$0	$0	$0	$6,844	$0	$14,837	$0	$18,831	$0	$235,880	$0	$0
ROBERT WANLESS MD
DIRECTOR	$0	$283,999	$0	$0	$0	$4,125	$0	$11,407	$0	$14,819	$0	$314,350	$0	$0
CHERYL CREASY
VP RISK MANAGEMENT	$139,461	$0	$0	$0	$5,644	$0	$9,819	$0	$18,605	$0	$173,529	$0	$0	$0
JAMES DAVIS
VP PHYSICIAN SERVICES	$0	$170,390	$0	$0	$0	$8,977	$0	$14,266	$0	$16,947	$0	$210,580	$0	$0
WILLIAM CASPERSON MD
VP MEDICAL AFFAIRS	$311,874	$0	$0	$0	$17,500	$0	$47,046	$0	$13,993	$0	$390,413	$0	$0	$0
LINDA FRITSCHE
TELEMETRY NURSE	$135,115	$0	$0	$0	$0	$0	$4,073	$0	$15,633	$0	$154,821	$0	$0	$0
MARIA GHORMLEY
EMERGENCY NURSE	$149,525	$0	$0	$0	$0	$0	$3,684	$0	$12,679	$0	$165,888	$0	$0	$0
AMY THOMAS
VICE PRESIDENT FINANCE	$186,090	$0	$0	$0	$17,500	$0	$16,504	$0	$16,722	$0	$236,816	$0	$0	$0
JOHN ZIEGLER
VP HUMAN RESOURCES	$165,219	$0	$0	$0	$17,500	$0	$13,030	$0	$18,643	$0	$214,392	$0	$0	$0
STARLA ELLER
DIRECTOR SURGICAL SERVICES	$180,855	$0	$0	$0	$0	$0	$9,584	$0	$7,900	$0	$198,339	$0	$0	$0
JENNIFER MEINKOTH
DIRECTOR INFORMATION TECHNOLOG	$189,817	$0	$0	$0	$0	$0	$10,612	$0	$16,684	$0	$217,113	$0	$0	$0
MICHAEL MCMANUS
CHIEF OPERATING OFFICER	$261,923	$0	$0	$0	$17,500	$0	$19,736	$0	$20,872	$0	$320,031	$0	$0	$0
GLEN KOHNZ
DIRECTOR PHARMACY	$145,727	$0	$0	$0	$0	$0	$7,046	$0	$7,900	$0	$160,673	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II, 4B	FormAndLineReferenceDesc
Explanation	DEFERRED COMPENSATION AND RETIREMENT CONTRIBUTIONS PER PART II(C): ROBERT WANLESS, DIRECTOR: RETIREMENT CONTRIBUTION - $11,407 DEFERRED COMPENSATION - NONE MARK TURNER, PRESIDENT: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $101,300 JOE H. LANIUS, VICE PRESIDENT FINANCE: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $13,200 CHERYL CREASY, VICE PRESIDENT RISK MANAGEMENT: RETIREMENT CONTRIBUTION - $6,996 DEFERRED COMPENSATION - $2,823 WILLIAM CASPERSON, VICE PRESIDENT MEDICAL AFFAIRS: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $30,926 NANCY WESTON, VICE PRESIDENT NURSING SERVICES: RETIREMENT CONTRIBUTION - $13,634 DEFERRED COMPENSATION - $10,976 RUTH HOLMES, ADMINISTRATOR MEMORIAL EAST: RETIREMENT CONTRIBUTION - $11,414 DEFERRED COMPENSATION - $3,423 JAMES DAVIS, VICE PRESIDENT PHYSICIAN SERVICES: RETIREMENT CONTRIBUTION - $9,776 DEFERRED COMPENSATION - $4,490 AMY THOMAS, VICE PRESIDENT FINANCE: RETIREMENT CONTRIBUTION - $10,607 DEFERRED COMPENSATION - $5,897 JOHN ZIEGLER, VICE PRESIDENT HUMAN RESOURCES: RETIREMENT CONTRIBUTION - $10,546 DEFERRED COMPENSATION - $2,484 MICHAEL MCMANUS, CHIEF OPERATING OFFICER: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $3,616 JENNIFER MEINKOTH, DIRECTOR INFORMATION TECHNOLOGY: RETIREMENT CONTRIBUTION - $10,612 DEFERRED COMPENSATION - NONE LINDA FRITSCHE, TELEMETRY NURSE: RETIREMENT CONTRIBUTION - $4,073 DEFERRED COMPENSATION - NONE STARLA ELLER, DIRECTOR SURGICAL SERVICES: RETIREMENT CONTRIBUTION - $9,584 DEFERRED COMPENSATION - NONE MARIA GHORMLEY, EMERGENCY NURSE: RETIREMENT CONTRIBUTION - $3,684 DEFERRED COMPENSATION - NONE GLEN KOHNZ, DIRECTOR PHARMACY RETIREMENT CONTRIBUTION - $7,046 DEFERRED COMPENSATION - $0	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHWEST ILLINOIS DEVELOPMENT AUTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	371234684	BondIssuerEIN
CUSIP	84553AAE2	CUSIPNum
Bond Issued	2013-12-06	BondIssuedDt
Issue Price	$156,712,718	IssuePriceAmt
Purpose	CAPITAL BUILDING PROJECTS	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
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Total Proceeds	$15,586,237	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$114,474	RefundingEscrowAmt
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Credit Enhancement	$0	CreditEnhancementAmt
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Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
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Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
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Hedge Provider Name HedgeProviderName

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Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART II	FormAndLineReferenceDesc
Explanation	ON DECEMBER 6, 2013, SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY ISSUED TO MEMORIAL GROUP, INC. REVENUE BONDS IN THE ORIGINAL PAR AMOUNT OF $156,712,718. OF THE TOTAL INDEBTEDNESS, $15,586,237 WAS ALLOCATED TO PROTESTANT MEMORIAL MEDICAL CENTER, INC. AND $16,763,777 WAS ALLOCATED TO SOUTHWEST ILLINOIS HEALTH VENTURES, INC. MEMORIAL GROUP, INC. WAS ALLOCATED $124,362,704.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	SUSAN MCMANUS	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	COO FAMILY MEMBER	RelationshipDescriptionTxt
Transaction	$38,605	TransactionAmt
Transaction	EMPLOYMENT	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART 1, LINE 1	BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES: PROTESTANT MEMORIAL MEDICAL CENTER OPERATES AN ACUTE CARE HOSPITAL AND SKILLED NURSING FACILITY WHOSE MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE AND COMPASSIONATE SERVICE TO THE RESIDENTS OF SOUTHWEST ILLINOIS.
COMMUNITY BENEFIT INFORMATION	I. SUMMARY The value of community benefits provided by Memorial Hospital during 2014 exceeded $35.0 million. Community Benefit Value ------------------------- Unpaid Costs of Medicaid and Medicare $19,721,868 Bad Debts 11,276,742 Charity Care 2,521,442 Volunteer Services 421,203 Subsidized Health Services 133,762 Education 652,063 Donations 271,944 Language Assistant Services 43,007 Other Community Activities 10,580 Total Community Benefits for 2014 $35,052,591 In 2015 Memorial Hospital will continue to provide a comprehensive range of quality healthcare services to residents of the communities it serves throughout Southwestern Illinois, continue its charity care assistance program, and improve communication with community partners and patients regarding the health resources and patient care. II. MISSION STATEMENT Provide exceptional healthcare and compassionate service. III. VISION STATEMENT Memorial, in partnership with its medical staff, employees, volunteers, and the community, is committed to being the healthcare provider of choice by: -Delivering extraordinary care and compassionate service to patients every day -Continually identifying performance improvement opportunities -Expanding services based on community need and enhancing accessibility to care -Providing physical facilities and acquiring the advanced technology to exceed patient and physician expectations -Being the employer of choice, continuing to recruit and retain skilled staff committed to providing service excellence to patients, visitors, and co-workers IV. COMMUNITY BENEFITS PROVIDED IN 2014 During 2014 Memorial provided the following community outreach services to area residents at no or minimal cost:
COMMUNITY BENEFIT INFORMATION (CONT)	Service Persons Served ------------------------------ ---------------- 1. Community Health Education -Smart Driver Program 39 -Healthy Conversation-Heart Health 15 -Healthy Conversation-Fabulous and Fit Over 50 10 2. Wellness Programs -Healthy Lifesyle 53 -Lively Lungs Participants 112 -Cardiac Wellness/Rehab Program 9,721 -Belleville East Health Education Club 200 -Parish Nurses 15 3. Speakers Bureau (Topics) -Nutrition (Benefits of Healthy Eating) 407 -Pharmacy Participants -Cardiac Rehabilitation in -Heart Health Speakers -Obstetrics Bureau -Heat Related Issues-Signs,Symptoms,Prevention -Dehydration and Heat Exhaustion -Health, Wellness, and Faith -Breast Health -Diabetes Education -Pain Management -EPI Pen Training -Belleville Health and Sports Center -CPR -Cancer Awareness and Prevention 4. Clinics, Screenings, and Services -Diabetes Alert Day 50 -Kidney Mobile 30 -Skin Cancer Screening at Memorial Hospital 109 -Skin Cancer Screening at St. Clair County Office 40 -Stress and Mediatation Class 20 Blood Drive Donations: -Memorial Blood Drives 309 -New Donors 26 5. Support Groups -Diabetes 161 -Pulmonary Rehab 350 -Mended Hearts 49 -Hope Blooms 67 -AWAKE 140 -Stroke 240 -Alzheimer's 144 -Heart Failure 60 -Spinal Cord Injury 180 6. Special Events and Partnerships -Healthy Kids Day at the YMCA 200 -Healthy Living Expo 250 -Mingle and Mammograms 56 -Salute to Scott 3,000 -Get Up and Go Biathlon 500 -Back Pack to School 500 -Maternity Fair 175 -Dominate Your Diabetes 100 -Zumba for Heart Health 50 -Zumba for Breast Cancer 50 -Making Strides Against Breast Cancer Kick-Off 50 -Day of Play at St. Clair Square 50 -Heart and Vascular Screenings 28 -East Belleville YMCA 120 -Passport to Wellness 150 -Law Day Run 200 -Mckendree Involvement Fair 1,000 Health Fairs and Screenings: -Belleville East High School (3) -Casino Queen (2) -Monroe County Employees -Collinsville Middle School -Madison County Government (2) -Allsup -Scott Air Force Base -American Legion O'Fallon -Atrium Senior Apartments -Signal Hill -Cedars of Lebanon -Hospice of Southern Illinois -New Antioch Baptist Church -Mckendree University -The National Shrine of Our Lady of the Snows -St. Nicholas Church-O'Fallon -Holy Trinity Catholic Church-Fairview Heights -Nick 5K Run -Dupo High School -Monroe County Electric -Zoar UCC-Waterloo, IL -Clergy Day -Freize Harley Davidson -O'Fallon Township High School -St. Teresa's School -St. Clair County Office of Aging -Fairview Heights VFW -SWIC -Bluffview Elementary School -City of O'Fallon -Metro East Air and Health Forum Healthy Direction (Wellness Vehicle) -Belleville East High School -Casino Queen -Madison County Government -Memorial Medical Group-Nashville, IL -Scout Event-Dupo, IL -Program and Services for Older Persons -MetroLink (2) -McKendree University -St. Teresa's Catholic Church -Plummer Johnson -Scott Credit Union -Memorial Medical Group-Columbia, IL -Beacon 5K -Monroe County YMCA -Village of Dupo -Cedarhurst-Shiloh, IL -Freeburg Township -St. Nicholas Catholic Church-O'Fallon, IL -Knollwood Retirement Center Screenings Provided Include: -Screening Mammography (Healthy Direction Wellness Vehicle) -Blood Pressure -BMI with Body Fat Percentage -Cholesterol/Glucose -Lipid panels -PSAs -Forced Vital Capacity -Pulse Oximetry -Colorectal Screenings -Skin Cancer Screening -Cardiac Risk Profiles Other -Heart Walk - Memorial and its employees participated in the American Heart Association Heart Walk and have been represented on various committees. -March of Dimes Walk America - Memorial has been a check point sponsor for this event the past several years and has had representation on its board via a nursery nurse. Memorial has been the host site for this event since 2009. -Making Strides Against Breast Cancer - Memorial has supported this event through sponsorship, participation, and other in-kind support. -American Diabetes Association Run/Walk - As a certified Center for Diabetic Education, Memorial served a major sponsor for this run/walk through participation and in-kind support. -Get Up & Go - Memorial Hospital supports the Get Up & Go initiative to promote health/wellness in St. Clair County as well as is a key supporter of its annual biathlon. TOTAL COMMUNITY BENEFITS Total community benefits, including outreach programs, totaled $35,052,591 during 2014. Below is a summary of these activities: 1. Unpaid costs of providing care to Medicaid and Medicare patients a. Target Populations - Medicaid and Medicare enrollees b. Objectives - Provide needed inpatient and outpatient services to the community. c. Costs and Outcomes - $19,721,868 2. Bad Debts a. Target Populations - Broad community b. Objectives - Provide needed inpatient and outpatient services to the community. c. Costs and Outcomes - $11,276,742 3. Charity Care a. Target Populations - Low income uninsured, underinsured residents b. Objectives - Provide medical services to patients unable to pay for care. c. Costs and Outcomes - $2,521,422 4. Volunteer Services a. Target Populations - Memorial patients, family, visitors and board community. b. Objectives - Promote employee and volunteer participation in community benefit activities. c. Community Partners - Various non-profit agencies d. Costs and Outcomes - $421,203 over 33,000 volunteer hours 5. Community Outreach: Education, Screenings, Support Groups, Self Help Program a. Target Populations - Broad community, the uninsured, low income residents, residents without a primary care physician. b. Objectives - Provide health and wellness, safety, early disease detection, disease maintenance/support c. Community Partners - Various local groups d. Costs and Outcomes - $133,762 6. Health Care Education a. Target Populations - Potential health care workers, scholarships, student training opportunities b. Objectives - Address workforce shortage with universities c. Community Partners - Area colleges and universities d. Costs and Outcomes - $652,063
COMMUNITY BENEFIT INFORMATION (CONT)	7. Cash and In Kind Donations a. Target Populations - Broad community, low income residents b. Objectives - provide funds, services, staff, equipment, supplies, space to support local agencies and community programs. c. Community Partners - Social service agencies, churches, schools, health care providers d. Costs and Outcome - $271,944 8. Language Assistant Services a. Target Populations - Non-English speaking residents b. Objectives - Provide communication assistants c. Community Partners - Social service agencies d. Costs and Outcome - $43,007 9. Other Community Benefits a. Costs and Outcomes - $10,580 IV. 2015 COMMUNITY BENEFIT PLAN This section describes the communities served by Memorial, the health needs identified, program goals and objectives for 2015, and program priorities. A. Populations and Communities Served by Memorial Hospital 1. 2014 Adult & Pediatric Inpatient Discharges by County of Residence County Number Percent of Total St. Clair 12,860 83.58% Madison 973 6.32 Monroe 333 2.16 Randolph 377 2.45 Clinton 279 1.81 Washington 181 1.18 Other 383 2.50 -------- --------- Total 15,386 100.0% 2. More than half of Memorial's inpatients reside in five cities: Belleville, O'Fallon, Fairview Heights, East St. Louis, and Cahokia. 2014 Adult & Pediatric Inpatient Discharges by Zip Code of Residents Zip Code City # of Discharges Percent of Total 62226 Belleville 1,969 12.4% 62221 Belleville 1,242 8.2 62223 Belleville 1,249 7.9 62269 O'Fallon 1,169 7.9 62208 Fairview Heights 898 6.1 62206 Cahokia 885 5.9 62220 Belleville 777 5.1 62205 East St. Louis 586 3.6 ------- ------ Total 8,775 57.1 62234 Collinsville 512 3.3 62203 East St. Louis 515 3.3 62232 Caseyville 493 3.2 ------- ------ Total 1,520 9.8 All Other 5,091 33.1 Total 15,386 100% 3. Medical and surgical patients account for 89.5 percent of Memorial's inpatients. 2014 Adult & Pediatric Inpatient Discharges by Clinical Service Service Type Number Percent of Total Medical 10,520 68.37% Surgery 3,259 21.18 Obstetrics 1,596 10.38 Pediatrics 5 0.03 Oral/Dental 6 0.04 ------- -------- Total 15,386 100.0% 4. Patients enrolled in government-sponsored healthcare programs account for 58% of Memorial's inpatients. Self-pay patients, from whom Memorial receives limited payment, account for 3% of admissions. 2014 Adult & Pediatric Discharges by Financial Class Financial Class Number Percent of Total Medicare 6,869 44.64% Medicaid 1,764 11.46 TRICARE 332 2.16 ------- ------- 8,965 58.26 Managed Care & Commercial 5,594 36.36 Self-pay 410 2.66 Other 417 2.72 ------- ------- Total 15,386 100.0% 5. Just over 50% percent of Memorial's inpatients are adults age 65 and over. 2014 Adult & Pediatric Inpatient Discharges by Age Group Age Group Number Percent of Total 0 - 14 7 0.04% 15 - 44 3,396 22.07 45 - 64 4,414 28.69 65 - 74 2,832 18.41 75+ 4,737 30.79 --------- --------- Total 15,386 100.0% 6. While adults comprise the majority of Emergency Department outpatient visits, children under 15 account for 15% of the visits. 2014 Emergency Department Visits by Age Group (Excludes Admitted Patients) Service Number Percent of Total 0 - 14 8,728 15.39% 15 - 44 27,747 48.93 45 - 64 12,616 22.25 65 - 74 3,290 5.80 75+ 4,323 7.63 --------- -------- Total 56,704 100.0% 7. Over 53% of Emergency Department outpatients are enrolled in government-sponsored programs while roughly 15% are self-pay. 2014 Emergency Department Visits by Financial Class (Excludes Admitted Patients) Financial Class Number Percent of Total Medicare 7,985 14.08% Medicaid 15,289 26.96 TRICARE 2,740 4.84 -------- --------- Total 26,014 45.88 Managed Care/ Commercial 24,765 43.67 Self-pay 5,236 9.23 Other 689 1.22 --------- -------- Total 56,704 100.0% In summary, the above data shows that Memorial primarily serves the residents of St. Clair County, particularly those living in Belleville and adjacent communities. Target populations within the county include the elderly, children, Medicare and Medicaid enrollees and the uninsured.
COMMUNITY BENEFIT INFORMATION (CONT)	B. Healthcare Needs Assessment 1. The following table below shows that St. Clair County ranks 86th in health outcomes among 102 counties in Illinois for the lowest health outcomes and health factors, moving up three places for last year's 89th ranking. Length of life dropped from 87 years to 80 in the latest rankings. Health Outcomes St Clair 2014 Illinois 2014 US 2014 1. Length of Life 8,341 6,349 5,200 -Premature Death- 2. Morbidity -Poor or Fair Health- 16% 15% 10% -Poor Physical Health 4.0 3.4 2.5 Days- -Poor Mental Health 3.5 3.3 2.3 Days- -Low Birthweight- 9.2% 8.4% 5.9% Health Factors: Health Behaviors -Adult Smoking- 22% 18% 14% -Adult Obesity- 31% 27% 25% -Food Environment Index- 5.9 7.8 8.4 -Physical Inactivity- 28% 23% 20% -Access to Exercise 82% 89% 92% Opportunities- -Excessive Drinking- 19% 20% 10% -Alcohol Impaired 41% 37% 14% Driving Deaths- -Teen Births- 48 35 20 -Sexually Transmitted Infection- 789 526 138 Clinical Care -Uninsured- 12% 15% 11% -Primary Care Physicians- 1,670:1 1,266:1 1,045:1 -Dentists- 1,517:1 1,453:1 1,377:1 -Mental Health Providers- 1,271:1 604:1 386:1 -Preventable Hospital Stays- 68 65 41 -Diabetic Screening- 82% 85% 90% -Mammography Screening- 61.8% 64.4% 70.7% Social and Economic Factors -High School Graduation- 81% 82% -Some College- 67.2% 66.7% 71% -Unemployment- 9.5% 9.2% 4.0% -Children In Poverty- 27% 21% 13% -Income inequality- 5.2% 4.8% 3.7% -Children-Single Parent 45% 32% 20% Households- -Violent Crime Rate- 904 430 59 -Injury Deaths- 70 50 50 Physical Environment -Air Pollution-Particulate 12.1 12.5 9.5 Matter- -Drinking Water Violations- 4% 2% 0% -Severe Housing Problems- 16% 19% 9% -Driving Alone To Work- 81% 74% 71% -Long Commute-Driving Alone- 31% 40% 15% Source: www.countyhealthrankings.org/illinois/st-clair-2015 2. A statewide comparison reveals that St. Clair County has more African-American residents but fewer Hispanic residents, and fewer not proficient in English. Demographic Characteristics of St. Clair County Characteristic St. Clair County Illinois Population 265,729 12,880,580 % Under 18 years of age 24.3% 23.5% % 65 and older 13.5% 13.5% % White 65.7% 77.7% % African-American 30.4% 14.7% % Asian 1.4% 5.1% % Hispanic or Latino 3.7% 16.5% % Language other than English 5.8% 22.3% % Foreign Born 2.7% 13.8% Source: U.S. Census Bureau (2011) Based on Memorial's Community Health Needs Assessment and analysis, the following health issues for St. Clair County residents have been identified in addition to the stated goals and objectives. C. 2015 Goals and Objectives Priority health issues for St. Clair County, as identified through Memorial's Community Health Needs Assessment include: 1. Lung Cancer 2. Chronic Obstructive Pulmonary Disease (COPD) 3. Diabetes 4. Cardiovascular Disease Memorial Hospital plans to provide the following community benefits in 2015: 1. Provide free or discounted healthcare services through Memorial's uninsured patient discount and charity care policies to persons who are unable to pay. 2. Provide minimal or no cost needed health services, such as community health screenings, health education and support groups to residents in the communities served. 3. Serve the residents of St. Clair County and surrounding counties as the area's IDPH Resource Hospital and Regional Hospital Coordination Center. 4. Work closely with local, state, and federal disaster preparedness agencies as the IDPH Hospital in St. Clair County and nine surrounding counties and coordinate necessary disaster response and relief activities in case of severe emergency events. 5. Assure access to primary care and specialty physicians for area residents through continued recruitment efforts.
COMMUNITY BENEFIT INFORMATION (CONT)	D. Community Benefit Program Priorities Based on the populations served by Memorial Hospital and the assessment of healthcare needs, the following priorities are identified for the 2015 Community Benefit Program: 1. Access: Access to healthcare services is the number one priority due to the high percentage of the service area population that is uninsured or insured through public programs such as Medicaid and Medicare. Memorial is committed to providing healthcare services to patients in the service area regardless of ability to pay. Memorial does not discriminate based on race, sex, religion, color, or national origin. Additionally, Memorial will continue its efforts to provide charity care to those in need by: -Communicating the availability of charity care to patients. -Quickly identifying patients requiring financial assistance. -Assisting patients in completing appropriate applications for financial assistance. 2. Physician Recruitment: Memorial will continue to invest in physician recruitment to improve access to primary and specialty healthcare services for area residents. 3. Age-Specific Programs: Adults, seniors, and children differ in terms of health conditions, health behaviors, sources of financing, and other issues of access. Programs will be targeted for specific age groups, particularly seniors and children, and will include the following: -Children -Visits to schools and an onsite health fair to acquaint children with the hospital, car seat safety checks, health fairs, and screening for school sports participants. -Seniors - Older adult driving course, health fairs for seniors, Senior Care outpatient mental health program, skilled nursing care in Memorial Care Center, cooperation and support of various community agencies serving seniors. 5. Disease Management: Chronic illnesses such as diabetes, heart disease and hypertension affect many St. Clair County residents. According to the Centers for Disease Control, premature mortality rates (per 100,000) for leading chronic disease conditions in St. Clair County are: Cardiovascular Disease 136.6 COPD 83.5 Diabetes 36.6 Lung Cancer 58.1 Efforts are ongoing to enhance self-management of chronic conditions to benefit individuals and their families, such as: -Heart disease - Presentations by physicians and dietitians, smoking cessation counseling, cholesterol and blood pressure checks, health fairs, CPR classes, cardiac support groups and rehabilitation exercise programs, meditation classes and a Heart Failure Program. -COPD and Lung Cancer-Smoking cessation consultations, education to school-aged children, COPD/Pulmonary Rehab program and support group, and exercise programs. -Diabetes - Diabetes Education Program, nutritional classes, support groups, health fairs, weight management classes. -Hypertension - Blood pressure checks, nutritional counseling, meditation and weight management classes. 5. Healthy Lifestyles: Many healthcare problems are the result of individual lifestyle choices which ultimately cause chronic conditions, hospitalization, and death. Memorial will work collaboratively with schools, community agencies, and others to promote healthy lifestyles and a safe community through: -Employee Wellness Program - Continue to educate and promote healthy living by providing resources and incentives to achieve a healthy balanced life among employees. Employees participate in biometric health screenings annually. Those who participate also receive daily health tips via email. -For the fourth consecutive year, Memorial was named a Platinum Level Fit Friendly Worksite by the American Heart Association. -Self-help programs - Smoking cessation counseling, weight management. -Education - Older adult driving course through AARP, family safety, car seat safety checks, nutrition, partnerships with local Farmers' Markets to promote healthy lifestyles to students as well as with local high school health education clubs. 6. Screenings: Regular, easily accessible screenings are essential to detect disease in its early stages and to facilitate responsibility for disease management by the individual. Many in St. Clair County do not use the formal healthcare system on a regular basis due to access issues. Memorial will continue to conduct screening programs, targeted by condition and age to reach the community. These programs include: -Healthy Direction, Memorial's wellness vehicle will continue to provide health screening services such as vein screenings, diabetes and cholesterol screenings, pulse oximeters as well as a variety of other health screenings and exams. -Screenings for heart disease, diabetes, hypertension, skin cancer, and colorectal screening. 7. Other Activities: In addition to the above priorities, Memorial is Engaged in the following 2015 initiatives to improve care for the residents in the communities it serves throughout Southwest Illinois: -Gather information for the 2015/2016 Community Health Needs Assessment -Work collaboratively with the St. Clair County Health Department to identify community health needs issues -Conduct a Consumer Perception Study -Continue to develop and promote the Heart and Vascular Center of Excellence to educate people about the quality of cardiovascular care conveniently available. A risk assessment tool will be added to the site in 2015. -Continue to promote the Heart Failure Clinic to reduce patient mortality and readmission. -Promote and further develop a comprehensive disease management center for Heart Failure, Diabetic Education and Nutrition Counseling. -Continue to implement and Electronic Medical Record system to improve patient care and safety. Functionality includes physician order entry and physician documentation. -Continue to promote the services available in The Center for Orthopedic and Neurosciences located on Memorial's main campus. The 85,000-square-foot facility houses outpatient services including physical, occupation, speech and hand therapy; pain management; sports medicine; an open MRI and CT scanner. -Promote the Joint Replacement Center of Excellence as part of Memorial's Orthopedic and Neurosciences Center. -Promote Onsite Neonatal Partners as part of the Family Care Birthing Center services. This service allows us to reduce transfers of special care babies. -Package and promote the Women's Health Services available at Memorial to include but not limited to Family Care Birthing Center, Breast Health Center, Minimally-invasive surgery using Robotics, Vein treatment -Plan for the opening of Memorial Hospital-East, a 94-bed satellite hospital in nearby Shiloh. This facility, anticipated to open in April 2016, will provide for all private beds at both the Belleville and Shiloh hospital locations. -Explore strategic affiliation opportunities with BJC Healthcare -Further develop Memorial's Breast Health Center of Excellence to provide an integrated multi-disciplinary delivery of breast care in the Metro East. Launch website memorialbreasthealth.com in 2015 as part of this initiative -Continue to promote the MyMemorial patient portal for access to test results and appointment information. -Continue ONECall centralized scheduling line allowing first-time patients and physician's assistance in making appointments for an array of services. -Continue to promote the Direct Call Transfer Line to assist facilities in outlying communities in making facility to facility transfers in accordance with established prototcols.
FORM 990, PART VI, LINES 6, 7A, 7B	GOVERANCE AND DISCLOUSRE: PROTESTANT MEMORIAL MEDICAL CENTER, INC. HAS TWO CLASSES OF MEMBERS - COMMUNITY AND CORPORATE. COMMUNITY MEMBERS, WHICH INCLUDE BOTH INDIVIDUALS AND LOCAL AREA CHURCHES, HAVE THE EXCLUSIVE POWER TO APPROVE NOMINEES FOR ELECTION AS ELECTED DIRECTORS. THE CORPORATE MEMBER, MEMORIAL GROUP, INC HAS THE POWER TO ELECT, REMOVE, AND REPLACE ANY DIRECTOR, APPROVE AMMENDMENTS TO GOVERNING DOCUMENTS AND TO MAKE INVESTMENT POLICY.
FORM 990, PART VI, LINE 11A	REVIEW PROCESS: DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER , INC. ARE PROVIDED A COPY OF THE TAX RETURN PRIOR TO FILING FOR REVIEW. ANY DISCREPANCIES OR QUESTIONS ARE THEN SUBMITTED TO THE VICE PRESIDENT OF FINANCE.
FORM 990, PART VI, LINE 12C	CONFLICT OF INTEREST POLICY: OFFICERS AND DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. TRANSACTIONS DISCLOSED ON THE STATEMENTS ARE REVIEWED BY THE BOARD. THE BOARD OR A DULY CONSTITUTED COMMITTEE THEREOF SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE.
FORM 990, PART VI, LINE 15A & 15B	COMPENSATION POLICIES: THE COMPENSATION COMMITTEE UTILIZES THE SERVICES OF AN INDEPENDENT CONSULTANT TO DEVELOP HOSPITAL SURVEY DATA TO COMPARE SALARIES AND BENEFITS FOR MEMORIAL'S CORPORATE OFFICERS (CEO AND VICE PRESIDENTS). BASED ON THE SURVEY RESULTS, THE COMPENSATION COMMITTEE ESTABLISHES COMPENSATION FOR THE ENSUING YEAR.
FORM 990, PART VI, LINES 18 & 19	PUBLIC DISCLOSURE: UPON FILING FORM 990 AND SUPPORTING SCHEDULES, PUBLIC DISCLOSURE COPIES ARE AVAILABLE FOR PUBLIC INSPECTION IN THE OFFICE OF THE PRESIDENT OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. DURING REGULAR BUSINESS HOURS OF 8:30AM-5:00PM. COPIES ARE PROVIDED UPON REQUEST FOR A NOMINAL FEE. WRITTEN REQUESTS ARE HONORED WITHIN 30 DAYS. REQUESTS IN PERSON ARE PROVIDED ON THE DAY OF REQUEST. PROTESTANT MEMORIAL MEDICAL CENTER, INC. PROVIDES FOR PUBLIC INSPECTION THE MOST RECENT THREE YEARS OF FILINGS. PROTESTANT MEMORIAL MEDICAL CENTER, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VI, LINE 2	GOVERANCE & DISCLOSURE: MARK TURNER, WILLIAM CASPERSON, AND LARY ECKERT ALL HAVE A BUSINESS RELATIONSHIP AS A RESULT OF ALSO SERVING AS OFFICERS OR DIRECTORS OF MEMORIAL CAPTIVE INSURANCE COMPANY, A RELATED TAXABLE ENTITY.
FORM 990, PART IX, LINE 11G	STATEMENT OF FUNCTIONAL EXPENSES - OTHER FEES FOR SERVICES PHYSICIAN FEES $11,379,872 CONSULTING FEES $4,151,665 TESTS PERFORMED BY OUTSIDE COMPANIES $3,858,900 PURCHASED SERVICES $3,706,652 COLLECTION FEES $2,101,838 TOTAL OTHER FEES FOR SERVICES $25,198,927
FORM 990, PART XI, LINE 9	RECONCILIATION OF NET ASSETS - LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: ($540,909) FUND BALANCE TRANSFER TO MEMORIAL GROUP, INC., A RELATED 501(C)(3) ORGANIZATION. ($210,600) FUND BALANCE TRANSFER TO MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND, A REALTED 501(C)(3) ORGANIZATION. $1,020,898 NET CHANGE IN INTEREST IN MEMORIAL FOUNDATION, INC., A RELATED 501(C)(3) ORGANIZATION. $269,389 TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 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
MEMORIAL HOSP SELF INSURANCE TRUST FUND
4500 MEMORIAL DRIVE	BELLEVILLE	IL	62226	371064809	INSURANCE	IL	501(C)(3)	11-TYPE I	MGI	false
MEMORIAL FOUNDATION INC
4500 MEMORIAL DRIVE	BELLEVILLE	IL	62226	371186034	FUNDRAISING	IL	501(C)(3)	11-TYPE I	MGI	false
SOUTHWEST ILLINOIS HEALTH VENTURES INC
4500 MEMORIAL DRIVE	BELLEVILLE	IL	62226	371413286	MANAGEMENT	IL	501(C)(3)	11-TYPE I	MGI	false
MEMORIAL GROUP INC
4500 MEMORIAL DRIVE	BELLEVILLE	IL	62226	371186035	MANAGEMENT	IL	501(C)(3)	11-III-FI	NA	false
METRO EAST SERVICES INC
4500 MEMORIAL DRIVE	BELLEVILLE	IL	62226	460838901	HEALTHCARE	IL	501(C)(3)	3	MGI	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 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	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
MEMORIAL CAPTIVE INSURANCE CO
1850 N CENTRAL AVENUE STE 1700	PHOENIX	AZ	85004	201267507	INSURANCE	AZ	MGI	C CORP	$0	$0	0.00000	false
MEMORIAL CAPTIVE INSURANCE COMPANY
				981082415	INSURANCE		MGI	C-CORP	$0	$0	0.00000	false	94 SOLARIS 2ND FLOOR	GEORGETOWN	CAYMAN ISLANDS	CJ	CJ

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	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