2014-12-01T11:00:48-06:00 2014-03-31 CROWE HORWATH LLP 9600 BROWNSBORO ROAD SUITE 400 LOUISVILLE KY 402411122 990 2013-04-01 370618939 SOUTHERN ILLINOIS HOSPITAL SERVICES SOUT 6184575200 PO BOX 3988 CARBONDALE IL 629023988 MIKE KASSER CFO 2014-11-08 true Rachel Spurlock P00520729 5023263996 2013 2015-11-30 17:44:51Z SOUTHERN ILLINOIS HEALTHCARE REX BUDDE PO BOX 3988 CARBONDALE IL 629023988 791472291 false X WWW.SIH.NET X 1946 IL SOUTHERN ILLINOIS HOSPITAL SERVICES' (SIHS) MISSION STATEMENT IS "WE ARE DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES WE SERVE." 13 12 3060 274 744466 -190433 3321897 2453089 380496986 403639319 18270190 37643751 4682486 10090495 406771559 453826654 445902 969461 0 0 167575408 175384686 0 0 207502 195335490 219781261 363356800 396135408 43414759 57691246 607114260 650327766 211021480 202895203 396092780 447432563 X SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) IS DEDICATED TO PROMOTING THE HEALTH AND WELL BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS GUIDED BY OUR VALUES: COMPASSION, COLLABORATION, QUALITY, STEWARDSHIP, INTEGRITY, ACCOUNTABILITY AND RESPECT. (CONTINUED IN SCHEDULE O) false false 333185772 0 411519546 SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THROUGH DAILY OPERATIONS, SIHS' HOSPITALS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE, UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE, SUBSIDIZED HEALTH SERVICES AND MEDICAL EDUCATION. THE PRIMARY SERVICE AREA OF SIHS IS A VERY RURAL SEVEN-COUNTY REGION WITH A COMBINED POPULATION OF APPROXIMATELY 244,000. THE RESIDENTS OF THESE COUNTIES' MEDIAN HOUSEHOLD INCOMES ARE BELOW THE STATE AVERAGE, PLUS THE POVERTY RATE IS HIGHER THAN THE STATE AVERAGE. (CONTINUED IN SCHEDULE O) 2193906 969461 0 SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. THE COMMUNITY BENEFITS DEPARTMENT OF SIHS WAS INSTITUTED IN 1994 WITH AN OPERATING BUDGET SPECIFICALLY ALLOCATED TO BRING HEALTH-RELATED PROGRAMS TO THE AREAS IN WHICH THEY WERE MOST NEEDED. COMMUNITY BENEFITS HAS UNDERTAKEN A WIDE VARIETY OF SUCCESSFUL PROGRAMS SINCE ITS INCEPTION. (CONTINUED IN SCHEDULE O) 130201 0 0 SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE CHILDREN AND ADOLESCENTS ATTENDING SOUTHERN ILLINOIS SCHOOLS. (CONTINUED IN SCHEDULE O) 335509879 true true false true false false false false false true false false true true true false true false false true false false false false false true true true false true true false false false false false false true false true false false false false false true true true true false false true 337 0 true 3060 true true true true CJ false false false false false false false false X 13 12 false false false false true true true true true false false true true true true true true true true true true IL X MIKE KASSER 6184575200 1239 EAST MAIN STREET CARBONDALE IL 62901 EUGENE BASANTA Vice Chair 2.00 2.00 X X 350 0 0 MARLENE SIMPSON Secretary 2.00 1.00 X X 400 0 0 REX BUDDE President/CEO 40.00 15.00 X X 1051133 0 241430 STEVE SABENS Chair 2.00 2.00 X X 450 0 0 BOB MEES Trustee 2.00 1.00 X 400 0 0 DEBRA MCMORROW Trustee 2.00 1.00 X 300 0 0 DR TERRENCE GLENNON Trustee 2.00 2.00 X 7280 0 0 GEORGE O'NEILL Trustee 2.00 2.00 X 400 0 0 HAROLD BARDO Trustee 2.00 2.00 X 250 0 0 KATHLEEN FRALISH Trustee 2.00 2.00 X 400 0 0 MARSHA RYAN MD Trustee 2.00 2.00 X 7165 0 0 MIKE ABSHER Trustee 2.00 1.00 X 350 0 0 MORTON LEVINE Trustee 2.00 2.00 X 350 0 0 DAVID HOLLAND VP/ Info Systems 40.00 10.00 X 350554 0 105751 JAMES MILLER MD VP/CMO 40.00 10.00 X 473599 0 66755 JOHN B MILLSTEAD VP/ Administrator 50.00 0 X 534639 0 172051 JOHN BROTHERS VP/Administrator 50.00 0 X 263910 0 117906 JULIE FIRMAN VP/CNO 50.00 0 X 330649 0 95865 MIKE KASSER VP/CFO/Treasurer 40.00 15.00 X 401237 0 145249 PAM HENDERSON VP/ HR 40.00 0 X 342460 0 86573 PHILIP SCHAEFER VP/ Amb & Phys Services 15.00 55.00 X 486711 0 164808 SHELLY PIERCE VP/Quality 30.00 25.00 X 190905 0 36606 TERRENCE FARRELL VP/ Administrator 60.00 0 X 354287 0 124019 WILLIAM SHERWOOD VP/ General Counsel 40.00 15.00 X 461443 0 173385 WILLIAM THORNE VP/ Community Benefits 32.00 0 X 304888 0 102548 CHARLES BROOKS Staff Nurse 40.00 0 X 182634 0 30276 DANIEL SKILES Exec Director PHO 40.00 0 X 190708 0 39302 LEAH MACFARLANE Pharmacist 40.00 0 X 178365 0 21560 REBECCA BRASEL Staff Nurse 40.00 0 X 181178 0 43733 THOMAS HENTRICH Pharmacist 40.00 0 X 184748 0 44089 BECKY ASHTON Former VP 0.00 0 X 249262 0 407 6731405 0 1812313 112 true true false BRIGHAM ANESTHESIA SOUTH LLC 35 ALBANY RD STE C CARBONDALE IL 62903 MEDICAL AND HEALTHCARE PAYMENTS 3649278 MEDICAL STAFFING NETWORK PO BOX 203000 DALLAS TX 72445 MEDICAL AND HEALTHCARE PAYMENTS 3065378 AOS LLC 1859 BOWKES AVE FENTON MO 63026 IT SERVICES 2830007 LAB CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 2011281 MIDWEST REGIONAL NEONATOLOGY 1809 WEST MAIN CARBONDALE IL 62901 MEDICAL AND HEALTHCARE PAYMENTS 1014878 44 16101 1785803 651185 2453089 PATIENT REVENUE 622110 401920581 401920581 0 0 PARTNERSHIP INCOME 900099 1510727 1510727 0 0 LEASEHOLD REVENUE FROM RELATED ORGANIZATIONS 531120 208011 208011 0 0 0 0 0 0 0 0 403639319 8782600 0 0 8782600 0 0 670891 637346 33545 0 33545 0 0 33545 365861072 8370 336808801 199490 29052271 -191120 28861151 0 0 28861151 0 0 0 CAFETERIA/VENDING/HOSPITAL AUXILIARY 900099 1961136 528879 0 1432257 MEDICAL RECORDS/X-RAY/INTERNET PHYSICIANS 621300 638179 123740 514439 0 REFERENCE LAB 621500 230027 0 230027 0 7227608 7227608 0 0 10056950 453826654 411519546 744466 39109553 X 969461 969461 0 0 0 0 0 0 7460026 1194379 6265647 0 43680 43680 0 0 125471649 103689202 21630195 152252 2868988 1741941 1124681 2366 29937717 27429410 2488929 19378 9602626 7753614 1837760 11252 0 0 0 0 612467 9231 603236 0 146133 0 146133 0 77000 0 77000 0 0 484592 0 484592 0 61046680 52581926 8464754 0 1056025 17748 1038277 0 8451517 7517532 911731 22254 9413074 6805653 2607421 0 0 0 0 0 7026148 5661496 1364652 0 770515 460779 309736 0 0 0 0 0 1008634 509679 498955 0 6700565 6662200 38365 0 0 0 0 0 27012904 17842811 9170093 0 8728918 8460282 268636 0 MEDICAL SUPPLIES 73586384 73586384 0 0 PROVIDER TAX 5854768 5854768 0 0 EQUIPMENT RENTAL 5736778 5241896 494882 0 HOSPITAL AUXILIARY 533726 533726 0 0 1534433 942081 592352 0 396135408 335509879 60418027 207502 0 6859 6325 4075871 8492184 83950513 82227368 0 0 0 0 1100268 789001 7876596 9332618 5080193 4844913 400487556 219428076 169697790 181059480 310962871 323940686 3014093 2805594 0 0 574500 21349206 36255097 607114260 650327766 45777524 47748475 135345000 128290000 0 0 29898956 26856728 211021480 202895203 X 395765997 447280642 326783 151921 396092780 447432563 607114260 650327766 X 57691246 -9453002 3101539 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 77000 false true 75875 152875 false Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i A PORTION OF DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION IS USED FOR LOBBYING BY THAT ASSOCIATION IN THE AMOUNT OF $75,875. SCHEDULE C, PART II-B, LINE 1G, DIRECT CONTRACT WITH LEGISLATORS THE ORGANIZATION HAS HIRED A PROFESSIONAL SERVICES FIRM TO CONDUCT LOBBYING ON BEHALF OF THE ORGANIZATION. 11331285 11331285 107968814 57414121 50554693 13110479 8782368 4328111 245336076 153231587 92104489 22740902 22740902 181059480 DUE FROM AFFILIATES 28249730 STUDENT/TUITION LOANS RECEIVABLE 710649 OTHER CURRENT ASSETS 908105 UNAMORTIZED BOND COSTS, NET 3918508 EXECUTIVE BENEFIT PLAN 2468105 36255097 0 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 11083309 INTEREST RATE SWAP CONTRACT 9853341 MEDICAL PROFESSIONAL LIABILITY 4603859 DUE TO AFFILIATES 96708 ACCRUED BOND INTEREST 631364 ASBESTOS LIABILITY 98378 LONG TERM EXECUTIVE RETIREMENT PLAN 338900 MISCELLANEOUS 150869 26856728 X Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote THE ORGANIZATION IS INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS. BELOW IS THE FIN 48 (ASC 740) FOOTNOTE FROM THOSE FINANCIAL STATEMENTS THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION REALIZED CERTAIN INCOME WHICH THE INTERNAL REVENUE SERVICE CONSIDERS TO BE UNRELATED BUSINESS INCOME SUBJECT TO INCOME TAX. FOR THE YEARS ENDED MARCH 31, 2014 AND 2013, NO TAX WAS DUE RELATED TO THESE OPERATIONS. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE MATTERS SUCH AS THE TAX EXEMPT ENTITY TAKING A TAX POSITION THAT AN ORGANIZATION IS TAX EXEMPT WITHOUT OBSERVING CORRESPONDING PROOF OF TAX EXEMPTION FROM FEDERAL AND STATE TAXING AUTHORITIES AND THERE IS MATERIAL NET INCOME GENERATED BY THE ENTITY OR EGREGIOUS COMPENSATION PAID TO INSIDERS THAT COULD RESULT IN REVOCATION OF EXEMPT STATUS (OUTSIDE THE SCOPE OF INTERMEDIATE SANCTIONS EXCISE TAX PENALTIES). THE TAX POSITION IS TO CONSIDER THAT THESE COMPENSATORY ARRANGEMENTS DO NOT JEOPARDIZE TAX EXEMPTION. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AT MARCH 31, 2014 AND 2013. THE CORPORATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE CORPORATION WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN MISCELLANEOUS EXPENSES. THERE WAS NO INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IDENTIFIED AND RECORDED AT MARCH 31, 2014 AND 2013. TAX RETURNS FILED BY THE CORPORATION ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE CORPORATION ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED MARCH 31, 2010 AND PRIOR. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 120000 0 0 120000 true false true false false false Schedule F, Part I, Line 3, Method to account for expenditures on org.'s financial statements CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL Schedule F, Part I, Line 3, Method to account for expenditures on org.'s financial statements CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL true true X true X true X true true true false true true 13260538 13260538 0.03350 68266981 45083070 23183911 0.05850 0 0.00000 0 0 81527519 45083070 36444449 0.09200 805548 805548 0.00200 2773270 615002 2158268 0.00540 3010926 1886301 1124625 0.00280 159410 159410 0.00040 973920 973920 0.00250 0 0 7723074 2501303 5221771 0.01310 0 0 89250593 47584373 41666220 0.10510 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 132823 132823 0.00030 416275 416275 0.00100 0 0.00000 0 0.00000 0 0 549098 0 549098 0.00140 false 10551849 2273446 134684659 141621371 -6936712 X true true PHYSCIAN'S SURGERY CENTER SURGERY CENTER 0.55 0.02 0.43 SOUTHERN ILLINOIS ORTHOPEDICS CENTER MEDICINE 0.34 0 0.66 3 1 MEMORIAL HOSPITAL OF CARBONDALE 405 WEST JACKSON STREET CARBONDALE IL 62901 WWW.SIH.NET 0000513 X X X X A 2 HERRIN HOSPITAL 201 SOUTH 14TH STREET HERRIN IL 62948 WWW.SIH.NET 0000935 X X X ACUTE REHAB A 3 ST JOSEPH MEMORIAL HOSPITAL 800 NORTH 2ND STREET MURPHYSBORO IL 62966 WWW.SIH.NET 0004614 X X X X A A 1 true X X X X X X X X X 12 true true true X www.sih.net/about/community-benefits/ X X X X X X X X X true false true true 200 true 400 true X X X X X X X true true X X X X X X true false X X X X true X false false Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) A - A: THE BROAD INTERESTS OF THE COMMUNITY WE SERVE WERE INCORPORATED BY INCLUDING INPUT FROM RESIDENTS, PATIENT GROUPS, HEALTH CARE PRACTITIONERS, LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY ORGANIZATIONS AND PARTNERS. PARTICIPANTS CONTRIBUTED TO THIS ASSESSMENT BY: IDENTIFYING AND PRIORITIZING NEEDS;HIGHLIGHTING CURRENT SUCCESSFUL AND ONGOING ACTIVITIES; IDENTIFYING GAPS WHERE ATTENTION IS NEEDED; FOSTERING COLLABORATION, PURSUING OPPORTUNITIES FOR INNOVATION AND SUSTAINABILITY; AND DEVELOPING PLANS TO ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. THE PROCESS WAS GUIDED BY A STEERING COMMITTEE COMPOSED OF AN INTERNAL TEAM OF SIH REPRESENTATIVES AND AN EXTERNAL TEAM OF COMMUNITY STAKEHOLDERS KNOWLEDGEABLE ABOUT HEALTH, NEEDS ASSESSMENT, AND THE LOCAL COMMUNITY. THE PROCESS INCLUDED A PRIMARY SURVEY OF OUR COMMUNITY'S HEALTH PRIORITIES, A PATIENT FOCUS GROUP, AND FACILITATED GROUP DISCUSSIONS WITH LOCAL PUBLIC HEALTH DEPARTMENT STAFF, HEALTH AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY MEMBERS. ACTIVE PARTICIPATION IN LOCAL HEALTH COMMUNITY COALITIONS ALSO PROVIDED INSIGHT INTO THE NEEDS AND PRIORITIES OF OUR COMMUNITY MEMBERS. ; Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment (1) A - A: HERRIN HOSPITAL, HERRIN, IL, ST JOSEPH MEMORIAL HOSPITAL, MURPHYSBORO, IL, MEMORIAL HOSPITAL OF CARBONDALE, CARBONDALE, IL; Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined (1) A - A: ORGANIZATION IS USING THE LOOK-BACK METHOD DESCRIBED IN 501(R)-5(B)(1). ; 24 RIC AND SIH REHABILITATION SERVICES LLC PO Box 3988 CARBONDALE IL 62901 REHABILITATION SERVICES PRAIRIE BUILDING 409 West Oak CARBONALE IL 62901 CARDIAC DIAGNOSTIC ST JO LAB AND IMAGING AT CMA 2601 West Main CARBONDALE IL 62901 LAB AND IMAGING SERIVCES PHYSICIANS SURGERY CENTER 2601 West Main St CARBONDALE IL 62901 SURGERY CENTER LPC WF IMAGING AND LAB 502 St Louis Street WEST FRANKFORT IL 62896 RADIOLOGY SERVICES, LABORATORY SERVICES CANCER CARE CENTER 3117 Williamson County Parkway MARION IL 62959 CANCER TREATMENT SERVICES SLEEP CENTER 8305 Express Drive MARION IL 62959 SLEEP STUDIES BREAST CENTER 1237 East Main Street CARBONDALE IL 62901 MAMMOGRAPHY FACILITY REHAB UNLIMITED 305 West Jackson CARBONDALE IL 62901 PHYSICAL THERAPY MINERS MEMORIAL HEALTH CENTER 2553 Ken Gray Blvd WEST FRANKFORT IL 62896 FAMILY PRACTICE, RADIOLOGY AND LAB SERVICES, AND SPECIALTY CLINICS LOGAN PARK RADIOLOGY AND LAB 405 Rushing Drive HERRIN IL 62948 RADIOLOGY SERVICES, LABORATORY SERVICES REHAB UNLIMITED AND FIT FOR WORK 515 East Vienna Street ANNA IL 62906 PHYSICAL THERAPY SERVICES REFERENCE LAB 500 Lincoln Drive HERRIN IL 62948 LAB SERVICES WOUND CARE 315 South 13th St HERRIN IL 62948 WOUND CARE REHAB UNLIMITED 6 East Shawnee Drive MURPHYSBORO IL 62864 PHYSICAL THERAPY SERIVCES FRANKLIN MEDICAL ARTS 203 Bailey Lane BENTON IL 62912 LAB AND IMAGING SERVICES LPC REHAB 3308 Logan Drive HERRIN IL 62948 REHABILITATION SERVICES RIC PHYSICIAN PRACTICES 3224 South Park Avenue HERRIN IL 62948 REHABILITATION SERVICES WOMEN'S CENTER 315 South 13th St HERRIN IL 62948 MAMMOGRAPHY SERVICE HERRIN MEDICAL ARTS 220 S Park Ave HERRIN IL 62948 OUTPT CARDIOVASCULAR CENTER/CHF CLINIC FIT FOR WORK 101 South Park Avenue HERRIN IL 62948 PHYSICAL THERAPY SERVICES WOUND CARE - HARRISBURG 411 West Poplar HARRISBURG IL 62948 WOUND CARE REHAB UNLIMITED - MARION 3905 Ernestine MARION IL 62959 REHABILITATION SERVICES REHAB UNLIMITED MCLEANSBORO 117-119 S Jackson MCLEANSBORO IL 62859 REHABILITATION SERVICES SCHEDULE H, PART I, LINE 7, BAD DEBT EXPENSE THE ORGANIZATION IS REQUIRED FOR GAAP TO RECORD BAD DEBT EXPENSE AS A CONTRA-REVENUE ACCOUNT. THEREFORE ON THE TAX RETURN THE BAD DEBT EXPENSE IS INCLUDED IN PART VIII AND NOT PART IX OF THE CORE FORM 990. THEREFORE THERE IS NO BAD DEBT EXPENSE TO REMOVE FROM TOTAL EXPENSES FOR PURPOSES OF CALCULATING CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES. Schedule H, Part I, Line 7, Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET NUMBER 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF CHARITY CARE PROVIDED AND WORKSHEET NUMBER 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE WAS UTILIZED FOR CALCULATING PORTIONS OF THE SUBSIDIZED HEALTH SERVICES. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE ENCOMPASSES ALL PATIENT TYPES, SERVICES, AND PAYORS. THE COST ASSOCIATED WITH A SERVICE ARE REVIEWED AND UPDATED ANNUALLY TO PROVIDE THE MOST ACCURATE COST POSSIBLE. BOTH DIRECT AND INDIRECT COSTS ARE CONSIDERED WHEN ENTERED INTO THE SYSTEM. ACTUAL COST OF HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH EDUCATION, RESEARCH PROGRAMS, SOME SUBSIDIZED HEALTH SERVICES AND DONATIONS ARE STATED AT ACTUAL COST. THE COSTS OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE. Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 0 Schedule H, Part I, Line 7g, Subsidized Health Services A FAMILY PRACTICE CENTER IS INCLUDED IN SUBSIDIZED HEALTH SERVICES. THE COST OF PROVIDING THIS CENTER WAS $626,881. Schedule H, Part II, Community Building Activities THROUGH COMMUNITY BUILDING ACTIVITIES, SOUTHERN ILLINOIS HOSPITAL SERVICES ADDRESSES THE CAUSES OF HEALTH PROBLEMS THROUGH PROGRAMS THAT ADVOCATE FOR COMMUNITY HEALTH IMPROVEMENTS. THESE PROGRAMS INCLUDE: HEALTHY COMMUNITIES - THE FOCUS OF THE WORK IN THE AREA OF HEALTHY COMMUNITIES IS TO INCREASE THE CAPACITY OF LOCAL AGENCIES TO WORK COLLABORATIVELY TO ADDRESS THE UNMET HEALTH NEEDS WITHIN THE COMMUNITIES SERVED BY SIH HOSPITALS. DEPARTMENT STAFF WORKS TO IMPROVE COMMUNITY HEALTH THROUGH THE ASSESSMENT OF COMMUNITY NEEDS AND THE PLANNING, IMPLEMENTATION, AND EVALUATION OF COMMUNITY-BASED HEALTH PROMOTIONS, EDUCATION, PREVENTION PROGRAMS, AND SERVICES. IN FY13 AN INCREASED FOCUS WILL BE DIRECTED ON INITIATIVES ADDRESSING CARDIOVASCULAR DISEASE AND CANCER, THE DEVELOPMENT OF STRATEGIES, PROGRAMMING, AND INTERVENTIONS TO REDUCE METHAMPHETAMINE USAGE, AND THE CONTINUATION OF EFFORTS TO EXPAND ACCESS TO CARE FOR THE UNINSURED AND UNDER-INSURED. SIH IS ACTIVE IN TWO HEALTHY COMMUNITIES COALITIONS IN LOCAL COUNTIES. THESE COALITIONS ARE COMPRISED OF HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CITIZENS AND OTHER INTERESTED COMMUNITY GROUPS. COORDINATED SCHOOL HEALTH - "HEALTHY STUDENTS- READY TO LEARN" - THROUGH THE COORDINATED SCHOOL HEALTH PROGRAM, THE PARTNERS IN HEALTH TEAM WORKS WITH SCHOOL DISTRICTS TO ENSURE THAT THE LEARNING ENVIRONMENT IS STRUCTURALLY SAFE AS WELL AS FREE FROM FEAR. POLICIES, SCHOOL SAFETY PLANS AND LESSONS FOCUSING ON VIOLENCE PREVENTION CONTRIBUTE TO A SAFE SCHOOL ENVIRONMENT. COMPREHENSIVE, SKILL-BASED HEALTH EDUCATION, PHYSICAL EDUCATION IN SCHOOL THAT EMPHASIZES IMPROVED FITNESS, THE DEVELOPMENT OF A LIFELONG INTEREST IN HEALTH AND WELLNESS, AND DEVELOPING EXPANDED AND SUSTAINABLE HEALTH SERVICES IN SCHOOLS ARE FOCUS AREAS OF THIS PROGRAM. THE "PARTNERS IN HEALTH" INITIATIVE NOW INVOLVES 41 SCHOOLS, 21,000 STUDENTS AND 1,100 FACULTY AND STAFF. THE COMPONENTS OF A COORDINATED SCHOOL HEALTH PROGRAM INCLUDE HEALTH INSTRUCTION, PHYSICAL EDUCATION, HEALTH SERVICES, NUTRITION SERVICES, DEVELOPMENT OF A HEALTHY SCHOOL ENVIRONMENT, HEALTH PROMOTION FOR STAFF, PSYCHOLOGICAL AND SOCIAL SERVICES, AND FAMILY/COMMUNITY INVOLVEMENT. IN ADDITION TO THE PARTNERS IN HEALTH, SOUTHERN ILLINOIS HOSPITAL SERVICES IS WORKING COLLABORATIVELY TO ESTABLISH SCHOOL-BASED HEALTH CENTERS IN THE COMMUNITIES OF CARBONDALE, MARION, WEST FRANKFORT, AND BENTON. THIS IS A COLLABORATION OF MULTIPLE COMMUNITY PARTNERS WHOSE GOAL IS TO ALLEVIATE THE OVERALL HEALTH DISPARITIES BETWEEN CHILDREN THAT RECEIVE REGULAR PRIMARY CARE, SCREENINGS AND SPECIALIZED SERVICES AND THOSE WHO DO NOT EXPERIENCE SUCH CARE. BY OFFERING HEALTH SERVICES FOR CHILDREN IN SCHOOL SETTINGS, IMPROVED COORDINATION OF CARE WITH PRIMARY PHYSICIANS WILL BE ENHANCED, CHRONIC CONDITIONS CAN BE BETTER MANAGED, AND ACCESS WILL BE INCREASED TO THOSE LACKING A PRIMARY CARE PROVIDER. CURRENT EFFORTS INCLUDE PLANNED PARTNERSHIPS BETWEEN THE SCHOOLS AND WOULD INVOLVE MULTIPLE COLLABORATIVE ENTITIES SUCH AS COMMUNITY HEALTH CENTERS, COMMUNITY MENTAL HEALTH AGENCIES, LOCAL HEALTH DEPARTMENTS, RURAL HEALTH CLINICS AND SIH COMMUNITY BENEFITS. PATIENT SUPPORT INITIATIVE - SOUTHERN ILLINOIS HOSPITAL SERVICES PROVIDES A PATIENT SUPPORT INITIATIVE (PSI) WITH THE GOAL OF PROVIDING PATIENTS WITH ADEQUATE CARE AND COMPENSATING PHYSICIANS AT REASONABLE RATES FOR PATIENTS THAT DO NOT HAVE RESOURCES AVAILABLE TO PAY THEIR HEALTH CARE BILLS. SIHS COMPENSATES PHYSICIANS FOR THE CARE OF PATIENTS THAT ENTER THE HEALTHCARE SYSTEM VIA THE EMERGENCY DEPARTMENTS AT SIHS FACILITIES AND ARE ASSIGNED TO PHYSICIANS BASED UPON THE ON-CALL ROTATION COVERAGE. PSI IS DESIGNED FOR PHYSICIAN/PATIENT CONTACT THAT OCCURS IN A HOSPITAL BASED SETTING WHEN THERE WAS NO PREVIOUS RELATIONSHIP BETWEEN THE PATIENT AND THE PHYSICIAN OR THE PHYSICIAN'S PRACTICE. PSI PAYS COMPENSATION FOR PROFESSIONAL FEES ONLY, RELATING DIRECTLY TO THE EPISODE OF CARE BEGUN IN THE EMERGENCY DEPARTMENT, NOT TO EXCEED 30 DAYS. INDIGENT CARE FUNDING - SOUTHERN ILLINOIS HOSPITAL SERVICES PROVIDES FUNDING TO PURCHASE PRESCRIPTIONS, MEDICAL SUPPLIES AND TRANSPORTATION TO PATIENTS DEEMED FINANCIALLY INDIGENT ON A CASE-BY- CASE BASIS. Schedule H, Part III, Line 2, Bad debt expense - methodology used to estimate amount IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE CORPORATION REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE PROVISION FOR BAD DEBT. Schedule H, Part III, Line 3, Bad Debt Expense Methodology COSTING METHODOLOGY OF BAD DEBT EXPENSE THE COST TO CHARGE RATIO IS CALCULATED UTILIZING WORKSHEET 2 INCLUDED IN THE INTERNAL REVENUE SERVICE'S FORM 990 SCHEDULE H INSTRUCTIONS. THIS COST TO CHARGE RATIO IS APPLIED TO THE CHARGES THAT ARE WRITTEN OFF PER THE ABOVE METHODOLOGY. COSTING METHODOLOGY TO ESTIMATE CHARITY CARE IN BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF CARE THAT WAS WRITTEN OFF AS BAD DEBT EXPENSE THAT WOULD HAVE BEEN ELIGIBLE FOR CHARITY UNDER OUR POLICY THE FOLLOWING STEPS WERE TAKEN: - THE NUMBER OF ENCOUNTERS BY COUNTY AT EACH OF OUR 3 FACILITIES WAS OBTAINED FROM OUR REGISTRATION SYSTEM. THE PERCENTAGE OF PATIENTS FROM EACH COUNTY VARIES BY FACILITY DUE TO THE LOCATION OF THE FACILITY. - THE AMOUNT OF BAD DEBT EXPENSE BY COUNTY AT EACH HOSPITAL WAS ESTIMATED BY APPLYING THE PERCENTAGES OBTAINED ABOVE TO THE AMOUNT OF TOTAL CHARGES WRITTEN OFF AT EACH FACILITY. - THE POVERTY RATE OF EACH COUNTY WAS THEN APPLIED TO THESE ALLOCATED CHARGES TO ESTIMATE THE AMOUNT OF CHARGES THAT WOULD HAVE BEEN ELIGIBLE UNDER OUR CHARITY POLICY BASED ON POVERTY LEVEL GUIDELINES. - THE COST TO CHARGE RATIO AS CALCULATED UTILIZING WORKSHEET 2 FROM THE SCHEDULE H INSTRUCTIONS WAS THEN USED TO DETERMINE THE COST OF THESE CHARGES. Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote PROVISION FOR BAD DEBT: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE CORPORATION REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs THE EXPENSES FROM THE AUDITED FINANCIAL STATEMENTS ARE ADJUSTED PER MEDICARE REGULATIONS. OVERHEADS ARE ALLOCATED BASED ON THE STEP-DOWN METHOD BY USING MEDICARE APPROVED STATISTICS. MEDICARE COSTS ARE DETERMINED BY MULTIPLYING THE DAYS OR CHARGES TIMES THE PER DIEM AMOUNT OR THE COST TO CHARGE RATIO APPLICABLE TO THE DEPARTMENT. HOME OFFICE EXPENSES ARE ALLOCATED TO THE FACILITIES BASED ON THE HOME OFFICE COST REPORT. STATISTICS USED ON THE HOME OFFICE COST REPORT ARE APPROVED BY THE MEDICARE INTERMEDIARY. ONE HUNDRED PERCENT OF THE SHORTFALL OF MEDICARE ALLOWABLE COSTS OVER MEDICARE REVENUE IS CONSIDERED TO BE A COMMUNITY BENEFIT. Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance THE FOLLOWING IS INCLUDED IN OUR POLICY - PATIENT FAIR BILLING AND COLLECTIONS, POLICY # SY-PF-128: PURSUING COLLECTION ACTION: SIH AND ITS AGENTS MAY PURSUE COLLECTION ACTION AGAINST AN UNINSURED PATIENT ONLY WHEN THE FOLLOWING CONDITIONS ARE MET: A. SIH HAS GIVEN THE UNINSURED PATIENT THE OPPORTUNITY TO: 1) ASSESS THE ACCURACY OF THE BILL. 2) APPLY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH SIH'S HEALTHCARE ASSISTANCE POLICY (HAP) POLICY WITHIN 60 DAYS OF DISCHARGE. 3) AVAIL THEMSELVES OF A REASONABLE PAYMENT PLAN BASED UPON THEIR ACCOUNT(S) BALANCE OR UPON THE PATIENT'S AVAILABLE INCOME AND ASSETS, THE AMOUNT OWED AND ANY PRIOR PAYMENTS. B. IF THE UNINSURED PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT, SIH OR AVADYNE HEALTH OFFERS THE PATIENT A REASONABLE PAYMENT PLAN. 1) SIH OR AVADYNE HEALTH MAY REQUIRE THE UNINSURED PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT. 2) SIH OR AVADYNE HEALTH MAY REQUIRE THE PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INCOME IF AN EXTENDED PAYMENT PLAN IS REQUESTED (THE EXTENDED PAYMENT PLAN ALLOWS LONGER TIME FRAME TO PAY THAN IS OUTLINED IN POLICY SY-PF-111 PAYMENT ARRANGEMENTS). C. WHEN THE CIRCUMSTANCES OF THE PATIENT SUGGEST THE POTENTIAL FOR HAP ELIGIBILITY, THE PATIENT IS GIVEN AT LEAST 60 DAYS FOLLOWING THE DATE OF DISCHARGE OR RECEIPT OF OUTPATIENT CARE TO SUBMIT A HAP APPLICATION BEFORE NON-ECA. D. THE PATIENT HAS FAILED TO MAKE PAYMENTS IN ACCORDANCE WITH A REASONABLE PAYMENT PLAN PREVIOUSLY AGREED TO WITH SIH OR AVADYNE HEALTH. E. THE PATIENT INFORMS SIH THAT HE OR SHE HAS APPLIED FOR HEALTHCARE COVERAGE UNDER MEDICAID, KIDCARE OR OTHER GOVERNMENT SPONSORED HEALTHCARE PROGRAM (AND THERE IS A REASONABLE BASIS TO BELIEVE THE PATIENT WILL QUALIFY FOR SUCH PROGRAM) BUT THE PATIENT'S APPLICATION IS DENIED. SIH DOES NOT REFER A BILL, OR PORTION THEREOF, TO A COLLECTION AGENCY OR ATTORNEY FOR COLLECTION ACTION AGAINST THE PATIENT, WITHOUT FIRST OFFERING THE PATIENT THE OPPORTUNITY TO REQUEST A REASONABLE PAYMENT PLAN FOR THE AMOUNT PERSONALLY OWED BY THE PATIENT. A) THIS OPPORTUNITY IS AVAILABLE FOR THE 80 DAYS FOLLOWING THE INITIAL BILL DATE. B) IF THE PATIENT REQUESTS A REASONABLE PAYMENT PLAN, BUT FAILS TO AGREE TO A PLAN WITHIN 80 DAYS OF THE REQUEST, SIH MAY PROCEED WITH COLLECTION ACTION AGAINST THE PATIENT. NO COLLECTION AGENCY, LAW FIRM OR INDIVIDUAL MAY INITIATE LEGAL ACTION FOR NON-PAYMENT OF A HOSPITAL BILL AGAINST A PATIENT WITHOUT THE WRITTEN APPROVAL OF THE CORPORATE DIRECTOR OF PFS WHO REASONABLY BELIEVES THE CONDITIONS FOR PURSUING COLLECTION HAVE BEEN MET. SIH FACILITIES WILL NOT ENGAGE IN ECA'S AGAINST AN INDIVIDUAL BEFORE THE FACILITY HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL MAY BE ELIGIBLE FOR HAP. SIH MAY ENGAGE AN OUTSIDE THIRD PARTY COLLECTION AGENCY, FIRM OR INDIVIDUAL TO MANAGE THE PROCESS OF IMPLEMENTING SIH'S FINANCIAL ASSISTANCE AND REASONABLE PAYMENT PLAN PROGRAMS AND POLICIES SO LONG AS SUCH AGENCY, FIRM OR INDIVIDUAL IS CONTRACTUALLY BOUND TO COMPLY WITH THE TERMS OF PUBLIC ACT 094-0885 (PATIENT FAIR BILLING ACT). COLLECTION LIMITATIONS: SIH DOES NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF A HOSPITAL BILL AGAINST PATIENTS WHO HAVE CLEARLY DEMONSTRATED THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS PROVIDED THE PATIENT HAS MET THEIR RESPONSIBILITIES AS LISTED BELOW. A. PATIENT RESPONSIBILITIES: 1) TO RECEIVE THE PROTECTION AND BENEFITS OF THE PATIENT FAIR BILLING ACT, A PATIENT RESPONSIBLE FOR PAYING A HOSPITAL BILL MUST ACT REASONABLY AND COOPERATE IN GOOD FAITH WITH SIH BY PROVIDING SIH WITH ALL OF THE REASONABLY REQUESTED FINANCIAL AND OTHER RELEVANT INFORMATION AND DOCUMENTATION NEEDED TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER HAP OR REASONABLE PAYMENT PLAN OPTIONS WITHIN 80 DAYS OF A REQUEST FOR SUCH INFORMATION. 2) TO RECEIVE THE PROTECTION AND BENEFITS OF THE PATIENT FAIR BILLING ACT, A PATIENT RESPONSIBLE FOR PAYING A HOSPITAL BILL COMMUNICATES TO SIH ANY MATERIAL CHANGE IN THE PATIENT'S FINANCIAL SITUATION THAT MAY AFFECT THE PATIENT'S ABILITY TO ABIDE BY THE PROVISIONS OF AN AGREED UPON REASONABLE PAYMENT PLAN OR QUALIFICATION FOR HAP WITHIN 30 DAYS OF THE CHANGE. Schedule H, Part VI, Line 2, Needs assessment. A COMPLETE COPY OF THE ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTP://WWW.SIH.NET/ABOUT/COMMUNITY-BENEFITS/ Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. THE FOLLOWING EXCERPT IS FROM OUR POLICY # SY-PF-128 PATIENT FAIR BILLING AND COLLECTIONS: PATIENT NOTIFICATION OF HEALTHCARE ASSISTANCE PROGRAM 7.1 NOTICES ARE PLACED IN ALL DEPARTMENTS WHERE PATIENT REGISTRATION TAKES PLACE. THIS NOTICE STATES SIH ACCEPTS MEDICARE, MEDICAID, AND ALL HEALTH INSURANCES, INCLUDING AUTOMOBILE AND LIABILITY. 7.2 PATIENT NOTIFICATION OF HEALTHCARE ASSISTANCE PROGRAM: A. FINANCIAL ASSISTANCE NOTICES ARE PLACED IN ALL DEPARTMENTS REGISTERING PATIENTS. 1) SIGNAGE IN ENGLISH, SPANISH AND ARABIC IS POSTED SAYING: A) A HEALTHCARE ASSISTANCE PROGRAM IS AVAILABLE TO ASSIST QUALIFYING PATIENTS TO AID IN THE FINANCIAL RESOLUTION OF THEIR HOSPITAL BILLS. B. SIH'S WEBSITE PROMINENTLY POSTS A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE THROUGH HAP ALONG WITH A DESCRIPTION OF THE HAP APPLICATION PROCESS AND A COPY OF THE HAP APPLICATION AND POLICY. C. INFORMATION (PAPER COPIES OF THE HAP, HAP APPLICATION FORM, PLAIN LANGUAGE SUMMARY OF THE HAP, AND OTHER APPLICABLE WRITTEN MATERIAL REGARDING THE HAP) IS AVAILABLE IN ALL PATIENT INTAKE OFFICES AND IN OTHER PUBLIC LOCATIONS WITHIN THE HOSPITAL AND BY MAIL (UPON REQUEST WITHOUT CHARGE). Schedule H, Part VI, Line 4, Community information. THE PRIMARY SERVICE AREA OF SOUTHERN ILLINOIS HEALTHCARE IS A SEVEN-COUNTY REGION BETWEEN THE MISSISSIPPI AND OHIO RIVERS IN SOUTHERN ILLINOIS THAT INCLUDES PERRY, JACKSON, FRANKLIN, WILLIAMSON, UNION, JOHNSON, AND SALINE COUNTIES. THE COMBINED POPULATION OF THIS AREA IS APPROXIMATELY 240,000. SIH FACILITIES ARE LOCATED IN COMMUNITIES THAT ARE ADJACENT TO RT. 13, THE PRIMARY EAST-WEST STATE HIGHWAY THROUGH THE REGION, AND ON INTERSTATE I-57, THE MAIN NORTH-SOUTH TRANSPORTATION ARTERY. THESE COUNTIES ARE VERY RURAL: WILLIAMSON COUNTY, THE MOST DENSELY POPULATED COUNTY IN THE SIH SERVICE TERRITORY, CONTAINS 158 PERSONS PER SQUARE MILE. JOHNSON COUNTY, THE LEAST DENSELY POPULATED, CONTAINS 37 PERSONS PER SQUARE MILE. THE AVERAGE NUMBER OF PERSONS PER SQUARE MILE IN ILLINOIS IS 231. COLLECTIVELY, THE RESIDENTS OF EACH OF THESE COUNTIES HAVE MEDIAN HOUSEHOLD INCOMES THAT ARE SUBSTANTIALLY LESS THAN THE STATEWIDE AVERAGE OF $55,735. OF THE SEVEN COUNTIES, JOHNSON'S MEDIAN HOUSEHOLD INCOME IS THE HIGHEST AT $41,619 AND JACKSON COUNTY'S IS THE LOWEST AT $32,169. MORE OF THE RESIDENTS IN THESE COUNTIES LIVE IN POVERTY THAN THE STATE AVERAGE OF 12.6% WITH THE HIGHEST PERCENTAGE BEING 28.5% IN JACKSON COUNTY AND THE LOWEST OF 13.6% IN JOHNSON COUNTY. FURTHER EVIDENCE OF THE ECONOMIC DISTRESS OF THE REGION IS REFLECTED IN THE DEGREE OF CHILDHOOD POVERTY. NOT SURPRISINGLY, THESE COUNTIES RANK AMONG THE POOREST OF ILLINOIS' 102 COUNTIES BASED UPON THE PERCENTAGE OF CHILDREN LIVING IN POVERTY. JACKSON COUNTY HAS THE HIGHEST RATE, 32.1%, OF CHILDHOOD POVERTY RANKING 98TH IN THE STATE. JACKSON, UNION, WILLIAMSON, AND SALINE COUNTIES FALL CLOSELY BEHIND WITH RANKINGS OF 97TH, 92ND, 89TH, AND 83RD RESPECTIVELY. THE POPULATION OF THIS AREA IS LARGELY HOMOGENEOUS WITH A RACIAL MAKEUP THAT IS PREDOMINATELY WHITE, 95%+. JACKSON COUNTY IS THE MOST DIVERSE OF THE COUNTIES WITH 78.5% OF THE POPULATION BEING WHITE AND 14.7% AFRICAN AMERICAN. Schedule H, Part VI, Line 5, Promotion of community health SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) IS DEDICATED TO PROMOTING THE HEALTH AND WELL BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS GUIDED BY OUR VALUES: COMPASSION, COLLABORATION, QUALITY, STEWARDSHIP, INTEGRITY, ACCOUNTABILITY AND RESPECT. OVER 3,000 EMPLOYEES, ALONG WITH PHYSICIANS AND VOLUNTEERS, ARE WORKING TOGETHER TO ACHIEVE OUR MISSIONS AND ENSURE THAT THE HEALTH CARE NEEDS OF THOSE WE SERVE ARE MET BY TREATING PATIENTS IN SIHS FACILITIES, BY OFFERING SERVICES IN RURAL CLINICS, BY COLLABORATING WITH SOME OF AMERICA'S BEST HOSPITALS AND BY IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITIES WITH OUR CHARITABLE COMMUNITY BENEFITS PROGRAMS. SIHS PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. SIHS OPERATES 3 COMMUNITY HOSPITALS WITH A COMBINED TOTAL OF 253 BEDS. EACH HOSPITAL OPERATES A FULL TIME EMERGENCY ROOM. NO ONE IS DENIED CARE OR TREATMENT WITHIN THE HOSPITALS OR EMERGENCY ROOMS. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SERVICES PROVIDED AT EACH FACILITY. THE BOARD OF TRUSTEES OF SIHS IS COMPRISED OF 13 MEMBERS. THESE MEMBERS ARE COMPRISED OF LOCAL COMMUNITY LEADERS, PHYSICIANS AND OUR CEO AND A MAJORITY OF THE BOARD IS COMPRISED OF PERSONS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS THEREOF. SIHS INVESTS EXCESS FUNDS FROM OPERATIONS INTO THE EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, REPAYMENT OF DEBT AND IMPROVEMENT IN PATIENT CARE. SOUTHERN ILLINOIS HOSPITAL SERVICES HAS ALSO EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. ANNUALLY OPERATING FUNDS ARE ALLOCATED SPECIFICALLY TO BRING HEALTH-RELATED PROGRAMS TO THE AREAS IN WHICH THEY ARE MOST NEEDED. OUR GOAL IS TO REACH OUT TO COMMUNITIES TO LEARN HOW SIHS CAN HELP IN COMPLETING THE HEALTH CARE PICTURE. CURRENTLY, THE COMMUNITY BENEFITS DEPARTMENT OF SIHS COLLABORATES WITH SOUTHERN ILLINOIS SCHOOLS TO PROVIDE SCHOOL NURSING SERVICES AND A COMPREHENSIVE SCHOOL HEALTH EDUCATION PROGRAM. INCLUDED IN THESE AND OTHER DEPARTMENTAL INITIATIVES ARE EFFORTS TO ADDRESS DISPARITIES IN LOCAL RESIDENT'S HEALTH STATUS AND HEALTH OUTCOMES. A HEALTH MINISTRY INITIATIVE, AIDING THE REGION'S FAITH COMMUNITIES THROUGH THE TRAINING AND SUPPORT OF PARISH NURSES, IS AN ONGOING EFFORT OF THE DEPARTMENT. OVER 100 PARISH NURSES HAVE BEEN TRAINED AND ARE BEING SUPPORTED IN THE HEALTH PROMOTION WORK OF THEIR RESPECTIVE FAITH COMMUNITIES TO DATE. ALSO THE DEPARTMENT IS ACTIVE IN THE CREATION AND FACILITATION OF HEALTHY COMMUNITY COALITIONS. THESE GROUPS INCLUDE HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CONCERNED CITIZENS AND OTHER COMMUNITY GROUPS INTERESTED IN IMPROVING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. THE GROUPS SEEK TO MEET LOCALLY IDENTIFIED COMMUNITY HEALTH NEEDS AND THROUGH THE IMPLEMENTATION OF PROGRAMS THAT ADDRESS THE DEMONSTRATED UNMET HEALTH NEEDS OF THE RESIDENTS OF THE COMMUNITIES SERVED. THESE COALITIONS MAKE A SIGNIFICANT IMPACT ON THE LIVES OF THOSE WITHIN THE COMMUNITIES SERVED BY SIHS. CURRENTLY, STAFF IS ENGAGED IN NUMEROUS COMMUNITY HEALTH PROMOTION, EDUCATION, AND PREVENTION INITIATIVES. AN INCREASE IN ACCESS TO PRIMARY HEALTH, BEHAVIORAL HEALTH, AND ORAL HEALTH CARE SERVICES HAS BEEN AFFECTED THROUGH THE SIHS SUPPORT OF EXISTING AND DEVELOPING COMMUNITY-BASED INTERVENTIONS. INCREASED NUMBERS OF COLLABORATIVE PARTNERSHIPS THAT SUPPORT INCREASED INDIVIDUAL AND COMMUNITY CAPACITY TO ACHIEVE A HEALTHY COMMUNITY VISION ARE ONGOING. IN ORDER TO ACCOMPLISH THE ORGANIZATION'S MISSION AS WELL AS THE OVERALL GOALS PREVIOUSLY OUTLINED, THE COMMUNITY BENEFITS DEPARTMENT OF SOUTHERN ILLINOIS HEALTHCARE IMPLEMENTS A NUMBER OF DIRECTED INITIATIVES. FOLLOWING IS A DESCRIPTION OF THESE INITIATIVES, THE SPECIFIC GOALS AND OBJECTIVES TO BE ACHIEVED FOR FY14, AND AN OUTLINE OF THE MEANS BY WHICH DEPARTMENT STAFF WILL WORK TO PLAN, IMPLEMENT, AND EVALUATE THESE PROGRAMS. THE HEALTH MINISTRY PROGRAM COLLABORATES WITH SOUTHERN ILLINOIS FAITH COMMUNITIES TO IMPROVE THE HEALTH AND WELLNESS OF PEOPLE IN THE COMMUNITIES THEY SERVE. EMPHASIZING WHOLENESS OF BODY, MIND AND SPIRIT, FAITH COMMUNITIES WITH A HEALTH MINISTRY OFFER HEALTH PROMOTION AND EDUCATION ACTIVITIES; ADVOCACY AND REFERRAL; AND CARING SPIRITUAL SUPPORT. THE FOCUS OF THE SIH HEALTH COMMUNITIES PROGRAM IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY MEMBERS OF SOUTHERN ILLINOIS HEALTHCARE'S SERVICE AREA AND TO IMPROVE THE HEALTH AND WELL-BEING OF SIH EMPLOYEES THROUGH A STRATEGIC WELLNESS PLAN INCLUDING PREVENTATIVE HEALTH SCREENINGS, EDUCATIONAL PROGRAMMING, AND DISEASE MANAGEMENT. IN ADDITION TO THE INITIATIVES WHICH DEPARTMENT STAFF PLANS, IMPLEMENTS, AND EVALUATES, COMMUNITY BENEFITS ALSO PROVIDES SIGNIFICANT FINANCIAL SUPPORT TO SEED NEW PROGRAMS WHICH MEET BOTH THE PRIORITIES OF THE DEPARTMENT AND PRESSING COMMUNITY NEEDS. THIS FINANCIAL SUPPORT IS PROVIDED TO APPLICANTS WHO DEMONSTRATE THE CAPACITY TO SUCCESSFULLY IMPLEMENT THE PROPOSED PROGRAM PLAN AND CREATE SUSTAINABLE SOLUTIONS TO UNMET HEALTH NEEDS. CURRENTLY, COMMUNITY BENEFITS IS WORKING CLOSELY WITH SEVERAL COMMUNITY-BASED PROVIDERS TO DESIGN PROGRAMS WHERE THE LEVERAGING OF SIH FUNDING, COMBINED WITH THE AGENCY'S RESOURCES AND EXPERTISE, RESULT IN INNOVATIVE PROGRAMS THAT MEET THE NEEDS OF THE COMMUNITIES SERVED BY SIH HOSPITALS AND IMPROVE BOTH INDIVIDUAL AND COMMUNITY HEALTH. SOME OF THE PROGRAMS INVOLVE INCREASING ACCESS TO PRIMARY AND LIMITED SPECIALTY HEALTH CARE, INCREASING ACCESS TO ORAL HEALTH CARE FOR THE UNINSURED, AND IMPROVING THE OVERALL HEALTH AND HUMAN SERVICE SYSTEM CAPACITY TO RECOGNIZE AND RESPOND TO DOMESTIC VIOLENCE AND CHILD ABUSE AND NEGLECT. Schedule H, Part VI, Line 6, Affiliated health care system SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) IS PART OF A LARGER SYSTEM THAT PROVIDES HEALTH SERVICES TO THE POPULATION OF SOUTHERN ILLINOIS. SIHS PROVIDES CARE THROUGH ITS THREE HOSPITALS AND ONE COMMUNITY HEALTH CENTER. SOUTHERN ILLINOIS MEDICAL SERVICES (SIMS) PROVIDES CARE THROUGH PHYSICIAN PRACTICES. THESE PRACTICES ARE COMPRISED OF THE CENTER FOR MEDICAL ARTS, LOGAN PRIMARY CARE, PHYSICIAN CARE GROUP, INDIVIDUAL PHYSICIAN PRACTICES, HOSPITAL PHYSICIANS AND EMERGENCY ROOM PHYSICIANS. SIHS AND SIMS WORK TOGETHER IN PROVIDING CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED. BOTH PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. Schedule H, Part VI, Line 7, State filing of community benefit report IL true SHAWNEE HEALTH SERVICES 109 CALIFORNIA ST PO BOX 577 CARTERVILLE IL 62918 370966854 501(C)(3) 499050 N/A N/A GENERAL PROGRAM FUNDING THE H GROUP 902 WEST MAIN ST WEST FRANKFORT IL 62896 370916475 501(C)(3) 185671 N/A N/A GENERAL PROGRAM FUNDING LAND OF LINCOLN LEGAL ASST FOUND 509 S UNIVERSITY AVE 3RD FLOOR CARBONDALE IL 62901 370958448 501(C)(3) 60000 N/A N/A GENERAL PROGRAM FUNDING JACKSON COUNTY AMBULANCE 520 NORTH UNIVERSITY AVE CARBONDALE IL 62901 376001092 JACKSON CO IL GOV 45000 N/A N/A GENERAL PROGRAM FUNDING SOUTHERN ILLINOIS UNIVERSITY 1235 DOUGLAS DRIVE CARBONDALE IL 62901 376005961 STATE OF IL UNIV 27125 N/A N/A GENERAL PROGRAM FUNDING COMMUNITY HEALTH & EMERG SRV CAIRO PO BOX 3008 CARBONDALE IL 62902 371100482 501(C)(3) 25000 N/A N/A GENERAL PROGRAM FUNDING JACKSON CO HEALTH DEPT 415 HEALTH DEPT ROAD MURPHYSBORO IL 62956 376001092 501(C)(3) 18512 N/A N/A GENERAL PROGRAM FUNDING CITY OF WEST FRANFORT PO BOX 2122 WEST FRANKFORT IL 62896 376000857 CITY OF IL GOVT 15000 N/A N/A GENERAL PROGRAM FUNDING ILLINOIS POISON CENTER 222 S RIVERSIDE PLAZA SUITE 1900 CHICAGO IL 60606 372167008 501(C)(3) 7077 N/A N/A GENERAL PROGRAM FUNDING REHAB INST OF CHICAGO 345 EAST SUPERIOR CHICAGO IL 60016 372256036 501(C)(3) 6500 N/A N/A GENERAL PROGRAM FUNDING RIVER TO RIVER RUNNERS 402 CARDINAL DRIVE MT VERNON IL 62864 371253714 501(C)(3) 5400 N/A N/A GENERAL PROGRAM FUNDING SIU FOUNDATION PO BOX 19666 SPRINFFIELD IL 62794 376024575 501(C)(3) 5250 N/A N/A GENERAL PROGRAM FUNDING 12 0 Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds ALL GRANTS MADE ARE UNRESTRICTED AND CAN BE USED IN ANY WAY THE DONEE ORGANIZATION SEES FIT TO FURTHER ITS EXEMPT PURPOSE. X X X X true true false false false false false false false REX BUDDE PRESIDENT/CEO 504541 0 57065 0 489527 0 214366 0 27064 0 1292563 0 444862 0 BECKY ASHTON FORMER VP 0 0 0 0 249262 0 0 0 407 0 249669 0 153153 0 MIKE KASSER VP/CFO/TREASURER 315920 0 36959 0 48358 0 108171 0 37078 0 546486 0 0 0 WILLIAM SHERWOOD VP/ GENERAL COUNSEL 252360 0 30445 0 178638 0 131974 0 41411 0 634828 0 130554 0 JULIE FIRMAN VP/CNO 197144 0 23654 0 109851 0 76580 0 19285 0 426514 0 66088 0 PHILIP SCHAEFER VP/ AMB & PHYS SERVICES 291294 0 35176 0 160241 0 117691 0 47117 0 651519 0 114919 0 PAM HENDERSON VP/ HR 206688 0 24716 0 111056 0 78474 0 8099 0 429033 0 63068 0 DAVID HOLLAND VP/ INFO SYSTEMS 220492 0 25792 0 104270 0 84824 0 20927 0 456305 0 60999 0 JOHN B MILLSTEAD VP/ ADMINISTRATOR 337149 0 39662 0 157828 0 131465 0 40586 0 706690 0 111928 0 JAMES MILLER MD VP/CMO 310100 0 36640 0 126859 0 27700 0 39055 0 540354 0 81451 0 WILLIAM THORNE VP/ COMMUNITY BENEFITS 173271 0 21170 0 110447 0 63444 0 39104 0 407436 0 53575 0 TERRENCE FARRELL VP/ ADMINISTRATOR 278806 0 32893 0 42588 0 97838 0 26181 0 478306 0 0 0 JOHN BROTHERS VP/ADMINISTRATOR 210923 0 24859 0 28128 0 104482 0 13424 0 381816 0 0 0 SHELLY PIERCE VP/QUALITY 186454 0 1549 0 2902 0 21863 0 14743 0 227511 0 0 0 THOMAS HENTRICH PHARMACIST 169781 0 1549 0 13418 0 7143 0 36946 0 228837 0 0 0 LEAH MACFARLANE PHARMACIST 176523 0 1548 0 294 0 7155 0 14405 0 199925 0 0 0 DANIEL SKILES EXEC DIRECTOR PHO 179760 0 1549 0 9399 0 6763 0 32539 0 230010 0 0 0 CHARLES BROOKS STAFF NURSE 173056 0 1548 0 8030 0 7098 0 23178 0 212910 0 0 0 REBECCA BRASEL STAFF NURSE 172653 0 1549 0 6976 0 7247 0 36486 0 224911 0 0 0 Schedule J, Part I, Line 4a, Severance or change-of-control payment BECKY ASHTON, FORMER VP/ADMINSTRATOR RECEIVED SEVERANCE PAYMENTS OF $14,760. Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan THE ORGANIZATION MADE THE FOLLOWING SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS/CONTRIBUTIONS: REX BUDDE - $444,862 PAYMENT, $204,166 DEFERRED COMPENSATION BECKY ASHTON-$153,153 PAYMENT, NO DEFERRED COMPENSATION PAM HENDERSON - $63,068 PAYMENT, $69,628 DEFERRED COMPENSATION DAVE HOLLAND - $60,999 PAYMENT, $76,182 DEFERRED COMPENSATION MIKE KASSER - NO PAYMENT, $97,971 DEFERRED COMPENSATION JAMES MILLER - $81,451 PAYMENT, $17,500 DEFERRED COMPENSATION BART MILLSTEAD - $111,928 PAYMENT, $121,265 DEFERRED COMPENSATION PHIL SCHAEFER - $114,919 PAYMENT; $107,491 DEFERRED COMPENSATION BILL SHERWOOD - $130,554 PAYMENT, $121,774 DEFERRED COMPENSATION JULIE FIRMAN - $66,088 PAYMENT, $69,338 DEFERRED COMPENSATION WILLIAM THORNE - $53,575 PAYMENT. $55,843 DEFERRED COMPENSATION TERENCE FARRELL - NO PAYMENT, $90,618 DEFERRED COMPENSATION SHELLY PIERCE - NO PAYMENT, $14,560 DEFERRED COMPENSATION JOHN BROTHERS - NO PAYMENT, $95,655 DEFERRED COMPENSATION A ILLINOIS FINANCE AUTHORITY 861091967 45200FSD2 2011-11-16 52750000 DEEMED REISSUANCE OF 2008 VARIABLE RATE DEMAND REVENUE BONDS false false false B ILLINOIS FINANCE AUTHORITY 861091967 45200FS42 2010-02-18 68985878 DEEMED REISSUANCE OF 2005 BONDS false false false C ILLINOIS FINANCE AUTHORITY 861091967 2011-10-27 14420000 REFUNDING 1998 BOND ISSUE false false false A 1515000 0 52750000 0 0 0 0 0 0 0 52750000 0 2011 true false true true B 0 0 68985878 0 0 0 0 0 0 0 68985878 0 2010 true false true true C 6365000 0 14420000 0 0 0 282518 0 0 0 14137482 0 2011 true false true true A false false true true true true 0.00000 0.00000 0.00000 false false true B false false true true true true 0.00000 0.00000 0.00000 false false true C false false true true true true 0.00000 0.00000 0.00000 false false true A false true false false true true MORGAN STANLEY CAPITAL SERVICES 27.3 false false false 0.0 false true B false true false false false false 0.0 false 0.0 false true C false true false false false false false false true A true B true C true SCHEDULE K, PART I, EXPLANATION OF BOND ISSUE THE BOND ISSUE REFERRED TO IN PART I, LINE A RELATES TO 2005 MULTI-MODAL BONDS THAT WERE CONVERTED TO A FLOATING INDEX RATE INTEREST MODE AND DEEMED REISSUED FOR PURPOSES OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, ON 11/5/2008. THE BOND WAS THEN CONVERTED TO A FIXED INTEREST RATE AND DEEMED REISSUED FOR PURPOSES OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, ON 02/18/2010. LIAM FARRELL SON OF TERENCE FARRELL 6712 GRANT NURSING SCHOLARSHIP JILL KASSER SPOUSE OF VP/CFO, MIKE KASSER 10212 EMPLOYEE COMPENSATION false LIAM FARRELL SON OF VP/ADMINISTRATOR TERENCE FARRELL 32173 EMPLOYEE COMPENSATION false FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION (CONTINUED FROM PART III) OVER 3,000 EMPLOYEES, ALONG WITH PHYSICIANS AND VOLUNTEERS, ARE WORKING TOGETHER TO ACHIEVE OUR MISSION AND ENSURE THAT THE HEALTH CARE NEEDS OF THOSE WE SERVE ARE MET BY TREATING PATIENTS IN SIHS FACILITIES, BY OFFERING SERVICES IN RURAL CLINICS, BY COLLABORATING WITH SOME OF AMERICA'S BEST HOSPITALS AND BY IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITIES WITH OUR CHARITABLE COMMUNITY BENEFITS PROGRAMS. OUR SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. FORM 990, PART III, LINE 4A, HOSPITAL SERVICES (CONTINUED FROM PART III) THE FACILITIES THAT MAKE UP SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) INCLUDE: MEMORIAL HOSPITAL OF CARBONDALE: OPENED IN 1950, MEMORIAL HOSPITAL OF CARBONDALE, WITH 140 LICENSED BEDS, IS THE FLAGSHIP HOSPITAL FOR SIH AND A REGIONAL REFERRAL CENTER FOR THE 16 COUNTY SOUTHERN ILLINOIS REGION. PHYSICIANS IN NEARLY 40 DIFFERENT SPECIALTIES PRACTICE HERE, BRINGING EXPERTISE AND NEW PROCEDURES, BUT SUCCESSFULLY TAILORING THEM TO THE PARTICULAR NEEDS OF A RURAL SETTING. IT IS HOME TO THE FIRST OPEN HEART SURGERY PROGRAM IN THE IMMEDIATE SOUTHERN ILLINOIS AREA AND IS THE CORE HOSPITAL FOR SIH'S COMPREHENSIVE, REGIONAL HEART PROGRAM, PRAIRIE HEART INSTITUTE. THE REGION'S ONLY PRIMARY STROKE CENTER IS LOCATED WITHIN THIS HOSPITAL. THE HOSPITAL IS ALSO HOME TO A COMMISSION ON CANCER ACCREDITED COMPREHENSIVE CANCER TREATMENT CENTER, THE ONLY LEVEL II PLUS NEO-NATAL INTENSIVE CARE UNIT, AND THE ONLY PEDIATRIC UNIT IN THE IMMEDIATE SOUTHERN ILLINOIS AREA. THE HOSPITAL IS AFFILIATED WITH SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL THROUGH ITS FAMILY PRACTICE RESIDENCY PROGRAM. HERRIN HOSPITAL: OPENED IN 1913, HERRIN HOSPITAL WAS THE FIRST HOSPITAL OWNED AND OPERATED BY THE ORGANIZATION. HERRIN HOSPITAL CURRENTLY OPERATES 85 LICENSED BEDS. IT IS ALSO HOME TO THE 29 BED ACUTE REHABILITATION CENTER, AN AFFILIATE PROGRAM WITH THE REHABILITATION INSTITUTE OF CHICAGO, RECOGNIZED AS THE TOP REHABILITATION HOSPITAL IN AMERICA. A RECENT RENOVATION UPGRADED PATIENT ACCOMMODATIONS TO INCLUDE PRIVATE ROOMS AND IMPROVED ACCESS TO OUTPATIENT SERVICES BY RELOCATING THOSE SERVICES TO THE MAIN FLOOR. THE AREA'S ONLY BARIATRIC SURGICAL PROGRAM FOR WEIGHT LOSS IS HOUSED AT THIS HOSPITAL AS WELL AS BEING THE REGION'S FIRST ACCREDITED CHEST PAIN CENTER. ST. JOSEPH MEMORIAL HOSPITAL: ST JOSEPH MEMORIAL HOSPITAL IS LOCATED IN MURPHYSBORO, ILLINOIS AND IS A FULL-SERVICE, CRITICAL ACCESS HOSPITAL WITH 25 LICENSED BEDS. ST. JOSEPH OPENED ON OCTOBER 1, 1960 AND WAS ACQUIRED BY SOUTHERN ILLINOIS HOSPITAL SERVICES ON JANUARY 5, 1995 FROM THE SISTERS OF THE ASC HEALTH SYSTEM. ST JOSEPH'S CATHOLIC IDENTITY HAS BEEN RETAINED BY SIHS SINCE THE PURCHASE AND THE STAFF TAKES PRIDE IN THE HOSPITAL'S SPIRITUAL ROOTS. ST. JOSEPH HAS EVOLVED OVER TIME TO BECOME A REGIONAL PROVIDER OF SPECIALIZED OUTPATIENT SERVICES. THESE SPECIALIZED SERVICES INCLUDE A SLEEP DISORDERS CENTER ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE, THE AREA'S ONLY COORDINATED INFUSION THERAPY PROGRAM, A WOULD CARE CENTER WITH HYPERBARIC THERAPY, AND AN OUTPATIENT GERIATRIC COUNSELING PROGRAM. MINERS MEMORIAL HEALTH CENTER: WEST FRANKFORT, ILLINOIS IS HOME TO MINERS MEMORIAL HEALTH CENTER. THE HEALTH CENTER HOUSES A PHYSICIAN SPECIALTY CLINIC THAT OFFERS VISITING SPECIALISTS INCLUDING UROLOGY, PODIATRY AND CARDIOLOGY. IT IS ALSO HOME TO WEST FRANKFORT FAMILY MEDICINE, WITH FAMILY MEDICINE AND OBSTETRIC PHYSICIANS FROM SIU SCHOOL OF MEDICINE, AND OFFERS MAMMOGRAPHY, X-RAY, ULTRASOUND, BONE DENSITOMETRY, AND LABORATORY SERVICES. SERVICES PROVIDED: DURING THIS REPORTING PERIOD, OUR HOSPITALS RECORDED 62,788 ADULT AND CHILD PATIENT DAYS AND 3,096 NEWBORN PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 314,386 WITH 67,720 OF THESE REGISTRATIONS BEING EMERGENCY ROOM VISITS. APPROXIMATELY 60.17% OF THESE DAYS AND REGISTRATIONS PROVIDED CARE THAT WAS CLASSIFIED AS EITHER UNCOMPENSATED CHARITY CARE OR UNCOMPENSATED GOVERNMENT HEALTH CARE. AN ADDITIONAL 2.9% OF THE CARE PROVIDED IN THESE DAYS AND REGISTRATIONS WERE WRITTEN OFF AS BAD DEBT. ROUTINE INPATIENT CARE AND OUTPATIENT PROCEDURES ARE PROVIDED AT ALL THREE OF OUR FACILITIES. EACH FACILITY ALSO HAS ITS OWN UNIQUE PROGRAMS AND PATIENT CARE UNITS. OUR TWO LARGER FACILITIES, CARBONDALE MEMORIAL HOSPITAL AND HERRIN HOSPITAL BOTH HOUSE INTENSIVE CARE UNITS. THESE TWO LARGER FACILITIES EACH HAVE SPECIALTY UNITS WITHIN THEIR RESPECTIVE FACILITIES. CARBONDALE MEMORIAL HOSPITAL PROVIDES OBSTETRICAL, PEDIATRICS, AND A NEONATAL NURSERY. HERRIN HOSPITAL PROVIDES THE ACUTE REHABILITATION CENTER. SURGICAL SERVICES ARE OFFERED AT ALL FACILITIES, WITH CARBONDALE MEMORIAL HOSPITAL PROVIDING OPEN-HEART AND CARDIAC SERVICES. ST. JOSEPH MEMORIAL HOSPITAL ALSO OPERATES SWING BEDS. ST. JOSEPH ALSO OFFERS UNIQUE OUTPATIENT SERVICES TO THE AREA. THE SLEEP DISORDERS CENTER OFFERS TWO LOCATIONS AND THE SENIOR RENEWAL PROGRAM OFFERS OUTPATIENT BEHAVIORAL HEALTH TREATMENT. SIHS HAS ALSO PROVIDED SUBSIDIZED HEALTH CARE SERVICES. SUBSIDIZED HEALTH SERVICES INCLUDE, BUT ARE NOT LIMITED TO PHYSICIAN REFERRAL CENTERS, FAMILY PRACTICE CENTERS, SENIOR MEMBERSHIP, ETC. THESE HEALTH CARE SERVICES ARE PROVIDED IN RESPONSE TO COMMUNITY NEEDS. THESE HEALTH SERVICES MUST BE SUBSIDIZED FROM OTHER REVENUE SOURCES IN ORDER TO BE PROVIDED. SIHS PROVIDES MEDICAL EDUCATION THROUGH AN AFFILIATION WITH THE SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL FAMILY PRACTICE RESIDENCY PROGRAM. FORM 990, PART III, LINE 4B, COMMUNITY BENEFITS (CONTINUED FROM PART III) THE COMMUNITY BENEFITS DEPARTMENT'S PRIMARY FUNCTIONS THAT ARE PERFORMED ON BEHALF OF SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) INCLUDE: - COORDINATE SYSTEM-WIDE COMMUNITY HEALTH ASSESSMENTS AND COMMUNITY BENEFIT PLANNING; - PLAN, IMPLEMENT, AND EVALUATE DEPARTMENTALLY INITIATED COMMUNITY HEALTH PROMOTION PROGRAMS AND SERVICES; - INITIATE AND PARTICIPATE IN COLLABORATIVE PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS TO DEVELOP AND IMPLEMENT SOLUTIONS TO UNMET HEALTH NEEDS; - CONVENE COMMUNITY-BASED ORGANIZATIONS AND PUBLIC SECTOR ENTITIES TO FOCUS ON PERVASIVE ISSUES AND TO DEVELOP HEALTH INITIATIVES; AND - IDENTIFY FUNDING OPPORTUNITIES/GRANT PROGRAMS THAT FUND COMMUNITY-BASED HEALTH PROGRAMS AND PUBLIC/PRIVATE HEALTH INITIATIVES. COMMUNITY BENEFITS SERVICES TARGET THE FOLLOWING COMMUNITIES AND POPULATIONS: - UNINSURED, UNDERINSURED AND UNDER-SERVED; - POPULATIONS VULNERABLE DUE TO A RANGE OF SOCIO-ECONOMIC BARRIERS SUCH AS POVERTY, EDUCATION LEVELS, EMPLOYMENT STATUS, AND/OR RACIAL DISPARITIES IN HEALTH CARE; - POPULATIONS HARD TO REACH DUE TO LANGUAGE AND CULTURAL CHALLENGES; - POPULATIONS WITH IDENTIFIED NEEDS THAT CAN BE EFFICIENTLY REACHED THROUGH THE LEVERAGING OF COMMUNITY LINKAGES (I.E. FAITH-BASED, SCHOOLS, NEIGHBORHOODS, COMMUNITIES, ETC.); - THE WORKING POOR; AND - POPULATIONS AT RISK OF EXPERIENCING ADVERSE HEALTH CONDITIONS OR OUTCOMES. IN ORDER TO ACCOMPLISH THE ORGANIZATION'S MISSION, THE COMMUNITY BENEFITS DEPARTMENT OF SIHS IMPLEMENTS A NUMBER OF DIRECTED INITIATIVES. PROGRAMS DURING THE REPORTING YEAR INCLUDE: HEALTH MINISTRY -- THE HEALTH MINISTRY PROGRAM COLLABORATES WITH SOUTHERN ILLINOIS FAITH COMMUNITIES TO IMPROVE THE HEALTH AND WELLNESS OF PEOPLE IN THE COMMUNITIES THEY SERVE. EMPHASIZING WHOLENESS OF BODY, MIND AND SPIRIT, FAITH COMMUNITIES WITH A HEALTH MINISTRY OFFER HEALTH PROMOTION AND EDUCATION ACTIVITIES; ADVOCACY AND REFERRAL; AND CARING SPIRITUAL SUPPORT. HEALTHY COMMUNITIES -- THE FOCUS OF THE WORK IN THE AREA OF HEALTHY COMMUNITIES IS TO INCREASE THE CAPACITY OF LOCAL AGENCIES TO WORK COLLABORATIVELY TO ADDRESS THE UNMET HEALTH NEEDS WITH THE COMMUNITIES SERVED BY SIHS. STAFF WILL WORK TO IMPROVE COMMUNITY HEALTH THROUGH THE ASSESSMENT OF COMMUNITY NEEDS AND THE PLANNING, IMPLEMENTATION, AND EVALUATION OF COMMUNITY BASED HEALTH PROMOTIONS, EDUCATION, PREVENTION PROGRAMS, AND SERVICES. AN INCREASED FOCUS OF THESE ACTIVITIES WILL BE DIRECTED TO INITIATIVES ADDRESSING CARDIOVASCULAR DISEASE AND CANCER, AND THE DEVELOPMENT OF STRATEGIES, PROGRAMMING, AND INTERVENTIONS TO REDUCE SUBSTANCE ABUSE, AND THE CONTINUATION OF EFFORTS TO EXPAND ACCESS TO CARE FOR THE UNINSURED AND THE UNDER-SERVED. HEALTHY COMMUNITY COALITIONS -- THE FORMAL GATHERING OF HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CONCERNED CITIZENS, AND OTHER COMMUNITY GROUPS INTERESTED IN IMPROVING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. SIHS IS ACTIVE IN THREE SUCH COALITIONS, REPRESENTING FOUR COUNTIES - JACKSON, PERRY, FRANKLIN AND WILLIAMSON COUNTIES. EMERGENCY ORAL HEALTH CARE - COLLABORATION WITH LOCAL DENTAL PROVIDERS TO PROVIDE PREVENTIVE ORAL HEALTH CARE FOR MEDICAID PATIENTS; HOPEFULLY REPLACING EMERGENCY ROOM VISITS FOR TOOTH RELATED COMPLAINTS. MEDICAL LEGAL PARTNERSHIP SI -- AN INNOVATIVE PROGRAM THAT PROVIDES LEGAL ASSISTANCE TO LOW-INCOME AND UNDERINSURED ADULTS SEEKING MEDICAL CARE. THE ONGOING MEDICAL-LEGAL COLLABORATION BETWEEN LAND OF LINCOLN LEGAL SERVICES AND SIH IS ADDRESSING MANY OF THE SOCIAL ISSUES FACED BY PATIENTS CONTRIBUTING TO THEIR HEALTH CARE NEEDS. LEGAL ASSISTANCE IN PROVIDED IN THE AREAS OF PUBLIC BENEFITS, DISABILITY, FAMILY, HOUSING AND CONSUMER ISSUES. START! WALKING - SIH IS A REGIONAL SPONSOR OF THE AMERICAN HEART ASSOCIATION'S START! WALKING GUIDE TO LOCAL PATHS AND PARKS. CURRENTLY APPROXIMATELY 50 PATHS ARE DESIGNATED AS START! WALKING PATHS. WE CHOOSE HEALTH SOUTHERNMOST ILLINOIS - A MULTI-YEAR INITIATIVE TO ENCOURAGE AND SUPPORT PLACE-BASED POLICIES, SYSTEMS AND ENVIRONMENTAL CHANGES AIMED AT IMPROVING AND SUSTAINING HEALTH. SIH IS ENGAGED WITH LOCAL HEALTH DEPARTMENTS AND COMMUNITY PARTNERS IN THE LOWER 16 COUNTIES IN ILLINOIS TO PROMOTE HEALTHY EATING AND ACTIVE LIVING IN SCHOOLS AND WORKSITES, REDUCE EXPOSURE TO SECONDHAND SMOKE IN MULTI-UNIT HOUSING COMPLEXES AND OUTDOOR PLACES, INCREASE ACCESS TO HEALTHIER FOODS AND PROMOTE BREASTFEEDING, IMPROVE OUR LOCAL BUILT ENVIRONMENT TO INCREASE OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND TO IMPROVE THE SOCIAL AND EMOTIONAL HEALTH OF STUDENTS. FORM 990, PART III, LINE 4C, SCHOOL BASED HEALTH SERVICES (CONTINUED FROM PART III) THE FOLLOWING IS A SUMMARY OF THE PROGRAMS DURING THIS REPORTING YEAR: HEALTHY CHILDREN - READY TO LEARN - SIH AND AREA AGENCIES COLLABORATE IN AN INITIATIVE TO IMPLEMENT THE EIGHT COMPONENTS OF A COORDINATED SCHOOL HEALTH PROGRAM IN AREA SCHOOLS. THE COMPONENTS OF A COORDINATED SCHOOL HEALTH PROGRAM INCLUDE HEALTH INSTRUCTION, PHYSICAL EDUCATION, HEALTH SERVICES, NUTRITION SERVICES, DEVELOPMENT OF A HEALTHY SCHOOL ENVIRONMENT, HEALTH PROMOTION FOR STAFF, PSYCHOLOGICAL AND SOCIAL SERVICES, AND FAMILY/COMMUNITY INVOLVEMENT PARTNERS IN HEALTH -- THROUGH THE COORDINATED SCHOOL HEALTH PROGRAM, THE PARTNERS IN HEALTH TEAM WORKS WITH SCHOOL DISTRICTS TO ENSURE THAT THE LEARNING ENVIRONMENT IS STRUCTURALLY SAFE AS WELL AS FREE FROM FEAR. POLICIES, SCHOOL SAFETY PLANS AND LESSONS FOCUSING ON SOCIAL AND EMOTIONAL LEARNING CONTRIBUTE TO A SAFE SCHOOL ENVIRONMENT. COMPREHENSIVE, SKILL-BASED HEALTH EDUCATION, PHYSICAL EDUCATION IN SCHOOL THAT EMPHASIZES IMPROVED FITNESS, THE DEVELOPMENT OF A LIFELONG INTEREST IN HEALTH AND WELLNESS, AND DEVELOPING EXPANDED AND SUSTAINABLE HEALTH SERVICES IN SCHOOLS ARE FOCUS AREAS OF THIS PROGRAM. A COMMITMENT TO THE COMMUNITY IS ALSO SEEN THROUGH THE EXTENSIVE COLLABORATION OF AGENCIES INVOLVED IN THIS EFFORT. SIH PARTNERS WITH SEVERAL COUNTY HEALTH DEPARTMENTS TO ENSURE THAT THE SCHOOL DISTRICTS HAVE AMPLE RESOURCES AND ACHIEVE THE COMMON GOALS AND OBJECTIVES. THIS INITIATIVE INVOLVES EIGHT COLLABORATING PARTNERS, 70 SCHOOLS DISTRICTS, 25,000 STUDENTS, AND APPROXIMATELY 1100 FACULTY AND STAFF. CATCH (COORDINATED APPROACH TO CHILD HEALTH) -- CATCH IS A PROGRAM DESIGNED TO PROMOTE PHYSICAL ACTIVITY, HEALTHY FOOD CHOICES, AND PREVENT TOBACCO USE IN ELEMENTARY SCHOOL AGED CHILDREN. CATCH EMPLOYS A COORDINATED APPROACH TO CHILD HEALTH PROMOTION BY TARGETING MULTIPLE ASPECTS OF THE SCHOOL ENVIRONMENT AND INVOLVING CLASSROOM TEACHERS, SCHOOL FOOD SERVICE STAFF, PHYSICAL EDUCATION (PE) TEACHERS, STUDENTS' FAMILIES, AND THE BROADER SCHOOL COMMUNITY IN A RANGE OF HEALTH PROMOTING ACTIVITIES FOR ALL CHILDREN IN GRADES PREK-8, SIMILAR TO THE CDC'S COORDINATED SCHOOL HEALTH PROGRAM MODEL. THE FOUR CORE COMPONENTS OF CATCH INCLUDE: (1) THE EAT SMART SCHOOL NUTRITION PROGRAM, (2) A CLASSROOM PHYSICAL ACTIVITY AND HEALTHY EATING CURRICULA, (3) THE CATCH PHYSICAL EDUCATION PROGRAM, AND (4) A FAMILY EDUCATION AND INVOLVEMENT PROGRAM. THE COORDINATION OF HEALTH MESSAGES AND ACTIVITIES BETWEEN THESE FOUR COMPONENT AREAS IS CRITICAL TO POSITIVELY IMPACTING CHILDREN'S KNOWLEDGE, SKILLS, AND BEHAVIOR. SIH AND PROGRAM PARTNERS ARE IMPLEMENTING COMPONENTS OF THE CATCH PROGRAM IN 70 ELEMENTARY SCHOOL DISTRICTS IN THE 16 COUNTIES IN THE SOUTHERN ILLINOIS REGION. THIS PROGRAM IMPACTS OVER 6,000 STUDENTS AND THEIR FAMILIES. Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee GOVERNANCE COMMITTEE THE BOARD HAS A GOVERNANCE COMMITTEE CONSISTING OF 5 TRUSTEES. THE PURPOSE OF THE GOVERNANCE COMMITTEE IS TO ASSURE THE BOARD OF TRUSTEES THAT THE RESPECTIVE PROGRAMS ARE FUNCTIONAL TO FULFILL THE RESPONSIBILITIES OF THE BOARD OF TRUSTEES: * DEVELOP AND MAINTAIN EFFECTIVE COMPENSATION AND BENEFIT POLICIES AND PRACTICES; REVIEW AND RECOMMEND IN ADVANCE ALL EXECUTIVE COMPENSATION ARRANGEMENTS; PROVIDE FOR THE EVALUATION OF THE PERFORMANCE OF THE CEO AND OTHER SYSTEM OFFICERS; REVIEW AND RECOMMEND ANNUAL PERFORMANCE OBJECTIVES FOR SYSTEM OFFICERS; PROVIDE FOR CONDUCT OF A PERIODIC SELF-EVALUATION OF THE BOARD OF TRUSTEES. * ASSURE THAT THE PROGRAMS WHICH ADDRESS NEW BOARD MEMBER ORIENTATION, CONTINUING EDUCATION, MENTORING, AND FACILITATE UNDERSTANDING OF CURRENT TRENDS IN HEALTHCARE AND MEDICAL TERMINOLOGY, ARE FUNCTIONAL. * IDENTIFY COMPETENT, HIGHLY QUALIFIED INDIVIDUALS TO SERVE AS MEMBERS OF THE BOARD OF TRUSTEES; RECOMMEND INDIVIDUALS TO SERVE IN LEADERSHIP POSITIONS ON THE BOARD; AND FACILITATE AND INTERVIEW POTENTIAL BOARD MEMBERS. * ACT FOR THE BOARD OF TRUSTEES IN ALL MATTERS AS SPECIFICALLY AUTHORIZED BY RESOLUTION OF THE BOARD OR WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION. Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders THE ORGANIZATION'S SOLE MEMBER IS SOUTHERN ILLINOIS HOSPITAL ENTERPRISES, INC., A RELATED TAX-EXEMPT ORGANIZATION. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO THE BOARD OF TRUSTEES AND APPROVE SOME DECISIONS OF THE BOARD. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES, HAS THE EXCLUSIVE RIGHT TO ELECT TRUSTEES TO THE ORGANIZATION'S BOARD OF TRUSTEES. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATIONS BYLAWS. EXCEPT FOR TRANSFERS IDENTIFIED IN THE BUDGET OF THE ORGANIZATION APPROVED BY THE CORPORATE MEMBER, THE ORGANIZATION MAY NOT TRANSFER ASSETS TO ENTITIES OTHER THAN THE CORPORATE MEMBER OR ENTITIES THAT THE CORPORATE MEMBER CONTROLS (THE "CORPORATE MEMBER AFFILIATES"), WITHOUT THE APPROVAL OF THE CORPORATE MEMBER. THE CORPORATE MEMBER HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO TRANSFER ASSETS TO THE EXTENT NECESSARY TO ACCOMPLISH THE CORPORATE MEMBER'S GOALS AND OBJECTIVES. THE CORPORATE MEMBER ALSO HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF THE CORPORATE MEMBER OR A CORPORATE MEMBER AFFILIATE. THE ORGANIZATION CANNOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS IN COMPLYING WITH ANY ASSET TRANSFERS DIRECTED BY THE CORPORATE MEMBER. IN ADDITION, THE FOLLOWING MATTERS MUST BE SUBMITTED TO AND RECEIVE THE APPROVAL OF THE CORPORATE MEMBER: 1. CAPITAL EXPENDITURES IN EXCESS OF $500,000; 2. THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF REAL PROPERTY BELONGING TO THE CORPORATION OR ANY OF ITS SUBSIDIARIES; 3. THE ESTABLISHMENT OR DISCONTINUANCE OF ANY MAJOR SERVICES; INCLUDING SERVICES REQUIRING CERTIFICATES OF NEED; 4. LONG-RANGE STRATEGIC PLANS; 5. MASTER FACILITIES AND SITE PLANS; 6. THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. JOINT VENTURE OR AFFILIATION AGREEMENTS; 8. THE INCURRENCE OF INDEBTEDNESS IN EXCESS OF $500,000; 9. SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE ORGANIZATION'S ARTICLES OF INCORPORATION, OR BY ITS BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 10. DELEGATION OF THE FUNCTIONS, POWERS, DUTIES AND RESPONSIBILITIES OF ANY OFFICER OF THE CORPORATION, AND; 11. ANY OTHER MATTER WHICH MAY BE SPECIFIED FROM TIME TO TIME BY THE CORPORATE MEMBER. IN ADDITION, THE CORPORATE MEMBER RETAINS THE RIGHT TO APPROVE ALL CHANGES TO THE ORGANIZATION'S BYLAWS. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE CEO, CFO AND CERTAIN VICE-PRESIDENTS OF THE CORPORATION FOR THEIR REVIEW AND COMMENTS. A DRAFT COPY WAS PRESENTED TO THE FINANCE COMMITTEE BY THE CFO AND THE ORGANIZATION'S TAX ADVISORS FOR REVIEW AND COMMENTS. AFTER THE REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy ANNUALLY, THE GENERAL COUNSEL SENDS OUT A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, MANAGER AND KEY EMPLOYEE TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. DURING EVERY BOARD MEETING, THE GENERAL COUNSEL REMINDS THE TRUSTEES THAT THE BOARD HAS A CONFLICT OF INTEREST POLICY, THAT THE GENERAL COUNSEL HAS REVIEWED THE AGENDA FOR ANY CONFLICTS, BUT THAT THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVER-LOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. INTERESTED PERSONS MAY ALSO BE ASKED, IN RARE SITUATIONS, TO RESIGN THEIR POSITION ON THE BOARD. Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2013. Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF ALL OFFICERS FOR THE FULL BOARD. ONLY THE COMMITTEE WILL HAVE THE AUTHORITY TO APPROVE THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND WILL REPORT IT'S ACTIONS TO THE BOARD. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2013. Form 990, Part VI, Sec C, Line 19, Required documents available to the public THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC ON ITS WEBSITE AND UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104; THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g, Other Expenses CONSULTING FEES - TOTAL EXPENSE: 2524886, PROGRAM SERVICE EXPENSE: 582201, MANAGEMENT AND GENERAL EXPENSES: 1942685, FUNDRAISING EXPENSES: 0; CREDIT & COLLECTION FEES - TOTAL EXPENSE: 733987, PROGRAM SERVICE EXPENSE: 31242, MANAGEMENT AND GENERAL EXPENSES: 702745, FUNDRAISING EXPENSES: 0; CLINICAL SERVICE FEES - TOTAL EXPENSE: 5690685, PROGRAM SERVICE EXPENSE: 5690685, MANAGEMENT AND GENERAL EXPENSES: 0, FUNDRAISING EXPENSES: 0; ENGINEERING FEES - TOTAL EXPENSE: 445443, PROGRAM SERVICE EXPENSE: 421856, MANAGEMENT AND GENERAL EXPENSES: 23587, FUNDRAISING EXPENSES: 0; ARCHITECT FEES - TOTAL EXPENSE: 55362, PROGRAM SERVICE EXPENSE: 41124, MANAGEMENT AND GENERAL EXPENSES: 14238, FUNDRAISING EXPENSES: 0; RECRUITMENT FEES - TOTAL EXPENSE: 557186, PROGRAM SERVICE EXPENSE: 234750, MANAGEMENT AND GENERAL EXPENSES: 322436, FUNDRAISING EXPENSES: 0; OTHER PROFESSIONAL FEES - TOTAL EXPENSE: 3418319, PROGRAM SERVICE EXPENSE: 2729084, MANAGEMENT AND GENERAL EXPENSES: 689235, FUNDRAISING EXPENSES: 0; AGENCY STAFFING - TOTAL EXPENSE: 3777827, PROGRAM SERVICE EXPENSE: 3764224, MANAGEMENT AND GENERAL EXPENSES: 13603, FUNDRAISING EXPENSES: 0; PHYSICIAN SERVICES - TOTAL EXPENSE: 35746986, PROGRAM SERVICE EXPENSE: 35605723, MANAGEMENT AND GENERAL EXPENSES: 141263, FUNDRAISING EXPENSES: 0; PURCHASED SERVICES - TOTAL EXPENSE: 8095999, PROGRAM SERVICE EXPENSE: 3481037, MANAGEMENT AND GENERAL EXPENSES: 4614962, FUNDRAISING EXPENSES: 0; Form 990 , Part XI, Line 9, Other changes in net assets or fund balances CHANGE IN FAIR VALUE OF INTEREST RATE SWAP - 2449618; GAIN/(LOSS) ON DERIVITIVE - 2703839; EQUITY TRANSFERS - -2051918; FORM 990, PART XII, LINE 3A, REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2014 SOUTHERN ILLINOIS HEALTHCARE SERVICES AND AFFILIATES RECEIVED AN AUDIT FOR THE 2013 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT. 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