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Munster Medical Research Foundation offers a wide range of surgical services, including gastroenterology, orthopedics, general surgery, bariatric surgery, urology, cardiovascular and gynecology. Our outpatient surgery center also includes services in ophthalmology, pain management, plastics and cosmetic. 66930909 104215475 Munster Medical Research Foundation has a 427 bed capacity. Nursing staff work to ensure the delivery of optimal patient care and excellent patient care services in population and acuity specific areas ranging from ICU, IMCU, telemetry, medical, surgical, pediatric, labor and delivery, and neonatology. 43130707 176052466 Munster Medical Research Foundation had 266,745 outpatient visits from it's three locations. 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HOME HEALTH REQUIRED DESCRIPTIONS PART I, LINE 3C N/A REQUIRED DESCRIPTIONS PART I, LINE 6A THE STATE OF INDIANA ACCEPTS FORM 990 SCHEDULE H IN LIEU OF COMMUNITY BENEFITS REPORT. REQUIRED DESCRIPTIONS PART I, LINE 7A BAD DEBT OF $19,404,417 IS EXCLUDED FROM THE CALCULATION. THE METHODOLOGY USED WAS THE COST TO CHARGE RATIO. IT IS FOR INPATIENT ONLY AND EXCLUDES MEDICAID, CHARITY AND BAD DEBT. REQUIRED DESCRIPTIONS PART III, LINE 4 COMMUNITY HOSPITAL EVALUATES THE COLLECTIBILITY OF ITS ACCOUNTS RECEVIABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. COMMUNITY HOSPITAL DOES NOT REQUIRE COLLATERAL. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT ARE REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED. WE ESTIMATED A PERCENTAGE OF BAD DEBTS BASED UPON THE PORTION OF UNINSURED INDIVIDUALS THAT WOULD BE ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THIS AMOUNT ENTERED ON PART III, LINE 3 SHOULD BE COUNTED AS A COMMUNITY BENEFIT. REQUIRED DESCRIPTIONS PART III - LINE 8 THE TOTAL REVENUE RECEIVED FROM MEDICARE WAS CALCULATED BY USING INFORMATION FROM THE COST ACCOUNTING SYSTEM. WE PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICE PROVIDED OR THE REIMBUSEMENT RECEIVED FROM MEDICARE, QUALIFYING THE $38,335,968 OF MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. REQUIRED DESCRIPTIONS PART III, LINE 9B COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW. REQUIRED DESCRIPTIONS LINE 1J - N/A LINE 3 - FOCUS GROUPS WITH COMMUNITY AND BUSINESS LEADERS LINE 4 - FRANCISCAN ALLIANCE AND THE METHODIST HOSPITALS LINE 5C - N/A LINE 6I - N/A LINE 7 - Community Health Needs: Areas Not Addressed The Community Health Needs assessment conducted by the hospitals of the Community Healthcare System identified areas of concern not identified in the hospital's implementation plan. These areas include: Community Hospital Service Areas: " Access to Health Services " Cancer " Chronic Kidney Disease " Educational & Community-Based Programs " Family Planning " Injury & Violence Prevention " Mental Health & Mental Disorders " Oral Health " Substance Abuse " Tobacco Use Many of these areas are being addressed by the hospitals of the Community Healthcare System as well as by other community organizations. For example, Community Healthcare System supports a large cancer program with a separate research foundation focused on improving access to clinical trials for area residents as well as providing free support and mind-body services through its Cancer Resource Centre. All hospitals provide routine low-cost and free screening programs for a variety of cancers. One of the three hospitals in the Community Healthcare System has a behavior health program and has recently expanded its outpatient services to improve access to mental health services. As the hospital focuses on lifestyle, education, prevention and access to care issues surrounding its four focused areas, positive outcomes will likely have positive effects on the health needs not addressed. To have the greatest impact, however, the hospital has chosen to focus on three of the most serious diseases and the related lifestyle issues facing our community as well investing in the health of the most vulnerable residents - our newborns. LINE 10 - N/A LINE 11 - N/A LINE 12H - N/A LINE 14G - N/A LINE 16E - N/A LINE 17E - N/A LINE 18E - N/A LINE 19C - N/A LINE 19D - N/A LINE 20D - SEE PART V, LINE 20D IN SUPPLEMENTAL INFORMATION LINE 21 - N/A LINE 22 - N/A NEEDS ASSESSMENT IN COLLABORATION WITH FRANCISCAN ALLIANCE AND THE METHODIST HOSPITALS, COMMUNITY HOSPITAL CONTRACTED WITH A THIRD PARTY TO PERFORM OUR COMMUNITY HEALTH NEEDS ASSESSMENT AS PER REGULATION 501(R). PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS WHO ARE ADMITTED WITHOUT INSURANCE ARE DIRECTED TO THE HOSPITAL'S FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS PERFORM AN INTERVIEW WITH THE PATIENTS TO EXPLAIN TO THEM THE PROCESS NECESSARY TO RECEIVE FINANCIAL ASSISTANCE. THIS PROCESS INCLUDES APPLYING FOR MEDICAID OR OTHER GOVERNMENT AID. THE APPLICANT THEN MUST FILL OUT A FINANCIAL INFORMATION WORKSHEET AND SUBMIT VARIOUS INFORMATION TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY. THE POLICY IS POSTED IN THE EMERGENCY ROOM AREA AS WELL AS AT EACH INPATIENT WAITING DESK. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. COMMUNITY INFORMATION THE COMMUNTIY SERVED INCLUDES NORTHWEST INDIANA AND ADJACENT COMMUNITIES IN ILLINOIS. OUR MARKET SHARE FOR THE CORE AREA IS 72.2%. THE POPULATION IS OLDER THAN MOST MARKETS BUT HAS A HIGHER MEDIAN HOUSEHOLD INCOME. COMMUNITY'S POPULATION CONSISTS OF AN UNINSURED POPULATION OF 9.9% AND MEDICAID OF 11.3%. PROMOTION OF COMMUNITY HEALTH I. 2012-2013 ANNUAL PROGRESS REPORT A. THE COMMUNITY HOSPITAL FITNESS POINTE THE GOAL OF FITNESS POINTE IS TO PROVIDE OPPORTUNITIES FOR PERSONS OF NORTHWEST INDIANA TO IMPROVE AND MAINTAIN THEIR HEALTHY LIFE-STYLE HABITS, LOWERING THEIR RISKS FOR HEART DISEASE, STROKES, AND DIABETES. THE FACILITY WAS DEVELOPED TO ADDRESS FINDINGS OF OUR 1995 HEALTH ASSESSMENT THAT IDENTIFIED OPPORTUNITIES TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. THE COMMUNITY HOSPITAL OPENED FITNESS POINTE ON NOVEMBER 1, 1998. THE 73,191 SQ. FT. FACILITY HOUSES THE HOSPITAL'S OUTPATIENT PHYSICAL THERAPY , OUTPATIENT DIETARY COUNSELING,OUTPATIENT DIABETIC EDUCATION, CARDIAC REHABILITATION PHASE III AND REHAB PLUS, AND THE FITNESS POINTE DEPARTMENTS. FITNESS POINTE PROGRAMS ADDRESS HEALTH EDUCATION/WELLNESS, AND FITNESS-RELATED CONTENT AREAS. THE COMMUNITY EDUCATION OFFERINGS AND THE CONTRIBUTIONS OF THE HOSPITAL EMPLOYEES AND MEDICAL STAFF ARE VITAL PIECES IN ADDRESSING THE HEALTH DISPARITIES IN LAKE COUNTY, SUPPORTING A VARIETY OF DISEASE PREVENTION GOALS. MANY OF THE COMMUNITY EDUCATION CLASSES ORIGINALLY DEVELOPED AT FITNESS POINTE ARE NOW ALSO OFFERED AT THE COMMUNITY HOSPITAL OUTPATIENT CENTRE IN ST. JOHN, FURTHER EXPANDING THE SCOPE OF SERVICES. HEALTH EDUCATION/WELLNESS SERVICES THE COMMUNITY HEALTH ASSESSMENT INDICATED LAKE COUNTY RESIDENTS HAVE INCREASED RISK FOR HEART DISEASE AND CANCER COMPARED TO STATE AND NATIONAL STATISTICS. A VARIETY OF HEALTH EDUCATION AND WELLNESS PROGRAMS ARE OFFERED TO THE COMMUNITY AT LITTLE OR NO CHARGE TO IMPROVE KNOWLEDGE AND AWARENESS OF LIFE-STYLE RELATED RISKS FOR THESE DISEASES. FITNESS POINTE PROVIDES A SUPPORTIVE ENVIRONMENT FOR AREA RESIDENTS TO MAINTAIN HEALTHY HABITS. RESEARCH INDICATES CERTAIN INDIVIDUALS ARE AT GREATER RISK FOR LIFE-STYLE RELATED DISEASES SUCH AS HEART DISEASE AND DIABETES BASED ON PHYSICAL MEASURES. FITNESS POINTE SCREENINGS FOR THESE RISKS DURING MANDATORY FITNESS PROFILES ARE PERFORMED ON ALL NEW PROGRAM PARTICIPANTS. IN A STUDY IN CONJUNCTION WITH VALPARAISO UNIVERSITY AND THE HEART CENTER AT COMMUNITY, FITNESS POINTE IDENTIFIED 1,321 INDIVIDUALS AT A SIGNIFICANTLY INCREASED RISK FOR DIABETES AND HEART DISEASE. OF THESE INDIVIDUALS, 700 OF THEM AT THE HIGHEST RISK LEVELS FOR HEART DISEASE AND DIABETES WERE INVITED TO UNDERGO ADDITIONAL SCREENING FOR BLOOD CHOLESTEROL, BODY MASS INDEX AND BLOOD PRESSURE. SOME OTHERS AT MODERATE TO HIGH RISK WERE TARGETED, THROUGH ADDITIONAL SCREENING AND LIFE-STYLE MODIFICATION, FOR INTERVENTION TO REDUCE THEIR RISK OF DISEASE. WITH 25% OF WHITE CHILDREN AND 33% OF AFRICAN AMERICAN AND HISPANIC CHILDREN BEING OVERWEIGHT ACCORDING TO 2001 STATISTICS, FITNESS POINTE HAS DEVELOPED PROGRAMS TO HELP ADDRESS THIS ISSUE. "FIT TRIP" IS A PROGRAM THAT BRINGS 1ST-3RD GRADE STUDENTS TO FITNESS POINTE FOR A 90 MINUTE INTRODUCTION AND EXPERIENCE WITH DIFFERENT TYPES OF EXERCISE COMBINED WITH BASIC NUTRITION TIPS. "TAKE 5 FOR LIFE" IS A PROGRAM DEVELOPED FOR 5TH GRADERS TO TEACH GOOD HEALTH, NUTRITION AND FITNESS HABITS WITHIN THE SCHOOL SETTING, AS WELL AS TO ENCOURAGE ACTIVITY. BASED ON THE HEALTH NEEDS AND INTERESTS OF THOSE PROGRAM ATTENDEES, PROGRAMS WERE DEVELOPED IN THE AREAS OF: WOMEN'S HEALTH, NUTRITION AND HEALTHY COOKING, RELAXATION, WEIGHT MANAGEMENT, SENIOR HEALTH, BACK AND OTHER ORTHOPEDIC HEALTH ISSUES, DIABETES MANAGEMENT, CANCER AWARENESS AND PREVENTION, HEART DISEASE RISK FACTOR AWARENESS AND SCREENING, MENTAL HEALTH, AND SMOKING CESSATION. THROUGH THE COLLABORATIVE EFFORTS OF THE COMMUNITY HOSPITAL'S WELLNESS SERVICES, PUBLIC RELATIONS, DIETARY SERVICES THERAPY, REHABILITATION, EDUCATION DEPARTMENT, NURSING SERVICES AND OTHERS, A QUARTERLY COMMUNITY EDUCATION CALENDAR CALLED "TAKE CARE!" IS CREATED. THE CALENDAR IS DISTRIBUTED TO MORE THAN 75,000 HOUSEHOLDS IN THE HOSPITAL'S SERVICE AREA, AND TO COMMUNITY CENTERS, PHYSICIAN OFFICERS, LIBRARIES AND OTHER PUBLIC LOCATIONS. IT FEATURES EDUCATIONAL AND SUPPORT PROGRAMS DESIGNED TO IMPROVE THE PHYSICAL, MENTAL, SAFETY, NUTRITIONAL AND SOCIAL WELL-BEING OF THE COMMUNITY. WELLNESS EDUCATION PROGRAM AREAS 1. HEART DISEASE-RELATED PROGRAMMING INCLUDES ONGOING DAILY BLOOD PRESSURE SCREENING BY THE EXERCISE STAFF, BLOOD PRESSURE SCREENING OFFERED DURING PERIODIC EVENTS, A COMPREHENSIVE SERIES ABOUT CHOLESTEROL THAT INCLUDES A SCREENING AND EDUCATION ON CHOLESTEROL MANAGEMENT, SMOKING CESSATION CLASS, A STROKE AWARENESS LECTURE, A PRESENTATION ON NEW ADVANCED GENETIC TESTING FOR HEART DISEASE, PERIPHERAL ARTERIAL DISEASE SCREENINGS, AND A CLASS THAT HELPS INDIVIDUALS MAINTAIN THEIR HEALTH WHILE ON HEART MEDICATIONS. HEART DISEASE-RELATED SUPPORT GROUPS INCLUDE A HEART FAILURE SUPPORT GROUP, A GROUP FOR WOMEN WITH HEART DISEASE, AND MENDED HEARTS - A NATIONAL ORGANIZATION THAT WHEREBY SEASONED HEART DISEASE PATIENTS VISIT NEWLY DIAGNOSED PATIENTS IN THE HOSPITAL AFTER SURGERY OR A PROCEDURE. OTHER COMMUNITY PROGRAMS RELATED TO THE HEART INCLUDED HOW TO RAISE A HEART-SMART CHILD, PROPER NUTRITION FOR LOWERING CHOLESTEROL, INFANT-CHILD CPR, DIABETES AS IT RELATES TO THE HEART, AND A SERIES OF PROGRAMS AND WOMEN AND HEART DISEASE. 2. CANCER AWARENESS AND PREVENTION PROGRAMS INCLUDE: A DAY OF CANCER AWARENESS WITH SKIN CANCER SCREENINGS, AND A VAST PUBLIC AWARENESS CAMPAIGN ABOUT THE LATEST ADVANCES IN PROSTATE CANCER DETECTION AND TREATMENT, INCLUDING THE VALUE OF EARLY DETECTION AND FREE SCREENING SESSIONS. THE COMMUNITY HOSPITAL CANCER RESEARCH FOUNDATION LAUNCHED THE CANCER RESOURCE CENTRE, WHICH HOSTS A VARIETY OF FREE PROGRAMS, CLASSES AND SUPPORT GROUPS ABOUT LIVING WITH CANCER. A SPECIAL SEGMENT OF CLASSES WAS BORN WITH THE OPENING OF THE CANCER RESOURCE CENTRE - A SUPPORT PROGRAM OF THE COMMUNITY HOSPITAL CANCER RESEARCH FOUNDATION. HERE, THOSE FACING CANCER ATTEND FREE CLASSES SUCH AS YOGA, BREATHING THROUGH PAIN, LEARNING ABOUT COMPLEMENTARY THERAPIES, AND A VARIETY OF SUPPORT GROUPS. 3. DIABETES EDUCATION EFFORTS HAVE EXPANDED TO INCLUDE DIABETES MANAGEMENT CLASSES IN CONJUNCTION WITH EXERCISE. THIS IS IN ADDITION TO A BASIC DIABETES EDUCATION CLASS AND A DIABETES MANAGEMENT CLASS CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. 4. SENIOR TOPICS OFFERED AT FITNESS POINTE INCLUDE FALL PREVENTION, UNDERSTANDING MANAGED CARE, UNDERSTANDING ADVANCED DIRECTIVES, UNDERSTANDING HOSPICE AND MEDICARE BENEFITS, HELP WITH DIZZINESS, MAKING SENSE OF MEDICAL TECHNOLOGY, MEDICATION SAFETY, URINARY INCONTINENCE PRESENTATION, A GRANDPARENT CLASS, AND A PROGRAM ON OSTEOPOROSIS. 5. ORTHOPEDIC PROGRAMS INCLUDE ARTHRITIS, TENDONITIS AND BURSITIS RECOGNITION AND MANAGEMENT, PREVENTION OF NECK AND LOW BACK PAIN, ATHLETIC FOOT AND ANKLE PROBLEMS, THE CARE AND TREATMENT OF KNEE, HIP, FOOT AND SHOULDER PROBLEMS, CERVICAL AND LUMBAR DISK PROBLEMS, A FALL PREVENTION AND BALANCE SCREENING PROGRAM, AND SPORTS INJURY PREVENTION. 6. NUTRITION PROGRAMS INCLUDE INDIVIDUAL NUTRITIONAL COUNSELING WITH A REGISTERED DIETITIAN, GROUP WEIGHT MANAGEMENT PROGRAMS, LUNCH & LEARN COOKING DEMONSTRATIONS, A CLASS ABOUT EMOTIONAL EATING, AND A CLASS ABOUT FAD DIETS AND PROPER NUTRITION. 7. MENTAL HEALTH RELATED PROGRAMS INCLUDE RELAXATION, STRESS MANAGEMENT, BREATHING EXERCISES, PROGRAMS ON COMPLEMENTARY THERAPIES, RECOGNIZING AND UNDERSTANDING DEPRESSION, AND LIFE MAPPING. 8. WOMEN'S WELLNESS PROGRAMS INCLUDE PRE-AND POST-NATAL EXERCISE, A SERIES ABOUT NUTRITION, SCREENING AND TREATMENT RELATED TO OSTEOPOROSIS, A COMPLETE HEALTH RETREAT FOR WOMEN, FIBROMYALGIA, GENETIC LINKS AND TESTING FOR CANCER, HORMONE REPLACEMENT THERAPY, STRENGTH TRAINING FOR WOMEN, AND HEADACHES IN WOMEN. 9. FAMILY HEALTH PROGRAMS INCLUDE A PRENATAL CLASS, SIBLING CLASS, TAKING CARE OF BABY, KEEPING BABY SAFE AND HEALTHY, INFANT GROWTH AND DEVELOPMENT, FAMILY AND FRIENDS CPR, BREAST FEEDING CLASSES AND LACTATION CONSULTATIONS, LAMAZE, TEEN CHILDBIRTH EDUCATION, GRANDPARENT EDUCATION, FILMS ABOUT CESAREAN SECTIONS, POISON PREVENTION AND TREATMENT, ASK THE PEDIATRICIAN AND HOW TO RAISE A HEART-SMART CHILD, AND A PARENT SUPPORT GROUP. PARTICIPATION IN HEALTH EDUCATION/WELLNESS PROGRAMS RANGES FROM AN AVERAGE OF 300-350 ATTENDEES A MONTH. APPROXIMATELY 20-30% OF THESE ATTENDEES ARE MEMBERS OF THE FITNESS POINTE FACILITY WHILE 70-80% ARE NON-MEMBERS FROM THE GENERAL COMMUNITY. FITNESS PROGRAM AREAS THE AMERICAN HEART ASSOCIATION RECOGNIZES THE LACK OF REGULAR PHYSICAL EXERCISE AS A MAJOR RISK FACTOR FOR HEART DISEASE. REGULAR EXERCISE IS ASSOCIATED WITH BETTER HEART HEALTH, MENTAL WELL-BEING, WEIGHT MANAGEMENT, CANCER PREVENTION, DIABETES CONTROL, LOW BACK PAIN PREVENTION/RELIEF AND OTHER LIFESTYLE-RELATED DISEASES. FITNESS POINTE'S GENERAL FITNESS MEMBERSHIP PROGRAM OFFERS A VARIETY OF EXERCISE PROGRAM OPTIONS DESIGNED TO MEET THE INDIVIDUAL NEEDS. INDIVIDUALS FROM THE COMMUNITY WHO TAKE ADVANTAGE OF THE GENERAL FACILITY MEMBERSHIP PROGRAM INCLUDE TRANSFERS FROM CARDIAC REHABILITATION AND PHYSICAL THERAPY, AND THOSE REFERRED BY THEIR PERSONAL PHYSICIAN. IN ADDITION, MANY ARE CORP AFFILIATED HEALTH CARE SYSTEM COMMUNITY HOSPITAL IS PART OF AN AFFILIATED SYSTEM. EACH HOSPITAL IN THE SYSTEM PROVIDES MEDICAL SERVICES TO THEIR COMMUNITIES AND ADJOINING COMMUNITIES. EACH ENTITY'S PURPOSE IS TO PROVIDE HEALTH CARE TO THOSE WHO NEED IT, INCLUDING THE UNINSURED OR UNDERINSURED. STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA FACILITY REPORTING GROUPS SEE REQUIRED DESCRIPTIONS PART III, LINE 8 Cost Report (14,800,993) Medicare Managed Care (3,025,980) Fee-based Outpatient charges (5,406,902) Disallowed Medicare expenses (15,102,093) Total (Shortfall) (38,335,968) PART V, LINE 20D Our maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care are based on a sliding scale. Up to 200% of federal poverty guidelines (FPG) is 100% free care. 201% -250% is discounted 80%. 251%-300% is discounted 60%. Patients may also be eligible for self-pay/prompt pay discounts regardless of the federal poverty level. We offer 30% discount to true self-pay accounts and a 10% discount to prompt pay accounts. false THE LONG ISLAND COMMUNITY FOUNDATION 1864 MUTTONTOWN ROAD SYOSSET NY 11791 136089923 501(C)3 11094 FMV SUPPLIES CONTRIBUTION SUPPLIES FOR HURRICANE SANDY RELIEF EFFORT TOWN OF MUNSTER 1005 RIDGE ROAD MUNSTER IN 46321 356001128 GOVERNMENT 10000 CONTRIBUTION CHINMAYA MISSION OF NW IN 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 275550095 501(c)3 8500 CONTRIBUTION CALUMET COUNCIL BOY SCOUTS OF AMERICA 8751 CALUMET AVENUE MUNSTER IN 46321 350867968 501(c)3 7000 CONTRIBUTION FRIENDS OF HOSPICE 600 SUPERIOR AVE MUNSTER IN 46321 351519392 501(c)3 5420 CONTRIBUTION 5 SUPPLEMENTAL INFORMATION REQUESTS FOR DONATIONS FROM QUALIFIED 501(C)(3) CHARITIES AND UNIVERSITIES ARE EVALUATED AS TO WHETHER THE POTENTIAL DONEE ORGANIZATION WILL USE THE FUNDS IN A MANNER CONSISTENT WITH OUR CHARITABLE MISSION AND THE INTENTION OF THE CONTRIBUTION. OUR DONATIONS/CONTRIBUTIONS ARE PRIMARILY MADE TO LOCAL ORGANIZATIONS. SINCE THESE ARE NOT GRANTS, THERE IS NO NEED TO MONITOR. X true true X X X X X false false false false false false false true false DONALD S POWERS 0 815238 0 510959 0 2716 0 27800 0 14360 0 1371073 0 0 DONALD P FESKO 0 410295 0 155625 0 25350 0 11100 0 27163 0 629533 0 0 MARY ANN SHACKLETT 0 412061 0 274998 0 26143 0 27800 0 24244 0 765246 0 0 LUIS MOLINA 331886 0 210786 0 10092 0 40866 0 19323 0 612953 0 0 0 RONDA MCKAY 187216 0 93782 0 1303 0 7161 0 2650 0 292112 0 0 0 RICHARD BERKOWITZ MD 555468 0 0 0 2322 0 27800 0 29402 0 614992 0 0 0 PANTHIRUVELIL S MOHAN-THOMAS MD 422212 0 0 0 2996 0 11100 0 23103 0 459411 0 0 0 ROBERT JOSEPH GRONEMEYER MD 421092 0 0 0 1952 0 11100 0 25104 0 459248 0 0 0 AZAD CHALLAPALLI MD 406994 0 0 0 20766 0 27800 0 19862 0 475422 0 0 0 MICHAEL A BRODY MD 421091 0 0 0 681 0 27800 0 25104 0 474676 0 0 0 SUPPLEMENTAL INFORMATION PART I, LINE 1A THE ORGANIZATION PAYS HEALTH/SOCIAL CLUB DUES ON BEHALF OF THE INDIVIDUAL WHICH IS THEN TAXED AS A FRINGE BENEFIT TO THE INDIVIDUAL. PART I, LINE 7 DESCRETIONARY BONUS IS PAID BASED ON FINANCIAL PERFORMANCE AND QUALITY INDICATORS TO CERTAIN EXECUTIVES. COMMUNITY CARDIOLOGY CENTER SN MAKAM PRTNR MORE THAN 5649198 INDEPENDENT CONTRACTOR false COMM CARD CTNR CON'T 5% OWNED INDEPENDENT CONTRACTOR HASSE CONSTRUCTION OWNED BY WILLIAM HASSE 361947 INDEPENDENT CONTRACTOR false SARN II DR. SHABEEB PART-OWNER 228201 RENTAL OF OFFICE SPACE false CARDIOLOGY ASSOC OF NW IN SN MAKAM OFFICER 103430 INDEPENDENT CONTRACTOR false KAY TORRENGA FAM MEM OF DONALD TORRENG 69521 EMPLOYMENT false GARY MCKAY FAM MEM OF RONDA MCKAY 64187 EMPLOYMENT false STEVEN PAUL CHOVANEC FAM MEM STEVEN G CHOVANEC 47865 EMPLOYMENT false RYAN TORRENGA FAM MEM OF DONALD TORRENG 12544 EMPLOYMENT false FAMILY OR BUSINESS RELATIONSHIPS PART VI LINE 2 Frankie Fesko is a family member of Donald Fesko and Donald S. Powers Members or Stockholders PART VI LINE 6 Community Foundation of Northwest Indiana, Inc. (CFNI) is the sole member or stockholder. DESCRIPTION OF THE CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PT VI-A, LINE 7A COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF MUNSTER MEDICAL RESEARCH FOUNDATION, INC AND HAS CONTROL TO ELECT MEMBERS OF THEIR GOVERNING BODY. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS PT VI-A, LINE 7B COMMUNITY FOUNDATION OF NORTHWEST INDIANA, INC IS THE PARENT COMPANY OF MUNSTER MEDICAL RESEARCH FOUNDATION, INC AND HAS RIGHTS TO APPROVE DECISIONS MADE BY MMRF. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 PT VI-A, LINE 11A THE 990 IS SUBMITTED TO THE SENIOR VP AND CFO FOR REVIEW. ONCE THIS REVIEW IS COMPLETE THE RETURNS ARE THEN PRESENTED TO SENIOR LEADERSHIP TO REVIEW. THE 990 IS ALSO REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BEFORE IT IS POSTED TO A SECURE WEBSITE TO ALLOW THE BOARD OF DIRECTORS TO REVIEW PRIOR TO FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PT VI-B, LINE 12C AS PART OF THE ORGANIZATION'S ANNUAL MONITORING & ENFORCEMENT PROCEDURE RELATING TO ITS CONFLICT OF INTEREST POLICY, ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY THE VP OF CORPORATE COMPLIANCE AND THOSE OFFICERS, DIRECTORS OR KEY EMPLOYEES WHO DO NOT RETURN OR FULLY COMPLETE THE QUESTIONNAIRE ARE CONTACTED TO RECONCILE THE OMISSION. OFFICERS & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PART VIB, LINE 15 IN 2003, THE PARENT COMPANY (CFNI) BOARD ADOPTED EXECUTIVE AND BOARD OF DIRECTORS COMPENSATION PHILOSOPHY AND REASONABLENESS STANDARDS. THIS IS TO ASCERTAIN THAT THESE STANDARDS ARE ADHERED TO. THEIR PROCESS FOR COLLECTING AND ASSEMBLING MARKET DATA IS CONSISTENT WITH THE REBUTTABLE PRESUMPTION CHECKLIST AND GUIDELINES ALONG WITH FAIR MARKET VALUE USED BY THE IRS IN CONDUCTING EXECUTIVE COMPENSATION REVIEWS AS WELL AS CONTEMPORARY COMPENSATION PRACTICES. ALL MARKET DATA IS ASSEMBLED FROM REPUTABLE COMMERCIALLY AVAILABLE SURVEYS. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC PT VI-C, LINE 19 MUNSTER MEDICAL RESEARCH FOUNDATION, INC DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. IN ACCORDANCE WITH BOND COVENANTS, MMRF THROUGH CFNI MAKES IT FINANCIAL STATEMENTS AND DISCLOSURES AVAILABLE TO THE PUBLIC THROUGH THE EMMA DATABASE. PROGRAM SERVICE ACCOMPLISHMENTS PART III, LINE 4A THE DESIGNATED POPULATION THAT THE COMMUNITY HOSPITAL IS FOCUSING ON INCLUDES THOSE INDIVIDUALS WHOSE LIFE-STYLE BEHAVIORS PUT THEM AT RISK FOR DISEASE AND ILLNESS. OUR PRIMARY FOCUS CONTINUES THIS YEAR ON TWO DISEASES THAT HAVE BEEN IDENTIFIED AS HEALTH DISCREPANCIES IN LAKE COUNTY, INDIANA - CANCER AND HEART DISEASE. THE INCIDENCE OF THESE DISEASES IN OUR REGION SURPASSED STATE AND NATIONAL AVERAGES, AND THEREFORE DEMANDED OUR PRIMARY FOCUS. THE COMMUNITY HOSPITAL HAS INVESTED GREATLY IN RECENT YEARS IN THESE TREATMENT PROGRAMS AND IN OFFERING PATIENTS ACCESS TO TREATMENTS NOT AVAILABLE ELSEWHERE IN THE COUNTY. THE FOCUS OF OUR COMMUNITY BENEFIT IS TO USE RESOURCES TO REACH BEYOND THE TREATMENT OF THESE DISEASES TO HELP EDUCATE, SUPPORT AND EMPOWER INDIVIDUALS TO LOWER THEIR RISKS. PART XI, LINE 5 OTHER CHANGES IN NET ASSETS INCLUDE THE FOLLOWING: MINIMUM PENSION LIABILITY ADJUSTMENT 10,588,038 TRANSFER FROM RELATED ORGANIZATION (17,984,383) TRANSFER FROM RELATED ORGANIZATION (1,173,943) TRANSFER FROM RELATED ORGANIZATION (80,000) TEMP RESTRICTED FUND TRANSFER (288,315) TEMP RESTRICTED ENDOWMENT FUND RELEASE 1,837 TOTAL CHANGES IN NET ASSETS (8,936,766) COMMUNITY FOUNDATION OF NW INDIANA INC 10010 DONALD POWERS DRIVE MUNSTER IN 46321 311128781 SUPPORTNG ORG IN 501(c)(3) 11(c) NA false ST CATHERINE HOSPITAL INC 4321 FIR STREET EAST CHICAGO IN 46312 351738708 HOSPITAL IN 501(c)(3) 3 CFNI true ST MARY MEDICAL CENTER INC 1500 S LAKE PARK AVE HOBART IN 46342 352007327 HOSPITAL IN 501(c)(3) 3 CFNI true COMMUNITY CANCER RESEARCH FOUNDATION 901 MACARTHUR BLVD MUNSTER IN 46321 352146374 CANCER FUNDRA IN 501(c)(3) 7 MMRF true COMMUNITY VILLAGE INC 10000 COLUMBIA AVE MUNSTER IN 46321 351956395 RETRMT HOME IN 501(c)(3) 9 CFNI true CVPA HOLDING COMPANY 1040 RIDGE RD MUNSTER IN 46321 351938136 TITLE HLDG CO IN 501(c)(2) N/A CFNI true THEATRE AT THE CENTER 905 RIDGE RD MUNSTER IN 46321 351939427 PLAYS & ARTS IN 501(c)(3) 9 CFNI true COMMUNITY CARE NETWORK INC 901 MACARTHUR BLVD MUNSTER IN 46321 454158203 PHYS SERVICES IN 501(c)(3) 3 MMRF SCH SMM true COMMUNITY RESOURCES INC 907 RIDGE ROAD MUNSTER IN 46321 351727711 MGMT SERVICES IN NA C CORP false true true false false false true false true false false false false true true true false false THEATRE AT THE CENTER B 80000 FMV COMMUNITY CARE NETWORK B 1173943 FMV COMMUNITY CANCER RESEARCH FOUNDATION C 280825 FMV COMMUNITY CARE NETWORK H 52884 FMV COMMUNITY CARE NETWORK J 163441 FMV ST CATHERINE HOSPITAL O 1016011 FMV ST MARY MEDICAL CENTER O 769010 FMV COMMUNITY CANCER RESEARCH FOUNDATION O 227490 FMV COMMUNITY CARE NETWORK O 5076571 FMV ST CATHERINE HOSPITAL P 2942364 FMV ST MARY MEDICAL CENTER P 7300385 FMV COMMUNITY CANCER RESEARCH FOUNDATION P 118450 FMV COMMUNITY CARE NETWORK P 7439002 FMV ST CATHERINE HOSPITAL Q 977247 FMV ST MARY MEDICAL CENTER Q 1882525 FMV COMMUNITY CARE NETWORK Q 1566559 FMV