2014-11-17T13:54:32-06:00 2013-12-31 420714325 MCGLADREY LLP 15 S OLD STATE CAPITOL PLZ STE 200 SPRINGFIELD IL 627011510 990 2013-01-01 370681540 PROCTOR HOSPITAL PROC 3096911064 5409 N KNOXVILLE AVENUE PEORIA IL 61614 ROBERT QUIN TREASURER 3096724893 2014-11-11 1 MICHAEL BASS P00458970 2177897700 2013 2015-11-30 17:44:51Z DEBORAH SIMON 5409 N KNOXVILLE AVENUE PEORIA IL 61614 102099313 0 X N/A X 1958 IL PROCTOR HOSPITAL PROVIDES A BROAD RANGE OF HEALTHCARE SERVICES AND ACTIVITIES TO THE COMMUNITY. THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE FACILITIES TO SUPPORT MEDICAL NEEDS OF THE COMMUNITY WITHOUT REGARD TO THE INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL ALSO PROVIDES EXTENSIVE EDUCATION TO MEMBERS OF THE COMMUNITY ABOUT VARIOUS HEALTH ISSUES. 16 15 1386 242 946948 -270528 24 0 108880545 101836674 -652613 -26828 -37208 163639 108190748 101973485 0 0 0 0 48868223 47568346 0 0 0 64037371 69906819 112905594 117475165 -4714846 -15501680 96942323 88218639 87912761 78018169 9029562 10200470 PROCTOR HOSPITAL PROVIDES A BROAD RANGE OF HEALTHCARE SRVICES AND ACTIVITIES TO THE COMMUNITY. 0 0 86642530 101026537 PROCTOR HOSPITAL IS AN ACUTE CARE FACILITY WHICH OPERATES 233 LICENSED BEDS IN PEORIA, ILLINOIS. TWENTY FIVE OF THE LICENSED BEDS ARE DEVOTED TO SKILLED NURSING AND ANOTHER 30 BEDS ARE DEVOTED TO A NATIONALLY UNIQUE ADDICTION RECOVERY CENTER. STATISTICS INCLUDE 29,401 PATIENT DAYS, 6,799 DISCHARGES AND 166,973 OUTPATIENT VISITS. OF TOTAL DAYS, SKILLED NURSING ACCOUNTED FOR 4,533 DAYS AND 537 DISCHARGES AND ADDICTION RECOVERY ACCOUNTED FOR 2,452 DAYS AND 376 DISCHARGES. IN ADDITION, THE ADDICTION RECOVERY CENTER HAD 6,748 PATIENT DAYS IN THEIR IADT PROGRAM. THE HOSPITAL ALSO HAS AN EMERGENCY ROOM WHICH TREATED 19,839 PATIENTS. 86642530 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 183 0 1 1386 1 1 1 0 0 0 0 0 0 0 0 0 X 16 15 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X ROBERT QUIN 3096724893 221 NE GLEN OAK PEORIA IL 61603 DEBORAH SIMON CEO 1.00 40.00 X X 0 618876 141555 BRUCE ALKIRE CHAIRMAN 1.00 X X 0 0 0 PATRICK O'LEARY VICE CHAIRMAN 1.00 X X 0 0 0 BRIAN COHEN MD DIRECTOR 1.00 X 0 0 0 FRANK CRESPO DIRECTOR 1.00 X 0 0 0 JILL DAUGHTERY DIRECTOR 1.00 X 0 0 0 JOHN ERWIN DIRECTOR 1.00 X 0 0 0 GREG GERSTNER MD DIRECTOR 1.00 X 0 0 0 VAUGHN HANNA MD DIRECTOR 1.00 X 0 0 0 PETER JOHNSEN PHD DIRECTOR 1.00 X 0 0 0 ALEXIS KHAZZAM DIRECTOR 1.00 X 0 0 0 JAY MARINO DIRECTOR 1.00 X 0 0 0 JAMES MAXEY MD DIRECTOR 1.00 X 0 0 0 KEVIN BARBIER DIRECTOR 1.00 X 0 0 0 JAMES VERGON DIRECTOR 1.00 X 0 0 0 DAVID WALTY DIRECTOR 1.00 X 0 0 0 ROBERT QUIN TREASURER 1.00 40.00 X 0 332124 62653 PAUL MACEK VICE PRESIDENT 16.00 24.00 X 156740 235111 103148 ANDREW BLAND COO 40.00 X 233193 0 10875 MARTY DORGAN CNO 40.00 X 203522 0 20241 TODD BAKER VP 40.00 X 168719 0 25513 STEPHEN BONOMO PHARMACIST 40.00 X 161668 0 12044 923842 1186111 376029 22 0 1 0 EMERGENCY PHYSICIAN STAFFING SOLUTIONS 12528 SR 78 HAVANA IL 62644 ER STAFFING 2408893 FULBRIGHT AND JAWORSKI 190 CARDONDELET PLAZA ST LOUIS MO 63105 LEGAL 1437193 PROFESSIONAL THERAPY SERVICES 2810 FRANK SCOTT PARKWAY WEST BELLEVILLE IL 62223 THERAPY 1342132 UNIDINE CORPORATION PO BOX 60479 CHAROLTTE NC 28260 CONTRACT SERVICES 1270680 CACI PO BOX 270480 ST LOUIS MO 63127 COLLECTION SERVICES 1158011 35 PATIENT SERVICE REVENUE 621500 94503568 94503568 OTHER OPERATING REVENUE 621500 7333106 6556756 776350 101836674 89373 99000 -9627 -9627 -9627 26828 -26828 -26828 -26828 DAYCARE REVENUE 622410 163911 163911 LAUNDRY REVENUE 812300 6687 6687 CAFETERIA REVENUE 621500 2668 2668 173266 101973485 101026537 946948 0 X 156740 156740 37090353 27190378 9899975 963048 703025 260023 6612730 4827293 1785437 2745475 2004197 741278 2027389 1479994 547395 163114 119073 44041 3738582 2729165 1009417 989567 722384 267183 1106911 808044 298867 1443708 1053907 389801 173318 126522 46796 1438637 1438637 5727569 4181125 1546444 1598498 1166904 431594 SUPPLIES 24060962 17564502 6496460 CONTRACT SERVICES 11356820 8290479 3066341 BAD DEBT EXPENSE 7169867 7169867 OTHER EXPENSES 4457771 3254174 1203597 4454106 3251497 1202609 117475165 86642530 30832635 0 125065 4185560 38666170 33305204 3442714 3498104 1363773 2652168 146384320 110728358 41642692 35655962 4965441 1865735 96255 0 6640213 7055906 96942323 88218639 29542036 34946345 32465601 30026540 25905124 13045284 87912761 78018169 X 2311087 3072942 510619 6651778 6207856 475750 9029562 10200470 96942323 88218639 X -15501680 3770 16668818 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 27004 27004 0 PART II-B, LINE 1: PROCTOR HOSPITAL PAYS DUES TO IHA. THE AMOUNT OF DUES PAID IN 2013 WAS $79,423 OF WHICH 34% OR $27,004 WAS USED FOR LOBBYING. 6081907 6081907 63595770 45388191 18207579 429739 154885 274854 75931867 65185282 10746585 345037 345037 35655962 DEFERRED CHARGES 13330 BENEFICIAL INTEREST IN PERPETUAL TRUST 7042576 7055906 MINIMUM PENSION LIABILITY 11454436 CAPITAL LEASE OBLIGATIONS 11470 RETIREMENT PLAN ACCRUAL 1579378 13045284 X PART X, LINE 2: UNITY POINT HEALTH (PARENT) AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2010. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. 1 1 1 X 1 X 1 1 0 1 1 765384 765384 0.00650 5251085 1818896 3432189 0.02920 6016469 1818896 4197573 0.03570 82878 82878 0.00070 4663250 1355374 3307876 0.02820 4746128 1355374 3390754 0.02890 10762597 3174270 7588327 0.06460 1 2495899 31832879 41002511 -9169632 X 1 1 1 1 PROCTOR HOSPITAL 5409 N KNOXVILLE AVENUE PEORIA IL 61614 X X X PROCTOR HOSPITAL 1 1 X X X X X X X X X 13 1 1 1 X X X X X 1 0 1 1 200.000000000000 1 600.000000000000 1 X X X X X 1 1 X X X X X X 1 0 1 X 0 0 PROCTOR HOSPITAL PART V, SECTION B, LINE 3: THE CHNA INCLUDED DETAILED ANALYSES OF SECONDARY DATA TO ASSESS INFORMATION REGARDING THE HEALTH STATUS OF THE COMMUNITIES. IN ORDER TO PERFORM THESE ANALYSES, INFORMATION WAS COLLECTED FROM NUMEROUS SECONDARY SOURCES, INCLUDING PUBLICALLY AVAILIABLE SOURCES, SUCH AS COUNTY-BASED DATA, AS WELL AS PRIVATE SOURCES OF DATA, SUCH AS HOSPITAL-SPECIFIC DATA. SPECIFICALLY, FINDINGS FROM THE SECONDARY SOURCES OF DATA HIGHLIGHTED SEVERAL CRITICAL AREAS OF COMMUNITY NEEDS.TO COLLECT DATA, THREE SURVEYING TECHINQUES WERE USED- ONLINE, PAPER, AND STRUCTURED INTERVIEWS.THE HOSPITALS THEN IDENTIFIED AND PRIORITIZED THE MOST IMPORTANT HEALTH-RELATED ISSUES IN THE TRI-COUNTY REGION. AFTER SUMMARIZING ALL OF THE ISSUES OF THE CHNA, A COMPREHENSIVE ASSESSMENT OF EXISTING COMMUNITY RESOURCES WAS PERFORMED TO IDENTIFY THE EFFICACY TO WHICH HEALTH-RELATED ISSUES WERE ALREADY BEING ADDRESSED. FINALLY, A COLLABORATIVE EFFORT OF LEADERS IN THE HEALTHCARE COMMUNITY USED AN IMPORTANCE/URGENCY METHODOLOGY TO IDENTIFY THE MOST CRITICAL ISSUES IN THE AREA. TEAM MEMBERS FOR THIS NEEDS ASSESSMENT INCLUDED TWO REPRESENTATIVES FROM EACH OF THE THREE PEORIA HOSPITALS, ADMINISTRATORS FROM THE THREE COUNTY HEALTH DEPARTMENTS, PHYSICIANS/ADMINISTRATORS FROM CLINICS SERVING THE AT-RISK POPULATION, REPRESENTATION FROM THE UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AND THE HEART OF ILLINOIS UNITED WAY. PROCTOR HOSPITAL PART V, SECTION B, LINE 4: PROCTOR HOSPITAL'S CHNA WAS A COLLABORATIVE UNDERTAKING BY PROCTOR HOSPITAL, METHODIST MEDICAL CENTER OF ILLINOIS AND OSF SAINT FRANCIS MEDICAL CENTER TO HIGHLIGHT THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN PEORIA, TAZEWELL, AND WOODFORD COUNTIES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $7,169,867. PART III, LINE 4: PATIENT RECEIVABLES DUE FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY, CREDIT HISTORY, AND CURRENT ECONOMIC CONDITIONS. INTEREST IS NOT CHARGED ON PATIENT RECEIVABLES. PATIENT RECEIVABLES ARE WRITTEN OFF AS A BAD DEBT WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. PART III, LINE 9B: NO COLLECTION EFFORTS WILL BE MADE BY PROCTOR HOSPITAL OR ITS DESIGNATED AGENTS ON ACCOUNTS WHERE PATIENTS HAVE COMPLETED THE FINANCIAL ASSISTANCE APPLICATION PROCESS AND ESTABLISHED THEIR ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 2: PROCTOR HOSPITAL'S BOARD OF TRUSTEES AND MANAGEMENT TEAM DEVELOPED GOALS FOR THE COMMUNITY BENEFIT PLAN USING FEEDBACK FROM EMPLOYEES, PATIENTS, FAMILIES, PHYSICIANS, FOCUS GROUPS, STUDIES OF LOCAL AND REGIONAL HEALTH TRENDS, AND REVIEWS OF CENSUS DATA TO PROVIDE THE NECESSARY EVIDENCE FROM WHICH TO CONCENTRATE OUR EFFORTS. FROM THE RESEARCH, THREE PRIMARY GOALS WERE ESTABLISHED AND ARE NOW REVIEWED ANNUALLY. NO SUBSTANTIVE CHANGES TO THE PRIMARY GOALS WERE MADE IN 2013. PROCTOR'S MOST SIGNIFICANT GOAL WORKS TO IMPROVE ACCESS TO THE DELIVERY OF HEALTHCARE SERVICES, INCLUDES MAKING OUR FACILITIES AND STAFF AVAILABLE TO ANYONE WHO HAS A NEED FOR HEALTH CARE. THE SECOND GOAL, ENHANCING THE QUALITY OF LIFE THROUGH EDUCATION AND PREVENTION, WAS DEVELOPED TO FURTHER THE ABILITY OF PEOPLE OF ALL AGES IN OUR COMMUNITY TO LEARN ABOUT HEALTH ISSUES THAT MAY IMPACT THEIR LIVES. OUR THIRD, AND FINAL PRIMARY GOAL, IS FOR PROCTOR HOSPITAL TO ENHANCE ITS REPUTATION AS A VIRTUAL "CORPORATE" CITIZEN OF PEORIA AND THE SURROUNDING AREA. AS A MAJOR EMPLOYER IN OUR PRIMARY AND SECONDARY SERVICE AREAS, PROCTOR IS COMMITTED TO PROVIDING RESOURCES TO ASSIST OTHER COMMUNITY BASED, NOT-FOR-PROFIT ORGANIZATIONS THAT DEMONSTRATE NEEDS RELATING TO SOME ASPECT OF HEALTH OR QUALITY OF LIFE. REQUESTS FOR ASSISTANCE IN NON-HEALTH/PERSONAL DEVELOPMENT COMMUNITY ENDEAVORS (I.E., ZOOS, MUSEUMS, ETC.) MAY BE CONSIDERED IF ADEQUATE RESOURCES ARE AVAILABLE BUT WILL BE SECONDARY TO CAUSES THAT RELATE SPECIFICALLY TO THE HOSPITAL'S MISSION, VISION AND VALUES. PART VI, LINE 3: PROCTOR HOSPITAL HAS POSTED A SIGN IN ALL ADMISSION AND REGISTRATION AREAS WITH THE FOLLOWING NOTICE:"YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE TERMS AND CONDITIONS THE HOSPITAL OFFERS TO QUALIFIED PATIENTS. FOR MORE INFORMATION CONTACT A PATIENT FINANCIAL SERVICE REPRESENTATIVE AT 309-691-1083."THE SIGN IS IN ENGLISH AND ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE OF AT LEAST 5% OF THE PATIENTS SERVICED BY THE HOSPITAL ANNUALLY.A NOTICE WAS PLACED ON THE PROCTOR HOSPITAL WEBSITE IN A PROMINENT LOCATION THAT (1)NOTIFIED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AT THE HOSPITAL, (2)DESCRIBED THE FINANCIAL ASSISTANCE APPLICATION PROCESS, AND (3)PROVIDED A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 4: FROM A DEMOGRAPHIC STANDPOINT, PROCTOR SERVES A POPULATION THAT DIFFERS SIGNIFICANTLY FROM ITS LARGER DOWNTOWN COMPETITORS. THE RACIAL AND ETHNIC MIX OF PROCTOR PATIENTS IS IMPACTED BY THE HOSPITAL'S NORTHSIDE LOCATION. PART VI, LINE 5: WE BELIEVE THAT GENERAL KNOWLEDGE OF HEALTH RELATED ISSUES IS LACKING. OUR FOCUS ON EDUCATION AND PREVENTION, THROUGH AN IMPRESSIVE ARRAY OF OPPORTUNITIES, WILL HELP PROVIDE INDIVIDUALS WITH INFORMATION NEEDED TO ASSIST IN MAKING NECESSARY LIFESTYLE CHANGES TO PREVENT DISEASE WHEN POSSIBLE. IF DISEASE CANNOT BE PREVENTED, OUR PLAN IS TO PROVIDE METHODS THAT PROVIDE OPTIONS FOR SOUND DECISION MAKING. RESEARCH CLEARLY STATES THAT EARLY DETECTION IS IMPERATIVE TO DISEASE PREVENTION AND THAT HEALTHY LIFESTYLE CHANGES POSITIVELY IMPACT ATTITUDES OF INDIVIDUALS AND FAMILIES. PART VI, LINE 6: PROCTOR HEALTH CARE INCORPORATED (CORPORATION), PROCTOR HEALTH CARE FOUNDATION (FOUNDATION), BELCREST SERVICES, LTD. (BELCREST), PROCTOR HEALTH SYSTEMS (PHS), PROFESSIONAL MEDICAL ASSOCIATES (PMA), HEALTH PLUS, INC., AND HULT HEALTH EDUCATIONAL CENTER (HULT) (COLLECTIVELY REFERRED TO HEREIN AS "PROCTOR" OR "PROCTOR HEALTH CARE INCORPORATED AND RELATED ORGANIZATIONS")ARE AFFILIATED WITH PROCTOR HOSPITAL (HOSPITAL).THE HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES HEALTH CARE SERVICES THROUGH ITS INPATIENT AND OUTPATIENT FACILITIES LOCATED IN AND AROUND PEORIA, ILLINOIS. THE FOUNDATION AND CORPORATION ARE NOT-FOR-PROFIT CORPORATIONS WHOSE PRIMARY PURPOSES ARE TO SUPPORT AND ENCOURAGE HEALTH CARE RELATED SERVICES BY PROVIDING FINANCIAL AND MANAGEMENT ASSISTANCE TO THE HOSPITAL. THE HOSPITAL IS CONTROLLED BY THE CORPORATION AND IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. BELCREST IS A WHOLLY-OWNED SUBSIDIARY OF THE CORPORATION, ESTABLISHED AS A FOR-PROFIT CORPORATION TO PROVIDE HEALTH CARE RELATED SERVICES. PHS IS A WHOLLY-OWNED SUBSIDIARY OF THE CORPORATION, ESTABLISHED TO PROVIDE PHYSICIAN PRACTICE MANAGEMENT SERVICES ON BEHALF OF THE PROCTOR HEALTH CARE DELIVERY SYSTEM. PMA WAS ESTABLISHED TO PROVIDE PROFESSIONAL MEDICAL SERVICES AND IS CONTROLLED BY THE CORPORATION. HEALTH PLUS, INC. IS A MANAGED CARE COMPANY, WHICH CONTRACTS WITH PROVIDERS AND INSURERS OF HEALTHCARE IN THE CENTRAL ILLINOIS MARKET. HEALTH PLUS, INC. IS A WHOLLY-OWNED SUBSIDIARY OF THE CORPORATION. THE HOSPITAL IS THE SOLE CORPORATE MEMBER OF HULT, A COMMUNITY EDUCATIONAL CENTER LOCATED ON THE HOSPITAL'S CAMPUS. PART VI, LINE 7, REPORTS FILED WITH STATES IL X X X X 1 1 0 0 0 0 0 0 0 DEBORAH SIMON CEO 0 368577 0 81803 0 168496 0 116938 0 24617 0 760431 0 0 ROBERT QUIN TREASURER 0 229581 0 39377 0 63166 0 53766 0 8887 0 394777 0 0 PAUL MACEK VICE PRESIDENT 156740 235111 0 0 0 0 34260 51390 6999 10499 197999 297000 0 0 ANDREW BLAND COO 49956 0 0 0 183237 0 698 0 10177 0 244068 0 0 0 MARTY DORGAN CNO 203522 0 0 0 0 0 4392 0 15849 0 223763 0 0 0 TODD BAKER VP 168719 0 0 0 0 0 4492 0 21021 0 194232 0 0 0 STEPHEN BONOMO PHARMACIST 161668 0 0 0 0 0 4250 0 7794 0 173712 0 0 0 PART I, LINES 4A-B PROCTOR'S COO ANDREW BLAND SEPARATED FROM PROCTOR. HE RECEIVED A SEVERANCE PAYMENT OF $183,237. PROCTOR ESTABLISHED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN DURING 2011 FOR ITS CHIEF EXECUTIVE OFFICER PAUL MACEK. THE AMOUNT OF THE CONTRIBUTION FOR 2013 WAS $78,000. A ILLINOIS FINANCE AUTHORITY-SERIES 2006A 861091674 45200BYW2 2006-05-11 22525000 REFUND 1991 BONDS 0 0 0 B ILLINOIS FINANCE AUTHORITY-SERIES 2010A 861091674 2010-12-16 15500000 PAYOFF 2006B AND NEW MONEY 0 0 0 A 22323401 19564161 446468 21876933 1 0 1 1 B 15500000 431184 178659 14890157 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 A 0 B 0 FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE NOVEMBER 7, 2013 METHODIST HEALTH SERVICES (MHSC) ENTERED INTO AN AFFILIATION AGREEMENT WITH PROCTOR HEALTH CARE INCORPORATED (PHCI) UNDER WHICH PHCI BECAME AN AFFILIATE OF MHSC. PHCI IS THE SOLE MEMBER OF PROCTOR (PROCTOR) HOSPITAL. CHANGES TO THE NUMBER AND COMPOSITION OF VOTING MEMBERS, OFFICERS OR KEY EMPLOYEES BECAUSE OF THIS AFFILIATION AGREEMENT ARE AS FOLLOWS: - THE NUMBER OF PROCTOR DIRECTORS SHALL NOT BE MORE THAN SIXTEEN (16) OR LESS THAN ELEVEN (11) AS DETERMINED FROM TIME TO TIME BY MHSC. THE MHSC BOARD, AFTER CONSIDERING THE RECOMMENDATIONS OF THE MHSC GOVERNANCE COMMITTEE, SHALL ELECT THE NUMBER OF PROCTOR DIRECTORS REQUIRED TO FILL THE VACANCIES COMING OPEN ON THE DATE OF THE ANNUAL MEETING OF THE MHSC BOARD WHO ARE NOT EX OFFICIO VOTING MEMBERS, TO HOLD OFFICE FOR A TERM OF THREE (3) YEARS AND UNTIL THEIR SUCCESSORS ARE ELECTED AND QUALIFIED. TERMS SHALL BE STAGGERED SO THAT NO MORE THAN ONE THIRD (1/3) OF THE PROCTOR DIRECTORS SHALL BE ELIGIBLE FOR RE-ELECTION ANNUALLY. THE MHSC BOARD SHALL ELECT THE SAME INDIVIDUALS TO SERVE AS PROCTOR DIRECTORS AND MMCI DIRECTORS FOR IDENTICAL TERMS ON THE PROCTOR BOARD AND THE MMCI BOARD RESPECTIVELY. NO PERSON OTHER THAN THE PRESIDENT MAY SERVE MORE THAN FOUR (4) CONSECUTIVE THREE (3) YEAR TERMS ON THE PROCTOR BOARD. A PERSON WHO HAS SERVED FOUR (4) CONSECUTIVE THREE (3) YEAR TERMS ON THE PROCTOR BOARD WILL BE ELIGIBLE TO SERVE ON THE PROCTOR BOARD FOR AN ADDITIONAL FOUR (4) CONSECUTIVE THREE (3) YEAR TERMS IF THE PERSON IS NOT ON THE PROCTOR BOARD FOR ONE (1) YEAR. -THE PRESIDENT AND CEO OF MHSC SHALL BE THE CEO OF PROCTOR. -THE CFO OF MHSC SHALL BE THE TREASURER OF PROCTOR. FORM 990, PART VI, SECTION A, LINE 6 PROCTOR HEALTH CARE INCORPORATED IS THE SOLE MEMBER OF PROCTOR HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A PROCTOR HEALTH CARE INCORPORATED PER THE BYLAWS HAS THE RIGHT TO "ELECT, REPLACE OR REMOVE AT ANY TIME AND FROM TIME TO TIME AND WITHOUT CAUSE, MEMBERS OF THE BOARD OF TRUSTEES OF THE CORPORATION." FORM 990, PART VI, SECTION A, LINE 7B THE DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY ITS MEMBER, PROCTOR HEALTH CARE INCORPORATED. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY MEMBERS OF THE BOARD EXECUTIVE COMMITTEE AND SENIOR MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A STANDING AGENDA ITEM FOR EACH BOARD MEETING WILL REQUEST FROM MEMBERS IF THERE ARE ANY RECENT EVENTS TO BE REPORTED UNDER THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR IS ESTABLISHED BY A COMMITTEE MADE UP OF MEMBERS OF PROCTOR HOSPITAL'S BOARD. VARIOUS METHODS ARE USED BY THIS COMMITTTEE TO ESTABLISH THE COMPENSATION. EXAMPLES OF THESE METHODS INCLUDE AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY OR SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 24E RENT & LEASE EXPENSES: PROGRAM SERVICE EXPENSES 2,789,075. MANAGEMENT AND GENERAL EXPENSES 1,031,576. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,820,651. REPAIRS & MANTENANCE: PROGRAM SERVICE EXPENSES 462,422. MANAGEMENT AND GENERAL EXPENSES 171,033. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 633,455. FORM 990, PART XI, LINE 9: ASSETS RELEASED FROM RESTRICTION 384,278. CHANGE IN MINIMUM PENSION LIABILITY 15,875,487. CHANGE IN TEMPORARILY RESTRICTED ASSETS 6,141,159. CHANGE IN PERMANENTLY RESTRICTED ASSETS -5,732,106. PROCTOR HEALTH CARE INCORPORATED 5409 N KNOXVILLE AVENUE PEORIA IL 61614 371133412 PROVISION OF MANAGEMENT SERVICES AND SUPPORT TO PROCTOR HOSPITAL IL 501(C)(3) 170(B)(1)(A)(III) 0 PROCTOR HEALTH CARE FOUNDATION 5409 N KNOXVILLE AVENUE PEORIA IL 61614 371133429 SOLICIT AND RECEIVE GIFTS IL 501(C)(3) 509(A)(3) TYPE I PROCTOR HOSPITAL 1 PROCTOR HEALTH SYSTEMS 5409 N KNOXVILLE AVENUE PEORIA IL 61614 364147437 PROVIDE HEALTH CARE IL 501(C)(3) 170(B)(1)(A)(III) PROCTOR HEALTH CARE INCORPORATED 1 HULT HEALTH EDUCATION CENTER 5409 N KNOXVILLE AVENUE PEORIA IL 61614 371295532 PROVIDE HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1)(A)(VI) PROCTOR HOSPITAL 1 METHODIST MEDICAL CENTER 221 NE GLEN OAK AVENUE PEORIA IL 61636 370661223 HOSPITAL IL 501(C)(3) 170(B)(1)(A)(III) 0 METHODIST HEALTH SERVICES CORPORATION 221 NE GLEN OAK AVENUE PEORIA IL 61636 371111135 SUPPORT AFFILIATES MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 509(A)(3) TYPE III 0 METHODIST MEDICAL CENTER FOUNDATION 221 NE GLEN OAK AVENUE PEORIA IL 61636 510186460 CHARITABLE FUNDRAISING IL 501(C)(3) 170(B)(1)(A)(VI) 0 METHODIST SERVICES INC 221 NE GLEN OAK AVENUE PEORIA IL 61636 371111134 OFFICE RENTAL IL 501(C)(3) 509(A)(2) 0 BELCREST LTD 5409 N KNOXVILLE AVENUE PEORIA IL 61614 371196307 MEDICAL SERVICES IL PROCTOR HEALTH CARE INCORPORATED C 6728737 5629339 1.00000 0 HEALTH PLUS INC 5409 N KNOXVILLE AVENUE PEORIA IL 61614 371295532 MANAGED CARE ADMINISTRATION IL PROCTOR HEALTH CARE INCORPORATED C 5414 1.00000 0 METHODIST HEALTH VENTURES INC PO BOX 87 PEORIA IL 61650 371140939 PHARMACY/OFFICE STAFFING IL C 0 METHODIST PHYSICIAN SERVICES INC PO BOX 87 PEORIA IL 61650 363858550 MEDICAL SERVICES IL C 0 PROVIDER RESOURCE MANAGEMENT INC PO BOX 87 PEORIA IL 61650 371223550 RESOURCE MANAGEMENT IL C 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 PROCTOR HEALTH CARE FOUNDATION K 656688 FMV PROCTOR HEALTH CARE FOUNDATION P 76046 FMV PROCTOR HEALTH CARE FOUNDATION Q 805688 FMV PROCTOR HEALTH CARE INCORPORATED P 37628 FMV PROCTOR HEALTH SYSTEMS O 2566759 FMV BELCREST LTD O 2824957 FMV HEALTH EDUCATION CENTER O 699676 FMV HEALTH PLUS INC O 57311 FMV