2013-02-12T10:33:04-06:00 2012-09-30 351178661 BLUE & CO LLC ONE AMERICAN SQUARE 2200 INDIANAPOLIS IN 46282 990 2011-10-01 350593390 DEACONESS HOSPITAL INC DEAC 8124502370 600 MARY STREET EVANSVILLE IN 47747 SHAWN MCCOY 8124502370 2013-02-11 1 ANGELA L ZIRKELBACH CPA P00572603 3176334705 2011 2016-02-25 16:41:14Z SHAWN MCCOY CAO 600 MARY STREET EVANSVILLE IN 47747 641114124 0 X WWW.DEACONESS.COM X 1895 IN PROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT CONTINUE TO SCH O TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. 15 8 5475 165 9811889 -228122 1557790 1888774 501428355 515082254 6874717 8461947 40944570 51646845 550805432 577079820 270222 295491 0 0 232797203 247753296 0 0 478439 267994072 270678198 501061497 518726985 49743935 58352835 757985603 819821086 361207034 382563647 396778569 437257439 X SEE SCHEDULE O. 0 0 131626106 292990192 PATIENT SERVICE REVENUE. SEE SCHEDULE O. 345119425 212487326 CHARITY CARE/SUBSIDIZED CARE. SEE SCHEDULE O. 16575319 9604736 GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION AND COMMUNITY BENEFIT. SEE SCHEDULE O. 295491 295491 26285383 ALL OTHER ACCOMPLISHMENTS - OTHER PROGRAM SERVICE REVENUE CONSISTS OF DEACONESS HOSPITAL'S INCOME FROM THE INVESTMENT IN JOINT VENTURES. OTHER PROGRAM SERVICE EXPENSES CONSISTED OF COMMUNITY BENEFIT GRANTS/ASSISTANCE. 295491 295491 26285383 493616341 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 0 0 1 463 0 1 5475 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 X 15 8 0 0 0 0 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 IN X JOHN L ZABROWSKI 8124503467 600 MARY STREET EVANSVILLE IN 47747 X LINDA E WHITE 50.00 X X 618312 307336 199466 JEROME A BENKERT JR 5.00 X 4400 0 0 STEVEN T TITZER CPA 5.00 X 5000 0 0 JOHN ENGELBRECHT 5.00 X 5200 0 0 BRUCE STALLINGS 5.00 X 5800 0 0 BRUCE ADYE MD 5.00 X 4600 0 0 MICHAEL J ALLEY 5.00 X 800 0 0 IRA G BOOTS 5.00 X 3800 0 0 STEVEN A CHURCH 5.00 X 4000 0 0 REV DR JOSEPH FRACCARO 5.00 X 3800 0 0 DR H RAY HOOPS 5.00 X 4600 0 0 DAVID A KOEHLER JR MD 5.00 X 5400 189389 5063 MATTHEW R LEE MD 5.00 X 5200 0 0 WILLIAM PENLAND MD 5.00 X 3600 0 0 RUSTON L STOLTZ MD 5.00 X 6470 320466 23579 ROBERT B WRIGHT 5.00 X 4800 0 0 DANIEL W WHITEHEAD MD 5.00 X 23600 0 0 SHAWN W MCCOY 50.00 X 483947 8200 113644 CHERYL A WATHEN 50.00 X 211355 135837 96986 JAMES R PORTER MD 50.00 X 508626 0 110233 CHERONA J HAJEWSKI 50.00 X 370171 0 79484 BRUCE E EPMEIER 50.00 X 364107 0 64986 LARRY F PILE 50.00 X 239612 0 23026 LYNN C LINGAFELTER 50.00 X 194863 0 23009 RICHARD B PERRY 50.00 X 190875 0 26825 JOHN L ZABROWSKI 50.00 X 173187 3200 34756 JOYCE A THOMAS 50.00 X 170172 0 47743 REBECCA L MALOTTE 50.00 X 162375 0 52474 VENKATESH R MADADI 50.00 X 711894 0 23960 NIRMAL JOSHI MD 50.00 X 672758 0 27070 RAJESH J PATEL MD 50.00 X 654170 0 36583 AYMAN ELFAR MD 50.00 X 647526 0 23960 LAWRENCE C KILINSKI JR MD 50.00 X 607095 0 25837 HARRY L SMITH JR 0.00 X 634537 1600 36167 RICHARD M STIVERS 0.00 X 206460 130822 7758 7913112 1096850 1082609 19 1 1 0 EVANSVILLE SURGERY CENTER ASSOC LLC 520 MARY STREET EVANSVILLE IN 47710 SURGICAL SERVICES 23972871 BOVIS LEND LEASE INC 1801 W END AVE SUITE 600 NASHVILLE TN 37203 BUILDING CONTRACTOR 10608493 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 53288 SOFTWARE/ CONSULTING 4005528 WINK CONSTRUCTION INC 4007 E EICHEL AVE EVANSVILLE IN 47716 BUILDING CONTRACTOR 3621309 ARUP LABORATORIES PO BOX 27964 SALT LAKE CITY UT 84127 LABORATORY 2352797 65 220865 193175 1474734 102025 1888774 NET PATIENT REVENUE 900099 515082254 515082254 515082254 7813968 7813968 58728 58728 6935231 2690232 4244999 4244999 4244999 60969504 812525 60465442 727336 504062 85189 589251 589251 44825 220865 151294 -106469 -106469 INVESTMENT IN JOINT VE 900099 26285383 26285383 LABORATORY SALES 621500 9363304 9363304 CMS MEANINGFUL USE 900099 5133258 5133258 6726370 448585 6277785 47508315 577079820 541367637 9811889 24011520 295491 295491 5488042 5488042 184691884 179433742 5015523 242619 14434823 13182288 1252535 30056632 28321107 1735525 13081915 12363801 718114 1297689 663861 633828 152918 152918 35357 35357 321564 305007 16557 58405092 57069225 1327760 8107 1052706 124481 928225 12051339 10953155 1052201 45983 9236220 8004741 1231479 16454021 14990209 1463812 820924 702411 118513 956099 788967 163667 3465 9043962 9035462 8500 34529998 32537629 1992363 6 1956557 1949666 6891 MEDICAL/SURGICAL SUPPLI 81329465 81241139 88326 MEDICAID ASSESSMENT FEE 22794075 22794075 EQUIP RENTAL/MAINTENANC 12098327 11906304 192023 AGENCY COLLECTION FEES 5632983 5632983 2508902 1625604 721596 161702 518726985 493616341 24632205 478439 47488383 54671462 106649065 88496093 959016 980947 4376580 5592070 4629844 4566672 716627726 387918977 334521835 328708749 195636448 270497387 30511704 33696074 15522009 15522009 17690719 17089623 757985603 819821086 50492334 59087211 110174 244662 219073884 205620955 91530642 117610819 361207034 382563647 X 393304791 432200551 2781774 3293842 692004 1763046 396778569 437257439 757985603 819821086 X 58352835 -17873965 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 35357 35357 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: LOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS HOSPITAL AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT. 8353428 6871 541295 3357168 5544426 8130489 1293267 294514 7052 1048880 308910 8353428 7433786 1683536 281910 192998 790792 284953 8130489 7797671 931781 337059 329950 1014396 288387 7433778 0.85000 0.15000 1 0 495397 9820472 10315869 42755830 416033381 218868044 239921167 238119700 169050933 69068767 9402946 9402946 328708749 ACCRUED PENSION/ACCRUED SICK 90715760 TAXABLE BOND- SERIES 1999B 9193834 REVENUE BOND-SERIES 2012A 8265000 CAPITAL LEASE OBLIGATIONS 4371590 ESTIMATED THIRD PARTY SETTLEMENTS 4311195 RELATED ORGANIZATION PAYABLES 753440 117610819 PART V, LINE 1E: ENDOWMENT FUNDS CONTRIBUTIONS INCLUDE CURRENT YEAR EXPENDITURE OF $53,098 AND A $3,304,070 RECLASSIFICATION OF PRIOR YEAR CONTRIBUTIONS DETERMINED TO NOT MEET THE DEFINITION OF AN ENDOWMENT UNDER ASC 958-210 AND 958-225 (CHANGE IN UNDERSTANDING.) PART V, LINE 4: THE DEACONESS HOSPITAL FOUNDATION UTILIZES ENDOWMENT FUNDS TO SUPPORT AND BENEFIT THE MISSION OF DEACONESS HOSPITAL. SPECIFICALLY, ENDOWMENT FUNDS ARE USED TO HELP SUPPORT ACTIVITIES OR PROJECTS THAT HELP TO PROVIDE QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES, AND COMMUNITIES OF THE TRI-STATE. PART VII AND IX: SECTIONS ARE NOT COMPLETED AS THE TOTALS FOR EACH LINE ARE LESS THAN 5% OF THE TOTAL ASSETS LISTED ON PART X, LINE 16. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, XII, AND XIII: SECTIONS ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENT IS AUDITED BY AN INDEPENDANT ACCOUNTING FIRM AND IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. DH PARTY OF YR 154465 127665 26800 3527 42299 7350 20802 DH CLASSIC 111225 93200 18025 37330 18376 15163 6447 0 265690 220865 44825 37330 3527 60675 22513 27249 151294 -106469 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 25309166 25309166 0.04450 79155354 56932374 22222980 0.03910 104464520 56932374 47532146 0.08360 814012 66774 747238 0.00130 4191775 1625455 2566320 0.00450 8492145 6157038 2335107 0.00410 1334642 384229 950413 0.00170 14832574 8233496 6599078 0.01160 119297094 65165870 54131224 0.09520 4125 4125 0.00000 1000 1000 0.00000 10892 150 10742 0.00000 6250 6250 0.00000 9313 9313 0.00000 1738 1738 0.00000 43173 14770 28403 0.00010 76491 14920 61571 0.00010 1 12385603 0 127812982 142292362 -14479380 X 1 1 3 1 DEACONESS HOSPITAL INC

600 MARY STREET EVANSVILLE IN 47747

X X X X 2 DEACONESS GATEWAY HOSPITAL

4011 GATEWAY BLVD NEWBURGH IN 47630

X X X X 3 DEACONESS CROSS POINTE

7200 E INDIANA STREET EVANSVILLE IN 47715

X DEACONESS HOSPITAL INC 1 1 1 300.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X 1 0 1 X 0 0 DEACONESS GATEWAY HOSPITAL 2 1 1 300.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X 1 0 1 X 0 0 DEACONESS CROSS POINTE 3 1 1 300.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X 1 0 1 X 0 0 47 DEACONESS PROCEDURE CENTER

421 CHESTNUT STREET EVANSVILLE IN 47713

OUTPATIENT SERVICES DEACONESS HOSPITAL PHYSICAL MEDICINE

520 MARY STREET SUITE 280 EVANSVILLE IN 47747

OUTPATIENT SERVICES DEACONESS COMPREHENSIVE PAIN CTR & PROG

4600 W LLOYD EXPRESSWAY EVANSVILLE IN 47712

OUTPATIENT SERVICES DEACONESS CHEMOTHERAPY INFUSION CTR

4055 GATEWAY BLVD SUITE 1200 NEWBURGH IN 47630

OUTPATIENT SERVICES DEACONESS HOSPITAL INFUSION SVCS

421 CHESTNUT STREET EVANSVILLE IN 47713

OUTPATIENT SERVICES DEACONESS HOSPITAL PHYSICAL MEDICINE

10455 ORTHOPAEDIC DRIVE NEWBURGH IN 47630

OUTPATIENT SERVICES DEACONESS COMPREHENSIVE PAIN CTR-GATEWAY

4099 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT SERVICES DEACONESS CRITICAL CARE GROUP

519 HARRIET STREET EVANSVILLE IN 47747

OUTPATIENT PHYSICIAN CLINIC DEACONESS HOSPITAL BREAST CENTER

520 MARY STREET SUITE 140 EVANSVILLE IN 47710

DIAGNOSTIC CENTER DEACONESS REGIONAL LAB

421 CHESTNUT STREET EVANSVILLE IN 47713

DIAGNOSTIC CENTER DEACONESS HOME CARE

701 GARFIELD STREET EVANSVILLE IN 47747

HOME HEALTH AGENCY CHANCELLOR CENTER FOR ONCOLOGY

4055 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT SERVICES DEACONESS SLEEP LAB

350 W COLUMBIA STREET SUITE 210 EVANSVILLE IN 47710

OUTPATIENT SERVICES DEACONESS SLEEP LAB

350 W COLUMBIA STREET SUITE LL-10 EVANSVILLE IN 47710

DIAGNOSTIC CENTER DEACONESS OHIO VALLEY HOSPICE

701 GARFIELD STREET EVANSVILLE IN 47747

HOSPICE DEACONESS REGIONAL LABORATORY

4133 GATEWAY BLVD SUITE 110 NEWBURGH IN 47630

DIAGNOSTIC CENTER THE FAMILY PRACTICE CENTER

515 READ STREET EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS COMP CENTER

329 W COLUMBIA STREET EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS WOUND CARE CENTER

611 HARRIET STREET SUITE 501 EVANSVILLE IN 47710

OUTPATIENT SERVICES DEACONESS HOSPITAL MAMMOGRAPHY & IMAGING

421 CHESTNUT STREET EVANSVILLE IN 47713

DIAGNOSTIC CENTER DEACONESS URGENT CARECOMP CARE

10455 ORTHOPAEDIC DRIVE EVANSVILLE IN 47630

OUTPATIENT PHYSICIAN CLINIC DEACONESS MEC MEDICAL CENTER

3844 FIRST AVENUE EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS CLINIC GATEWAY REG LAB

4233 GATEWAY BLVD NEWBURGH IN 47630

DIAGNOSTIC CENTER DEACONESS ANTICOAGULATION CLINIC

4107 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT SERVICES DEACONESS CLINIC WEST REG LAB RADIOLOGY

545 S BOEHNE CAMP ROAD EVANSVILLE IN 47712

OUTPATIENT PHYSICIAN CLINIC MIDWEST RADIOLOGIC IMAGING

10455 ORTHOPAEDIC DRIVE NEWBURGH IN 47630

DIAGNOSTIC CENTER MIDWEST RADIOLOGICAL IMAGING

4087 GATEWAY BLVD NEWBURGH IN 47630

DIAGNOSTIC CENTER DEACONESS REGIONAL LABORATORY

611 HARRIET STREET SUITE 102 EVANSVILLE IN 47710

DIAGNOSTIC CENTER DEACONESS RILEY CHILDREN'S SPECIALTY CTR

4133 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT PHYSICIAN CLINIC DEACONESS RILEY SPECIALITY CTR OP

4121 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT PHYSICIAN CLINIC DOCTOR'S PLAZA X-RAY

611 HARRIET STREET EVANSVILLE IN 47710

DIAGNOSTIC CENTER DEACONESS PRIMARY CARE FOR SENIORS

4498 FIRST AVENUE EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS REGIONAL LABORATORY

4494 N FIRST AVENUE EVANSVILLE IN 47710

DIAGNOSTIC CENTER DEACONESS CLINIC PRINCETON RADIOLOGY SRV

685 VAIL STREET PRINCETON IN 47670

OUTPATIENT PHYSICIAN CLINIC DEACONESS PRIMARY CARE FOR SENIORS

1750 OAK HILL ROAD EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS PRE-ADMISSION TESTING

520 MARY STREET SUITE 330 EVANSVILLE IN 47747

DIAGNOSTIC CENTER MT VERNON MEDICAL CENTER LAB & RADIOLOGY

1900 W FOURTH STREET MT VERNON IN 47620

DIAGNOSTIC CENTER DEACONESS FAMILY MEDICINE

611 HARRIET STREET SUITE 504 EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS DIABETES CENTER - EDUCATION

421 CHESTNUT STREET EVANSVILLE IN 47713

OUTPATIENT SERVICES DEACONESS GATEWAY GASTROENTEROLOGY

4133 GATEWAY BLVD NEWBURGH IN 47630

OUTPATIENT PHYSICIAN CLINIC DEACONESS WEIGHT LOSS SOLUTIONS

310 W IOWA STREET EVANSVILLE IN 47710

OUTPATIENT PHYSICIAN CLINIC DEACONESS REGIONAL LABORATORY

1204 W WILLIAMS STREET OAKLAND CITY IN 47660

DIAGNOSTIC CENTER DEACONESS CROSS POINTE-PRINCETON

1808 SHERMAN DRIVE RM 2208 PRINCETON IN 47670

OUTPATIENT PHYSICIAN CLINIC DEACONESS CROSS POINTE-ROCKPORT

2792 N US HIGHWAY 231 ROCKPORT IN 47635

OUTPATIENT PHYSICIAN CLINIC DEACONESS CROSS POINTE-OWENSBORO

920 FREDERICA STREET SUITE 1003 OWENSBORO KY 42301

OUTPATIENT PHYSICIAN CLINIC DEACONESS CROSS POINTE-HENDERSON

209 N ELM STREET HENDERSON KY 42420

OUTPATIENT PHYSICIAN CLINIC DEACONESS CROSS POINTE OUTPATIENT CLINIC

445 CROSS POINTE BLVD EVANSVILLE IN 47715

OUTPATIENT PHYSICIAN CLINIC PART I, LINE 6A: DEACONESS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS MADE AVAILABLE IN THE FOLLOWING WAYS:1. MAILED TO ALL THE MAJOR EMPLOYERS IN THE TRI-STATE AREA.2. AN ADVERTISEMENT IS PLACED IN THE SUNDAY PAPER OF THE EVANSVILLE COURIER AND PRESS.3. IS MADE AVAILABLE ON THE DEACONESS WEBSITE AT HTTP://WWW.DEACONESS.COM/CAREERS/FOR-OUR-EMPLOYEES/ OUR-COMMUNITY/COMMUNITY-BENEFIT.ASPX PART I, LINE 7: A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. IRS INSTRUCTION'S WORKSHEET 2 WAS USED FOR THIS CALCULATION. WE DID NOT USE THE COST TO CHARGE RATIO FOR LINE 7G AS IT WAS NOT RELEVANT TO THESE SERVICES. THE ACTUAL COST FROM OUR COSTING SYSTEM WAS USED WHEN AVAILABLE. THE COST TO CHARGE RATIO FOR EACH SERVICE TYPE WAS USED TO ESTIMATE COST WHEN NOT AVAILABLE FROM OUR INTERNAL COSTING SYSTEM. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES ATTRIBUTED TO PHYSICIAN CLINICS HAVE A COST OF $259,516. THESE CLINICS ARE OPERATED AS A BENEFIT TO THE COMMUNITY. PART I, L7 COL(F): THE BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) DUE TO EARLY ADOPTION OF ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, HEALTHCARE ENTITIES (TOPIC 954). BAD DEBT EXPENSE DOES IMPACT NOT REMOVED FOR THE CALCULATION OF THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN F. PART II: DEACONESS HOSPITAL AND ITS RELATED ORGANIZATIONS PARTICIPATE IN VARIOUS COMMUNITY BUILDING ACTIVITIES. DEACONESS CROSS POINTE, A 60 BED INPATIENT PSYCHIATRIC HOSPITAL UNDER THE DEACONESS HOSPITAL LICENSE, IS A MEMBER OF THE SUICIDE PREVENTION COALITION. VANDERBURGH COUNTY SUICIDES REACHED AN ALL TIME HIGH IN 2010 AND AS A RESULT OF THE COALITION, SUICIDES DROPPED BY 18.5% IN 2011. PRIOR TO 2011, VANDERBURGH COUNTY HAD ONE OF THE HIGHEST PER CAPITA SUICIDE RATES IN INDIANA. DEACONESS CROSS POINTE OFFERS A VARIETY OF FREE SUICIDE AWARENESS AND PREVENTION PROGRAMS TO HELP REDUCE THE INCIDENCE OF SUICIDE IN THE TRI-STATE. IN ADDITION, DEACONESS CROSS POINTE HOSTS AND CHAIRS THE SUICIDE PREVENTION COALITION. DEACONESS HOSPITAL SPONSORS THE HEALTH SCIENCE INSTITUTE WHICH ALLOWS HIGH SCHOOL STUDENTS TO EXPERIENCE FIRSTHAND THE WONDERS OF MEDICINE AND MEDICAL RESEARCH THROUGH SEMINARS, CLINICAL EXPERIENCES, AND DEMONSTRATIONS. INTERACTION WITH LEADING HEALTH CARE PROFESSIONALS BROADENS STUDENTS' KNOWLEDGE OF MEDICAL CARE AND CAREER OPPORTUNITIES IN HEALTH CARE AND HEALTH SCIENCES. STUDENTS FROM SOUTHWESTERN INDIANA HIGH SCHOOLS ARE CHOSEN TO PARTICIPATE. DEACONESS EMPLOYEES, LEADERS AND ADMINISTRATORS SERVE AS BOARD MEMBERS ON NUMEROUS COMMUNITY NON-PROFIT ORGANIZATIONS.DEACONESS HOSPITAL HAS A STRONG PARTNERSHIP WITH ECHO COMMUNITY HEALTH CARE. DEACONESS PROVIDES KEY SERVICES AND MONETARY DONATIONS TO THE ECHO COMMUNITY HEALTH CARE AND WORKS TO ENSURE THE COMMUNITY HAS HEALTH SERVICES PROVIDED TO THE UNDERSERVED POPULATION.DEACONESS HOSPITAL HAS BEEN WORKING WITH ST. MARY'S MEDICAL CENTER (ALSO A NON-PROFIT HOSPITAL), THE BAPTIST FOUNDATION AND ECHO COMMUNITY HEALTH CARE TO DEVELOP A COMMUNITY WIDE HEALTH ASSESSMENT. THE GROUP HAS IDENTIFIED FOUR (4) KEY AREAS THAT THE COMMUNITY IS IN NEED OF. THE FOUR ORGANIZATIONS CAME TOGETHER MONTHLY TO DISCUSS AND PLAN HOW TO ADDRESS THESE NEEDS. THE PLAN IS TO BEGIN TO IMPLEMENT NEW PROGRAMS AND FOCUS RESOURCES IN THESE AREAS DURING THE COMING YEAR.DEACONESS HOSPITAL DEVELOPED A MEDICATION ASSISTANCE PROGRAM (MAP) TO PROVIDE ASSISTANCE TO THOSE IN THE COMMUNITY WHO HAVE FINANCIAL DIFFICULTY IN OBTAINING THEIR MEDICATION. THE PROGRAM HAS BEEN IN PLACE SINCE 2005 AND HAS MADE SIGNIFICANT IMPACT TO THE COMMUNITY. IN FISCAL YEAR 2012, THERE WERE 1,219 ACTIVE PATIENTS IN THE PROGRAM. THOSE PARTICIPANTS RECEIVED $4,198,097 IN SAVINGS AND FREE MEDICATIONS. EACH MONTH AN AVERAGE OF OVER 600 PATIENTS APPLY FOR ASSISTANCE IN THE PROGRAM WITH ALMOST 500 PER MONTH RECEIVING BENEFIT.THE MAIN CAMPUS OF DEACONESS HOSPITAL IS LOCATED IN THE JACOBSVILLE NEIGHBORHOOD IN EVANSVILLE, INDIANA. THIS IS A HIGHLY UNDERSERVED AREA IN THE EVANSVILLE COMMUNITY. DEACONESS WORKS WITH THE ELEMENTARY SCHOOLS IN THIS AREA TO PROVIDE HEALTH EDUCATION AND DONATIONS TO ASSIST THE SCHOOLS. DEACONESS HOSPITAL ALSO OPERATES A RESOURCE CENTER THAT PROVIDES A WIDE RANGE OF SERVICES TO THE COMMUNITY WITH A FOCUS ON WELLNESS. THE RESOURCE CENTER HAD OVER 19,000 ENCOUNTERS DURING FISCAL YEAR 2012. THE RESOURCE CENTER OPERATED AT A LOSS ON OPERATIONS DURING THAT TIME. PART III, LINE 4: SECTION A. BAD DEBT EXPENSE. LINE 2 FOOTNOTE TO ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: AS PERMITTED, EFFECTIVE SEPTEMBER 1, 2011, THE SYSTEM ELECTED TO EARLY ADOPT ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISION FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENT OF OPERATIONS RATHER THAN AS AN OPERATING EXPENSE. ALL PERIODS PRESENTED HAVE BEEN RECLASSIFIED TO CONFORM TO THIS PRESENTATION. THE SYSTEM'S ADOPTION OF THIS STANDARD HAD NO NET IMPACT ON THE CONSOLIDATED FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS.ASU 2011-07 ALSO REQUIRES HEALTHCARE ENTITIES TO PROVIDE ENHANCED DISCLOSURE ABOUT THEIR POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS, AS WELL AS QUALITATIVE AND QUANTITATIVE INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. (BELOW IS THE PORTION OF THE AUDITED FINANCIAL STATEMENT FOOTNOTE "PATIENT ACCOUNTS RECEIVABLE, ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS AND NET PATIENT SERVICE REVENUE" RELATED TO BAD DEBTS.)PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THE SYSTEM'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO ITS SERVICE AREA AND THE HEALTHCARE INDUSTRY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PAYMENTS THE SYSTEM 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 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 UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE ESTIMATED BASED UPON THE 2011 MEDICARE COST REPORT AND THE 2012 CONTRACTUAL MODEL FOR EXPECTED REIMBURSEMENT. THE MEDICARE SHORTFALL FOR DEACONESS HOSPITAL IS TREATED AS COMMUNITY BENEFIT DUE TO THE HOSPITAL PROVIDING CARE TO MEDICARE PATIENTS AT LESS THAN THE ALLOWABLE MEDICARE COSTS. PART III, LINE 9B: DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY WILL BE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 13G: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 13G: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. DEACONESS CROSS POINTE PART V, SECTION B, LINE 13G: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES. DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 19D: DEACONESS HOSPITAL OFFERS A 35% DISCOUNT TO INDIVIDUALS WHO DO NOT HAVE INSURANCE AND RECEIVE EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THIS DISCOUNT APPROXIMATES AN AVERAGE OF ALL CONTRACTED DISCOUNTS. DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 19D: DEACONESS HOSPITAL OFFERS A 35% DISCOUNT TO INDIVIDUALS WHO DO NOT HAVE INSURANCE AND RECEIVE EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THIS DISCOUNT APPROXIMATES AN AVERAGE OF ALL CONTRACTED DISCOUNTS. DEACONESS CROSS POINTE PART V, SECTION B, LINE 19D: DEACONESS HOSPITAL OFFERS A 35% DISCOUNT TO INDIVIDUALS WHO DO NOT HAVE INSURANCE AND RECEIVE EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THIS DISCOUNT APPROXIMATES AN AVERAGE OF ALL CONTRACTED DISCOUNTS. PART VI, LINE 2: DEACONESS HOSPITAL'S COMMUNITY BENEFIT COMMITTEE GATHERS AND ANALYZES HOSPITAL AND COMMUNITY DATA TO INDICATE COMMUNITY NEEDS. IN ADDITION DURING FISCAL YEAR 2012, DEACONESS HOSPITAL PARTICIPATED IN COMMISSIONING A STUDY BY PROFESSIONAL RESEARCH CONSULTANTS, INC. TO PROVIDE A DETAILED STUDY ON THE SOUTHERN INDIANA COMMUNITY AND TO DETERMINE ITS NEEDS. BASED UPON THE STUDY, DEACONESS HOSPITAL WILL BE IMPLEMENTING STRATEGIES AROUND COMMUNITY BENEFIT TO FOCUS ON THE AREAS OF NEED IN FISCAL YEAR 2013. THE COMMITTEE USES A DYNAMIC, ONGOING PROCESS TO INCLUDE A REVIEW OF PREVIOUS OR CURRENT ASSESSMENTS BY OTHER COMMUNITY GROUPS, PRESENTATIONS MADE BY OUTSIDE GROUPS SOLICITING DEACONESS HOSPITAL'S INVOLVEMENT IN COMMUNITY INITIATIVES, REVIEW OF HEALTH AND DEMOGRAPHIC INFORMATION OF INPATIENTS AND OUTPATIENTS, AND ANALYSIS OF INFORMATION FROM OUTSIDE ORGANIZATIONS AND INTERNAL RECORDS TO IDENTIFY TRENDS AND AREAS OF CONCERN REQUIRING ATTENTION. PART VI, LINE 3: DEACONESS HOSPITAL UTILIZES FINANCIAL COUNSELORS TO EDUCATE, INFORM AND ASSIST PATIENTS AND FAMILIES IN UNDERSTANDING THEIR FINANCIAL OBLIGATION, ABILITY TO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH DEACONESS HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PAYMENT OPTIONS. SPECIFICALLY, FINANCIAL COUNSELORS STAFF THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, CASHIER AREA, AS WELL AS, FLOAT AMONG INPATIENT AREAS TO ENSURE EACH AND EVERY PATIENT REQUIRING ASSISTANCE IS REACHED. IN ADDITION TO THE PERSONAL AND INDIVIDUALIZED COUNSELING PROVIDED BY THE FINANCIAL COUNSELORS, VARIOUS FORMS OF MEDIA ARE DISTRIBUTED THROUGHOUT DEACONESS HOSPITAL EXPLAINING THE FINANCIAL ASSISTANCE PROCESS. ADDITIONALLY, POLICIES FOR FINANCIAL ASSISTANCE ARE POSTED WIDELY THROUGHOUT DEACONESS HOSPITAL AND ON THE INTERNET AT WWW.DEACONESS.COM. HTTP://WWW.DEACONESS.COM/DEACONESSHOSPITAL/BUSINESS-OFFICE/FINANCIAL-ASSISTANCE.ASPX PART VI, LINE 4: DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 25-COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 305 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 66 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 61 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 96 MEDICAL/ SURGICAL BEDS AND 5 HOSPICE BEDS. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 158 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 16 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS, AND 32 GENERAL MED/ TELEMETRY BEDS. THE HOSPITAL PROVIDES A FULL ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICE ON THE GATEWAY CAMPUS. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60-BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE. ALSO, THE HOSPITAL IS AN OWNER IN THREE JOINT VENTURE HOSPITALS:1. DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA, LLC D/B/A THE WOMEN'S HOSPITAL, A FREE STANDING SPECIALTY 74-BED WOMEN'S AND INFANT'S HOSPITAL, LOCATED ON THE GATEWAY CAMPUS.2. HEALTHSOUTH/DEACONESS, LLC D/B/A TRI-STATE REGIONAL REHABILITATION HOSPITAL, A 80-BED INPATIENT ACUTE REHABILITATION HOSPITAL, LOCATED APPROXIMATELY 8 MILES TO THE SOUTHEAST OF THE MAIN CAMPUS.3. THE HEART HOSPITAL AT DEACONESS GATEWAY, LLC, A 24-BED CARDIOVASCULAR SPECIALTY HOSPITAL, RESIDING ON THE GATEWAY CAMPUS. THE HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM, A POST-GRADUATE PHARMACY RESIDENT PROGRAM, AND SEVERAL UNDERGRADUATE MEDICAL AFFILIATIONS. THE HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, AND THE COMMUNITY AT LARGE. THE HOSPITAL, THROUGH ITS RELATED CORPORATIONS, PROVIDES OUTREACH SERVICES TO NURSING HOMES, PHYSICIANS' OFFICES AND SURROUNDING SMALLER HOSPITALS IN ITS SERVICE AREA. PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY INCLUDES: A MAJORITY OF ORGANIZATION'S GOVERNING BODY IS INDEPENDENT AND COMPRISED OF PERSONS WHO RESIDED IN THE ORGANIZATION'S PRIMARY SERVICE AREA; EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY; AND APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE. PART VI, LINE 6: DEACONESS HOSPITAL WORKS IN CONCERT WITH DEACONESS HEALTH SYSTEM AND DEACONESS CLINIC TO PROVIDE HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. DEACONESS HEALTH SYSTEM WORKS TO INCREASE ACCESS TO HEALTHCARE SERVICES WITHIN OUR COMMUNITY THROUGH DEACONESS HOSPITAL AND DEACONESS CLINIC. DEACONESS HOSPITAL IS A MEDICAL INSTITUTION DEDICATED TO PROVIDING QUALITY PATIENT CARE WITH UNRELENTING ATTENTION TO CLINICAL EXCELLENCE, PATIENT SAFETY AND AN UNPARALLELED PASSION AND COMMITMENT TO ASSURE THE VERY BEST HEALTHCARE FOR THE PATIENTS SERVED. DEACONESS CLINIC PROVIDES EXCELLENT PRIMARY AND MULTI-SPECIALTY HEALTHCARE IN A PERSONALIZED FASHION WITH A DEDICATED FOCUS TO SERVE THE COMMUNITY WITH EXCELLENT, TIMELY AND COMPASSIONATE PATIENT CARE. REPORTS FILED WITH STATES PART VI, LINE 7 IN 1 YMCA OF SW INDIANA INC 222 NW 6TH ST EVANSVILLE IN 47708 350869074 3 21600 GENERAL SUPPORT EVANSVILLE MUSEUM OF ARTS AND SCIENCE 411 SE RIVERSIDE DR EVANSVILLE IN 47713 350874517 3 20000 CAPITAL CAMPAIGN GILDA'S CLUB EVANSVILLE INC PO BOX 5134 EVANSVILLE IN 47716 261932741 3 20000 CAPITAL CAMPAIGN JUNIOR LEAGUE OF EVANSVILLE 123 N 4TH ST STE 422 EVANSVILLE IN 47708 356017802 3 15500 GENERAL SUPPORT KOMEN GREATER EVANSVILLE AFFILIATE 4424 VOGEL RD STE 205 EVANSVILLE IN 47715 752844632 3 15000 GENERAL SUPPORT INDIANA UNIVERSITY FOUNDATION PO BOX 660245 EVANSVILLE IN 462660245 356018940 3 15000 GENERAL SUPPORT EVANSVILLE AREA COMMUNITY CHURCHES 713 N 2ND AVE EVANSVILLE IN 47710 350886837 3 12000 FOOD FOR FOOD PANTRY EVANSVILLE KIDNEY ASSOCIATION 1312 PROFESSIONAL BLVD EVANSVILLE IN 47714 260219765 3 10000 GENERAL SUPPORT AURORA 1100 LINCOLN AVE PO BOX 74 EVANSVILLE IN 477010074 351759576 3 10000 CAPITAL CAMPAIGN GIRL SCOUTS OF SOUTHWEST INDIANA 223 NW 2ND STREET EVANSVILLE IN 47708 350876380 3 8000 GENERAL SUPPORT CHILDREN'S MUSEUM OF EVANSVILLE PO BOX 122 EVANSVILLE IN 477010074 351951848 3 7500 GENERAL SUPPORT IVY TECH FOUNDATION 3501 N 1ST AVENUE EVANSVILLE IN 47710 237073977 3 7500 GENERAL SUPPORT YOUTH RESOURCES OF SOUTHWESTER PO BOX 3635 EVANSVILLE IN 477353635 351719143 3 6000 GENERAL SUPPORT YOUTH FIRST INC 3420 E MORGAN AVE STE A EVANSVILLE IN 47715 352050168 3 5500 GENERAL SUPPORT HOLLY'S HOUSE INC PO BOX 4125 EVANSVILLE IN 477240125 204475135 3 5500 GENERAL SUPPORT OTHERS 5000 116391 GENERAL SUPPORT 15 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DEACONESS HOSPITAL CONFIRMS ALL RECIPIENTS OF FUNDS ARE ORGAANIZATIONS WHOSE GOALS COINCIDE WITH DEACONESS' MISSION OF PROVIDING QUALITY HEALTH CARE WITH A COMPASSIONATE AND CARING SPIRIT. THE ORGANIZATIONS PROVIDE NEEDED SERVICES TO OUR COMMUNITY TO IMPROVE HEALTH AND WELLNESS FOR THE CITIZENS IN THE SURROUNDING AREA. X 1 1 X X X X X 1 1 0 0 0 0 1 0 0 LINDA E WHITE 300960 300936 307650 0 9702 6400 97055 72743 14834 14834 730201 394913 0 0 DAVID A KOEHLER JR MD 0 165193 0 23476 5400 720 0 0 0 5063 5400 194452 0 0 RUSTON L STOLTZ MD 0 248828 0 33086 6470 38552 0 0 0 23579 6470 344045 0 0 SHAWN W MCCOY 330876 0 149675 0 3396 8200 86599 0 27045 0 597591 8200 0 0 CHERYL A WATHEN 121230 126637 88469 0 1656 9200 43664 20424 16449 16449 271468 172710 0 0 JAMES R PORTER MD 368557 0 138173 0 1896 0 85720 0 24513 0 618859 0 0 0 CHERONA J HAJEWSKI 263546 0 98681 0 7944 0 53781 0 25703 0 449655 0 0 0 BRUCE E EPMEIER 194088 0 72850 0 97169 0 45334 0 19652 0 429093 0 93773 0 LARRY F PILE 190207 0 48043 0 1362 0 5853 0 17173 0 262638 0 0 0 LYNN C LINGAFELTER 163308 0 31555 0 0 0 17946 0 5063 0 217872 0 0 0 RICHARD B PERRY 136555 0 53144 0 1176 0 4739 0 22086 0 217700 0 0 0 JOHN L ZABROWSKI 146305 0 25706 0 1176 3200 4416 0 30340 0 207943 3200 0 0 JOYCE A THOMAS 141490 0 27585 0 1097 0 22815 0 24928 0 217915 0 0 0 REBECCA L MALOTTE 135208 0 26206 0 961 0 33294 0 19180 0 214849 0 0 0 VENKATESH R MADADI 665968 0 0 0 45926 0 0 0 23960 0 735854 0 0 0 NIRMAL JOSHI MD 612741 0 0 0 60017 0 0 0 27070 0 699828 0 0 0 RAJESH J PATEL MD 618194 0 0 0 35976 0 11098 0 25485 0 690753 0 0 0 AYMAN ELFAR MD 611650 0 0 0 35876 0 0 0 23960 0 671486 0 0 0 LAWRENCE C KILINSKI JR MD 561213 0 0 0 45882 0 0 0 25837 0 632932 0 0 0 HARRY L SMITH JR 23410 0 39347 0 571780 1600 5880 0 30287 0 670704 1600 67981 0 RICHARD M STIVERS 0 0 0 0 206460 130822 2940 2940 939 939 210339 134701 68458 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR LINDA WHITE, JAMES PORTER AND SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEES. PART I, LINES 4A-B SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED LINDA E. WHITE $ -0- $16,500 $ -0- RUSTON L. STOLTZ, MD. 0 16,500 0 DAVID A. KOEHLER, JR., MD. 0 16,500 0 SHAWN W. MCCOY 0 16,500 0 JAMES R. PORTER, MD. 0 16,500 0 CHERONA J. HAJEWSKI 0 16,500 0 BRUCE E. EPMEIER 0 16,500 0 VENKATESH R. MADADI, MD. 0 16,500 0 RAJESH J. PATEL, MD. 0 16,500 0 LAWRENCE C. KILINSKI, JR., MD. 0 16,500 0 RICHARD M. STIVERS 265,487 0 0 HARRY L. SMITH, JR. 391,056 16,500 0 PART I, 4B: LINDA WHITE: CONTRIBUTIONS MADE TO A SUPPLEMENTAL ACCUMULATION ACCOUNT OF $158,038. HARRY SMITH: SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $67,981. RICHARD STIVERS: SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $68,458. JAMES PORTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $73,960. SHAWN MCCOY: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $74,839. CHERONA HAJEWSKI: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $42,021. BRUCE EPMEIER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $35,890; SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $93,773. CHERYL WATHEN: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $52,328. PART I, LINE 5 INCENTIVE COMPENSATION PAYMENTS ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED. INDIANA FINANCE AUTHORITY 351602316 45471AAK8 2009-03-26 55914771 FACILITY CONSTRUCTION 0 0 0 INDIANA FINANCE AUTHORITY 351602316 45471AAG7 2009-03-26 40000000 FACILITY CONSTRUCTION 0 0 0 INDIANA HLTH FACILITY FINANCING AUTHORITY 351611409 4547977Y1 2004-05-27 55371597 FACILITY CONSTRUCTION 0 0 0 INDIANA HLTH FACILITY FINANCING AUTHORITY 351611409 4547978A2 2004-05-27 25000000 FACILITY CONSTRUCTION 0 0 0 55914771 5636806 5733841 828073 43061620 699759 2011 0 0 1 1 40000000 402226 60789 36864650 2672335 2011 0 0 1 1 55581965 3742909 611421 2187409 47524358 1515868 2006 0 0 1 1 25000000 181203 141281 24677516 2006 0 0 1 1 0 1 0 0 0.01590 0.01590 1 0 1 0 0 0.01000 0.01000 1 0 1 0 0 0.01100 0.01100 1 0 1 0 0 0.01760 0.01760 1 1 0 0 1 TRINITY PLUS 2.000000000000 1 0 1 1 1 0 1 CREDIT AGRICOLE 2.000000000000 1 0 1 1 0 0 0 0 1 1 1 0 0 0 1 X INDIANA FINANCE AUTHORITY 351602316 45471AFF4 2011-12-02 20667197 3/15/99 BOND REFUNDING 0 0 0 20270000 397197 396556 541 1 0 1 1 0 0 0 0 0 0 0 0 0 1 ADRIENNE WATHAN FAMILY OF OFFICER 10537 COMPENSATION 0 SHERRI MCCOY FAMILY OF OFFICER 27503 COMPENSATION 0 MISTY ADYE FAMILY OF BD MBR 31978 COMPENSATION 0 LETTA FRACCARO FAMILY OF BD MBR 48592 COMPENSATION 0 ALEX SEIBERT FAMILY OF OFFICER 74188 COMPENSATION 0 ANN TORNATTA FAMILY OF BD MBR 106110 COMPENSATION 0 NANCY KOEHLER FAMILY OF BD MBR 127156 COMPENSATION 0 SOUTH CENTRAL COMMUNICATIONS COMMON BD MBR 161838 ADVERTISING PROVIDER 0 EVANSVILLE RADIOLOGY PC COMMON BD MBR 744907 MANAGEMENT SERVICES 0 VECTREN ENERGY DELIVERY COMMON BOARD MEMBER 5742366 GAS/ ELECTRIC UTILITY 0 SCH L, PART IV, ABBREVIATION: BD MBR = BOARD MEMBER X 15 65000 FAIR MARKET VALUE X GIFT CERTIFICATES 55 32025 COST X OFFICE EQUIPMENT 1 5000 COST 0 1 0 THIRD PARTY USE: PART I, LINE 32B: SCHEDULE M - SUPPLEMENTAL INFORMATION THE NUMBER OF CONTRIBUTIONS REPORTED IN COLUMN B ON SCHEDULE M IS THE ACTUAL NUMBER OF ITEMS RECEIVED FROM EACH CONTRIBUTOR. ORGANIZATION'S MISSION: FORM 990, PART III, LINE 1 DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. AT DEACONESS HOSPITAL, OUR VALUES ARE BASED ON OUR COMMITMENT TO QUALITY. WE DEFINE QUALITY AS THE CONTINUOUS IMPROVEMENT OF SERVICES TO MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF THE CUSTOMERS WE SERVE. OUR VALUES ARE QUALITY IN EVERYTHING WE DO, RESPECT FOR ALL PEOPLE, EFFICIENCY AND EFFECTIVENESS IN THE USE OF RESOURCES, INNOVATION TOWARD CONTINUOUS SYSTEMS IMPROVEMENT, PARTNERSHIP WITH THOSE WE SERVE AND WITH SUPPLIERS, EDUCATION FOR CONTINUOUS GROWTH AND KNOWLEDGE AND PRIDE IN WORKMANSHIP. TO ACCOMPLISH ITS MISSION, DEACONESS HOSPITAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THE PEOPLE OF THE TRI-STATE BY DEMONSTRATING EXCELLENCE IN HEALTHCARE SERVICES, PROVIDING ACCESS TO HEALTHCARE, PROVIDING CHARITY CARE TO THOSE IN NEED,PROMOTING HEALTHY LIFESTYLES, OFFERING SPIRITUAL AND PSYCHOLOGICAL SUPPORT, SUPPORTING HEALTH RELATED EDUCATION, AND ADVANCING HEALTH KNOWLEDGE THROUGH RESEARCH. PROGRAM SERVICES ACCOMPLISHMENT 1: PATIENT SERVICE REVENUE. FORM 990, PART III, LINE 4A DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 25 COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MAIN CAMPUS WITH A TOTAL OF 305 BEDS CONSISTING OF 38 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 66 CARDIAC BEDS, 23 ONCOLOGY/ PULMONOLOGY BEDS, 61 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 5 PEDIATRIC TRAUMA BEDS, 18 MENTAL HEALTH BEDS, 96 MEDICAL/ SURGICAL BEDS AND 5 HOSPICE BEDS. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MAIN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 158 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 13 ADULT INTENSIVE CARE BEDS, 17 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 16 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 16 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS AND 32 GENERAL MED/ TELEMETRY BEDS. THE HOSPITAL PROVIDES A FULL ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICE ON THE GATEWAY CAMPUS. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60 BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MAIN CAMPUS IN EVANSVILLE. PROGRAM SERVICES ACCOMPLISHMENT 2: CHARITY CARE/ SUBSIDIZED CARE. FORM 990, PART III, LINE 4B DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES AVAILABLE FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY ARE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. DEACONESS HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT OF REIMBURSEMENT IS BELOW COST, DEACONESS HOSPITAL ABSORBS THESE COSTS IN MEETING ITS MISSION TO THE COMMUNITY. IN SUPPORT OF ITS MISSION, DEACONESS HOSPITAL PROVIDED $24.9 MILLION OF CHARITY CARE AND $17.6 MILLION OF SUBSIDIZED SERVICES TO THE MEDICAID PROGRAM, AND $50.3 MILLION OF SUBSIDIZED SERVICES TO THE MEDICARE PROGRAM. PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4C PROGRAM SERVICES ACCOMPLISHMENT 3: GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION & COMMUNITY BENEFITS. DEACONESS HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM AND A POST-GRADUATE PHARMACY RESIDENCY PROGRAM. DEACONESS HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, COMMUNITY HEALTH PROGRAMS AND A CHAPLAIN RESIDENCY PROGRAM. IN ADDITION TO EDUCATIONAL SERVICES, DEACONESS HOSPITAL PROVIDED $6.5 MILLION IN COMMUNITY BENEFIT ACTIVITIES (ALL ON A COST BASIS), SERVING A MINIMUM OF 698,675 PEOPLE WITHIN THE TRI-STATE AREA. FORM 990, PART VI, SECTION A, LINE 6 DEACONESS HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF DEACONESS HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS MAY ELECT ONE OR MORE NON-MEDICAL STAFF MEMBERS OF THE GOVERNING BODY THROUGH AN APPROVED ELECTION AND APPROVAL PROCESS. THE ELECTION AND APPROVAL PROCESS FOR NON-MEDICAL STAFF MEMBERS BEGINS WITH A RECOMMENDATION BY THE GOVERNANCE COMMITTEE FOR MEMBERSHIP TO THE BOARD OF DIRECTORS. THAT RECOMMENDATION IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. DEPENDING ON THE DECISION REACHED BY THE BOARD OF DIRECTORS, MEMBERSHIP MAY OR MAY NOT BE GRANTED TO THAT INDIVIDUAL. MEDICAL STAFF EXECUTIVE COUNCIL LEADERSHIP ARE APPOINTED TO BOARD OF DIRECTOR MEMBERSHIP THROUGH THEIR POSITION AS ELECTED MEDICAL STAFF LEADERS. THROUGH THE ELECTION PROCESS OF THE MEDICAL STAFF EXECUTIVE COUNCIL, THEIR APPOINTMENT IS CONFIRMED AND APPROVED. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS THAT DEACONESS HOSPITAL UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE ASSISTANT CONTROLLER, CONTROLLER, CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND, ANNUALLY, THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE" AND/OR "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: DEACONESS HOSPITAL UTILIZES A COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICE COMPENSATION 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DEACONESS HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. DEACONESS HOSPITAL IS PART OF A CONSOLIDATED FINANCIAL STATEMENT WHICH IS AVAILABLE WITH THE PUBLIC DISCLOSURE COPY OF THE IRS FORM 990. ALSO, AS REQUIRED BY LAW, THE HOSPITAL SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC FORM 990, PART VII LARRY F PILE - 8065 WYNGATE CIRCLE, NEWBURGH, IN 47630. AVERAGE HOURS PER WEEK FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) THE AVERAGE HOURS WORKED PER WEEK INCLUDE RELATED PARTY HOURS FOR MS. WHITE AND MS. WATHEN. HOURS LISTED IN PART VII RELATE TO TIME DEVOTED TO DEACONESS HEALTH SYSTEM (DHS), DEACONESS CLINIC, INC. (DCI), AND DEACONESS HOSPITAL, INC. (DHI). SEE THE AVERAGE HOURS PER WEEK BELOW: DHS DCI DHI TOTAL MS. WHITE 20 10 40 70 MS. WATHEN 5 5 50 60 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 20,240,846. CHANGE IN PENSION LIABILITY -20,535,930. CAPITAL CONTRIBUTION TO DEACONESS HEALTH SYSTEM -17,807,842. CHANGE IN BENEFICIAL INTERESTS IN TRUSTS 1,070,967. FOUNDATION MONIES GRANTED FROM RESTRICTION -842,006. TOTAL TO FORM 990, PART XI, LINE 5: -17,873,965. OVERSIGHT OF AUDIT FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. 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