2013-11-14T06:51:42-06:00 2012-12-31 990 2012-01-01 370661223 METHODIST MEDICAL CENTER OF ILLINOIS METH 3096725914 221 NE GLEN OAK AVE PEORIA IL 616360002 ROBERT A QUIN 3096724893 2013-11-09 2012 2016-02-25 16:41:14Z DEBBIE SIMON 221 NE GLEN OAK AVE PEORIA IL 616360002 434804076 0 X WWW.UNITYPOINT.ORG/PEORIA.ASPX X 1898 IL WE ARE COMMITTED TO DELIVERING OUTSTANDING HEALTHCARE. PERIOD. 10 4 3682 257 4244263 544514 1115092 1732488 374216858 357076337 6073820 7095235 7444979 3220525 388850749 369124585 1229963 1060412 0 0 178149213 165094653 0 0 0 205135403 172002998 384514579 338158063 4336170 30966522 433984380 454964929 314870159 286579773 119114221 168385156 X WE ARE COMMITTED TO DELIVERING OUTSTANDING HEALTHCARE. PERIOD. 0 0 306662410 0 360296862 HEALTH-CARE SERVICESMETHODIST MEDICAL CENTER OF ILLINOIS IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE CENTRAL ILLINOIS COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. METHODIST MEDICAL CENTER OF ILLINOIS PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2012, METHODIST MEDICAL CENTER OF ILLINOIS ADMITTED 15,548 PATIENTS RESULTING IN A TOTAL OF 75,998 PATIENT DAYS. OUTPATIENT VISITS TOTALED 129,806 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 7,748. THERE WERE ALSO 56,545 EMERGENCY ROOM VISITS AND 1,737 BABIES DELIVERED. 1060412 1060412 0 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: METHODIST MEDICAL CENTER OF ILLINOIS PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $7,970,816 IN 2012. OFTENTIMES, METHODIST MEDICAL CENTER OF ILLINOIS RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. METHODIST MEDICAL CENTER OF ILLINOIS PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. METHODIST MEDICAL CENTER OF ILLINOIS' NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $11,042,436 FOR 2012. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $19,013,252OTHER BENEFITS: METHODIST MEDICAL CENTER OF ILLINOIS PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. METHODIST MEDICAL CENTER OF ILLINOIS COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. METHODIST MEDICAL CENTER OF ILLINOIS HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $7,733,025 307722822 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 3682 1 1 1 0 0 0 0 0 0 0 0 0 X 10 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA IL X X TONY MOORE 3096725914 221 NORTHEAST GLEN OAK AVE PEORIA IL 61636 BRUCE ALKIRE 1.00 0.00 X X 0 0 0 BRIAN COHEN MD 40.00 0.00 X 347148 0 15690 JOHN ERWIN PHD 1.00 0.00 X 0 0 0 GREG GERSTNER FR 062012 1.00 0.00 X 0 0 0 PETER JOHNSEN PHD 1.00 1.00 X 0 0 0 ALEXIS KHAZZAM 1.00 1.00 X X 0 0 0 KEITH KNEPP MD 40.00 0.00 X 287539 0 51034 PATRICK O'LEARY FR 062012 1.00 0.00 X 0 0 0 SCOTT REID DO 1.00 0.00 X 0 0 0 DEBORAH SIMON 40.00 1.00 X X 522675 0 188883 DEVENDRA TRIVEDI MD TO 062012 1.00 1.00 X 0 14737 0 ROBERT QUIN 40.00 1.00 X 275133 0 60631 TAMMY DUVENDACK 40.00 0.00 X 200038 0 30566 GARY KNEPP 40.00 0.00 X 248825 0 11064 JOHN MILLER 40.00 0.00 X 275539 0 15690 MIKE NAMANNY 40.00 0.00 X 175775 0 30774 JEANINE SPAIN 40.00 0.00 X 225751 0 114129 TERRY WATERS 40.00 0.00 X 231576 0 102522 RICK ANDERSON TO 062012 40.00 0.00 X 346084 0 93710 ERICK LAINE TO 022012 1.00 40.00 X 36951 375353 24411 ALEXANDER ADLER 40.00 0.00 X 654880 0 52205 CHARLES EGLEY 40.00 0.00 X 791075 0 46391 JOEL KUPFER 40.00 0.00 X 686880 0 11184 JAMES LOCHER 40.00 0.00 X 639659 0 21940 DWAYNE MCQUITTY 40.00 0.00 X 952789 0 15690 CALVIN MACKAY 0.00 0.00 X 317591 0 88132 7215908 390090 974646 258 1 1 0 METHODIST PHYSICIAN SERVICES PO BOX 87 PEORIA IL 61650 CONTRACT EMPLOYEES 12165088 MCKESSON TECHNOLOGIES INC PO BOX 98347 CHICAGO IL 606938347 IT SUPPLIER 3719280 PROFESSIONAL THERAPY SERVICES INC 2810 FRANK SCOTT PRKWAY WEST SUITE BELLEVILLE IL 62223 PHYSICAL THERAPY 3390992 PHILIPS MEDICAL SYSTEMS PO BOX 100355 ATLANTA GA 303840355 MAINTENANCE CONTRACT 3037663 U OF I COLLEGE OF MEDICINE AT PEORIA PO BOX 4196 SPRINGFIELD IL 62708 PHYSICIAN SERVICES 2814068 30 751153 630058 351277 1732488 NET PATIENT REVENUE 621990 237080940 237080940 LABORATORY SERVICES 621500 103142800 100219359 2923441 EDUCATION REVENUE 900099 9033322 9033322 SUBS & JOINT VENTURES 900099 3426143 3416237 9906 MANAGEMENT, IT AND SUPPORT SERVIC 561000 1493907 1493907 2899225 1501942 925435 471848 357076337 4523136 4523136 68033896 177680 65479897 159580 2553999 18100 2572099 2572099 52246 40014 12232 12232 MISCELLANEOUS REVENUE 900099 1303850 1183360 120490 CAFETERIA 722210 1069309 1069309 EDUCATION & RESEARCH 900099 831025 566034 264991 4109 4109 3208293 369124585 355580751 4244263 7567083 X 1060412 1060412 3887618 3887618 516061 516061 137140960 127865078 9275882 -4016409 -3744749 -271660 18541848 17287723 1254125 9024575 8414175 610400 564951 564951 6270 6270 35573 35573 374245 374245 56336037 48610101 7725936 1334276 167857 1166419 5838213 4822012 1016201 4116180 2837583 1278597 13838208 11192797 2645411 760650 532691 227959 2354130 2354130 21790441 21654150 136291 7673439 7673439 INCOME TAXES -44973 -44973 MEDICAL SUPPLIES 47323902 47323902 MEDICAID PROVIDER ASSES 9283361 9283361 MISCELLANEOUS EXPENSE 348900 318965 29935 69195 69195 338158063 307722822 30435241 0 17420123 27285483 56662570 55909580 9570726 8970666 3166168 3807483 7010411 2938487 193638845 26969818 172143738 166669027 130444371 148125369 29068326 30744592 1500750 1165264 6997197 9348978 433984380 454964929 33398819 37418529 13427931 5209789 109180000 104180000 896645 194647 27934212 31368721 130032552 108208087 314870159 286579773 X 106203404 154268006 8990848 10133549 3919969 3983601 119114221 168385156 433984380 454964929 X 30966522 10130114 8174299 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 35573 35573 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: FEES PAID FOR LOBBYING FOR HOSPITAL-RELATED ISSUES. 12910818 806329 1233627 811152 22471 14117151 13430146 875797 -485319 887357 22449 12910818 12893992 907320 1009081 1380247 13430146 11526661 887757 1625606 1146032 12893992 15826355 1478221 -4720647 1057268 11526661 0.00000 0.28220 0.71780 0 0 1458352 1458352 109858987 7264523 102594464 74094135 19063132 55031003 8227371 642163 7585208 166669027 METHODIST MEDICAL CENTER FOUNDATION 18236599 F AMERICAN HEALTHCARE SYSTEM 1290000 F CENTRAL ILLINOIS WORK INJURY RESOURCE 1003396 F GREATER PEORIA SPECIALTY HOSPITAL 3297027 F CENTRAL ILLINOIS ENDOSCOPY CENTER 3602666 F CENTRAL ILLINOIS CANCER CARE CENTER 2168495 F REHABILITATION THERAPY SERVICES 1114409 F MMCI ORTHOPEDIC CO-MANAGEMENT COMPANY 32000 F 30744592 DUE TO AFFILIATES 1338170 SELF-INSURANCE RESERVE 14920096 LONG-TERM RETENTION INCENTIVES 3501089 ASBESTOS REMOVAL LIABILITY 1023680 DB RETIREMENT PLAN LIABILITY 87425052 108208087 X 378210000 9840190 40081 9880271 368329729 374245 420611 794856 369124585 337824000 40182 40182 337783818 374245 374245 338158063 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PERMANENT ENDOWMENTS ARE MAINTAINED TO PROVIDE A PERMANENT SOURCE OF INCOME, WITH THE STIPULATION THAT THE PRINCIPAL BALANCE MUST BE INVESTED AND KEPT INTACT IN PERPETUITY, WHILE ONLY THE INCOME GENERATED CAN BE USED BY THE ORGANIZATION. THE TEMPORARY ENDOWMENTS ARE MAINTAINED TO PROVIDE A SOURCE OF INCOME FOR EITHER A SPECIFIC PERIOD OF TIME OR UNTIL A SPECIFIC EVENT OCCURS. THE MAJORITY OF METHODIST'S ENDOWMENTS HAVE DESIGNATIONS FOR USE FOR HOSPICE, MEDICAL EQUIPMENT AND PEDIATRIC CARE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IOWA HEALTH SYSTEM 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 HEALTH SYSTEM FILES FORM 990 FOR SUBSTANTIALLY 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 2009. THE HEALTH SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME DURING THE CARRYFORWARD PERIOD. NO INCOME TAX BENEFIT HAS BEEN RECOGNIZED FOR THE NET OPERATING LOSS CARRYFORWARDS OR OTHER POTENTIAL DEFERRED TAX ASSETS IN THE CONSOLIDATED FINANCIAL STATEMENTS BECAUSE THE HEALTH SYSTEM BELIEVES REALIZATION OF THESE BENEFITS IS UNLIKELY. PART XI, LINE 2D - OTHER ADJUSTMENTS: SALES OF INVENTORY 40,014. ROUNDING 67. PART XI, LINE 4B - OTHER ADJUSTMENTS: TAX REVENUES IN UNRESTRICTED FUND BALANCE 288,776. TAX REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 131,835. PART XII, LINE 2D - OTHER ADJUSTMENTS: SALES OF INVENTORY 40,014. ROUNDING 168. CENTRAL AMERICA/CARIBBEAN 0 0 INVESTMENTS 18415973 0 0 0 0 0 0 18415973 0 18415973 0 0 0 0 0 0 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 7970816 7970816 0.02360 50274348 39231912 11042436 0.03270 58245164 39231912 19013252 0.05630 3211154 1891911 1319243 0.00390 7917484 4860889 3056595 0.00900 4955404 3406416 1548988 0.00460 449824 395503 54321 0.00020 1753878 1753878 0.00520 18287744 10554719 7733025 0.02290 76532908 49786631 26746277 0.07920 1 35000 35000 0.00010 3 55000 55000 0.00020 2 106500 106500 0.00030 6 196500 196500 0.00060 0 5608175 0 88709763 83503283 5206480 X 1 1 2 1 METHODIST MEDICAL CENTER OF ILLINOIS

221 NE GLEN OAK AVENUE PEORIA IL 61636

X X X X 2 GREATER PEORIA SPECIALTY HOSPITAL

500 W ROMEO B GARRETT AVE PEORIA IL 61605

X X X LONG TERM ACUTE CARE METHODIST MEDICAL CENTER OF ILLINOIS 1 1 1 200.000000000000 1 600.000000000000 1 X X X 1 1 X X X 1 0 X X X X 1 X 0 0 GREATER PEORIA SPECIALTY HOSPITAL 2 1 1 200.000000000000 1 600.000000000000 1 X X X 1 1 X X X 1 0 X X X X 1 X 0 0 29 METHODIST EAST CAMPUS

415 ST MARKS COURT PEORIA IL 61603

COLLEGE OF NURSING; DAYCARE; ADMINISTRATION METHODIST PHYSICIANS MEDICAL PLAZA

214 NE GLEN OAK AVE PEORIA IL 61636

PHYSICIAN OFFICES; SLEEP LAB METHODIST HEART LUNG AND VASCULAR INST

112 CRESCENT AVE PEORIA IL 61603

PHYSICIAN OFFICES; MEDICAL IMAGING; CARDIOLOGY METHODIST ATRIUM

900 MAIN STREET PEORIA IL 61602

PHYSICIAN OFFICES; REHABILITATION METHODIST FAMILY MEDICAL CENTER

815 MAIN STREET PEORIA IL 61602

PHYSICIAN OFFICES MMG AT FARMINGTON

158 E FULTON AVENUE FARMINGTON IL 61531

PHYSICIAN OFFICES METHODIST CENTER FOR INTEGRATIVE MED

9101 N ALLEN ROAD PEORIA IL 61615

PHYSICIAN OFFICES MMG AT CHILLICOTHE

525 SWEETBRIAR CHILLICOTHE IL 61523

PHYSICIAN OFFICES; REHABILITATION MMG AT METAMORA

901 W WALNUT METAMORA IL 61548

PHYSICIAN OFFICES MMG AT PRINCEVILLE

223 EAST MAIN STREET PRINCEVILLE IL 61559

PHYSICIAN OFFICES METHODIST NORTH

2338 WEST SUDS PKWY PEORIA IL 61615

PHYSICIAN OFFICES; REHABILITATION; MEDICAL IMAGING; CARDIOLOGY MMG AT CANTON

2076 N MAIN STREET CANTON IL 61520

PHYSICIAN OFFICES MMG AT LACON

1112 E FIFTH STREET LACON IL 61540

PHYSICIAN OFFICES MMG AT MT HAWLEY - FAMILY MEDICINE

7725 N KNOXVILLE AVE PEORIA IL 61614

PHYSICIAN OFFICES MMG AT EAST PEORIA

200 RIVER ROAD EAST PEORIA IL 61611

PHYSICIAN OFFICES MMG AT KNOXVILLE

2709 N KNOXVILLE AVE PEORIA IL 61604

PHYSICIAN OFFICES METHODIST GLEN OAK MEDICAL CENTER

120 NE GLEN OAK AVE PEORIA IL 61602

ADMINISTRATION MMG AT STERLING

3335 N STERLING AVE PEORIA IL 61615

PHYSICIAN OFFICES METHODIST MEDPOINTE AT PEORIA

8914 N KNOXVILLE AVE PEORIA IL 61615

PHYSICIAN OFFICES METHODIST AT MORTON

1909 N MORTON AVE MORTON IL 61550

PHYSICIAN OFFICES; REHABILITATION METHODIST AT PEKIN

1800 BROADWAY PEKIN IL 61554

PHYSICIAN OFFICES MMG AT PEARTREE

6831 N PEAR TREE LANE PEORIA IL 61615

PHYSICIAN OFFICES MMG ON SOUTH JEFFERSON

2127 SE JEFFERSON PEORIA IL 61605

PHYSICIAN OFFICES MMG CARDIOLOGY

765 KELLOGG STREET GALESBURG IL 61401

PHYSICIAN OFFICES CENTRAL ILLINOIS CANCER CARE CENTER

7309 N KNOXVILLE AVE PEORIA IL 61614

OUTPATIENT RADIATION THERAPY CENTRAL ILLINOIS ENDOSCOPY CENTER

1001 MAIN ST SUITE 500B PEORIA IL 61606

OCCUPATIONAL ENDOSCOPY SERVICES ILLINOIS WORK INJURY RESOURCE CENTER

736 SW WASHINGTON ST SUITE 2 PEORIA IL 61602

OCCUPATIONAL MEDICINE MMG AT WASHINGTON

205 CUMMINGS LANE WASHINGTON IL 61571

PHYSICIAN OFFICES; REHABILITATION REHABILITATION THERAPY SERVICES

2988 COURT STREET PEKIN IL 61554

REHABILITATION PART I, LINE 6A: THE METHODIST MEDICAL CENTER OF ILLINOIS' COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. PART I, LINE 7: A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS WAS USED TO CALCULATE THE AMOUNT IN LINES 7A-7C. THE AMOUNTS FOR LINES 7E, 7F, 7H, AND 7I ARE DERIVED FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED IN PART BY A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS WHILE OTHERS THAT ROLL UP FOR THIS CALCULATION ARE DERVIED FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZTION AND ARE BASED ON COST. PART I, LINE 7G: METHODIST SUBSIDIZES SEVERAL PEDIATRIC HEALTH SERVICES INCLUDING PEDIATRIC GASTROENTEROLOGY ALONG WITH CHILD AND ADOLESCENT PSYCHIATRY INPATIENT HEALTH SERVICES AT THE MEDICAL CENTER. THE MEDICAL CENTER ALSO SUBSIDIZED HOSPICE, IN-SCHOOL HEALTH AND GERIATRIC SERVICES IN 2012. PART II: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. METHODIST CONTRIBUTES TO MANY AREA COMMUNITY BUILDING ACTIVITIES IN CENTRAL ILLINOIS. THESE ORGANIZATIONS HELP BUILD ACTIVITIES IN THE AREAS OF ECONOMIC AND HEALTHCARE IMPROVEMENT. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $16,899,030.THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.METHODIST IS PAID BELOW LEVELS THAT FULLY COMPENSATE IT FOR THE UNDERLYING COSTS OF CARE TO MEDICARE BENEFICIARIES. METHODIST TREATS ITS MEDICARE SHORTFALL AS A COMMUNITY BENEFIT DUE TO THE LARGE POPULATION OF SENIORS THE HOSPITAL SERVES. THE POPULATION AT AGE 65 OR ABOVE IS MUCH HIGHER FOR METHODIST'S SERVICE AREA COMPARED TO THE REST OF ILLINOIS. THE MEDICARE SHORTFALL IS CALCULATED USING A COST ACCOUNTING SYSTEM. PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.IT IS THE POLICY OF METHODIST MEDICAL CENTER TO WRITE OFF ACCOUNTS AS BAD DEBT/UNCOLLECTIBLE WHEN CRITERIA FOR FINANCIAL/CHARITY ASSISTANCE IS NOT MET. METHODIST REVIEWS PATIENT BALANCES AT A NUMBER OF DIFFERENT CHECK POINTS IN THE COLLECTION PROCESS. INITIAL REVIEWS CAN OCCUR DURING THE REGISTRATION PROCESS AND OR AT THE POINT OF ADMISSION. THE FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS WITH FINANCIAL QUESTIONS AT THE POINT OF REGISTRATION. SUBSEQUENT REVIEWS OF PATIENT BALANCES OCCUR DURING THE BACK END COLLECTION PROCESS THROUGH INTERNAL LETTER CAMPAIGNS, ASSIGNMENT TO A PRE-COLLECT AGENCY AND THEN FINALLY THROUGH INTERNAL CREDIT SCORING MECHANISMS. OUR WEBSITE ALSO HAS DETAILED INFORMATION ON OUR BILLING POLICIES AS WELL.ONCE A PATIENT IS IN THE FINANCIAL/CHARITY ASSISTANCE PROCESS, ALL COLLECTION ACTIVITY IS PLACED ON HOLD WHILE THE REVIEW PROCESS TAKES PLACE. THE PATIENT THEN RECEIVES A WRITTEN STATEMENT ONCE FINAL DETERMINATION IS REACHED. HOWEVER, IF AN INDIVIDUAL HAS CHOSEN NOT TO HONOR THEIR FINANCIAL OBLIGATION FOR RENDERED SERVICES, THOSE ACCOUNTS ARE PLACED WITH A PROFESSIONAL COLLECTION RECOVERY SERVICE. METHODIST MEDICAL CENTER OF ILLINOIS PART V, SECTION B, LINE 20D: IF THE INDIVIDUAL APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE SERVICES AT THE HOSPITAL FACILITY TO DETERMINE THE AMOUNTS BILLED FOR ALL SERVICES, INCLUDING EMERGENCY OR MEDICALLY NECESSARY CARE. THIS OCCURS REGARDLESS WHETHER THE INDIVIDUAL HAS INSURANCE COVERAGE. ALSO, IF THE INDIVIDUAL HAS INSURANCE COVERAGE AND DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE INSURER'S NEGOTIATED RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY. HOWEVER, IF THE INDIVIDUAL DOES NOT HAVE INSURANCE COVERAGE AND EITHER DOES NOT APPLY OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE GROSS RATES FOR THOSE SERVICES TO DETERMINE THE AMOUNTS BILLED. IF THE UNINSURED INDIVIDUAL AGREES TO PAY THE BILL IN FULL, THE HOSPITAL FACILITY WILL PROVIDE A 20%-30% DISCOUNT FROM THE GROSS RATES FOR THOSE INDIVIDUALS. GREATER PEORIA SPECIALTY HOSPITAL PART V, SECTION B, LINE 20D: IF THE INDIVIDUAL APPLIES AND QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE SERVICES AT THE HOSPITAL FACILITY TO DETERMINE THE AMOUNTS BILLED FOR ALL SERVICES, INCLUDING EMERGENCY OR MEDICALLY NECESSARY CARE. THIS OCCURS REGARDLESS WHETHER THE INDIVIDUAL HAS INSURANCE COVERAGE. ALSO, IF THE INDIVIDUAL HAS INSURANCE COVERAGE AND DOES NOT APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE INSURER'S NEGOTIATED RATE FOR THOSE SERVICES AT THE HOSPITAL FACILITY. HOWEVER, IF THE INDIVIDUAL DOES NOT HAVE INSURANCE COVERAGE AND EITHER DOES NOT APPLY OR DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FACILITY'S FINANCIAL ASSISTANCE POLICY, THE HOSPITAL FACILITY USES THE GROSS RATES FOR THOSE SERVICES TO DETERMINE THE AMOUNTS BILLED. IF THE UNINSURED INDIVIDUAL AGREES TO PAY THE BILL IN FULL, THE HOSPITAL FACILITY WILL PROVIDE A 20%-30% DISCOUNT FROM THE GROSS RATES FOR THOSE INDIVIDUALS. INSERT STATISTICS PROVIDED BY SUSAN EYRICH ON % OF SELF PAYS (UNINSURED) WITH NO DISCOUNT CODES, ETC. PART VI, LINE 2: THE COMMUNITY BENEFITS PLAN ADOPTED BY METHODIST IS ABOUT IMPROVING HEALTH; THE HEALTH OF EACH INDIVIDUAL, AND THE HEALTH OF THE COMMUNITY. IN DEVELOPING THE PLAN, SEVERAL SOURCES OF INFORMATION WERE UTILIZED TO HELP IDENTIFY SPECIFIC HEALTHCARE NEEDS. FIRST, ONE OF THE MORE COMPREHENSIVE LOCAL ASSESSMENTS IS LED BY THE DEPARTMENT OF PUBLIC HEALTH. THE PEORIA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED LOCAL HEALTH PRIORITIES AS CEREBROVASCULAR DISEASE (STROKE), HIP FRACTURES AND INFANT MORTALITY. THE LEADING CAUSES OF MORTALITY WERE IDENTIFIED AS HEART DISEASES. THE SECOND SOURCE WAS HEALTHY PEOPLE 2010. HEALTHY PEOPLE 2010 SET OUT NATIONAL OBJECTIVES FOR HEALTH IMPROVEMENT AND ARE BUILT AROUND THE CONCEPTS OF DISEASE PREVENTION AND HEALTH PROMOTION. OTHER SOURCES OF DATA WERE REVIEWED, HEARTLAND ALLIANCE MID-AMERICA INSTITUTE ON POVERTY, UNITED STATES CENSUS BUREAU DATA, ILLINOIS BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY DATA, METHODIST ACCESS DATA AND CENSUS BUREAU DATA. COLLECTIVELY, THESE DATA SOURCES HAVE SUPPORTED OUR ASSESSMENT OF THE COMMUNITIES NEEDS. PART VI, LINE 3: AS A SERVICE TO OUR COMMUNITY, METHODIST MEDICAL CENTER PROVIDES CARE AT A REDUCED RATE OR WITHOUT CHARGE TO ELIGIBLE PERSONS DEMONSTRATING FINANCIAL NEED AND THE INABILITY TO PAY. THE "PATIENT GUIDE TO UNDERSTANDING YOUR BILL" IS MADE AVAILABLE TO EACH PATIENT DURING THE REGISTRATION PROCESS AND THIS GUIDE CONTAINS INFORMATION ON THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT METHODIST AS WELL INFORMATION ON HOW TO APPLY FOR STATE FUNDED PROGRAMS. THE GUIDE ALSO CONTAINS BOTH LOCAL AND TOLL FREE PHONES NUMBERS TO OUR BILLING OFFICES ALONG WITH OUR HOURS OF OPERATION SO THE PATIENT IS FULLY INFORMED OF WHAT INFORMATION IS AVAILABLE AND WHO THEY CAN CONTACT WITH QUESTIONS. INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAMS IS POSTED ON OUR METHODIST INTERNET HOME PAGE AND ON OUR PATIENT BILLING STATEMENTS. PART VI, LINE 4: METHODIST IS THE SECOND LARGEST HEALTHCARE PROVIDER IN CENTRAL ILLINOIS. THE HOSPITAL IS LICENSED FOR 329 BEDS. ALONG WITH METHODIST THERE ARE TWO OTHER HOSPITALS IN THE PEORIA AREA, ALONG WITH FOUR SMALLER HOSPITALS IN OUR SERVICE AREA. IN 2011, METHODIST SERVED 17,388 INPATIENTS, 126,761 OUTPATIENTS, 58,210 EMERGENCY PATIENTS, 51,300 HOME CARE AND 303,656 PHYSICIAN VISITS. METHODIST'S PRIMARY SERVICE AREA CONSISTS OF FULTON, PEORIA, TAZEWELL AND WOODFORD COUNTIES. THIS GEOGRAPHIC REGION REPRESENTS 85% OF ALL HOSPITAL ADMISSIONS. THE SECONDARY SERVICE AREA INCLUDES 14 CENTRAL ILLINOIS COUNTIES, MOSTLY RURAL IN NATURE. COMBINED, METHODIST SERVES A POPULATION OF NEARLY ONE MILLION PEOPLE. METHODIST IS CLASSIFIED AS AN URBAN, TEACHING HOSPITAL. AS COMPARED TO THE DEMOGRAPHIC CHARACTERISTICS OF THE PEKIN/PEORIA MSA (METROPOLITAN STATISTICAL AREA), METHODIST SERVES A LARGER MINORITY AND SENIOR POPULATION. THE DEMOGRAPHICS OF METHODIST'S PATIENT POPULATION ARE A FUNCTION OF SEVERAL VARIABLES SUCH AS THE INCIDENCE AND PREVALENCE OF DISEASE AMONG AGE COHORTS, AND RACES, GEOGRAPHIC PROXIMITY TO MINORITY POPULATIONS AND OUTREACH EFFORTS TO IMPROVE ACCESS TO MEDICAL SERVICES. METHODIST'S INPATIENTS ARE: WHITE 80.4%, BLACK 15.8%, ASIAN 0.3%, HISPANIC 0.5% AND OTHER 3.0%. THIS IS COMPARED TO THE PEKIN/PEORIA MSA OF: WHITE 85.5%, BLACK 9.1%, ASIAN 1.6%, HISPANIC 2.3% AND OTHER 1.5%. METHODIST HAS THE LEAST FAVORABLE PAYOR MIX IN OUR PRIMARY SERVICE AREA. METHODIST HAS THE LARGEST MEDICAID MARKET SHARE BECAUSE OF OUR BEHAVIORAL HEALTH AND EMERGENCY PROGRAMS. THE MEDIAN AGE IN OUR SERVICE AREA IS 36.0 AS COMPARED TO 34.7 YEARS STATEWIDE. THE MEDIAN AGE IS HIGHER DUE TO A GREATER PERCENTAGE OF THE POPULATION AT AGE 65 OR ABOVE. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE.PHYSICIAN OFFICES ARE SPREAD ACROSS THE REGION TO PROVIDE BETTER ACCESS TO A WIDE NUMBER OF PATIENTS. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM. INITIALLY FORMED IN 1995, IOWA HEALTH SYSTEM IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 29 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND 280 PHYSICIAN CLINICS, IOWA HEALTH SYSTEM PROVIDES CARE THROUGHOUT IOWA AND ILLINOIS.IOWA HEALTH SYSTEM ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 24,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 4 MILLION PATIENT VISITS, IOWA HEALTH SYSTEM HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $2.7 BILLION, IOWA HEALTH SYSTEM IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. IOWA HEALTH SYSTEM AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2012, IOWA HEALTH SYSTEM AND ITS AFFILIATES PROVIDED $421 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY IOWA HEALTH SYSTEM AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. REPORTS FILED WITH STATES PART VI, LINE 7 IL 1 AMERICAN HEART ASSOCIATION 221 S MISSOURI AVE MORTON IL 61550 135613797 501(C)(3) 5000 EVENT SPONSOR BRADLEY UNIVERSITY 1501 WEST BRADLEY PEORIA IL 61625 370661494 501(C)(3) 200000 CAPITAL BUILDING CAMPAIGN BRADLEY UNIVERSITY 1501 WEST BRADLEY PEORIA IL 61625 370661494 501(C)(3) 201250 PROGRAM SUPPORT COMMUNITY FOUNDATION OF ILLINOIS 331 FULTON ST SUITE 310 PEORIA IL 61602 371283245 501(C)(3) 5000 EVENT SPONSOR EASTER SEALS UCP 501 E ARMSTRONG AVE PEORIA IL 61603 370686250 501(C)(3) 28500 PROGRAM SUPPORT HEART OF ILLINOIS UNITED WAY 509 W HIGH STREET PEORIA IL 61605 370661504 501(C)(3) 79000 PROGRAM SUPPORT HEARTLAND COMMERCE & ECONOMIC DEVELOPMENT FOUNDATION 100 SW WATER ST PEORIA IL 61602 371271212 501(C)(3) 35000 PROGRAM SUPPORT ICC EDUCATIONAL FOUNDATION 1 COLLEGE DRIVE EAST PEORIA IL 61635 371207827 501(C)(3) 21500 PROGRAM SUPPORT JUNIOR LEAGUE OF PEORIA 256 NE RANDOLPH AVE PEORIA IL 61606 376032315 501(C)(3) 25000 CAPITAL BUILDING CAMPAIGN JUVENILE DIABETES RESEARCH FOUNDATION 11 S LASALLE ST CHICAGO IL 60603 231907729 501(C)(3) 10000 EVENT SPONSOR KOMEN PEORIA RACE FOR THE CURE 4700 N UNIVERSITY AVE PEORIA IL 61614 371286285 501(C)(3) 8500 EVENT SPONSOR LAKEVIEW MUSEUM 1125 W LAKE AVE PEORIA IL 61614 370818561 501(C)(3) 65000 PROGRAM SUPPORT MORTON COMMUNITY FOUNDATION 309 N MAIN ST STE B MORTON IL 61550 371397503 501(C)(3) 10000 PROGRAM SUPPORT MORTON ECONOMIC DEVELOPMENT COUNCIL 415 W JEFFERSON ST MORTON IL 61550 261927395 501(C)(6) 25000 PROGRAM SUPPORT PEORIA AREA CHAMBER OF COMMERCE 100 SW WATER ST PEORIA IL 61602 370459010 501(C)(3) 5000 PROGRAM SUPPORT PEORIA PROMISE FOUNDATION 331 FULTON ST PEORIA IL 61602 134353454 501(C)(3) 25000 PROGRAM SUPPORT PEORIA RIVERFRONT ASSOCIATION 405 SW COMMERCIAL PEORIA IL 61602 364157912 501(C)(3) 5000 PROGRAM SUPPORT PUBLIC EMPLOYEES - COMMUNITY CONCERNS 419 FULTON ST SUITE 207 PEORIA IL 61602 376001761 501(C)(3) 5000 EVENT SPONSOR QUALITY QUEST FOR HEALTH 416 MAIN ST SUITE 717 PEORIA IL 61602 263896631 501(C)(3) 75000 PROGRAM SUPPORT UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE PO BOX 1649 PEORIA IL 61656 376000511 501(C)(3) 110000 CAPITAL BUILDING CAMPAIGN WD BOYCE COUNCIL 1014 NE MADISON AVE PEORIA IL 61603 370661188 501(C)(3) 14000 PROGRAM SUPPORT WASHINGTON AREA COMMUNITY CENTER 360 N WILMOR RD WASHINGTON IL 61571 364141385 501(C)(3) 20000 PROGRAM SUPPORT 21 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: RECIPIENTS WERE GIVEN GRANTS BASED ON THE NEEDS OF THE MEDICAL COMMUNITY AND THE LOCAL COMMUNITY AT LARGE. COMMUNITY BENEFITS COMMITTEE AND CEO REVIEW ASSISTANCE REQUESTS AND APPROVE BASED ON NEED. X X X X X 1 1 0 0 0 0 0 0 0 BRIAN COHEN MD 321830 0 0 0 25318 0 0 0 15690 0 362838 0 0 0 KEITH KNEPP MD 268389 0 0 0 19150 0 35500 0 15534 0 338573 0 0 0 DEBORAH SIMON 361217 0 0 0 161458 0 165303 0 23580 0 711558 0 0 0 ROBERT QUIN 218006 0 0 0 57127 0 51744 0 8887 0 335764 0 31110 0 TAMMY DUVENDACK 164017 0 0 0 36021 0 22510 0 8056 0 230604 0 0 0 GARY KNEPP 242047 0 0 0 6778 0 0 0 11064 0 259889 0 0 0 JOHN MILLER 272721 0 0 0 2818 0 0 0 15690 0 291229 0 0 0 MIKE NAMANNY 161699 0 0 0 14076 0 15627 0 15147 0 206549 0 0 0 JEANINE SPAIN 180830 0 0 0 44921 0 98595 0 15534 0 339880 0 0 0 TERRY WATERS 154455 0 0 0 77121 0 96955 0 5567 0 334098 0 0 0 RICK ANDERSON TO 062012 148523 0 0 0 197561 0 84119 0 9591 0 439794 0 0 0 ERICK LAINE TO 022012 31443 276361 0 25000 5508 73992 0 8461 2729 13221 39680 397035 0 0 ALEXANDER ADLER 634785 0 0 0 20095 0 36515 0 15690 0 707085 0 0 0 CHARLES EGLEY 748353 0 0 0 42722 0 30701 0 15690 0 837466 0 0 0 JOEL KUPFER 661062 0 0 0 25818 0 6250 0 4934 0 698064 0 0 0 JAMES LOCHER 602449 0 0 0 37210 0 6250 0 15690 0 661599 0 0 0 DWAYNE MCQUITTY 912491 0 0 0 40298 0 0 0 15690 0 968479 0 0 0 CALVIN MACKAY 284359 0 0 0 33232 0 76578 0 11554 0 405723 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE YEAR THAT WAS INCLUDED IN THEIR TAXABLE INCOME: RICK ANDERSON $166,151, CALVIN MACKAY $254,167. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 457(F): RICK ANDERSON $27,272, CALVIN MACKAY $12,842, DEBORAH SIMON $76,755, ROBERT QUIN $37,322. THE PLAN'S FUNDS ARE VESTED QUARTERLY TWO YEARS AFTER EACH CONTRIBUTION OR EARLIER BASED ON THE PARTICIPANT'S AGE AND YEARS OF SERVICE. A ILLINOIS FINANCE AUTHORITY 861091967 2011-05-12 63780000 SEE PART VI 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45203HAE2 2011-05-12 51220000 SEE PART VI 0 0 0 A 72506422 55540033 471772 16494617 2011 1 0 1 1 B 62036639 661528 13293368 48081744 2011 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.01810 0.01810 0 0 1 A 0 0 1 0 0 1 MORGAN STANLEY CAPITAL SECURITIES 33.500000000000 0 1 0 0 1 B 0 0 1 0 1 1 MORGAN STANLEY CAPITAL SECURITIES 33.500000000000 0 1 0 0 1 PART I, COLUMN (F) DESCRIPTION OF PURPOSE LINE A - REFUND THE ILLINOIS FINANCE AUTHORITY'S HOSPITAL FACILITIES REVENUE BONDS, (METHODIST MEDICAL CENTER) SERIES 1998. LINE B - REFINANCE BANK LINE OF CREDIT. CENTRAL ILLINOIS ENDOSCOPY CENTER LLC COMMON BOARD MEMBER/OFFICER 2189000 OWNERSHIP DISTRIBUTION, MANAGEMENT FEES, SUPPLIES 0 CENTRAL ILLINOIS CANCER CARE CENTER LLC COMMON BOARD MEMBER/OFFICER 4767000 OWNERSHIP DISTRIBUTION, PATIENT SERVICE REVENUE, MANAGEMENT FEES, LEASED EMPLOYEES, ETC. 0 DEBBIE ANDERSON FAMILY MEMBER OF KEY EMPLOYEE RICK ANDERSON 30318 EMPLOYEE OF METHODIST MEDICAL CENTER OF ILLINOIS 0 CENTRAL ILLINOIS WORK INJURY RESOURCE CENTER LLC COMMON BOARD MEMBER/OFFICER 3112000 OWNERSHIP DISTRIBUTION, PATIENT SERVICE REVENUE, LEASED EMPLOYEES, RENT, SUPPLIES, ETC. 0 GREATER PEORIA SPECIALTY HOSPITAL LLC COMMON BOARD MEMBER/OFFICER 3539000 OWNERSHIP DISTRIBUTION, MANAGEMENT FEES, SUPPLIES 0 MARION WILLEMSEN-REID FAMILY MEMBER OF BOARD MEMBER SCOTT REID 80020 EMPLOYEE OF METHODIST MEDICAL CENTER OF ILLINOIS 0 MID ILLINI SURGICAL ASSOCIATES COMMON BOARD MEMBER/OFFICER 238590 PURCHASED SERVICES 0 METHODIST MEDICAL CENTER OF ILLINOIS ORTHOPEDIC CO-MANAGEMENT COMPANY LL COMMON BOARD MEMBER/OFFICER 32000 PURCHASED SERVICES 0 PEORIA METRO CONSTRUCTION COMMON BOARD MEMBER/OFFICER 661533 CONTRACTOR SERVICES 0 PEORIA-TAZEWELL PATHOLOGY GROUP COMMON BOARD MEMBER/OFFICER 486614 PURCHASED SERVICES 0 REHABILITATION THERAPY SERVICES LLC COMMON BOARD MEMBER/OFFICER 1743000 OWNERSHIP DISTRIBUTION, PATIENT SERVICE REVENUE, RENT, FINANCIAL SERVICES, ETC. 0 FORM 990, PART VI, SECTION A, LINE 2 GARY KNEPP; KEITH KNEPP; FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 METHODIST HEALTH SERVICES CORPORATION, A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A METHODIST HEALTH SERVICES CORPORATION, AS THE SOLE MEMBER, MAY APPOINT AND REMOVE ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B METHODIST HEALTH SERVICES CORPORATION, AS SOLE MEMBER, DIRECTS, APPROVES AND RECOMMENDS MERGERS, CONSOLIDATIONS, ACQUISITONS, DISSOLUTION, LIQUIDATION OR DISPOSITION, INIATES AND APPROVES BUDGETS AND LONG-RANGE STRATEGIC PLANS, INITIATES AND APPROVES THE FORMATION OF ANY PERSON CONTROLLED BY A SUBSIDIARY, APPROVES CONFLICT OF INTEREST POLICY, AND AMENDMENTS TO ARTICLES AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN 2012 FOR THE FOLLOWING INDIVIDUALS: DEBORAH SIMON. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, HAS VOLUNTARILY ADOPTED MANY OF OUR INDUSTRY'S GOVERNANCE "BEST PRACTICES." IOWA HEALTH SYSTEM HAS DONE SO TO FURTHER ASSURE OUR STAKEHOLDERS THAT OUR GOVERNANCE AND MANAGEMENT IS CONDUCTED RESPONSIBLY AND WARRANTS THE TRUST YOU PLACE IN US. IN SEPTEMBER 2003, THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS VOLUNTARILY ADOPTED OVER 40 CHANGES TO ITS GOVERNANCE STRUCTURE TO BETTER COMPLY WITH GOVERNANCE BEST PRACTICES AND THE INTENT AND APPLICABLE REQUIREMENTS OF THE SARBANES-OXLEY ACT OF 2003. IN ADDITION, GOVERNANCE POLICIES AND RELATED INFORMATION HAS BEEN ADDED TO THE IOWA HEALTH SYSTEM WEBSITE, WWW.IHS.ORG, INCLUDING BUT NOT LIMITED TO: OVER 130 CORPORATE COMPLIANCE POLICIES, INCLUDING CHARITY CARE AND CONFLICTS OF INTEREST POLICIES; GOVERNANCE BEST PRACTICE POLICIES; THE IDENTIFICATION OF BOARD MEMBERS AND BOARD COMMITTEES; COMPENSATION FOR HOSPITAL CEO'S; AND FINANCIAL INFORMATION FOR THE PAST SEVEN YEARS. COPIES OF THE DOCUMENTS ARE ALSO AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G HEALTHCARE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 34,829,654. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,829,654. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 12,715,611. MANAGEMENT AND GENERAL EXPENSES 6,627,076. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,342,687. CBO COLLECTION FEES: PROGRAM SERVICE EXPENSES 957,940. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 957,940. OUTSIDE CONSULTANT FEES: PROGRAM SERVICE EXPENSES 106,896. MANAGEMENT AND GENERAL EXPENSES 1,098,860. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,205,756. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PENSION FUNDING LIABILITY 5,712,407. FOUNDATION INVESTMENT 2,461,892. 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