2012-08-03T12:23:55-05:00 2011-09-30 MCGLADREY LLP 1 SOUTH WACKER SUITE 600 CHICAGO IL 60606 990 2010-10-01 900756744 MEMORIAL HEALTH SYSTEM GROUP RETURN MEMO 2177883000 701 NORTH FIRST STREET SPRINGFIELD IL 62781 ROBERT W KAY 2177883198 2012-08-03 1 3126343400 2010 2016-02-24 21:20:13Z EDGAR J CURTIS 701 NORTH FIRST STREET SPRINGFIELD IL 62781 950919800 1 0 5670 X WWW.MHSIL.COM X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 101 49 6255 0 6398378 0 8342369 4849898 682971780 697580334 4264741 9334461 16186886 18813043 711765776 730577736 9287222 3037265 0 0 283742163 301090474 14319 36000 482249 377174135 401154757 670217839 705318496 41547937 25259240 809405620 802781836 459739516 410250929 349666104 392530907 X TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 82718739 90993030 CARDIOVASCULARTHE PROGRAMS OF MEMORIAL MEDICAL CENTER'S HEART & VASCULAR SERVICES FOCUS ON REDUCING THE INCIDENCE OF CARDIAC AND VASCULAR DISEASE. THROUGH PREVENTION PROGRAMS AND THE LATEST DIAGNOSTIC AND TREATMENT PROCEDURES, OUR GOAL IS TO WORK WITH PATIENTS TO ACHIEVE GREAT PATIENT OUTCOMES AND OPTIMUM LONG-TERM HEALTH. IN FISCAL YEAR 2011, MEMORIAL MEDICAL CENTER'S CARDIAC CATH LAB PERFORMED 3,420 HEART CATHS, 1,779 CORONARY INTERVENTIONS, 2,120 ELECTROPHYSIOLOGY (EP) PROCEDURES, AND 1,084 VASCULAR CASES. RECOGNIZED AS A LEADER AND INNOVATOR IN HEART AND VASCULAR TECHNOLOGY, THE MEMORIAL HEART & VASCULAR SERVICES TEAM ALSO PERFORMED 330 CORONARY BYPASS AND VALVE SURGERIES. OTHER SERVICES INCLUDE NON-INVASIVE CARDIAC AND VASCULAR TESTING, CARDIAC AND PULMONARY REHABILITATION, VALVE CENTER, HEART FAILURE CLINIC, NUTRITION COUNSELING, AND SUPPORT GROUPS. MEMORIAL MEDICAL CENTER IS A NATIONAL LEADER IN OUR RESPONSE TIME FOR TREATING HEART ATTACKS. THE TIME IT TAKES TO RE-ESTABLISH BLOOD FLOW TO THE HEART IS CRITICAL IN SAVING A PATIENT'S LIFE. THE AMERICAN COLLEGE OF CARDIOLOGY USES 90 MINUTES AS THE RECOMMENDED STANDARD OF CARE FOR BALLOON ANGIOPLASTY, MEANING NO MORE THAN 90 MINUTES SHOULD ELAPSE FROM THE MOMENT THE PATIENT COMES THROUGH THE HOSPITAL DOORS UNTIL BALLOON ANGIOPLASTY IS COMPLETED AND BLOOD FLOW IS RESTORED TO THE HEART. MEMORIAL MEDICAL CENTER'S GOAL IS TO PERFORM THE PROCEDURE IN LESS THAN 80 MINUTES. MEMORIAL MEDICAL CENTER HAS BEEN RECOGNIZED BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION FOR ITS COMMITMENT AND SUCCESS IN IMPLEMENTING HIGHER STANDARDS OF CARE FOR HEART ATTACK PATIENTS. 75321289 71630372 SURGICAL SERVICES DEPARTMENTTHE SURGICAL SERVICES DEPARTMENT AT MEMORIAL MEDICAL CENTER PROVIDES A WIDE VARIETY OF INPATIENT AND OUTPATIENT SERVICES IN BOTH THE MAIN SURGERY AND CARDIAC SURGERY DEPARTMENTS. BAYLIS DAY SURGERY IS UTILIZED FOR OUTPATIENT PROCEDURES. MEMORIAL MEDICAL CENTER PERFORMED 20,227 SURGICAL PROCEDURES IN FY11. MEMORIAL MEDICAL CENTER CONTINUES TO STRIVE FOR EXCELLENCE IN PATIENT CARE. IT HAS RECEIVED A RARE FIVEFOLD ACCREDITATION FOR ITS REHABILITATION SERVICES FROM THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF).MEMORIAL MEDICAL CENTER PROVIDES A WIDE RANGE OF CARDIAC, THORACIC AND VASCULAR PROCEDURES. PROCEDURES PERFORMED IN THE CARDIAC SURGERY AREA INCLUDE CORONARY ARTERY BYPASS GRAFTING, VALVE REPLACEMENTS, PACEMAKER INSERTIONS, AND OTHER VASCULAR PROCEDURES AND LUNG PROCEDURES.A VARIETY OF SURGERIES ARE ROUTINELY PERFORMED TO ASSIST PATIENTS WITH EAR, NOSE AND THROAT CONDITIONS. PROCEDURES SUCH AS TONSILLECTOMY, ADENOIDECTOMY, MYRINGOTOMY TUBE INSERTION, SEPTOPLASTY, FUNCTIONAL ENDOSCOPIC SINUS SURGERY, AND UVULOPALATOPLASTY (FOR TREATMENT OF SLEEP APNEA) ARE FREQUENTLY PERFORMED AT MEMORIAL MEDICAL CENTER. RIGID AND/OR FLEXIBLE ENDOSCOPIC TECHNIQUES ARE USED FOR ESOPHAGOSCOPY, BRONCHOSCOPY, AND DIRECT LARYNGOSCOPY PROCEDURES. FACIAL FRACTURES ARE TREATED USING VARIOUS PLATING SYSTEMS. MAJOR SURGERIES OF THE EAR ARE PERFORMED USING TECHNIQUES TO IMPROVE OR RESTORE HEARING LOSS. SURGERIES FOR THE DIAGNOSIS AND TREATMENT OF HEAD-AND-NECK CANCER ARE ALSO PERFORMED. AN OPERATIVE MICROSCOPE IS FREQUENTLY USED TO PROVIDE THE VISUALIZATION NECESSARY FOR MANY ENT PROCEDURES. STATE-OF-THE-ART COMPUTER-GUIDED TECHNOLOGY IS ALSO USED TO PROMOTE TREATMENT OF SOME ENT PROCEDURES. TECHNIQUES EMPLOYING THE USE OF A CO2 LASER ARE ALSO AVAILABLE.LAPAROSCOPIC TECHNOLOGY PROVIDES THE VISUALIZATION OF INTERNAL ORGANS WITH A TELESCOPE INSERTED THROUGH A SMALL ABDOMINAL INCISION. THIS TECHNOLOGY IS USED FOR DIAGNOSIS AND TREATMENT OF DISEASE. LAPAROSCOPIC TECHNIQUES ARE OFTEN USED TO REMOVE THE GALLBLADDER OR APPENDIX, OR FOR HERNIA REPAIR. A WIDE RANGE OF PROCEDURES FOR CANCER OF THE COLON, LIVER, BREAST AND OTHER ANATOMICAL SITES ARE PERFORMED IN CONJUNCTION WITH THE CARE PROVIDED TO PATIENTS WHO COME TO MEMORIAL'S REGIONAL CANCER CENTER. RADIOFREQUENCY TECHNOLOGY IS AVAILABLE TO ASSIST IN THE TREATMENT OF LIVER TUMORS. SENTINEL NODE MAPPING IS USED IN THE IDENTIFICATION OF LYMPH NODES IN BREAST AND MELANOMA CANCERS.A FULL RANGE OF SERVICES ARE AVAILABLE FOR PATIENTS NEEDING GYNECOLOGIC SURGERY. LAPAROSCOPIC PROCEDURES ARE PERFORMED FOR DIAGNOSTIC PURPOSES AND OPERATIVE TREATMENT. CO2 LASER THERAPY IS AVAILABLE FOR TREATMENT. A VARIETY OF OPERATIONS ARE COMPLETED TO ASSIST PATIENTS WITH REPRODUCTIVE DISORDERS, INCLUDING STERILIZATION REVERSAL, GIFT, AND IN-VITRO PROCEDURES. MALIGNANCIES INVOLVING THE REPRODUCTIVE ORGANS, INCLUDING CANCER OF THE CERVIX, UTERUS, AND OVARIES CAN BE TREATED WITH STATE-OF-THE-ART SURGICAL OPERATIONS, AND FACILITIES ARE AVAILABLE IN THE HOSPITAL FOR CHEMOTHERAPY OR RADIATION THERAPY.MEMORIAL'S NEUROSURGICAL SERVICE ENCOMPASSES THE AREAS OF GENERAL SPINE (CERVICAL/THORACIC/LUMBAR DISCECTOMY, LAMINECTOMY); COMPLEX SPINE (SPINAL FUSION AND INSTRUMENTATION); PERIPHERAL NERVE (CARPAL TUNNEL SYNDROME AND ULNAR DECOMPRESSION); AND BRAIN AND SPINAL-TUMOR SURGERY. STATE-OF-THE-ART TECHNOLOGY BASED ON COMPUTER GUIDANCE SERVICES KNOWN AS STEREOTACTIC RADIOIMAGING IS UTILIZED TO PROVIDE IMPROVED TREATMENTS FOR NEUROSURGICAL CONDITIONS, SUCH AS BRAIN TUMORS AND PHYSIOLOGIC-MOVEMENT DISORDERS. ALSO AVAILABLE TO OUR PHYSICIANS IS A HIGHLY SOPHISTICATED COMPUTERIZED NAVIGATIONAL TECHNIQUE REFERRED TO AS AN IMAGE-GUIDED SYSTEM. THIS SYSTEM OFFERS A THREE-DIMENSIONAL COMPUTERIZED ANATOMIC VISUALIZATION TO ASSIST THE NEUROSURGEON IN PINPOINTING THE OPERATIVE SITE AND PROMOTING PATIENT OUTCOMES.MEMORIAL MEDICAL CENTER OFFERS OUTPATIENT AND INPATIENT OPHTHALMIC SERVICES. STRABISMUS REPAIRS CORRECT EYE MUSCLE PROBLEMS IN SMALL CHILDREN. OCCULOPLASTIC PROCEDURES OFFER PLASTIC RECONSTRUCTION FOR PATIENTS OF ALL AGES. TREATMENT OPTIONS ARE AVAILABLE FOR PATIENTS WITH GLAUCOMA. CATARACT SURGERY IS FREQUENTLY PERFORMED ON PATIENTS IN THE AGING POPULATION. SPECIALTY TREATMENTS ARE AVAILABLE FOR PATIENTS WITH DISEASES AND INJURIES OF THE RETINA. THESE INCLUDE LASER THERAPY, VITRECTOMY, SCLERAL BUCKLING, PLACEMENT OF SILICONE OIL, RETINAL TACK PLACEMENT, AND CRYOTHERAPY. CORNEAL TRANSPLANTS ARE AVAILABLE FOR PATIENTS WHO HAVE SUFFERED DAMAGE TO THE CORNEA.INNOVATIVE TREATMENT OPTIONS ARE AVAILABLE FOR PATIENTS SEEKING TREATMENT FOR ORAL AND MAXILLOFACIAL PROBLEMS OR FACIAL FRACTURES. IN ADDITION TO ROUTINE DENTAL PROCEDURES, MEMORIAL OFFERS PROGRESSIVE SURGICAL TREATMENTS, INCLUDING THE USE OF A MANDIBULAR BONE TRANSPORT SYSTEM FOR TREATMENT OF PATIENTS WITH CANCER OF THE MANDIBLE. THE RIGID EXTERNAL DISTRACTION SYSTEM IS AVAILABLE FOR PATIENTS WITH CRANIOMAXILLOFACIAL ANOMALIES. ANOTHER TECHNICAL ADVANCEMENT IS THE MAXILLOFACIAL CEMENT SYSTEM USED FOR FACIAL-SKELETAL DEFORMITY REPAIRS AS WELL AS RIGID FIXATION FOR DENTAL-FACIAL DEFORMITY AND FRACTURE REPAIR.MEMORIAL PROVIDES COMPREHENSIVE CARE FOR PATIENTS SEEKING PLASTIC AND RECONSTRUCTIVE SURGERY. THESE PROCEDURES INCLUDE ROUTINE OUTPATIENT COSMETIC SURGERIES AS WELL AS EXTENSIVE RECONSTRUCTION OPERATIONS WHICH ARE AVAILABLE TO PATIENTS ADMITTED TO OUR REGIONAL BURN CENTER. MICROSURGERY TECHNIQUES ARE USED ON VARIOUS PLASTIC RECONSTRUCTIVE PROCEDURES SUCH AS REATTACHMENT AND RESTORATION OF AMPUTATED DIGITS OR LIMBS. A COMPREHENSIVE PLAN OF CARE IS OFFERED FOR PATIENTS WITH SKIN OR BREAST CANCER WHICH MAY INCLUDE THE USE OF TISSUE EXPANDERS, IMPLANTS OR VARIOUS FLAP RECONSTRUCTION TECHNIQUES. 62154064 81794650 ORTHOPEDICSMEMORIAL MEDICAL CENTER'S ORTHOPEDICS SERVICE OFFERS STATE-OF-THE-ART INTERDISCIPLINARY CARE FOR BONE AND JOINT DISORDERS. WORKING WITH COMMUNITY ORTHOPEDIC SURGEONS, OUR TEAM OF HEALTHCARE PROFESSIONALS PROVIDES COMPREHENSIVE PATIENT EDUCATION, DIAGNOSTIC, SURGICAL AND REHABILITATION SERVICES FOR PATIENTS OF ALL AGES. THESE SERVICES ARE PROVIDED IN THE PREMIER TREATMENT FACILITIES IN THE REGION.MEMORIAL'S INNOVATIVE JOINTWORKS PROGRAM IS PART OF ORTHOPEDIC SERVICES. THROUGH JOINTWORKS, ABOUT 1,200 PATIENTS UNDERGO HIP AND KNEE REPLACEMENTS AT MEMORIAL MEDICAL CENTER ANNUALLY. AN EXPERIENCED TEAM OF ORTHOPEDIC SURGEONS, ANESTHESIOLOGISTS, NURSES, THERAPISTS, AND SOCIAL WORKERS GUIDES OUR PATIENTS FROM PRE-SURGERY EDUCATION THROUGH POST-SURGERY REHABILITATION.DURING FY 11, MEMORIAL MEDICAL CENTER'S ORTHOPEDICS SERVICE COMPLETED 4,822 ORTHOPEDIC PROCEDURES. THE JOINTWORKS PROGRAM PERFORMED 824 TOTAL KNEE REPLACEMENT PROCEDURES AND 394 TOTAL HIP REPLACEMENTS. OTHER ORTHOPEDIC SERVICES INCLUDED 123 CERVICAL FUSION PROCEDURES, 100 CLOSED REDUCTION OF FRACTURE OF THE FEMUR, AND 98 LUMBAR FUSION PROCEDURES. IN JANUARY, MEMORIAL ORTHOPEDICS BEGAN PARTICIPATING IN "OWN THE BONE", A NATIONAL DATABASE REGISTRY AND EDUCATION PROGRAM AIMED AT APPROPRIATE FOLLOW-UP CARE FOR FRAGILITY FRACTURE PATIENTS. IN JULY, THE JOINTWORKS PROGRAM RECEIVED CERTIFICATION FROM THE JOINT COMMISSION FOR HIP REPLACEMENT AND KNEE REPLACEMENT SURGERY. IN OCTOBER, MEMORIAL ORTHOPEDICS BEGAN AN INTERNAL REGISTRY FOR HIP AND KNEE REPLACEMENT SURGERY. 378727295 3037265 461506378 SURGICAL PRODUCT LINE; 25,936 CASES; 41,118 PATIENT DAYS PULMONARY/THORACIC PRODUCT LINE; 13,004 CASES; 29,686 DAYSHEMATOLOGY/ONCOLOGY PRODUCT LINE; 35,148 CASES; 146,563 DAYS 378727295 3037265 461506378 598921387 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 1 1 411 0 1 6255 1 1 1 0 0 0 1 1 1 1 0 0 0 0 X 101 49 1 0 0 0 1 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 IL X ROBERT W KAY SVP & CFO 2177883198 701 NORTH FIRST STREET SPRINGFIELD IL 62781 A KRAIG KRAUSE 0.70 X 0 0 0 CLYDE R REYNOLDS 0.70 X X 0 0 0 ERIC D GRAUE 0.70 X X 0 0 0 FRANCES C GUZZARDO 0.70 X 0 0 0 GAIL NUNNERY 0.70 X X 0 0 0 HAROLD L DRAKE 0.70 X 0 0 0 JAMES R DREW 0.70 X 0 0 0 JOAN GRAUE 0.70 X 0 0 0 JUDITH N LOZIER 0.70 X 0 0 0 KAREN SAMS DAVIS 0.70 X 0 0 0 KENT E CROSS 0.70 X 0 0 0 MARY ROSE MOREHEAD 0.70 X 0 0 0 PAMELA K WHITE 0.70 X 0 0 0 ROBERT BD ARNEAUD 0.70 X X 0 0 0 SHIRLEY S EDWARDS 0.70 X 0 0 0 A PATRICK DOOLIN 0.70 X 0 0 0 BRADLEY E NEAL 0.70 X 0 0 0 DAVID A CAMPBELL 0.70 X X 0 0 0 DENNIS M CARROLL MD 0.70 X 0 0 0 JOANN MCCULLOUGH 0.70 X 0 0 0 MARY BETH SPARKS 0.70 X 0 0 0 MARY CONRADY 0.70 X 0 0 0 MARY S MCLAUGHLIN 0.70 X 0 0 0 MELISSA L COX MD 0.70 X 0 0 0 REV ANDREW NYREN 0.70 X 0 0 0 REV ROBERT HENDERSON 0.70 X X 0 0 0 RICHARD A HAMM 0.70 X 0 0 0 RICHARD BIVIN MD 50.00 X 249769 0 49769 RONALD SCHILLING 0.70 X 0 0 0 STEVEN D AUGHENBAUGH 0.70 X X 0 0 0 ELAINE YOUNG 50.00 X X 0 247187 44482 KEVIN ENGLAND 50.00 X X 0 313740 68774 THOMAS WESTRICK 50.00 X X 180143 0 11227 DOLAN DALPOAS 50.00 X X 265113 0 46356 DANIEL RAAB 50.00 X X 244901 0 42669 CAROL J POSEGATE 0.80 X X 0 0 0 CLIFTON R BAXTER 1.10 X 0 0 0 DALE M BECKER 0.80 X X 0 0 0 DEAN E ROBERT 0.40 X 0 0 0 DIANE K RUTLEDGE PHD 1.00 X 0 0 0 DWIGHT H O'KEEFE III 1.50 X X 0 0 0 FRANK V AGUIRRE MD 0.60 X 0 0 0 J ERIC BLEYER MD 0.70 X 0 0 0 JAMES P BRUNER 1.70 X X 0 0 0 JERRY E KRUSE MD 0.30 X 0 0 0 JOHN D BLACKBURN 1.70 X X 0 0 0 JOSEPH M HURWITZ 1.00 X X 0 0 0 MARK H FERGUSON 1.60 X X 0 0 0 MICHAEL A PICK MD 0.70 X 0 0 0 NINA M HARRIS 1.00 X 0 0 0 WILLIAM A SIMPSON 0.70 X 0 0 0 WILLIAM R ENLOW 1.00 X 0 0 0 EDGAR CURTIS 50.00 X X 0 666927 458534 ROBERT KAY 50.00 X X 0 410448 231627 ANN COOMBE 0.70 X 0 0 0 ANN P ROBERT 0.70 X 0 0 0 BRADLEY J NIKLES 0.70 X 0 0 0 BRIDGET L LAMONT 0.70 X 0 0 0 CRAIG R SCHERMERHORN 0.70 X X 0 0 0 DAVID L GRIFFEN MD 0.70 X 0 0 0 DONALD A ALTORFER 0.70 X 0 0 0 ELVIN G ZOOK MD 0.70 X 0 0 0 GARY D NEUBAUER 0.70 X X 0 0 0 GEOFFREY ISRINGHAUSEN 0.70 X 0 0 0 J CHRISTOPHER SMITH 0.70 X X 0 0 0 JULIE CELLINI 0.70 X 0 0 0 MICHAEL A AIELLO 0.70 X 0 0 0 MICHAEL A MYERS 0.70 X 0 0 0 MICHAEL E O'SHEA 0.70 X 0 0 0 R LEE ALLEN 0.70 X 0 0 0 ROY NEWMAN 0.70 X 0 0 0 STEPHEN L PATTON 0.70 X X 0 0 0 MARK HANSEN MD 50.00 X 621070 0 93472 MARSHALL HALE MD 50.00 X X 300837 0 58691 PAUL KASA MD 50.00 X 213223 0 43244 DOUGLAS RAHN 50.00 X X 550825 0 96033 BERNADETTE SALISBURY 0.70 X X 0 0 0 CARL NIEMANN 0.70 X 0 0 0 DANIEL AUSTIN 0.70 X X 0 0 0 DAVID KIEL MD 0.70 X 0 0 0 GARY A SPURLING 0.70 X 0 0 0 GARY MCNEELY 0.70 X X 0 0 0 HWA LONG CHEN MD 0.70 X 0 0 0 JAMES R ADCOCK 0.70 X 0 0 0 JERRY D GARDNER 0.70 X X 0 0 0 RONALD MIZER DDS 0.70 X 0 0 0 LORETTA KAHLE 0.70 X 0 0 0 MARGARET J FRY 0.70 X 0 0 0 THOMAS F FORD 0.70 X X 0 0 0 YASER FREJI MD 0.70 X 0 0 0 BILL SMITH 0.70 X X 0 0 0 BONNIE BRUNS 0.70 X X 0 0 0 DAN LITTEKEN 0.70 X 0 0 0 ERIC KAHLE 0.70 X 0 0 0 JOHN CURTIN 0.70 X 0 0 0 JUDY MOULTON 0.70 X 0 0 0 LINDA SMITH 0.70 X X 0 0 0 ROGER HICKMAN 0.70 X 0 0 0 SR VIRGINIA WALSH 0.70 X 0 0 0 WILLIAM CHASTAIN 0.70 X 0 0 0 LEIGH STEINER 0.70 X X 0 0 0 WILLIAM D MEYER 0.70 X X 0 0 0 MICHAEL MCGLASSON 0.70 X X 0 0 0 JANET STOVER 0.70 X X 0 0 0 RANDALL GERMERAAD 0.70 X 0 0 0 JANICE GAMBACH 50.00 X X 0 152483 16680 CHARLES CALLAHAN 50.00 X X 287512 0 50160 TRAVIS DOWELL 50.00 X X 250029 0 47076 JOHN FERRY DDS 0.70 X 0 0 0 ELENA KEZELIS 50.00 X 161347 0 14273 MARSHA PRATER 50.00 X 259204 0 144348 SCOTT KIRIAKOS 50.00 X 307661 0 56701 DAVID J JOERGER 50.00 X 183558 0 15057 FERINAND SALVACION MD 50.00 X 616961 0 117036 DAVID SANDERCOCK MD 50.00 X 362384 0 73033 JAMES GILDNER MD 50.00 X 538672 0 110181 STEVEN LILLPOP MD 50.00 X 373291 0 80996 VIRGINIA DOLAN MD 50.00 X 334072 0 56618 ROBERT CLARKE X 0 382201 0 6300572 2172986 2027037 19 1 1 0 HAROLD O'SHEA BUILDERS INC 3401 CONSTITUTION DR SPRINGFIELD IL 62711 CONSTRUCTION 32217451 SIU SCHOOL OF MEDICINE PO BOX 19607 SPRINGFIELD IL 62794 PHYSICIAN SERVICES 13559672 O'SHEAMCCARTHY JV 1341 N ROCK HILL ROAD ST LOUIS MO 63124 CONSTRUCTION 10163875 MIDWEST EMERGENCY DEPARTMENT SPECIALIST 2000 SPRING RD SUITE 200 OAKBROOK IL 60523 ER STAFFING 3969537 SIEMENS MEDICAL SOLUTIONS DEPT CH 14195 PALATINE IL 60055 PREVENTIVE MAINTENANCE 3115056 306 6032 274248 588628 1677927 2303063 14342 4849898 PATIENT SERVICE REV 900099 608606655 608606655 PROGRAM RELATED REV 900099 64839332 64839332 PARTNERSHIP INCOME 531190 7323898 7323898 HOME HEALTH SERVICES 621610 7229706 7229706 HOSPICE SERVICES 621610 5792280 5792280 3788463 2996565 791898 697580334 6525563 6525563 35067 35067 1539230 525480 1013750 1013750 1013750 219031438 3312948 216628668 2941887 2402770 371061 2773831 2773831 301715 274248 246029 55686 55686 REFERENCE LAB REVENUE 621500 5242746 5242746 CAFETERIA REVENUE 722320 4697329 136683 4560646 EMPLOYMENT SERVICES 561300 723105 723105 7080427 6139429 295844 645154 17743607 730577736 705924430 6398378 17193493 1970805 1970805 1066460 1066460 3138607 1512183 1485607 140817 170138 47447 24538 98153 223627196 203928748 19622475 75973 23662318 21430160 2232158 34527820 31216477 3241207 70136 15964395 14376935 1570489 16971 2867416 2867416 762790 762790 32235 32235 44669 44669 36000 36000 1330534 120106 1210428 69295216 57102551 12192665 1172862 68922 1102392 1548 19184819 16037686 3126536 20597 11595102 10232648 1362371 83 18888910 17189140 1699770 1258537 1114803 143631 103 551206 362218 188988 8269372 6738132 1531240 31499370 26257075 5242295 4020795 21328 3999467 PATIENT SERV. SUPPLIES 85026791 85026791 0 PURCHASED CONTR. SERVIC 37803729 37348520 455209 MANAGEMENT FEE 36248011 398652 35849359 DRUGS 19294270 19294270 PROV. FOR UNCOLLECTABLE 18149609 16602490 1547119 33858514 29456840 4379806 21868 705318496 598921387 105914860 482249 6214073 7850566 132342317 68055507 2021755 1500704 104673675 128443126 26560 129793 10606969 10662837 11011891 7862118 506587807 242959159 221218847 263628648 258582306 260997893 8253386 6381443 54453841 47269201 809405620 802781836 71853338 61483167 194323 224782 11086747 5687849 179018200 177033644 16870000 15070000 180716908 150751487 459739516 410250929 X 304310763 346852884 40458307 40739279 4897034 4938744 349666104 392530907 809405620 802781836 X 25259240 17605563 X 0 1 1 X 1 1 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: MEMBER'S OF THE GROUP REASON FOR PUBLIC CHARITY STATUS BELOW: MEMORIAL MEDICAL CENTER PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). ABRAHAM LINCOLN MEMORIAL HOSPITAL PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). TAYLORVILLE MEMORIAL HOSPITAL PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). MEMORIAL HEALTH VENTURES PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(3). B TYPE II. LINE 11E NO, 11F NO, 11G (I)(II)(III) NO, 11H (I)SUPPORTS MMC (II)37-06612203 (III) (IV) YES, (V) YES (VI) YES (VII)$0 MEMORIAL HOME SERVICES PART I LINE 9. AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIPS FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS- SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME FROM BUSINESS ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. MEMORIAL PHYSICIAN SERVICES PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(3). B TYPE II. SPRINGFIELD RESIDENTIAL SERVICES PART I LINE 9. AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIPS FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS- SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME FROM BUSINESS ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. MEMORIAL MEDICAL CENTER FOUNDATION PART I LINE 7 IS AN ORGANIZATION THAT NORMALLY RECIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI). ABRAHAM LINCOLN HEALTHCARE FOUNDATION PART I LINE 7 IS AN ORGANIZATION THAT NORMALLY RECIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI). TAYLORVILLE MEMORIAL HEALTHCARE FOUNDATION PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1). B TYPE III. LINE 11E NO, 11F NO, 11G (I)(II)(III) NO, 11H (I)SUPPORTS TMH (II)37-06612503 (III) (IV) YES, (V) YES (VI) YES (VII)$21,541 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 74938 74938 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: MEMORIAL MEDICAL CENTER (MMC) ENGAGES LOBBYISTS TO ASSIST IN SECURING FEDERAL GRANTS AND MONITORING STATE REGULATIONS IN SUPPORT OF FURTHERING THE MEMORIAL MEDICAL CENTER MISSION, WHICH IS "TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE". THIS INCLUDES ASSISTING MEMORIAL MEDICAL CENTER IN DEVELOPING PRESENTATIONS TO THE ILLINOIS CONGRESSIONAL DELEGATION REQUESTING APPROPRIATIONS FOR PRIORITY PROJECTS INVOLVING LOCAL PATIENT SAFETY, QUALITY IMPROVEMENT AND IMPROVED LOCAL ACESS TO MEDICAL CARE. THE LOBBYISTS ALSO ASSIST MMC IN COMMUNICATING THE IMPORTANCE OF ADEQUATE MEDICAID FUNDING IN SUPPORT OF THE SUBSTANTIAL SERVICES MMC'S AFFILIATES PROVIDE TO THOSE IN POVERTY AND IN MONITORING LEGISLATIVE AND REGULATORY DEVELOPMENTS THAT WOULD AFFECT MEMORIAL MEDICAL CENTER'S ABILITY TO CONTINUE DELIVERING ITS ALREADY SUBSTANTIAL COMMUNITY BENIFIT. ABRAHAM LINCOLN MEMORIAL HOSPITAL(ALMH) PAID FUNDS OF $15,517 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HOSPITALS REGARDING LEGISLATVE CHANGES. TAYLORVILLE MEMORIAL HOSPITAL(TMH) PAID FUNDS OF $14,752 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HOSPITALS REGARDING LEGISLATIVE CHANGES. MEMORIAL HOME SERVICES(MHSVC) PAID FUNDS OF $783 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HEALTHCARE ORGANIZATIONS REGARDING LEGISLATIVE CHANGES. 7410408 48483 -47525 42758 97366 7271242 5942467 1050046 599812 35500 107317 39101 7410407 5911356 35189 194785 53949 107863 37051 5942467 0.15000 0.85000 0 1 1 971929 6685570 7657499 2808690 247256629 116525905 133539414 2306853 1236940 1069913 4978 158946514 97228534 61722958 87606644 27967780 59638864 263628648 DONOR RESTRICTED ASSETS - LITTLER TRUST 21081634 UNCONSOLIDATED AFFILIATE 14624075 INSURANCE RECOVERABLES 4677086 UNAMORTIZED BOND DISCOUNTS AND ISSUE COSTS 3574648 REAL ESTATE INVESTMENT 1231005 CHARITABLE REMAINDER TRUST 762302 PARTNERSHIP INVESTMENTS 379996 DUE FROM AFFILIATES 732375 CASH SURRENDER VALUE OF LIFE INSURANCE 144599 OTHER RECEIVABLES 61481 47269201 DEFERRED COMPENSATION 9928190 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 28096371 MINIMUM PENSION LIABILITY 71954894 RESERVE FOR POST EMPLOYMENT BENEFITS 8836610 SWAP LIABILITY 4708883 WORKERS' COMPENSATION AND PROFESSIONAL LIABILITY 20859269 OTHER 6367270 150751487 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: MEMORIAL HOME SERVICES HAS ONE PERMANENTLY RESTRICTED ENDOWMENT FUND WITH INCOME TO BE USED FOR OPERATING EXPENSES. MEMORIAL MEDICAL CENTER FOUNDATION'S ENDOWMENT FUNDS CONSIST OF 30 INDIVIDUAL DONOR-RESTRICTED FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE FOUNDATION HAS A POLICY OF APPROPRIATING FOR DISTRIBUTION EASH YEAR 5% OF ITS ENDOWMENT FUND'S MOVING AVERAGE FAIR VALUE OVER THE PRIOR 36 MONTHS AS OF SEPTEMBER 30 OF THE PRECEEDING FISCAL YEAR IN WHICH THE DISTRIBUTION IS PLANNED. IN ESTABLISHING THIS POLICY, THE FOUNDATION CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENTS. ACCORDINGLY, OVER THE LONG TERM, THE FOUNDATION EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT AN AVERAGE OF THE LONG-TERM RATE OF INFLATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: EFFECTIVE OCTOBER 1, 2008, MEMORIAL HEALTH SYSTEM ADOPTED GUIDANCE PROVIDED BY THE RECOGNITION SUBSECTION OF THE INCOME TAXES TOPIC OF THE FASB ACCOUNTING STANDARDS CODIFICATION. THIS SUBTOPIC PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ADOPTION OF THIS GUIDANCE DID NOT HAVE AN IMPACT ON THE FY 11 CONSOLIDATED BALANCE SHEETS, CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS, AND CONSOLIDATED STATEMENTS OF CASH FLOWS. X X X 1 WOODBURN KYLE & COMPANY 400 EAST FIRST STREET MADISON IN 47250 CONSULTING ON FUNDRAISING 0 55324 36000 19324 55324 36000 19324 IL FESTIVAL OF TREES (MMCF) 471553 241140 230413 40665 12452 42277 550 100819 GOLF OUTING (ALHF) 29119 11182 17937 600 4600 4272 800 8 75291 21926 53365 0 10471 1678 9115 500 17230 575963 274248 301715 600 51136 18730 55664 1050 118849 246029 55686 EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) CONSULTING FEES FOR TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION 1 1 X 1 X 250.000000000000 1 X 750.000000000000 1 1 1 0 1 1 3 12444 17534958 0 17534958 0.02490 1 78507 78474067 65541840 12932227 0.01830 8 466 214034 425419 -211385 0.00000 12 91417 96223059 65967259 30255800 0.04320 71 16652 1284597 6470 1278127 0.00180 34 2747 23141475 4647278 18494197 0.02620 1 90 4258 4258 0.00000 5 273691 273691 0.00040 25 100 893492 893492 0.00130 136 19589 25597513 4653748 20943765 0.02970 148 111006 121820572 70621007 51199565 0.07290 16 7941 7941 0.00000 27 252625 252625 0.00040 7 1858 1858 0.00000 21 3926 3926 0.00000 15 20 2629 2629 0.00000 12466 12466 0.00000 4 219 63047 63047 0.00010 32900 32900 0.00000 90 239 377392 377392 0.00050 1 5391069 202111232 220981174 -18869942 X 1 1 3 1 MEMORIAL MEDICAL CENTER

701 NORTH FIRST STREET SPRINGFIELD IL 62781

X X X X X 9 ABRAHAM LINCOLN MEMORIAL HOSPITAL

200 STALHUT DRIVE LINCOLN IL 62656

X X X X 10 TAYLORVILLE MEMORIAL HOSPITAL

201 E PLEASANT TAYLORVILLE IL 62568

X X X X NOT REQUIRED 1 20 SPINEWORKS PAIN CLINIC

501 NORTH FIRST STREET SPRINGFIELD IL 62702

OUTPATIENT SERVICES KOKE MILL MEDICAL ASSOCIATES

3132 OLD JACKSONVILLE RD SPRINGFIELD IL 62704

MPS PHYSICIAN FAMILY MEDICAL CENTER OF LINCOLN

515 NORTH COLLEGE STREET LINCOLN IL 62526

MPS PHYSICIAN WOMEN'S HEALTHCARE

747 NORTH RUTLEDGE SPRINGFIELD IL 62701

MPS PHYSICIAN THE WOUND HEALING CENTER

901 NORTH FIRST STREET SPRINGFIELD IL 62702

OUTPATIENT SERVICES FAMILY MEDICAL CENTER OF CHATHAM

101 EAST PLUMMER CHATHAM IL 62629

MPS PHYSICIAN CAPITOL HEALTHCARE MEDICAL ASSOCIATES

2603 SOUTH SIXTH SPRINGFIELD IL 62703

MPS PHYSICIAN JACKSONVILLE FAMILY MEDICAL ASSOCIATES

1602 WEST LAFAYETTE JACKSONVILLE IL 62650

MPS PHYSICIAN JACKSONVILLE PEDIATRIC ASSOCIATES

1600 WEST WALNUT JACKSONVILLE IL 62650

MPS PHYSICIAN MEMORIAL EXPRESSCARE AT SOUTH SIXTH

2950 SOUTH SIXTH STREET SPRINGFIELD IL 62703

ANCILLARY SERVICES MEMORIAL INDUSTRIAL REHAB

775 ENGINERING DRIVE SPRINGFIELD IL 62703

OUTPATIENT SERVICES MEMORIAL EXPRESSCARE AT KOKE MILL

3132 OLD JACKSONVILLE RD SPRINGFIELD IL 62704

ANCILLARY SERVICES MEMORIAL EXPRESSCARE AT NORTH DIRKSEN

3220 ATLANTA STREET SPRINGFIELD IL 62702

ANCILLARY SERVICES MENARD MEDICAL CENTER

1 CENTRE DRIVE PETERSBURG IL 62675

OUTPATIENT SERVICES JACKSONVILLE FAMILY PRATICE

800 WEST STATE STREET JACKSONVILLE IL 62650

MPS PHYSICIAN NORTH DIRKSEN MEDICAL ASSOCIATES

3220 ATLANTA STREET SPRINGFIELD IL 62707

MPS PHYSICIAN BENJAMIN MONTGOMERY MD

1606 WEST LAFAYETTE JACKSONVILLE IL 62650

MPS PHYSICIAN SOUTH SIXTH MEDICAL ASSOCIATES

2950 SOUTH SIXTH STREET SPRINGFIELD IL 62703

MPS PHYSICIAN DAVID COULTAS MD

1606 WEST LAFAYETTE JACKSONVILLE IL 62650

MPS PHYSICIAN MICHELLE COLEN MD

800 WEST STATE STREET JACKSONVILLE IL 62650

MPS PHYSICIAN PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON THE WEBSITES OF ALL THREE MEMORIAL HEALTH SYSTEM HOSPITALS, AS WELL AS ITS AFFILIATE WEBSITES. PART I, LINE 7: THE COSTING METHODOLOGY FOR CHARITY CARE, MEDICAID, AND OTHER MEANS TESTED PROGRAMS WAS DERIVED FROM EACH HOSPITAL'S COST ACCOUNTING SYSTEM. THIS SYSTEM HAS THE ABILITY TO COMPUTE THE ACTUAL COST OF ALL MEDICAL PROCEDURES AT THE PATIENT-ACCOUNT LEVEL REGARDLESS OF PAYOR TYPE OR WHETHER THE PATIENT WAS INPATIENT OR OUTPATIENT. THE ONLY CATEGORY BY WHICH A COST TO CHARGE RATIO WAS UTILIZED FOR SCHEDULE H IS FOR THE DETERMINATION OF BAD DEBT EXPENSE AT COST IN PART III, SECTION A, LINE 2. PART II: COMMUNITY BUILDING ACTIVITIESMEMORIAL MEDICAL CENTER PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THAT ARE NOT ACCOUNTED FOR ELSEWHERE ON SCHEDULE H. IT SUPPORTS THE UNITED WAY OF CENTRAL ILLINOIS, WHICH, FOLLOWING AN EXTENSIVE COMMUNITY NEED ASSESSMENT, IS CREATING A CONTINUUM OF LEARNING FROM BIRTH THROUGH YOUNG ADULT. UNITED WAY ALSO FUNDS CRITICAL SERVICES SUCH AS ACCESS TO FOOD, SHELTER, HEALTHCARE AND VICTIM SERVICES.MEMORIAL MEDICAL CENTER SUPPORTS ECONOMIC DEVELOPMENT THROUGH THE MID-ILLINOIS MEDICAL DISTRICT AS WELL AS THE SPRINGFIELD CHAMBER OF COMMERCE'S QUANTUM GROWTH PARTNERSHIP, WHICH HAS A STRATEGIC PLAN TO IMPROVE THE LOCAL ECONOMY. AS THE LARGEST LOCAL EMPLOYER OUTSIDE OF STATE GOVERNMENT, MEMORIAL MEDICAL CENTER IS AN IMPORTANT ECONOMIC LINK THAT PROVIDES EMPLOYMENT AND BENEFITS FOR THOUSANDS OF FAMILIES. WORKFORCE DEVELOPMENT IS A KEY AREA OF INVOLVEMENT AS MEMORIAL MEDICAL CENTER COLLABORATES WITH OTHERS TO EXPAND OPPORTUNITIES TO TRAIN AND RECRUIT HEALTHCARE PROFESSIONALS TO EXPAND ACCESS IN RURAL AREAS.LEADERS FROM MEMORIAL MEDICAL CENTER ALSO VOLUNTEER ON A WIDE RANGE OF LOCAL NONPROFIT BOARDS SUCH AS THE UNITED WAY, HELPING HANDS HOMELESS SHELTER, SPRINGFIELD URBAN LEAGUE, CENTRAL ILLINOIS FOOD BANK, SANGAMON COUNTY CONTINUUM OF LEARNING, GIRL SCOUTS OF CENTRAL ILLINOIS, MID-ILLINOIS MEDICAL DISTRICT AT SPRINGFIELD, SPRINGFIELD YMCA, AND THE GREATER SPRINGFIELD CHAMBER OF COMMERCE. MEMORIAL MEDICAL CENTER ALSO SUPPORTS THE FUNDRAISING ACTIVITIES OF SUCH ORGANIZATIONS AS THE SPRINGFIELD URBAN LEAGUE, CENTRAL ILLINOIS FOOD BANK, YMCA, LOCAL AMERICAN CANCER SOCIETY, LOCAL AMERICAN HEART ASSOCIATION, SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINES SIMMONS CANCER INSTITUTE, UNITED WAY AND OTHERS. MMC ALSO COLLABORATES WITH LOCAL SCHOOLS TO OFFER MULTIPLE OPPORTUNITIES FOR STUDENTS TO EXPLORE HEALTHCARE CAREER OPTIONS. AS ONE OF THE LARGEST EMPLOYERS IN LOGAN COUNTY, ABRAHAM LINCOLN MEMORIAL HOSPITAL(ALMH) IS AN IMPORTANT ECONOMIC LINK THAT PROVIDES EMPLOYMENT AND BENEFITS FOR 280 FAMILIES. ALMH AND ABRAHAM LINCOLN HEALTHCARE FOUNDATION (ALHF) FINANCIALLY CONTRIBUTE TO THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, LINCOLN ART & BALLOON FESTIVAL AND THE LOGAN COUNTY FOOD BANK. SUPPORT IS ALSO PROVIDED FOR THE LOCAL MULTIPLE SCLEROSIS WALK AND THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE. ALMH IS A MEMBER OF THE LINCOLN/LOGAN COUNTY CHAMBER OF COMMERCE AND THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, WHICH ARE ACTIVELY WORKING TO IMPROVE THE ECONOMIC VITALITY OF LOGAN COUNTY. AN ALMH TEAM MEMBER SITS ON EACH OF THESE BOARDS. ALMH ALSO PROVIDED IN-KIND SUPPORT IN THE FORM OF MEETING SPACE FOR THE CHAMBER'S LEADERSHIP ACADEMY. THIS 8-WEEK PROGRAM PREPARES COMMUNITY MEMBERS FOR COMMUNITY LEADERSHIP ROLES. ABRAHAM LINCOLN MEMORIAL HOSPITAL'S COMMUNITY BUILDING ACTIVITIES INCLUDE STAFF WHO VOLUNTEER FOR LEADERSHIP ON LOCAL NONPROFIT BOARDS FOR ORGANIZATIONS THAT IMPACT THE HEALTH AND QUALITY OF LIFE FOR OUR COMMUNITY. AMONG THESE ARE THE LINCOLN/LOGAN COUNTY CHAMBER OF COMMERCE, THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, THE LINCOLN ART & BALLOON FESTIVAL, TOGETHER FOR LINCOLN, LINCOLN ROTARY CLUB, ZONTA, LOGAN COUNTY BOARD OF HEALTH, UNITED WAY OF LOGAN COUNTY, LOGAN COUNTY FOOD BANK, LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE, COMMUNITY CHILD CARE CONNECTION, COMMUNITY & CHILDREN'S HEALTH FAIR PLANNING COMMITTEE, 'FROM THE GROUND UP' COMMUNITY BEAUTIFICATION TEAM, APEX AT CITY CENTER TASK FORCE, CAPCIL (COMMUNITY ACTION OF CENTRAL ILLINOIS) HEALTH ADVISORY COMMITTEE, PROFESSIONAL CONSULTATION COMMITTEE FOR CLINICAL PASTORAL EDUCATION, LEPC (LOCAL EMERGENCY PLANNING COMMITTEE). TAYLORVILLE MEMORIAL HOSPITAL COMMUNITY BUILDING ACTIVITIES INCLUDE STAFF WHO VOLUNTEER FOR LEADERSHIP ON LOCAL NONPROFIT BOARDS FOR ORGANIZATIONS THAT IMPACT THE HEALTH AND QUALITY OF LIFE FOR OUR COMMUNITY. AMONG THESE ARE THE UNITED WAY OF CHRISTIAN COUNTY, CHRISTIAN COUNTY YMCA, TAYLORVILLE SERTOMA CLUB, AMERICAN CANCER SOCIETY RELAY FOR LIFE OF CHRISTIAN COUNTY, CHRISTIAN COUNTY ECONOMIC DEVELOPMENT CORPORATION AND TAYLORVILLE DEVELOPMENT ASSOCIATION. PART III, LINE 4: MEMORIAL MEDICAL CENTER'S BAD DEBT EXPENSE AT COST WAS DETERMINED BY COMPUTING A COST TO CHARGE RATIO AND APPLYING THIS RATIO AGAINST BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED 9/30/2011.THE COST TO CHARGE RATIO WAS CALCULATED AS FOLLOWS:TOTAL OPERATING EXPENSES PER AUDITED FINANCIAL STMTS $555,332,384LESS:OTHER OPERATING REVENUE (BEFORE CAPITATION ADJ) (14,577,240)PURCHASED MEDICAL SERVICES CAPITATION (35,516,824)HOSPITAL PROVIDER ASSESSMENT (11,366,455)BAD DEBT EXPENSE (13,379,150)ADJUSTED OPERATING EXPENSES $480,492,715GROSS PATIENT SERVICE REVENUE (BEFORE CAPITATION) $1,537,050,557RATIO OF COST TO CHARGES FOR BAD DEBT COSTING 31.3%ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL USED THE METHOD PRESCRIBED IN WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS.FOOTNOTE 2 OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MEMORIAL HEALTH SYSTEM CONTAINS A SPECIFIC FOOTNOTE RELATING TO BAD DEBT EXPENSE, AS FOLLOWS:THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED AMOUNTS TO BE COLLECTED, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING. THIS REVIEW TAKES INTO CONSIDERATION RECENT WRITE OFF EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHER FACTORS. THE RESULTS OF THIS EVALUATION IS USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, MEMORIAL HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.THE HOSPITALS OF MEMORIAL HEALTH SYSTEM DO NOT INCLUDE BAD DEBT AMOUNTS IN COMMUNITY BENEFIT. PART III, LINE 8: THE COSTING METHODOLOGY UTILIZED FOR THE DETERMINATION OF MEMORIAL MEDICAL CENTER'S MEDICARE ALLOWABLE COST (SCHEDULE H, PART III, LINE 6) WAS CALCULATED AS FOLLOWS:MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL UTILIZED MEDICARE COSTING DATA FROM THE FISCAL YEAR ENDED 9/30/2011 MEDICARE COST REPORT AS FILED. MEMORIAL MEDICAL CENTER WAS ABLE TO CAPTURE THE MEDICARE COSTING FOR INPATIENT MEDICAL SURGICAL, INPATIENT PSYCHIATRIC, INPATIENT REHABILITATION, AND OUTPATIENT MEDICAL SURGICAL SERVICES DURING THAT FISCAL PERIOD. THIS COSTING DATA EXCLUDED THE DIRECT MEDICAL EDUCATION COST FOR THE RESIDENCY PROGRAM ASSOCIATED WITH THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. THIS COST WAS INCLUDED IN THE HEALTH PROFESSIONS EDUCATION SECTION OF PART I, LINE 7 (F) OF SCHEDULE H.OTHER SECTIONS OF MEDICARE COST THAT WOULD NORMALLY BE EXCLUDED FROM THE MEDICARE COST REPORT BUT SHOULD BE INCLUDED FOR PURPOSES OF THIS SCHEDULE ARE THE FOLLOWING:1. MEMORIAL MEDICAL CENTER'S ESRD PROGRAM - THIS PROGRAM RELATED TO THE END-STAGE RENAL DIALYSIS PROGRAM. THE PROGRAM IS REFLECTED ON THE W/S I OF THE COST REPORT BUT DOES NOT HAVE A SETTLEMENT. 2. MEMORIAL MEDICAL CENTER'S OUTPATIENT CLINICAL LAB CHARGES - THESE MEDICARE OUTPATIENT CHARGES ARE PAID ON A FEE-FOR-SERVICE BASIS AND ARE NOT REFLECTED ON THE AS FILED MEDICARE COST REPORT. 3. MEMORIAL MEDICAL CENTER'S OUTPATIENT THERAPY SERVICES - THESE MEDICARE OUTPATIENT CHARGES RELATED TO THERAPEUTIC SERVICES, SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY SERVICES, ARE SUBJECT TO A FEE-FOR-SERVICE PAYMENT METHOD AND NOT FILED ON THE MEDICARE COST REPORT.4. PART B PROFESSIONAL FEES - MEMORIAL MEDICAL CENTER HAS ITS PART B MEDICARE PROFESSIONAL FEES BILLED THROUGH A SEPARATE CORPORATION OF MEMORIAL HEALTH SYSTEM. THE BILLING SERVICE IS CALLED PHYSICIAN BILLING SERVICE. IT BILLS FOR THE PROFESSIONAL FEES ON BEHALF OF MEMORIAL MEDICAL CENTER AND SWEEPS THE MEDICARE PAYMENTS BACK TO IT. SOME OF THE PROFESSIONAL FEES BILLED BY PHYSICIAN BILLING SERVICE ARE CRNA, HEARING CENTER, SPINEWORKS CLINIC, HEART FAILURE CLINIC, CLINICAL PSYCHOLOGISTS, DIETARY CONSULTING, BARIATRIC SURGERY AND EKG INTERPRETATIONS. THESE SERVICES ARE TYPICALLY EXCLUDED FROM THE MEDICARE COST REPORT BUT SHOULD BE INCLUDED FOR PURPOSE OF SCHEDULE H.THE MEDICARE CHARGES ASSOCIATED WITH BULLET POINTS 1 THROUGH 4 ABOVE WERE APPLIED TO THE CALCULATED COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT TO DETERMINE ITS COST. THIS COST DATA, ALONG WITH THE COST DATA ALREADY COMPILED FROM THE AS FILED MEDICARE COST REPORT WAS THE BASIS FOR THE ALLOWABLE MEDICARE COST OF $192,483,728. THE TOTAL SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 WAS $18,869,942. THE ENTIRE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT FOR MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL. THIS SHORTFALL REFLECTS THE EXCESS COSTS INCURRED BY MEMORIAL MEDICAL CENTER THAT CURRENT FEE-FOR-SERVICE PAYMENTS PRESENTLY DO NOT COVER. THESE ARE VITAL SERVICES TO THE COMMUNITY THESE THREE HOSPITALS SERVE THAT CURRENT MEDICARE PAYMENTS DO NOT COVER.IN THE COMMUNITY THAT MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLOVILLE MEMORIAL HOSPITAL SERVE, MEDICARE IS AN IMPORTANT PAYOR. ACCORDINGLY, ALL THREE HOSPITALS ACCEPT MEDICARE PATIENTS REGARDLESS OF WHETHER THEIR TREATMENTS WILL RESULT IN A SURPLUS OR DEFICIT TO THE HOSPITAL. BY PROVIDING THESE SERVICES TO MEDICARE PATIENTS, THE MHS HOSPITALS PROMOTE ACCESS TO HEALTH CARE AND PROVIDE A COMMUNITY BENEFIT. ADDITIONALLY, THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS AND THE U.S. GOVERNMENT WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY. ACCORDINGLY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE LESSENED THE BURDENS OF GOVERNMENT BY PROVIDING SERVICES TO THIS AT-RISK POPULATION. PART III, LINE 9B: MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL PROACTIVELY INFORM PATIENTS OF THEIR CHARITY CARE AND UNINSURED DISCOUNT ASSISTANCE AND THE ELIGIBILITY CRITERIA, WHICH EXTENDS UP TO 750% OF FEDERAL POVERTY GUIDELINES. A FINANCIAL ASSISTANCE/BILLING LINK ON EACH HOSPITAL WEBSITE GOES TO BILLING INFORMATION WHICH INCLUDES A LINK TO THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM INFORMATION AND APPLICATION. THE APPLICATION FORM IS AVAILABLE IN SPANISH AS WELL AS ENGLISH. FOREIGN LANGUAGE TRANSLATION ASSISTANCE IS AVAILABLE UPON REQUEST. INFORMATION ON THE AVAILABILITY OF CHARITY CARE AND UNINSURED DISCOUNT ASSISTANCE IS POSTED AT ALL PATIENT REGISTRATION POINTS, INCLUDING THE EMERGENCY DEPARTMENT. THE "PEACE OF MIND REGARDING PAYMENT" BROCHURE IS OFFERED TO EVERY PATIENT AT EVERY VISIT AND IS AVAILABLE IN SPANISH. EMPLOYEES IN PATIENT REGISTRATION, PATIENT FINANCIAL SERVICES AND SOCIAL SERVICES ARE TRAINED TO UNDERSTAND THE CHARITY CARE POLICY AND KNOW HOW TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVE. HOSPITAL STAFF WHO REGULARLY INTERACT WITH PATIENTS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY. IF NECESSARY, THEY ARE ABLE TO DIRECT PATIENT QUESTIONS REGARDING THE POLICY TO A KNOWLEDGEABLE HOSPITAL REPRESENTATIVE WHO IS ALSO ABLE TO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID OR OTHER STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. EACH HOSPITAL EMPLOYS PATIENT FINANCIAL COUNSELORS WHOSE JOB IS TO VISIT ALL INPATIENTS WHO ARE IDENTIFIED AS SELF-PAY WITHIN 24 HOURS OF ADMISSION. THE FINANCIAL COUNSELORS PROVIDE INFORMATION ON CHARITY CARE AND UNINSURED DISCOUNTS AND, IF THE PATIENT HAS APPROPRIATE INFORMATION, COMPLETE THE CHARITY CARE APPLICATION ON THE SPOT. ANY SELF-PAY INPATIENT WHO MAY HAVE BEEN DISCHARGED WITHOUT A VISIT FROM THE FINANCIAL COUNSELOR RECEIVES A FOLLOW-UP PHONE CALL OR CHARITY CARE APPLICATION PACKET IN THE MAIL. IF INPATIENTS ARE IDENTIFIED AS BEING ELIGIBLE FOR MEDICAID OR OTHER GOVERNMENT BENEFITS, THIS APPLICATION PROCESS IS ALSO IMMEDIATELY STARTED WHILE THEY ARE PATIENTS. MEMORIAL MEDICAL CENTER EMPLOYS A FULL-TIME MEDICAID COORDINATOR WHO CONTINUES WORKING WITH PATIENTS POST-DISCHARGE TO WALK THEM THROUGH THE ENTIRE APPLICATION PROCESS. EVERY HOSPITAL BILLING STATEMENT INCLUDES FINANCIAL ASSISTANCE INFORMATION WITH A PHONE NUMBER TO CALL FOR INFORMATION. PATIENTS ARE ENCOURAGED TO INQUIRE ABOUT FINANCIAL ASSISTANCE AT ANY STAGE OF THE BILLING PROCESS.THE MHS HOSPITALS STRIVE TO HAVE A CONSISTENT AND COURTEOUS APPROACH TO COLLECTIONS. MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL OFFER FINANCIAL COUNSELING AND SCREENING TO PATIENTS TO ENSURE THAT ANY OTHER POTENTIAL THIRD PARTY COVERAGE UNDER OTHER GOVERNMENT PROGRAMS SUCH AS MEDICAID CAN BE IDENTIFIED. MEMORIAL MEDICAL CENTER WILL NOT REFER ACCOUNTS TO A COLLECTION AGENCY, FILE ANY LAWSUIT, OR GARNISH WAGES AGAINST ANY PARTICULAR PATIENT TO COLLECT MEDICAL DEBT UNTIL MMC VERIFIES THE FOLLOWING: REASONABLE BASIS FOR BELIEVING PATIENT OWES THE DEBT; MMC WILL MAKE ALL REASONABLE ATTEMPTS TO BILL THIRD PARTY PAYERS AND CONFIRM ANY REMAINING AMOUNTS ARE TRULY THE FINANCIAL RESPONSIBILITY OF THE PATIENT; WHEN THE PATIENT HAS INDICATED AN INABILITY TO PAY (MMC WILL VERIFY THE INABILITY TO PAY) AND MMC WILL OFFER A REASONABLE PAYMENT PLAN AND; THE PATIENT HAS BEEN GIVEN A REASONABLE OPPORTUNITY TO SUBMIT AN APPLICATION FOR CHARITY CARE. ALL HOSPITALS HAVE A CODE OF CONDUCT POLICY THAT SETS FORTH CERTAIN PRINCIPLES TO WHICH AGENCIES, REPRESENTATIVES AND COLLECTORS ARE EXPECTED TO ADHERE. THE AGENCIES ARE REQUIRED TO COMPLY WITH ALL OF THE RELEVANT TERMS OF THE FAIR PATIENT BILLING ACT, AND, IN PARTICULAR, SECTION 30(C) WHICH ENUMERATES CERTAIN PREREQUISITE CONDITIONS WHICH MUST BE SATISFIED BEFORE AN AGENCY CAN INITIATE ANY LEGAL ACTION AGAINST A PATIENT WHICH IS RELATED TO A FAILURE BY THAT PATIENT TO PAY A HOSPITAL BILL. THE AGENCIES ARE ALSO REQUIRED TO COMPLY WITH ALL OF THE RELEVANT TERMS OF THE ACA INTERNATIONAL CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY.ONCE A CHARITY CARE DETERMINATION IS MADE, ALL COLLECTION EFFORTS CEASE. IF AN ACCOUNT IS AT A COLLECTION AGENCY, THE ACCOUNT IS RETURNED BACK TO THE HOSPITAL FOR CHARITY PROCESSING.ALL PATIENT COMPLAINTS REGARDING DISSATISFACTION WITH SERVICES RENDERED OR BILLING ISSUES ARE HANDLED PROMPTLY AND IN A COURTEOUS MANNER TO ENSURE THAT CUSTOMER SERVICE REMAINS THE FOCUS OF ANY PATIENT CONCERN. ALL COMPLAINTS ARE CONSIDERED VALID AND PATIENT FEEDBACK IS WELCOME WITH RESPECT TO DISPUTED MATTERS. PART VI, LINE 2: NEEDS ASSESSMENTTHE MISSION OF MEMORIAL HEALTH SYSTEM IS TO HELP MAINTAIN, RESTORE AND IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. THE COMMUNITY BENEFIT COMMITTEE OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSEEING AND MAKING RECOMMENDATIONS WITH RESPECT TO ALL FORMS OF BENEFIT PROVIDED BY MHS AND ITS AFFILIATES, INCLUDING OUR CHARITY CARE POLICY AND PERFORMANCE. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS FOR THE THREE MHS HOSPITALS: MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL. THE COMMITTEE ALSO APPROVES THE ANNUAL COMMUNITY BENEFIT POLICY AND COMMUNITY NEEDS ASSESSMENT AND RECOMMENDS TO THE BOARD THE ANNUAL COMMUNITY BENEFIT PLAN AND BUDGET. THE COMMITTEE MEETS QUARTERLY TO RECEIVE UPDATES ON THE COMMUNITY BENEFIT PROGRAMS AND ANNUALLY RATES THE SUCCESS IN MEETING THE COMMUNITY BENEFIT PLAN'S GOALS.MEMORIAL HEALTH SYSTEM PARTICIPATES IN NUMEROUS NEED ASSESSMENTS CONDUCTED BY LOCAL AGENCIES IN SANGAMON, LOGAN AND CHRISTIAN COUNTIES. THESE INCLUDE THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH'S "ILLINOIS PROJECT FOR LOCAL ASSESSMENTS OF NEEDS"(IPLAN) FOR LOCAL PUBLIC HEALTH DEPARTMENTS IN SANGAMON, LOGAN AND CHRISTIAN COUNTIES. MHS HAS PARTICIPATED IN ADDITIONAL NEED ASSESSMENTS CONDUCTED BY LOCAL UNITED WAYS, LOGAN COUNTY HEALTHY COMMUNITIES PARTNERSHIP, THE SANGAMON COUNTY MEDICAL SOCIETY, SANGAMON COUNTY COMMUNITY HEALTH INITIATIVE, LOCAL CHAMBERS OF COMMERCE, YMCAS AND OTHERS. ADDITIONAL INFORMATION TO ASSESS NEED COMES FROM HOSPITAL ADMISSIONS AND DISCHARGES, LEADING CAUSES OF MORTALITY AND MORBIDITY IN EACH COUNTY AS REPORTED BY THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH, AND THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTHY PEOPLE 2020. INFORMATION FROM ALL THESE SOURCES IS USED TO PRIORITIZE MHS'S COMMUNITY BENEFIT INITIATIVES, AND TO ASSURE THAT THOSE INITIATIVES ARE ALIGNED WITH MHS'S MISSION, STATEMENT OF VALUES, STRATEGIC PLAN AND BUDGET. PRIORITIES ARE ESTABLISHED BASED ON OVERALL NEED, LEADING CAUSES OF DEATH, IMPACT ON HEALTH STATUS, ORGANIZATIONAL CORE COMPETENCIES, RESOURCES AND WHEREWITHAL TO MEANINGFULLY ADDRESS THE NEED. EACH MEMORIAL AFFILIATE HAS THE FLEXIBILITY TO DEVELOP SPECIFIC COMMUNITY BENEFIT PROGRAMS AND INITIATIVES THAT ARE DESIGNED TO RESPOND TO THE NEEDS OF ITS PARTICULAR COMMUNITY. MEMORIAL HEALTH SYSTEM UNDERSTANDS THAT COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS IS AN IMPORTANT COMPONENT OF COMMUNITY HEALTH IMPROVEMENT EFFORTS AND RESPONDS TO DIRECT COMMUNITY REQUESTS FOR PROGRAMS AND ASSISTANCE.PRIORITY FOCUS AREAS FOR FY2011 COMMUNITY BENEFIT PROGRAMS WERE (1) IMPROVING ACCESS TO CARE, (2) INCREASING PUBLIC AWARENESS OF RISK FACTORS ASSOCIATED WITH CORONARY ARTERY DISEASE, (3) INCREASING PUBLIC AWARENESS OF RISK FACTORS ASSOCIATED WITH CANCER, (4) EXECUTING OTHER COMMUNITY BENEFIT PROGRAMS TO MEET DEFINED COMMUNITY NEEDS, IN COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS WHEN POSSIBLE, AND (5) PREPARING TO CONDUCT A COMMUNITY HEALTH NEED ASSESSMENT TO BE COMPLETED IN FY12 THAT MEETS THE GUIDELINES OF THE SECTION 9007 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE REQUIREMENTS OF IRS NOTICE 2011-52. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEMEMORIAL HEALTH SYSTEM HOSPITALS RECOGNIZE THAT THERE ARE UNFORTUNATE OCCASIONS WHEN PATIENTS ARE NOT FINANCIALLY ABLE TO PAY FOR THEIR MEDICAL CARE, AND ARE NOT ELIGIBLE FOR FEDERAL OR STATE MEDICAL ASSISTANCE PROGRAMS. SINCE THE PROVISION OF CARE IS NOT DEPENDENT ON THE PATIENT'S ABILITY TO PAY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE ESTABLISHED GUIDELINES IN WHICH A PATIENT MAY APPLY AND QUALIFY FOR CHARITY CARE ASSISTANCE. IT IS IMPORTANT THAT CHARITY CARE APPLICANTS COOPERATE WITH THE HOSPITAL'S NEED FOR ACCURATE AND DETAILED INFORMATION WITHIN A REASONABLE TIMEFRAME. IN THE ABSENCE OF A COMPLETED CHARITY APPLICATION, CHARITY MAY BE CONSIDERED WHEN SUPPORTED BY OTHER COLLABORATING CREDIT INFORMATION. IN CASES WHERE THE PATIENT DOES NOT PROVIDE INFORMATION FOR CHARITY CARE, MMC, ALMH AND TMH UTILIZE AN OUTSIDE TOOL FROM TRANSUNION CREDIT BUREAU TO EVALUATE THE PATIENT'S FINANCIAL STATUS AND CREDIT WORTHINESS. NOT ONLY DOES TRANSUNION SUPPLY THE USER WITH A CREDIT REPORT, BUT IT PROVIDES OTHER HELPFUL INFORMATION INCLUDING ESTIMATED MONTHLY INCOME AND ONE'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN CASES WHERE REPORTS COME BACK INDICATING THAT THE PATIENT MEETS THE HOSPITAL'S CHARITY DEFINITION, THE PATIENT WILL BE GRANTED CHARITY. THIS IS TO PREVENT QUALIFYING CHARITY PATIENTS WHO DO NOT COMPLETE A CHARITY APPLICATION FROM BEING TURNED OVER FOR COLLECTIONS. PART VI, LINE 4: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEMEMORIAL HEALTH SYSTEM HOSPITALS RECOGNIZE THAT THERE ARE UNFORTUNATE OCCASIONS WHEN PATIENTS ARE NOT FINANCIALLY ABLE TO PAY FOR THEIR MEDICAL CARE, AND ARE NOT ELIGIBLE FOR FEDERAL OR STATE MEDICAL ASSISTANCE PROGRAMS. SINCE THE PROVISION OF CARE IS NOT DEPENDENT ON THE PATIENT'S ABILITY TO PAY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE ESTABLISHED GUIDELINES IN WHICH A PATIENT MAY APPLY AND QUALIFY FOR CHARITY CARE ASSISTANCE. IT IS IMPORTANT THAT CHARITY CARE APPLICANTS COOPERATE WITH THE HOSPITAL'S NEED FOR ACCURATE AND DETAILED INFORMATION WITHIN A REASONABLE TIMEFRAME. IN THE ABSENCE OF A COMPLETED CHARITY APPLICATION, CHARITY MAY BE CONSIDERED WHEN SUPPORTED BY OTHER COLLABORATING CREDIT INFORMATION. IN CASES WHERE THE PATIENT DOES NOT PROVIDE INFORMATION FOR CHARITY CARE, MMC, ALMH AND TMH UTILIZE AN OUTSIDE TOOL FROM TRANSUNION CREDIT BUREAU TO EVALUATE THE PATIENT'S FINANCIAL STATUS AND CREDIT WORTHINESS. NOT ONLY DOES TRANSUNION SUPPLY THE USER WITH A CREDIT REPORT, BUT IT PROVIDES OTHER HELPFUL INFORMATION INCLUDING ESTIMATED MONTHLY INCOME AND ONE'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN CASES WHERE REPORTS COME BACK INDICATING THAT THE PATIENT MEETS THE HOSPITAL'S CHARITY DEFINITION, THE PATIENT WILL BE GRANTED CHARITY. THIS IS TO PREVENT QUALIFYING CHARITY PATIENTS WHO DO NOT COMPLETE A CHARITY APPLICATION FROM BEING TURNED OVER FOR COLLECTIONS. PART VI, LINE 6: EACH OF THE HOSPITAL'S BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS WHO RESIDE IN THAT HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE IN THEIR OVERSIGHT ROLE AND ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, FUNDRAISING, AND GENERAL STEWARDSHIP. MORE THAN 500 PEOPLE VOLUNTEER AT THE THREE HOSPITALS AS ESCORTS, WAITING ROOM HOSTS AND HOSTESSES AND A WIDE RANGE OF OTHER VOLUNTEER ROLES.ALL MHS HOSPITALS HAVE OPEN MEDICAL STAFFS THAT ALLOW MEMBERSHIP TO ANYONE WHO MEETS CREDENTIALING REQUIREMENTS. ALL THREE HOSPITALS PARTICIPATE IN MEDICARE, MEDICAID, CHAMPUS, TRICARE AND OTHER GOVERNMENT PROGRAMS AND ARE DISPROPORTIONATE SHARE MEDICAID HOSPITALS THAT PROVIDE FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS ACCORDING TO BOARD-APPROVED CHARITY CARE POLICIES. MEMORIAL MEDICAL CENTER SERVES AS THE REGIONAL BURN CENTER, SERVING ACUTELY BURNED PATIENTS FROM CENTRAL AND SOUTHERN ILLINOIS, AND IS THE REGIONAL REHABILITATION PROVIDER FOR SPINAL CORD INJURIES, CLOSED HEAD INJURIES, STROKES AND COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION.MEMORIAL MEDICAL CENTER MAINTAINS A 24-HOUR EMERGENCY DEPARTMENT THAT IS PART OF THE SOUTHERN ILLINOIS (LEVEL 1) TRAUMA CENTER. THE EMERGENCY DEPARTMENT HAS TRADITIONALLY SERVED AS A SAFETY NET HEALTHCARE PROVIDER FOR THE UNINSURED AND UNDERINSURED WHO DO NOT HAVE PRIMARY CARE PHYSICIANS. IT PROVIDES SERVICES TO ALL PEOPLE REGARDLESS OF ABILITY TO PAY. TO HELP MEET COMMUNITY NEED AND ALLEVIATE USE OF THE EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE, MHS OPERATES THREE EXPRESSCARE WALK-IN FACILITIES. THESE PROMPT-CARE SITES USE THE SAME CRITERIA FOR PATIENTS AS THE EMERGENCY DEPARTMENT: THE UNINSURED AND THOSE ON PUBLIC INSURANCE PROGRAMS RECEIVE THE SAME LEVEL OF CARE AND TREATMENT AS ANY OTHER PATIENTS. CHARITY CARE IS PROVIDED AS NEEDED.MEMORIAL MEDICAL CENTER COLLABORATES WITH COMMUNITY PROVIDERS TO SERVE THE LOW INCOME AND UNINSURED POPULATION. MMC PROVIDES DIAGNOSTIC, OUTPATIENT AND INPATIENT SERVICES FOR PATIENTS OF CENTRAL COUNTIES HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER THAT MEMORIAL MEDICAL CENTER WAS INSTRUMENTAL IN STARTING. MMC ALSO PROVIDES FREE AND REDUCED-COST INPATIENT AND OUTPATIENT SERVICES TO PATIENTS OF SOUTHERN ILLINOIS UNIVERSITY CENTER FOR FAMILY MEDICINE, A PRIMARY CARE MEDICAL GROUP THAT SERVES LOW INCOME MEDICAID AND MEDICARE POPULATIONS. MMC ALSO PROVIDES OPERATING EXPENSES FOR COORDINATED ACCESS TO COMMUNITY HEALTH (CATCH), A PROGRAM THAT IS INCREASING ACCESS TO CARE, PARTICULARLY PHYSICIAN SPECIALISTS, FOR UNINSURED ADULTS IN SANGAMON COUNTY. MMC PROVIDES CHARITY CARE FOR CATCH PATIENTS. MMC UTILIZES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. DURING FY11 MMC USED SURPLUS FUNDS TO EXPAND THE EMERGENCY DEPARTMENT BY EIGHT ROOMS TO MEET GROWING COMMUNITY NEED FOR ADDITIONAL ACCESS TO SERVICES. DURING THE PAST YEAR MMC'S REGIONAL CANCER CENTER MADE SEVERAL SIGNIFICANT RENOVATIONS,ADDING TWO NEW LINEAR ACCELERATORS TO ITS RADIATION THERAPY DEPARTMENT, DELIVERING HIGHER DOSES OF RADIATION MORE PRECISELY AND QUICKLY, REDUCING SIDE EFFECTS AND LONG-TERM COMPLICATIONS FOR CANCER PATIENTS. IT ALSO OPENED A NEW INFUSION SERVICES DEPARTMENT THAT IS DOUBLE THE SIZE OF THE PREVIOUS UNIT, OFFERING CHEMOTHERAPY AND OTHER INFUSION SERVICES TO ABOUT 1,000 PATIENTS ANNUALLY. IN FY11 MMC ALSO RENOVATED ITS OUTPATIENT IMAGING CENTER, IMPROVING ACCESS TO CARE AS WELL AS PATIENT SAFETY, PRIVACY AND COMFORT FOR MORE THAN 26,000 PATIENTS ANNUALLY, MANY WHO TRAVEL 60-75 MILES TO GET THESE SERVICES AT MMC. SURPLUS FUNDS ARE ALSO DEVOTED TO MEMORIAL'S COMMITMENT TO MEDICAL EDUCATION. MEMORIAL MEDICAL CENTER SERVES AS A TEACHING HOSPITAL FOR SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. MMC AND ALMH ALSO SERVE AS CLINICAL TRAINING SITES FOR MULTIPLE NURSING SCHOOLS AND OTHER UNIVERSITY AND COLLEGE HEALTH PROFESSIONAL TRAINING PROGRAMS IN THE REGION. THESE INCLUDE RADIOLOGY AND PHARMACY TECHNICIANS, CERTIFIED REGISTERED NURSE ANESTHESIOLOGISTS, CLINICAL LABORATORY SCIENTISTS, SPEECH PATHOLOGISTS, PHYSICAL AND OCCUPATIONAL THERAPISTS AND OTHERS. MMC ALSO SUPPORTS CLINICAL RESEARCH AND OFFERS NUMEROUS CANCER TRIALS THROUGH THE CENTRAL ILLINOIS COMMUNITY CLINICAL ONCOLOGY PROGRAM, WHICH RECEIVES SUPPORT FROM THE NATIONAL CANCER INSTITUTE. MORE THAN 450 RESEARCH PROJECTS AND PROTOCOLS ARE OPEN AT ANY GIVEN TIME. MMC PROVIDES FUNDING AND SUPPORT FOR THE SPRINGFIELD COMMITTEE ON RESEARCH IN HUMAN SUBJECTS, THE LOCAL INSTITUTIONAL REVIEW BOARD FOR CLINICAL RESEARCH TRIALS IN SPRINGFIELD.MMC, ALMH, AND TMH SURPLUS FUNDS ALSO PROVIDE SERVICES AND EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITIES WE SERVE THROUGH: EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON A WIDE RANGE OF WELLNESS TOPICS; FREE AND LOW-COST HEALTH SCREENINGS; AND FREE SUPPORT GROUPS FOR PARTICULAR DISEASES/HEALTH ISSUES (SUCH AS BREAST CANCER, PROSTATE CANCER, KIDNEY/PANCREAS TRANSPLANT PATIENTS, STROKE/BRAIN INJURY, AND HEART FAILURE). MMC ALSO PAYS FOR PHARMACEUTICAL PRESCRIPTIONS FOR INDIGENT PATIENTS UPON DISCHARGE WHO CANNOT AFFORD TO FILL THEIR PRESCRIPTIONS. MMC SUPPORTS KUMLER OUTREACH MINISTRIES, A LOCAL PROGRAM THAT PROVIDES PHARMACEUTICAL ASSISTANCE TO THE INDIGENT. MMC ALSO COVERS THE COSTS FOR AMBULANCES AND MEDICARS THAT TRANSFER MEDICARE PATIENTS AND THE INDIGENT FROM THE HOSPITAL TO THEIR HOMES. ALMH HAS 25 STAFFED BEDS AND SERVICES OFFERED INCLUDE 24-HOUR EMERGENCY MEDICINE, GENERAL ACUTE INPATIENT CARE, INTENSIVE CARE, PAIN MANAGEMENT, ORTHOPEDICS, SURGERY AND THE FAMILY MATERNITY SUITES. ALMH ALSO OFFERS A FULL RANGE OF OUTPATIENT REHABILITATION, THERAPY, AND DIAGNOSTIC TESTING. WITH THE OPENING OF A NEW REPLACEMENT HOSPITAL IN MARCH, 2011, ALMH BEGAN OFFERING WARM-WATER THERAPY FOR PHYSICAL THERAPY PATIENTS AND ARTHRITIS PATIENTS SEEKING RELIEF FROM THEIR SYMPTOMS. A FIXED MRI UNIT AND UPGRADED CT SCAN OPENED UP A NUMBER OF NEW TESTS FOR LOCAL PATIENTS, WHO PREVISOULY HAD TO BE TRANSFERRED OUT OF THE COUNTY FOR THESE TESTS.ABRAHAM LINCOLN MEMORIAL HOSPITAL'S EMERGENCY DEPARTMENT HAS TRADITIONALLY SERVED AS A SAFETY NET HEALTHCARE PROVIDER FOR THE UNINSURED AND UNDERINSURED WHO DO NOT HAVE PRIMARY CARE PHYSICIANS. TO HELP MEET COMMUNITY NEED AND ALLEVIATE USE OF THE EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE, ABRAHAM LINCOLN MEMORIAL HOSPITAL COLLABORATES THROUGH THE HEALTHY COMMUNITIES PARTNERSHIP WITH THE LOGAN COUNTY DEPARTMENT OF PUBLIC HEALTH AND FAMILY MEDICAL CENTER (PART OF MEMORIAL PHYSICIAN SERVICES, AN MHS AFFILIATE) TO TAKE PRIMARY AND PREVENTIVE CARE TO SMALL RURAL COMMUNITIES IN LOGAN COUNTY VIA THE H.O.P.E. MOBILE. A NURSE PRACTITIONER AND PUBLIC HEALTH NURSE STAFF THIS MOBILE UNIT, WHICH MAKES WEEKLY VISITS TO OUTLYING RURAL COMMUNITIES IN LOGAN COUNTY. THIS PROGRAM, ESTABLISHED IN 1998, IS ESPECIALLY BENEFICIAL TO RURAL SENIORS: OVER 30% OF THE PATIENTS ARE AGED 61-80 YEARS OLD, AND OVER 40% ARE OVER THE AGE OF 81. IN FY2011, THE H.O.P.E. MOBILE PROVIDED 403 DENTAL APPOINTMENTS FOR LOW-INCOME CHILDREN AND PREGNANT WOMEN, AND 1,993 OTHER PRIMARY- AND PREVENTIVE-CARE MEDICAL SERVICES. ABRAHAM LINCOLN MEMORIAL HOSPITAL EMPLOYS THE PROGRAM COORDINATOR AND OVERSEES MAINTENANCE OF THE UNIT. ABRAHAM LINCOLN HEALTHCARE FOUNDATION CONTRIBUTES FUNDING AND ONGOING SUPPORT THAT MAKES THE PROGRAM POSSIBLE.TAYLORVILLE MEMORIAL HOSPITAL USES SURPLUS FUNDS TO CONTINUALLY IMPROVE PATIENT CARE. IN MARCH 2011 THE HOSPITAL OPENED A 32,000-SQUARE-FOOT FACILITY THAT IS HOME TO A NEW EMERGENCY DEPARTMENT, RADIOLOGY SERVICES AND OUTPATIENT SURGERY CENTER. THE NEW FACILITY IS DESIGNED FOR OUTPATIENT SERVICES, OFFERS CLOSE PARKING, AND IMPROVES PATIENT SAFETY. THE NEW EMERGENCY DEPARTMENT OFFERS 10 TREATMENT ROOMS, INCLUDING TWO LEVEL-TWO TRAUMA BAYS AND AN ISOLATION ROOM WITH NEGATIVE AIR FLOW FOR PATIENTS WHO ARE AT RISK OF AIRBORNE TRANSMISSION OF CONTAGIOUS DISEASES. CONVENIENTLY NEAR THE EMERGENCY DEPARTMENT IS THE NEW RADIOLOGY SERVICES AREA, WHICH ADDED A NEW MRI UNIT. FOR THE PAST 20 YEARS THE HOSPITAL RELIED ON A MOBILE MRI THAT HAD LIMITED AVAILABILITY. OTHER SERVICES OFFERED INCLUDE CT, DIGITAL MAMMOGRAPHY, ECHOCARDIOLOGY, ULTRASOUND/SONOGRAPHY AND NUCLEAR MEDICINE. THE NEW OUTPATIENT SURGERY CENTER OFFERS THREE OPERATING ROOMS WITH ADVANCED TECHNOLOGY AND NEW EQUIPMENT FOR A VARIETY OF OUTPATIENT SURGICAL PROCEDURES. TWO INDIVIDUAL PATIENT ASSESSMENT ROOMS OFFER A PLACE FOR PRIVATE INTERVIEWS. AN ADDITIONAL INVESTMENT THE HOSPITAL MADE WAS IMPROVING SAFETY IN ACCESSING THE HOSPITAL. A NEW ROADWAY NOW DIRECTLY CONNECTS THE HOSPITAL WITH ROUTE 29, PROVIDING AMBULANCES A MORE DIRECT AND SAFER ROUTE, AND DIVERTING THE MAJORITY OF THE HOSPITAL TRAFFIC AWAY FROM THE RESIDENTIAL AND SCHOOL AREA THAT PREVIOUSLY WAS THE ONLY WAY TO ACCESS THE HOSPITAL. PART VI, LINE 7: MEMORIAL HEALTH SYSTEM, A 501(C)(3) CORPORATION, IS THE SOLE CORPORATE MEMBER OF ABRAHAM LINCOLN MEMORIAL HOSPITAL, A RURAL CRITICAL ACCESS HOSPITAL; TAYLORVILLE MEMORIAL HOSPITAL, A RURAL CRITICAL ACCESS HOSPITAL; AND MEMORIAL MEDICAL CENTER, A 500-BED TERTIARY CARE HOSPITAL THAT OFFERS A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES. OTHER AFFILIATES INCLUDE: MEMORIAL PHYSICIAN SERVICES, A PRIMARY CARE PHYSICIAN NETWORK THAT INCLUDES SEVERAL CLINICS LOCATED IN MEDICALLY UNDERSERVED OR HEALTH MANPOWER SHORTAGE AREAS; MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS, A MULTI-COUNTY OUTPATIENT MENTAL HEALTH NETWORK THAT PROVIDES SERVICE BASED ON A SLIDING-SCALE FEE SCHEDULE AND FREE CARE TO A WIDE RANGE OF PATIENTS WITH PSYCHIATRIC DISORDERS; MEMORIAL HOME SERVICES, A MULTI-COUNTY HOME CARE AND HOSPICE PROGRAM; A CHILD CARE CENTER; AND THREE HOSPITAL FOUNDATIONS, ALL OF WHICH ARE 501(C)(3) ENTITIES. HEALTH SYSTEM AFFILIATES INTEGRATE SERVICES TO PROVIDE IMPROVED ACCESS AND STREAMLINED TRANSITIONS BETWEEN THE DOCTORS OFFICES, HOSPITAL, HOME HEALTH AGENCY, NURSING HOME AND MENTAL HEALTH CLINICS. MEMORIAL HEALTH SYSTEM'S AFFILIATES ENGAGE IN A WIDE RANGE OF COMMUNITY BENEFIT ACTIVITIES. IN ADDITION TO THE HOSPITAL ACTIVITIES FOR MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL MENTIONED IN PART VI, LINE 5, OTHER AFFILIATE COMMUNITY BENEFITS INCLUDE THE FOLLOWING. MENTAL HEALTH CENTER'S OF CENTRAL ILLINOIS PROVIDES NUMEROUS COMMUNITY BENEFITS. JUST A FEW OF THESE INCLUDE PSYCHIATRIC CRISIS INTERVENTION WITH LOCAL SCHOOLS DEALING WITH SUICIDE OR OTHER TRAUMATIC EVENTS; CRISIS INTERVENTION TRAINING FOR LOCAL LAW ENFORCEMENT DEALING WITH MENTALLY ILL INDIVIDUALS; AND MENTALLY ILL HOMELESS PERSONS ADVOCACY AND COUNSELING. IN FY11, MHCCI DEVELOPED A SUICIDE PREVENTION TRAINING/WEBINAR FOR SCHOOL PERSONNEL AND ALSO RAISED AWARENESS ABOUT MENTAL ILLNESS THROUGH COMMUNITY EVENTS AND PRESENTATIONS. MHCCI IS COLLABORATING WITH LOCAL PARTNERS ON A PROJECT TO DEVELOP A PLAN FOR A COMMUNITY-BASED SYSTEM OF CARE THAT WILL TRANSFORM AND IMPROVE THE WAY MENTAL HEALTH SERVICES ARE PROVIDED TO CHILDREN AND YOUTH IN SPRINGFIELD.MEMORIAL PHYSICIAN SERVICES PROVIDES MEDICAL EDUCATION OPPORTUNITIES FOR PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. A PHYSICIAN FROM MPS WORKED WITH THE SPRINGFIELD SCHOOL DISTRICT TO PROVIDE STRESS COPING TRAINING FOR TEACHER (FUNDING CAME FROM THE MEMORIAL MEDICAL CENTER FOUNDATION).MEMORIAL HOME SERVICES PROVIDES HOME HOSPICE CARE IN 14 ILLINOIS COUNTIES, OFFERING MEDICAL, SPIRITUAL AND EMOTIONAL SUPPORT FOR BOTH PATIENTS AND THEIR FAMILIES. MEMORIAL HOME SERVICES ALSO PROVIDED 129 FREE HEALTH SCREENING EVENTS THROUGHOUT THE YEAR, OFFERING 2,342 FREE BLOOD PRESSURE AND 1,000 GLUCOSE SCREENINGS IN A WIDE VARIETY OF COMMUNITY LOCATIONS; 21% OF THE BLOOD PRESSURE SCREENINGS AND 12% OF THE GLUCOSE SCREENINGS WERE ABNORMAL. THOSE PARTICIPANTS ARE REFERRED TO THEIR PHYSICIANS FOR FOLLOW-UP CARE. MEMORIAL HOME SERVICES ALSO DONATES WHEELCHAIRS AND OXYGEN TANKS FOR MULTIPLE LAND OF LINCOLN HONOR FLIGHTS, WHICH TAKE WORLD WAR II AND KOREAN WAR VETERANS ON FREE TOURS OF WAR MEMORIALS IN WASHINGTON, D.C.THE MEMORIAL MEDICAL CENTER FOUNDATION (MMCF) PROVIDES GRANTS FOR PATIENT CARE, EDUCATION AND RESEARCH. ELEVEN GRANTS WERE AWARDED IN FY11. THESE GRANTS INCLUDED FUNDING FOR A STROKE TELEMEDICINE PROGRAM FOR RURAL PATIENTS; A STUDY TO PREDICT AND TEST FOR THE PRESENCE OF CHLAMYDIA AND GONORRHEA IN WOMEN WHO VISIT THE MEDICAL CENTER'S EMERGENCY DEPARTMENT; SUPPORT FOR AN INDIGENT PHARMACEUTICAL PROGRAM; MEDICATION RECONCILIATIONS FOR SENIOR CITIZENS DISCHARGED FROM HOSPITALIZATION; A STUDY COMPARING RESULTS OF SURGICAL AND NON-SURGICAL TREATMENTS OF HAND FRACTURES; PURCHASE OF A PORTABLE PERIPHERAL BONE DENSITOMETER TO USE IN COMMUNITY HEALTH SCREENINGS; AND TRAINING FOR ELEMENTARY SCHOOL TEACHERS TO TEACH THEIR STUDENTS CRITICAL COPING SKILLS FOR CLASSROOM READINESS. MANY OF THE RESEARCH GRANTS WERE PROVIDED TO SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. THE FOUNDATION ALSO ADMINISTERS A CANCER PATIENT ASSISTANCE FUND THAT ASSISTS CANCER PATIENTS WITH UTILITIES, RENT AND OTHER BASIC EXPENSES WHILE UNDERGOING CANCER TREATMENT AND A TRANSPLANT PATIENT ASSISTANCE FUND THAT ASSISTS KIDNEY TRANSPLANT PATIENTS WITH THE COSTS OF ANTI-REJECTION MEDICATIONS. IN FY11, MMCF SUPPORTED A COMMUNITY-WIDE WOMEN'S HEALTH FAIR TO PROVIDE A VARIETY OF HEALTH SCREENINGS AND TO EDUCATE WOMEN ABOUT HEALTH ISSUES RANGING FROM CANCER TO BLOOD PRESSURE. THE ABRAHAM LINCOLN HEALTHCARE FOUNDATION (ALHF) UNDERWRITES THE OPERATING EXPENSES OF THE LOGAN COUNTY HEALTHY COMMUNITIES PARTNERSHIP AND THE H.O.P.E. MOBILE. IN VISITING RURAL COMMUNITIES, 1,993 PRIMARY AND PREVENTIVE HEALTH SERVICES WERE PROVIDED BY THE H.O.P.E MOBILE IN FY11. DENTAL APPOINTMENTS FOR LOW-INCOME CHILDREN AND PREGNANT WOMEN WERE ALSO PROVIDED BY THE H.O.P.E. MOBILE. THE HEALTHY COMMUNITIES PARTNERSHIP ALSO COLLABORATIVELY ADDRESSES ALCOHOL AND DRUG USE, TEEN PREGNANCY, DOMESTIC ABUSE, SENIOR HEALTH ISSUES, PARISH NURSING AND EDUCATION ON THE LOCAL COMMUNITY LEVEL. ALHF'S CONTRIBUTION TO THE HEALTHY COMMUNITIES PARTNERSHIP IN FY2011 WAS $104,231. THE ABRAHAM LINCOLN HEALTHCARE FOUNDATION ALSO PROVIDED $5,500 IN HEALTHCARE SCHOLARSHIPS TO LOCAL RESIDENTS PREPARING FOR A PHARMACY AND A NURSING DEGREE, $8,863 FOR PAIN MEDICATION FOR HOSPICE PATIENTS, $10,000 IN SUPPORT FOR A MEDI-CAR TRANSPORTATION SERVICE FOR WHEELCHAIR-BOUND RESIDENTS, AND PROVIDED OVER $9,600 IN PHARMACEUTICAL ASSISTANCE TO DISCHARGED PATIENTS WHO COULD NOT AFFORD TO FILL THEIR PRESCRIPTIONS. AN ACTIVE LIFELINE PROGRAM, WHICH PLACES EMERGENCY CALL AND RESPONSE UNITS IN THE HOMES OF SENIORS, IS MANAGED BY ALMH STAFF AND FUNDED BY THE FOUNDATION. TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION CONTINUES TO SUPPORT PROGRAMS WHICH ASSIST IN THE TRAINING OF FUTURE HEALTHCARE PROVIDERS IN OUR SERVICES AREA. IN ADDITION, A WIDE RANGE OF COMMUNITY HEALTH SCREENINGS, CLASSES, AND OTHER EDUCATIONAL EVENTS ARE REGULARLY UNDERTAKEN. REPORTS FILED WITH STATES PART VI, LINE 7 IL 0 SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE PO BOX 19620 SPRINGFIELD IL 62794 376005961 115 891774 SOUTHERN ILLINOIS SCHOOL OF MEDICINE WITH THE PURPOSE THAT THE FUNDS WILL BE USED FOR MEDICAL RESEARCH. THE POST-TERTIARY CLINICAL SERVICES FUND APPLICATION EXPLICITLY LISTED THREE SOUTHERN ILLINOIS SCHOLL OF MEDICINE CANCER PROGRAMS. MEMORIAL MEDICAL CENTER IS THE PASS THROUGH AGENCY FOR THESE PROGRAM-RESTRICTED FUNDS AND THE SOUTHERN ILLINOIS SCHOOL OF MEDICINE'S CANCER PROGRAMS ARE LISTED AS THE BENEFICIARIES. MEMORIAL MEDICAL CENTER FOUNDATION 1 MEMORIAL PLAZA SPRINGFIELD IL 62781 371110301 501 (C) (3) 18000 AS A SPECIAL REMEMBRANCE, MEMORIAL MEDICAL CENTER MAKES A DONATION TO THE MEMORIAL MEDICAL CENTER FOUNDATION IN MEMORY OF EMPLOYEES AND CERTAIN EMPLOYEE FAMILY MEMBERS UPON THEIR DEATH. CITY OF LINCOLN 315 EIGHTH STREET LINCOLN IL 62656 376001283 CITY OF LINCOLN 99360 BOOK LAND DONATION OF LAND AMERICAN HEART ASSOCIATION 2524 FARRAGUT DRIVE SUITE A SPRINGFIELD IL 62704 370673511 501 (C) (3) 25000 SPONSOR OF ANNUAL HEART WALK AND START WALKING INITIATIVES TO HELP EDUCATE AND IMPROVE THE CARDIOVASCULAR HEALTH OF THE PEOPLE AND COMMUNITIES SERVED. SANGAMON COUNTY MEDICAL SOCIETY 230 WEST CARPENTER STREET SPRINGFIELD IL 62702 376027693 501 (C) (3) 50000 FUNDING OF CATCH PROGRAM THAT PROVIDES SERVICES TO UNINSURED PATIENTS IN SANGAMON COUNTY. LINCOLN ELEMENTARY SCHOOL DISTRICT NO 27 304 8TH ST LINCOLN IL 62656 376003668 LINCOLN SCHOOL DISTR 98466 BOOK LAND DONATION OF A BUILDING AND LAND SIU SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 10150 3D ULTRA SOUND FOR TENDONS. SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 6015 STUDY EFFECT OF HBO ON HINDLIMB TRANSPLANTATION. SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 63307 HAND FRACTURE BEST PRATICES. MEMORIAL PHYSICAN SERVICES 3132 OLD JACKSONVILLE ROAD STE 200 SPRINGFIELD IL 62704 379999999 501 (C) (3) 48200 PROVIDE COPING SKILLS TRAINING FOR TEACHERS. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 10693 PROVIDE COMFORT KITS FOR PSYCHIATRIC PATIENTS. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 75940 DEVELOP STROKE TELEMEDICINE PROGRAM. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 10090 PURCHASE BONE DENSITOMETER FOR JOINTWORKS PROGRAM. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 50300 PROVIDE SUPPORT FOR NURSING DEVELOPMENT. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 16982 PROVIDE GENERAL SUPPORT. MEMORIAL HEALTH SYSTEM 701 NORTH FIRST STREET SPRINGFIELD IL 62703 378888888 501 (C) (3) 7010 PROJECT CPR ANYTIME. SIU SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 26314 PROVIDE STD SCREENING IN THE EMERGENCY ROOM. SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 19184 RESOLVE PRESCRIPTION DISCREPANCIES FOR SENIORS. SIU SCHOOL OF MEDICINE 801 NORTH RUTLEDGE SPRINGFIELD IL 62702 376005961 115 5553 PROVIDE GENERAL SUPPORT. KUMLER OUTREACH MINISTRIES 303 NORTH GRAND AVENUE EAST SPRINGFIELD IL 62702 370695489 501 (C) (3) 16000 PROVIDE PRESCRIPTIONS TO INDIGENT PATIENTS. MEMORIAL HOME SERVICES 720 NORTH BOND STREET SPRINGFIELD IL 62702 370714225 501 (C) (3) 8724 PROVIDE GENERAL SUPPORT. NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE 303 EAST CHICAGO AVENUE CHICAGO IL 60611 362167817 501 (C) (3) 75000 PARTICIPATION IN THE BOOST MENTORING PROGRAM. KUMLER OUTREACH MINISTRIES 303 NORTH GRAND AVENUE EAST SPRINGFIELD IL 62702 370695489 501 (C) (3) 22000 TO ASSIST IN THE PHARMACEUTICAL ASSISTANCE PROGRAM. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 48107 PROVIDE EQUIPMENT AND SUPPLIES. MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET SPRINGFIELD IL 62781 370661220 501 (C) (3) 74139 PROVIDE SUPPORT FOR EDUCATION. ABRAHAM LINCOLN MEMORIAL HOSPITAL 315 EIGHTH STREET LINCOLN IL 62656 370723793 501 (C) (3) 136448 VARIOUS INCLUDING SCHOLORSHIPS, CARE-A-VAN, MEDICAL TECHNOLOGIES, PATIENT PHARMACY. MEMORIAL HOME SERVICES 315 EIGHTH STREET LINCOLN IL 62656 370714225 501 (C) (3) 8863 UNDERWRITE COST OF PAIN MEDICATION FOR HOSPICE PATIENTS. TAYLORVILLE MEMORIAL HOSPITAL 201 E PLEASANT TAYLORVILLE IL 62568 370661250 501 (C) (3) 40465 TO BE USED IN THE PURCHASE OF SPECIFIC MEDICAL EQUIPMENT AND THE CONSTRUCTION OF THE CENTER. EDUCATIONAL GRANTS 153 653666 TUITION REIMBURSEMENT 135 253045 SCHOLARSHIPS FOR EMPLOYEES 24 91730 EMPLOYEE ASSISTANCE WITH CATASTROPHIC EVENTS 28 28908 SHELTER AND UTILITY ASSISTANCE FOR PATIENTS 23 9915 DIRECT CASH ASSISTANCE TO PATIENTS 8 3992 PRESCRIPTION DRUG ASSISTANCE 21 6208 SCHOLARSHIPS 5 4000 EDUCATION SCHOLARSHIPS 2 5500 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS AND ASSISTANCE ARE PROVIDED TO LOCALLY MANAGED, NON-PROFIT 501(C)(3) ORGANIZATIONS OR EMPLOYEES WHO MEET THE CRITERIA FOR FINANCIAL ASSISTANCE. EMPLOYEES ASSIST IN OVERSITE AS VOLUNTEER MEMBERS OF LOCAL AGENCY BOARD OF DIRECTORS. THE CAMPUS OF SIU SCHOOL OF MEDICINE IS ADJACENT TO THE MEMORIAL MEDICAL CENTER CAMPUS. GRANTS AND ASSISTANCE PROVIDED TO THE MEDICAL SCHOOL ARE MONITORED BY THE EXECUTIVE DIRECTOR OF MEMORIAL MEDICAL CENTER FOUNDATION. 1 X X X X 0 1 0 0 0 0 0 1 0 RICHARD BIVIN MD 175457 0 2453 0 71859 0 16844 0 32925 0 299538 0 0 0 ELAINE YOUNG 0 190359 0 51971 0 4857 0 25047 0 19435 0 291669 0 0 KEVIN ENGLAND 0 233351 0 64775 0 15614 0 31355 0 37419 0 382514 0 0 THOMAS WESTRICK 157728 0 21725 0 690 0 0 0 11227 0 191370 0 0 0 DOLAN DALPOAS 203547 0 54953 0 6613 0 26783 0 19573 0 311469 0 0 0 DANIEL RAAB 180647 0 50050 0 14204 0 24142 0 18527 0 287570 0 0 0 EDGAR CURTIS 0 640422 0 0 0 26505 0 452498 0 6036 0 1125461 0 0 ROBERT KAY 0 364084 0 0 0 46364 0 201735 0 29892 0 642075 0 0 MARK HANSEN MD 405664 0 58768 0 156638 0 42796 0 50676 0 714542 0 0 0 MARSHALL HALE MD 285649 0 13870 0 1318 0 19058 0 39633 0 359528 0 0 0 PAUL KASA MD 203143 0 8836 0 1244 0 11671 0 31573 0 256467 0 0 0 DOUGLAS RAHN 383574 0 146896 0 20355 0 64489 0 31544 0 646858 0 0 0 JANICE GAMBACH 0 132074 0 19119 0 1290 0 0 0 16680 0 169163 0 0 CHARLES CALLAHAN 208214 0 57603 0 21695 0 27704 0 22456 0 337672 0 0 0 TRAVIS DOWELL 189187 0 53625 0 7217 0 26014 0 21062 0 297105 0 0 0 ELENA KEZELIS 141049 0 19839 0 459 0 0 0 14273 0 175620 0 0 0 MARSHA PRATER 240984 0 0 0 18220 0 128573 0 15775 0 403552 0 0 0 SCOTT KIRIAKOS 233410 0 64336 0 9915 0 31377 0 25324 0 364362 0 0 0 DAVID J JOERGER 159431 0 22837 0 1290 0 0 0 15057 0 198615 0 0 0 FERINAND SALVACION MD 462511 0 154000 0 450 0 90857 0 26179 0 733997 0 0 0 DAVID SANDERCOCK MD 301033 0 57176 0 4175 0 29063 0 43970 0 435417 0 0 0 JAMES GILDNER MD 502737 0 27926 0 8009 0 56247 0 53934 0 648853 0 0 0 STEVEN LILLPOP MD 347626 0 17601 0 8064 0 35975 0 45021 0 454287 0 0 0 VIRGINIA DOLAN MD 209452 0 55000 0 69620 0 18223 0 38395 0 390690 0 0 0 ROBERT CLARKE 0 0 0 0 0 382201 0 0 0 0 0 382201 0 0 PART I, LINE 4B PART I, LINE 4B THE ORGANIZATION PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO THE FOLLOWING OFFICERS AND KEY EMPLOYEES: EDGAR J. CURTIS, $353,433, ROBERT W. KAY, $184,860, DOUGLAS L. RAHN, $48,372, FORREST G. HESTER, $25,781, MITCHELL L. JOHNSON, $18,515, ELAINE L. YOUNG, $21,527, KEVIN R. ENGLAND, $12,884, ANNA N. EVANS, $38,780, MARK E. WEAVER, M.D., $69,501, AND DAVID GRAHAM, M.D., $33,625. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A "SUBSTANTIAL RISK OF FORFEITURE." THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. TO BECOME ENTITLED TO THE BENEFITS PROVIDED, EACH COVERED EMPLOYEE MUST MEET SUBSTANTIAL REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES AND NOT MET THESE SUBSTANTIAL REQUIREMENTS, THESE SUPPLEMENTAL RETIREMENT BENEFITS WOULD HAVE BEEN FORFEITED. THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ACCORDINGLY, ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE. THE LEADERSHIP COMPENSATION COMMITTEE OF THE MHS BOARD APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER SENIOR LEADERS, IN A MANNER INTENDED TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL INCOME TAX LAW. PART I, LINE 7 MEMBERS OF SENIOR MANAGEMENT RECEIVE INCENTIVE COMPENSATION UNDER THE ANNUAL INCENTIVE COMPENSATION PLANS SPONSORED BY MEMORIAL HEALTH SYSTEM. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). THE PLANS ARE DESIGNED TO CONDITION A PORTION OF COMPENSATION ON PERFORMANCE AGAINST PRE-DETERMINED ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM. THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD HAS REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. SUSAN K CURTIS SUNLEY EMPLOYEE; DAUGHTER OF EDGAR J. CURTIS, CEO OF MEMORIAL HEALTH SYSTEM 47447 MEMORIAL MEDICAL CENTER PAID COMPENSATION OF $47,447 AND BENEFITS OF $8,563 TO SUSAN K. CURTIS SUNLEY RELATED TO EMPLOYMENT SERVICES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010. THE COMPENSATION PAID WAS NEGOTIATED AT ARM'S LENGTH AND REPRESENTS FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 SANGAMON EYE ASSOCIATES INC OWNER'S WIFE IS A BOARD MEMBER 543320 MEMORIAL MEDICAL CENTER LEASED PROPERTY FROM SANGAMON EYE ASSOCIATES, INC. FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $543,320. THE OWNER OF SANGAMON EYE ASSOCIATES, INC. IS THE HUSBAND OF CAROL J. HANSEN POSEGATE, A MEMBER OF THE MEMORIAL MEDICAL CENTER'S BOARD OF DIRECTORS. THE LEASE IS UNDERTAKEN AT ARM'S LENGTH AND IS AT FAIR MARKET VALUE. 0 SORLING NORTHRUP HANNA CULLEN & COCHRAN BOARD MEMBER IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN 140240 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF SORLING, NORTHRUP, HANNA, CULLEN & COCHRAN, LTD. FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $140,240. WILLIAM R. ENLOW, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN, LTD. ALL FEES ARE NEGOIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 SPRINGFIELD CLINIC BOARD MEMBER IS EMPLOYEE OF SPRINGFIELD CLINIC 1267774 MEMORIAL MEDICAL CENTER PAID FEES TO SPRINGFIELD CLINIC, LLP FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $1,267,774. A PHYSICIAN OF THIS COMPANY, MICHAEL A. PICK, M.D., IS ALSO A MEMBER OF MEMORIAL MEDICAL CENTER'S BOARD OF DIRECTORS. ALL FEES ARE NEGOTIATED AT ARMS LENGTH AND ARE AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 SORLING NORTHRUP HANNA CULLEN & COCHRAN BOARD MEMBER IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN 140240 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF SORLING, NORTHRUP, CULLEN & COCHRAN, LTD FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $140,240. MARK H. FERGUSON, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT SOLING, NORTHRUP, CULLEN & COCHRAN, LTD. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 GRANTS MEADOWS ASSOCIATES CURRENT DIRECTOR, MARSHAL HALE, M.D. HAS A 33.33% OWNERSHIP INTEREST 118268 GRANTS MEADOW ASSOCIATES LEASES A MEDICAL OFFICE BUILDING LOCATED AT 1602 WEST LAFAYETTE, JACKSONVILLE, ILLINOIS TO THE REPORTING ORGANIZATION. THE AMOUNTS TRANSACTED BETWEEN THE REPORTING ORGANIZATION AND GRANTS MEADOW ASSOCIATES REFLECT THE FAIR MARKET VALUE OF GOODS AND SERVICES RECEIVED. 0 BROWN HAY & STEPHENS PAST BOARD MEMBER IS A PARTNER OF BROWN, HAY & STEPHENS LLP 534500 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF BROWN, HAY & STEPHENS LLP, LTD FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $534,500. DWIGHT H. O'KEEFE, A PAST MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT BROWN, HAY & STEPHENS LLP. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 MIDWEST EMERGENCY DEPARTMENT SPECIALISTS BOARD MEMBER IS A KEY EMPLOYEE OF MIDWEST EMERGENCY DEPARTMENT SPECIALISTS 4279087 MEMORIAL MEDICAL CENTER PAID FEES TO MIDWEST EMERGENCY DEPARTMENT SPECIALISTS FOR EMERGENCY ROOM SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $4,279,087. DAVID L. GRIFFEN, MD, PHD, A MEMBER OF THE BOARD OF DIRECTORS, IS A KEY EMPLOYEE AT MIDWEST EMERGENCY DEPARTMENT SPECIALISTS. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 CRAWFORD MURPHY & TILLY INC BOARD MEMBER IS A PARTNER AT CRAWFORD MURPHY & TILLY 254598 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF CRAWFORD, MURPHY & TILLY, INC FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $254,598. CLIFTON R. BAXTER, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT CRAWFORD MURPHY & TILLY, INC. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. 0 FORM 990, PART VI, SECTION A, LINE 2 MARK H. FERGUSON AND WILLIAM R. ENLOW, BOTH MEMORIAL MEDICAL CENTER BOARD MEMBERS, ARE PARTNERS AT THE SAME LAW FIRM, SORLING, NORTHRUP, HANNA, CULLEN & COCHRAN, LTD. FORM 990, PART VI, SECTION A, LINE 6 MEMORIAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF THE AFFILIATES REPORTED IN THIS GROUP RETURN. MEMORIAL HEALTH SYSTEM CORPORATION CONTAINS 105 INDIVIDUAL MEMBERS WHO ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 A FINAL DRAFT COPY OF THE MHS GROUP FORM 990 AND ALL ATTACHMENTS IS PROVIDED TO ALL OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS AND A BOARD COMMITTEE PRIOR TO FILING. AT THE BOARD MEETING, A PRESENTATION IS MADE BY THE CFO TO THE BOARD, FOLLOWED BY A QUESTION AND ANSWER SESSION. PRESENTATIONS ARE MADE TO THE AFFILIATE MEMBERS' BOARDS IN THE SAME TIME FRAME, ALTHOUGH COPIES OF THE COMPLETE FORM 990 AND ALL ATTACHMENTS ARE NOT PROVIDED PRIOR TO THOSE MEETINGS, EXCEPT TO BOARD MEMBERS WHO REQUEST COMPLETE COPIES. ALL QUESTIONS AND COMMENTS ARISING FROM THESE REVIEWS ARE ADDRESSED PRIOR TO SUBMISSION OF THE RETURN TO THE APPROPRIATE TAXING AUTHORITIES. FORM 990, PART VI, SECTION B, LINE 12C MEMORIAL HEALTH SYSTEM AND ITS SUBORDINATES MONITOR AND ENFORCE THEIR CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING AGENDA IS PREPARED. ANY OFFICER OR DIRECTOR WHO HAS A CONFLICT IS NOTIFIED OF SUCH CONFLICT, AS WELL AS THEIR OBLIGATION TO ABSTAIN FROM THE DISCUSSION AND VOTE ON ANY CONFLICTED ISSUES(S). SUCH ABSTENTION(S), IF REQUIRED, ARE DOCUMENTED IN THE MINUTES OF EACH MEETING. BOARD MEMBERS ARE ALSO REQUIRED TO UPDATE THEIR CONFLICT OF INTEREST DISCLOSURE STATEMENTS PROMPTLY IN THE EVENT OF ANY CHANGE IN PERSONAL OR BUSINESS ACTIVITIES THAT WOULD REQUIRE SUCH DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE MADE UP OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, AND HAS DELEGATED TO IT THE RESPONSIBILITY OF ADMINISTERING, OVERSEEING AND APPROVING ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE LEADERSHIP, INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE BOARD HAS ADOPTED A LEADERSHIP COMPENSATION PHILOSOPHY STATEMENT DESCRIBING THE ROLE AND RESPONSIBILITIES OF THE COMMITTEE. THIS PHILOSOPHY EXPRESSLY STATES THE COMMITTEE'S INTENT, ON BEHALF OF THE CORPORATION, TO TAKE ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE ANALYZES EVERY ELEMENT OF COMPENSATION (INCLUDING CURRENT, INCENTIVE AND DEFERRED COMPENSATION) AND BENEFITS (INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS). THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. IN CONNECTION WITH THE MOST RECENT REVIEW AND APPROVAL PROCESS, THE COMMITTEE RECEIVED PROFESSIONAL ADVICE FROM AN INDEPENDENT CONSULTANT AND OUTSIDE LEGAL COUNSEL. THE COMMITTEE CONSISTS ENTIRELY OF DISINTERESTED MEMBERS OF THE BOARD OR DISINTERESTED COMMITTEE MEMBERS WHO UNDER STATE CORPORATE LAW MAY SERVE ON SUCH A COMMITTEE. THE COMMITTEE WORKS WITH ITS COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERTO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -14,492,815. CHANGE IN MINIMUM PENSION LIABILITY 28,385,974. TRANSFERS 3,530,000. OTHER 182,404. TOTAL TO FORM 990, PART XI, LINE 5: 17,605,563. 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