2011-02-08T13:13:41-05:00 2010-09-30 ERNST & YOUNG US LLP PO Box 44972 Indianapolis IN 462440972 990 2009-10-01 350593390 Deaconess Hospital Inc DEAC 8124502370 600 MARY STREET EVANSVILLE IN 47747 Linda E White 2011-02-07 3176817000 2009 2016-02-24 21:20:13Z LINDA E WHITE PRESIDENTCEO 600 MARY STREET EVANSVILLE IN 47747 580059742 false X www.deaconess.com X 1895 IN DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. 18 9 5549 109 8679291 0 1221896 1809153 483100660 487028074 11615625 4920579 37652466 34195826 533590647 527953632 276650 215303 0 0 215324559 225824244 0 0 295256 270535827 257674542 486137036 483714089 47453611 44239543 702922543 734618250 370074161 361198226 332848382 373420024 DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. false false 160713938 341363516 Patient Service Revenue - Deaconess Hospital is a major referral center for a 25-county tri-state area in Southwestern Indiana, Western Kentucky, and Southeastern Illinois. The Hospital and its facilities are located on four campuses which include the main 28-acre campus on the near north side of Evansville in Vanderburgh County, the 63-acre Gateway Campus located in Warrick County on the eastern border of Vanderburgh County, and two other eastside Evansville locations for psychiatric behavioral services and rehabilitation services. The Hospital operates a Main Campus with a total of 318 beds consisting of 24 intensive care beds, 26 cardiac intensive care beds, 66 cardiac beds, 23 oncology/pulmonology beds, 61 orthopaedic/neurological beds, 5 pediatric trauma beds, 13 mental health beds, 96 medical/surgical beds and 4 hospice beds. In addition, the Hospital provides a full-array of comprehensive outpatient and ambulatory services on its Main Campus and other specific services at multiple sites within its primary and secondary service areas. The Hospital operates the 94 bed Deaconess Gateway Hospital which was opened in January 2006, on the Gateway Campus consisting of 13 adult intensive care beds, 17 pediatric and pediatric intensive care beds, 32 medical/surgical beds, 16 orthopaedic beds, and 16 neurosurgical beds. The Hospital provides a full array of comprehensive outpatient and ambulatory services on the Gateway Campus. The Hospital owns and operates Deaconess Cross Pointe a free-standing, 60-bed inpatient psychiatric hospital located approximately 7 miles east of the Main Campus in Evansville. 282688443 133737341 Charity Care / Subsidized Care- Deaconess Hospital makes a distinction between charity and bad debt. In determining an individual or family's ability to pay, Deaconess Hospital evaluates whether or not the responsible party has sufficient resources available for payment. If an individual is determined to not have sufficient resources to pay, they are considered eligible for charity care and will not be processed through either internal or external collections. Accounts of charity care patients who are unable to pay do not result in bad debt and are not collected upon. Deaconess Hospital provides care to persons covered by governmental programs below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, Deaconess Hospital absorbs these costs in meeting its mission to the community. In support of its mission, Deaconess Hospital provided $20.6 million of charity care and $31.3 million of subsidized services to the Medicaid program, and $40.3 million of subsidized services to the Medicare program. 17713724 11927217 Graduate Medical Education, Medical Education and Community Benefit - Deaconess Hospital plays an active role in medical education, operating a three year family medicine residency program and a post-graduate pharmacy residency program. Deaconess Hospital also provides continuing medical education programs for attending physicians, other health professionals, other allied health programs, community health programs and a chaplain residency program. In addition to educational services, Deaconess Hospital provided $5.4 million in community benefit activities (all on a cost basis), serving a minimum of 641,445 people within the Tri-State area. 215303 215303 16089590 461331408 true true false true false false false false true true false true false false false false false false true false true true false true true false false false false false false false false true true false false false false false true true false false true 412 0 true 5549 true true true false false false false true true false false false false false false 18 9 false false false false true true false true true true false true true true true true true true true true true IN X CHERYL A WATHEN 8124502370 600 MARY STREET Evansville IN 47747 LINDA WHITE 50.0 X X 1807619 350850 178330 DAVID D CHRISTESON MD 5.0 X 0 429073 45280 RUSTON L STOLTZ MD 5.0 X 2713 306267 7871 DAVID A KOEHLER JR MD 5.0 X 31887 108589 4483 BRUCE ROMICK MD 5.0 X 21538 0 0 WILLIAM R PENLAND MD 5.0 X 11600 0 0 JEROME A BENKERT 5.0 X 9200 0 0 BRUCE STALLINGS 5.0 X 8400 0 0 ROBERT B WRIGHT 5.0 X 8000 0 0 MATTHEW R LEE MD 5.0 X 8000 0 0 DR H RAY HOOPS 5.0 X 6800 0 0 BRUCE ADYE MD 5.0 X 6400 0 0 JOHN D ENGELBRECHT 5.0 X 6000 0 0 STEVEN T TITZER CPA 5.0 X 6000 0 0 REV DR JOSEPH FRACCARO 5.0 X 5200 0 0 IRA G BOOTS 5.0 X 4000 0 0 ROBERT G JONES 5.0 X 3600 0 0 STEVEN A CHURCH 5.0 X 3200 0 0 RICHARD M STIVERS 50.0 X 759797 236533 53438 HARRY L SMITH JR 50.0 X 524250 0 132281 JAMES R PORTER MD 50.0 X 381166 0 98464 SHAWN W MCCOY 50.0 X 357777 0 86486 CHERONA J HAJEWSKI 50.0 X 318533 0 78378 BRUCE E EPMEIER 50.0 X 251139 0 58516 LARRY F PILE 50.0 X 224674 0 19538 CHERYL A WATHEN 50.0 X 216784 0 43422 RICHARD B PERRY 50.0 X 164296 0 25044 JOYCE A THOMAS 50.0 X 161281 0 25817 VENKATESH R MADADI 50.0 X 761459 0 22872 RAJESH J PATEL MD 50.0 X 753318 0 29110 NIRMAL JOSHI MD 50.0 X 729755 0 24723 AYMAN ELFAR MD 50.0 X 656349 0 21728 SUSAN DOUGLAS MD 50.0 X 626070 0 17735 8836805 1431312 973516 167 false true false EVANSVILLE SURGERY CENTER ASSOCLLC 520 MARY STREET EVANSVILLE IN 47710 SURGICAL SVCS 36736387 BOVIS LEND LEASE INC 1801 W END AVENUE SUITE 600 NASHVILLE TN 37203 BLDG CONTRACTOR 18450426 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 53288 SOFTWARE/CONSUL 9414572 WINK CONSTRUCTION INC 4007 E EICHEL AVENUE EVANSVILLE IN 47716 BLDG CONTRACTOR 3033198 ARUP LABORATORIES PO BOX 27964 SALT LAKE CITY UT 84127 LABORATORY 2165232 71 208955 176007 1424191 1454 1809153 NET PATIENT REVENUE 900099 487028074 487028074 487028074 5610522 5610522 149 149 0 6455065 2966115 3488950 3488950 3488950 48251186 39712 48912951 68039 -661765 -28327 -690092 -690092 39250 208955 159005 -119755 -119755 0 0 INVESTMENT IN JOINT VENTURES 900099 16089590 16089590 LABORATORY SALES 621500 8358621 8358621 OTHER HOSPITAL SERVICES 900099 6057750 6057750 320670 320670 30826631 527953632 503117664 8679291 14347524 215303 215303 0 0 0 5700343 5700343 0 168387792 165923744 2245308 218740 13817103 12650921 1166182 25694618 24467077 1227541 12224388 11671599 552789 0 966032 365607 600425 233451 233451 30764 30764 0 277335 276834 501 54068416 50707079 3354214 7123 685024 100026 584998 91407208 90657240 705264 44704 8532400 7553523 978877 0 16230644 14748454 1482190 605528 511315 93905 308 0 621129 470147 150982 6374865 6374865 0 30877465 28736287 2138916 2262 3154119 3149602 4517 PROVISION FOR BAD DEBTS 23784726 23784726 EQUIP RENTAL/MAINTENANCE 13532803 13372783 160020 AGENCY COLLECTION FEES 5150431 5150431 DUES & SUBSCRIPTIONS 571932 289139 281263 1530 MISCELLANEOUS 570270 431540 118642 20088 483714089 461331408 22087425 295256 27945770 45404178 90460730 103136210 3682013 5359268 4811478 4844936 646537046 321425049 284502073 325111997 230672547 192039805 34159545 31252043 16076946 15940119 10611441 11529694 702922543 734618250 54382213 55207479 229031236 224161915 139127 19721 86521585 81809111 370074161 361198226 X 325414596 365289535 2968260 3424795 4465526 4705694 332848382 373420024 702922543 734618250 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 30764 30764 false false Schedule C Part II-B, Line 1i Lobbying expenditures consisted of a portion of membership dues to professional organizations in which Deaconess Hospital and its employees are members. The lobbying portion of the dues is noted on the membership application or billing statement. 7433786 1683536 281910 192998 790792 284953 8130489 7797671 728055 203927 203726 1211206 288387 7433786 0.66000 0.34000 0.00000 false false 10266155 10266155 358532138 182464922 176067216 188130649 138960127 49170522 89608104 89608104 325111997 0 ACCRUED PENSION/ ACCRUED SICK 60709075 TAXABLE BOND-SERIES 1999B 11200000 CAPITAL LEASE OBLIGATIONS 5858590 ESTIMATED THIRD-PARTY SETTLEMENTS 4041446 81809111 Intended Uses for Endowment Funds Part V, Line 4 The Deaconess Hospital Foundation utilizes endowment funds to support and benefit the mission of Deaconess Hospital. Specifically, endowment funds are used to help support activities or projects that help to provide quality healthcare services with a compassionate and caring spirit to persons, families and communities of the Tri-State. Part XIV Part VII and IX are not completed due to the total of each line being less than 5% of the total assets listed on Part X, Line 16. Part XI, XII, XIII are not required as the organization is a part of a consolidated financial statement. The consolidated financial statement is audited by an independent accounting firm and is prepared in accordance with generally accepted accounting principles. DH PARTY OF YR 154903 132503 22400 9007 58615 9495 32543 DH CLASSIC 93302 76452 16850 17273 19001 13071 0 248205 208955 39250 9007 75888 28496 45614 159005 -119755 true true X true X 300. true X true true true false true true 19638639 19638639 0.03900 46660663 14778402 31882261 0.06340 66299302 14778402 51520900 0.10240 747633 82111 665522 0.00130 3616209 1433196 2183013 0.00430 10261099 8397662 1863437 0.00370 1169759 289671 880088 0.00180 15794700 10202640 5592060 0.01110 82094002 24981042 57112960 0.11350 348 348 1760 1760 11234 11234 5097 5097 72159 15405 56754 0.00010 90598 15405 75193 0.00010 true 7803769 123661234 138807124 -15145890 X true true Deaconess Hospital Inc

600 Mary Street Evansville IN 47747

X X X X Deaconess Gateway Hospital

4011 Gateway Blvd Newbrugh IN 47630

X X X X Deaconess Cross Pointe

7200 E Indiana Street Evansville IN 47715

X Deaconess Primary Care for Seniors

4498 First Avenue Evansville IN 47710

Outpatient Physician Clinic Mt Vernon Medical Center

1900 W Fourth Street Mt Vernon IN 47620

Diagnostic Center Deaconess Diabetes Center

421 Chestnut Street Evansville IN 47713

Outpatient Services Deaconess Mec Medical Center

3844 First Avenue Evansville IN 47710

Outpatient Physician Clinic Deaconess Pain Management

4099 Gateway Blvd Newburgh IN 47630

Outpatient Services Deaconess Riley Childrens Specialty Ctr

4133 Gateway Blvd Newburgh IN 47630

Outpatient Physician Clinic Deaconess Hospital Sleep Lab

350 W Columbia Street Suite LL-10 Evansville IN 47710

Diagnostic Center Deaconess Family Practice Center

515 Read Street Evansville IN 47710

Outpatient Physician Clinic Deaconess Cardiac Rehab Heart Care Ctr

415 W Columbia Evansville IN 47710

Outpatient Services Deaconess Regional Laboratory

4494 N First Avenue Evansville IN 47710

Diagnostic Center Deaconess Regional Laboratory

611 Harriet Street Suite 102 Evansville IN 47710

Diagnostic Center Deaconess Wound Care Center

611 Harriet Street Suite 501 Evansville IN 47710

Outpatient Services Chancellor Center for Oncology

4055 Gateway Blvd Newburgh IN 47630

Outpatient Services Deaconess Primary Care for Seniors

1750 Oak Hill Road Evansville IN 47711

Outpatient Physician Clinic Deaconess Cross Pointe Outpatient Clinic

445 Cross Pointe Blvd Evansville IN 47715

Outpatient Services Surgical Weight Loss Clinic

310 W Iowa Street Evansville IN 47710

Outpatient Physician Clinic Deaconess Comp Center

329 W Columbia Street Evansville IN 47710

Outpatient Physician Clinic Deaconess Cross Pointe-Princeton

1808 Sherman Drive Princeton IN 47670

Outpatient Physician Clinic Deaconess Cross Pointe-Rockport

2792 N US Highway 231 Rockport IN 47635

Outpatient Physician Clinic USI Student Health Center

8600 University Blvd Evansville IN 47712

Outpatient Physician Clinic Deaconess Cross Pointe-Owensboro

920 Frederica Suite 1003 Owensboro KY 42301

Outpatient Physician Clinic Deaconess Cross Pointe-Henderson

209 N Elm Street Henderson KY 42420

Outpatient Physician Clinic Deaconess Procedure Center

421 Chestnut Street Evansville IN 47713

Outpatient Services Deaconess Hospital Physical Medicine

520 Mary Street Suite 260 Evansville IN 47747

Outpatient Services Deaconess Family Medicine

520 Mary Street Suite 340 Evansville IN 47747

Outpatient Physician Clinic Deaconess Family Medicine

4121 Gateway Blvd Newburgh IN 47630

Outpatient Physician Clinic Deaconess Pre-Admission Testing

520 Mary Street Suite 330 Evansville IN 47747

Diagnostic Center Deaconess Primary Care for Seniors

4107 Gateway Blvd Newburgh IN 47630

Outpatient Physician Clinic Deaconess Urgent CareComp Care

10455 Orthopaedic Drive Newburgh IN 47630

Outpatient Physician Clinic Midwest Radiological Imaging Gateway Phy

4087 Gateway Blvd Newburgh IN 47630

Diagnostic Center Deaconess Hospital Physical Medicine

10455 Orthopaedic Drive Newburgh IN 47630

Outpatient Services Deaconess Clinic Princeton Med Ofc Bldg

685 Vail Street Princeton IN 47670

Diagnostic Center Deaconess Chemotherapy Infusion Ctr

4055 Gateway Blvd Suite 1200 Newburgh IN 47630

Outpatient Services Deaconess Clinic West

545 S Boehne Camp Road Evansville IN 47712

Diagnostic Center Deaconess Clinic Gateway

4233 Gateway Blvd Newburgh IN 47630

Diagnostic Center Deaconess Critical Care Group

519 Harriett Street Evansville IN 47747

Outpatient Physician Clinic Deaconess Gateway Gastroenterology

4133 Gateway Blvd Newburgh IN 47630

Outpatient Physician Clinic Deaconess Hospital Infusion Svcs

421 Chestnut Street Evansville IN 47713

Outpatient Services Deaconess Hospital Mammography & Imaging

421 Chestnut Street Evansville IN 47713

Diagnostic Center Deaconess Radiology

611 Harriett Street Suite 103 Evansville IN 47710

Diagnostic Center Deaconess Regional Laboratory

4155 Gateway Blvd Suite 110 Newburgh IN 47630

Diagnostic Center Deaconess Sleep Center

350 W Columbia Street Suite 210 Evansville IN 47710

Outpatient Services Doctor's Plaza X-Ray

611 Harriett Street Evansville IN 47710

Diagnostic Center Not Applicable - Deaconess Hospital prepares its own Community Benefit Report. A cost to charge ratio was used for most of the calculations for the table. Worksheet 2 was used for this calculation. We did not use the cost to charge ratio for line 7g as it was not relevant to these services. The actual cost from our costing system was used when available. The cost to charge ratio for each service type was used to estimate cost when not available from our internal costing system. Subsidized health services attributed to physician clinics have a cost of $891,803. Bad debt expense included on Form 990, Part IX, line 25, column (a), but subtracted for purposes of calculating percentage in this column is $23,784,726. Deaconess Hospital's audited financial statements do not include a footnote discussing bad debt expense. The Medicare total revenue and allowable costs were estimated based upon the 2009 Medicare Cost Report and the 2010 contractual model for expected reimbursement. The Medicare shortfall for Deaconess Hospital is treated as community benefit due to the hospital providing care to Medicare patients at less than the allowable Medicare costs. Deaconess Hospital makes a distinction between charity and bad debt. In determining an individual or family's ablility to pay, Deaconess Hospital evaluates whether or not the responsible party has sufficient resources for payment. If an individual is determined to not have sufficient resources to pay, they will be considered eligible for charity care and will not be processed through either internal or external collections. Accounts of charity care patients who are unable to pay do not result in bad debt and are not collected upon. Deaconess Hospital's Community Benefit Committee gathers and analyzes hospital and community data to indicate community needs. The committee uses a dynamic, ongoing process to include a review of previous or current assessments by other community groups, presentations made by outside groups soliciting Deaconess' involvement in community initiatives, review of health and demographic information of inpatients and outpatients, and analysis of information from outside organizations and internal records to identify trends and areas of concern requiring attention. Deaconess Hospital utilizes Financial Counselors to educate, inform and assist patients and families in understanding their financial obligation, ability to qualify for financial assistance through Deaconess Hospital's Financial Assistance Program and payment options. Specifically, Financial Counselors staff the Emergency Department, Registration Areas, Cashier Area as well as float among Inpatient areas to ensure each and every patient requiring assistance is reached. In addition to the personal and individualized counseling provided by the Financial Counselors, various forms of media are distributed throughout Deaconess Hospital explaining the financial assistance process. Additionally, policies for financial assistance are posted widely throughout Deaconess Hospital and on the internet at www.deaconess.com. Deaconess Hospital is a major referral center for a 25-county Tri-State area in Southwestern Indiana, Western Kentucky, and Southeastern Illinois. The Hospital and its facilities are located on four campuses which include the main 28-acre campus on the near north side of Evansville in Vanderburgh County, the 63-acre Gateway Campus located in Warrick County on the eastern border of Vanderburgh County, and two other eastside Evansville locations for psychiatric behavioral services and rehabilitation services. The Hospital operates a Main Campus with a total of 318 beds consisting of 24 intensive care beds, 26 cardiac intensive beds, 66 cardiac beds, 23 oncology/pulmonology beds, 61 orthopaedic/neurological beds, 5 pediatric trauma beds, 13 mental health beds, 96 medical/surgical beds and 4 hospice beds. In addition, the Hospital provides a full-array of comprehensive outpatient and ambulatory services on its Main Campus and other specific services at multiple sites within its primary and secondary service areas. The Hospital operates the 94 bed Deaconess Gateway Hospital which was opened in January 2006, on the Gateway Campus consisting of 13 adult intensive care beds, 17 pediatric and pediatric intensive care beds, 32 medical/surgical beds, 16 orthopaedic beds and 16 neurosurgical beds. The Hospital provides a full array of comprehensive outpatient and ambulatory services on the Gateway Campus. The Hospital owns and operates Deaconess Cross Pointe, a free-standing, 60 -bed inpatient psychiatric hospital located approximately 7 miles east of the Main Campus in Evansville. Also, the Hospital is an owner in three joint venture hospitals, Deaconess Women's Hospital of Southern Indiana, LLC d/b/a The Women's Hospital, a free standing specialty 74-bed women's and infant's hospital (located on the Gateway Campus), HealthSouth/Deaconess, LLC d/b/a Tri-State Regional Rehabilitation Hospital, a 78-bed inpatient acute rehabilitation hospital located approximately 8 miles to the southeast of the Main Campus and the Heart Hospital at Deaconess Gateway, LLC, a 24-bed cardiovascular specialty hospital which resides on the Gateway Campus. The Hospital plays an active role in medical education, operating a three-year family medicine residency program, a post-graduate pharmacy residency program, and several undergraduate medical affiliations. The Hospital also provides continuing medical education programs for attending physicians, other health professionals, other allied health programs, and the community at large. The Hospital, through its related corporations, provides outreach services to nursing homes, physicians' offices and surrounding smaller hospitals in its service area.` Deaconess Hospital and its related organizations participate in various community building activities. Deaconess Cross Pointe is a member of the Suicide Prevention Coalition. Deaconess Cross Pointe offers a variety of free suicide awareness and prevention programs to help reduce the incidence of suicide in the Tri-State. Deaconess Hospital sponsors the Health Science Institute which allows high school students to experience firsthand the wonders of medicine and medical research through seminars, clinical experiences and demonstrations. Interaction with leading health care professionals broadens students' knowledge of medical care and career opportunities in health care and health sciences. Students from Southwestern Indiana high schools are chosen to participate. Deaconess leaders and administrators serve as board members on local university boards. They serve on educational planning committees and determine the educational needs of students and businesses in the community. List of States Where Community Benefit Report is Filed: INDIANA Deaconess Hospital works in concert with Deaconess Health System and Deaconess Clinic to provide healthcare services with a compassionate and caring spirit to persons, families and communities of the Tri-State. Deaconess Health System works to increase access to healthcare services within our community through Deaconess Hospital and Deaconess Clinic. Deaconess Hospital is a medical institution dedicated to providing qualtiy patient care with unrelenting attention to clinical excellence, patient safety and an unparalleled passion and commitment to assure the very best healthcare for the patients served. Deaconess Clinic provides excellent primary and multi-speciality healthcare in a personalized fashion with a dedicated focus to serve the community with excellent, timely and compasssionate patient care. true Aurora Inc 1100 Lincoln Avenue Evansville IN 47714 351759576 3 10000 General Support Evansville Area Comm Churches 713 N 2nd Avenue Evansville IN 47710 350886837 3 12000 Food for Food Pantry Girl Scouts of Raintree Council PO Box 1350 Evansville IN 47706 353876380 3 7575 Healthier You Prog Economic Development Coalition 100 NW 2nd StSte 208 Evansville IN 47737 320152630 3 25000 General Support Evansville Museum of Arts & Science 411 SE Riverside Drive Evansville IN 47713 350874517 3 10000 Capital Campaign American Cancer Society 6301 Old Boonville HwySteB Evansville IN 47715 381387120 3 6000 General Support YMCA of SW Indiana Inc 222 NW 6th Street Evansville IN 47708 350869074 3 11500 General Support Evansville Regional Buisness One Vectren Sq Ste 744 Evansville IN 47708 030408032 6 10000 General Support Four Rivers Resource Services 1001 E Main St PO Box 367 Washington IN 47501 351665140 3 6000 Capital Campaign United Way of Southwestern Indiana PO Box 18 Evansville IN 47701 350868069 3 15000 General Support 10 0 Additional Information Part 1, Line2 Deaconess Hospital confirms all recipients of funds are organizations whose goals coincide with Deaconess' mission of providing quality health care with a compassionate and caring spirit. The organizations provide needed services to our community to improve health and wellness for the citizens in the surrounding area. X true true X X X X X false true false false false false true false false LINDA WHITE 307823 289696 151669 0 1348127 65154 161405 0 14167 14167 1983191 369017 1397694 0 DAVID D CHRISTESON MD 0 341058 0 86074 0 1941 0 25113 0 25482 0 479668 0 0 RUSTON L STOLTZ MD 0 276243 0 29304 2713 720 0 7601 0 5585 2713 319453 0 0 RICHARD M STIVERS 208544 196232 90267 0 460986 45701 37315 0 10719 10719 807831 252652 491246 0 HARRY L SMITH JR 421404 0 95062 0 7784 4000 112467 0 30883 0 667600 4000 0 0 JAMES R PORTER MD 319584 0 59641 0 1941 0 82903 0 21057 0 485126 0 0 0 SHAWN W MCCOY 288399 0 64603 0 4775 2800 71190 0 22082 0 451049 2800 0 0 CHERONA J HAJEWSKI 264087 0 49833 0 4613 0 50340 0 28381 0 397254 0 0 0 BRUCE E EPMEIER 195388 0 36789 0 18962 0 46363 0 16971 0 314473 0 15521 0 LARRY F PILE 190774 0 32278 0 1622 0 5847 0 19006 0 249527 0 0 0 CHERYL A WATHEN 193664 0 21419 0 1701 2200 22825 0 25912 0 265521 2200 0 0 RICHARD B PERRY 135237 0 27838 0 1221 0 7842 0 22517 0 194655 0 0 0 JOYCE A THOMAS 142040 0 19241 0 0 0 23517 0 7615 0 192413 0 0 0 VENKATESH R MADADI 699538 0 0 0 61921 0 6749 0 21439 0 789647 0 0 0 RAJESH J PATEL MD 696713 0 0 0 56605 0 10655 0 23770 0 787743 0 0 0 NIRMAL JOSHI MD 660936 0 0 0 68819 0 5308 0 24730 0 759793 0 0 0 AYMAN ELFAR MD 599732 0 0 0 56617 0 5605 0 21439 0 683393 0 0 0 SUSAN DOUGLAS MD 571854 0 0 0 54216 0 12040 0 10150 0 648260 0 0 0 SUPPLEMENTAL INFORMATION Part 1, Line 1a Social club dues are paid for Linda White and Harry Smith for organization business only. Any personal use of the club must be paid by the employees. Part 1, Line 4b Linda White: supplemental retirement payout of $1,309,125; contributions made to a supplemental accumulation account of $149,645; contributions made to a 457 plan of $16,500; suppplemental accumulation account payout of $88,569 Harry Smith: contributions to supplemental accumulation account of $100,707; contributions made to a 457 plan of $16,500 Richard Stivers: supplemental retirement payment of $433,225; supplemental accumulation account payout of $58,023; contributions made to a 457 plan of $16,500 James Porter: supplemental accumulation account contributions of $71,143; contributions made to a 457 plan of $16,500 Shawn McCoy: supplemental accumulation account contributions of $59,430; contributions made to a 457 plan of $16,500 Cherona Hajewski: supplemental accumulation account contributions of $38,580; contributions made to a 457 plan of $16,500 Bruce Epmeier: supplemental accumulation account contributions of $37,149; contributions made to a 457 plan of $16,500; supplemental accumulation account payout of $15,521 Nirmal Joshi: contributions made to a 457 plan of $438 Ayman Elfar: contributions made to a 457 plan of $2,885 Rajesh Patel: contributions made to a 457 plan of $16,500 Venkatesh Madadi: contributions made to a 457 plan of $16,500 David Christeson: contributions made to a 457 plan of $16,500 Ruston Stoltz: contributions made to a 457 plan of $16,500 Part 1, Line 6b Incentive compensation payments are based upon successful achievement of established inpatient satisfaction measures, outpatient satisfaction measures, compliance with publicly reported quality indicators, operating margin as well as other technical and personal functional goals. Deaconess Hospital's incentive compensation programs are formulated to reward behavior that balances patient needs and efficient delivery of patient care to ensure the best outcomes are achieved. INDIANA FINANCE AUTHORITY 351602316 45471AAJI 2009-03-26 55914771 FACILITY CONSTRUCTION false false INDIANA FINANCE AUTHORITY 351602316 45471AAG7 2009-03-26 40000000 FACILITY CONSTRUCTION false false INDIANA HLTH FACILITY FINANCING AUTHORITY 351611409 4547977Y1 2004-05-27 55371597 FACILITY CONSTRUCTION false false INDIANA HLTH FACILITY FINANCING AUTHORITY 351611409 4547978A2 2004-05-27 25000000 FACILITY CONSTRUCTION false false 55914771 12025077 825245 43064449 2011 false false false true 40000000 2672335 460597 36867068 2011 false false false true 55581965 5255622 2798830 47527513 2006 false false true true 25000000 322484 24677516 2006 false false true true false false false false true 0.01590 0.01590 true false false false false true 0.01000 0.01000 true false true false false true 0.01100 0.01100 true false true false false true 0.01760 0.01760 true true false false true TRINITY PLUS 2. true false true true true false true CREDIT AGRICOLE 2. true false true true false false false false true true true false false false true Misty Adye Family Mbr of Bd Mbr 30851 Compensation false Alex Seibert Family of Key Employee 72636 Compensation false Letta Fraccaro Family Mbr of Bd Mbr 45365 Compensation false Ann Tornatta Family Mbr of Bd Mbr 95074 Compensation false Nancy Koehler Family Mbr of Bd Mbr 111316 Compensation false Vectren Energy Delivery Common Bd Mbr 5216591 Gas/ Electric Utility false Form 990, Part I, Line 1 Organization's Mission or Most Significant Activities Deaconess Hospital provides quality healthcare services with a compassionate and caring spirit to persons, families and communities of the Tri-State. At Deaconess Hospital, our values are based on our commitment to Quality. We define Quality as the continuous improvement of services to meet the needs and exceed the expectations of the customers we serve. Our Values are quality in everything we do, respect for all people, efficiency and effectiveness in the use of resources, innovation toward continuous systems improvement, partnership with those we serve and with suppliers, education for continuous growth and knowledge and pride in workmanship. To accomplish its mission, Deaconess Hospital is committed to improving the quality of life for the people of the Tri-State by demonstrating excellence in healthcare services, providing access to healthcare, providing charity care to those in need, promoting healthly lifestyles, offering spiritual and psychological support, supporting health related education, and advancing health knowledge through research. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES Other Program Service Revenue consists of Deaconess Hospital's income from the investment in joint ventures. Other Program Service expenses consisted of Community Benefit grants/assistance. FORM 990, Part VI, Line 6 CLASSES OF MEMBERS OR STOCKHOLDERS Deaconess Health System, Inc. is the sole corporate member of Deaconess Hospital, Inc. Form 990, Part VI, Line 7a ELECTION OF MEMBERS AND THEIR RIGHTS The Board of Directors may elect one or more Non-Medical Staff Members of the governing body through an approved election and approval process. The election and approval process for Non-Medical Staff Members begins with a recommendation by the Governance Committee for Membership to the Board of Directors. That recommendation is then reviewed and approved by the Board of Directors. Depending on the decision reached by the Board of Directors, Membership may or may not be granted to that individual. Medical Staff Executive Council Leadership are appointed to Board of Directors Membership through their position as elected Medical Staff Leaders. Through the election process of the Medical Staff Executive Council, their appointment is confirmed and approved. Form 990, Part VI, Line 9 OFFICERS WHO CANNOT BE REACHED Richard M. Stivers 9901 Browning Road Evansville, IN 47725 Form 990, Part VI, Line 11a Organization's process to review form 990 The process that Deaconess Hospital utilizes to present the Form 990 to its governing body prior to filing is to present the Form 990 to the Controller, CFO and CEO of the organization for review. After this review is performed and all questions are answered, the Form 990 is presented to the Board of Directors at the board meeting prior to the filing date of the Form 990. Any additional questions are answered and the final filing is then completed. Form 990, Part VI, Line 12c ENFORCEMENT OF CONFLICTS POLICY Conflict of Interest review and compliance activities are conducted throughout the year under the direction of Deaconess Hospital's Corporate Compliance Officer. Upon appointment and, annually, thereafter, officers, directors, trustees, and key employees, also known as interested persons, are required to complete "The Conflicts of Interest Questionnaire" and/or "The Disclosure Questionnaire". These documents serve to ensure interested persons or committee members with board delegated powers have an appropriate and timely manner in which to disclose any potential conflicts. Conflicts are considered with respect to outside interest, investments, outside activities, and business interests among the interested persons as will as their family members. On a periodic basis, reviews occur to ensure Deaconess Hospital operates in a manner consistent with its charitable purpose. Subjects that are reviewed on a periodic basis include compensation, physician relationships, partnership and joint venture arrangements. Form 990, Part VI, Line 15a COMPENSATION PROCESS FOR TOP OFFICIAL Deaconess Hospital utilizes a compensation committee to approve executive, director and physician compensation as well as executive and physician benefits programs. The Compensation Committee is appointed by the Board of Directors and must meet the independence requirements of the SEC. The Committee has the power and authority to, annually review and approve and recommend to the Board of Directors for its final approval for the CEO and each other executive officer of the System all elements of executive compensation, monitor broadly the structure, philosophy or competitiveness of the system's general hiring or compensation practices, oversee the establishment and administration of the Company's broad-based benefits plans and programs, and review or approve significant amendments or changes to the plans and programs, to retain and terminate any compensation consultant to be used to assist in the evaluation of director, CEO or executive officer compensation and shall have the sole authority to approve the consultant's fees and other retention terms. The Committee also has the authority to obtain advice and assistance from internal or external legal, accounting or other advisors, to approve all Physician and Physician-related contracts and to make regular reports to the Board. Form 990, Part VI, Line 15b Compensation Process for Officers Deaconess Hospital utilizes a compensation committee to approve executive, director and physician compensation as well as executive and physician benefits programs. The Compensation Committee is appointed by the Board of Directors and must meet the independence requirements of the SEC. The Committee has the power and authority to, annually review and approve and recommend to the Board of Directors for its final approval for the CEO and each other executive officer of the System all elements of executive compensation, monitor broadly the structure, philosophy or competitiveness of the system's general hiring or compensation practices, oversee the establishment and administration of the Company's broad-based benefits plans and programs, and review or approve significant amendments or changes to the plans and programs, to retain and terminate any compensation consultant to be used to assist in the evaluation of director, CEO or executive officer compensation and shall have the sole authority to approve the consultant's fees and other retention terms. The Committee also has the authority to obtain advice and assistance from internal or external legal, accounting or other advisors, to approve all Physician and Physician-related contracts and to make regular reports to the Board. Form 990, Part VI, Line 19 Governing Documents Disclosure Explanation Deaconess Hospital does not make its governing documents, conflict of interest policy or financial statements available to the public. Form 990, PART VII, SECTION B The average worked hours of Ms. White and Mr. Stivers are reported as 50 hours per week on the Deaconess Hospital, Inc. return. This time relates to hours worked and paid from Deaconess Hospital, Inc., the paymaster for Ms. White and Mr. Stivers. A portion of those 50 hours relates to time devoted to Deaconess Health System issues and concerns. The allocation of time for service to Deaconess Health System is 20 hours and 10 hours per week for Ms. White and Mr. Stivers, respectively. SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTS PERSON NAME AND RELATIONSHIP AMOUNT AND DESCRIPTION SHARE REVENUE SOUTH CENTRAL COMMUNICATIONS $ 143,470 BOARD MEMBER ADVERTISING PROVIDER SHERRI MCCOY $ 19,532 FAM OF KEY EMPL COMPENSATION Deaconess Health System Inc 600 Mary Street Evansville IN 47747 351532889 Healthcare IN 501(c)(3) 11a na Deaconess Clinic Inc 421 Chestnut Street Evansville IN 47713 263083364 Healthcare IN 501(c)(3) 3 na Deaconess Hlth Plns 350 W Columbia Suite 400 Evansville IN 47710 383492529 Perf Prov IN na Related 259460 1866266 false false Heartcare Hlth Sys 415 W Columbia Evansville IN 47710 352038344 Healthcare IN na Related -627211 157166 false false Progressive Hlth IN 150 N Rosenberger Evansville IN 47712 208480988 Outpatient IN na Related 1281525 1075269 false false Hrt Hosp Deac Gtewy 4007 Gateway Blvd Newburgh IN 47630 261766835 Hospital DE na Related 922511 7996728 false false Tri-St Rad Oncology 1500 Rosecrans Avenue Manhattan Beach CA 90266 263706834 Outpatient DE na Related 1183247 3501042 false false Tri-St Med Mgmt 600 Mary Street Evansville IN 47747 351875888 Phy Mgmt IN na C 0 0 1.00000 false true false false false false false false true true false false false true false true true false Deaconess Clinic Inc p 5499498 Heart Hosp at Deac Gateway LLC p 5761912 Heart Hosp at Deac Gateway LLC n 6871258 Deaconess Health Plans LLC p 214649 Deaconess Clinic Inc i 291485 Deaconess Health System LLC p 132465 Deaconess Health System LLC j 1423678 Deaconess Health System LLC Q 18171317 Heartcare Health System LLC B 595667 Deaconess Health System LLC N 664969 Heartcare Health System LLC P 238766 Deaconess Health Plans LLC I 53247