2011-11-15T13:18:01-05:00 2010-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE INDIANAPOLIS IN 46204 990 2010-01-01 350868132 MEMORIAL HOSPITAL OF SOUTH BEND INC MEMO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 JEFFREY COSTELLO 2011-11-15 3176817000 2010 2016-02-24 21:20:13Z PHILIP NEWBOLD 615 N MICHIGAN STREET SOUTH BEND IN 46601 419825198 false X www.qualityoflife.org X 1923 IN MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. 21 14 3036 547 38888 13534 3220079 5006001 394957158 372173020 -777596 4909387 21237837 12921446 418637478 395009854 0 1222556 0 0 147694088 148393083 0 0 0 203891263 210491302 351585351 360106941 67052127 34902913 622488889 638068406 201354161 219938003 421134728 418130403 X MEMORIAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE OF THE PEOPLE IN OUR COMMUNITY. false false 65561780 157865066 Ancillary Services offers the following services for patients and facilities: - Imaging Services - Outpatient Physical, Occupational and Speech Therapy - Infusion Treatments - Radiation Oncology Therapy - Cancer Research - Cardiac Cath Lab - Sleep Lab - Interventional Radiology - Environmental Services - Nutritional Services - Pharmacy Services - Laboratory 2010 Statistics for this service unit include: - 453,328 Inpatient procedures - 292,525 Outpatient procedures - 1,359 Inpatient Caths - 1,519 Outpatient Caths - 295,014 Outpatient visits - 655,868 Meals 56838457 91592813 Patient Care Unit Services provides a wide variety of hospital services including: - Inpatient rehabilitation CARF accredited - Medical - Post surgical - Orthopedic - Oncology - Intensive and intermediate - Heart and Vascular - Mother and Child - Special Care Obstetrics - Neonatal Intensive Care Level III - Emergency - Trauma Level II - Pediatrics - Pediatric Intensive Care - Pediatric Hematology Oncology - Medical Flight program - Pediatric Intensive Care Transports 2010 Statistics for this service unit include: - 84,088 Patient Days - 16,911 Inpatient ER visits - 96,481 Outpatient ER visits - 2,837 Births - 6,586 Observation stays - 235 Medical flights - 840 Full time equivalent employees 45258500 99397638 Surgical Services provides the following services: - General Surgery - Vascular Surgery - Cardiac Surgery - Orthopedic Surgery - Gynecological Surgery - Trauma Surgery - GI Labs - Pulmonary Services - Pain Center - DaVinci Robotic Surgery 2010 Statistics for this service unit include: - 8,085 Inpatient procedures - 366 Open Heart procedures - 18,363 Outpatient procedures 110300483 1222556 27714847 277959220 true true false true false false false false false true true false false true false true true false false true false false false false false true false true false true true true false false false false false false true true true false false false false false true true true false false true 382 0 true 3036 true true true false false false false false false false false false X 21 14 false false false false true true true true true false false true false false false true true true true IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 X Wellington Jones Jr 2.0 X X 4318 0 0 Charles Miller 2.0 X X 2073 0 0 Etta Nevel MD 2.0 X 1053 0 0 Robert Yount MD 2.0 X 0 25000 0 Keith Sherry MD 20.0 X 176435 0 18498 Sandra Brown MD 2.0 X 3011 0 0 Faye Magneson MD 2.0 X 4091 0 0 James Schwartz Sr 2.0 X 0 0 0 Gerard Duprat MD 2.0 X 3990 0 0 Thomas Cassady Jr 2.0 X X 4460 0 0 Jesse Hseih MD 2.0 X 0 0 0 Maurice Hurwich MD 4.0 X 32671 0 0 M Rose Meissner 2.0 X X 0 0 0 Margaret King 2.0 X 0 0 0 Thomas Burish PhD 2.0 X 0 0 0 Thomas Hauch MD 2.0 X 0 0 0 Maria Slager 2.0 X 0 0 0 Perry Watson III 2.0 X X 0 0 0 Gayle Rosencrantz 2.0 X 0 0 0 Steven Cramer PhD 2.0 X 3051 0 0 Melvin Hall 2.0 X 0 0 0 Delores Wilmoski 2.0 X 0 0 0 Peter Baranay 2.0 X 0 0 0 Carlton Lyons MD 2.0 X 2797 0 0 Philip Newbold 2.0 X 0 1001875 229464 George Soper 2.0 X 0 244651 99920 Jeffrey Costello 2.0 X 0 469348 99022 Kreg Gruber 40.0 X 436921 0 98455 Connie M McCahill 40.0 X 222879 0 44036 Cheryl Wibbens - Lesh MD 40.0 X 368127 0 38149 Robert Riley MD 40.0 X 286762 0 39014 Scott Thomas MD 23.0 X 335306 0 9968 Thomas Sutula MD 40.0 X 220359 0 37550 Mark Lavallee 40.0 X 222761 0 37417 2331065 1740874 751493 99 false true false SOUTH BEND EMERGENCY PHYSICIANS 615 N Michigan SOUTH BEND IN 46601 Physician services 6320660 SOUTH BEND MEDICAL FOUNDATION 530 N Lafayette Blvd SOUTH BEND IN 46601 Lab services 6172764 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 IS SFTWR MAINTENANCE 3177987 INDIANA BLOOD CENTER 3450 N Meridian Street INDIANAPOLIS IN 46208 Blood Processing Svc 3086064 WOODCOX BLDG CONTRACTORS 51175 PRESCOTT AVE SOUTH BEND IN 46637 CONSTRUCTION MANAGER 2005882 83 3450860 1555141 5006001 NET PATIENT REVENUE 621110 370805467 370805467 RENTAL REVENUE 532000 1173329 1173329 MEDICAL EDUCATION 611710 77469 77469 CASH DISCOUNTS 561499 34272 34272 AMBULANCE SUPPLY 621910 82483 82483 372173020 3296799 3296799 91693 91693 0 0 62798 15164 47634 47634 47634 26316575 4500 24797573 2607 1519002 1893 1520895 1520895 0 0 0 GAIN ON SWAP TERMINATION 561499 5270917 5270917 ATHLETIC CLUB 713940 1661156 1661156 MRI (JOINT VENTURE) INCOME 561499 1326311 1326311 4615428 3071033 38888 1505507 12873812 395009854 376570364 38888 13394601 1222556 1222556 0 0 0 1058738 0 1058738 0 40200 40200 0 114072645 85616439 28456206 0 5636316 4230315 1406001 0 19356492 14648769 4707723 0 8228692 6176013 2052679 0 0 0 171419 171419 0 214598 214598 0 14727 11053 3674 0 0 0 1337932 1337932 0 37559161 28189553 9369608 0 77348 58053 19295 0 71927324 53983016 17944308 0 24426 18333 6093 0 0 0 6231210 4676811 1554399 0 783313 587913 195400 0 0 0 211634 158841 52793 0 2675987 2008452 667535 0 0 24524075 18406450 6117625 0 2328440 1747602 580838 0 CORPORATE FEE 21712987 16296599 5416388 UNCOLLECTIBLE ACCOUNTS 37433659 37433659 DUES & SUBSCRIPTIONS 889044 666783 222261 RECRUITMENT 161813 121448 40365 WEARING APPAREL 126081 94630 31451 2086124 1565732 520392 360106941 277959220 82147721 0 18825 19325 74667024 50012044 462022 539700 70257527 61880211 68370 12376 11710633 13706162 1104326 1083100 541206724 261294425 274080186 279912299 103833867 123873292 73770696 99517740 788973 765284 0 1171474 11726440 5575399 622488889 638068406 39071682 34064199 153845 14027 142195035 138791700 0 1780830 19933599 45287247 201354161 219938003 X 414636025 414391549 6498703 3738854 421134728 418130403 622488889 638068406 X 34902913 -37907238 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 14727 false 14727 false false Lobbying Detail Schedule C, Part IV Memorial Hospital paid dues to the following organizations for which the percentage listed was attributable to lobbying: AASM (American Academy of Sleep Medicine) - 1% AORN (Association of periOperative Registered Nurses) - flat amount $26.94 AOTA (American Occupational Therapy Association) - 13% ASET, Inc (American Society of Electroneurodiagnostic Technologists) - flat amount $25 Dietary Managers Association, Inc. - 2% Indiana Chamber of Commerce - 18% Indiana Hospital Association - 5.45% ISMA (Indiana State Medical Association) - 26% Society of Nuclear Medicine, Inc - 2% AAFP (American Academy of Family Physicians) - 20% Chamber of Commerce of St. Joseph County - 5% 18964553 18964553 304348743 97503997 206844746 722092 698406 23686 202153138 160464371 41688767 15018198 2627651 12390547 279912299 BOND RESERVE FUND 53000 ALTERNATIVE INVESTMENTS 99464740 99517740 0 ASSET RETIREMENT OBLIGATION 4137590 INTEREST RATE SWAP 36316078 CAPITAL LEASE PAYABLE 1707226 BOND ARBITRAGE REBATE PAYABLE 3126353 45287247 395009854 360106941 34902913 -37917238 -37917238 -3014325 378814938 13417708 -27657429 -14239721 393054659 1955195 1955195 395009854 360111101 4160 4160 360106941 360106941 Change in Net Assets Part XI Reconciliaton of Change in Net Assets from 990 to Audited Fin Stmt Unrealized Loss on Swap Transactions (27,671,589) Transfers to Affiliates (21,016,908) Change in Interest in Recipient Org (2,759,849) Unrealized Gain on Investments 13,417,708 Capital Contributions 113,400 Total (37,917,238) Reconciliation of Revenue Part XII Reconciliation of Revenue per Audited Fin Stmt w Revenue per 990 Line 2d Other South Bend Chocolate Cafe Expense 15,164 Unrealized Loss on Swap Transaction (27,671,589) Expense Posted to Revenue (1,004) TOTAL (27,657,429) Line 4b Other Net Assets Released 1,955,195 Reconciliation of Expenses Part XIII Reconciliation of Expenses per Audited Fin Stmt w Exp per 990 Line 2d South Bend Chocolate Cafe 15,164 Ambulance donation (10,000) Expense classified as revenue 1,004) TOTAL 4,160 Central America and the Caribbean Investments 81581380 81581380 81581380 true false true false true false true true true X true X true true true false true true 6812762 6812762 0.02110 50709192 19718568 30990624 0.09600 57521954 19718568 37803386 0.11710 3998651 712373 3286278 0.01020 6051113 2405868 3645245 0.01130 820036 697447 122589 0.00040 1098235 225085 873150 0.00270 11968035 4040773 7927262 0.02460 69489989 23759341 45730648 0.14170 false 14791196 7395598 74496965 90796161 -16299196 true true 1 1 Memorial Hospital of South Bend

615 N Michigan Street South Bend IN 46601

X X X X X X Memorial Hospital of South Bend 1 6 MEMORIAL SLEEP DISORDER CENTER

53990 CARMICHAEL DRIVE SOUTH BEND IN 46601

OUTPATIENT CLINIC PROVIDING SLEEP RELATED DIAGNOSIS AND TREATMENT MEMORIAL HEALTH PLEX

111 W JEFFERSON ST SOUTH BEND IN 46601

OUTPATIENT REHABILITATION FACILITY AND FITNESS FACILITY MEMORIAL BREAST CARE CENTER

100 NAVARRE PLACE SOUTH BEND IN 46601

OUTPATIENT DIAGNOSIS AND TREATMENT MEMORIAL CHILDREN'S THERAPY CENTER

100 NAVARRE PLACE SOUTH BEND IN 46601

OUTPATIENT DIAGNOSIS AND TREATMENT MEMORIAL RADIOLOGY

100 NAVARRE PLACE SOUTH BEND IN 46601

OUTPATIENT DIAGNOSIS AND TREATMENT MEMORIAL LIGHTHOUSE PHYSICAL THERAPY

6913 N MAIN STREET GRANGER IN 46530

OUTPATIENT DIAGNOSIS AND TREATMENT Part I, Line 3c Not applicable Part I, Line 6a The Community Benefit Fund is the System's mechanism for re-investing funds to improve the health status of communities it serves. The System, which includes Memorial Hospital of South Bend Inc., tithes 10% of the previous year's bottom line and transfers it to the Community Benefit Fund for investment in the community. This investment is in addition to the Hospital's charity care and prevention, and education activities supported through its operating budget. The Community Health Enhancement Committee of the Board began the fund in 1993 and makes ongoing policy and oversees the administration of the fund and determines specific investment allocations. Volunteers and staff are committed to prudently investing these resources in an accountable manner. As a community not-for-profit organization, we take seriously our responsibility to invest our resources and energies into understanding and meeting the divergent health care needs of all, and ensure that everyone, regardless of their ability to pay, receives the care they need. Memorial has long been recognized for the collaboration efforts which engage individuals and organizations with diverse socio-economic religious, ethnic, race, age, and gender identity characteristics. Our team of passionate and dedicated health care professionals, along with many partners throughout the Northern Indiana and Southern Michigan (Michiana) region, helped us contribute significantly to the health and well-being of our community. In 2010, we provided charity care to 7,139 individuals. Further, Memorial plays a key role in serving the community as a whole. However, the above is only part of Memorial's community service and investment of the benefit's story. This report paints a picture, of how we touch and improve the health and the quality of lives throughout Michiana. It is a testimony to the commitment and leadership of our medical staff, volunteer board of trustees, employees, auxiliary volunteers, and community partners, whose dedication to serve, touch many lives and make our community a better place to live, work, and play. Part I, Line 7, Column F Bad Debt Expense removed from Total Expenses $37,433,659 Part I, Line 7g Not applicable Costing Methodology Part I, Line 7 Donations - the actual cost of the donation or departmental net contribution, whichever is appropriate, from General Ledger records and reports are included In-Kind/Volunteer Services - When a specific person is listed as the event volunteer, the YTD hourly wage is pulled from the labor distribution report for 12/31, multiplied by the number of hours at the event or events. When a specific job class is listed (i.e. "peds rehab"), the average hourly wage is computed for all employees in that job class and department and used in the same manner. Benefits are added to each at a ratio of benefit dollars to total salaries, multiplied by total salaries calculated for the event. Part III, Line 4 The Corporation evaluates the collectability of its accounts receivable based on the length of time the receivable is outstanding, payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for doubtful accounts when they are deemed uncollectible. Costing methodology is the same as tax form 990, schedule H, worksheet 2 methodology. Patient care cost adjusted by non-patient activity, expenses, and patient care charges. Rationale for inclusion of the Medicare shortfall as a Community Benefit Part III, Line 8 Participation in the governmental Medicare program does not provide the opportunity for a hospital to negotiate a reimbursement rate or structure that would allow the hospital to cover the cost of the medical service rendered to the program participant, as would be the case in contractual negotiations with commercial insurance companies. Nor is the hospital allowed to provide only the services for which reimbursement covers the direct cost of care. This produces the same shortfall outcome as does the participation in the Medicaid program. The Medicaid program is recognized as a community benefit on Schedule H and on community benefit reports for most states. The quality and cost of the patient care is the same regardless of payor source. Hence the acceptance of Medicare reimbursement represents a reduction or relief of the government burden to pay the full cost of care provided. Financial Assistance Policy Part III, Line 9b The collection policy and procedures are as follows related to patients who are known to qualify for charity care or financial assistance: To ensure the Hospital fulfills its mission and commitment to the poor, the Hospital shall annually plan for and provide free health care and health-related services to the poor and qualified uninsured/underinsured. A patient is considered for Financial Assistance if all other State and Federal assistance opportunities have been exhausted. The Federal Income and Poverty Guidelines will serve as a guide in determining those patients that may qualify for Financial Assistance. All patients shall be treated consistently in the approval process including Medicare and non Medicare patients. PURPOSE: To provide financial assistance to those patients who cannot afford to pay and to provide discounted care to uninsured patients receiving healthcare services from Memorial Hospital of South Bend. PROCEDURE: 1.Memorial Hospital will assist patients in making a determination regarding whether or not the patient may be able to qualify for some form of entitlement through a Federal or State Government program and complete the appropriate applications for assistance. It is required that the patient will assist in the determination and application process. If the patient does not qualify for any Federal or State Assistance, we will start the Financial Assistance Approval process. 2.Identify patients potentially eligible for Financial Assistance through the pre-registration, admission, eligibility process, or through self pay account review and collection activities. 3.Provide to the patient a Financial Evaluation form. 4.Obtain or receive a signed, completed Financial Evaluation Form from the patient. 5.Determine eligibility by obtaining the following information from the patient: a)Gross income and most recent W-2 b)Prior years tax return (including all schedules) c)Last 3 pay stubs (if unemployed, Work One statement of earnings) d)Employment status and future earnings capacity e)Family size f)Medical expenses including drugs and medical supplies g)Last three bank statements If the patient does not have a prior year tax return, we will make our determination based on current income. A credit report may be run to substantiate documentation. There may be circumstances where a patient may not be able to provide all the above documentation needed to approve financial assistance. It will be up to the discretion of the Department Director and/or the CFO to grant approval in this circumstance. 6.Determine the amount of Financial Assistance by utilizing the Federal Poverty guidelines as a basis for qualification levels. Gross Annual income plus cash assets are used as the basis for income calculations. Financial Assistance will be granted for those patients who are homeless. If a patient is deceased and has no estate, we will grant charity on any outstanding self pay account balances. Documentation that an estate has not been filed will be attached to the Financial Assistance approval form. Note: Approval may be made based on Medical indigence. ie: Patients who have excessive pharmacy, oxygen, or ongoing medical expense. This amount would be deducted from their gross income. Financial Assistance will not be granted for non-medically necessary services. 7.Complete the Financial Assistance Approval form and forward to the Collection Coordinator. 8.The Collection Coordinator will review the Financial Assistance application to ensure that it is complete. The Coordinator will approve or deny the application before sending it to the Patient Account Manager for approval. Depending on the dollar amount of the financial assistance write off, approval signatures are required. The approval guidelines are as follows: $1.00 to $2,500.00 Collection Coordinator $2,501.00 to $10,000.00 Patient Account Service Manager $10,001.00 to $25,000.00 Director, Patient Account Services $25,001.00 and above Vice President, CFO 9. After all the appropriate signatures have been obtained, the Financial Assistance write off along with the corresponding documentation will be forwarded to Cash Application for write off. 10.Send determination letter to notify patient of the approval for Financial Assistance. 11.Financial Assistance approvals will apply retroactively to all open accounts with existing balances (including accounts in collections) and will be active for 6 months following the date of approval. 12.The document will be placed in the Financial Assistance file drawer under the date the write off was posted. UNINSURED SELF PAY DISCOUNTS For those patients who have no insurance and do not meet the above financial assistance guidelines, Memorial Hospital will provide an uninsured discount based on the following tiered structure: 30% discount if account is paid within 30 days from date of service 20% discount if account is paid within 90 days from date of service 10% discount if patient chooses to participate in the CarePayment financing Any exceptions must be approved by the Department Manager or Director. Needs Assessment Part VI, Line 2 At Memorial Hospital and Health System, our goal is to strengthen the health and well-being of our individual patients and neighbors, as well as the broader community. Grant dollars totaling $2,174,024 were obtained and blended with Memorial tithing dollars to deliver services and programs that impacted the physical health, mental health and quality of life of tens of thousands of individuals and families. Memorial invested $2,737,938 of tithing funds in community benefit, which in a time of economic upheaval is more important to building the vitality of our community than ever before. The services we provide are essential to not only the community's overall health, but also to the quality of life of every resident. This belief is supported in our culture; our volunteer board of trustees, physicians, nurses, patient care and support staff, and auxiliary volunteers take pride in the community outreach we do in the neighborhoods. It takes a whole system working together and committed to serving the inhabitants of our community. Our community is becoming increasingly diverse. The health risks associated with chronic diseases like diabetes, hypertension, and obesity, are particularly high among our growing, and often medically underserved, Hispanic and African-American populations. We reach out to these groups through churches, local community organizations, and grassroots efforts. Our goal is to help all residents access the care they need; to help them learn to manage their conditions and live healthier lives. In the past year, we collaborated with a number of organizations to gather information about the needs and strengths of our community residents. This information helps us to collaboratively determine our short- and long-term priorities as well as strategies for improving the overall community. Community Plunges provide opportunities for community and hospital leadership to spend time in the neighborhoods meeting with grassroots leaders and neighbors. Getting acquainted with the reality that many of us never see, and do not understand. Community Plunges have become a mainstay of Memorial's research into health and social ills as well as assets and strengths that influence and shape our community. (Plunges are offered annually, beginning in 1988 through 2010.) A committee of the Board of Trustees provides input and oversight into the decision-making of partnership opportunities, addressing the needs, building on the strengths of the community, and setting priorities for resource allocation. The Board Committee is composed of community members who serve on the four System-wide Boards of Directors. In addition, the division of Community Health Enhancement staff and employees of the Hospital and System are seated on most of the social service and health agencies boards and task forces in the community. This involvement provides a vehicle for ongoing communication, which flows continuously between the hospital and the community. The St. Joseph County Health Department Board is chaired by Memorial's Chief Nursing Officer. The CNO also has taken the lead in emergency preparation for the entire county. The greatest health and quality of life needs identified by the community include: - Access to primary and specialty care for the uninsured - Minorities disparities and access to prevention and disease management - Teen pregnancy and minority infant mortality In the coming year, the Hospital will be participating with the Health Department to develop the St. Joseph County Local Public Health System Performance Assessment as part of the State Department of Health's Indiana Public Health System Quality Improvement Program. Once this infrastructure is built through the identification and partnership of key stakeholders, the next activity will be the design and execution of the Community Health Needs Assessment. The projected timeline continues into the spring of 2012 through the strategic identification and planning stage to the implementation of activities to support the objectives based upon the priorities evidenced by the data. Patient Education and Eligibility for assistance Part VI, Line 3 When uninsured patients present to our hospital, they are offered the opportunity to meet with our eligibility specialists. Our eligibility specialists discuss the potential eligibility of the patient for multiple assistance programs, including our own internal financial assistance program. Our statements also include a notice that financial assistance is available to patients, and they can contact our customer service group for guidelines. Community Information Part VI, Line 4 Hoosier Healthwise (HHW), Children of Special Health Care Services, and Healthy Indiana Plan (HIP), are programs provided through the State of Indiana, to provide health care for children, and adults ages ranging from birth to 64 years of age, as well as children with special health care needs and developmental delays. The Community Health Enhancement team provides education, resources and assistance for community-based enrollment for individuals and families in our community for these programs. Spanish-speaking team members assist with enrollment at all community sites. In 2010, the Community Health Enhancement team facilitated needed coverage being obtained for over 700 individuals in our community. Community Information (geography and demographics) Established in 1830, St. Joseph County, Indiana has become the fourth largest county in the state of Indiana. The county spans 467 square miles, which includes a comfortable mix of rural cultural heritage and urban amenities. St. Joseph County is also the regional center for higher education. The County is home to more than eight colleges and universities including but not limited to Notre Dame University, Indiana University, Purdue Ext., Bethel University and St. Mary's College. The heart of the Health System is located within a mile of the University of Notre Dame, 10 miles south of the Michigan state line, and 40 miles east of Lake Michigan. Through the years, the environment of South Bend, the largest city in St. Joseph County, has changed from a focus on manufacturing (Studebaker and Uniroyal) to one of service industry. In fact, among the ten largest employers in the county, just two represent manufacturing. The University of Notre Dame is the largest employer, followed by Memorial Health System, the South Bend Community School Corporation, AM General, and St. Joseph Regional Medical Center. St. Joseph County, the five contiguous counties comprising its secondary service area and 12 counties in its tertiary service area are characterized by a mix of small to mid-size metropolitan areas and rural communities. Population mix is diverse and includes large numbers of first-generation European immigrants, African Americans, Asians, Hispanics, and Amish. The population for St. Joseph County in 2010 was 268,299 individuals. The race in the County is 80% Caucasians, 11.8% African America, and Hispanics represent 6.6, with 1.6 listed as Other. As expected, with an area saturated with post-secondary education, the county has higher than would be projected educational level. Thirty-three percent of the population is high school graduates, 19.4% have some college, 23.3% have graduated from college, and 10.3% have completed post graduate classes. The average household income was $61,271. Of the primary and secondary Memorial service area, St. Joseph County is the largest, with a population just over 274,372 followed by Elkhart County with just over 197,098. Elkhart County continues to have an industrial focus as a major center of the automotive, recreational vehicle, manufactured housing and musical instrument industries. Additional secondary service area counties and their populations include Berrien (MI) 174,642, LaPorte (IN) 109,124; Cass (MI) 43,701 and Marshall (IN) 50,099. Our service area includes patients from St. Joseph and surrounding counties in Indiana and Michigan; a pediatric emergency transport program serving 18 counties; and our MedFlight helicopter that covers communities within a 150-mile radius. We have the region's only Level 3 Newborn Intensive Care Unit, the only Pediatric Intensive Care Unit and the only Pediatric Hematology/Oncology program in the area. Memorial is also the only hospital in the region with Pediatric Hospitalist and Child Life programs. Memorial is not only recognized nationally as a leader in providing high quality care, but also as a leader in innovation, offering new approaches to patient satisfaction and customer service that set us apart from other health care providers. As the region's only designated children's hospital, Memorial Children's Hospital welcomes and treats children with a wide variety of medical and surgical diagnoses from more than 20 referral hospitals throughout Southwestern Michigan and Northern Indiana. Our world-class team includes pediatric hospitalists and intensivists, registered nurses, child life specialists, pediatric diabetic educators, pediatric dietitians, social workers, neonatologists, pediatric oncologists, respiratory therapists, clinical nurse specialists, pastoral care, and pediatric specialists in physical therapy, pulmonary medicine and infectious disease. Memorial Hospital and Health System also serves the community with Memorial Neighborhood Health Center - Southeast Clinic, and the Central Neighborhood Clinic at the Center for the Homeless. These two clinics offer primary health care services including all basic services as well as family planning and reproductive health, low-risk obstetrics, and colonoscopy services. Services are available to anyone, and our fees are within the customary range for your community. We accept Medicaid, Medicare and private insurance, and offer a sliding fee scale based on income guidelines for uninsured. We also participate in Hoosier Healthwise, the CHIP program that provides healthcare for Indiana children, pregnant women and low-income families. Other hospitals in our region include: St. Joseph Regional Medical Center, Elkhart General Hospital, Goshen Hospital and Lakeland Health Care. Education and Research for a Healthy Future We consider education and research to be part of our mission. Each is vital to preparing the next generation of health care professionals to meet future health care demands. As our country ages, we will need more caregivers than ever before; at the same time, there is a shortage of new graduates in key clinical and technical positions. To ensure that we have the quality workforce we need to care for our patients in the future, we are committed to the education of current and future caregivers, and have partnered with local high schools, colleges, universities and Indiana University Medical School at Notre Dame. Preparing for tomorrow's health care needs also requires a commitment to researching new and innovative treatments that battle tomorrow's health care challenges. Clinical research is a part of programming across the Health System. Memorial Medical Group participates in a significant number of pharmaceutical trials annually; physicians in the Hospital participate in various research projects that are national in scope and are evaluated by FDA guidelines by Memorial's Institutional Review Board. Memorial is also a member of an Oncology Consortium which does cancer-related research with grants funding in excess of $853,600. Our medical staff is working to find tomorrow's treatments and cures today. Research also evolves from the nursing, pre-medical and social service disciplines at the local post-secondary education institutions. The University of Notre Dame is a close partner in community-based research, which includes evaluating education curricula, intervention modalities, and quantitative analysis as well as qualitative research methods. Together, we offer a comprehensive learning experience for medical students, enabling interns, residents, and fellows to utilize our state-of-the-art training facilities and integrate advanced technology learned in the classroom directly with patient care. Together, we further the evidence of community-based research in addition to clinical research, particularly in the intersection of neuroscience and medical interventions, such as the impact of chemotherapy on the memory and cognitive functioning of breast cancer victims. Community Building Activities Part VI, Line 5 All information included in Part I, see 'Other Information Required'. Part VI, Line 6 Community plunges were developed at Memorial 23 years ago. The first was the Aging Plunge, which looked at the plight of an aging society, living independently as long as possible, often isolated, suffering from depression, had little opportunities for socialization, and was mismanaging their health with polypharmacy resulting in counter indications, and dangerous interactions, from seeing different physicians to treat many different diseases and ailments. Board members, staff, and community leaders spend a few hours together delving into the problems confronting our society; personally interacting with an Alzheimer's victim, a gang member, a cocaine addict, a child in the midst of family and neighborhood, a mother whose two-year-old had suffered a Sickle Cell stroke, homeless children with developmental delays, bright children of immigrants without citizenship and in dead-in jobs, rural communities without sufficient access to medical care, pregnant teens, and high school drop-outs. In 2010, Memorial invested $26,087 in acquainting Community Leaders with the needs in the community through their participation in plunges. Over the past two decades, these forays into the community have educated us about the reality of poverty, of being uninsured, pregnant with the tenth child, with only two living babies, both with severe disabilities. The stories often move us to tears, which makes the learning even more poignant and the reality more urgent. Two plunges that have influenced outreach programming have been (a) "Enough is Enough: Violence as a Public Health Mandate," and (b) "High School Drop Out" which incorporated a number of opportunities for youth who had dropped out to tell their stories about the bearing it has had on their life and economic health. Included in the plunge was "The Pact" - shared by three doctors who grew up in public housing in Newark; had brushes with the law, and succeeded in their middle-school pact to become doctors. The teens from Washington High School, who spent time with The Three Doctors, developed an anti-violence mime which was produced along with a discussion guide by the group. The students then formed and named their team 212-degrees. This skit and the 212-degree teens were instrumental in participating in the Civic League's competition which resulted in South Bend being named one of the top ten cities in the nation. Quality of Life Programs Memorial's Community Health Enhancement team innovatively served Michiana with a wide range of effective, evidence-based and fiscally-responsible programs and initiatives in 2010. Community Health Enhancement's programs reached across the life span, ensuring healthy pregnancies, productive senior years, and proactive disease management now and wise investment in our community's future. Pre-Natal Programs Community Health Enhancement's team provided a variety of programs for expectant mothers with two common goals - helping the women stay healthy, and helping their babies be born healthy - and one common denominator: caring staff skillful at building trusting relationships. Specific 2010 highlights include: Keeping pregnant women alcohol free throughout pregnancy through Foundations for Alcohol Cessation, Education, and Support. Educators teach expectant women about alcohol's harmful effects on fetal brain development and screen for alcohol use during pregnancy. 22% of women screened in 2010 received an intervention, and 98% who were followed remained alcohol-free throughout their pregnancy. Numbers Served: 3,271 The establishment of Black American Mothers Breastfeeding Awareness Initiative, a local initiative to increase awareness of the benefits of breastfeeding throughout the African American Community. This group is also studying reasons African American women are less inclined to breastfeed than their white and Latina peers. Bedtime Basics for Baby: This First Candle program educates families about safe infant sleep practices and provides free pack and play cribs. Numbers Served: 180 Pre-natal Care Coordination educators work with clients to reduce barriers to receiving prenatal care and connect them with resources such as breastfeeding classes, medical and mental health care providers and insurance programs, programs teaching parenting and childcare skills, immunization resources, and the BABE store. 275 Pregnant women were served, Almost daily science and medicine are making groundbreaking discoveries that will forever change how we: -focus on building a strong brain foundation during the critical early childhood development years, -help teens navigate new brain impulses toward risky behaviors on their way to learning reasoning and judgment, -understand and use our own brain to find efficiency, focus, and calm in this overwhelming world of many distractions and obligations, -best assure a vibrant mind and working memory able to be resilient against Alzheimer's and dementia. In 2010, BrainWorks continued innovating at the intersection of lifestyle, science and medicine offering actionable step to bring the insights of neuroscience into daily life to a total of over 4600 attendees. Feedback from programs confirmed the relevance of this information with 88% of individuals stating that some or all the information they learned was new to them, and that they intended to make changes in their life because of it. BrainWorks chartered new territory in an early childhood development plunge by bringing together the views from academic research, pediatrics and NICU care, school psychology, and parenting for an art based learning journey about best practices in early childhood brain health and development. In follow-up to this, BrainWorks awarded mini-grants of up to $5,000 to each of five local non-profits so they could add brain-based childhood development programming to their services to children between the ages of 0 - 4, or to create additional capacity in well orchestrated existing programs that support healthy brain development. This nicely supplemented the success BrainWorks achieved in influencing mother/child play practices through the redesign of play spaces, the most recent of which was implemented at the YWCA in conjunction with and with support from the Junior League of South Bend's Done in a Day projects. In the business community, BrainWorks provided 65 brain health based programs to 1775 individuals ranging from a full-day conference to the Mendoza School of Business team to break out sessions for the St. Joseph County Public Libraries professional development day to being part of courses offered at IUSB, Holy Cross College, and the University of Notre Dame. BrainWorks continue to partner with others for the purpose of contributing to research that results in useable information to our community. In conjunction with Indiana University South Bend and Memorial Sleep Lab, BrainWorks kicked off a research project exploring the impact of sleep variability on cognitive processes in two differently aged populations. Running concurrently with this, and staged to begin in spring of 2011, a second research project assessing a non-medical protocol to improve the side effects of Community Health Enhancement commonly called chemobrain will begin. And lastly, BrainWorks was proud to be able to continue the over a decade long tradition of bringing national experts in to speak to the community. Dr. Bruce Perry, national expert in brain-based remediation for children of trauma presented to service providers, physicians, and the general public. And through the generous support of the Butler-Oare Foundation, Dr. James Rippe, national lifestyle medicine expert provided an educational program for the physicians of our community and a complementary evening program to the public on improving mind and body health through lifestyle changes. Health Education and Outreach for At-Risk, Underserved Populations The Health System's innovative community outreach has received national recognition for models of involvement as well as state and federal grants to assist in the support of some of these programs. African American Women in Touch, provides breast care information, education, and screenings. Forty women were referred to the free community-based gestational diabetes program (Bebes Dulces sin Azucar: Sweet Babies without Sugar); there were no babies born over ten pounds, overall birth outcomes were positive, and mothers returned to normal glucose readings six-weeks post-partum. Memorial was in collaboration with the Health Department to address the potential influenza pandemic; as well as preparing the community for a national and/or regional disaster. Additional Spanish-speaking education and screens for cancer included breast screens for Latino women, and Latino men were screened for prostate cancer. A program for African American men had been introduced at a local barbershop, to increase awareness and encourage men to make behavioral changes to monitor their blood pressur Affiliated Health Care System Roles See 'Other Information Required'. Financial Assistance Patients are notified on their statements that financial assistance is available. Charges for Medical Care Uninsured patient accounts do not have discounts posted automatically. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IN, true BIKE MICHIANA COALITION INC 66841 WALNUT RD WALKERTON IN 46574 263357356 501(c)(3) 7100 DONATION NORTHERN INDIANA HISTORICAL SOCIETY INC 808 W WASHINGTON SOUTH BEND IN 46601 351124156 501(C)(3) 10600 GOLD SPONSORSHIP COMMUNITY COORDINATED CHILD CARE OF ST JOSEPH CNTY 401 E COLFAX AVE SUITE 210 SOUTH BEND IN 46617 351389028 501(C)(3) 76721 SPONSORSHIP COMMUNITY FOUNDATION OF ST JOSEPH COUNTY PO BOX 837 SOUTH BEND IN 46624 237365930 501(C)(3) 10000 SPONSORSHIP AFRICAN AMERICAN COMM EL CAMPITO INC 1024 THOMAS ST SOUTH BEND IN 46601 351438892 501(C)(3) 8160 CHE MINI GRANT FAMILY & CHILDREN'S CENTER CDS 1411 LINCOLNWAY WEST MISHAWAKA IN 46544 351404782 501(C)(3) 57000 CHAG 2010 GRACE COMMUNITY CENTER INC PO BOX 1671 SOUTH BEND IN 46634 351900380 501(C)(3) 25000 VOYAGES 2010 HABITAT FOR HUMANITY INTERNATIONAL INC 402 E SOUTH ST SOUTH BEND IN 46601 311196894 501(C)(3) 10000 WOMEN BUILD 2010 HISPANIC LEADERSHIP COALITION INC PO BOX 3744 SOUTH BEND IN 46619 352151895 501(c)(3) 5250 SPONSORSHIP RESCUE INC PO BOX 4488 SOUTH BEND IN 46634 351038532 501(C)(3) 75000 2010 HOPE FOR KIDS INNOVATION PART AT NOTRE DAME INC 1400 E ANGELA BLVD SOUTH BEND IN 46634 943445005 501(C)(3) 10000 CONTRIBUTION MEDICAL EDUCATION FOUNDATION INC PO BOX 1132 SOUTH BEND IN 46634 351291588 501(C)(3) 15000 MED BALL BENEFACTOR NEAR NORTHWEST NEIGHBORHOOD PO BOX 1132 SOUTH BEND IN 46624 237414729 501(C)(3) 35000 CONTRIBUTION NORTHEAST NEIGHBORHOOD REVITALIZATION ORGANIZATION 803 LINCOLNWAY WEST SOUTH BEND IN 46616 352118149 501(C)(3) 50000 CONTRIBUTION O'HANA HERITAGE FOUNDATION INC PO BOX 186 SOUTH BEND IN 46624 371523448 501(C)(3) 80000 CONTRIBUTION PENN-HARRIS-MADISON EDUC FOUNDATION INC 55900 BITTERSWEET RD MISHAWAKA IN 46545 351996785 501(C)(3) 7000 RUNNING FOR EDUCATION PROJECT FUTURE CHARITABLE FUND 401 E COLFAX SOUTH BEND IN 46617 311033632 501(C)(3) 120000 CONTRIBUTION SALVATION ARMY 540 S CARROLL ST SOUTH BEND IN 46601 362167910 501(c)(3) 50000 CONTRIBUTION SJC BRIDGES OUT OF POVERTY INC 117 N LAFAYETTE BLVD SOUTH BEND IN 46601 263195466 501(C)(3) 73160 CONTRIBUTION SOUTH BEND HERITAGE FOUNDATION INC 803 LINCOLNWAY WEST SOUTH BEND IN 46601 237394320 501(C)(3) 72500 CONTRIBUTION SOUTH BEND SYMPHONY 127 N MICHIGAN ST SOUTH BEND IN 46601 356042189 501(C)(3) 10000 STRYCKER MUSIC THE NATIONAL FOOTBALL FOUNDATION & COLLEGE HALL OF 1105 CLERMONTH DR SOUTH BEND IN 46617 351436531 501(C)(3) 5250 2010 ENSHRINEMENT UNIVERSITY OF NOTRE DAME DU LAC 731 GRACE HALL NOTRE DAME IN 46556 350868188 501(C)(3) 115545 CONTRIBUTION MICHIANA PUBLIC BROADCASTING CORPORATION 300 W JEFFERSON SOUTH BEND IN 46601 351155594 501(C)(3) 105430 SPONSORSHIP STUDEBAKER NATIONAL MUSEUM INC 201 S CHAPIN STREET SOUTH BEND IN 46601 351555535 501(C)(3) 20000 CONTRIBUTION SAINT JOSEPH COUNTY POLICE DEPARTMENT 401 SOUTH SAMPLE STREET SOUTH BEND IN 46601 356000194 10000 AMBULANCE 29 0 GRANT MONITORING PROCEDURES SCHEDULE I, PART IV Part of the Organization's mission is to improve the health of our community. In order to fulfill this goal, our Administrators have the ability to make donations to Organizations that improve the health and well being of our community. X X X X true true X X X X X false true false false false true true false false Philip Newbold 0 556903 0 304355 0 140617 0 210175 0 19289 0 1231339 0 140555 George Soper 0 178933 0 44616 0 21102 0 78746 0 21174 0 344571 0 0 Jeffrey Costello 0 273186 0 106000 0 90162 0 84363 0 14659 0 568370 0 0 Keith Sherry MD 176435 0 0 0 0 0 6281 0 12217 0 194933 0 0 0 Kreg Gruber 298224 0 119480 0 19217 0 72250 0 26205 0 535376 0 0 0 Cheryl Wibbens - Lesh MD 296356 0 70042 0 1729 0 19671 0 18478 0 406276 0 0 0 Connie M McCahill 169043 0 42073 0 11763 0 29814 0 14222 0 266915 0 0 0 Robert Riley MD 282033 0 0 0 4729 0 27587 0 11427 0 325776 0 0 0 Scott Thomas MD 335014 0 0 0 292 0 9968 0 0 0 345274 0 0 0 Thomas Sutula MD 214878 0 0 0 5481 0 20247 0 17303 0 257909 0 0 0 Mark Lavallee 197208 0 20892 0 4661 0 18709 0 18708 0 260178 0 0 0 Health Club and Spousal Travel Schedule J, Part I, Line 1A Memorial Hospital reimburses trustees for the tax effect of the 1099 reportable benefits for health club membership with Memorial's Health and Lifestyle Center and spousal travel. This reporting impacts 11 current Board Members. Memorial Hospital also reimburses for direct expenses related to any travel on Memorial's behalf. Social club membership included in taxable compensation - 2 employees (Jeff Costello and Kreg Gruber) Spousal travel included in taxable compensation - 1 employee (Philip Newbold) CHARTER TRAVEL FOR INVESTMENT COMMITTEE MEMBERS TO TRAVEL TO INVESTMENT ADVISOR, LOCATED IN MINNEAPOLIS. CHARTER TRAVEL ALLOWED THE ORGINIZATION TO REDUCE THE OVERALL COST OF TRAVEL, BY ELIMINATING THE NEED FOR OVER NIGHT ACCOMIDATIONS. THE CHARTER TRAVEL ALSO REDUCED THE TIME UNPAID BOARD MEMBERS HAD TO COMMIT. (1 INDIVIDUAL LISTED ON PART VII, SECTION LINE 1A - JEFFREY COSTELLO) Supplemental Non-Qualified Retirement Plan Schedule J, Part I, Line 4B Related Organization (Memorial Health System, Inc.) 2010 Earned Vested 457(f) Phillip Newbold $108,930 Jeffrey Costello $ 66,001 Memorial Health System provides a non-qualified Supplemental Executive Retirement Program (SERP) to certain executives. The plan provides for an added retirement benefit over the qualified retirement program. Qualified individuals are eligible to receive a benefit, in the form of an after tax lump sum which is the actuarial equivalent of an annuity equal to 65% of the average of their last five years of preretirement earnings, or 70% with more than 25 years of service, with offsets for the value of social security and qualified retirement plan benefits. Participants vest into the SERP after five years of service. The increase in value of the benefit each year is included in the taxable compensation of vested SERP participants. Such amounts are included in Part II Column (b) (iii). The annual value of the benefit is converted to a lump sum and paid to the participant after fulfilling the terms of their non-compete agreement. Compensation Contingent on Net Earnings Schedule J, Part I, Line 6A & 6B The related organization has 2 incentive plans (employee and management) which have a net operating income to budget measurement for the payout threshold. The employee plan shares the excess over budgeted net operating income with the non-management employees for Memorial Health System, Inc and the affiliated entities which includes Memorial Hospital of South Bend, Inc. The employee incentive pool has a maximum cap of $2,500,000. The management incentive plan pays a sliding percentage of base compensation if the net operating income is equal to or greater than 80% of the budgeted net operating income. The sliding scale caps when operating income reaches 120% of the budgeted operating income. HOSPITAL AUTHORITY OF ST JOSEPH COUNTY 356311914 79061BCQ6 2007-05-01 80000000 SEE SCHEDULE O FOR DESCRIPTION false false false HOSPITAL AUTHORITY OF ST JOSEPH COUNTY 356311914 79061BCW3 2006-03-16 38580000 SEE SCHEDULE O FOR DESCRIPTION false false false HOSPITAL AUTHORITY OF ST JOSEPH COUNTY 356311914 79061BCX1 2008-08-28 39915000 SEE SCHEDULE O FOR DESCRIPTION false false false HOSPITAL AUTHORITY OF ST JOSEPH COUNTY 356311914 000000000 2008-07-01 2147750 SEE SCHEDULE O FOR DESCRIPTION false false false 84814783 762312 79201600 4850871 2009 false false true true 38580000 38580000 1243764 2000 true false true true 39915000 39337496 577204 2003 true false true true 2147750 2147750 2008 false false true true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false true false true HYPO PUBLIC FINANCE 3.91 false false false false true true CITIGROUP FINANCIAL false false false false true true CITIGROUP FINANCIAL false false false false true false false false false false false false false Geralrd Duprat MD Trustee 2151838 Purchase of JV ownership false Sandra Brown MD Trustee 349517 Bldg rental, Proctor Services false Carlton Lyons MD Trustee 349517 Bldg rental, Proctor Services false Candace Hurwich See Part V 40200 See Part V false Robert Yount MD Trustee 604688 Trauma Call Services false Jesse Hseih MD Trustee 258920 Trauma Call Services false Keith Sherry MD Trustee 6320660 Professional ER Phys. Services false Business Transactions Involving Interested Persons Schedule L, Part IV Candace Hurwich, wife of Maurice Hurwich, MD (Trustee and Medical Director) was compensated for services as a Staff RN on the Emergency Response Team. VOLUNTEERS Form 990, Part I, Line 6 Memorial Hospital of South Bend has a department called Ambassador and Customer Services. It is the responsibilty of this department to recruit, orient, process and place new ambassadors in approximately 30 service areas of the hospital. It is also the responsibility of the department to follow up, schedule and recognize ambassadors. Some of the areas of service include Major Surgery Waiting Room, Escort Service, Flower Delivery, Mail Delivery, Living History Program, Emergency Department Volunteers and Cookie Bakers. In 2010, Memorial had 547 volunteers in this program who served 38,567.5 hours. Other Program Services Form 990, Part III, Line 4d Memorial Health System, Inc. (the "Corporation") was established as the parent corporation of Memorial Hospital of South Bend, Inc. (the "Hospital") in 1981 to develop a full spectrum of health-related services for North Central Indiana and Southwestern Michigan. The Corporation is community-owned and not-for-profit. Along with its subsidiaries, the Corporation serves the greater community throughout the continuum of care from health promotion and sickness prevention to diagnosis, inpatient, outpatient and home health services. It controls the Hospital, Memorial Health Foundation, the Hospital's philanthropic arm, and Memorial Home Care, Inc., collectively referred to as the "System". The Hospital with 526 licensed adult beds and 80 bassinets, a staff of approx. 2,693, a medical staff of more than 605, and a volunteer Auxiliary of 594, is the largest hospital in the primary and secondary service areas. The Corporation owns and operates the acute care Hospital facility and Family Practice Residency Program. The Hospital's purpose is to provide hospital care and enhance wellness for the community. The Hospital has its own Board of Trustees (the "Hospital Board") elected by the persons serving on the Board of Directors of the Corporation. The Hospital Board has responsibility for the operation of the Hospital as defined in its bylaws. Memorial Hospital of South Bend is the largest and most comprehensive tertiary care medical center in Northern Indiana. Services are delivered through service divisions and professional ancillary services: Adult Patient Services, Cardiovascular & Critical Care Services, Women's and Children's Services, Surgical Services, Oncology Services and Professional Services. Key utilization Statistics for the Hospital for 2010 include: Admissions 18,824 Total Patient Days 77,727 Births 2,614 Inpatient Surgical Procedures 4,357 Outpatient Surgical Procedures 7,825 Emergency Department visits 52,349 Creating community health is at the core of Memorial Hospital of South Bend, Inc's mission. Promotion of community health is the right thing to do and a key to long term cost effectiveness. In addition, improving the health status of a community is as much a social, economic and environmental issue, as it is a medical one. Consequently, the System takes a broad approach to creating community health. This approach has included ongoing education of board members, staff and local leaders through community plunges (experiential activities to involve the community residents with a neighborhood-based agency), Community Foundation support, ongoing allocation of tithing resources, a clear statement of vision and goals, a commitment to continuous quality improvement and promotion of volunteer involvement and community partnerships. In the early 1990s, the System made a dramatic shift from a disease-focused medical model to a prevention-focused model. Its vision is to continue the journey to be among the nation's healthiest communities. Memorial's health enhancement plan focuses on five priorities: schools, neighborhoods, congregations, seniors and mother/child concerns. Its methods include building partnerships, investing dollars, listening and communicating, nurturing leadership, and continuous evaluation backed by sound outcome and impact measurement. The Community Benefit Fund is the System's mechanism for re-investing funds to improve the health status of communities it serves. The System, which includes Memorial Hospital of South Bend Inc, tithes 10% of the previous year's excess operating revenue and transfers it to the Community Benefit Fund. This investment is in addition to the Hospital's charity care and prevention and education activities supported through its operating budget. The Community Health Enhancement Committee of the Board began the fund in 1993 and makes ongoing policy and oversees the administration of the fund and determines specific investment allocations. Volunteers and staff are committed to prudently investing these resources in an accountable manner. BrainWorks at Memorial Hospital is housed within the Leighton Center, located on the Hospital campus. The programs sponsored at the Leighton Center promote a holistic understanding and approach to brain health across the lifespan, emphasizing the importance of a healthy brain to enhance the quality of life at every age. Education and physical movement are important aspects of aging well for all of us. Programming at the Leighton Center supports a platform to expand the knowledge of brain health. While the focus continues to be on holistic health, brain health as a key component to well-being which can contribute to the prevention of neurodegenerative disorders, improve rehabilitation and recovery from trauma, and enhance productivity and capabilities to be realized in the later years. As a part of senior programming, Memorial's Sage-ing Center contributes to spiritually Eldering and socially responsible aging. The System's innovative community outreach has received national recognition for models of involvement as well as state and federal grants to assist in the support of some of these programs. Programs include: African American Women in Touch - breast care education and screening programs, the PEDS developmental delay screening program for infants 0 to 3 years of age which is offered at the St. Joseph County WIC clinics, the YWCA, and the Center for the Homeless, and health education and outreach into the Latino community, including an innovative diabetes education and case management program that has had significant results. More than 220 Type II diabetics have participated in the program with no hospitalizations in 2010. The program expanded to include African Americans and Caucasians as well. The newest addition has two Zumba exercise classes, which have approximately 50 individuals of all ages participating in each session. Nearly 40 women were referred to the gestational diabetes program; of the deliveries, there were a few minor complications, however the overall birth outcomes were positive, and mothers returned to normal glucose readings six-weeks post-partum. Two programs which received federal grants to be initiated in St. Joseph County were the Fetal Alcohol screening and education program for pregnant women, and the HUD affiliated program working with Healthy Homes. Other noteworthy programs include the free Children's Health Clinic providing school physicals and early detection of health problems at Memorial's Southeast Neighborhood Clinic's event for approximately 150 children. 6,207 South Bend youths, in school year 2010-2011, participated in the evidenced-based program, "Draw the Line, Respect the Line" targeting middle school aged students on making and practicing good choices. The "Healthy Babies Program" focused on proper prenatal care and reducing infant mortality. A program for African American men was held at three local barbershops during one weekend, to increase awareness and encourage men to make behavioral changes to monitor their blood pressure and take steps to control high blood pressure received additional support. In 2010, 98 men participated in the program. The Sickle Cell Initiative serves Northwest Indiana with screening, education, and counseling. In 2010, new initiatives included high school athlete screening, regular educational newsletters, and public service announcements. The total number served in 2010 was 5,233 individuals. The "Domestic Violence Ends ("DOVE") project, and the Health Professionals, a free service for residents needing physician referral or health information have proven their value to the community, while the partnership with South Bend Community School's magnet schools finds Memorial's evolving role in building a high school program intended to prepare students for future careers in health care and scientific research. Summer programs were offered to Latino students at La Casa de Amistad, Martin Luther King Center, and with the South Bend Community School Corporation's Bilingual Education department. As a supporter of the St. Joseph County Volunteer Provider Network providing care for the uninsured adults in our community, with over 363 physicians, diagnostic service providers, and two hospitals, VPN contributed over 7 million dollars worth of care in 2010. A demonstration project in partnership with South Bend Heritage Foundation provides health and social service case management to 60 low-income elderly living independently in the converted Robertson's Department Store. The results of the intervention have shown a decrease in depression and increases in 8 indices of health in those elderly participating in the program. This project received funding from a local foundation to expand to seniors living in public housing. Members of the Organization Form 990, Part VI, Section A, Line 6 Membership in Memorial Hospital of South Bend shall be divided into two classes: Corporate and Personal. The Corporate Member shall be Memorial Health System, Inc. The Personal Members shall be the directors of Memorial Hospital of South Bend. Election of Board Members Form 990, Part VI, Section A Line 7A The Corporate Member shall appoint the Board of Directors of Memorial Hospital of South Bend and shall have such powers of advance approval regarding corporate actions as are delineated in the By-Laws of Memorial Hospital of South Bend. Decisions of The Board of Directors Form 990, Part VI, Section A, Line 7B Decisions of the Board of Directors must be approved by the Corporate Member. FORM 990, PART VI, SECTION B THE ORGINIZATION HAS WRITTEN POLICIES AND PROCEDURES THAT COVER NUMEROUS TOPICS. THESE POLICIES AND PROCEDURES WERE NOT APPROVED BY THE GOVERNING BOARD IN THE CURRENT TAX YEAR, BUT WILL BE REVIEWED AND APPROVED BY THE GOVERNING BOARD IN FUTURE YEARS. A FEW OF THE TOPICS COVERED BY THE CURRENT POLICIES AND PROCEDURES OF THE ORGINIZATION ARE: - LOCAL CHAPTERS, BRANCHES AND AFFILIATES - CONFLICT OF INTEREST - WHISTLEBLOWER - DOCUMENT RETENTION AND DESTRUCTION - JOINT VENTURES Review Process Form 990, Part VI, Section B, Line 11B The organization incorporates numerous parties in the production and review of the Form 990 and associated schedules. Senior accounting staff and management complete the Form 990 and schedules. The forms and schedules are reviewed by the Accounting Manager, Controller and CFO. Subsequent to those steps, the organization engaged Ernst & Young to review the completed Form 990 and appropriate schedules. Prior to filing the return, the compensation committee of the organization and the CEO conduct a general overview of the form 990, including applicable compensation schedules. In addition, the Board of Directors and the Audit Committee will receive a copy of the 990 prior to filing. Conflict of Interest Policy Form 990, Part VI, Section B, Line 12 There are three separate forms that are sent out through the Internal Audit Department to Key Employees or Board Members regarding Conflict of Interest. They are as follows 1. The first is a Conflict of Interest Statement that is sent to Senior level Administration, Management, and select staff such as Purchasing Department employees. The purpose of the Statement is to require these Employees to disclose any potential conflict of interests they may have. The Statements are sent in January of each year and we pursue the replies to get a 100% response rate. In the current year we sent out over 250 Statements and did achieve a 100% response rate. Each response is reviewed by the Director of Internal Audit and the results are reported to the CEO of Memorial as well as the Audit Committee of the Board of Directors. 2. The second Statement is the Board Duality of Interest Statement that is sent to current Board Members, former Board Members from the last five years, the five highest compensated employees from the previous year, employees that are on the Grant and Scholarship Committees, and Other key Employees. The Duality of Interest Statements was sent out in May, 2010. The replies are reviewed by the Director of Internal Audit who summarizes the results which are reviewed by an independent party. The results are reported to the CEO of Memorial and the Audit Committee of the Board of Directors. 3. The third Statement is entitled "Code of Ethics for Senior Financial Officers". The Statement requires an acknowledgment form to be signed by Memorial's Key Financial Employees that Memorial's financial information is to the best of their knowledge true and accurate. This Statement was sent out in early January, 2010 and the signed acknowledgements are kept by the Director of Internal Audit. In 2010, fourteen designated employees were requested to sign the form and we had a 100% compliance rate. Any potential Conflicts of Interest are reviewed by independent parties both internal and external to the organization, and if necessary, corrective action would be taken to resolve a true Conflict. The individual with the potential conflict of interest is excluded from all review proceedings. Process For Determining Compensation Form 990, Part VI, Section B, Line 15 An extensive examination is conducted using comparable market data and it is then reviewed by an independent consultant hired by, and reporting to, the Board of Directors. Recommendations are presented to the Compensation Committee of the Memorial Health System Inc Board for deliberation and final decision. Deliberation and final decision are performed by the independent members of the Board. Public Availability for Documents Form 990, Part VI, Section C, Line 19 The governing documents and conflict of interest policy are not made available to the public. The financial statements are distributed quarterly to the Electronic Municipal Market Access (EMMA) website as part of the continuing disclosures for the Memorial Health System, Inc. bonds. Other Changes in Net Assets of Fund Balances Part XI, Line 5 Unrealized Loss on Swap Transactions (27,671,589) Transfers to Affiliates (21,016,908) Change in Interest in Recipient Org (2,759,849) Unrealized Gain on Investments 13,417,708 Capital Contributions 113,400 Ambulance donation 10,000 Total (37,907,238) Bond Purpoase Descr for Schedule K Schedule K, Part I, Column F Line A(f) - The Hospital Authority of St. Joseph County Health System Revenue Bonds, Series 2007 (Memorial Health System) were issued for the purpose, together with other available funds, of financing the costs of health care capital improvements. Line B(f) - The Hospital Authority of St. Joseph County Health System Revenue Bonds, Series 2006 (Memorial Health Care Network), were issued for the purpose, together with other available funds, of refunding all or a portion of the Organization's Series 2000 Bonds which were originally issued on 12/01/2000. The Series 2006 Bonds were exchanged for the Hospital Authority of St. Joseph County Health System Revenue Bonds, Series 2008A (Memorial Health System) on August 28, 2008. Based on the advice of bond counsel, the Organization is treating the Series 2008A Bonds as the same issue as the Series 2006 Bonds for federal income tax purposes. Further information regarding the Series 2008A Bonds is set forth in the table below. Line C(f) - The Hospital Authority of St. Joseph County Health System Revenue Refunding Bonds, Series 2008B Memorial Health System) were issued for the purpose, together with other available funds, of refunding the then-outstanding Hospital Authority of St. Joseph County Health System Revenue Bonds, Series 2003 (Memorial Health System), on a current basis. Line D(f) - The Lease Obligations under a Lease Purchase Agreement dated July 1, 2008 were issued for the purpose of financing certain equipment used for health care purposes. Private Business Use for Schedule K Schedule K, Part III, Line 5 In August 2008, the Hospital Authority of St. Joseph County, on behalf of the Corporation, issued revenue refunding bonds in the principal amount of $39,915,000 to refund Series 2003 Bonds. The Series 2003 Bonds were used to finance various capital projects including the Heart and Vascular Center. As part of the planning for the Series 2003 Bonds, the Memorial Hospital management team planned for private use of the first floor of the Heart and Vascular Center. After planning for the private use of the first floor the Memorial management team consulted bond counsel at that time. Bond counsel advised that the first floor should be funded through equity. Memorial Hospital followed bond counsels recommendations and the Heart and Vascular Center first floor was entirely funded by equity. Memorial Hospital had used approximately $22,100,000 in equity in relation to the projects funded with Series 2003 bond draws. Arbitrage for Schedule K Schedule K, Part IV Part IV is not completed for the Series 2008A Bonds because such bonds indirectly refunded new money bonds issued in 2000. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Yount MD TITLE:Trustee; Employed Physician HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Newbold TITLE:CEO/President HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:George Soper TITLE:Asst. Secretary/VP HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jeffrey Costello TITLE:Asst. Treasurer/CFO HOURS:40 Memorial Health System Inc 615 N Michigan Street South Bend IN 46601 351536132 Corp Svc/Clin IN 501c(3) 9 NA Memorial Health Foundation Inc 615 N Michigan Street South Bend IN 46601 351536129 Financial Sup IN 501c(3) 9 MHS Memorial Home Care Inc 615 N Michigan Street South Bend IN 46601 351901068 Home Medical IN NA C false true true false false false false true false false true true true true true true true true Memorial Health Foundation Inc C 175884 Memorial Health Foundation Inc H 163004 Memorial Health Foundation Inc L 3450860 Memorial Health Foundation Inc O 77061 Memorial Health Foundation Inc Q 82427 Memorial Home Care Inc L 717407 Memorial Home Care Inc R 642419