2011-11-14T14:15:36-06:00 2010-12-31 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2010-01-01 350868133 THE METHODIST HOSPITALS INC METH 2198864402 600 GRANT STREET GARY IN 46402 MATTHEW DOYLE 2198864549 2011-11-14 1 CAROL LALONDE CPA 2695674500 2010 2016-03-07 17:11:31Z IAN MCFADDEN 600 GRANT STREET GARY IN 46402 284658270 0 X WWW.METHODISTHOSPITALS.ORG X 1941 IN THE METHODIST HOSPITALS, INC. (METHODIST) IS AN INDIANA NONPROFIT CORPORATION OPERATING TWO GENERAL ACUTE CARE HOSPITALS IN NORTHWEST INDIANA. AS GENERAL ACUTE CARE FACILITIES, METHODIST PROVIDES A BROAD RANGE OF DIAGNOSTIC, THERAPEUTIC, EMERGENCY, REHABILITATION, INPATIENT, OUTPATIENT, AND ANCILLARY SERVICES. METHODIST'S MISSION IS TO PROVIDE HIGH QUALITY HEALTHCARE TO ALL PERSONS REGARDLESS OF THEIR RACE, RELIGION, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. METHODIST STRIVES TO PROVIDE APPROPRIATE HEALTH EDUCATION, WELLNESS, AND PREVENTATIVE SERVICES. IN ADDITION, METHODIST IS COMMITTED TO BEING A RESPONSIBLE MEMBER OF THE COMMUNITY, OFFERING ITS RESOURCES TO ASSIST IN THE ACCOMPLISHMENT OF COMMUNITY OBJECTIVES. 15 11 2529 235 95000 0 372693 173892 282491870 278983138 4228534 4401960 4831396 -3093977 291924493 280465013 235822 238990 0 0 129782348 130936220 0 0 0 155963859 139333163 285982029 270508373 5942464 9956640 330507671 336648957 164133126 156705075 166374545 179943882 X THE METHODIST HOSPITALS, INC'S MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE SERVICES TO ALL THOSE IN NEED. 0 0 240416132 238990 276922776 THE METHODIST HOSPITALS, INC. HAS A COMMITMENT TO RESPOND TO THE NEEDS OF ITS DIVERSE COMMUNITIES THROUGH QUALITY SERVICES. ITS REGIONAL REPUTATION FOR EXCELLENCE SINCE 1923 CONTINUES TO SUPPORT THE MARKET POSITION.METHODIST HOSPITALS IS AN INDIANA NOT-FOR-PROFIT CORPORATION, 634 BED COMMUNITY-BASED HEALTHCARE SYSTEMS GOVERNED BY A BOARD OF DIRECTORS. STEWARDS OF THE MISSION, REINVESTMENT IN THE COMMUNITIES IS CARRIED OUT THROUGH CHARITABLE GIVING, COMMUNITY EDUCATION PROGRAMS, ECONOMIC DEVELOPMENT FORUMS, SUPPORT SERVICES, SCREENINGS, AND ADVOCATING QUALITY CARE FOR THE MOST VULNERABLE AND UNDERSERVED. METHODIST HOSPITALS CONTINUES TO BE A FRONTRUNNER IN PROMOTING COMMUNITY HEALTH INITIATIVES AND SERVING POPULATIONS WITH HIGH INCIDENTS OF ACUTE ILLNESSES. METHODIST HOSPITALS HAS TWO FULL SERVICE ACUTE CARE CAMPUSES, 14 MILES APART. NORTHLAKE IS THE URBAN CAMPUS IN GARY, WHILE SOUTHLAKE CAMPUS IN MERRILLVILLE IS LOCATED NEAR ONE OF THE MIDWEST'S BUSIEST RETAIL AREAS. COMBINED CAMPUS BED CAPACITY IS 634 INCLUDING NURSERIES. METHODIST PROVIDES A BROAD RANGE OF DIAGNOSTIC, THERAPEUTIC, EMERGENCY, REHABILITATION, INPATIENT, OUTPATIENT AND ANCILLARY SERVICES.MIDLAKE CAMPUS IS AN OUTPATIENT FACILITY IN GARY CONVENIENTLY LOCATED BETWEEN NORTHLAKE AND SOUTHLAKE CAMPUSES, PARALLEL TO INTERSTATE 94. THE REHAB CENTERS, PROVIDING OUTPATIENT REHABILITATION SERVICES AT MIDLAKE, OPENED IN 2003. LOCATED ADJACENT TO THE MAIN ENTRANCE OF THE SOUTHLAKE CAMPUS IN MERRILLVILLE, IS THE DIAGNOSTIC OUTPATIENT CENTER AND MEDICAL OFFICE BUILDING. THIS FACILITY PROVIDES ADVANCED DIAGNOSTIC AND IMAGING SERVICES AND LABORATORY SERVICES AS WELL AS PROFESSIONAL OFFICES FOR MANY OF THE MEDICAL STAFF.THE MEDICAL STAFF OF MORE THAN 500 PHYSICIANS REPRESENTS NEARLY 60 MEDICAL SPECIALTIES. METHODIST HOSPITALS IS ONE OF THE TOP EMPLOYERS IN NORTHWEST INDIANA WITH OVER 2,000 EMPLOYEES. MISSIONTHE MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE SERVICES TO ALL THOSE IN NEED.VISIONTHE VISION IS TO BE THE BEST PLACE FOR EMPLOYEES TO WORK, THE BEST PLACE FOR PATIENTS TO RECEIVE CARE AND THE BEST PLACE FOR PHYSICIANS TO PRACTICE MEDICINE. 240416132 1 1 0 1 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 1 0 1 0 1 0 0 0 0 1 1 1 0 0 0 1 214 0 1 2529 1 1 1 0 0 0 0 0 0 0 0 0 X 15 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 IN X MATTHEW DOYLE 2198864000 600 GRANT STREET GARY IN 46402 ADOLPHUS ANEKWE MD 8.00 X 48350 0 0 AMEAD ATASSI MD 6.00 X 47025 0 0 ANDRE ARTIS MD 5.00 X 37081 0 0 BHARAT BARAI MD 9.00 X 71665 0 0 CHARLES D BROOKS JR 2.00 X 0 0 0 CHARLES O DAVIDSON MD 2.00 X 0 0 0 DOUGE BARTHELEMY MD 2.00 X X 120 0 0 EDWARD E CHARBONNEAU 2.00 X X 0 0 0 F RITCHEY EIBEL 2.00 X 0 0 0 GLENN C HANNAH 2.00 X 0 0 0 IJ ROBERTS 2.00 X 0 0 0 IAN MCFADDEN 40.00 X X 623661 0 17496 JOHN R BARNEY 2.00 X 0 0 0 LOREN CHANDLER 40.00 X X 403398 0 7469 LOUISE E ELISHA 2.00 X 0 0 0 MAMON POWERS JR 2.00 X X 0 0 0 MICHAEL J COYNER 1.00 X 0 0 0 SCOTT T RIBORDY 2.00 X 0 0 0 WILLIAM G BRAMAN 2.00 X X 0 0 0 REV DR CYNTHIA REYNOLDS 2.00 X 0 0 0 ROBERT E JOHNSON III 2.00 X 0 0 0 GLENN S VICAN 2.00 X 0 0 0 CONNIE HICKMAN 2.00 X 0 0 0 SHELLY MAJOR 40.00 X 303706 0 11806 ANTHONY JONES 40.00 X 335481 0 7469 MICHAEL DAVENPORT MD 40.00 X 397634 0 13810 JUANMIGUEL T LIMJOCO MD 40.00 X 306303 0 13898 ELIZABETH E SENGUPTA MD 40.00 X 283120 0 14274 JUSTIN WOOD MD 40.00 X 319522 0 7469 LIBRADA VAZQUEZ MD 40.00 X 338562 0 16106 MATTHEW DOYLE 40.00 X 262074 0 0 3777702 0 109797 67 0 1 0 CRAWFORD ANESTHESIA 301 N MADISON ST JOLIET MI 60435 ANESTHESIA MEDICAL SERVICES 8430833 COMPREHENSIVE PHARMACY SERVICES 6409 QUAIL HOLLOW ROAD MEMPHIS TN 38120 PHARMACY MANAGEMENT AND STAFFING 5718968 NORTHWEST EMERGENCY ASSOCIATES LLC 600 GRANT ST GARY IN 46402 EMERGENCY ROOM PHYSICIAN SERVICES 5342344 CROTHALL SERVICES GROUP 955 CHESTERBROOK BLVD SUITE 300 WAYNE PA 19087 MAINTENANCE SERVICES 4195269 CANDESCENT HEALING LLC 220 WHITE PLAINS RD 4TH FLOOR TARRYTOWN NY 10591 WOUND CARE SERVICES 2307846 64 173892 173892 HEALTHCARE AND SOCIAL 621500 244922776 244922776 DISPROPORTIONATE SHARE 621500 32000000 32000000 OTHER PATIENT SERVICES 621500 2060362 1965362 95000 278983138 4101863 4101863 1099280 4193257 -3093977 -3093977 -3093977 300097 300097 300097 300097 280465013 278888138 95000 1307983 238990 238990 2326171 204241 2121930 105043696 94789696 10254000 2648703 2357391 291312 13769748 12231698 1538050 7147902 6318121 829781 725083 703492 21591 995130 885111 110019 217950 193979 23971 184909 184909 219537 195388 24149 37499276 35709482 1789794 1422096 1266630 155466 55175774 49210265 5965509 3293835 2945061 348774 5355495 3805823 1549672 349204 295683 53521 43528 39314 4214 6479000 4398102 2080898 17724079 15822322 1901757 2424602 2223884 200718 BAD DEBT EXPENSE 6810701 6061234 749467 DUES & SUBSCRIPTIONS 344431 267850 76581 LICENSES 68533 67466 1067 270508373 240416132 30092241 0 12679241 34133292 38950505 16591962 40804155 18322824 168908 7134941 7544392 2481172 2907315 440155227 314070326 126551225 126084901 98224872 128691410 662890 603475 3018670 1600478 330507671 336648957 23004709 22306506 72619680 69472919 23880234 23704386 44628503 41221264 164133126 156705075 X 165848145 179405594 501400 513288 25000 25000 166374545 179943882 330507671 336648957 X 9956640 3612697 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 43818 0 1 141091 184909 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: ENGAGED BARNES & THORNBURG AND BAKER & DANIELS AS FEDERAL LOBBYING COUNCIL TO REVIEW, DISCUSS, AND ADVOCATE RELATIVE TO MEDICARE GEOGRAPHICAL REIMBURSEMENT ISSUES. IN ADDITION, THEY WILL DRAFT LEGISLATION OR AMENDMENTS TO LEGISLATION, REVIEW PROPOSED RULES & REGULATIONS AND FILE ALL NECESSARY FORMS TO ENSURE THE HOSPITAL IS PROPERLY REGISTERED UNDER FEDERAL LOBBYING LAWS. IN ADDITION, THE VP OF GOVERNMENT & EXTERNAL AFFAIRS MEETS WITH STATE AND LOCAL LEGISLATORS ON ISSUES AFFECTING THE ORGANIZATION. A PORTION OF MEMBERSHIP DUES PAID TO THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL (MCHC) AND THE INDIANA HOSPITAL ASSOCIATION (IHA) IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE RESPECTIVE PERCENTAGES HAVE BEEN APPLIED, AS PROVIDED BY THE RESPECTIVE ORGANIZATIONS. PART IV, SUPPLEMENTAL INFORMATION: PART II-B, LINE 1(G): THE VP OF GOVERNMENT AND EXTERNAL AFFAIRS MEETS WITH STATE AND LOCAL LEGISLATORS ON ISSUES AFFECTING THE ORGANIZATION. 3745499 3745499 232887451 171559229 61328222 4554860 3091018 1463842 162825692 129832992 32992700 36141725 9587087 26554638 126084901 THIRD PARTY PAYOR SETTLEMENT 7785462 ESTIMATED SELF INSURANCE LIABILITY 6867887 ASBESTOS MITIGATION LIABILITY 447724 PENSION & POST RETIREMENT OBLIGATIONS 25304918 OTHER LIABILITES 815273 41221264 280465013 270508373 9956640 5235605 -1622908 3612697 13569337 PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION RELATED CHANGES OTHER THAN NET PERIODIC COST -1,612,908. EQUITY TRANSFER TO METHODIST FOUNDATION -10,000. 1 1 X 1 X 1 X 1 1 1 0 1 1 17315182 17315182 0.06400 58552029 66281283 -7729254 0.00000 3354586 3354586 0.01240 79221797 66281283 12940514 0.07640 64 739122 2500 736622 0.00270 393836 488441 -94605 0.00000 64 1132958 490941 642017 0.00270 64 80354755 66772224 13582531 0.07910 1 2362998 945199 102099247 109047825 -6948578 X 1 1 8 1 THE METHODIST HOSPITALS INC

600 GRANT STREET GARY IN 46402

X X X 2 THE METHODIST HOSPITALS INC

8701 BROADWAY MERRILLVILLE IN 46410

X X X 3 THE METHODIST HOSPITALS INC

2269 WEST 25TH STREET GARY IN 46404

OUTPATIENT REHAB 4 METHODIST SURGERY CENTER LLC

101 E 87TH AVENUE MERRILLVILLE IN 46410

OUTPATIENT SURGERY CENTER 5 METHODIST HOSPITALS CARDIAC REHABILITATI

753 EAST 81ST AVE STE 4 MERRILLVILLE IN 46410

OUTPATIENT CARDIAC REHAB 6 METHODIST HOSPITALS OUTPATIENT DIAG CENT

101 E 87TH AVENUE MERRILLVILLE IN 46410

IMAGING AND LAB SERVICES 7 METHODIST HOSPITALS REHAB CENTER

303 E 89TH AVE MERRILLVILLE IN 46410

OUTPATIENT REHAB 8 METHODIST HOME HEALTH CENTER

650 GRANT STREET GARY IN 46408

HOME HEALTH SERVICES THE METHODIST HOSPITAL INC 1 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X X 1 1 X X X X 1 X X X 1 X X X X X X X 1 X 0 1 PART I, LINE 7: METHODIST HOSPITALS, INC USES PUBLISHED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR CHARITY. PART I, L7 COL(F): COLUMN F IS THE AMOUNT OF CHARITY CARE PROVIDED AS A PERCENTAGE OF EXPENSES SHOWN ON PART IX, LINE 25 LESS BAD DEBT EXPENSE OF $6,810,701. PART II: METHODIST HOSPITALS CONTINUED ITS PARTICIPATION IN THE NW INDIANA HEALTH DISPARITIES INITIATIVE REGION 1. THIS PARTNERSHIP WITH LAKE COUNTY MINORITY HEALTH COALITION AND BROTHERS UPLIFTING BROTHERS INCLUDES 7 COUNTIES (LAKE, PORTER, JASPER, NEWTON, LAPORTE, STARKE, AND PULASKI). FIVE MAJOR HEALTH PROGRAMS WERE HELD FOCUSING ON HEART HEALTH, OBESITY, AND HIV/AIDS. METHODIST CONCLUDED ITS SERIES OF MONTHLY HEALTH EDUCATION SEMINARS, HEALTH MATTERS, IN COOPERATION WITH THE YWCA OF NORTHWEST INDIANA. THESE PROGRAMS FOCUSED ON MONTHLY NATIONAL HEALTH AWARENESS THEMES. PART III, LINE 4: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. PART III, LINE 8: THE HOSPITAL DOES NOT REPORT ANY SHORTFALL WITH MEDICARE AS A COMMUNITY BENEFIT. PART III, LINE 9B: LIABILITIES FOR NON-COVERED SERVICES, INSURANCE RESIDUALS AND PURE SELF PAY LIABILITIES ARE DUE WITHIN 30 DAYS OF DISCHARGE. ATTEMPTS ARE MADE TO COLLECT DEDUCTIBLES PRE-SERVICE AND DEPOSITS OR PAYMENT IN-FULL PRE-SERVICE FOR SELF-PAY PATIENTS. IF A PATIENT CANNOT PAY THE ENTIRE BALANCE WITHIN 30 DAYS, PAYMENT PLANS ARE AVAILABLE. IF THE PATIENT CANNOT PAY AT ALL, THE HOSPITAL OFFERS NEED-BASED FINANCIAL ASSISTANCE BASED ON HOUSEHOLD INCOME AS A PERCENT OF THE FPL. PATIENTS WHO HAVE THE ABILITY TO PAY, YET DEFAULT ON PAYMENT PLANS ARE SENT TO COLLECTIONS (BAD DEBT). ACCOUNTS SENT TO BAD DEBT ARE PERIODICALLY RE-SCREENED FOR PRESUMPTIVE CHARITY QUALIFICATION AND IF QUALIFIED, ARE REMOVED FROM THE COLLECTION PROCESS. MEDICARE RESIDUALS ARE INVOICED TO THE PATIENT AND SENT THROUGH A BAD DEBT COLLECTION CYCLE. IF COLLECTION ATTEMPTS ARE UNSUCCESSFUL, THE MEDICARE ACCOUNT IS REMOVED FROM COLLECTIONS AND IS REPORTED AS MEDICARE BAD DEBT. THE METHODIST HOSPITAL, INC. PART V, SECTION B, LINE 11H: FAMILY UNIT - NUMBER AND EXPENSES THE METHODIST HOSPITAL, INC. PART V, SECTION B, LINE 19D: SELF PAY POLICY DEFINES FLAT PERCENTAGES; THE ONLY QUALIFICATION IS NO INSURANCE. THE METHODIST HOSPITAL, INC. PART V, SECTION B, LINE 21: WHEN THE PATIENT DID NOT COOPERATE IN PROVIDING INFORMATION OR MAINTAIN THE DISCOUNTED PAYMENT AGREEMENT. METHODIST HOSPITALS, INC VALUES ITS LEADERSHIP ROLE IN THE COMMUNITY AND IS COMMITTED TO ASSISTING INDIVIDUALS ACHIEVE A HIGHER QUALITY OF LIFE THROUGH QUALITY HEALTHCARE SERVICES, COMMUNITY OUTREACH PROGRAMS, AND PARTNERING WITH COMMUNITY ORGANIZATIONS. PART VI, LINE 2: METHODIST HOSPITAL, INC ASSESSES THE SERVICES NEEDED BASED UPON A REVIEW OF DEMOGRAPHIC AND CLINICAL FACTORS. BASED UPON THE DATA, THE HEALTHCARE NEEDS ARE THEN COMPARED TO THE SERVICES CURRENTLY PROVIDED OR AVAILABLE IN THE COMMUNITY AND SURROUNDING COMMUNITIES. PART VI, LINE 3: METHODIST HOSPITALS, INC USES PUBLISHED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR CHARITY.METHODIST PROVIDES PATIENTS WITH A PAYMENT OPTIONS BROCHURE AND "FINANCIALLY CLEARS" PATIENTS PRIOR TO SERVICE DELIVERY. FINANCIAL CLEARANCE INVOLVES ESTIMATING THE PATIENT LIABILITY, EDUCATING THE PATIENT ABOUT INSURANCE BENEFITS AND OUT-OF-POCKET EXPENSES AND AGREEING TO A PLAN WITH THE PATIENT FOR HOW THAT LIABILITY WILL BE COVERED. SELF PAY PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FEDERAL, STATE AND LOCAL PAYMENT SOURCES. PART VI, LINE 4: METHODIST HOSPITALS, INC SERVES NORTHWEST INDIANA WITH THE PRIMARY GEOGRAPHIC AREA BEING SERVED AS LAKE COUNTY, INDIANA. PORTER COUNTY, INDIANA COMPRISES MOST OF THE SECONDARY SERVICE AREA. THE DEMOGRAPHIC AREA OF THE REGION IS VERY DIVERSE, RANGING FROM THE VERY AFFLUENT TO A SIGNIFICANT INDIGENT POPULATION. PART VI, LINE 6: METHODIST HOSPITALS, INC PROVIDES MONTHLY STROKE AND CANCER SCREENINGS, PREVENTATIVE HEALTHCARE SCREENINGS, EDUCATIONAL SEMINARS, AND HOSTS SEVERAL SUPPORT GROUPS TO THE COMMUNITY MEMBERS ROUTINELY THROUGHOUT THE YEAR. PART VI, LINE 7: N/A REPORTS FILED WITH STATES PART VI, LINE 7 IN 0 INDIAN MEDICAL ASSOC OF NWI 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 314130002 501C(3) 15000 SCHOLARSHIP PROGRAMS AMERICAN CANCER SOCIETY 1551 E85TH AVE MERRILLVILLE IN 46410 160743902 501C(3) 5245 CANCER PROGRAMS ASIAN AMERICAN MEDICAL ASSOCIATION 99 E 86TH AVE MERRILVILLE IN 46411 351487544 501C(3) 6000 COMMUNITY MEDICAL ASSISTANCE NORTHWEST INDIANDA HINDU RELIGIOUS CENTER 8605 MERRILLVILLE RD MERRILLVILLE IN 46410 351981658 501C(3) 31000 CULTURAL ARTS PROGRAMS AMERICAN HEART ASSOCIATION 405 BOARDWALK HEBRON IN 46341 135613797 501C(3) 99750 HEART DISEASE AWARENESS/PREVENTION PROGRAMS GARY CHAMBER OF COMMERCE 839 BROADWAY GARY IN 46402 350329470 501C(3) 6500 PROGRAMS TO BUILD/IMPROVE BUSINESS ENVIRONMENT NORTHWEST INDIANA PUBLIC BROADCASTING INC 8625 INDIANA PL MERRILLVILLE IN 46410 310960136 501C(3) 5000 BACK-TO-SCHOOL HEALTH FAIR NORTHWEST INDIANA SYMPHONY SOCIETY 1040 RIDGE ROAD MUNSTER IN 46321 351359750 501C(3) 5640 CULTURAL ARTS PROGRAMS CROSSROADS REGIONAL CHAMBER OF COMMERCE 255 W 80TH PLACE MERRILLVILLE IN 46410 356043684 501C(3) 9174 PROGRAMS TO BUILD/IMPROVE BUSINESS ENVIRONMENT 9 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION DOES NOT MONITOR HOW THE GRANTS ARE USED BY THE ORGANIZATION RECEIVING THE FUNDS. X X X X X X 0 0 0 0 0 1 0 0 0 IAN MCFADDEN 473335 0 121800 0 28526 0 10027 0 7469 0 641157 0 0 0 LOREN CHANDLER 295513 0 68063 0 39822 0 0 0 7469 0 410867 0 0 0 SHELLY MAJOR 248018 0 55688 0 0 0 4337 0 7469 0 315512 0 0 0 ANTHONY JONES 277318 0 58163 0 0 0 0 0 7469 0 342950 0 0 0 MICHAEL DAVENPORT MD 320909 0 76725 0 0 0 6341 0 7469 0 411444 0 0 0 JUANMIGUEL T LIMJOCO MD 306303 0 0 0 0 0 6429 0 7469 0 320201 0 0 0 ELIZABETH E SENGUPTA MD 283120 0 0 0 0 0 6805 0 7469 0 297394 0 0 0 JUSTIN WOOD MD 319522 0 0 0 0 0 0 0 7469 0 326991 0 0 0 LIBRADA VAZQUEZ MD 338562 0 0 0 0 0 8637 0 7469 0 354668 0 0 0 MATTHEW DOYLE 215762 0 0 0 46312 0 0 0 0 0 262074 0 0 0 PART I, LINE 6 THERE ARE APPROXIMATELY SIX PEOPLE THAT ARE CLASSIFIED AS EXECUTIVES WHO QUALIFY FOR A BONUS. ONE COMPONENT OF THE EXECUTIVE BONUS PACKAGE IS TIED TO THE ORGANIZATION'S OVERALL FINANCIAL PERFORMANCE. THIS ACCOUNTS FOR APPROXIMATELY 25% OF THE ENTIRE BONUS PACKAGE. OTHER FACTORS OF THE BONUS PACKAGE INCLUDE MEETING OR EXCEEDING GOALS SET FOR: QUALITY MEASURES, PATIENT SATISFACTION SCORES, AND EMPLOYEE SATISFACTION SCORES ALONG WITH OTHER ORGANIZATIONAL GOALS THAT ARE DEFINED FOR EACH OF THE EXECUTIVE'S ROLES WITHIN THE HOSPITAL. IAN MCFADDEN X 100000 71877 0 1 1 LOREN CHANDLER X 135000 97031 0 1 1 168908 MUNSTER 45TH LLC BOARD MEMBER 499638 THE ORGANIZATION RENTS PROPERTY FROM AN ENTITY OWNED BY MR. BARNEY 0 POWERS SONS CONSTRUCTION CO BOARD MEMBER 197458 THE ORGANIZATION CONTRACTED CONSTRUCTION SERVICES FROM A COMPANY OWNED BY MR. POWERS. 0 MCDOYLE LLC CONTROLLER 146820 DOYLE OWNS MCDOYLE, LLC WHO LEASES EMPLOYEES TO THE HOSPITAL. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CONTROLLER AND CFO OF THE ORGANIZATION AND THEN SENT TO MEMBERS OF THE GOVERNING BODY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD PASSED A RESOLUTION IN 1994 WHICH REQUIRES EACH BOARD MEMBER TO ANNUALLY DISCLOSE ALL SITUATIONS WHERE A POTENTIAL CONFLICT OF INTEREST MAY EXIST. THE CONFLICT OF INTEREST/RELATED PARTY QUESTIONNARIES ARE COMPLETED AND REVIEWED ON AN ANNUAL BASIS. ANY POTENTIALLY CONFLICTED DIRECTORS ARE PROHIBITED FROM PARTICIPATING IN THE DISCUSSION ABOUT OR VOTING ON ANY CONFLICTED ISSUE. FORM 990, PART VI, SECTION B, LINE 15 THE HR AND GOVERNANCE COMMITTEE USES INDEPENDENT AND EXTERNAL RESOURCES FOR THE ESTABLISHMENT OF COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES. THE COMMITTEE USES COMPARABILITY DATA AND MARKET COMPARISONS INCLUDING COMPENSATION SURVEYS AND FORM 990 INFORMATION FROM OTHER ORGANIZATIONS AS PART OF THE COMPENSATION DETERMINATION PROCESS. THE COMPENSATION APPROACH, PROCESS, AND DATA ARE THOROUGHLY DISCUSSED IN THE COMMITTEE MEETINGS AND THE REVIEW AND APPROVALS ARE DOCUMENTED THROUGHOUT THE PROCESS. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS 2010. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,235,605. PENSION RELATED CHANGES OTHER THAN NET PERIODIC COST -1,612,908. EQUITY TRANSFER TO METHODIST FOUNDATION -10,000. TOTAL TO FORM 990, PART XI, LINE 5: 3,612,697. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED. METHODIST PATHOLOGY LLC 600 GRANT ST GARY IN 46402 203642476 PATHOLOGY SERVICES IN 878378 56682 THE METHODIST HOSPITALS INC METHODIST ANESTHESIA LLC 600 GRANT ST GARY IN 46402 201954536 ANESTHESIA SERVICES IN 2638498 286984 THE METHODIST HOSPITALS INC METHODIST CARDIOGRAPHICS LLC 600 GRANT ST GARY IN 46402 201349870 READING CARDIOGRAMS IN 554843 50880 THE METHODIST HOSPITALS INC NORTHWEST EMERGENCY ASSOSCIATES LLC 600 GRANT ST GARY IN 46402 205290680 EMERGENCY ROOM MEDICAL SERVICES IN 1219688 144812 THE METHODIST HOSPITALS INC MERRILLVILLE SURGERY CENTER LLC 11356 MORTON COURT CROWN POINT IN 46307 364478344 SURGICAL CENTER IN THE METHODIST HOSPITALS INC METHODIST AUXILIARY 600 GRANT ST GARY IN 46402 SUPPORT IN 0 0 THE METHODIST HOSPITALS INC THE METHODIST HOSPITALS FOUNDATION 600 GRANT STREET GARY IN 46402 271495289 SUPPORTING ORGANIZATION IN 501(C)(3) LINE 11A, I THE METHODIST HOSPITALS INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0