2024-11-10T20:22:04+00:00 2023-12-31 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE INDIANAPOLIS IN 462045100 990 2023-01-01 350868132 Memorial Hospital of South Bend Inc MEMO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 JEFFREY COSTELLO CFO 5746473549 2024-11-11 true Jennifer D Rhoderick P00395735 3176817000 2024-11-05 2023 2024-10-15 13:58:12Z LARRY TRACY 615 N MICHIGAN STREET SOUTH BEND IN 46601 730558688 false X BEACONHEALTHSYSTEM.ORG X 1923 IN WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART. 10 8 3825 376 0 0 19267895 5467805 662192725 702912880 -796229 980489 15916550 21181074 696580941 730542248 481730 391700 0 266263207 245500017 0 0 330371587 345904362 597116524 591796079 99464417 138746169 591875904 668333733 232639448 285895745 359236456 382437988 X WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART. false false 143370889 397565141 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. 2023 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 718,933 INPATIENT PROCEDURES - 566,859 OUTPATIENT PROCEDURES - 1,466 INPATIENT CATHS - 1,504 OUTPATIENT CATHS - 1,849 OUTPATIENT VISITS. 138817266 172271417 PATIENT CARE UNIT SERVICES PROVIDES A WIDE VARIETY OF HOSPITAL SERVICES INCLUDING: - INPATIENT REHABILITATION CARF (COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES) 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. 2023 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 84,178 PATIENT DAYS - 10,142 INPATIENT ER VISITS - 65,620 OUTPATIENT ER VISITS - 2,509 BIRTHS - 26,636 OBSERVATION STAYS. 68695532 149696630 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. 2023 STATISTICS FOR THIS SERVICE UNIT INCLUDE: - 8,251 INPATIENT PROCEDURES - 429 OPEN HEART PROCEDURES - 18,863 OUTPATIENT PROCEDURES. 190682702 391700 OTHER PROGRAM SERVICES OTHER PROGRAM SERVICES INCLUDE PSYCHIATRIC DEPARTMENTS, SOCIAL SERVICES, COMMUNITY OUTREACH PROGRAMS, TITHING, GRANTS, AND SUPPORTING SERVICES SUCH AS ADMINISTRATION, FINANCE, PAYROLL, PATIENT ACCOUNTING, LAUNDRY SERVICES, HEALTH AND LIFESTYLE CENTER, AND MEDICAL RECORDS. DUE TO THE NON-REVENUE GENERATING OR COMMUNITY INVESTMENT NATURE OF MANY OF THE PROGRAMS, THEY OPERATE AT A LOSS. SEE SCHEDULE H FOR DETAILS ON THE HOSPITALS TITHING AND COMMUNITY OUTREACH REPRESENTED IN OTHER PROGRAM SERVICES. 190682702 391700 541566389 true true false true false false false false true true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false true false false false false false false true true true false false true 190 0 true 3825 true false false false false false false false false false false false false X 10 8 true false false false true true true true true false false true true true true true true false false true true IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 Brad Toothaker Chair thru 3/31/23 2.0 0 X X 540 0 0 Peter Baranay Director/Chair begin 3/31/23 2.0 2.0 X X 225 0 0 Ronald Nelson MD Secretary 2.0 40.0 X X 0 177854 25832 Stephanie Steele Vice Chair 2.0 0 X X 0 0 0 Daniel Adams Director 2.0 0 X 225 0 0 John Callaghan MD Director 2.0 0 X 225 0 0 Linda Paskiewicz Director 2.0 0 X 225 0 0 Martha Smith Director 2.0 0 X 1220 0 0 Raquel Buari JD Director 2.0 0 X 225 0 0 Renee Fleming Director 2.0 0 X 860 0 0 Tim Durham MD Director 2.0 0 X 225 0 0 Jeffrey P Costello CFO 2.0 50.0 X 0 744234 118036 Kreg R Gruber CEO 2.0 50.0 X 0 1162712 170134 Larry A Tracy President 40.0 0 X 559220 0 104093 Kristine E Jennings Dir of Med Residency Program 40.0 0 X 300991 0 35210 Linda A Mansfield Dir of Sports Medicine 40.0 0 X 312112 0 35834 Marion Mahone Assoc. Dir Resident Program 40.0 0 X 303145 0 19740 Matthew R Reed Employed Physician 40.0 0 X 302694 0 28743 Michelle A Thompson VP Medical Affairs 40.0 0 X 423821 0 38089 2205953 2084800 575711 545 false true false WALSH CONSTRUCTION COMPANY 929 WEST ADAMS CHICAGO IL 60607 CONSTRUCTION SERVICES 24905200 SOUTH BEND EMERGENCY PHYSICIANS 615 N MICHIGAN SOUTH BEND IN 46601 PHYSICIAN SERVICES 3611208 SOUTH BEND MEDICAL FOUNDATION 530 N LAFAYETTE BLVD SOUTH BEND IN 46601 LAB SERVICES 3386126 METRO AVIATION INC 1214 HAWN AVENUE SHREVEPORT LA 71107 MEDICAL FLIGHTS 2513971 PEDIATRIX MEDICAL GROUP OF INDIANA PC PO BOX 281034 ATLANTA GA 303841034 PHYSICIAN SERVICES 2399618 27 0 0 0 639106 4828699 0 0 5467805 NET PATIENT REVENUE 622110 699915617 699915617 0 0 AFFILIATE RENTAL REVENUE 532000 2927972 2927972 0 0 JOINT VENTURE ACTIVITY 561499 65216 65216 0 0 MEDICAL EDUCATION REVENUE 561499 4075 4075 0 0 0 0 0 0 702912880 872460 0 0 872460 0 0 0 0 0 0 0 0 902459 0 15462 0 886997 0 886997 0 0 886997 0 109007 978 -978 109007 108029 0 0 108029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OUTPATIENT PHARMACY 561499 12858200 12858200 0 0 CAFETERIA SALES 561499 1586962 0 0 1586962 QUALITY INCENTIVE 561499 1232186 1232186 0 0 4616729 2529922 0 2086807 20294077 730542248 719533188 0 5541255 391700 391700 0 0 0 0 0 0 667283 0 667283 0 0 0 0 0 196780480 172182920 24597560 0 6406509 5605695 800814 0 27967505 24471567 3495938 0 13678240 11968460 1709780 0 1019766 892295 127471 0 112646 0 112646 0 293204 0 293204 0 6483 5673 810 0 0 0 33567 0 33567 0 37951842 36019227 1932615 0 375045 328164 46881 0 1493985 1307237 186748 0 28402 24852 3550 0 0 0 0 0 6631545 5802602 828943 0 457002 399877 57125 0 0 0 0 0 26026 22773 3253 0 5610357 4909062 701295 0 0 0 0 0 29271462 25612529 3658933 0 3697742 3235524 462218 0 MEDICAL SUPPLIES 124440355 124440355 0 0 BAD DEBT EXPENSE 22425556 22425556 0 0 CORPORATE ALLOCATION 81336016 71169014 10167002 0 HOSPITAL ASSESSMENT FEE 27956934 27956934 0 0 2736427 2394373 342054 0 591796079 541566389 50229690 0 19526 20766 21933359 21510137 746385 573139 117491424 136256547 0 0 0 0 0 248 18016039 20100045 962733 733635 871633612 502614067 357221347 369019545 2730375 2853422 0 1360897 1999203 1171474 1171474 70222345 114095572 591875904 668333733 50895976 47259588 0 0 19397 2540 158110415 222735475 0 0 0 0 0 0 0 0 23613660 15898142 232639448 285895745 X 349883265 371605031 9353191 10832957 359236456 382437988 591875904 668333733 X 138746169 4999805 0 0 0 -120544442 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6483 6483 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING DETAIL SCHEDULE C, PART IV MEMORIAL HOSPITAL PAID DUES TO THE FOLLOWING ORGANIZATIONS FOR WHICH THE AMOUNT OR PERCENTAGE LISTED WAS ATTRIBUTED TO LOBBYING: AAFP (AMERICAN ACADEMY OF FAMILY PHYSICIANS) - 21% AASM (American Academy of Sleep Medicine) - 2% ACHE (American College of Healthcare Executives) - 1% ACS (American College of Surgeons) - 4% AMA (American Medical Association) - 65% AND (Academy of Nutrition and Dietetics) - 10% APA (American Psychiatric Association) - 15% APTA (American Physical Therapy Association) - 31% ASHE (American Society for Health Care Engineering) - 32% ASHP (American Society of Health-System Pharmacists) - 19% CAP (College of American Pathologists) - 35% ENA (Emergency Nurses Association) - 22% NACHRI (National Association of Children's Hospitals and Related Institutions) - 25% NAEMSP (National Association of EMS Physicians) - 28% STFM (Society of Teachers of Family Medicine) - 10% When unable to ascertain allocation of dues attributed to Lobbying a conservative estimate of 20% is applied. 38758960 2440358 2682415 1424963 0 0 42456770 42986124 3689060 -4645969 3270255 0 0 38758960 37554313 3126708 3841751 1536648 42986124 34924914 1692784 2289915 1353300 37554313 30834712 2588247 3242314 1740359 34924914 0.7449 0.0 0.2551 false true true 27002676 27002676 530816454 272662899 258153555 324743 324743 0 259502184 225426886 34075298 53987555 4199539 49788016 369019545 DUE FROM 3RD PARTY PAYORS 40055869 INT IN NET ASSETS OF REC ORG 10832957 INTEREST RECEIVABLE - SWAP 231231 OTHER RECEIVABLES 3561979 2016 BOND FUND 11581 RIGHT OF USE FINANCING ASSET 1018316 2022 US BANK BOND FUND 58383639 114095572 INTEREST RATE SWAP 6077585 ASSET RETIREMENT OBLIGATION 5559799 IBNR 3134377 DUE TO THIRD PARTY 45123 FINANCING LEASE LIABILITY 1048057 DUE TO AFFILIATES 33201 15898142 X Schedule D, Part V, Line 4 Intended uses of endowment funds NET ASSETS WITH DONOR RESTRICTIONS CONSIST OF ASSETS WHOSE USE IS LIMITED BY DONOR IMPOSED, TIME AND/OR PURPOSE RESTRICTIONS. IN ACCORDANCE WITH THE RESTRICTION, A MAJORITY OF THE INVESTMENT INCOME AND INVESTMENT GAINS OR LOSSES FROM THESE NET ASSETS ARE RESTRICTED BY THE DONOR FOR A SPECIFIC PURPOSE. A SPECIFIED PORTION OF INCOME EARNED BY THE NET ASSETS IS RELEASED FROM RESTRICTION AND USED FOR OPERATIONS EACH YEAR AND, THEREFORE, IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS OTHER REVENUE. THE BOARD HAS DISCRETION TO UTILIZE EACH YEAR THE INCOMES, REVENUES AND PROFITS ARISING AND ACCRUING FROM THE ENDOWMENTS IN DEFRAYING COSTS ASSOCIATED WITH THE TRUST AND THE REMAINDER FOR SUPPORT, BETTERMENT, IMPROVEMENT, UPKEEP, EXPANSION AND REPLACEMENT OF BEACON HEALTH SYSTEM, INC. AND ITS CORPORATE AFFILIATES. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote ASC 740, Income Taxes, requires that realization of an uncertain income tax position be more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it is recognized in the consolidated financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the years ended December 31, 2023 or 2022. true true X true X true X true true false true true 1815623 0 1815623 0.0032 137764713 137139057 625656 0.0011 0 0 0 0.0 0 0 139580336 137139057 2441279 0.0043 6193695 4557882 1635813 0.0029 10007483 1555659 8451824 0.0148 0 0 0 0.0 386101 89578 296523 0.0005 346460 0 346460 0.0006 0 0 16933739 6203119 10730620 0.0188 0 0 156514075 143342176 13171899 0.0231 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 35207 161 35046 0.0001 0 0.0 0 0.0 0 0.0 0 0 35207 161 35046 0.0001 true 4845447 2422724 82700995 115098429 -32397434 X true true 1 1 MEMORIAL HOSPITAL OF SOUTH BEND INC 615 N MICHIGAN STREET SOUTH BEND IN 46545 WWW.BEACONHEALTHSYSTEM.ORG 23-005053-1 X X X X X X MEMORIAL HOSPITAL OF SOUTH BEND INC 1 false false true X X X X X X X X X 21 true true false true X HTTPS://IMPACT.BEACONHEALTHSYSTEM.ORG/CHNA X X true 22 true HTTPS://IMPACT.BEACONHEALTHSYSTEM.ORG/CHNA false true X 200.0 350.0 X X X true true X X X true X www.beaconhealthsystem.org/patients-and-visitors X www.beaconhealthsystem.org/patients-and-visitors X www.beaconhealthsystem.org/patients-and-visitors X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: Beginning in January 2021, Beacon Health System undertook completing a Community Health Needs Assessment (CHNA). Our approach utilizes both quantitative data (secondary data, key informant survey) and qualitative data (focus groups, open-ended responses). Once the results of the survey were determined, a qualitative approach was used to gather richer insight into the main issues faced by the community. The methodology followed for this needs assessment consists of three steps: 1) Identify needs; 2) Analyze the links between needs and the information required to make decisions; 3) Make recommendations that guide decision-making. The data collection and analysis process started in January 2021 and concluded in November 2021. The key findings were consolidated in one report which provided a snapshot of the three-county overall health status. The Key Informant Survey collected information from February 2021 through May 2021. Focus Groups launched in August 2021 and concluded in October 2021. This assessment focused on creating a better understanding of the health needs of the Beacon Community (Elkhart, LaPorte, Marshall, and St. Joseph Counties) and the response necessary to address the need. Data was collected through secondary data collection, a key informant survey, and community focus groups on a variety of topics centered on health indicators and social determinants of health. The goal of the CHNA is to provide Beacon Health System with a clear picture of Elkhart, LaPorte, Marshall, and St. Joseph County, which constitutes the service areas of Elkhart General Hospital, Memorial Hospital of South Bend, and Community Hospital of Bremen. The findings from the assessment will be used by Beacon Health System to prioritize health issues in the community. The research took the following approach to better understand the community health needs: Key Informant Survey - A survey was provided to community leaders and those knowledgeable about the communities' health issues. The list of key informants was developed by Beacon Community Impact staff along with input from a variety of key stakeholders. Two hundred and seven completed responses were collected and analyzed. Secondary Data Research - information related to the current state of the communities' economic, social and health status published by established sources. Data, when possible, was collected for a three-year period in order to establish a trend. Over 1,000 data points were collected and analyzed, encompassing more than 80 best practice indicators. Data from Beacon Health System's electronic health record (EHR) was also used as a secondary data source. The secondary data reviewed so far has all been aggregated at the county level and does not reveal when there are differences in indicators based on race, ethnicity, age, neighborhood, or socio-economic status. When stratified by these categories, publicly available sources and data from Beacon's electronic health record (EHR) from late 2020 - early 2021, demonstrate disparities in both health outcomes and social determinants of health. Community Focus Groups - groups of 3 - 18 individuals were engaged in conversations about the current health needs of the community. Beacon Community Impact utilized Stanford's Focus Group Guide and conducted three focus groups per county (Elkhart, Marshall, and St. Joseph). Staff conducted at least two English and one Spanish focus group per county. Each focus group was recorded for continuity. Focus group recordings were transcribed and de-identified using a professional transcription service and qualitative research software tools were utilized to analyze the transcripts for common themes. Staff then engaged in an interrater reliability check to ensure accuracy of identified themes. For the purpose of the Community Health Needs Assessment (CHNA), the community served is defined as those persons residing in Elkhart, Marshall, and St Joseph Counties, who were program participants. Beacon Community Impact makes a special effort to focus on populations with the highest unmet needs, specifically those persons who are known as vulnerable, through chronic diseases, lower-income and poverty, members of a minority population and/or the uninsured. Stakeholders in the community participated and represented a broad knowledge of interests, including public health, and minority, cultural, and underserved populations. Through the following organizations Beacon ensured that under-represented populations (Medically Underserved, Low-Income, and Minority Populations) were engaged in the consultation process, actively reaching out to them, ensuring that needs and perceptions from a wide range of demographic and socioeconomic groups were taken into consideration in the definition of top community health issues. The following organizations helped increase the reach of the survey, hence solicited in order for Beacon to take into account input received from persons who represent the broad interests of the community it serves: AIDS Ministries, American Cancer Society, American University Beirut, Baugo Community Schools, Beacon Cancer Care, Beacon Community Impact, Beacon Health System, Pokagon Health Services, IU School of Medicine - South Bend, Beacon Medical Group, Beacon Pediatric Specialty, Beacon - North Central Indiana Sickle Cell Initiative, Big Brothers Big Sisters Southern Lake Michigan Region, Bowen Center, Boys & Girls Club of St. Joseph County, Bremen Public Schools, CAPS, Catholic Charities, Center for Civic Innovation, Center for Healing & Hope, Center for the Homeless, Child and Parent Services, Inc, City of South Bend, Community Hospital of Bremen, Crossroads United Way, Cultivate Food Rescue, David's Courage, Division of Family Resources, Elkhart Community Schools, Elkhart County Health Department, Elkhart Education Foundation, Elkhart General Hospital, enFocus, Inc, Goodwill Industries of Michiana, Inc, Goshen Family Physicians, Greenspire Solutions, Harper Cancer Research Institute, Health Improvement Alliance of St. Joseph County, Healthlinc, HealthMarkets, Horizon Education Alliance, Elkhart City Council, Imani Unidad, Indiana University, Indiana University South Bend, Indiana University South Bend - Elkhart Center, Ivy Tech Community College, Junior Achievement, La Casa de Amistad, Marshall County Project HOPE, Marshall County, Board of Health, Marshall County Community Foundation, Memorial Hospital of South Bend, Mental Health Awareness of Michiana, Michiana Area Council of Governments, Michiana Health Information, Network/Indiana Health Information Exchange, Middlebury Community Schools, Minority Health, Coalition Elkhart County, Near Northwest Neighborhood, Northern Indiana Hispanic Health Coalition, Oaklawn Psychiatric Center, OI, Partnership for Drug-Free St. Joseph County, Purdue Extension - St. Joseph County, REAL Services, Reins of Life, Inc, Ribbon of Hope, Inc, RiverBend Cancer Services, Robinson Community Learning Center, Saint Joseph Health System, School City of Mishawaka, Shaw Center for Children and Families at the University of Notre Dame, SJC Cares, Smoke Free St. Joe, South Bend Adult Education, South Bend Common Council, South Bend Community School Corporation, South Bend Elkhart Regional Partnership, South Bend Heritage Foundation, South Bend Regional Chamber, Spiritual & Personal Adjustments - Women's Ministry Homes, St. Joseph County Department of Health, St. Joseph County Public Library, St. Vincent de Paul Society, The Community Foundation of Elkhart County, The Jewish Community, The LGBTQ Center, The Michiana Athletic and Recreation Association, United Health Services Suicide Prevention Center, United Way of LaPorte County, United Way of Marshall County, United Way of St. Joseph County, Unity Gardens Inc, University of Notre Dame, Upper Room Recovery Community, WIC, YMCA of Greater Michiana, Youth Service Bureau of St. Joseph County, YWCA North Central Indiana. The assessment process identified two health priorities that can be streamlined into the essential components of Beacon Health System's mission. Priority Areas - Healthcare Access (Health Literacy) and Mental Health provide a framework for the alignment of intervention strategies with BHS mission and values that aim for 1) providing information and enhance skills to patients/practitioners/community; 2) improving equitable access to health and wellness; 3) leveraging incentives for long-term behavioral change; and 4) improving and strengthening the social and healthcare systems in the three-county area. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY (CONTINUED): Three Rivers Health, which serves St. Joseph County in Michigan, joined the Beacon family after the completion of the 2021 CHNA. They participated in their local health department's CHNA, which found mental health and resource accessibility to be among the top three health needs, which aligns with our priority areas and implementation strategy. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. Memorial Hospital of South Bend (MHSB) developed the 2021 St. Joseph County CHNA in partnership with Elkhart General Hospital and Community Hospital of Bremen, Beacon Health System (BHS) care partners. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. The Community Health Needs Assessment (CHNA) was made widely available to the community through posting on the MHSB website at beaconhealthsystem.org/CHNA and through email transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. Beacon Health System's 2021 Community Health Needs Assessment identified two top health priorities: Mental Health and Healthcare Access. These were common across all three counties where Beacon operates a hospital. Our approach to Community Benefit includes addressing these health needs from three angles. With each approach, both internal programs and externally funded partners are required to report on common metrics. This allows Beacon to focus its resources to achieve and demonstrate a deeper impact in our priority health areas. Beacon Community Impact provided community resources to 52,794 individuals across our service area - Elkhart, Marshall, and St. Joseph, IN Counties. In 2023, we first recognized the importance of partnering with other organizations who are experts in what they do, Beacon funds community non-profits who have boots on the ground in the most vulnerable neighborhoods in our service area, and with more diverse populations. Each of our funded partners who are addressing one of the tactics outlined on the Implementation Strategy are responsible for reporting both the number of participants they serve and one or more outcome metric in the priority areas of Mental Health or Healthcare Access. Within Beacon Health System, the Beacon Community Impact Department leads efforts impact our priority areas of mental health and healthcare access using a combination of internal programs and collaborative partnerships. Our implementation strategy incorporates a three-pronged approach: We provide direct services to clients through Beacon's Early Childhood Services and Community Health Services teams. Early Childhood Services include the St. Joseph County (Ind.) WIC program, two sickle cell programs and our Family & Infants Support Program. These programs focus on the health status of women, infants and young families, particularly the most vulnerable in Beacon's service area. Our Community Health Services team focuses on prevention through community health educators with school curricula delivered throughout middle and high schools in the three Indiana counties we serve. Summer programming shifts to health-related day camps and participation at community health fairs. Though it may not be their primary focus, these community health teams screen for and provide referrals for clients experiencing mental health challenges. Likewise, they emphasize the importance of trusted adults as protective factors for youth. We fund local community organizations with expertise in their service areas. These organizations are community nonprofits with boots-on-the-ground services in the most vulnerable neighborhoods and more diverse populations. Each of the funded partners addresses the top two health priorities and reports on the number of participants and on an outcome metric for either mental health or healthcare access. In addition, Beacon partnered with the local health department in Three Rivers, Michigan, to support building out their Community Health Worker Program to increase services addressing healthcare access and mental health. Beacon administers state and federal grants as the fiscal agent to deliver direct programming funded by the grants and to build out the data infrastructure in Beacon communities. In 2023, we completed the final year of the COVID grants from the Health Resources and Services Administration (HRSA) under the U. S. Dept. of Health and Human Services. These grants funded two programs to provide COVID vaccines and vaccine education. This was also the final year of administering Project HOPE and the second year for Supported and Safe, also funded by HRSA, which established a coalition of organizations to address opioid use in Marshall County. In the fall of 2023, we were awarded the Indiana Safety Pin - FIMR grant for St. Joseph County, IN, to re-establish the fetal infant mortality review (FIMR) program. Beacon Community Impact also provides services and collaborates with outside organizations with funding from a State of Indiana Safety Pin grant. Finally, Beacon functions as the fiscal agent for programming run by local outpatient mental health provider Oaklawn to build crisis response teams. Mental Health Strategy - Provide wrap-around mental health support with a multidisciplinary team from various referral sources. - Partner on the development of a Self-Healing Community to build resilience and relieve stress on the traditional mental health care system. - Drive the rollout of Trauma-Informed Care throughout Beacon and the community. - Health and Wellness Team - provide evidence-based community and school education. - Community Health Workers (CHWs) on the Early Childhood Services and Community Health Services teams provide peer-led education to address mental wellness and resilience. Healthcare Access Strategy - Embed in Beacon Medical Group practices to work with pregnant women with adverse childhood experiences and social determinants of health needs. - Have a community health worker at Community Hospital of Bremen. - Grow and standardize the use of community health workers for scaling out in the future. - Implement experts in navigating the healthcare system. - Educate patients to optimize their use of the health system. - Refer to insurance navigators for insurance enrollment. - Build organizational health literacy between Beacon and Community Impact departments. Mental Health Metrics % of the population with frequent mental health distress % of the population with two or more trusted support people Healthcare Access Metrics % of the population with health insurance (adults < 65 and children) % of adults who reported their healthcare providers always involved them in decisions about their care, as much as they wanted. NEEDS NOT BEING ADDRESSED: By overlapping the top identified needs from the Key Informants, Secondary Data, and Focus Groups, we see that Mental Health, Chronic Disease, and Healthcare Access are the top health issues identified by all data sources combined. Other issues may have ranked higher by just one source, but not all three. Notably, sexually transmitted disease, immunization and infectious disease, and injury and violence prevention were among the top issues according to secondary data, but among the lowest rated issues according to key informants and focus groups. Overweight / obesity is also a top health issue according to secondary data; it ranked as a moderate health issue according to the other sources, just not at the top. Community Gaps Key Informants provided many ideas on areas of improvement. Most commonly, is the concern about the lack of mental health providers in the area. "From my experience, our biggest challenge stems from workforce shortages in mental health. If we could hire the amount of staff we need, our capacity would be much greater. It has been very difficult to find a competent and caring staff that can maintain a career in mental health and substance use." More specifically, the area needs more programs and/or services around pediatric mental health. As one Key Informant stated, "Mental health issues have drastically increased in our K-12 student population. We need to empower more school personnel to help students with these issues, and we need more mental health professionals in our school systems." Accessing mental health and more broadly, health services, is increasingly hard for low-income individuals. Focus group participants and Key Informants noted how navigating the healthcare system is too complex. Health insurance navigators and additional community resources are needed to ensure everyone can get to the appointments they need to get to and are informed. "I believe we need more outreach efforts. I think Beacon has the ability to meet families where they are-- whether it's at the childcare provider or a place of employment. We need to make healthcare more accessible." Another Key Informant went on to mirror these thoughts, "I think our wellness system is still not accessible to everyone. Self-advocacy, tenacity, and resilience are necessary to access health systems and to navigate social support systems. We need ways to reach people by attraction and positive experiences without screening highest need which causes further barriers." Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - MEMORIAL HOSPITAL OF SOUTH BEND, INC. PART V, SECTION B, LINE 11 (Continued) Community Strengths Key informants identified collaboration among non-profit service providers, agencies addressing food insecurity, and the public parks system, particularly South Bend's Venues Parks and Arts, as strengths in the community. They identified a number of organizations who do quality work to improve the health of the community. These include medical providers who serve low-income or the uninsured population, multiple organizations who provide emergency food access, some who serve specific populations such as homeless individuals, people with cancer, children, or people with substance use disorder. Again, collaborative efforts were noticed by the key informants. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - MEMORIAL HOSPITAL OF SOUTH BEND, INC.. FINANCIAL ASSISTANCE CRITERIA THE POLICY ALLOWS FOR PATIENTS TO QUALIFY FOR ASSISTANCE BY TWO MEANS: FINANCIAL OR CATASTROPHIC. THE FINANCIAL ASSISTANCE PROGRAM ALSO ALLOWS FOR PARTIAL ASSISTANCE OR FULL ASSISTANCE BASED ON ELIGIBILITY CRITERIA IN THIS POLICY. FINANCIAL ASSISTANCE 1. A PATIENT QUALIFYING FOR FINANCIAL ASSISTANCE IS A PERSON WHO IS UNINSURED OR UNDERINSURED, RECEIVES CARE AND UNABLE TO PAY THEIR BILL. 2.TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE GUIDELINES, A PERSON'S INCOME SHALL BE AT OR BELOW A PERCENTAGE OF THE FEDERAL POVERTY LEVEL (FPL) AS DETERMINED BY FEDERAL POVERTY GUIDELINES. HOUSEHOLD SIZE AND INCOME DETERMINES THE % OF FPL. MEMORIAL HOSPITAL OF SOUTH BEND, OR ITS DESIGNEE, MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. 3. MEMORIAL HOSPITAL OF SOUTH BEND WILL USE THE MOST CURRENT POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE POVERTY INCOME GUIDELINES ARE PUBLISHED ANNUALLY IN THE FEDERAL REGISTER AND FOR THE PURPOSES OF THIS POLICY WILL BECOME EFFECTIVE THE FIRST DAY OF THE MONTH FOLLOWING THE MONTH OF PUBLICATION. 4. TO QUALIFY UNDER THE FINANCIAL ASSISTANCE PORTION OF THIS POLICY, A COMPLETED, SIGNED FINANCIAL ASSISTANCE APPLICATION MUST BE SUBMITTED AND PROOF OF INCOME, PROOF OF NO INCOME, PROOF OF LACK OF FINANCIAL ASSETS AND OTHER REQUIRED DOCUMENTS MUST ACCOMPANY THE APPLICATION. CATASTROPHIC ASSISTANCE CRITERIA 1. A PATIENT QUALIFYING FOR CATASTROPHIC ASSISTANCE IS A PERSON WHOSE HOSPITAL BILLS EXCEED A SPECIFIED PERCENTAGE OF THE PERSON'S ANNUAL GROSS INCOME AS SET FORTH IN THE POLICY AND WHO IS UNABLE TO PAY THE REMAINING BILL. 2. TO BE ELIGIBLE FOR CATASTROPHIC ASSISTANCE THE AMOUNT OWED BY THE PATIENT MUST EXCEED ONE HUNDRED FIFTY (150) PERCENT OF THE PATIENT'S ANNUAL GROSS INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. MEMORIAL HOSPITAL OF SOUTH BEND MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ABILITY TO PAY. 3. IF A DETERMINATION IS MADE THAT A PATIENT HAS THE ABILITY TO PAY THE REMAINDER OF THE BILL, SUCH A DETERMINATION DOES NOT PREVENT A REASSESSMENT OF THE PATIENT'S ABILITY TO PAY AT A LATER DATE SHOULD THEIR FINANCIAL CIRCUMSTANCES CHANGE. 4. AFTER ELIGIBILITY IS DETERMINED UNDER THIS PROVISION, ASSISTANCE WILL BE PROVIDED TO DISCOUNT THE BILL BY 75% OF THE CURRENT BALANCE. 5. IF A PATIENT HAS CASH ASSETS, THOSE ASSETS WILL BE ADDED TO THEIR INCOME WHEN DETERMINING ELIGIBILITY FOR ASSISTANCE. 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 Schedule H, Part I, Line 3c FACTORS TO BE CONSIDERED FOR FINANCIAL ASSISTANCE HOUSEHOLD SIZE AND INCOME THE FOLLOWING FACTORS MAY BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR ASSISTANCE AND MUST BE PROVIDED BY ALL INCOME EARNING RESIDENTS IN THE COUNTABLE HOUSEHOLD UNIT UNLESS THEY ARE NOT DEPENDENTS BASED ON IRS GUIDELINES FOR DETERMINING WHETHER A HOUSEHOLD MEMBER CAN BE CONSIDERED A DEPENDENT. 1. INDIANA WORKFORCE WAGE REPORT FOR LAST 2 QUARTERS (UNEMPLOYMENT INCOME) 2. LAST 3 PAY STUBS OR A LETTER OR PRINTOUT FROM EMPLOYER(S) PROVIDING VERIFICATION OF GROSS INCOME IF CURRENTLY EMPLOYED. THIS DOCUMENTATION SHOULD NOT BE MORE THAN 30 DAYS OLD FROM DATE OF ISSUE AND INCLUDE YEAR-TO-DATE INFORMATION. 3. LAST 3 BANK STATEMENTS (INCLUDING EXPLANATIONS OF REGULAR DEPOSITS NOT EXPLAINED BY PAY STUBS) 4. SOCIAL SECURITY AWARD OR ENTITLEMENT LETTER OR OTHER PROOF OF GROSS MONTHLY AWARD. 5. RETIREMENT INCOME. 6. INVESTMENT INCOME. 7. STATEMENT FROM PERSON(S) THAT ARE PROVIDING DIRECT SUPPORT. 8. NUMBER OF DEPENDENTS. 9. MOST RECENT TAX RETURN (INCLUDING W2 AND ALL SUPPORTING SCHEDULES). 10. OTHER FINANCIAL OBLIGATIONS. 11. AMOUNT AND FREQUENCY OF HOSPITAL/MEDICAL BILLS. 12. OTHER FINANCIAL RESOURCES THAT PRODUCE INCOME. 13. IF SELF-EMPLOYED, GROSS INCOME LESS COST OF GOODS SOLD AND EMPLOYEE SALARIES. FINANCIAL CAPACITY 1. INDIVIDUALS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE MAY BE REQUIRED TO PURCHASE AND WILL BE PROVIDED ACCESS TO MEET WITH AN INDIANA CERTIFIED NAVIGATOR AS A MEANS OF ASSURING ACCESS TO HEALTHCARE SERVICES, FOR THEIR OVERALL PERSONAL HEALTH, AND FOR THE PROTECTION OF THEIR INDIVIDUAL ASSETS. 2. INDIVIDUALS HAVE BEEN FOUND THEY ARE INELIGIBLE FOR MEDICAID OR OTHER AFFORDABLE HEALTH CARE COVERAGE MUST PROVIDE PROOF OF DENIAL. 3. FOOD STAMPS OR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) WILL NOT BE COUNTED AS INCOME. 4. COSMETIC SERVICES ARE NOT ELIGIBLE FOR ANY TYPE OF ASSISTANCE AND CANNOT BE INCLUDED IN THE AMOUNT OF HOSPITAL/MEDICAL BILLS OWED. Schedule H, Part I, Line 7f BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES $22,425,566 Schedule H, Part I, Line 7 EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE COSTING METHODOLOGY THE COSTING METHOD USED TO CALCULATE FINANCIAL ASSISTANCE REPORTED ON LINES 7 A THROUGH D WAS THE COST-TO-CHARGE RATION AS DERIVED ON TAX FORM 990, SCHEDULE H, WORKSHEET 2. ALL OTHER COMMUNITY BENEFITS WERE CALCULATED USING DIRECT COSTS. Schedule H, Part II COMMUNITY BUILDING ACTIVITIES - COALITION BUILDING COMMUNITY BUILDING ACTIVITIES - COALITION BUILDING - PARTICIPATION IN COMMUNITY COALITIONS AND OTHER COLLABORATIVE EFFORTS WITH THE COMMUNITY TO ADDRESS HEALTH AND SAFETY ISSUES In 2017 The Executive Director of Beacon Community Impact was asked to represent Beacon Health System as one of six anchor organizations. We currently maintain this seat. This group, now recognized as the St. Joseph County Health Improvement Alliance Group, has met several times since the original assessment. Together the group worked on a vision, mission, and direction for the group. As a result of these brainstorming sessions, the group decided to focus on our stakeholders top priorities in order to increase public health infrastructure and ultimately improve the community's health. The ultimate goal is to improve the health of our community by collaboratively working together to decrease duplication of services and increase the utilization of existing services and resources. Schedule H, Part I, Line 6a EXPLANATION OF ORGANIZATION'S PREPARATION OF COMMUNITY BENEFIT REPORT Creating community health is at the core of Memorial Hospital of South Bend's mission. Promotion of community health is our social responsibility 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 organization takes a broad approach to creating community health. This approach has included: ongoing education of board members, staff and local leaders through community plunges (experimental activities to involve the community residents with a neighborhood-based clear statement of vision and goals, a commitment to continuous quality improvement and promotion of volunteer involvement and community partnerships. Memorial Hospital of South Bend invests in the community. This investment is in addition to the hospital's financial assistance and prevention, and education activities supported through its operating budget. The Beacon Community Impact Advisory Council makes ongoing policy and oversees the administration of the fund and determines specific investment allocations based upon the assets and needs of the community. 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 Hospital of South Bend 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 or our community. Further, Memorial Hospital of South Bend plays a key role in serving the community as a whole. Beacon Health System, Inc. EIN 45-3864076, prepares the annual community benefit reporting for Memorial Hospital of South Bend. Schedule H, Part I, Line 7b EXPL OF CALC OF NET COMM BENEFIT IN RELATION TO DSH PYMTS RECEIVED IN 2023, MHSB RECVEIVED A LARGE MEDICAID DISPROPORTIONATE SHARE HOSPITAL (DSH) PAYMENT THAT INCLUDED PAYMENTS RELATED TO PRIOR YEARS. THE TOTAL DSH PAYMENT RECEIVED WAS $16,998,000, WHICH INCLUDES APPROXIMATELY $9,775,000 RELATED TO YEARS PRIOR TO 2023. WITHOUT THE DSH PAYMENTS RELATED TO PRIOR YEARS, THE NET COMMUNITY BENEFIT EXPENSE WOULD HAVE BEEN $10,400,656, OR 1.83% OF TOTAL EXPENSE. Schedule H, Part I, Line 6a Community benefit report prepared by related organization BEACON HEALTH SYSTEM, INC, EIN 45-3864076 prepares the annual community benefit reporting for Memorial Hospital of South Bend. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 22425556 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount 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. THE COSTING METHODOLOGY IS THE SAME AS THE TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE COST IS ADJUSTED BY NON-PATIENT ACTIVITY EXPENSES, AND PATIENT CARE CHARGES. THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 IS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO, AS DETERMINED BY WORKSHEET 2, TO TOTAL BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BAD DEBT ATTRIBUTABLE TO THE FAP IS ESTIMATED BASED ON THE HISTORICAL TREND OF THE SOURCES OF THE BAD DEBT. THE MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO UNINSURED PATIENTS WHICH REPRESENT THE MAJORITY OF THE POPULATION THAT WOULD FALL UNDER THE FAP. WE HAVE APPLIED THE HISTORICAL ESTIMATE 50% TO THE TOTAL BAD DEBT EXPENSE TO DETERMINE THE AMOUNT ATTRIBUTABLE TO THE FAP. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS TAKING INTO CONSIDERATION THE TRENDS IN HEALTH CARE COVERAGE, HISTORICAL ECONOMIC TRENDS, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCES PERIODICALLY THROUGHOUT THE YEAR BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN UTILIZED TO MAKE MODIFICATIONS, AS NECESSARY, TO THE PROVISION FOR BAD DEBTS TO PROVIDE FOR AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT 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. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance COLLECTIONS PRACTICES PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE FOLLOW THE SAME COLLECTION POLICY AS ALL INDIVIDUALS WITH BALANCES REMAINING AFTER APPLICATION OF FINANCIAL ASSISTANCE. CREDIT AND COLLECTIONS POLICY: MEMORIAL HOSPITAL OF SOUTH BEND RELIES ON TIMELY PAYMENT OF PATIENT ACCOUNTS RECEIVABLE TO ALLOW THE HOSPITAL TO CONTINUE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND TO SECURE THE LATEST IN HEALTH CARE TECHNOLOGY FOR ITS PATIENTS. MEMORIAL HOSPITAL, RECOGNIZING THE BURDEN THAT UNEXPECTED HEALTH CARE EXPENSES CAN PLACE ON PATIENTS AND THEIR FAMILIES, WILL ASSIST PATIENTS TO RESOLVE OPEN ACCOUNTS FOR HOSPITAL SERVICES BY WORKING WITH THIRD PARTY PAYERS TO ADJUDICATE PATIENT'S INSURANCE CLAIMS AND BY PROVIDING ALTERNATIVE PAYMENT PLANS FOR PATIENTS. THE HOSPITAL ALSO PROVIDES SUBSIDIZED CARE FOR THOSE PATIENTS WHO QUALIFY. HOWEVER, WITH THE EXCEPTION OF SOME GOVERNMENT AND CONTRACTED CARE PLANS, ULTIMATE RESPONSIBILITY FOR RESOLUTION OR PAYMENT OF ACCOUNTS RESTS WITH THE PATIENT. PATIENTS ARE EXPECTED TO WORK WITH HOSPITAL PERSONNEL TO RESOLVE ACCOUNTS WITH THEIR INSURANCE COMPANIES AND/OR EMPLOYERS AS APPROPRIATE. WHERE THERE IS AN ESTIMATED SELF-PAY BALANCE DUE, MEMORIAL HOSPITAL WILL ASK NON-EMERGENCY PATIENTS TO PAY THAT BALANCE PRIOR TO OR AT THE TIME OF ADMISSION/REGISTRATION. 1. IF A PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND DOES NOT PAY THEIR ACCOUNT ACCORDING TO THE OPTIONS PROVIDED, THEN THE PATIENT'S ACCOUNT WILL BE PROCESSED ACCORDING TO THE BAD DEBT WRITE OFF POLICY. 2. IF A PATIENT HAS BEGUN MAKING PAYMENTS BUT THEN IS LATER DETERMINED TO QUALIFY UNDER THE FAP, MEMORIAL HOSPITAL WOULD ISSUE A REFUND TO THE PATIENT FOR ANY AMOUNT THAT HAS BEEN DETERMINED TO EXCEED THEIR NEWLY DETERMINED FINANCIAL RESPONSIBILITY. 3. MEMORIAL HOSPITAL OF SOUTH BEND MAY REQUEST AND COLLECT A DEPOSIT, BASED ON THE PATIENT'S TOTAL ESTIMATED PORTION OF A BILL, FROM APPROPRIATE NON-EMERGENCY INPATIENT ADMISSIONS, SAME DAY SURGERY PATIENTS, AND PATIENTS SCHEDULED FOR HIGH-DOLLAR OUTPATIENT PROCEDURES PRIOR TO OR AT THE TIME OF ADMISSION OR REGISTRATION. IN THE EVENT THAT A REQUEST FOR PAYMENT IS NOT MADE PRIOR TO OR AT THE TIME OF THE PATIENT'S ARRIVAL, A FINANCIAL COUNSELOR MAY CALCULATE THE ESTIMATED DEPOSIT AMOUNT AND CONFER WITH THE PATIENT/GUARANTOR FOR PAYMENT FOLLOWING THE ADMISSION OR REGISTRATION PROCESS VIA A FINANCIAL INTERVIEW. (IN SOME INSTANCES, THIS COULD OCCUR WHILE THE PATIENT IS IN HIS/HER ASSIGNED ROOM.) AT THE TIME OF DISCHARGE, EMERGENCY PATIENTS MAY BE REQUESTED TO PAY ANY CO-PAY OR DEDUCTIBLE. 4. WHERE APPROPRIATE, MEMORIAL HOSPITAL OF SOUTH BEND WILL IDENTIFY, AND REQUEST PAYMENT OF, AGED PATIENT BALANCES AS PART OF THE REQUEST FOR DEPOSIT. PAYMENT FOR OPEN PRIOR BALANCES WILL NOT DELAY CARE FOR EMERGENCY OR MEDICALLY NECESSARY CARE. AGED OPEN PRIOR BALANCES WILL BE CONSIDERED BY THE COLLECTION STAFF IN PATIENT ACCOUNT SERVICES WHENEVER PAYMENT ARRANGEMENTS OR AN ALTERNATIVE PAYMENT PROGRAM IS DEVELOPED FOR A PATIENT. 5. UNINSURED PATIENTS ARE GIVEN A 35% DISCOUNT FROM GROSS CHARGES. 6. MEMORIAL HOSPITAL OF SOUTH BEND WILL CONDUCT FINANCIAL INTERVIEWS WITH PATIENTS AND/OR GUARANTORS WHEN NECESSARY. ALL FINANCIAL INTERVIEWS WILLBE CONDUCTED IN AN ENVIRONMENT THAT IS BOTH PRIVATE AND PROFESSIONAL. 7. IN ADDITION TO CASH, CHECK, AND CREDIT CARDS, THE APPROVED PAYMENT ARRANGEMENT METHODS MIGHT INCLUDE: A. HOSPITAL PAYMENT PLAN - A PAYMENT PLAN WITH THE HOSPITAL IS NOT TO EXCEED THREE MONTHS. EXCEPTIONS MUST BE APPROVED BY THE MANAGER OF PATIENT ACCOUNT SERVICES OR REVENUE CYCLE DIRECTOR. PATIENTS MAY BE REQUIRED TO SIGN A PROMISSORY NOTE BASED ON THE AGREED UPON PAYMENT ARRANGEMENT. B. CAREPAYMENT - AN EXTENDED PAYMENT PLAN WHICH ALLOWS THE PATIENT AN EXTENDED PERIOD NOT TO EXCEED 36 MONTHS AT 0% INTEREST TO PAY THEIR BALANCE BETWEEN $100 AND $15,000. PATIENTS MAY BE AUTOMATICALLY ENROLLED IN THE CAREPAYMENT PLAN IF THEIR ACCOUNT HAS NOT BEEN PAID IN FULL 2 MONTHS AFTER THEIR FIRST STATEMENT. ALL PATIENTS ARE ELIGIBLE PROVIDED THAT THEY PROVIDE A VALID SOCIAL SECURITY NUMBER, ARE OVER 18 AND HAVE NOT PREVIOUSLY DEFAULTED ON THEIR CAREPAYMENT ACCOUNT. C. MEDICAID/HIP - PATIENTS WHO DO NOT HAVE COVERAGE WHEN THEY PRESENT TO THE HOSPITAL FOR TREATMENT WILL BE SCREENED FOR OTHER COVERAGE THROUGH STATE ASSISTANCE PROGRAMS. AN ELIGIBILITY SPECIALIST WILL ASSIST THE PATIENT/GUARANTOR TO COMPLETE AND SUBMIT ALL NECESSARY FORMS REQUIRED BY THE INDIANA DEPARTMENT OF PUBLIC AID FOR THESE TYPES OF PROGRAMS. D. HOSPITAL FINANCIAL ASSISTANCE (UNCOMPENSATED CARE) - REASONABLE EFFORTS WILL BE MADE TO DETERMINE IF PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ALL FINANCIAL ASSISTANCE MUST BE APPROVED ACCORDING TO THE FAP FOR THE HOSPITAL. (REFER TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY) 8. EXTRAORDINARY COLLECTION ACTIONS WILL NOT BE TAKEN UNTIL AFTER MEMORIAL HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT WILL QUALIFY FOR FINANCIAL ASSISTANCE. EXTRAORDINARY COLLECTION ACTIONS INCLUDE SUIT, WAGE GARNISHMENT, LIEN OR ADVERSE CREDIT BUREAU REPORTING. Schedule H, Part V, Section B, Line 16a FAP website - MEMORIAL HOSPITAL OF SOUTH BEND, INC: Line 16a URL: www.beaconhealthsystem.org/patients-and-visitors; Schedule H, Part V, Section B, Line 16b FAP Application website - MEMORIAL HOSPITAL OF SOUTH BEND, INC: Line 16b URL: www.beaconhealthsystem.org/patients-and-visitors; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MEMORIAL HOSPITAL OF SOUTH BEND, INC: Line 16c URL: www.beaconhealthsystem.org/patients-and-visitors; Schedule H, Part VI, Line 2 Needs assessment Beacon Community Impact formed the first Community Health Advisory Council in 2016. Still operating on an as needed basis today the Council consists of representation from Community Hospital of Bremen, Elkhart General Hospital, and Memorial Hospital of South Bend. The council is made up of individuals from Beacon Health System and Community stakeholders - i.e. Council at Large, Public School Systems, other Health Care entities, Indiana University South Bend, University of Notre Dame, Ivy Tech Community College, community organizations, local churches, community persons, etc.). The Advisory Council will meet 2-4 times per year to learn about community health, the CHNA process, and to review local hospital and community data collected regarding health in our community; there are periodic email communications as well. The Advisory Council provides input on the health priority areas, offers best practices, identifies areas of opportunities, and monitors progress on addressing health needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance When 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. Patients are also made aware of our financial assistance program via telephone conversation with our Patient Accounts staff. Staff is particularly sensitive to address this program with anyone who indicates there might be a financial need. Schedule H, Part VI, Line 4 Community information Established in 1830, St. Joseph County Indiana has become the fourth largest county in the state of Indiana. The county spans 457.78 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, with more than eight colleges and universities with a population of 272,388 according to the U.S. Census Bureau. Through the years, the environment of South Bend, the largest city in St. Joseph County, has changed from a focus on manufacturing (Studebaker, Bosch, and Uniroyal) to health, education and customer services. Elkhart, Marshall and St. Joseph Counties are all located in Northern Indiana. They have a total of 6 cities and 16 towns with a combined population of 525,437. St. Joseph is the largest and Marshall the smallest, which is classified as rural. St. Joseph County, Michigan borders Elkhart County, Indiana and is similar in rural classification as Marshall County. Although each varies in population density, they are closer in geographic size (SJC, IN-457 square miles, Elkhart-463, Marshall-443, SJC, MI-521). The median household income (2018-2022) is comparable in Elkhart ($63,978) ,St. Joseph, IN ($61,877) and St. Joseph, MI ($62,281) but higher in Marshall County -$66,016 where 10.5 % of people live in poverty compared to the higher rates of 13.8% in St. Joseph, IN 12% in Elkhart and 13% in St. Joseph, MI. Elkhart's RV industry is a multi-billion-dollar industry and nearly 1,000 RV manufacturers are located there. Marshall County has become one of the leading agricultural counties in Indiana. St. Joseph, IN is the regional center for higher education, with more than eight colleges and universities. These campuses have shifted the county's focus from manufacturing to health, education, and customer services. St. Joseph, MI has over 42 lakes and over 220 acres of woodlands in one of the towns, Sturgis. Schedule H, Part VI, Line 5 Promotion of community health In partnership with Beacon Health System (BHS), the mission of Memorial Hospital of South Bend (MHSB) is to deliver outstanding care, inspire health and connect with heart. BHS is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead BHS to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both BHS and MHSB consistently invest funds to improve the quality of life for our communities. BHS values reflect an unwavering commitment to the communities we serve. MHSB has as its values: Patients are at the center - Patient needs, care and safety are our top priority. - Trust - Our actions will firmly demonstrate our integrity, abilities and our character. - Respect - We will treat our patients, community members, and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. - Integrity - We will continually do the right thing for patients, associates, and communities we serve. - Compassion - We will appropriately demonstrate empathy and sympathy, and express the desire to help. MHSB seeks to promote the health and well-being of St. Joseph (SJC) residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community as a whole. A key mechanism by which this goal is carried out is MHSB's serious, consistent, and deliberate search for and partnership with like-minded organizations. MHSB continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances include local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers. Memorial Hospital South Bend's governing body is comprised of persons who reside in St. Joseph County. Board of Directors, who serve without pay, guides the system in its mission to provide high quality, affordable health care to the communities it serves. The Board's roles include guaranteeing fair and equal access, approving new medical staff members and approving long-term strategies for the continued success of the hospital. Additionally, Memorial Hospital South Bend extends medical staff privileges to all qualified physicians in our community. Beacon Health System welcomed Three Rivers Health in Three Rivers, Michigan, to the Beacon family in September 2021. In 2023, Community Impact established a working relationship with the local health department, Branch-Hillsdale-St. Joseph Community Health Agency, to address the top needs in the community. After seeing the impact of food insecurity on patients, a Beacon family medicine resident dedicated her service project to addressing this need. Now more than 50 bags of food are given to families and individuals in our community every month. Individuals experiencing homelessness often have poor access to medical care, for a variety of reasons that range from costs to transportation to social barriers. The Street Medicine South Bend program established by the Beacon Memorial Family Medicine Residency program a year ago has enabled physician volunteers to begin building trust and meeting these individuals where they are. So far, the physicians have seen more than 120 individuals experiencing homelessness. The St. Joseph County (Ind.) WIC program, hosted by Beacon Health System continues to promote breastfeeding, once again putting it in the top five WIC agencies in Indiana - and ensuring that more women can successfully breastfeed their infants, giving them a healthier start in life. Beacon Health System-funded Self-Healing Communities of Greater Michiana is building resilience to trauma and adversity by teaching people to care for themselves and each other, creating learning communities and establishing a website to share neuroscience-based resources. Through Beacon Community Impact, Beacon Health System was awarded over $3.8 million in external grant funds to prevent child abuse, help people stop smoking, improve the health of mothers and babies, increase access to COVID-19 vaccination and much more. Schedule H, Part VI, Line 6 Affiliated health care system In 2011, MHSB affiliated with Elkhart General Hospital of Elkhart, Indiana, under the name of Beacon Health System. In 2018, Beacon Health System affiliated with Community Hospital of Bremen. In October 2021, Beacon Health System affiliated with Three Rivers Health System. All organizations continue as full-care providers for their respective Counties and they are committed to promoting the health of the communities they serve. The Memorial Hospital of South Bend board of directors consists of 10 voting board members. The Beacon Health System Board of Directors consists of 14 voting board members. Schedule H, Part VI, Line 7 State filing of community benefit report IN true UNITED WAY OF STJOSEPH INDIANA 3517 E JEFFERSON SOUTH BEND IN 46660 351063368 501(C)(3) 45000 CORPORATE SPONSOR OAKLAWN PSYCHIATRIC CENTER INC PO BOX 809 GOSHEN IN 46527 351070041 501(C)(3) 40000 GENERAL SUPPORT TRANSFORMATION MINISTRIES INC 1519 PORTAGE AVE SOUTH BEND IN 46616 823641234 501(C)(3) 34000 GENERAL SUPPORT IMANI UNIDAD INC 234 CHAPIN ST STE B SOUTH BEND IN 46616 810615463 501(C)(3) 30000 GENERAL SUPPORT GENTLEMAN AND SCHOLARS INC 1412 W WASHINGTON ST SOUTH BEND IN 46601 465141303 501(C)(3) 25000 GENERAL SUPPORT LGBTQ RESOURCE CENTER 251 E SAMPLE ST STE 10 SOUTH BEND IN 46601 203906347 501(C)(3) 25000 GENERAL SUPPORT PLAY LIKE A CHAMPION TODAY ED SERVICES PO BOX 72 NOTRE DAME IN 46556 813305202 501(C)(3) 25000 PROGRAM SPONSOR MENTAL HEALTH AWARENESS OF MICHIANA 3220 E JEFFERSON BLVD SOUTH BEND IN 46615 824359500 501(C)(3) 21500 GENERAL SUPPORT VENUES PARKS AND ARTS FOUNDATION 301 S ST LOUIS BLVD SOUTH BEND IN 46617 273843043 501(C)(3) 20000 EVENT SPONSORSHIP INDIANA UNIVERSITY FOUNDATION IUSM-SB 1234 NOTRE DAME AVE RACIN-CARMICHAEL HALL SOUTH BEND IN 46617 356018940 501(C)(3) 17500 EVENT SPONSORSHIP FOUNDATION FOR THE CENTER FOR HOSPICE 501 COMFORT PL MISHAWAKA IN 46545 300433147 501(C)(3) 15000 GENERAL SUPPORT WNIT-TV CHANNEL 34 300 W JEFFERSON SOUTH BEND IN 46601 351155594 501(C)(3) 15000 EVENT SPONSORSHIP UNITED HEALTH SERVICES 6910 N MAIN ST BLDG 9 MAIL UNIT 10 GRANGER IN 46530 351118647 501(C)(3) 12800 GENERAL SUPPORT DOWNTOWN SOUTH BEND INC 217 S MICHIGAN ST SOUTH BEND IN 46601 351546291 501(C)(6) 10000 GENERAL SUPPORT ENFOCUS INC 506 E SOUTH ST NO 100 SOUTH BEND IN 46601 455638209 501(C)(3) 10000 GENERAL SUPPORT NEAR NORTHWEST NEIGHBORHOOD INC 1007 PORTAGE AVE SOUTH BEND IN 46616 237414729 501(C)(3) 6000 EVENT SPONSORSHIP VIBES MUSIC FESTIVAL INC 408 W WESTERN AVE APT 2104 SOUTH BEND IN 46601 921035774 501(C)(3) 6000 EVENT SPONSORSHIP 16 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. DONATIONS AND GRANTS GIVEN TO ORGANIZATIONS THAT IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY ARE MONITORED THROUGH OUTCOME MEASUREMENT REPORTS THAT ARE PROVIDED TO MEMORIAL BY THE VARIOUS ORGANIZATIONS. THESE REPORTS INFORM US OF HOW THE DONATIONS AND GRANTS WERE USED. X true true false true false false false false false true false Ronald Nelson MD Secretary 0 165151 0 9994 0 2709 0 7231 0 18601 0 203686 0 0 Jeffrey P Costello CFO 0 607351 0 0 0 136883 0 95606 0 22430 0 862270 0 88827 Kreg R Gruber CEO 0 1003311 0 0 0 159401 0 149636 0 20498 0 1332846 0 131845 Larry A Tracy President 494350 0 0 0 64869 0 78945 0 25148 0 663312 0 51968 0 Kristine E Jennings Dir of Med Residency Program 300691 0 0 0 300 0 12464 0 22746 0 336202 0 0 0 Marion Mahone Assoc. Dir Resident Program 302142 0 0 0 1003 0 12195 0 7545 0 322885 0 0 0 Linda A Mansfield Dir of Sports Medicine 299881 0 859 0 11372 0 12771 0 23063 0 347946 0 0 0 Matthew R Reed Employed Physician 302424 0 0 0 270 0 12195 0 16548 0 331437 0 0 0 Michelle A Thompson VP Medical Affairs 419548 0 2487 0 1787 0 13200 0 24889 0 461910 0 0 0 Schedule J, Part I, Line 1a Health or social club dues or initiation fees MEMORIAL HOSPITAL OF SOUTH BEND, INC. OFFERS COMPLIMENTARY HEALTH CLUB MEMBERSHIP TO BEACON HEALTH SYSTEM'S HEALTH AND LIFESTYLE CENTER, A RELATED PARTY. MEMORIAL HOSPITAL OF SOUTH BEND INC. REIMBURSES DIRECTORS FOR THE TAX EFFECT OF THE 1099 REPORTABLE BENEFITS FOR SPOUSAL TRAVEL. MEMORIAL HOSPITAL OF SOUTH BEND INC. ALSO REIMBURSES FOR DIRECT EXPENSES RELATED TO ANY TRAVEL ON THE ORGANIZATION'S BEHALF. HEALTH OR SOCIAL CLUB DUES FOR THE FOLLOWING INDIVIDUALS WAS INCLUDED IN TAXABLE COMPENSATION: BRAD TOOTHAKER, MARTHA SMITH AND RENEE FLEMING. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation MEMORIAL HOSPITAL OF SOUTH BEND, INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2023, REFLECTED IN COLUMN (B)(III): * KREG GRUBER, $113,175 * JEFFREY COSTELLO, $96,631 * LARRY TRACY $55,437 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2023 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: * KREG GRUBER, $136,436 * JEFFREY COSTELLO, $82,406 * LARRY TRACY, $65,745 Schedule J, Part I, Line 7 Non-fixed payments THE ORGANIZATION HAS THREE INCENTIVE PLANS (EMPLOYEE, MANAGEMENT AND EXECUTIVE) WHICH HAVE A NET OPERATING INCOME TO BUDGET MEASUREMENT FOR THE PAYOUT THRESHOLD. THE EMPLOYEE PLAN SHARES THE EXCESS OVER BUDGET NET OPERATING INCOME WITH THE NON-MANAGMENT EMPLOYEES FOR BEACON HEALTH SYSTEM, INC AND THE AFFILIATED ENTITIES. THE EMPLOYEE INCENTIVE HAS A MAXIMUM CAP OF $4,500,000. THE PAYOUT AND AMOUNT OF THE PAYOUT FOR THE EMPLOYEE INCENTIVE PLAN IS MADE AT THE DISCRETION OF THE BOARD. THE MANAGEMENT INCENTIVE PLAN IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE MANAGEMENT INCENTIVE IS MADE AT THE DISCRETION OF THE BOARD. EXECUTIVES ARE COVERED UNDER THE BEACON HEALTH SYSTEM EXECUTIVE SHORT-TERM INCENTIVE PLAN (ESTIP). THE ESTIP IS FUNDED WHEN OPERATING INCOME IS EQUAL TO OR GREATER THAN 50% OF THE BUDGETED NET OPERATING INCOME. REWARD AMOUNTS ARE BASED ON A BALANCED SCORE CARD METHODOLOGY UTILIZING BEACON'S STRATEGIC IMPERATIVES AND MEASURED USING SELECTED METRICS SET ON A SLIDING SCALE DEFINED AS THRESHOLD 50%, TARGET 100%. AND MAXIMUM 150%. THE STRATEGIC IMPERATIVES ARE CLINICAL EXCELLENCE, GREAT WORKPLACE, CUSTOMER-DRIVEN CULTURE, SMART GROWTH, AND FINANCIAL SUSTAINAILITY. EACH IMPERATIVE CARRIES A DEFAULT WEIGHT OF 20%. THE PAYOUT OF THE ESTIP IS MADE AT THE DISCRETION OF THE BOARD. A INDIANA FINANCE AUTHORITY 351602316 000000000 2017-09-08 37240000 REFERS TO SCHEDULE K, PART I, LINE A: REFUND BONDS ISSUED 03/16/2006 false false false B HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 911914363 79062WAA6 2013-05-21 45523353 REFERS TO SCHEDULE K, PART I, LINE B: REFUND BONDS ISSUED 05/10/2007 false false false C INDIANA FINANCE AUTHORITY 351602316 000000000 2023-06-16 40658950 REFERS TO SCHEDULE K, PART I, LINE C: REFUND TAXABLE BONDS ISSUED ON 9/21/2021 false false false D HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY 911914363 000000000 2022-05-19 150000000 REFERS TO SCHEDULE K, PART I, LINE D: CONSTRUCT TOWER ON MEMORIAL HOSPITAL false false false A 1495000 0 37240000 0 0 0 0 0 0 0 37240000 0 2000 true false true true B 0 0 45523353 0 0 0 511271 0 0 0 45012082 0 2009 true false true true C 0 0 40658950 0 0 0 95083 0 0 0 40563867 0 false true true true D 0 0 150000000 0 0 0 175395 0 0 44184787 0 105639818 2003 false false false true A 0.0 0.0 0.0 B false false true true false 0.0 0.0 0.0 false false true C false false true true false 0.0 0.0 0.0 false false true D false false false false 0.0 0.0 0.0 false false true A false false true false true true WELLS FARGO NA 21.7 false false false false true B false false false true false false false false true C false true false false false false false true D false false false false false false false false true A true B true C true D true Schedule K, Part III Column A COLUMN A IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND, THROUGH A SERIES OF 2006 REFUNDINGS, BONDS ISSUED BEFORE 01/01/2003. Schedule K, Part IV, Line 2c Column B THE DATE THE REBATE COMPUTATION WAS PERFORMED ON THE HOSPITAL AUTHORITY OF SANT JOSEPH COUNTY AND INDIANA FINANCE AUTHORITY WAS 5/18/2018. Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: INDIANA FINANCE AUTHORITY PART III, COLUMN A; COLUMN A IS NOT COMPLETED BECAUSE SUCH BONDS WERE ISSUED AFTER 12/31/2002 TO REFUND, THROUGH A SERIES OF REFUNDINGS, BONDS ISSUED BEFORE 01/01/2003. Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY PART IV, LINE 2C, COLUMN B THE DATE THE REBATE COMPUTATION WAS PERFORMED ON THE HOSPITAL AUTHORITY OF SANT JOSEPH COUNTY AND INDIANA FINANCE AUTHORITY WAS 5/18/2018. Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: HOSPITAL AUTHORITY OF SAINT JOSEPH COUNTY PART II, LINE 3, COLUMN D: THE 2022 BOND IS A DRAW DOWN BOND AS OF DECEMBER 31, 2023. THE 2022 BOND HAS AN ISSUE PRICE OF $150,000,000 BUT AST OF DECEMBER 31, 2023 ONLY $101,940,000 WAS DRAWN ON THE BOND. Katharine Callaghan Board Member is father 154780 Compensation false Form 990, Part I, Line 6 VOLUNTEERS VOLUNTEERS - MEMORIAL HOSPITAL OF SOUTH BEND HAS A DEPARTMENT CALLED AMBASSADOR AND CUSTOMER SERVICES. IT IS THE RESPONSIBILITY 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 A MAJOR SURGERY WAITING ROOM, PATIENT ESCORTS, FLOWER DELIVERY, MAIL DELIVERY, LIVING HISTORY PROGRAM, EMERGENCY DEPARTMENT VOLUNTEERS AND COOKIE BAKERS. IN 2023, MEMORIAL HAD 376 VOLUNTEERS IN THIS PROGRAM WHO SERVED 19,089 HOURS. Form 990, Part III, Line 4d Description of other program services (Expenses $ 190,682,702 including grants of $ 391,700) OTHER PROGRAM SERVICES OTHER PROGRAM SERVICES INCLUDE PSYCHIATRIC DEPARTMENTS, SOCIAL SERVICES, COMMUNITY OUTREACH PROGRAMS, TITHING, GRANTS, AND SUPPORTING SERVICES SUCH AS ADMINISTRATION, FINANCE, PAYROLL, PATIENT ACCOUNTING, LAUNDRY SERVICES, HEALTH AND LIFESTYLE CENTER, AND MEDICAL RECORDS. DUE TO THE NON-REVENUE GENERATING OR COMMUNITY INVESTMENT NATURE OF MANY OF THE PROGRAMS, THEY OPERATE AT A LOSS. SEE SCHEDULE H FOR DETAILS ON THE HOSPITALS TITHING AND COMMUNITY OUTREACH REPRESENTED IN OTHER PROGRAM SERVICES. Form 990, Part VI, Line 15 COMPENSATION DETERMINATION PROCESS CORE FORM, PART VI, SECTION B, LINE 15A & 15B COMPENSATION DETERMINATION PROCESS MEMORIAL HOSPITAL OF SOUTH BEND'S PARENT, BEACON HEALTH SYSTEM, INC. HAS AN EXTENSIVE EXAMINATION THAT IS CONDUCTED, FOR VICE PRESIDENT AND HIGHER, USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. HUMAN RESOURCES CONDUCTS THE ANALYSIS AND MAKES RECOMMENDATIONS TO THE CEO WHO THEN MAKES THE RECOMMENDATIONS FOR ALL OTHER EXECUTIVES/OFFICERS TO THE BOARD FOR APPROVAL. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Katharine Callaghan - Family relationship Form 990, Part VI, Line 6 Classes of members or stockholders MEMBERS OF THE ORGANIZATION - BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF MEMORIAL HOSPITAL OF SOUTH BEND, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ELECTION OF BOARD MEMBERS 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. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders DECISIONS OF THE BOARD OF DIRECTORS DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. BEACON HEALTH SYSTEM, THE SOLE MEMBER OF MEMORIAL HOSPITAL OF SOUTH BEND, HAS CONTROL OVER MEMORIAL HOSPITAL OF SOUTH BEND'S OPERATIONS. THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF BEACON HEALTH SYSTEM'S BOARD: 1. SELECTION AND RETENTION OF AUDITORS 2. APPROVAL OF ALL CONTRACTS, POLICIES, OR PROGRAMS OF INSURANCE ESTABLISHING THE TYPES OF INSURANCE COVERAGE REQUIRED AS WELL AS THE COVERAGE LEVELS 3. THE NOMINATION, ELECTION AND REMOVAL OF MEMBERS OF THE BOARD OF THE CORPORAION 4. OTHER MATTERS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS Form 990, Part VI, Line 11b Review of form 990 by governing body FORM 990 REVIEW PROCESS 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. SOME FORMS AND SCHEDULES ARE REVIEWED BY THE CONTROLLER. SUBSEQUENT TO THOSE STEPS, THE ORGANIZATION ENGAGED ERNST & YOUNG TO REVIEW THE COMPLETED FORM 990 AND APPROPRIATE SCHEDULES. PRIOR TO FILING THE RETURN, THE CFO, THE AUDIT COMMITTEE OF THE ORGANIZATION AND THE CEO CONDUCT A GENERAL OVERVIEW OF THE FORM 990, INCLUDING APPLICABLE COMPENSATION SCHEDULES. IN ADDITION, EACH BOARD MEMBER RECEIVES NOTIFICATION OF THE IRS FORM 990 PLACEMENT ON THE ORGANIZATION'S BOARD PORTALS WHICH ALLOWS FOR BOARD MEMBER REVIEW PRIOR TO FILING THE RETURN. Form 990, Part VI, Line 12c Conflict of interest policy CONFLICT OF INTEREST DISCLOSURE 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 FOR THE PREVIOUS YEAR ACTIVITIES AND WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT OVER 375 STATEMENTS AND ARE WORKING TO ACHIEVE A 100% RESPONSE RATE. EACH RESPONSE IS REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT AND THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, 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, AND OTHER KEY EMPLOYEES. THE DUALITY OF INTEREST STATEMENT IS SENT USING A WEB BASED SURVEY TOOL PROVIDED BY ERNST & YOUNG. THE REPLIES ARE REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT. THE RESULTS OF THE SURVEY ARE SUMMARIZED USING THE WEB BASED TOOL, AND ARE REVIEWED BY ERNST & YOUNG IN COMPLETING THE 990. THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, 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 ACKNOWLEDGEMENT FORM TO BE SIGNED BY BEACON HEALTH SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT ON JANUARY 4, 2024 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2023, 26 DESIGNATED EMPLOYEES WERE REQUESTED TO SIGN THE FORM AND WE HAD A 100% COMPLIANCE RATE. ANY POTENTIAL CONFLICTS OF INTERESTS 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 WOULD BE EXCLUDED FROM ALL REVIEW PROCEEDINGS. Form 990, Part VI, Line 19 Required documents available to the public AVAILABILITY OF ORGANIZATIONAL DOCUMENTS 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 BEACON HEALTH SYSTEM, INC. BONDS 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 BEACON HEALTH SYSTEM, INC. BONDS. Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue ALL OTHER - Total Revenue: 1492044, Related or Exempt Function Revenue: 1492044, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; STARBUCKS SALES - Total Revenue: 1001993, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1001993; COUNTY MENTAL HEALTH - Total Revenue: 876120, Related or Exempt Function Revenue: 876120, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; PARKING - Total Revenue: 600698, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 600698; SUBWAY SALES - Total Revenue: 484116, Related or Exempt Function Revenue: 0, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 484116; RESEARCH REVENUE - Total Revenue: 98305, Related or Exempt Function Revenue: 98305, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; AMBULANCE RESTOCKING - Total Revenue: 63453, Related or Exempt Function Revenue: 63453, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances WRITE OFF INTER COMPANY, BEACON HEALTH SYSTEM, INC. - -XXX-XX-XXXX; ROUNDING - -234; CHANGE IN INTEREST IN RECIPIENT ORG - 1480000; BEACON MEDICAL GROUP INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 PHY PRACTICES IN 501(c)(3) 10 BHS true BEACON HEALTH FOUNDATION INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536129 FINANCIAL SUP IN 501(c)(3) 7 BHS true ELKHART GENERAL HOSPITAL INC 600 EAST BOULEVARD ELKHART IN 46514 350877574 HOSPITAL IN 501(c)(3) 3 BHS true MEMORIAL ENDOWMENT FUND FOR MEM HOS PO BOX 1602 SOUTH BEND IN 46634 356068581 ENDOWMENT IN 501(c)(3) Type III-O MHSB true BEACON HEALTH SYSTEM INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 PARENT ORG IN 501(c)(3) Type III-O NA false COMMUNITY HOSPITAL OF BREMEN INC 1020 HIGH RD BREMEN IN 46506 350835006 HOSPITAL IN 501(c)(3) 3 BHS true THREE RIVER HEALTH SYSTEM 701 S HEALTH PARKWAY THREE RIVERS MI 49093 451257972 HOSPITAL MI 501(c)(3) 3 BHS true BEACON HEALTH VENTURES INC 615 N MICHIGAN ST SOUTH BEND IN 46601 351901068 HOME MEDICAL IN BHS C Corporation BEACON HEALTH VENTURES MICHIGAN INC 615 N MICHGIAN ST SOUTH BEND IN 46601 208259773 HOME MEDICAL MI BHS C Corporation false false true false false false false false false true true false false false false true true true true BEACON MEDICAL GROUP P 8829582 ACTUAL CHARGES BEACON MEDICAL GROUP Q 4627307 ACTUAL CHARGES BEACON MEDICAL GROUP R 208038 CASH BEACON MEDICAL GROUP J 1899234 ACTUAL CHARGES BEACON MEDICAL GROUP S 2526328 CASH BEACON HEALTH VENTURES P 1241452 ACTUAL CHARGES BEACON HEALTH VENTURES R 172714 CASH BEACON HEALTH VENTURES Q 673601 ACTUAL CHARGES BEACON HEALTH VENTURES S 430303 CASH ELKHART GENERAL HOSPITAL P 908999 ACTUAL CHARGES ELKHART GENERAL HOSPITAL Q 1686206 ACTUAL CHARGES ELKHART GENERAL HOSPITAL S 653304 CASH ELKHART GENERAL HOSPITAL R 1430511 CASH COMMUNITY HOSPITAL OF BREMEN Q 13015731 ACTUAL CHARGES COMMUNITY HOSPITAL OF BREMEN P 1372841 ACTUAL CHARGES COMMUNITY HOSPITAL OF BREMEN S 400177 CASH COMMUNITY HOSPITAL OF BREMEN R 12043067 CASH BEACON HEALTH FOUNDATION C 639106 ACTUAL CHARGES BEACON HEALTH FOUNDATION S 68205 CASH BEACON HEALTH FOUNDATION P 63588 ACTUAL CHARGES THREE RIVERS HOSPITAL Q 1010907 ACTUAL CHARGES THREE RIVERS HOSPITAL R 1007614 CASH