2024-05-09T14:15:56-05:00 2023-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2022-07-01 201890414 HEARTLAND HEALTH SYSTEM INC HEAR 2173482102 1000 HEALTH CENTER DR MATTOON IL 61938 DENNIS PLUARD CFO 2173482102 2024-05-03 1 DENNIS PLUARD 999009999 0 EMILIE M KNIERIEM CPA P01330194 3176334705 2024-04-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z FAYETTE COUNTY HOSPITAL KAREN DYER 1000 HEALTH CENTER DR MATTOON IL 61938 38061941 0 X HTTPS://WWW.FAYETTECOUNTYHOSPITAL.ORG X 2004 IL TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. 4 2 384 0 0 0 257722 23783 36603300 36835565 36576 2504 3073155 1200089 39970753 38061941 0 0 0 0 20555094 20800986 0 0 0 17391755 19097955 37946849 39898941 2023904 -1837000 11169711 27864710 4122581 22654580 7047130 5210130 THE MISSION OF HEARTLAND HEALTH SYSTEM IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. HEARTLAND HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF FAYETTE COUNTY, ILLINOIS AND SURROUNDING COUNTIES. 0 0 35145630 37879113 PROVISION OF ACUTE HOSPITAL SERVICES, INCLUDING INPATIENT URGENT CARE, EMERGENCY CARE, OUTPATIENT ANCILLARY SERVICES, PHYSICIAN SERVICES TO THE FAYETTE AND SURROUNDING COUNTIES. IN ADDITION, WE PROVIDE SKILLED NURSING AND LONG TERM NURSING HOME SERVICES. 35145630 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 35 0 1 384 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 2 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X DENNIS PLUARD 2173482102 1000 HEALTH CENTER DR MATTOON IL 61938 TINA STOVALL CHAIRPERSON 1.00 4.00 X X 0 0 0 BARB HALL VICE CHAIRPERSON 1.00 3.00 X X 0 0 0 KIMBERLY UPHOFF SECRETARY/CHAIRPERSON PARTIAL YEAR 5.00 50.00 X X 0 664708 74980 JERRY ESKER CHAIRPERSON PARTIAL YEAR 5.00 50.00 X 0 594308 80102 DENNIS PLUARD BOARD MEMBER 5.00 50.00 X 0 574225 78856 GREG STARNES CEO 40.00 0.00 X 0 380980 58970 KAREN DYER CEO 55.00 0.00 X 0 193317 8235 MARCI BARTH V/P PATIENT CARE 40.00 0.00 X 161017 0 49848 JEFFREY CARROLL PHYSICAL THERAPIST 40.00 0.00 X 162151 0 883 GLENN SKOW PHYSICIAN 36.00 0.00 X 275020 0 48119 RICHARD FUNNEMAN PHYSICIAN 40.00 0.00 X 255562 0 54231 CHRISTOPHER WHITTEN PHYSICAL THERAPIST 40.00 0.00 X 165618 0 30132 1019368 2407538 484356 21 0 1 0 ACUTE CARE INC 1609 ANKENY BLVD SUITE 200 ANKENY IA 50023 ER PHYSICIANS 1820235 TEN BROECK HEALTHCARE PO BOX 1100 WINDERMERE FL 34780 MANAGEMENT SERVICES 539000 ONE STAFF C/O AMERICAN NATIONAL BANK PO BOX 3 OMAHA NE 68103 CONTRACT EMPLOYEES 535789 10 23783 23783 NET PATIENT SERVICE REVENUE 621300 36598668 36598668 340B PHARMACY SERVICES 621300 236897 236897 36835565 2504 2504 43746 0 43746 43746 43746 OTHER OPERATING REVENUE 900099 1043548 1043548 CAFETERIA REVENUE 722514 112795 112795 1156343 38061941 37879113 0 159045 X 16503256 14564441 1938815 3158711 2787623 371088 1139019 1005206 133813 588000 518921 69079 20500 20500 8563071 7557075 1005996 750 662 88 1337304 1180196 157108 1449043 1278808 170235 18197 16059 2138 23267 20534 2733 3959 3494 465 1194093 1053810 140283 980279 865115 115164 MEDICAL SUPPLIES 3711938 3275857 436081 REPAIRS & MAINTENANCE 542276 478569 63707 HOSPITAL TAX ASSESSMENT 217879 217879 DUES & SUBSCRIPTIONS 136394 120370 16024 311005 201011 109994 39898941 35145630 4753311 0 990 990 4092231 4878097 3911949 9552340 588611 294270 200401 123871 20649959 8271960 2082991 12377999 284760 240690 7778 396453 11169711 27864710 2524825 2350279 10163 139060 21197 360895 1566396 19804346 4122581 22654580 X 7047130 5210130 7047130 5210130 11169711 27864710 -1837000 0 X X 0 1 X 1 1 1 X 19764807 8271960 11492847 885152 885152 12377999 DUE TO RELATED PARTIES 19597686 ESTIMATED THIRD PARTY SETTLEMENT 206660 19804346 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE ENTITIES HAVE FILED THEIR FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH JUNE 30, 2022. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). 1 1 X 1 X 190.000000000000 1 X 1 1 0 0 325387 325387 0.00820 9626967 5103838 4523129 0.11340 9952354 5103838 4848516 0.12160 9952354 5103838 4848516 0.12160 1 3617370 3932321 3969568 -37247 X 1 1 1 1 FAYETTE COUNTY HOSPITAL 650 W TAYLOR ST VANDALIA IL 62471 HTTPS://WWW.FAYETTECOUNTYHOSPITAL.ORG 0000695 X X FAYETTE COUNTY HOSPITAL 0 0 1 X X X X X X X X X 21 0 0 0 1 X SEE PART V, PAGE 8 X 1 21 1 HTTPS://SBLFCH.ORG/COMMUNITY-NEEDS-ASSESSMENT 0 1 X 190.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X 1 X 0 0 FAYETTE COUNTY HOSPITAL PART V, SECTION B, LINE 11: 1. IMPROVE LOCAL ACCESS TO MENTAL HEALTH CARE A. ACCESS TO MENTAL HEALTH CARE HAS BEEN EXPANDED TO THE COMMUNITY WITH THE ADDITION OF KELSEY KINGSBOROUGH, NP SPECIALIZING IN PSYCHIATRY. KELSEY PROVIDES COVERAGE THROUGH THE FCH PHYSICIAN SPECIALTY CLINIC. B. THE CARE COORDINATORS CONTINUE TO ASSESS PATIENTS REGARDING SOCIAL DETERMINANTS OF HEALTH AND MAKE APPROPRIATE REFERRALS WHEN NEEDS ARE IDENTIFIED.2. IMPROVE LOCAL ACCESS TO GERIATRIC SERVICES A. EXPAND SENIOR RENEWAL PROGRAM - MANY COMMUNITY AWARENESS ACTIVITIES REGARDING THE SENIOR RENEWAL PROGRAM TAKE PLACE EACH MONTH.3. IMPROVE COMMUNITY EDUCATION ABOUT AVAILABLE LOCAL RESOURCES FOR PHYSICAL AND MENTAL HEALTH AND WELLNESS SERVICES A. ADDITIONAL EDUCATIONAL INFORMATION HAS BEEN POSTED USING SOCIAL MEDIA AND THE HOSPITAL WEBSITE.4. IMPROVE LOCAL ACCESS TO PEDIATRIC SERVICES A. A PEDIATRIC NURSE PRACTITIONER WAS ADDED TO OUR HOSPITAL MEDICAL STAFF IN JULY 2023. PART V, SECTION B, LINE 16: SCHEDULE H, PART V, LINE 16A:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, LINE 16B:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, LINE 16C:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/ FAYETTE COUNTY HOSPITAL: PART V, SECTION B, LINE 7A: HTTPS://SBLFCH.ORG/COMMUNITY-NEEDS-ASSESSMENT 3 1 - FAMILY MEDICAL CENTER 825 NEW YORK DRIVE SUITE 2 VANDALIA IL 62471 CLINIC 2 - RURAL HEALTH - VANDALIA 1442 N 8TH STREET VANDALIA IL 62471 CLINIC 3 - RURAL HEALTH - ST ELMO 515 N MAIN STREET ST ELMO IL 62458 CLINIC PART I, LINE 7: THE COSTING METHODOLOGY THAT WAS USED TO CALCULATE THESE AMOUNTS WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 OF THE WORKING PAPERS. PART III, LINE 2: USED THE RATIO OF PATIENT CARE COST TO CHARGES (0.375168) AS COMPUTED ON WORKSHEET 2 OF THE ACCOUNTING WORKPAPERS TO CALCULATE THE BAD DEBT EXPENSE (3,617,370) AT COST (1,357,121). WE REDUCE BAD DEBT EXPENSE BY THE DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS. PART III, LINE 4: SEE THE PATIENT ACCOUNTS RECEIVABLE NOTE ON PAGE 7 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: ALTHOUGH HEARTLAND HEALTH SYSTEM DOES NOT TREAT SHORTFALL FOR MEDICARE AS A COMMUNITY BENEFIT, THERE COULD BE A CASE MADE THAT NOT BEING FULLY REIMBURSED FOR TREATING THE ELDERLY IS CONSIDERED TO BE THE PROVISION OF A BENEFIT TO THE COMMUNITY. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 AND ALSO DETAILED ON WORKSHEET C OF THE WORKING PAPERS. PART VI, LINE 2: EVERY THREE YEARS, HEARTLAND HEALTH SYSTEM, INC. ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH SURVEY THAT IS BASED LARGELY ON THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH A SERIES OF KEY INFORMANT FOCUS GROUPS. BASED ON THE RESULTS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, HHS DETERMINED TO FOCUS ON IMPROVING LOCAL ACCESS TO MENTAL HEALTH CARE, IMPROVING LOCAL ACCESS TO GERIATRIC SERVICES, IMPROVING COMMUNITY EDUCATION ABOUT AVAILABLE LOCAL RESOURCES FOR PHYSICAL AND MENTAL HEALTH AND WELLNESS EDUCATION AND SERVICES AND IMPROVING LOCAL ACCESS TO PEDIATRIC SERVICES. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:WHEN A PATIENT IS PRIVATE PAY (OR SHOWS CONCERN ABOUT PAYING THE BILL), OUR REGISTRATION CLERK INFORMS THEM OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION. ALL STAFF ARE ORIENTED AS TO HOW THE PROGRAM WORKS DURING NEW EMPLOYEE ORIENTATION. WE ALSO HAVE FINANCIAL ASSISTANCE REPRESENTATIVES AVAILABLE DURING NORMAL BUSINESS HOURS TO SPEAK WITH THE PATIENT IF THERE ARE QUESTIONS BEYOND THE REGISTRATION CLERK'S KNOWLEDGE. PATIENTS ARE INFORMED (NOT NECESSARILY AT REGISTRATION) THEY NEED TO APPLY FOR MEDICAID SHOULD THEY HAVE ANY PRE-QUALIFIERS FOR THE PROGRAM (IE: BLIND, DISABLED, DEPENDENT CHILDREN IN THE HOME, ETC.). THIS INFORMATION IS IN THE FINANCIAL ASSISTANCE BROCHURE WITH THE APPLICATION AS WELL. IF A PATIENT NEEDS TO APPLY FOR MEDICAID PRIOR TO FINANCIAL ASSISTANCE, WE PROVIDE THEM THE INFORMATION AND ASSISTANCE TO APPLY AT THE PUBLIC AID OFFICE. ADDITIONALLY, OUR SBL FINANCIAL ASSISTANCE PROGRAM BROCHURES ARE IN EVERY DEPARTMENT AND CLINIC IN THE SYSTEM AND WIDELY AVAILABLE THROUGHOUT THE FACILITY. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE (INCLUDING APPLICATIONS) WITH A DEDICATED PHONE NUMBER. PART VI, LINE 4: COMMUNITY INFORMATION:HEARTLAND HEALTH SYSTEM SERVES RURAL COMMUNITIES IN EAST CENTRAL ILLINOIS. HHS'S MARKET AREA ENCOMPASSES 9 COUNTIES INCLUDING: CLARK, COLES, CUMBERLAND, DOUGLAS, EDGAR, EFFINGHAM, JASPER, MOULTRIE, AND SHELBY. THE POPULATION OF THE HOSPITAL'S SERVICE AREA IS ESTIMATED AT 157,198 PEOPLE. THE REGION IS PREDOMINANTLY WHITE, WITH FEWER THAN 4 PERCENT OF THE POPULATION IDENTIFYING THEMSELVES AS MEMBERS OF RACIAL MINORITY GROUPGS. THE REGION IS RURAL, WITH MORE THAN 53 PERCENT OF THE POPULATION LIVING IN COMMUNITIES OF LESS THAN 2,500. THE MEDIAN AGE IN EACH COUNTY, EXCEPT COLES, IS HIGHER THAN THE ILLINOIS MEDIAN OF 36.2 YEARS. TWELVE PERCENT OF THE POPULATION AS INCOMES BELOW THE FEDERAL POVERTY LEVEL. AN ESTIMATED 13.5 PERCENT OF ADULT POPULATION UNDER AGE 65 IS WITHOUT HEALTHCARE INSURANCE. ALTHOUGH HHS HAS HAD A POSITIVE IMPACT ON THE PHYSICIAN-TO-POPULATION RATIOS OF THE REGION, THE AREA IS MEDICALLY UNDERSERVED AS DETERMINED BY BOTH FEDERAL AND STATE GUIDELINES. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:HEARTLAND HEALTH SYSTEM HAS AN OPEN MEDICAL STAFF AS WELL AS A COMMUNITY BOARD. SCHEDULE H, PART I, LINE 7, COLUMN F: THE ORGANIZATION INCURRED BAD DEBT EXPENSE IN THE AMOUNT OF 3,617,370. HOWEVER, IT HAS BEEN DISREGARDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. 0 1 0 0 0 0 1 0 0 KIMBERLY UPHOFF SECRETARY/CHAIRPERSON PARTIAL YEAR 0 418532 0 93704 0 152472 0 10250 0 64730 0 739688 0 0 JERRY ESKER CHAIRPERSON PARTIAL YEAR 0 530731 0 400 0 63177 0 10250 0 69852 0 674410 0 0 DENNIS PLUARD BOARD MEMBER 0 383896 0 114162 0 76167 0 10250 0 68606 0 653081 0 0 GREG STARNES CEO 0 270077 0 90144 0 20759 0 10250 0 48720 0 439950 0 0 GLENN SKOW PHYSICIAN 273420 0 1360 0 240 0 4683 0 43436 0 323139 0 0 0 RICHARD FUNNEMAN PHYSICIAN 239978 0 14000 0 1584 0 4639 0 49592 0 309793 0 0 0 MARCI BARTH V/P PATIENT CARE 160465 0 0 0 552 0 2954 0 46894 0 210865 0 0 0 KAREN DYER CEO 0 174876 0 17009 0 1432 0 7030 0 1205 0 201552 0 0 CHRISTOPHER WHITTEN PHYSICAL THERAPIST 164658 0 600 0 360 0 2957 0 27175 0 195750 0 0 0 JEFFREY CARROLL PHYSICAL THERAPIST 159103 0 0 0 3048 0 0 0 883 0 163034 0 0 0 PART I, LINE 6 ADDITIONAL COMPENSATION TO OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DEPENDENT ON SPECIFIC ORGANIZATIONAL AND INDIVIDUAL GOALS. THESE GOALS INCLUDE FINANCIAL, QUALITY, CUSTOMER SERVICE, AND OTHER GOALS RELATED TO THE ORGANIZATION'S STRATEGIC PLAN. SCHEDULE J, PART I, LINE 4B: SARAH BUSH LINCOLN HEALTH CENTER CURRENTLY MAINTAINS A NONQUALIFIED, UNFUNDED, DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ON BEHALF OF CERTAIN DESIGNATED MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE PLAN IS INTENDED TO BE AN UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, AS DESCRIBED IN THE EMPLOYEE RETIREMENT SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE FOLLOWING PERSONS LISTED IN FORM 990, PART VII ARE PARTICIPANTS IN THE PLAN: DENNIS PLUARD JERRY EKSER KIM UPHOFF THERE WERE NO DISTRIBUTIONS FROM THE PLAN DURING THE TAX YEAR BY THESE PARTICIPANTS. FORM 990, PART VI, SECTION A, LINE 2 DENNIS PLUARD, JERRY ESKER, KIM UPHOFF, SCOTT WILSON, AND TINA STOVAL HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER AS A RESULT OF ALL SERVING AS BOARD MEMBERS OF SBL PRACTICE ACQUISITIONS, A FOR-PROFIT AFFILIATE OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS SARAH BUSH LINCOLN HEALTH CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER HAS THE POWER TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE BOARD OF DIRECTORS OF THE CORPORATION OR ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BODY MAY NOT TAKE THE FOLLOWING ACTION WITHOUT PRIOR APPROVAL OF THE SOLE CORPORATE MEMBER: 1. ESTABLISH, APPROVE, OR MODIFY THE PHILOSOPHY, VISION, VALUES AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES 2. LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE ANY REAL PROPERTY OR INTEREST IN REAL PROPERTY OF THE CORPORATION 3. APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS 4. APPROVE ANY PURCHASE OR OTHER ACQUISITION BY THE CORPORATION THAT IS NOT INCLUDED IN ITS OPERATING AND CAPITAL BUDGETS AND EXCEEDS $100,000 5. APPROVE ANY BORROWING OR DEBT FINANCING ON BEHALF OF THE CORPORATION, TO STRUCTURE INDEBTEDNESS OF THE CORPORATION, AND TO ENTER INTO AND AMEND AGREEMENTS RELATING TO INDEBTEDNESS OF THE CORPORATION 6. REQUIRE A CERTIFIED AUDIT OF THE FINANCES OF THE CORPORATION AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM ANY AUDIT 7. APPROVE THE ENGAGEMENT OF AND TO DISMISS ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS OR IN CONNECTION WITH ANY MATTER DEEMED BY MEMBER TO HAVE SIGNIFICANCE FOR THE MEMBER AND/OR AFFILIATES 8. ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE BOARD OF DIRECTORS OR THE CORPORATION OR ANY MEMBER OF THE BOARD OF DIRECTORS OF THE CORPORATION 9. MERGE OR CONSOLIDATE THE CORPORATION WITH OTHER ENTITIES, TO MERGE OTHER ENTITIES INTO THE CORPORATION, OR TO DISSOLVE THE CORPORATION, IN ACCORDANCE WITH APPLICABLE LAW 10. AMEND THE BYLAWS AND ARTICLES OF INCORPORATION OF THE CORPORATION IN ACCORDANCE WITH APPLICABLE LAW 11. EXPAND, CONSOLIDATE, TERMINATE OR CLOSE ANY FACILITIES AND SERVICES OF THE CORPORATION 12. APPROVE STRATEGIC PLAN AND MANAGEMENT OBJECTIVES FOR THE CORPORATION, WHICH WILL BE DEVELOPED BY THE CORPORATION AND RECOMMENDED TO MEMBER 13. ADOPT OR MODIFY THE OPERATING BUDGET AND CAPITAL BUDGET FOR ANY FISCAL YEAR FOR THE CORPORATION, WHICH WILL BE DEVELOPED BY THE CORPORATION AND RECOMMENDED TO MEMBER 14. GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION WILL BE A PARTY TO JOINT VENTURES AND OTHER AFFILIATIONS WITH THIRD PARTIES, AND APPROVE THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY LEGAL ENTITY IN WHICH THE CORPORATION WILL HAVE ANY INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY 15. APPROVE APPOINTMENTS TO GOVERNING BODIES OF JOINT VENTURES BETWEEN THE CORPORATION AND THIRD PARTIES AND OTHER LEGAL ENTITIES IN WHICH THE CORPORATION HAS ANY POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS 16. TAKE ANY AND ALL ACTIONS DEEMED NECESSARY, IN SOLE JUDGMENT OF THE MEMBER, TO PROTECT AND PRESERVE THE TAX-EXEMPT STATUS AND PUBLIC CHARITY STATUS OF THE MEMBER AND ANY TAX-EXEMPT AFFILIATE OF THE MEMBER (INCLUDING FEDERAL AND STATE INCOME TAX EXEMPTIONS, PROPERTY TAX EXEMPTIONS, AND SALES TAX EXEMPTIONS); PROVIDED THE MEMBER HAS GIVEN A WRITTEN REQUEST TO THE CORPORATION TO TAKE ACTION OR REFRAIN FROM TAKING ACTION, WHICH WOULD HAVE SUFFICIENTLY PROTECTED AND PRESERVED SUCH TAX-EXEMPT AND PUBLIC CHARITY STATUS, AND THE CORPORATION HAS FAILED TO PROMPTLY TAKE SUCH ACTION OR REFRAIN FROM TAKING SUCH ACTION. FORM 990, PART VI, SECTION B, LINE 11B THE SENIOR ACCOUNTING STAFF REVIEWS ALL ELEMENTS OF THE 990 BASED ON PRIOR KNOWLEDGE AND INTERVIEWS WITH OTHER INDIVIDUALS IN THE ORGANIZATION. IN ADDITION, BOARD MEMBERS SUBMIT DETAILED QUESTIONNAIRES WITH REGARDS TO THEIR RELATIONSHIPS WITH THE ORGANIZATION. THE FINAL FORM 990 IS MADE AVAILABLE TO THEM ONLINE VIA A WEB PORTAL AND AT THEIR BOARD MEETING FOR REVIEW AND QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ANNUALLY COMPLETE A CERTIFICATION STATEMENT WHICH IDENTIFIES POSSIBLE CONFLICTS OF INTEREST RELATED TO THEIR PROFESSIONAL AND PERSONAL LIVES DURING DELIBERATIONS AND DECISIONS ON WHICH THERE APPEARS TO BE A CONFLICT OF INTEREST, THE BOARD MEMBER IS EXCUSED FROM THE DISCUSSION AND DELIBERATION, SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON OR BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM IN RESPECT TO THE TRANSACTION OR CONTRACT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED FOR THE PRESIDENT & CEO, VP MEDICAL AFFAIRS, VP FINANCE & OPERATIONS, VP PRACTICE MANAGEMENT, VP PATIENT CARE SERVICES, VP INFORMATION SERVICES, VP HUMAN RESOURCES, AND THE VP DEVELOPMENT & FOUNDATION BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE SBL BOARD. AN INDEPENDENT CONSULTANT, HAY GROUP, INC., REVIEWED CURRENT COMPENSATION FOR EACH POSITION AND COMPARED IT TO SIMILAR POSITIONS IN LIKE ORGANIZATIONS. THE COMMITTEE APPROVED COMPENSATION CONSISTENT WITH THE BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THIS PROCESS IS DONE ANNUALLY, BETWEEN JUNE AND AUGUST, FOR ALL THE LISTED POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,829,832. MANAGEMENT AND GENERAL EXPENSES 642,946. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,472,778. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,837,130. MANAGEMENT AND GENERAL EXPENSES 244,558. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,081,688. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 890,113. MANAGEMENT AND GENERAL EXPENSES 118,492. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,008,605. FORM 990 PART XII, LINE 2C: THE AUDIT COMMITTEE OF THE SOLE CORPORATE MEMBER ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. SARAH BUSH LINCOLN HEALTH SYSTEM 1000 HEALTH CENTER DRIVE MATTOON IL 61938 371136714 PARENT COMPANY IL 501(C)(3) LINE 12B, II N/A 0 SARAH BUSH LINCOLN HEALTH CENTER FOUNDATION 1000 HEALTH CENTER DRIVE MATTOON IL 61938 371136713 FUNDRAISING IL 501(C)(3) LINE 12A, I SARAH BUSH LINCOLN HEALTH SYSTEM 0 SARAH BUSH LINCOLN HEALTH CENTER 1000 HEALTH CENTER DRIVE MATTOON IL 61938 237098532 HEALTH CARE IL 501(C)(3) LINE 3 SARAH BUSH LINCOLN HEALTH SYSTEM 0 SARAH BUSH LINCOLN CAPTIVE INSURANCE LTD 18 FORUM LANE 2ND FLOOR PO BOX 69 GEORGE TOWN GRAND CAYMAN CJ 980566036 INSURANCE CJ SARAH BUSH LINCOLN HEALTH SYSTEM C 0 SBL PRACTICE ACQUISITIONS INC 1000 HEALTH CENTER DRIVE MATTOON IL 61938 824716884 MANAGEMENT IL SARAH BUSH LINCOLN HEALTH SYSTEM C 0 BONUTTI ORTHOPEDIC SERVICES INC 1303 EVERGREEN AVE EFFINGHAM IL 62401 371257387 HEALTHCARE IL SBL PRACTICE ACQUISITIONS C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0