2025-08-15T12:10:20-05:00 2024-09-30 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2023-10-01 363492268 ABRAHAM LINCOLN HEALTHCARE FOUNDATION ABRA 2177322161 701 NORTH FIRST STREET SPRINGFIELD IL 62781 KATHRYN J KEIM SENIOR VP & CFO 2177883830 2025-08-15 1 0 JESSICA A WAGENER P01622613 3128792000 2023 2025-03-06 01:10:19Z LINCOLN MEMORIAL FOUNDATION DOLAN C DALPOAS 701 NORTH FIRST STREET SPRINGFIELD IL 62781 7211110 0 X N/A X 1986 IL TO IMPROVE LIVES AND BUILD STRONGER COMMUNITIES THROUGH BETTER HEALTH. 18 17 0 98 0 0 142689 1347549 58723 65330 591975 1327516 143644 4241 937031 2744636 83152 185047 0 0 0 0 0 0 54891 787464 580563 870616 765610 66415 1979026 35947066 41273326 151432 256611 35795634 41016715 X TO IMPROVE LIVES AND BUILD STRONGER COMMUNITIES THROUGH BETTER HEALTH. 0 0 134024 134024 LMF USES CHARITABLE GIFTS TO PURCHASE MEDICAL EQUIPMENT AND PATIENT CARE ITEMS FOR LMH, WHICH IN THE PAST YEAR INCLUDED DEFIBRILLATORS AND NECK WRAPS FOR INPAITENT CARE. THE AUXILIARY GRANTS INCLUDED MASSAGE CHAIRS, SAFE SITTER KITS AND NEW LOBBY DECOR. 76435 ABRAHAM LINCOLN HOSPITAL FOUNDATION D/B/A LINCOLN MEMORIAL FOUNDATION'S (LMF) COMMUNITY HEALTH COLLABORATIVE HOUSES ALL COMMUNITY HEALTH INITIATIVES THAT EXTEND OUTSIDE THE WALLS OF LINCOLN MEMORIAL HOSPITAL (LMH). ITS VISION IS TO CREATE THE HEALTHIEST COMMUNITY IN THE NATION. CURRENT INITIATIVES INCLUDE THE LMH MARKET PROVIDING ACCESS TO FRESH PRODUCE AND FREE HEALTH SCREENINGS TO ALL IN OUR COMMUNITY; THE COORDINATED APROACH TO CHILD HEALTH (CATCH) PROGRAM PROMOTES HEALTHY EATING AND PHYSICAL ACTIVITY IMPACTING OVER 5 SCHOOLS WITH 3,200 LOCAL STUDENTS; SUPPORTING THE TRAILBLAZERS AND COLLABORATIVE MEETINGS. 51023 51023 HEALTH EDUCATION AND OUTREACH PROGRAM IS A MAJOR TENET OF LMF FUNDING. IN ORDER TO ENSURE A SUPPLY OF TALENTED HEALTHCARE WORKERS DOWN THE ROAD, ALHF HAS ESTABLISHED A PROGRAM THAT PROVIDES EDUCATIONAL GRANTS TO LOCAL STUDENTS WITH COMMITMENTS TO RETURN TO THE HOSPITAL UPON GRADUATION. IN FY2024, LMF AWARDED 5 EDUCATIONAL GRANTS TO LOCAL STUDENTS AND COLLEAGUES. LMF ALSO HAS A FUND FOR LMH COLLEAGUES TO HAVE AN OPPORTUNITY TO FURTHER THEIR PROFESSIONAL CAREERS BY OBTAINING CERTIFICATIONS. LMF FUNDED 10 CERTIFICATIONS. LMF ALSO PROVIDED COLLEAGUE EMERGENCY ASSISTANCE TO 1 COLLEAGUE. 142476 82253 LMF PROVIDES SERVICES TO COLLEAGUES AND VISITORS THROUGH THE HOSPITAL'S GIFT SHOP, LMF FUNDS THE LIFELINE SERVICE FOR SENIORS, AND FUNDS THE FARMERS MARKET TO PROVIDE ACCESS TO FRESH FOOD TO THE COMMUNITY. 142476 82253 403958 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 18 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X KATHRYN KEIM SENIOR VP & CFO 2177883830 701 NORTH FIRST STREET SPRINGFIELD IL 62781 EDGAR CURTIS EX-OFFICIO PRESIDENT & CEO 25.00 25.00 X X 1829103 0 55097 CHARLES CALLAHAN PHD PRES. MH HOSPITAL GROUP (THRUJUN24) 25.00 25.00 X 0 953637 153449 RAJESH GOVINDAIAH MD SVP & CPE (THRUJUN24) 25.00 25.00 X 695157 0 100376 KATHRYN KEIM SVP & CFO 25.00 25.00 X 646710 0 140043 AIMEE DAILY PHD SVP & CHIEF TRANSFORMATION OFFICER(THRUSEP23) 25.00 25.00 X 609788 0 95300 JAMESON ROSZHART PRSMHAMGRPTRUJUN24;PRS&CEOSMH&MBHFRMJUL24 25.00 25.00 X 554864 0 125137 KEVIN ENGLAND SVP & CHIEF ADMINISTRATIVE OFFICER 25.00 25.00 X 552217 0 116854 ANNA EVANS JD SVP & GENERAL COUNSEL 25.00 25.00 X 512035 0 154835 MARSHA PRATER PHD SVP & CNO (THRUSEP23) 25.00 25.00 X 0 614580 38900 DREW EARLY PRESIDENT & CEO DMH 0.00 50.00 X 482729 0 105714 ELISABETH KLAR SVP & CHIEF HUMAN RESOURCES OFFICER 25.00 25.00 X 405962 0 100976 AKINDELE ADARAMOLA MD CHIEF MEDICAL OFFICER SMH 0.00 50.00 X 413884 0 87889 J TRAVIS DOWELL PRESIDENT & CEO MMG (THRU JUN24) 0.00 50.00 X 400643 0 97691 DOLAN DALPOAS PRESIDENT & CEO LMH 0.00 50.00 X 388408 0 61937 KIMBERLY BOURNE PRESIDENT&CEO TMH&TMF; BRDMBR MHC 0.00 50.00 X 351342 0 89822 ROBERT SCOTT FORMER SVP & CHIEF HR OFFICER 0.00 0.00 X 235700 0 0 JOHN WADDOCK BOARD MEMBER 0.70 1.40 X 0 0 0 JOSEPH HURWITZ BOARD MEMBER 0.70 0.00 X 0 0 0 WILLIAM PUTMAN MD BOARD MEMBER 0.70 0.00 X 0 0 0 REGINALD BENTON BOARD MEMBER 0.70 0.70 X 0 0 0 JERRY KRUSE MD MSPH BOARD MEMBER 0.70 0.00 X 0 0 0 JOHN BLACKBURN BOARD MEMBER (THRU DEC23) 0.70 0.00 X 0 0 0 RANDALL GERMERAAD BOARD MEMBER 0.70 0.00 X 0 0 0 AIMEE FYKE BOARD MEMBER 0.70 1.40 X 0 0 0 JONATHAN LOCKE MD BOARD MEMBER (THRU DEC23) 0.70 0.70 X 0 0 0 DAVID GRIFFEN MD PHD BOARD MEMBER (FRM JAN24) 0.70 1.40 X 0 0 0 DIANE RUTLEDGE PHD BOARD MEMBER 0.70 0.00 X 0 0 0 DEAN ROBERT JR IMMPSTCHR(THUDEC23)/BRDMBR(FRMJAN24) 1.40 0.70 X 0 0 0 JENNIFER GILL BOARD MEMBER 0.70 0.00 X 0 0 0 SERGIO PECORI BOARD MEMBER 0.70 0.00 X 0 0 0 GUSSIE REED BOARD MEMBER (FRM JAN24) 0.70 1.40 X 0 0 0 ERIC GRAUE BOARD MEMBER (FRM JAN24) 0.70 1.40 X 0 0 0 BARBARA FARLEY BRDMBR(THRDEC23)/2NDVIR (FRM JAN24) 1.40 0.70 X X 0 0 0 CHERYL MARTIN 2VCHR&TRS(DEC23)/1VCHR&TRS(FRMJAN24) 1.40 1.40 X X 0 0 0 NINA HARRIS SECRETARY 1.40 1.40 X X 0 0 0 MICHAEL AIELLO 1STVCHR(THRUDEC23)/CHR(FRM JAN24) 1.40 1.40 X X 0 0 0 TODD WISE CHR(THRUDEC23)/IMPASTCHAIR(FRMJAN24) 1.40 1.40 X X 0 0 0 8078542 1568217 1524020 14 1 1 0 0 27162 1320387 1009779 1347549 LIFE LINE 900099 44838 44838 FARMERS MARKET 900099 20492 20492 65330 838031 838031 4895644 4406159 489485 489485 489485 6709 27162 20331 -13622 -13622 2183 1243 940 940 55664 38741 16923 16923 2744636 82253 0 1314834 134024 134024 51023 51023 105602 105602 9076 8054 1022 141836 88413 29631 23792 9573 5880 3693 622 622 796 332 464 34881 34881 3718 3718 PURCHASED SERVICES 232182 94431 122548 15203 DONOR RECOGNITION & CUL 16407 1533 14874 HEALTHY BEHAVIORS 15853 15853 SALES TAX 5326 5326 4691 4691 765610 403958 306761 54891 315 315 326505 294330 1589401 1362556 10524 18602 4113 678944 253966 460410 424978 31625560 37486553 1926273 1689957 35947066 41273326 25519 18117 139116 99764 95927 26149 3451 151432 256611 X 32593103 38053265 3202531 2963450 35795634 41016715 35947066 41273326 X 1979026 3478151 -236096 X 0 1 X 1 0 X 1984558 1703181 1287835 142689 1347549 6465812 1984558 1703181 1287835 142689 1347549 6465812 4557518 1908294 277139 222516 381949 795314 838031 2514949 2118 22937 17532 8892 51479 9032240 1045707 0.21130 0.30220 X THE LINCOLN MEMORIAL FOUNDATION (LMF) QUALIFIES AS PUBLICLY SUPPORTED BECAUSE IT MEETS THE 10% FACTS AND CIRCUMSTANCES TEST UNDER TREASURY REG. 1.170A-9(F) (1)-(4). LMF MAINTAINS A CONTINUOUS AND BONA FIDE PROGRAM FOR SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC AND CARRIES ON ACTIVITIES DESIGNED TO ATTRACT SUPPORT FROM ORGANIZATIONS DESCRIBED IN SECTION 170(B)(1)(A)(I)-(VI) OF THE INTERNAL REVENUE CODE. THE FOLLOWING DISCUSSION PRESENTS THE APPLICABLE FACTS AND CIRCUMSTANCES.1. 10 PERCENT OF SUPPORT LIMITATION - LMF'S PUBLIC SUPPORT PERCENTAGE IS 21.13% FOR TY2023. THIS IS WELL ABOVE THE 10% THRESHOLD. LMF RECEIVED ONE OF ITS LARGEST BEQUESTS EVER IN FY24 OF $1.3M, WHICH CREATED EXCESS CONTRIBUTIONS OVER $1M FOR THIS DONOR. THIS CAUSED THE PUBLIC SUPPORT PERCENTAGE TO DROP TO 21% FROM 30% LAST YEAR. OVER THE PAST 5 YEARS, LMF HAS RECEIVED $1M FROM A SINGLE DONOR IN 4 OF THE YEARS. THIS MAKES IT CHALLENGING FOR LMF TO PASS THE PUBLIC SUPPORT TEST. 2. ATTRACTION OF PUBLIC SUPPORT - LMF IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL SUPPORT ON A CONTINUOUS BASIS. IT HAD THE SUPPORT OF 509 UNIQUE DONORS THIS YEAR WITH AN AVERAGE GIFT OF $250. LMF IS ACTIVELY SEEKING NEW DONORS. LMF SEEKS SUPPORT THROUGH COMMUNITY MEETINGS AND EVENTS, DIRECT MAILINGS, WEBSITE DONATIONS, AND GIFTS FROM HOSPITAL EMPLOYEES. 3. SOURCES OF SUPPORT - THE MISSION OF LMF IS TO IMPROVE LIVES AND BUILD STRONGER COMMUNITIES THROUGH BETTER HEALTH. THIS MISSION TOUCHES THE LIVES OF ALL THE RESIDENTS OF THE COMMUNITY. LMF RECEIVES SUPPORT FROM INDIVIDUALS, FOUNDATIONS, AND CORPORATIONS. THE BROAD BASE OF SUPPORT IS GENERALLY REPRESENTATIVE OF THE PUBLIC IN LOGAN COUNTY ILLINOIS. 4. REPRESENTATIVE GOVERNING BODY - THE BOARD OF DIRECTORS CONSISTS OF 18 LEADERS FROM THE COMMUNITY. THIS DIVERSE GROUP ENGAGES THE ENTIRE COMMUNITY IN SUPPORTING LMF. EXCEPT FOR THE PRESIDENT & CEO OF LINCOLN MEMORIAL HOSPITAL, ALL LMF BOARD MEMBERS ARE INDEPENDENT OF LMF AND PROVIDE OVERSIGHT AND GUIDANCE TO THE LMF STAFF. 5. AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATION IN PROGRAMS OR POLICIES - LMF SUPPORTS THE HEALTH OF THE PEOPLE AND THE COMMUNITY WE SERVE. PROGRAMS INCLUDE HEALTHCARE CAREER SCHOLARSHIPS, CREATION OF COMMUNITY WALKING TRAILS, A PRODUCER ONLY HEALTHY FOODS FARMERS MARKET THAT PROVIDES FREE FOOD TO LOW-INCOME INDIVIDUALS AND THE COORDINATED APPROACH TO CHILD'S HEALTH (CATCH) PROGRAM IMPACTING THE LIVES OF 3,200 LOCAL STUDENTS AND THEIR FAMILIES. LMF SUPPORTS LINCOLN MEMORIAL HOSPITAL BY PURCHASING EXPENSIVE MEDICAL EQUIPMENT, ECHOCARDIOGRAPHY. SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: GOLF OUTING FUNDRAISER - 2019 AMOUNT: $ 2,118. 2021 AMOUNT: $ 20,385. 2022 AMOUNT: $ 14,736. 2023 AMOUNT: $ 6,709. HEALING LIFE FUNDRAISER - TIS THE SEASON FUNDRAISER - 2021 AMOUNT: $ 1,747. 2022 AMOUNT: $ 1,980. 5K FUNDRAISER - GAMING - 2021 AMOUNT: $ 805. 2022 AMOUNT: $ 816. 2023 AMOUNT: $ 2,183. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21762 8690 13072 657182 245276 411906 424978 DUE TO AFFILIATES 3451 3451 X PART X, LINE 2: EACH OF MH'S SUBSIDIARIES, EXCLUDING THOSE DESCRIBED IN THE FOLLOWING PARAGRAPH, IS A SEPARATELY INCORPORATED NOT-FOR-PROFIT CORPORATION AS DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE AND IS TAX-EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY DO, HOWEVER, OPERATE CERTAIN PROGRAMS THAT MAY RESULT IN UNRELATED BUSINESS INCOME. UPON REVIEW AS REQUIRED BY ASC 740, INCOME TAXES, NO TAX PROVISION WAS RECORDED FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2024 OR 2023. MH IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019. QALICB, MCDEKK, AND MHP ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES AND ARE EXEMPT FROM INCOME TAX. MHSCI IS A TAXABLE FOR-PROFIT CORPORATION SUBJECT TO FEDERAL AND STATE INCOME TAXES. GOLF OUTING 29461 24812 4649 6758 4893 5795 TIS THE SEASON 4410 2350 2060 325 2195 100 265 33871 27162 6709 7083 7088 100 6060 20331 -13622 1 ABRAHAM LINCOLN MEMORIAL HOSPITAL 200 STAHLHUT DRIVE LINCOLN IL 62656 370723793 501(C)(3) 133398 0 SEE PART IVVARIOUS INCLUDING FITNESS COURT, BIKE PATH, LANDSCAPING, PATIENT SUPPLIES. 1 0 EDUCATION GRANTS 4 20405 COLLEAGUE ASSISTANCE 1 874 RURAL HEALTH CAREER GRANT 1 25000 COLLEAGE CERTIFICATIONS 10 4661 PATIENT TRANSPORT 13 83 PART I, LINE 2: LINCOLN MEMORIAL FOUNDATION (LMF) WILL EITHER REIMBURSE THE GRANT RECIPIENT OR DIRECTLY PAY A VENDOR FOR THE GRANT EXPENDITURES. GRANT RECIPIENTS MUST SUBSTANTIATE THE EXPENDITURE WITH AN INVOICE OR RECEIPT PRIOR TO REIMBURSEMENT TO THE GRANT RECIPIENT OR DIRECT PAYMENT TO THIRD-PARTY VENDOR. ANY UNSPENT GRANT FUNDS REVERT BACK TO LMF. 0 1 0 0 0 0 0 0 0 EDGAR CURTIS EX-OFFICIO PRESIDENT & CEO 1126301 0 0 0 702802 0 31250 0 23847 0 1884200 0 0 0 CHARLES CALLAHAN PHD PRES. MH HOSPITAL GROUP (THRUJUN24) 0 664548 0 0 0 289089 0 117438 0 36011 0 1107086 0 135582 RAJESH GOVINDAIAH MD SVP & CPE (THRUJUN24) 560912 0 0 0 134245 0 96237 0 4139 0 795533 0 47154 0 KATHRYN KEIM SVP & CFO 597929 0 0 0 48781 0 105250 0 34793 0 786753 0 0 0 AIMEE DAILY PHD SVP & CHIEF TRANSFORMATION OFFICER(T 332559 0 0 0 277229 0 86768 0 8532 0 705088 0 29670 0 JAMESON ROSZHART PRSMHAMGRPTRUJUN24;PRS&CEOSMH&MBHFRM 486620 0 0 0 68244 0 91308 0 33829 0 680001 0 25420 0 KEVIN ENGLAND SVP & CHIEF ADMINISTRATIVE OFFICER 474706 0 0 0 77511 0 92848 0 24006 0 669071 0 26986 0 ANNA EVANS JD SVP & GENERAL COUNSEL 453311 0 0 0 58724 0 120707 0 34128 0 666870 0 37107 0 MARSHA PRATER PHD SVP & CNO (THRUSEP23) 0 291390 0 0 0 323190 0 31153 0 7747 0 653480 0 0 DREW EARLY PRESIDENT & CEO DMH 443534 0 0 0 39195 0 71577 0 34137 0 588443 0 0 0 ELISABETH KLAR SVP & CHIEF HUMAN RESOURCES OFFICER 387257 0 0 0 18705 0 68820 0 32156 0 506938 0 0 0 AKINDELE ADARAMOLA MD CHIEF MEDICAL OFFICER SMH 396245 0 0 0 17639 0 85348 0 2541 0 501773 0 0 0 J TRAVIS DOWELL PRESIDENT & CEO MMG (THRU JUN24) 346984 0 0 0 53659 0 65068 0 32623 0 498334 0 24677 0 DOLAN DALPOAS PRESIDENT & CEO LMH 326352 0 0 0 62056 0 61810 0 127 0 450345 0 27961 0 KIMBERLY BOURNE PRESIDENT&CEO TMH&TMF; BRDMBR MHC 296715 0 0 0 54627 0 59860 0 29962 0 441164 0 25633 0 ROBERT SCOTT FORMER SVP & CHIEF HR OFFICER 0 0 0 0 235700 0 0 0 0 0 235700 0 217571 0 PART I, LINE 3 MEMORIAL HEALTH, A RELATED ORGANIZATION OF LINCOLN MEMORIAL FOUNDATION, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B DOLAN DALPOAS PARTICIPATES IN ONE OR MORE NONQUALIFIED DEFERRED COMPENSATION PLANS OF MEMORIAL HEALTH (MH), A RELATED ORGANIZATION. MH CREDITS ANNUAL CONTRIBUTION AMOUNTS TO THESE PLANS, AND THESE AMOUNTS SERVE TO PROVIDE SUPPLEMENTAL RETIREMENT INCOME. ALL CREDITED AMOUNTS ARE REVIEWED AND APPROVED BY A COMMITTEE OF THE MH BOARD AS PART OF REASONABLE TOTAL COMPENSATION. ALL AMOUNTS CREDITED ARE UNVESTED WHILE THE EXECUTIVE IS REQUIRED TO PROVIDE SUBSTANTIAL FUTURE SERVICES, AND THEN ARE TAXED IN FULL WHEN THE SERVICE PERIOD IS COMPLETED AND THE AMOUNTS BECOME VESTED. ALL AMOUNTS CREDITED TO THESE EXECUTIVES UNDER THESE PLANS ARE INCLUDED IN COLUMN (C) AS UNVESTED, NONTAXABLE DEFERRED COMPENSATION WHEN FIRST CREDITED, AND THEN ARE AGAIN INCLUDED IN COLUMN (B)(III) WHEN THE AMOUNTS BECOME VESTED AND ARE SUBJECT TO TAX. DOLAN DALPOAS RECEIVED DEFERRED COMPENSATION PAYOUTS IN THE CALENDAR YEAR FROM MH WHICH TOTALED $27,961. TO BECOME ENTITLED TO THE BENEFITS PROVIDED, EACH COVERED EMPLOYEE MUST MEET SUBSTANTIAL REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES AND NOT MET THESE SUBSTANTIAL REQUIREMENTS, THESE SUPPLEMENTAL RETIREMENT BENEFITS WOULD HAVE BEEN FORFEITED. THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ACCORDINGLY, ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE. THE LEADERSHIP COMPENSATION COMMITTEE OF THE MH BOARD APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER SENIOR LEADERS, IN A MANNER INTENDED TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL INCOME TAX LAW. X 17 1009779 AVG HIGH AND LOW PRICE 0 1 1 PART I, COLUMN (B): LINE 9 - COLUMN B REPRESENTS 17 STOCK HOLDINGS FOR THE ESTATE OF H S PEACOCK. THE DONOR EXECUTED A TRANSFER OF SECURITIES ON A SPECIFIC DATE. PART I, LINE 32B: STOCK IS TRANSFERRED DIRECTLY TO THE LMF MASTER TRUST ACCOUNT. THE STOCK IS SOLD WHEN DIRECTED BY LMF/MH TREASURY AND THE PROCEEDS ARE INVESTED IN THE INVESTMENT ACCOUNT. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE CORPORATION CONSISTS OF ONE CORPORATE MEMBER, MEMORIAL HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATE MEMBER OF THE CORPORATION ELECTS THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF THE CORPORATION REQUIRE THE ADVANCE APPROVAL OF THE CORPORATE MEMBER OF CORPORATE, ADMINISTRATIVE AND OPERATIONAL ACTIONS WHICH INCLUDE, BUT ARE NOT LIMITED TO, THE ESTABLISHMENT OF, AND AMENDMENT TO, RULES AND REGULATIONS GOVERNING THE PRINCIPAL AND INCOME OF THE CORPORATION'S FUNDS; THE BORROWING OF ANY SUM, THE PRINCIPAL OF WHICH EXCEEDS $500,000, OR WHICH HAS A STATED TERM OF GREATER THAN ONE YEAR, OR WHICH IS SECURED BY A MORTGAGE OF ALL OR ANY PORTION OF THE CORPORATION'S REAL PROPERTY OR THE CREATION OF A SECURITY INTEREST IN THE CORPORATION'S ASSETS, INCLUDING PERSONAL PROPERTY AND REVENUES, FOR THE BENEFIT OF THE LENDER, LESSOR OR VENDOR, OR THE DEFEASANCE, ADVANCE PAYMENT OR CANCELLATION OF ANY OUTSTANDING DEBT OF THE CATEGORY DESCRIBED HEREIN; ANY GUARANTY OF ANY DEBT EXCEEDING $250,000; THE VOLUNTARY DISSOLUTION, MERGER, CONSOLIDATION, SALE OR TRANSFER OF ANY OR THE CORPORATION'S ASSETS WHICH EXCEEDS ONE PERCENT OF THE CORPORATION'S TOTAL ASSETS OR ANY CREATION OF A SUBSIDIARY OR AFFILIATE OF THE CORPORATION; THE APPROVAL OF ALL ANNUAL AND LONG TERM CAPITAL AND OPERATIONAL BUDGETS AND STRATEGIC PLANS; ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; THE SELECTION OF OR CHANGE OF INDEPENDENT AUDITORS; ANY AGREEMENT OR TRANSACTION, EITHER OF WHICH OF A MATERIAL NATURE, WITH ANOTHER CORPORATION CONTROLLED BY OR AFFILIATED WITH THE CORPORATE MEMBER OR WHICH IS A SUBSIDIARY OR AFFILIATE OF THE CORPORATE MEMBER; AND ANY GENERAL PLAN FOR THE SOLICITATION OF CHARITABLE CONTRIBUTIONS AND THE ACCEPTANCE OF A CONTRIBUTION WHICH IMPOSES A MATERIAL OBLIGATION. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PREPARES AND REVIEWS THE RETURN. AN OUTSIDE TAX ADVISOR THEN REVIEWS THE RETURN, PROVIDING COMMENTS AND GUIDANCE AS NEEDED. ALHF BOARD MEMBERS ARE THEN PROVIDED WITH A FINAL COPY OF FORM 990 AND ITS SUPPORTING SCHEDULES FOR REVIEW AT A REGULARLY SCHEDULED BOARD MEETING. REVIEW, DISCUSSION, AND RATIFICATION OF THE FORM ARE AN AGENDA ITEM. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE CORPORATION ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A SPECIFIC DISCLOSURE STATEMENT WHICH IS ATTACHED TO THE POLICY. ABRAHAM LINCOLN MEMORIAL HOSPITAL FOUNDATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING IS CALLED TO ORDER. ANY OFFICER OR DIRECTOR WHO HAS A CONFLICT IS NOTIFIED OF SUCH CONFLICT, AS WELL AS THEIR OBLIGATION TO ABSTAIN FROM THE DISCUSSION AND VOTE ON ANY CONFLICTED ISSUES(S). SUCH ABSTENTION(S), IF REQUIRED, ARE DOCUMENTED IN THE MINUTES OF EACH MEETING. BOARD MEMBERS ARE ALSO REQUIRED TO UPDATE THEIR CONFLICT OF INTEREST DISCLOSURE STATEMENTS PROMPTLY IN THE EVENT OF ANY CHANGE IN PERSONAL OR BUSINESS ACTIVITIES THAT WOULD REQUIRE SUCH DISCLOSURE. FORM 990, PART VI, SECTION B, LINE 15 THE CORPORATE MEMBER OF THE CORPORATION HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE AND HAS DELEGATED TO IT THE RESPONSIBILITY OF ADMINISTERING, OVERSEEING AND APPROVING ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE LEADERSHIP, INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE CORPORATE MEMBER'S BOARD OF DIRECTORS HAS ADOPTED A LEADERSHIP COMPENSATION PHILOSOPHY STATEMENT DESCRIBING THE ROLE AND RESPONSIBILITIES OF THE COMMITTEE. THIS PHILOSOPHY EXPRESSLY STATES THE COMMITTEE'S INTENT, ON BEHALF OF THE CORPORATION, TO TAKE ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE ANALYZES EVERY ELEMENT OF COMPENSATION (INCLUDING CURRENT, INCENTIVE AND DEFERRED COMPENSATION) AND BENEFITS (INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS). THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. IN CONNECTION WITH THE MOST RECENT REVIEW AND APPROVAL PROCESS, THE COMMITTEE RECEIVED PROFESSIONAL ADVICE FROM AN INDEPENDENT CONSULTANT AND OUTSIDE LEGAL COUNSEL. THE COMMITTEE CONSISTS ENTIRELY OF DISINTERESTED MEMBERS OF THE BOARD OR DISINTERESTED COMMITTEE MEMBERS WHO UNDER STATE CORPORATE LAW MAY SERVE ON SUCH A COMMITTEE. THE COMMITTEE WORKS WITH ITS COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF ABRAHAM LINCOLN HEALTHCARE FOUNDATION D/B/A LINCOLN MEMORIAL FOUNDATION, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D). FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF CHARITABLE LIFE INSURANCE 804. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -237,310. RECOVERIES OF PRIOR YEAR GRANTS 410. SPRINGFIELD MEMORIAL HOSPITAL 701 NORTH FIRST ST SPRINGFIELD IL 627810001 370661220 HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH 0 LINCOLN MEMORIAL HOSPITAL 200 STAHLHUT DR LINCOLN IL 62656 370723793 HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH 0 TAYLORVILLE MEMORIAL HOSPITAL 201 EAST PLEASANT TAYLORVILLE IL 62568 370661250 HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH 0 JACKSONVILLE MEMORIAL HOSPITAL 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 370661230 HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH 0 DECATUR MEMORIAL HOSPITAL 2300 N EDWARD DECATUR IL 62526 370661199 HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH 0 MEMORIAL HOME CARE 720 NORTH BOND SPRINGFIELD IL 62702 370714225 HOME HEALTH AND HOSPICE IL 501(C)(3) LINE 7 MEMORIAL HEALTH 0 SPRINGFIELD MEMORIAL FOUNDATION 701 N FIRST STREET SPRINGFIELD IL 62781 371110301 GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) LINE 7 SPRINGFIELD MEMORIAL HOSPITAL 0 TAYLORVILLE MEMORIAL FOUNDATION 201 EAST PLEASANT TAYLORVILLE IL 62568 371337485 GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) LINE 7 TAYLORVILLE MEMORIAL HOSPITAL 0 MEMORIAL BEHAVIORAL HEALTH 701 NORTH EIGHTH STREET SPRINGFIELD IL 627026395 370646367 TRAINING, PSYCHIATRIC, AND RESIDENT SERVICES FOR MENTALLY ILL AND DISABLED IL 501(C)(3) LINE 7 MEMORIAL HEALTH 0 SPRINGFIELD RESIDENTAL SERVICES 701 NORTH EIGHTH STREET SPRINGFIELD IL 62702 371298589 RESIDENTAL HUD HOUSING PROJECT FOR MENTALLY ILL IL 501(C)(3) LINE 7 MEMORIAL BEHAVIORAL HEALTH 0 JACKSONVILLE MEMORIAL FOUNDATION 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 461037396 SUPPORTING THE HOSPITAL IL 501(C)(3) LINE 7 JACKSONVILLE MEMORIAL HOSPITAL 0 JACKSONVILLE CRNA'S INC 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 273093265 CRNA SERVICES IL 501(C)(3) LINE 10 JACKSONVILLE MEMORIAL HOSPITAL 0 MEMORIAL MEDICAL GROUP 701 NORTH FIRST ST SPRINGFIELD IL 627810001 371181194 HEALTH CLINICS IL 501(C)(3) LINE 10 MEMORIAL HEALTH 0 MEMORIAL HEALTH VENTURES 701 NORTH FIRST ST SPRINGFIELD IL 62781 363492266 HEALTHCARE ACTIVITIES IL 501(C)(3) LINE 10 MEMORIAL HEALTH 0 DECATUR MEMORIAL FOUNDATION 2300 N EDWARD DECATUR IL 62526 454256254 GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) LINE 12A, I DECATUR MEMORIAL HOSPITAL 0 MEMORIAL HEALTH 701 NORTH FIRST ST SPRINGFIELD IL 627801000 371110690 PARENT IL 501(C)(3) LINE 12A, I DCE 0 MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS 701 NORTH FIRST STREET SPRINGFIELD IL 62781 371190216 PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTS IL N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1