2025-08-15T11:16:20-05:00 2024-09-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-10-01 920574205 DEACONESS ILLINOIS CLINIC INC DEAC 8124503296 600 MARY ST EVANSVILLE IN 47710 BRADLEY SCHEU MD SENIOR VICE PRESIDENT 8124503296 2025-08-15 1 1 EMILIE M KNIERIEM CPA P01330194 3176334705 2025-08-14 2023 2025-03-06 01:10:19Z BRADLEY SCHEU MD 600 MARY ST EVANSVILLE IN 47710 7170231 0 X WWW.DEACONESS.COM X 2022 IN TO DELIVER HEALTH CARE TO THE PUBLIC. 4 0 140 0 0 0 0 0 4387213 7170231 0 0 0 0 4387213 7170231 0 0 0 0 4765887 8968521 0 0 0 1846397 2878750 6612284 11847271 -2225071 -4677040 4770723 9975412 3795017 5617823 975706 4357589 IN KEEPING WITH OUR CHRISTIAN HERITAGE AND TRADITION OF SERVICE, THE MISSION OF DEACONESS IS TO ADVANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITY, WITH A COMPASSIONATE AND CARING SPIRIT. 0 0 10417950 7170231 DELIVERING, OR ARRANGING OR SUPPORTING THE DELIVERY OF QUALITY, COST-EFFECTIVE HEALTH CARE AND MEDICAL SERVICES TO THE PUBLIC, INCLUDING PHYSICIAN SERVICES. 10417950 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 1 140 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X KYLE DILLMAN 8124503296 600 MARY ST EVANSVILLE IN 47710 DR JAMES PORTER CHAIRMAN 1.00 67.00 X X 0 1006179 199566 DR BRADLEY SCHEU PRESIDENT 1.00 61.00 X X 0 627737 139321 JULIE DINGMAN SECRETARY 1.00 51.00 X X 0 277971 22105 KYLE DILLMAN TREASURER 1.00 51.00 X X 0 139518 42051 BRETT HUTCHERSON PHYSICIAN 50.00 X 319531 0 14531 SUZANNE M BURGE PHYSICIAN 50.00 X 295779 0 23001 ERIC GRAHAM PHYSICIAN 50.00 X 274891 0 23149 DENNON W DAVIS PHYSICIAN 50.00 X 254802 1231 37343 NICOLE KENNEDY PHYSICIAN 50.00 X 248337 0 8681 1393340 2052636 509748 13 0 1 0 INNOVATIVE HEALTHCARE COLLABORATIVE 8180 CLEARVISTA PARKWAY 200 INDIANAPOLIS IN 46256 HEALTHCARE SUPPORT 157349 1 NET PATIENT SERVICE RE 621110 7170231 7170231 7170231 7170231 7170231 0 0 6848523 6198206 650317 1682505 1437699 244806 437493 392023 45470 4004 3686 318 1154422 1062819 91603 6005 5381 624 148412 132987 15425 966313 595558 370755 10883 9752 1131 11000 9857 1143 SUPPLIES 548784 544063 4721 SALES TAX 17187 15401 1786 LICENSES 4996 4477 519 6744 6041 703 11847271 10417950 1429321 0 2403668 8709166 2338188 1246224 21068 15996 7799 4026 4770723 9975412 902294 1887929 2892723 3729894 3795017 5617823 X 975706 4357589 975706 4357589 4770723 9975412 -4677040 8058923 0 X X 0 1 X 1 0 X 4387213 7170231 11557444 4387213 7170231 11557444 0 0 0 11557444 4387213 7170231 11557444 X SCHEDULE A, PART II, SHORT YEAR EXPLANATION: THE ORGANIZATION'S FIRST TAX YEAR WAS ALSO A SHORT YEAR BEGINNING JANUARY 2023 -SEPTEMBER 2023. 0 INTERCOMPANY LIABILITIES 3729894 3729894 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 SEPTEMBER 30, 2024 AND 2023, 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. 0 1 0 0 0 0 0 0 0 DR JAMES PORTER CHAIRMAN 0 654409 0 224407 0 127363 0 170838 0 28728 0 1205745 0 122628 DR BRADLEY SCHEU PRESIDENT 0 443192 0 130947 0 53598 0 101540 0 37781 0 767058 0 50859 BRETT HUTCHERSON PHYSICIAN 220289 0 97932 0 1310 0 0 0 14531 0 334062 0 0 0 SUZANNE M BURGE PHYSICIAN 210849 0 83255 0 1675 0 0 0 23001 0 318780 0 0 0 JULIE DINGMAN SECRETARY 0 230507 0 46066 0 1398 0 6800 0 15305 0 300076 0 0 ERIC GRAHAM PHYSICIAN 176662 0 95636 0 2593 0 0 0 23149 0 298040 0 0 0 DENNON W DAVIS PHYSICIAN 219752 1231 18633 0 16417 0 12791 0 24552 0 292145 1231 0 0 NICOLE KENNEDY PHYSICIAN 153402 0 93612 0 1323 0 0 0 8681 0 257018 0 0 0 KYLE DILLMAN TREASURER 0 117416 0 21051 0 1051 0 10807 0 31244 0 181569 0 0 PART I, LINE 4B SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED BRADLEY SCHEU $ - $ 22,500.00 $ - JAMES PORTER $ - $ 22,500.00 $ - SUZANNE BURGE $ - $ 22,500.00 $ - PART 1, 4B: BRADLEY SCHEU: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $78,626.39 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $50,858.83 JAMES PORTER: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $137,927.68 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $122,628.38 FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF DEACONESS ILLINOIS CLINIC ARE DEACONESS HEALTH SYSTEM, INC., AN INDIANA NONPROPFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(A) OF THE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND DEACONESS REGIONAL HEALTHCARE SERVICES ILLINOIS, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(A) OF THE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER SHALL APPOINT AND REMOVE DIRECTORS OF THE CORPORATION IN ACCORDANCE WITH THE PROVISIONS OF ARTICLE III OF THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS SHALL HAVE THE AUTHORITY TO TAKE ANY ACTION ON BEHALF OF, OR WITH RESPECT TO, THE CORPORATION, WHICH IS REQUIRED TO ACHIEVE COMPLIANCE WITH APPLICABLE LAW, INCLUDING WITHOUT LIMITATION, ANY ACTION TO PRESERVE, PROTECT OR PROMOTE THE CORPORATION'S TAX-EXEMPT STATUS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS THAT DEACONESS ILLINOIS CLINIC UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE CONTROLLER, CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT, AND ANNUALLY THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE AND/OR THE "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS ILLINOIS CLINIC OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: SALARIES AND BENEFITS OF OFFICERS AND PHYSICIANS AT DEACONESS ILLINOIS CLINIC ARE APPROVED BY THE DEACONESS HEALTH SYSTEM COMPENSATION COMMITTEE. DEACONESS ILLINOIS CLINIC BOARD CAN ONLY MAKE RECOMMENDATION TO THE DEACONESS HEALTH SYSTEM COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM INC. AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW, APPROVE, AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE VICE PRESIDENT AND EACH OTHER EXECUTIVE OFFICERS ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS. 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, VICE PRESIDENT OR EXECUTIVE OFFICE COMPENSATION. 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN-RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DEACONESS ILLINOIS CLINIC'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. AS REQUIRED BY LAW, DEACONESS CLINIC SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FORM 990 PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. 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