Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
701 NORTH FIRST STREET
 
Room/suite
City or town, state or country, and ZIP + 4
SPRINGFIELD, IL62781
D Employer identification number

90-0756744
E Telephone number

G Gross receipts $ 950,919,800
F Name and address of principal officer:
EDGAR J CURTIS
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MHSIL.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?Click to see attachment
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5670
K Form of organization:
 
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 101
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 49
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 6,255
6 Total number of volunteers (estimate if necessary) .... 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 6,398,378
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 8,342,369 4,849,898
9 Program service revenue (Part VIII, line 2g) ......... 682,971,780 697,580,334
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,264,741 9,334,461
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 16,186,886 18,813,043
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 711,765,776 730,577,736
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 9,287,222 3,037,265
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 283,742,163 301,090,474
16a Professional fundraising fees (Part IX, column (A), line 11e).... 14,319 36,000
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet482,249    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 377,174,135 401,154,757
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 670,217,839 705,318,496
19 Revenue less expenses. Subtract line 18 from line 12...... 41,547,937 25,259,240
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 809,405,620 802,781,836
21 Total liabilities (Part X, line 26)............ 459,739,516 410,250,929
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 349,666,104 392,530,907
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 82,718,739 including grants of $   ) (Revenue $ 90,993,030 )
CARDIOVASCULARTHE PROGRAMS OF MEMORIAL MEDICAL CENTER'S HEART & VASCULAR SERVICES FOCUS ON REDUCING THE INCIDENCE OF CARDIAC AND VASCULAR DISEASE. THROUGH PREVENTION PROGRAMS AND THE LATEST DIAGNOSTIC AND TREATMENT PROCEDURES, OUR GOAL IS TO WORK WITH PATIENTS TO ACHIEVE GREAT PATIENT OUTCOMES AND OPTIMUM LONG-TERM HEALTH. IN FISCAL YEAR 2011, MEMORIAL MEDICAL CENTER'S CARDIAC CATH LAB PERFORMED 3,420 HEART CATHS, 1,779 CORONARY INTERVENTIONS, 2,120 ELECTROPHYSIOLOGY (EP) PROCEDURES, AND 1,084 VASCULAR CASES. RECOGNIZED AS A LEADER AND INNOVATOR IN HEART AND VASCULAR TECHNOLOGY, THE MEMORIAL HEART & VASCULAR SERVICES TEAM ALSO PERFORMED 330 CORONARY BYPASS AND VALVE SURGERIES. OTHER SERVICES INCLUDE NON-INVASIVE CARDIAC AND VASCULAR TESTING, CARDIAC AND PULMONARY REHABILITATION, VALVE CENTER, HEART FAILURE CLINIC, NUTRITION COUNSELING, AND SUPPORT GROUPS. MEMORIAL MEDICAL CENTER IS A NATIONAL LEADER IN OUR RESPONSE TIME FOR TREATING HEART ATTACKS. THE TIME IT TAKES TO RE-ESTABLISH BLOOD FLOW TO THE HEART IS CRITICAL IN SAVING A PATIENT'S LIFE. THE AMERICAN COLLEGE OF CARDIOLOGY USES 90 MINUTES AS THE RECOMMENDED STANDARD OF CARE FOR BALLOON ANGIOPLASTY, MEANING NO MORE THAN 90 MINUTES SHOULD ELAPSE FROM THE MOMENT THE PATIENT COMES THROUGH THE HOSPITAL DOORS UNTIL BALLOON ANGIOPLASTY IS COMPLETED AND BLOOD FLOW IS RESTORED TO THE HEART. MEMORIAL MEDICAL CENTER'S GOAL IS TO PERFORM THE PROCEDURE IN LESS THAN 80 MINUTES. MEMORIAL MEDICAL CENTER HAS BEEN RECOGNIZED BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION FOR ITS COMMITMENT AND SUCCESS IN IMPLEMENTING HIGHER STANDARDS OF CARE FOR HEART ATTACK PATIENTS.
4b (Code:   ) (Expenses $ 75,321,289 including grants of $   ) (Revenue $ 71,630,372 )
SURGICAL SERVICES DEPARTMENTTHE SURGICAL SERVICES DEPARTMENT AT MEMORIAL MEDICAL CENTER PROVIDES A WIDE VARIETY OF INPATIENT AND OUTPATIENT SERVICES IN BOTH THE MAIN SURGERY AND CARDIAC SURGERY DEPARTMENTS. BAYLIS DAY SURGERY IS UTILIZED FOR OUTPATIENT PROCEDURES. MEMORIAL MEDICAL CENTER PERFORMED 20,227 SURGICAL PROCEDURES IN FY11. MEMORIAL MEDICAL CENTER CONTINUES TO STRIVE FOR EXCELLENCE IN PATIENT CARE. IT HAS RECEIVED A RARE FIVEFOLD ACCREDITATION FOR ITS REHABILITATION SERVICES FROM THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF).MEMORIAL MEDICAL CENTER PROVIDES A WIDE RANGE OF CARDIAC, THORACIC AND VASCULAR PROCEDURES. PROCEDURES PERFORMED IN THE CARDIAC SURGERY AREA INCLUDE CORONARY ARTERY BYPASS GRAFTING, VALVE REPLACEMENTS, PACEMAKER INSERTIONS, AND OTHER VASCULAR PROCEDURES AND LUNG PROCEDURES.A VARIETY OF SURGERIES ARE ROUTINELY PERFORMED TO ASSIST PATIENTS WITH EAR, NOSE AND THROAT CONDITIONS. PROCEDURES SUCH AS TONSILLECTOMY, ADENOIDECTOMY, MYRINGOTOMY TUBE INSERTION, SEPTOPLASTY, FUNCTIONAL ENDOSCOPIC SINUS SURGERY, AND UVULOPALATOPLASTY (FOR TREATMENT OF SLEEP APNEA) ARE FREQUENTLY PERFORMED AT MEMORIAL MEDICAL CENTER. RIGID AND/OR FLEXIBLE ENDOSCOPIC TECHNIQUES ARE USED FOR ESOPHAGOSCOPY, BRONCHOSCOPY, AND DIRECT LARYNGOSCOPY PROCEDURES. FACIAL FRACTURES ARE TREATED USING VARIOUS PLATING SYSTEMS. MAJOR SURGERIES OF THE EAR ARE PERFORMED USING TECHNIQUES TO IMPROVE OR RESTORE HEARING LOSS. SURGERIES FOR THE DIAGNOSIS AND TREATMENT OF HEAD-AND-NECK CANCER ARE ALSO PERFORMED. AN OPERATIVE MICROSCOPE IS FREQUENTLY USED TO PROVIDE THE VISUALIZATION NECESSARY FOR MANY ENT PROCEDURES. STATE-OF-THE-ART COMPUTER-GUIDED TECHNOLOGY IS ALSO USED TO PROMOTE TREATMENT OF SOME ENT PROCEDURES. TECHNIQUES EMPLOYING THE USE OF A CO2 LASER ARE ALSO AVAILABLE.LAPAROSCOPIC TECHNOLOGY PROVIDES THE VISUALIZATION OF INTERNAL ORGANS WITH A TELESCOPE INSERTED THROUGH A SMALL ABDOMINAL INCISION. THIS TECHNOLOGY IS USED FOR DIAGNOSIS AND TREATMENT OF DISEASE. LAPAROSCOPIC TECHNIQUES ARE OFTEN USED TO REMOVE THE GALLBLADDER OR APPENDIX, OR FOR HERNIA REPAIR. A WIDE RANGE OF PROCEDURES FOR CANCER OF THE COLON, LIVER, BREAST AND OTHER ANATOMICAL SITES ARE PERFORMED IN CONJUNCTION WITH THE CARE PROVIDED TO PATIENTS WHO COME TO MEMORIAL'S REGIONAL CANCER CENTER. RADIOFREQUENCY TECHNOLOGY IS AVAILABLE TO ASSIST IN THE TREATMENT OF LIVER TUMORS. SENTINEL NODE MAPPING IS USED IN THE IDENTIFICATION OF LYMPH NODES IN BREAST AND MELANOMA CANCERS.A FULL RANGE OF SERVICES ARE AVAILABLE FOR PATIENTS NEEDING GYNECOLOGIC SURGERY. LAPAROSCOPIC PROCEDURES ARE PERFORMED FOR DIAGNOSTIC PURPOSES AND OPERATIVE TREATMENT. CO2 LASER THERAPY IS AVAILABLE FOR TREATMENT. A VARIETY OF OPERATIONS ARE COMPLETED TO ASSIST PATIENTS WITH REPRODUCTIVE DISORDERS, INCLUDING STERILIZATION REVERSAL, GIFT, AND IN-VITRO PROCEDURES. MALIGNANCIES INVOLVING THE REPRODUCTIVE ORGANS, INCLUDING CANCER OF THE CERVIX, UTERUS, AND OVARIES CAN BE TREATED WITH STATE-OF-THE-ART SURGICAL OPERATIONS, AND FACILITIES ARE AVAILABLE IN THE HOSPITAL FOR CHEMOTHERAPY OR RADIATION THERAPY.MEMORIAL'S NEUROSURGICAL SERVICE ENCOMPASSES THE AREAS OF GENERAL SPINE (CERVICAL/THORACIC/LUMBAR DISCECTOMY, LAMINECTOMY); COMPLEX SPINE (SPINAL FUSION AND INSTRUMENTATION); PERIPHERAL NERVE (CARPAL TUNNEL SYNDROME AND ULNAR DECOMPRESSION); AND BRAIN AND SPINAL-TUMOR SURGERY. STATE-OF-THE-ART TECHNOLOGY BASED ON COMPUTER GUIDANCE SERVICES KNOWN AS STEREOTACTIC RADIOIMAGING IS UTILIZED TO PROVIDE IMPROVED TREATMENTS FOR NEUROSURGICAL CONDITIONS, SUCH AS BRAIN TUMORS AND PHYSIOLOGIC-MOVEMENT DISORDERS. ALSO AVAILABLE TO OUR PHYSICIANS IS A HIGHLY SOPHISTICATED COMPUTERIZED NAVIGATIONAL TECHNIQUE REFERRED TO AS AN IMAGE-GUIDED SYSTEM. THIS SYSTEM OFFERS A THREE-DIMENSIONAL COMPUTERIZED ANATOMIC VISUALIZATION TO ASSIST THE NEUROSURGEON IN PINPOINTING THE OPERATIVE SITE AND PROMOTING PATIENT OUTCOMES.MEMORIAL MEDICAL CENTER OFFERS OUTPATIENT AND INPATIENT OPHTHALMIC SERVICES. STRABISMUS REPAIRS CORRECT EYE MUSCLE PROBLEMS IN SMALL CHILDREN. OCCULOPLASTIC PROCEDURES OFFER PLASTIC RECONSTRUCTION FOR PATIENTS OF ALL AGES. TREATMENT OPTIONS ARE AVAILABLE FOR PATIENTS WITH GLAUCOMA. CATARACT SURGERY IS FREQUENTLY PERFORMED ON PATIENTS IN THE AGING POPULATION. SPECIALTY TREATMENTS ARE AVAILABLE FOR PATIENTS WITH DISEASES AND INJURIES OF THE RETINA. THESE INCLUDE LASER THERAPY, VITRECTOMY, SCLERAL BUCKLING, PLACEMENT OF SILICONE OIL, RETINAL TACK PLACEMENT, AND CRYOTHERAPY. CORNEAL TRANSPLANTS ARE AVAILABLE FOR PATIENTS WHO HAVE SUFFERED DAMAGE TO THE CORNEA.INNOVATIVE TREATMENT OPTIONS ARE AVAILABLE FOR PATIENTS SEEKING TREATMENT FOR ORAL AND MAXILLOFACIAL PROBLEMS OR FACIAL FRACTURES. IN ADDITION TO ROUTINE DENTAL PROCEDURES, MEMORIAL OFFERS PROGRESSIVE SURGICAL TREATMENTS, INCLUDING THE USE OF A MANDIBULAR BONE TRANSPORT SYSTEM FOR TREATMENT OF PATIENTS WITH CANCER OF THE MANDIBLE. THE RIGID EXTERNAL DISTRACTION SYSTEM IS AVAILABLE FOR PATIENTS WITH CRANIOMAXILLOFACIAL ANOMALIES. ANOTHER TECHNICAL ADVANCEMENT IS THE MAXILLOFACIAL CEMENT SYSTEM USED FOR FACIAL-SKELETAL DEFORMITY REPAIRS AS WELL AS RIGID FIXATION FOR DENTAL-FACIAL DEFORMITY AND FRACTURE REPAIR.MEMORIAL PROVIDES COMPREHENSIVE CARE FOR PATIENTS SEEKING PLASTIC AND RECONSTRUCTIVE SURGERY. THESE PROCEDURES INCLUDE ROUTINE OUTPATIENT COSMETIC SURGERIES AS WELL AS EXTENSIVE RECONSTRUCTION OPERATIONS WHICH ARE AVAILABLE TO PATIENTS ADMITTED TO OUR REGIONAL BURN CENTER. MICROSURGERY TECHNIQUES ARE USED ON VARIOUS PLASTIC RECONSTRUCTIVE PROCEDURES SUCH AS REATTACHMENT AND RESTORATION OF AMPUTATED DIGITS OR LIMBS. A COMPREHENSIVE PLAN OF CARE IS OFFERED FOR PATIENTS WITH SKIN OR BREAST CANCER WHICH MAY INCLUDE THE USE OF TISSUE EXPANDERS, IMPLANTS OR VARIOUS FLAP RECONSTRUCTION TECHNIQUES.
4c (Code:   ) (Expenses $ 62,154,064 including grants of $   ) (Revenue $ 81,794,650 )
ORTHOPEDICSMEMORIAL MEDICAL CENTER'S ORTHOPEDICS SERVICE OFFERS STATE-OF-THE-ART INTERDISCIPLINARY CARE FOR BONE AND JOINT DISORDERS. WORKING WITH COMMUNITY ORTHOPEDIC SURGEONS, OUR TEAM OF HEALTHCARE PROFESSIONALS PROVIDES COMPREHENSIVE PATIENT EDUCATION, DIAGNOSTIC, SURGICAL AND REHABILITATION SERVICES FOR PATIENTS OF ALL AGES. THESE SERVICES ARE PROVIDED IN THE PREMIER TREATMENT FACILITIES IN THE REGION.MEMORIAL'S INNOVATIVE JOINTWORKS PROGRAM IS PART OF ORTHOPEDIC SERVICES. THROUGH JOINTWORKS, ABOUT 1,200 PATIENTS UNDERGO HIP AND KNEE REPLACEMENTS AT MEMORIAL MEDICAL CENTER ANNUALLY. AN EXPERIENCED TEAM OF ORTHOPEDIC SURGEONS, ANESTHESIOLOGISTS, NURSES, THERAPISTS, AND SOCIAL WORKERS GUIDES OUR PATIENTS FROM PRE-SURGERY EDUCATION THROUGH POST-SURGERY REHABILITATION.DURING FY 11, MEMORIAL MEDICAL CENTER'S ORTHOPEDICS SERVICE COMPLETED 4,822 ORTHOPEDIC PROCEDURES. THE JOINTWORKS PROGRAM PERFORMED 824 TOTAL KNEE REPLACEMENT PROCEDURES AND 394 TOTAL HIP REPLACEMENTS. OTHER ORTHOPEDIC SERVICES INCLUDED 123 CERVICAL FUSION PROCEDURES, 100 CLOSED REDUCTION OF FRACTURE OF THE FEMUR, AND 98 LUMBAR FUSION PROCEDURES. IN JANUARY, MEMORIAL ORTHOPEDICS BEGAN PARTICIPATING IN "OWN THE BONE", A NATIONAL DATABASE REGISTRY AND EDUCATION PROGRAM AIMED AT APPROPRIATE FOLLOW-UP CARE FOR FRAGILITY FRACTURE PATIENTS. IN JULY, THE JOINTWORKS PROGRAM RECEIVED CERTIFICATION FROM THE JOINT COMMISSION FOR HIP REPLACEMENT AND KNEE REPLACEMENT SURGERY. IN OCTOBER, MEMORIAL ORTHOPEDICS BEGAN AN INTERNAL REGISTRY FOR HIP AND KNEE REPLACEMENT SURGERY.
(Code:   ) (Expenses $ 378,727,295 including grants of $ 3,037,265 ) (Revenue $ 461,506,378 )
SURGICAL PRODUCT LINE; 25,936 CASES; 41,118 PATIENT DAYS PULMONARY/THORACIC PRODUCT LINE; 13,004 CASES; 29,686 DAYSHEMATOLOGY/ONCOLOGY PRODUCT LINE; 35,148 CASES; 146,563 DAYS
4d Other program services. (Describe in Schedule O.)
(Expenses $ 378,727,295 including grants of $ 3,037,265 ) (Revenue $ 461,506,378 )
4e Total program service expensesMediumBullet$ 598,921,387
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
Yes
 
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
411
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
6,255
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
Yes
 
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
Yes
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
101
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
49
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
ROBERT W KAY SVP & CFO
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
(217) 788-3198
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) A KRAIG KRAUSE
BOARD MEMBER ALMF
 .70 X           0 0 0
(2) CLYDE R REYNOLDS
TREASURER ALMF
 .70 X   X       0 0 0
(3) ERIC D GRAUE
VICE CHAIR/CHAIR ALMF
 .70 X   X       0 0 0
(4) FRANCES C GUZZARDO
BOARD MEMBER ALMF
 .70 X           0 0 0
(5) GAIL NUNNERY
BOARD MEMBER/VICE CHAIR ALMF
 .70 X   X       0 0 0
(6) HAROLD L DRAKE
BOARD MEMBER ALMF
 .70 X           0 0 0
(7) JAMES R DREW
BOARD MEMBER ALMF
 .70 X           0 0 0
(8) JOAN GRAUE
BOARD MEMBER ALMF
 .70 X           0 0 0
(9) JUDITH N LOZIER
BOARD MEMBER ALMF
 .70 X           0 0 0
(10) KAREN SAMS DAVIS
BOARD MEMBER ALMF
 .70 X           0 0 0
(11) KENT E CROSS
BOARD MEMBER ALMF
 .70 X           0 0 0
(12) MARY ROSE MOREHEAD
BOARD MEMBER ALMF
 .70 X           0 0 0
(13) PAMELA K WHITE
BOARD MEMBER ALHMF
 .70 X           0 0 0
(14) ROBERT BD ARNEAUD
SECRETARY ALMF
 .70 X   X       0 0 0
(15) SHIRLEY S EDWARDS
BOARD MEMBER ALMF
 .70 X           0 0 0
(16) A PATRICK DOOLIN
BOARD MEMBER ALMH
 .70 X           0 0 0
(17) BRADLEY E NEAL
CHAIR ELECT ALMH/BOARD MEM ALMF
 .70 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) DAVID A CAMPBELL
PAST CHAIR ALMH/BOARD MEMBER ALMF
 .70 X   X       0 0 0
(19) DENNIS M CARROLL MD
BOARD MEMBER ALMH
 .70 X           0 0 0
(20) JOANN MCCULLOUGH
AUX PRES BOARD MEMBER ALMH ALMF
 .70 X           0 0 0
(21) MARY BETH SPARKS
BOARD MEMBER ALMH/ALHF
 .70 X           0 0 0
(22) MARY CONRADY
CHAIRMAN ELECT/CHAIR ALMH
 .70 X           0 0 0
(23) MARY S MCLAUGHLIN
BOARD MEMBER ALMH
 .70 X           0 0 0
(24) MELISSA L COX MD
BOARD MEMBER ALMH
 .70 X           0 0 0
(25) REV ANDREW NYREN
BOARD MEMBER ALMH
 .70 X           0 0 0
(26) REV ROBERT HENDERSON
TREASURER ALMH
 .70 X   X       0 0 0
(27) RICHARD A HAMM
BOARD MEMBER ALMH
 .70 X           0 0 0
(28) RICHARD BIVIN MD
BOARD MEMBER ALMH
 50.00 X           249,769 0 49,769
(29) RONALD SCHILLING
BOARD MEMBER ALMH
 .70 X           0 0 0
(30) STEVEN D AUGHENBAUGH
CHAIRMAN/SECRETARY ALMH
 .70 X   X       0 0 0
(31) ELAINE YOUNG
SEC TREAS MHSVC/MHV
 50.00 X   X       0 247,187 44,482
(32) KEVIN ENGLAND
DIR MHSVC/PRES MHV
 50.00 X   X       0 313,740 68,774
(33) THOMAS WESTRICK
PRESIDENT MHSVC
 50.00 X   X       180,143 0 11,227
(34) DOLAN DALPOAS
DIR MHSVC/PRES ALMH ALMF
 50.00 X   X       265,113 0 46,356
(35) DANIEL RAAB
DIR MHSVC/PRES TMH TMHF
 50.00 X   X       244,901 0 42,669
(36) CAROL J POSEGATE
SECRETARY MMC
 .80 X   X       0 0 0
(37) CLIFTON R BAXTER
BOARD MEMBER MMC
 1.10 X           0 0 0
(38) DALE M BECKER
TREASURER MMC MMCF
 .80 X   X       0 0 0
(39) DEAN E ROBERT
BOARD MEMBER MMC
 .40 X           0 0 0
(40) DIANE K RUTLEDGE PHD
BOARD MEMBER MMC
 1.00 X           0 0 0
(41) DWIGHT H O'KEEFE III
PAST CHAIR MMC/TREAS MMC
 1.50 X   X       0 0 0
(42) FRANK V AGUIRRE MD
BOARD MEMBER MMC
 .60 X           0 0 0
(43) J ERIC BLEYER MD
BOARD MEMBER MMC
 .70 X           0 0 0
(44) JAMES P BRUNER
1ST/2ND VICE CHAIR MMC
 1.70 X   X       0 0 0
(45) JERRY E KRUSE MD
BOARD MEMBER MMC
 .30 X           0 0 0
(46) JOHN D BLACKBURN
TREASURER/2ND VICE CHAIR MMC
 1.70 X   X       0 0 0
(47) JOSEPH M HURWITZ
1ST VICE CHAIR/CHAIR MMC
 1.00 X   X       0 0 0
(48) MARK H FERGUSON
PAST CHAIR/CHAIR MMC
 1.60 X   X       0 0 0
(49) MICHAEL A PICK MD
BOARD MEMBER MMC
 .70 X           0 0 0
(50) NINA M HARRIS
BOARD MEMBER MMC
 1.00 X           0 0 0
(51) WILLIAM A SIMPSON
BOARD MEMBER MMC
 .70 X           0 0 0
(52) WILLIAM R ENLOW
BOARD MEMBER MMC
 1.00 X           0 0 0
(53) EDGAR CURTIS
BRD MEMBER CEO MMC/MMCF/MPS
 50.00 X   X       0 666,927 458,534
(54) ROBERT KAY
BRD MEM MMC/VC MHSVC/SEC TR MPS
 50.00 X   X       0 410,448 231,627
(55) ANN COOMBE
BOARD MEMBER MMCF
 .70 X           0 0 0
(56) ANN P ROBERT
BOARD MEMBER MMCF
 .70 X           0 0 0
(57) BRADLEY J NIKLES
BOARD MEMBER MMCF ALMH
 .70 X           0 0 0
(58) BRIDGET L LAMONT
BOARD MEMBER MMCF
 .70 X           0 0 0
(59) CRAIG R SCHERMERHORN
CHAIR/VICE CHAIR MMCF
 .70 X   X       0 0 0
(60) DAVID L GRIFFEN MD
BOARD MEMBER MMCF MMC
 .70 X           0 0 0
(61) DONALD A ALTORFER
BOARD MEMBER MMCF
 .70 X           0 0 0
(62) ELVIN G ZOOK MD
BOARD MEMBER MMCF
 .70 X           0 0 0
(63) GARY D NEUBAUER
BOARD MEMBER/SECREATARY MMCF
 .70 X   X       0 0 0
(64) GEOFFREY ISRINGHAUSEN
BOARD MEMBER MMCF MMC
 .70 X           0 0 0
(65) J CHRISTOPHER SMITH
VICE CHAIR/CHAIR MMCF
 .70 X   X       0 0 0
(66) JULIE CELLINI
BOARD MEMBER MMCF
 .70 X           0 0 0
(67) MICHAEL A AIELLO
BOARD MEMBER MMCF
 .70 X           0 0 0
(68) MICHAEL A MYERS
BOARD MEMBER MMCF
 .70 X           0 0 0
(69) MICHAEL E O'SHEA
BOARD MEMBER MMCF
 .70 X           0 0 0
(70) R LEE ALLEN
BOARD MEMBER MMCF
 .70 X           0 0 0
(71) ROY NEWMAN
BOARD MEMBER MMCF
 .70 X           0 0 0
(72) STEPHEN L PATTON
SECRETARY MMCF
 .70 X   X       0 0 0
(73) MARK HANSEN MD
BOARD MEMBER MPS
 50.00 X           621,070 0 93,472
(74) MARSHALL HALE MD
CHAIR MPS
 50.00 X   X       300,837 0 58,691
(75) PAUL KASA MD
BOARD MEMBER ALMH MPS
 50.00 X           213,223 0 43,244
(76) DOUGLAS RAHN
BD MEM MPS/CHAIR MHV MHSVC
 50.00 X   X       550,825 0 96,033
(77) BERNADETTE SALISBURY
SECRETARY/VICE CHAIR TMH
 .70 X   X       0 0 0
(78) CARL NIEMANN
BOARD MEMBER TMH
 .70 X           0 0 0
(79) DANIEL AUSTIN
BOARD MEMBER/SECRETARY TMH
 .70 X   X       0 0 0
(80) DAVID KIEL MD
BOARD MEMBER TMH
 .70 X           0 0 0
(81) GARY A SPURLING
BOARD MEMBER TMH
 .70 X           0 0 0
(82) GARY MCNEELY
CHAIR/BOARD MEMBER TMH
 .70 X   X       0 0 0
(83) HWA LONG CHEN MD
BOARD MEMBER TMH
 .70 X           0 0 0
(84) JAMES R ADCOCK
BOARD MEMBER TMH
 .70 X           0 0 0
(85) JERRY D GARDNER
VICE CHAIR/CHAIR TMH
 .70 X   X       0 0 0
(86) RONALD MIZER DDS
BOARD MEMBER TMH
 .70 X           0 0 0
(87) LORETTA KAHLE
BOARD MEMBER TMH
 .70 X           0 0 0
(88) MARGARET J FRY
BOARD MEMBER TMH
 .70 X           0 0 0
(89) THOMAS F FORD
TREASURER TMH
 .70 X   X       0 0 0
(90) YASER FREJI MD
BOARD MEMBER TMH
 .70 X           0 0 0
(91) BILL SMITH
VICE PRESIDENT TMHF
 .70 X   X       0 0 0
(92) BONNIE BRUNS
SECRETARY TMHF
 .70 X   X       0 0 0
(93) DAN LITTEKEN
BOARD MEMBER TMHF
 .70 X           0 0 0
(94) ERIC KAHLE
BOARD MEMBER TMHF
 .70 X           0 0 0
(95) JOHN CURTIN
BOARD MEMBER TMHF
 .70 X           0 0 0
(96) JUDY MOULTON
BOARD MEMBER TMHF
 .70 X           0 0 0
(97) LINDA SMITH
TREASURER TMHF
 .70 X   X       0 0 0
(98) ROGER HICKMAN
BOARD MEMBER TMHF
 .70 X           0 0 0
(99) SR VIRGINIA WALSH
BOARD MEMBER TMHF
 .70 X           0 0 0
(100) WILLIAM CHASTAIN
BOARD MEMBER TMHF
 .70 X           0 0 0
(101) LEIGH STEINER
CHAIRMAN SRS
 .70 X   X       0 0 0
(102) WILLIAM D MEYER
VICE CHAIRMAN SRS
 .70 X   X       0 0 0
(103) MICHAEL MCGLASSON
TREASURER SRS
 .70 X   X       0 0 0
(104) JANET STOVER
SECRETARY SRS
 .70 X   X       0 0 0
(105) RANDALL GERMERAAD
BOARD MEMBER SRS
 .70 X           0 0 0
(106) JANICE GAMBACH
PRESIDENT SRS
 50.00 X   X       0 152,483 16,680
(107) CHARLES CALLAHAN
BRD MEMBER MHV/VP OPS MMC
 50.00 X     X     287,512 0 50,160
(108) TRAVIS DOWELL
PRESIDENT MPS
 50.00 X   X       250,029 0 47,076
(109) JOHN FERRY DDS
PRESIDENT TMHF
 .70     X       0 0 0
(110) ELENA KEZELIS
EXEC DIR MMCF
 50.00     X       161,347 0 14,273
(111) MARSHA PRATER
SVP & CNO MMC
 50.00       X     259,204 0 144,348
(112) SCOTT KIRIAKOS
VP CLINICAL INTEGRATION MMC
 50.00       X     307,661 0 56,701
(113) DAVID J JOERGER
ADMIN PREOP SERVICE
 50.00       X     183,558 0 15,057
(114) FERINAND SALVACION MD
PHYSICIAN MMC
 50.00         X   616,961 0 117,036
(115) DAVID SANDERCOCK MD
PHYSICIAN MPS
 50.00         X   362,384 0 73,033
(116) JAMES GILDNER MD
PHYSICIAN MPS
 50.00         X   538,672 0 110,181
(117) STEVEN LILLPOP MD
PHYSICIAN MPS
 50.00         X   373,291 0 80,996
(118) VIRGINIA DOLAN MD
PHYSICIAN MPS
 50.00         X   334,072 0 56,618
(119) ROBERT CLARKE
FMR BRD MEM MMC/FMR CEO
             X 0 382,201 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 6,300,572 2,172,986 2,027,037
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet19
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
HAROLD O'SHEA BUILDERS INC
3401 CONSTITUTION DR
SPRINGFIELD,IL62711 		CONSTRUCTION 32,217,451
SIU SCHOOL OF MEDICINE
PO BOX 19607
SPRINGFIELD,IL62794 		PHYSICIAN SERVICES 13,559,672
O'SHEAMCCARTHY JV
1341 N ROCK HILL ROAD
ST LOUIS,MO63124 		CONSTRUCTION 10,163,875
MIDWEST EMERGENCY DEPARTMENT SPECIALIST
2000 SPRING RD SUITE 200
OAKBROOK,IL60523 		ER STAFFING 3,969,537
SIEMENS MEDICAL SOLUTIONS
DEPT CH 14195
PALATINE,IL60055 		PREVENTIVE MAINTENANCE 3,115,056
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet306
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a 6,032
b Membership dues....1b  
c Fundraising events....1c 274,248
d Related organizations...1d 588,628
e Government grants (contributions)1e 1,677,927
f All other contributions, gifts, grants, and
similar amounts not included above1f 		2,303,063
g Noncash contributions included in lines 1a-1f:$ 14,342
h Total. Add lines 1a-1f.......MediumBullet 4,849,898
Program Service Revenue Business Code
2a PATIENT SERVICE REV 900,099 608,606,655 608,606,655    
b PROGRAM RELATED REV 900,099 64,839,332 64,839,332    
c PARTNERSHIP INCOME 531,190 7,323,898 7,323,898    
d HOME HEALTH SERVICES 621,610 7,229,706 7,229,706    
e HOSPICE SERVICES 621,610 5,792,280 5,792,280    
f All other program service revenue . 3,788,463 2,996,565   791,898
g Total. Add lines 2a–2f........MediumBullet 697,580,334
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 6,525,563     6,525,563
4 Income from investment of tax-exempt bond proceeds..MediumBullet 35,067     35,067
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 1,539,230  
b Less: rental expenses 525,480  
c Rental income or (loss) 1,013,750  
d Net rental income or (loss).......MediumBullet 1,013,750     1,013,750
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 219,031,438 3,312,948
b Less: cost or other basis and sales expenses 216,628,668 2,941,887
c Gain or (loss) 2,402,770 371,061
d Net gain or (loss)..........MediumBullet 2,773,831     2,773,831
8a Gross income from fundraising events (not including
$ 274,248
of contributions reported on line 1c). See Part IV, line 18 ...
a 301,715
b Less: direct expenses ...b 246,029
c Net income or (loss) from fundraising events..MediumBullet 55,686   55,686
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a REFERENCE LAB REVENUE 621,500 5,242,746   5,242,746  
b CAFETERIA REVENUE 722,320 4,697,329   136,683 4,560,646
c EMPLOYMENT SERVICES 561,300 723,105   723,105  
d All other revenue .... 7,080,427 6,139,429 295,844 645,154
e Total. Add lines 11a–11d ......MediumBullet 17,743,607
12 Total revenue. See Instructions....MediumBullet 730,577,736 705,924,430 6,398,378 17,193,493
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 1,970,805 1,970,805
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 1,066,460 1,066,460
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,138,607 1,512,183 1,485,607 140,817
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 170,138 47,447 24,538 98,153
7 Other salaries and wages 223,627,196 203,928,748 19,622,475 75,973
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 23,662,318 21,430,160 2,232,158  
9 Other employee benefits ....... 34,527,820 31,216,477 3,241,207 70,136
10 Payroll taxes ........... 15,964,395 14,376,935 1,570,489 16,971
11 Fees for services (non-employees):        
a Management ...... 2,867,416   2,867,416  
b Legal ......... 762,790   762,790  
c Accounting ........... 32,235   32,235  
d Lobbying ........... 44,669   44,669  
e Professional fundraising. See Part IV, line 17.. 36,000 36,000
f Investment management fees ...... 1,330,534 120,106 1,210,428  
g Other .......... 69,295,216 57,102,551 12,192,665  
12 Advertising and promotion .... 1,172,862 68,922 1,102,392 1,548
13 Office expenses ....... 19,184,819 16,037,686 3,126,536 20,597
14 Information technology ...... 11,595,102 10,232,648 1,362,371 83
15 Royalties ..        
16 Occupancy ........... 18,888,910 17,189,140 1,699,770  
17 Travel ............ 1,258,537 1,114,803 143,631 103
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 551,206 362,218 188,988  
20 Interest ........... 8,269,372 6,738,132 1,531,240  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 31,499,370 26,257,075 5,242,295  
23 Insurance .............. 4,020,795 21,328 3,999,467  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a PATIENT SERV. SUPPLIES 85,026,791 85,026,791 0  
b PURCHASED CONTR. SERVIC 37,803,729 37,348,520 455,209  
c MANAGEMENT FEE 36,248,011 398,652 35,849,359  
d DRUGS 19,294,270 19,294,270    
e PROV. FOR UNCOLLECTABLE 18,149,609 16,602,490 1,547,119  
f All other expenses 33,858,514 29,456,840 4,379,806 21,868
25 Total functional expenses. Add lines 1 through 24f 705,318,496 598,921,387 105,914,860 482,249
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 6,214,073 1 7,850,566
2 Savings and temporary cash investments ....... 132,342,317 2 68,055,507
3 Pledges and grants receivable, net ......... 2,021,755 3 1,500,704
4 Accounts receivable, net ......... 104,673,675 4 128,443,126
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 26,560 7 129,793
8 Inventories for sale or use .............. 10,606,969 8 10,662,837
9 Prepaid expenses and deferred charges ............ 11,011,891 9 7,862,118
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 506,587,807
b Less: accumulated depreciation. ..... 10b 242,959,159 221,218,847 10c 263,628,648
11 Investments—publicly traded securities .......... 258,582,306 11 260,997,893
12 Investments—other securities. See Part IV, line 11 ...... 8,253,386 12 6,381,443
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 54,453,841 15 47,269,201
16 Total assets. Add lines 1 through 15 (must equal line 34)... 809,405,620 16 802,781,836
Liabilities 17 Accounts payable and accrued expenses . 71,853,338 17 61,483,167
18 Grants payable .......... 194,323 18 224,782
19 Deferred revenue .......... 11,086,747 19 5,687,849
20 Tax-exempt bond liabilities .......... 179,018,200 20 177,033,644
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 16,870,000 23 15,070,000
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 180,716,908 25 150,751,487
26 Total liabilities. Add lines 17 through 25..... 459,739,516 26 410,250,929
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 304,310,763 27 346,852,884
28 Temporarily restricted net assets ..... 40,458,307 28 40,739,279
29 Permanently restricted net assets ..... 4,897,034 29 4,938,744
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 349,666,104 33 392,530,907
34 Total liabilities and net assets/fund balances ..... 809,405,620 34 802,781,836
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
730,577,736
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
705,318,496
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
25,259,240
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
349,666,104
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
17,605,563
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
392,530,907
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: MEMBER'S OF THE GROUP REASON FOR PUBLIC CHARITY STATUS BELOW: MEMORIAL MEDICAL CENTER PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). ABRAHAM LINCOLN MEMORIAL HOSPITAL PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). TAYLORVILLE MEMORIAL HOSPITAL PART I LINE 3 HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). MEMORIAL HEALTH VENTURES PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(3). B TYPE II. LINE 11E NO, 11F NO, 11G (I)(II)(III) NO, 11H (I)SUPPORTS MMC (II)37-06612203 (III) (IV) YES, (V) YES (VI) YES (VII)$0 MEMORIAL HOME SERVICES PART I LINE 9. AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIPS FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS- SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME FROM BUSINESS ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. MEMORIAL PHYSICIAN SERVICES PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(3). B TYPE II. SPRINGFIELD RESIDENTIAL SERVICES PART I LINE 9. AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIPS FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS- SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME FROM BUSINESS ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. MEMORIAL MEDICAL CENTER FOUNDATION PART I LINE 7 IS AN ORGANIZATION THAT NORMALLY RECIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI). ABRAHAM LINCOLN HEALTHCARE FOUNDATION PART I LINE 7 IS AN ORGANIZATION THAT NORMALLY RECIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI). TAYLORVILLE MEMORIAL HEALTHCARE FOUNDATION PART I LINE 11 AN ORGANIZATION ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE PUBLICLY SUPPORTED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1). B TYPE III. LINE 11E NO, 11F NO, 11G (I)(II)(III) NO, 11H (I)SUPPORTS TMH (II)37-06612503 (III) (IV) YES, (V) YES (VI) YES (VII)$21,541
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
  		Employer identification number

90-0756744
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
  		Employer identification number

90-0756744
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
  		Employer identification number

90-0756744
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
74,938
j
Total. lines 1c through 1i ...................................
74,938
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: MEMORIAL MEDICAL CENTER (MMC) ENGAGES LOBBYISTS TO ASSIST IN SECURING FEDERAL GRANTS AND MONITORING STATE REGULATIONS IN SUPPORT OF FURTHERING THE MEMORIAL MEDICAL CENTER MISSION, WHICH IS "TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE". THIS INCLUDES ASSISTING MEMORIAL MEDICAL CENTER IN DEVELOPING PRESENTATIONS TO THE ILLINOIS CONGRESSIONAL DELEGATION REQUESTING APPROPRIATIONS FOR PRIORITY PROJECTS INVOLVING LOCAL PATIENT SAFETY, QUALITY IMPROVEMENT AND IMPROVED LOCAL ACESS TO MEDICAL CARE. THE LOBBYISTS ALSO ASSIST MMC IN COMMUNICATING THE IMPORTANCE OF ADEQUATE MEDICAID FUNDING IN SUPPORT OF THE SUBSTANTIAL SERVICES MMC'S AFFILIATES PROVIDE TO THOSE IN POVERTY AND IN MONITORING LEGISLATIVE AND REGULATORY DEVELOPMENTS THAT WOULD AFFECT MEMORIAL MEDICAL CENTER'S ABILITY TO CONTINUE DELIVERING ITS ALREADY SUBSTANTIAL COMMUNITY BENIFIT. ABRAHAM LINCOLN MEMORIAL HOSPITAL(ALMH) PAID FUNDS OF $15,517 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HOSPITALS REGARDING LEGISLATVE CHANGES. TAYLORVILLE MEMORIAL HOSPITAL(TMH) PAID FUNDS OF $14,752 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HOSPITALS REGARDING LEGISLATIVE CHANGES. MEMORIAL HOME SERVICES(MHSVC) PAID FUNDS OF $783 TO HEALTHCARE ASSOCIATIONS TO AID AND ASSIST HEALTHCARE ORGANIZATIONS REGARDING LEGISLATIVE CHANGES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 7,410,408 5,942,467 5,911,356
b Contributions ........ 48,483 1,050,046 35,189
c Investment earnings or losses ... -47,525 599,812 194,785
d Grants or scholarships .....   35,500 53,949
e Other expenditures for facilities
and programs ........ 		42,758 107,317 107,863
f Administrative expenses .... 97,366 39,101 37,051
g End of year balance ...... 7,271,242 7,410,407 5,942,467
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet15.000 %
b
Permanent endowment: SchDMd Bullet85.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 971,929 6,685,570 7,657,499
b Buildings ................ 2,808,690 247,256,629 116,525,905 133,539,414
c Leasehold improvements ............   2,306,853 1,236,940 1,069,913
d Equipment ................ 4,978 158,946,514 97,228,534 61,722,958
e Other .................   87,606,644 27,967,780 59,638,864
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 263,628,648
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DONOR RESTRICTED ASSETS - LITTLER TRUST 21,081,634
(2) UNCONSOLIDATED AFFILIATE 14,624,075
(3) INSURANCE RECOVERABLES 4,677,086
(4) UNAMORTIZED BOND DISCOUNTS AND ISSUE COSTS 3,574,648
(5) REAL ESTATE INVESTMENT 1,231,005
(6) CHARITABLE REMAINDER TRUST 762,302
(7) PARTNERSHIP INVESTMENTS 379,996
(8) DUE FROM AFFILIATES 732,375
(9) CASH SURRENDER VALUE OF LIFE INSURANCE 144,599
(10) OTHER RECEIVABLES 61,481
Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 47,269,201
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
DEFERRED COMPENSATION 9,928,190
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 28,096,371
MINIMUM PENSION LIABILITY 71,954,894
RESERVE FOR POST EMPLOYMENT BENEFITS 8,836,610
SWAP LIABILITY 4,708,883
WORKERS' COMPENSATION AND PROFESSIONAL LIABILITY 20,859,269
OTHER 6,367,270


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 150,751,487
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: MEMORIAL HOME SERVICES HAS ONE PERMANENTLY RESTRICTED ENDOWMENT FUND WITH INCOME TO BE USED FOR OPERATING EXPENSES. MEMORIAL MEDICAL CENTER FOUNDATION'S ENDOWMENT FUNDS CONSIST OF 30 INDIVIDUAL DONOR-RESTRICTED FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE FOUNDATION HAS A POLICY OF APPROPRIATING FOR DISTRIBUTION EASH YEAR 5% OF ITS ENDOWMENT FUND'S MOVING AVERAGE FAIR VALUE OVER THE PRIOR 36 MONTHS AS OF SEPTEMBER 30 OF THE PRECEEDING FISCAL YEAR IN WHICH THE DISTRIBUTION IS PLANNED. IN ESTABLISHING THIS POLICY, THE FOUNDATION CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENTS. ACCORDINGLY, OVER THE LONG TERM, THE FOUNDATION EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT AN AVERAGE OF THE LONG-TERM RATE OF INFLATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: EFFECTIVE OCTOBER 1, 2008, MEMORIAL HEALTH SYSTEM ADOPTED GUIDANCE PROVIDED BY THE RECOGNITION SUBSECTION OF THE INCOME TAXES TOPIC OF THE FASB ACCOUNTING STANDARDS CODIFICATION. THIS SUBTOPIC PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ADOPTION OF THIS GUIDANCE DID NOT HAVE AN IMPACT ON THE FY 11 CONSOLIDATED BALANCE SHEETS, CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS, AND CONSOLIDATED STATEMENTS OF CASH FLOWS.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
 
WOODBURN KYLE & COMPANY
400 EAST FIRST STREET
 
MADISON, IN47250 		CONSULTING ON FUNDRAISING   No 55,324 36,000 19,324
Total .................right arrow 55,324 36,000 19,324
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
IL
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

FESTIVAL OF TREES (MMCF)
(event type) 		(b) Event #2

GOLF OUTING (ALHF)
(event type) 		(c) Other Events

8
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 471,553 29,119 75,291 575,963
2 Less: Charitable
contributions . . . 		241,140 11,182 21,926 274,248
3 Gross income (line 1
minus line 2) . . . 		230,413 17,937 53,365 301,715
VerticalDirectExpenses 4 Cash prizes . . .   600 0 600
5 Non-cash prizes . . 40,665   10,471 51,136
6 Rent/facility costs . . 12,452 4,600 1,678 18,730
7 Food and beverages . . 42,277 4,272 9,115 55,664
8 Entertainment . . . 550   500 1,050
9 Other direct expenses . 100,819 800 17,230 118,849
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 246,029
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow 55,686
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) CONSULTING FEES FOR TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		3 12,444 17,534,958 0 17,534,958 2.490 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		1 78,507 78,474,067 65,541,840 12,932,227 1.830 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) .... 8 466 214,034 425,419 -211,385 0 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		12 91,417 96,223,059 65,967,259 30,255,800 4.320 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		71 16,652 1,284,597 6,470 1,278,127 0.180 %
f Health professions education
(from Worksheet 5) .. 		34 2,747 23,141,475 4,647,278 18,494,197 2.620 %
g Subsidized health services
(from Worksheet 6) .. 		1 90 4,258   4,258 0 %
h Research (from Worksheet 7) 5   273,691   273,691 0.040 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		25 100 893,492   893,492 0.130 %
jTotal Other Benefits ... 136 19,589 25,597,513 4,653,748 20,943,765 2.970 %
kTotal. Add lines 7d and 7j. .. 148 111,006 121,820,572 70,621,007 51,199,565 7.290 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 16   7,941   7,941 0 %
3 Community support 27   252,625   252,625 0.040 %
4 Environmental improvements 7   1,858   1,858 0 %
5 Leadership development and training for community members 21   3,926   3,926 0 %
6 Coalition building 15 20 2,629   2,629 0 %
7 Community health improvement advocacy     12,466   12,466 0 %
8 Workforce development 4 219 63,047   63,047 0.010 %
9 Other     32,900   32,900 0 %
10 Total 90 239 377,392   377,392 0.050 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
5,391,069
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
202,111,232
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
220,981,174
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-18,869,942
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?3
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MEMORIAL MEDICAL CENTER
701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		X X   X   X X    
9 ABRAHAM LINCOLN MEMORIAL HOSPITAL
200 STALHUT DRIVE
LINCOLN,IL62656 		X X     X   X    
10 TAYLORVILLE MEMORIAL HOSPITAL
201 E PLEASANT
TAYLORVILLE,IL62568 		X X     X   X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NOT REQUIRED
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?20
Name and address Type of Facility (Describe)
1 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
2 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
3 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
4 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
5 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
6 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
7 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
8 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
9 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
10 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
11 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
12 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
13 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
14 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
15 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
16 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
17 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
18 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
19 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
20 SPINEWORKS PAIN CLINIC
501 NORTH FIRST STREET
SPRINGFIELD,IL62702 		OUTPATIENT SERVICES
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE ON THE WEBSITES OF ALL THREE MEMORIAL HEALTH SYSTEM HOSPITALS, AS WELL AS ITS AFFILIATE WEBSITES.
    PART I, LINE 7: THE COSTING METHODOLOGY FOR CHARITY CARE, MEDICAID, AND OTHER MEANS TESTED PROGRAMS WAS DERIVED FROM EACH HOSPITAL'S COST ACCOUNTING SYSTEM. THIS SYSTEM HAS THE ABILITY TO COMPUTE THE ACTUAL COST OF ALL MEDICAL PROCEDURES AT THE PATIENT-ACCOUNT LEVEL REGARDLESS OF PAYOR TYPE OR WHETHER THE PATIENT WAS INPATIENT OR OUTPATIENT. THE ONLY CATEGORY BY WHICH A COST TO CHARGE RATIO WAS UTILIZED FOR SCHEDULE H IS FOR THE DETERMINATION OF BAD DEBT EXPENSE AT COST IN PART III, SECTION A, LINE 2.
    PART II: COMMUNITY BUILDING ACTIVITIESMEMORIAL MEDICAL CENTER PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THAT ARE NOT ACCOUNTED FOR ELSEWHERE ON SCHEDULE H. IT SUPPORTS THE UNITED WAY OF CENTRAL ILLINOIS, WHICH, FOLLOWING AN EXTENSIVE COMMUNITY NEED ASSESSMENT, IS CREATING A CONTINUUM OF LEARNING FROM BIRTH THROUGH YOUNG ADULT. UNITED WAY ALSO FUNDS CRITICAL SERVICES SUCH AS ACCESS TO FOOD, SHELTER, HEALTHCARE AND VICTIM SERVICES.MEMORIAL MEDICAL CENTER SUPPORTS ECONOMIC DEVELOPMENT THROUGH THE MID-ILLINOIS MEDICAL DISTRICT AS WELL AS THE SPRINGFIELD CHAMBER OF COMMERCE'S QUANTUM GROWTH PARTNERSHIP, WHICH HAS A STRATEGIC PLAN TO IMPROVE THE LOCAL ECONOMY. AS THE LARGEST LOCAL EMPLOYER OUTSIDE OF STATE GOVERNMENT, MEMORIAL MEDICAL CENTER IS AN IMPORTANT ECONOMIC LINK THAT PROVIDES EMPLOYMENT AND BENEFITS FOR THOUSANDS OF FAMILIES. WORKFORCE DEVELOPMENT IS A KEY AREA OF INVOLVEMENT AS MEMORIAL MEDICAL CENTER COLLABORATES WITH OTHERS TO EXPAND OPPORTUNITIES TO TRAIN AND RECRUIT HEALTHCARE PROFESSIONALS TO EXPAND ACCESS IN RURAL AREAS.LEADERS FROM MEMORIAL MEDICAL CENTER ALSO VOLUNTEER ON A WIDE RANGE OF LOCAL NONPROFIT BOARDS SUCH AS THE UNITED WAY, HELPING HANDS HOMELESS SHELTER, SPRINGFIELD URBAN LEAGUE, CENTRAL ILLINOIS FOOD BANK, SANGAMON COUNTY CONTINUUM OF LEARNING, GIRL SCOUTS OF CENTRAL ILLINOIS, MID-ILLINOIS MEDICAL DISTRICT AT SPRINGFIELD, SPRINGFIELD YMCA, AND THE GREATER SPRINGFIELD CHAMBER OF COMMERCE. MEMORIAL MEDICAL CENTER ALSO SUPPORTS THE FUNDRAISING ACTIVITIES OF SUCH ORGANIZATIONS AS THE SPRINGFIELD URBAN LEAGUE, CENTRAL ILLINOIS FOOD BANK, YMCA, LOCAL AMERICAN CANCER SOCIETY, LOCAL AMERICAN HEART ASSOCIATION, SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINES SIMMONS CANCER INSTITUTE, UNITED WAY AND OTHERS. MMC ALSO COLLABORATES WITH LOCAL SCHOOLS TO OFFER MULTIPLE OPPORTUNITIES FOR STUDENTS TO EXPLORE HEALTHCARE CAREER OPTIONS. AS ONE OF THE LARGEST EMPLOYERS IN LOGAN COUNTY, ABRAHAM LINCOLN MEMORIAL HOSPITAL(ALMH) IS AN IMPORTANT ECONOMIC LINK THAT PROVIDES EMPLOYMENT AND BENEFITS FOR 280 FAMILIES. ALMH AND ABRAHAM LINCOLN HEALTHCARE FOUNDATION (ALHF) FINANCIALLY CONTRIBUTE TO THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, LINCOLN ART & BALLOON FESTIVAL AND THE LOGAN COUNTY FOOD BANK. SUPPORT IS ALSO PROVIDED FOR THE LOCAL MULTIPLE SCLEROSIS WALK AND THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE. ALMH IS A MEMBER OF THE LINCOLN/LOGAN COUNTY CHAMBER OF COMMERCE AND THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, WHICH ARE ACTIVELY WORKING TO IMPROVE THE ECONOMIC VITALITY OF LOGAN COUNTY. AN ALMH TEAM MEMBER SITS ON EACH OF THESE BOARDS. ALMH ALSO PROVIDED IN-KIND SUPPORT IN THE FORM OF MEETING SPACE FOR THE CHAMBER'S LEADERSHIP ACADEMY. THIS 8-WEEK PROGRAM PREPARES COMMUNITY MEMBERS FOR COMMUNITY LEADERSHIP ROLES. ABRAHAM LINCOLN MEMORIAL HOSPITAL'S COMMUNITY BUILDING ACTIVITIES INCLUDE STAFF WHO VOLUNTEER FOR LEADERSHIP ON LOCAL NONPROFIT BOARDS FOR ORGANIZATIONS THAT IMPACT THE HEALTH AND QUALITY OF LIFE FOR OUR COMMUNITY. AMONG THESE ARE THE LINCOLN/LOGAN COUNTY CHAMBER OF COMMERCE, THE LOGAN COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP, THE LINCOLN ART & BALLOON FESTIVAL, TOGETHER FOR LINCOLN, LINCOLN ROTARY CLUB, ZONTA, LOGAN COUNTY BOARD OF HEALTH, UNITED WAY OF LOGAN COUNTY, LOGAN COUNTY FOOD BANK, LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE, COMMUNITY CHILD CARE CONNECTION, COMMUNITY & CHILDREN'S HEALTH FAIR PLANNING COMMITTEE, 'FROM THE GROUND UP' COMMUNITY BEAUTIFICATION TEAM, APEX AT CITY CENTER TASK FORCE, CAPCIL (COMMUNITY ACTION OF CENTRAL ILLINOIS) HEALTH ADVISORY COMMITTEE, PROFESSIONAL CONSULTATION COMMITTEE FOR CLINICAL PASTORAL EDUCATION, LEPC (LOCAL EMERGENCY PLANNING COMMITTEE). TAYLORVILLE MEMORIAL HOSPITAL COMMUNITY BUILDING ACTIVITIES INCLUDE STAFF WHO VOLUNTEER FOR LEADERSHIP ON LOCAL NONPROFIT BOARDS FOR ORGANIZATIONS THAT IMPACT THE HEALTH AND QUALITY OF LIFE FOR OUR COMMUNITY. AMONG THESE ARE THE UNITED WAY OF CHRISTIAN COUNTY, CHRISTIAN COUNTY YMCA, TAYLORVILLE SERTOMA CLUB, AMERICAN CANCER SOCIETY RELAY FOR LIFE OF CHRISTIAN COUNTY, CHRISTIAN COUNTY ECONOMIC DEVELOPMENT CORPORATION AND TAYLORVILLE DEVELOPMENT ASSOCIATION.
    PART III, LINE 4: MEMORIAL MEDICAL CENTER'S BAD DEBT EXPENSE AT COST WAS DETERMINED BY COMPUTING A COST TO CHARGE RATIO AND APPLYING THIS RATIO AGAINST BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED 9/30/2011.THE COST TO CHARGE RATIO WAS CALCULATED AS FOLLOWS:TOTAL OPERATING EXPENSES PER AUDITED FINANCIAL STMTS $555,332,384LESS:OTHER OPERATING REVENUE (BEFORE CAPITATION ADJ) (14,577,240)PURCHASED MEDICAL SERVICES CAPITATION (35,516,824)HOSPITAL PROVIDER ASSESSMENT (11,366,455)BAD DEBT EXPENSE (13,379,150)ADJUSTED OPERATING EXPENSES $480,492,715GROSS PATIENT SERVICE REVENUE (BEFORE CAPITATION) $1,537,050,557RATIO OF COST TO CHARGES FOR BAD DEBT COSTING 31.3%ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL USED THE METHOD PRESCRIBED IN WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS.FOOTNOTE 2 OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MEMORIAL HEALTH SYSTEM CONTAINS A SPECIFIC FOOTNOTE RELATING TO BAD DEBT EXPENSE, AS FOLLOWS:THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED AMOUNTS TO BE COLLECTED, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING. THIS REVIEW TAKES INTO CONSIDERATION RECENT WRITE OFF EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHER FACTORS. THE RESULTS OF THIS EVALUATION IS USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, MEMORIAL HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.THE HOSPITALS OF MEMORIAL HEALTH SYSTEM DO NOT INCLUDE BAD DEBT AMOUNTS IN COMMUNITY BENEFIT.
    PART III, LINE 8: THE COSTING METHODOLOGY UTILIZED FOR THE DETERMINATION OF MEMORIAL MEDICAL CENTER'S MEDICARE ALLOWABLE COST (SCHEDULE H, PART III, LINE 6) WAS CALCULATED AS FOLLOWS:MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL UTILIZED MEDICARE COSTING DATA FROM THE FISCAL YEAR ENDED 9/30/2011 MEDICARE COST REPORT AS FILED. MEMORIAL MEDICAL CENTER WAS ABLE TO CAPTURE THE MEDICARE COSTING FOR INPATIENT MEDICAL SURGICAL, INPATIENT PSYCHIATRIC, INPATIENT REHABILITATION, AND OUTPATIENT MEDICAL SURGICAL SERVICES DURING THAT FISCAL PERIOD. THIS COSTING DATA EXCLUDED THE DIRECT MEDICAL EDUCATION COST FOR THE RESIDENCY PROGRAM ASSOCIATED WITH THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. THIS COST WAS INCLUDED IN THE HEALTH PROFESSIONS EDUCATION SECTION OF PART I, LINE 7 (F) OF SCHEDULE H.OTHER SECTIONS OF MEDICARE COST THAT WOULD NORMALLY BE EXCLUDED FROM THE MEDICARE COST REPORT BUT SHOULD BE INCLUDED FOR PURPOSES OF THIS SCHEDULE ARE THE FOLLOWING:1. MEMORIAL MEDICAL CENTER'S ESRD PROGRAM - THIS PROGRAM RELATED TO THE END-STAGE RENAL DIALYSIS PROGRAM. THE PROGRAM IS REFLECTED ON THE W/S I OF THE COST REPORT BUT DOES NOT HAVE A SETTLEMENT. 2. MEMORIAL MEDICAL CENTER'S OUTPATIENT CLINICAL LAB CHARGES - THESE MEDICARE OUTPATIENT CHARGES ARE PAID ON A FEE-FOR-SERVICE BASIS AND ARE NOT REFLECTED ON THE AS FILED MEDICARE COST REPORT. 3. MEMORIAL MEDICAL CENTER'S OUTPATIENT THERAPY SERVICES - THESE MEDICARE OUTPATIENT CHARGES RELATED TO THERAPEUTIC SERVICES, SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY SERVICES, ARE SUBJECT TO A FEE-FOR-SERVICE PAYMENT METHOD AND NOT FILED ON THE MEDICARE COST REPORT.4. PART B PROFESSIONAL FEES - MEMORIAL MEDICAL CENTER HAS ITS PART B MEDICARE PROFESSIONAL FEES BILLED THROUGH A SEPARATE CORPORATION OF MEMORIAL HEALTH SYSTEM. THE BILLING SERVICE IS CALLED PHYSICIAN BILLING SERVICE. IT BILLS FOR THE PROFESSIONAL FEES ON BEHALF OF MEMORIAL MEDICAL CENTER AND SWEEPS THE MEDICARE PAYMENTS BACK TO IT. SOME OF THE PROFESSIONAL FEES BILLED BY PHYSICIAN BILLING SERVICE ARE CRNA, HEARING CENTER, SPINEWORKS CLINIC, HEART FAILURE CLINIC, CLINICAL PSYCHOLOGISTS, DIETARY CONSULTING, BARIATRIC SURGERY AND EKG INTERPRETATIONS. THESE SERVICES ARE TYPICALLY EXCLUDED FROM THE MEDICARE COST REPORT BUT SHOULD BE INCLUDED FOR PURPOSE OF SCHEDULE H.THE MEDICARE CHARGES ASSOCIATED WITH BULLET POINTS 1 THROUGH 4 ABOVE WERE APPLIED TO THE CALCULATED COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT TO DETERMINE ITS COST. THIS COST DATA, ALONG WITH THE COST DATA ALREADY COMPILED FROM THE AS FILED MEDICARE COST REPORT WAS THE BASIS FOR THE ALLOWABLE MEDICARE COST OF $192,483,728. THE TOTAL SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7 WAS $18,869,942. THE ENTIRE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT FOR MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL. THIS SHORTFALL REFLECTS THE EXCESS COSTS INCURRED BY MEMORIAL MEDICAL CENTER THAT CURRENT FEE-FOR-SERVICE PAYMENTS PRESENTLY DO NOT COVER. THESE ARE VITAL SERVICES TO THE COMMUNITY THESE THREE HOSPITALS SERVE THAT CURRENT MEDICARE PAYMENTS DO NOT COVER.IN THE COMMUNITY THAT MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLOVILLE MEMORIAL HOSPITAL SERVE, MEDICARE IS AN IMPORTANT PAYOR. ACCORDINGLY, ALL THREE HOSPITALS ACCEPT MEDICARE PATIENTS REGARDLESS OF WHETHER THEIR TREATMENTS WILL RESULT IN A SURPLUS OR DEFICIT TO THE HOSPITAL. BY PROVIDING THESE SERVICES TO MEDICARE PATIENTS, THE MHS HOSPITALS PROMOTE ACCESS TO HEALTH CARE AND PROVIDE A COMMUNITY BENEFIT. ADDITIONALLY, THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS AND THE U.S. GOVERNMENT WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY. ACCORDINGLY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE LESSENED THE BURDENS OF GOVERNMENT BY PROVIDING SERVICES TO THIS AT-RISK POPULATION.
    PART III, LINE 9B: MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL PROACTIVELY INFORM PATIENTS OF THEIR CHARITY CARE AND UNINSURED DISCOUNT ASSISTANCE AND THE ELIGIBILITY CRITERIA, WHICH EXTENDS UP TO 750% OF FEDERAL POVERTY GUIDELINES. A FINANCIAL ASSISTANCE/BILLING LINK ON EACH HOSPITAL WEBSITE GOES TO BILLING INFORMATION WHICH INCLUDES A LINK TO THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM INFORMATION AND APPLICATION. THE APPLICATION FORM IS AVAILABLE IN SPANISH AS WELL AS ENGLISH. FOREIGN LANGUAGE TRANSLATION ASSISTANCE IS AVAILABLE UPON REQUEST. INFORMATION ON THE AVAILABILITY OF CHARITY CARE AND UNINSURED DISCOUNT ASSISTANCE IS POSTED AT ALL PATIENT REGISTRATION POINTS, INCLUDING THE EMERGENCY DEPARTMENT. THE "PEACE OF MIND REGARDING PAYMENT" BROCHURE IS OFFERED TO EVERY PATIENT AT EVERY VISIT AND IS AVAILABLE IN SPANISH. EMPLOYEES IN PATIENT REGISTRATION, PATIENT FINANCIAL SERVICES AND SOCIAL SERVICES ARE TRAINED TO UNDERSTAND THE CHARITY CARE POLICY AND KNOW HOW TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVE. HOSPITAL STAFF WHO REGULARLY INTERACT WITH PATIENTS ARE TRAINED AND KNOWLEDGEABLE ABOUT THE CHARITY CARE POLICY. IF NECESSARY, THEY ARE ABLE TO DIRECT PATIENT QUESTIONS REGARDING THE POLICY TO A KNOWLEDGEABLE HOSPITAL REPRESENTATIVE WHO IS ALSO ABLE TO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT PROGRAMS, SUCH AS MEDICAID OR OTHER STATE PROGRAMS, AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. EACH HOSPITAL EMPLOYS PATIENT FINANCIAL COUNSELORS WHOSE JOB IS TO VISIT ALL INPATIENTS WHO ARE IDENTIFIED AS SELF-PAY WITHIN 24 HOURS OF ADMISSION. THE FINANCIAL COUNSELORS PROVIDE INFORMATION ON CHARITY CARE AND UNINSURED DISCOUNTS AND, IF THE PATIENT HAS APPROPRIATE INFORMATION, COMPLETE THE CHARITY CARE APPLICATION ON THE SPOT. ANY SELF-PAY INPATIENT WHO MAY HAVE BEEN DISCHARGED WITHOUT A VISIT FROM THE FINANCIAL COUNSELOR RECEIVES A FOLLOW-UP PHONE CALL OR CHARITY CARE APPLICATION PACKET IN THE MAIL. IF INPATIENTS ARE IDENTIFIED AS BEING ELIGIBLE FOR MEDICAID OR OTHER GOVERNMENT BENEFITS, THIS APPLICATION PROCESS IS ALSO IMMEDIATELY STARTED WHILE THEY ARE PATIENTS. MEMORIAL MEDICAL CENTER EMPLOYS A FULL-TIME MEDICAID COORDINATOR WHO CONTINUES WORKING WITH PATIENTS POST-DISCHARGE TO WALK THEM THROUGH THE ENTIRE APPLICATION PROCESS. EVERY HOSPITAL BILLING STATEMENT INCLUDES FINANCIAL ASSISTANCE INFORMATION WITH A PHONE NUMBER TO CALL FOR INFORMATION. PATIENTS ARE ENCOURAGED TO INQUIRE ABOUT FINANCIAL ASSISTANCE AT ANY STAGE OF THE BILLING PROCESS.THE MHS HOSPITALS STRIVE TO HAVE A CONSISTENT AND COURTEOUS APPROACH TO COLLECTIONS. MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL OFFER FINANCIAL COUNSELING AND SCREENING TO PATIENTS TO ENSURE THAT ANY OTHER POTENTIAL THIRD PARTY COVERAGE UNDER OTHER GOVERNMENT PROGRAMS SUCH AS MEDICAID CAN BE IDENTIFIED. MEMORIAL MEDICAL CENTER WILL NOT REFER ACCOUNTS TO A COLLECTION AGENCY, FILE ANY LAWSUIT, OR GARNISH WAGES AGAINST ANY PARTICULAR PATIENT TO COLLECT MEDICAL DEBT UNTIL MMC VERIFIES THE FOLLOWING: REASONABLE BASIS FOR BELIEVING PATIENT OWES THE DEBT; MMC WILL MAKE ALL REASONABLE ATTEMPTS TO BILL THIRD PARTY PAYERS AND CONFIRM ANY REMAINING AMOUNTS ARE TRULY THE FINANCIAL RESPONSIBILITY OF THE PATIENT; WHEN THE PATIENT HAS INDICATED AN INABILITY TO PAY (MMC WILL VERIFY THE INABILITY TO PAY) AND MMC WILL OFFER A REASONABLE PAYMENT PLAN AND; THE PATIENT HAS BEEN GIVEN A REASONABLE OPPORTUNITY TO SUBMIT AN APPLICATION FOR CHARITY CARE. ALL HOSPITALS HAVE A CODE OF CONDUCT POLICY THAT SETS FORTH CERTAIN PRINCIPLES TO WHICH AGENCIES, REPRESENTATIVES AND COLLECTORS ARE EXPECTED TO ADHERE. THE AGENCIES ARE REQUIRED TO COMPLY WITH ALL OF THE RELEVANT TERMS OF THE FAIR PATIENT BILLING ACT, AND, IN PARTICULAR, SECTION 30(C) WHICH ENUMERATES CERTAIN PREREQUISITE CONDITIONS WHICH MUST BE SATISFIED BEFORE AN AGENCY CAN INITIATE ANY LEGAL ACTION AGAINST A PATIENT WHICH IS RELATED TO A FAILURE BY THAT PATIENT TO PAY A HOSPITAL BILL. THE AGENCIES ARE ALSO REQUIRED TO COMPLY WITH ALL OF THE RELEVANT TERMS OF THE ACA INTERNATIONAL CODE OF ETHICS AND PROFESSIONAL RESPONSIBILITY.ONCE A CHARITY CARE DETERMINATION IS MADE, ALL COLLECTION EFFORTS CEASE. IF AN ACCOUNT IS AT A COLLECTION AGENCY, THE ACCOUNT IS RETURNED BACK TO THE HOSPITAL FOR CHARITY PROCESSING.ALL PATIENT COMPLAINTS REGARDING DISSATISFACTION WITH SERVICES RENDERED OR BILLING ISSUES ARE HANDLED PROMPTLY AND IN A COURTEOUS MANNER TO ENSURE THAT CUSTOMER SERVICE REMAINS THE FOCUS OF ANY PATIENT CONCERN. ALL COMPLAINTS ARE CONSIDERED VALID AND PATIENT FEEDBACK IS WELCOME WITH RESPECT TO DISPUTED MATTERS.
    PART VI, LINE 2: NEEDS ASSESSMENTTHE MISSION OF MEMORIAL HEALTH SYSTEM IS TO HELP MAINTAIN, RESTORE AND IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. THE COMMUNITY BENEFIT COMMITTEE OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSEEING AND MAKING RECOMMENDATIONS WITH RESPECT TO ALL FORMS OF BENEFIT PROVIDED BY MHS AND ITS AFFILIATES, INCLUDING OUR CHARITY CARE POLICY AND PERFORMANCE. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS FOR THE THREE MHS HOSPITALS: MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL. THE COMMITTEE ALSO APPROVES THE ANNUAL COMMUNITY BENEFIT POLICY AND COMMUNITY NEEDS ASSESSMENT AND RECOMMENDS TO THE BOARD THE ANNUAL COMMUNITY BENEFIT PLAN AND BUDGET. THE COMMITTEE MEETS QUARTERLY TO RECEIVE UPDATES ON THE COMMUNITY BENEFIT PROGRAMS AND ANNUALLY RATES THE SUCCESS IN MEETING THE COMMUNITY BENEFIT PLAN'S GOALS.MEMORIAL HEALTH SYSTEM PARTICIPATES IN NUMEROUS NEED ASSESSMENTS CONDUCTED BY LOCAL AGENCIES IN SANGAMON, LOGAN AND CHRISTIAN COUNTIES. THESE INCLUDE THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH'S "ILLINOIS PROJECT FOR LOCAL ASSESSMENTS OF NEEDS"(IPLAN) FOR LOCAL PUBLIC HEALTH DEPARTMENTS IN SANGAMON, LOGAN AND CHRISTIAN COUNTIES. MHS HAS PARTICIPATED IN ADDITIONAL NEED ASSESSMENTS CONDUCTED BY LOCAL UNITED WAYS, LOGAN COUNTY HEALTHY COMMUNITIES PARTNERSHIP, THE SANGAMON COUNTY MEDICAL SOCIETY, SANGAMON COUNTY COMMUNITY HEALTH INITIATIVE, LOCAL CHAMBERS OF COMMERCE, YMCAS AND OTHERS. ADDITIONAL INFORMATION TO ASSESS NEED COMES FROM HOSPITAL ADMISSIONS AND DISCHARGES, LEADING CAUSES OF MORTALITY AND MORBIDITY IN EACH COUNTY AS REPORTED BY THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH, AND THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTHY PEOPLE 2020. INFORMATION FROM ALL THESE SOURCES IS USED TO PRIORITIZE MHS'S COMMUNITY BENEFIT INITIATIVES, AND TO ASSURE THAT THOSE INITIATIVES ARE ALIGNED WITH MHS'S MISSION, STATEMENT OF VALUES, STRATEGIC PLAN AND BUDGET. PRIORITIES ARE ESTABLISHED BASED ON OVERALL NEED, LEADING CAUSES OF DEATH, IMPACT ON HEALTH STATUS, ORGANIZATIONAL CORE COMPETENCIES, RESOURCES AND WHEREWITHAL TO MEANINGFULLY ADDRESS THE NEED. EACH MEMORIAL AFFILIATE HAS THE FLEXIBILITY TO DEVELOP SPECIFIC COMMUNITY BENEFIT PROGRAMS AND INITIATIVES THAT ARE DESIGNED TO RESPOND TO THE NEEDS OF ITS PARTICULAR COMMUNITY. MEMORIAL HEALTH SYSTEM UNDERSTANDS THAT COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS IS AN IMPORTANT COMPONENT OF COMMUNITY HEALTH IMPROVEMENT EFFORTS AND RESPONDS TO DIRECT COMMUNITY REQUESTS FOR PROGRAMS AND ASSISTANCE.PRIORITY FOCUS AREAS FOR FY2011 COMMUNITY BENEFIT PROGRAMS WERE (1) IMPROVING ACCESS TO CARE, (2) INCREASING PUBLIC AWARENESS OF RISK FACTORS ASSOCIATED WITH CORONARY ARTERY DISEASE, (3) INCREASING PUBLIC AWARENESS OF RISK FACTORS ASSOCIATED WITH CANCER, (4) EXECUTING OTHER COMMUNITY BENEFIT PROGRAMS TO MEET DEFINED COMMUNITY NEEDS, IN COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS WHEN POSSIBLE, AND (5) PREPARING TO CONDUCT A COMMUNITY HEALTH NEED ASSESSMENT TO BE COMPLETED IN FY12 THAT MEETS THE GUIDELINES OF THE SECTION 9007 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND THE REQUIREMENTS OF IRS NOTICE 2011-52.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEMEMORIAL HEALTH SYSTEM HOSPITALS RECOGNIZE THAT THERE ARE UNFORTUNATE OCCASIONS WHEN PATIENTS ARE NOT FINANCIALLY ABLE TO PAY FOR THEIR MEDICAL CARE, AND ARE NOT ELIGIBLE FOR FEDERAL OR STATE MEDICAL ASSISTANCE PROGRAMS. SINCE THE PROVISION OF CARE IS NOT DEPENDENT ON THE PATIENT'S ABILITY TO PAY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE ESTABLISHED GUIDELINES IN WHICH A PATIENT MAY APPLY AND QUALIFY FOR CHARITY CARE ASSISTANCE. IT IS IMPORTANT THAT CHARITY CARE APPLICANTS COOPERATE WITH THE HOSPITAL'S NEED FOR ACCURATE AND DETAILED INFORMATION WITHIN A REASONABLE TIMEFRAME. IN THE ABSENCE OF A COMPLETED CHARITY APPLICATION, CHARITY MAY BE CONSIDERED WHEN SUPPORTED BY OTHER COLLABORATING CREDIT INFORMATION. IN CASES WHERE THE PATIENT DOES NOT PROVIDE INFORMATION FOR CHARITY CARE, MMC, ALMH AND TMH UTILIZE AN OUTSIDE TOOL FROM TRANSUNION CREDIT BUREAU TO EVALUATE THE PATIENT'S FINANCIAL STATUS AND CREDIT WORTHINESS. NOT ONLY DOES TRANSUNION SUPPLY THE USER WITH A CREDIT REPORT, BUT IT PROVIDES OTHER HELPFUL INFORMATION INCLUDING ESTIMATED MONTHLY INCOME AND ONE'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN CASES WHERE REPORTS COME BACK INDICATING THAT THE PATIENT MEETS THE HOSPITAL'S CHARITY DEFINITION, THE PATIENT WILL BE GRANTED CHARITY. THIS IS TO PREVENT QUALIFYING CHARITY PATIENTS WHO DO NOT COMPLETE A CHARITY APPLICATION FROM BEING TURNED OVER FOR COLLECTIONS.
    PART VI, LINE 4: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEMEMORIAL HEALTH SYSTEM HOSPITALS RECOGNIZE THAT THERE ARE UNFORTUNATE OCCASIONS WHEN PATIENTS ARE NOT FINANCIALLY ABLE TO PAY FOR THEIR MEDICAL CARE, AND ARE NOT ELIGIBLE FOR FEDERAL OR STATE MEDICAL ASSISTANCE PROGRAMS. SINCE THE PROVISION OF CARE IS NOT DEPENDENT ON THE PATIENT'S ABILITY TO PAY, MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL, AND TAYLORVILLE MEMORIAL HOSPITAL HAVE ESTABLISHED GUIDELINES IN WHICH A PATIENT MAY APPLY AND QUALIFY FOR CHARITY CARE ASSISTANCE. IT IS IMPORTANT THAT CHARITY CARE APPLICANTS COOPERATE WITH THE HOSPITAL'S NEED FOR ACCURATE AND DETAILED INFORMATION WITHIN A REASONABLE TIMEFRAME. IN THE ABSENCE OF A COMPLETED CHARITY APPLICATION, CHARITY MAY BE CONSIDERED WHEN SUPPORTED BY OTHER COLLABORATING CREDIT INFORMATION. IN CASES WHERE THE PATIENT DOES NOT PROVIDE INFORMATION FOR CHARITY CARE, MMC, ALMH AND TMH UTILIZE AN OUTSIDE TOOL FROM TRANSUNION CREDIT BUREAU TO EVALUATE THE PATIENT'S FINANCIAL STATUS AND CREDIT WORTHINESS. NOT ONLY DOES TRANSUNION SUPPLY THE USER WITH A CREDIT REPORT, BUT IT PROVIDES OTHER HELPFUL INFORMATION INCLUDING ESTIMATED MONTHLY INCOME AND ONE'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN CASES WHERE REPORTS COME BACK INDICATING THAT THE PATIENT MEETS THE HOSPITAL'S CHARITY DEFINITION, THE PATIENT WILL BE GRANTED CHARITY. THIS IS TO PREVENT QUALIFYING CHARITY PATIENTS WHO DO NOT COMPLETE A CHARITY APPLICATION FROM BEING TURNED OVER FOR COLLECTIONS.
    PART VI, LINE 6: EACH OF THE HOSPITAL'S BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS WHO RESIDE IN THAT HOSPITAL'S PRIMARY SERVICE AREA. THESE VOLUNTEERS GIVE NUMEROUS HOURS OF SERVICE IN THEIR OVERSIGHT ROLE AND ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, FUNDRAISING, AND GENERAL STEWARDSHIP. MORE THAN 500 PEOPLE VOLUNTEER AT THE THREE HOSPITALS AS ESCORTS, WAITING ROOM HOSTS AND HOSTESSES AND A WIDE RANGE OF OTHER VOLUNTEER ROLES.ALL MHS HOSPITALS HAVE OPEN MEDICAL STAFFS THAT ALLOW MEMBERSHIP TO ANYONE WHO MEETS CREDENTIALING REQUIREMENTS. ALL THREE HOSPITALS PARTICIPATE IN MEDICARE, MEDICAID, CHAMPUS, TRICARE AND OTHER GOVERNMENT PROGRAMS AND ARE DISPROPORTIONATE SHARE MEDICAID HOSPITALS THAT PROVIDE FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS ACCORDING TO BOARD-APPROVED CHARITY CARE POLICIES. MEMORIAL MEDICAL CENTER SERVES AS THE REGIONAL BURN CENTER, SERVING ACUTELY BURNED PATIENTS FROM CENTRAL AND SOUTHERN ILLINOIS, AND IS THE REGIONAL REHABILITATION PROVIDER FOR SPINAL CORD INJURIES, CLOSED HEAD INJURIES, STROKES AND COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION.MEMORIAL MEDICAL CENTER MAINTAINS A 24-HOUR EMERGENCY DEPARTMENT THAT IS PART OF THE SOUTHERN ILLINOIS (LEVEL 1) TRAUMA CENTER. THE EMERGENCY DEPARTMENT HAS TRADITIONALLY SERVED AS A SAFETY NET HEALTHCARE PROVIDER FOR THE UNINSURED AND UNDERINSURED WHO DO NOT HAVE PRIMARY CARE PHYSICIANS. IT PROVIDES SERVICES TO ALL PEOPLE REGARDLESS OF ABILITY TO PAY. TO HELP MEET COMMUNITY NEED AND ALLEVIATE USE OF THE EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE, MHS OPERATES THREE EXPRESSCARE WALK-IN FACILITIES. THESE PROMPT-CARE SITES USE THE SAME CRITERIA FOR PATIENTS AS THE EMERGENCY DEPARTMENT: THE UNINSURED AND THOSE ON PUBLIC INSURANCE PROGRAMS RECEIVE THE SAME LEVEL OF CARE AND TREATMENT AS ANY OTHER PATIENTS. CHARITY CARE IS PROVIDED AS NEEDED.MEMORIAL MEDICAL CENTER COLLABORATES WITH COMMUNITY PROVIDERS TO SERVE THE LOW INCOME AND UNINSURED POPULATION. MMC PROVIDES DIAGNOSTIC, OUTPATIENT AND INPATIENT SERVICES FOR PATIENTS OF CENTRAL COUNTIES HEALTH CENTER, A FEDERALLY QUALIFIED HEALTH CENTER THAT MEMORIAL MEDICAL CENTER WAS INSTRUMENTAL IN STARTING. MMC ALSO PROVIDES FREE AND REDUCED-COST INPATIENT AND OUTPATIENT SERVICES TO PATIENTS OF SOUTHERN ILLINOIS UNIVERSITY CENTER FOR FAMILY MEDICINE, A PRIMARY CARE MEDICAL GROUP THAT SERVES LOW INCOME MEDICAID AND MEDICARE POPULATIONS. MMC ALSO PROVIDES OPERATING EXPENSES FOR COORDINATED ACCESS TO COMMUNITY HEALTH (CATCH), A PROGRAM THAT IS INCREASING ACCESS TO CARE, PARTICULARLY PHYSICIAN SPECIALISTS, FOR UNINSURED ADULTS IN SANGAMON COUNTY. MMC PROVIDES CHARITY CARE FOR CATCH PATIENTS. MMC UTILIZES SURPLUS FUNDS TO IMPROVE PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. DURING FY11 MMC USED SURPLUS FUNDS TO EXPAND THE EMERGENCY DEPARTMENT BY EIGHT ROOMS TO MEET GROWING COMMUNITY NEED FOR ADDITIONAL ACCESS TO SERVICES. DURING THE PAST YEAR MMC'S REGIONAL CANCER CENTER MADE SEVERAL SIGNIFICANT RENOVATIONS,ADDING TWO NEW LINEAR ACCELERATORS TO ITS RADIATION THERAPY DEPARTMENT, DELIVERING HIGHER DOSES OF RADIATION MORE PRECISELY AND QUICKLY, REDUCING SIDE EFFECTS AND LONG-TERM COMPLICATIONS FOR CANCER PATIENTS. IT ALSO OPENED A NEW INFUSION SERVICES DEPARTMENT THAT IS DOUBLE THE SIZE OF THE PREVIOUS UNIT, OFFERING CHEMOTHERAPY AND OTHER INFUSION SERVICES TO ABOUT 1,000 PATIENTS ANNUALLY. IN FY11 MMC ALSO RENOVATED ITS OUTPATIENT IMAGING CENTER, IMPROVING ACCESS TO CARE AS WELL AS PATIENT SAFETY, PRIVACY AND COMFORT FOR MORE THAN 26,000 PATIENTS ANNUALLY, MANY WHO TRAVEL 60-75 MILES TO GET THESE SERVICES AT MMC. SURPLUS FUNDS ARE ALSO DEVOTED TO MEMORIAL'S COMMITMENT TO MEDICAL EDUCATION. MEMORIAL MEDICAL CENTER SERVES AS A TEACHING HOSPITAL FOR SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. MMC AND ALMH ALSO SERVE AS CLINICAL TRAINING SITES FOR MULTIPLE NURSING SCHOOLS AND OTHER UNIVERSITY AND COLLEGE HEALTH PROFESSIONAL TRAINING PROGRAMS IN THE REGION. THESE INCLUDE RADIOLOGY AND PHARMACY TECHNICIANS, CERTIFIED REGISTERED NURSE ANESTHESIOLOGISTS, CLINICAL LABORATORY SCIENTISTS, SPEECH PATHOLOGISTS, PHYSICAL AND OCCUPATIONAL THERAPISTS AND OTHERS. MMC ALSO SUPPORTS CLINICAL RESEARCH AND OFFERS NUMEROUS CANCER TRIALS THROUGH THE CENTRAL ILLINOIS COMMUNITY CLINICAL ONCOLOGY PROGRAM, WHICH RECEIVES SUPPORT FROM THE NATIONAL CANCER INSTITUTE. MORE THAN 450 RESEARCH PROJECTS AND PROTOCOLS ARE OPEN AT ANY GIVEN TIME. MMC PROVIDES FUNDING AND SUPPORT FOR THE SPRINGFIELD COMMITTEE ON RESEARCH IN HUMAN SUBJECTS, THE LOCAL INSTITUTIONAL REVIEW BOARD FOR CLINICAL RESEARCH TRIALS IN SPRINGFIELD.MMC, ALMH, AND TMH SURPLUS FUNDS ALSO PROVIDE SERVICES AND EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITIES WE SERVE THROUGH: EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON A WIDE RANGE OF WELLNESS TOPICS; FREE AND LOW-COST HEALTH SCREENINGS; AND FREE SUPPORT GROUPS FOR PARTICULAR DISEASES/HEALTH ISSUES (SUCH AS BREAST CANCER, PROSTATE CANCER, KIDNEY/PANCREAS TRANSPLANT PATIENTS, STROKE/BRAIN INJURY, AND HEART FAILURE). MMC ALSO PAYS FOR PHARMACEUTICAL PRESCRIPTIONS FOR INDIGENT PATIENTS UPON DISCHARGE WHO CANNOT AFFORD TO FILL THEIR PRESCRIPTIONS. MMC SUPPORTS KUMLER OUTREACH MINISTRIES, A LOCAL PROGRAM THAT PROVIDES PHARMACEUTICAL ASSISTANCE TO THE INDIGENT. MMC ALSO COVERS THE COSTS FOR AMBULANCES AND MEDICARS THAT TRANSFER MEDICARE PATIENTS AND THE INDIGENT FROM THE HOSPITAL TO THEIR HOMES. ALMH HAS 25 STAFFED BEDS AND SERVICES OFFERED INCLUDE 24-HOUR EMERGENCY MEDICINE, GENERAL ACUTE INPATIENT CARE, INTENSIVE CARE, PAIN MANAGEMENT, ORTHOPEDICS, SURGERY AND THE FAMILY MATERNITY SUITES. ALMH ALSO OFFERS A FULL RANGE OF OUTPATIENT REHABILITATION, THERAPY, AND DIAGNOSTIC TESTING. WITH THE OPENING OF A NEW REPLACEMENT HOSPITAL IN MARCH, 2011, ALMH BEGAN OFFERING WARM-WATER THERAPY FOR PHYSICAL THERAPY PATIENTS AND ARTHRITIS PATIENTS SEEKING RELIEF FROM THEIR SYMPTOMS. A FIXED MRI UNIT AND UPGRADED CT SCAN OPENED UP A NUMBER OF NEW TESTS FOR LOCAL PATIENTS, WHO PREVISOULY HAD TO BE TRANSFERRED OUT OF THE COUNTY FOR THESE TESTS.ABRAHAM LINCOLN MEMORIAL HOSPITAL'S EMERGENCY DEPARTMENT HAS TRADITIONALLY SERVED AS A SAFETY NET HEALTHCARE PROVIDER FOR THE UNINSURED AND UNDERINSURED WHO DO NOT HAVE PRIMARY CARE PHYSICIANS. TO HELP MEET COMMUNITY NEED AND ALLEVIATE USE OF THE EMERGENCY DEPARTMENT FOR NON-EMERGENT CARE, ABRAHAM LINCOLN MEMORIAL HOSPITAL COLLABORATES THROUGH THE HEALTHY COMMUNITIES PARTNERSHIP WITH THE LOGAN COUNTY DEPARTMENT OF PUBLIC HEALTH AND FAMILY MEDICAL CENTER (PART OF MEMORIAL PHYSICIAN SERVICES, AN MHS AFFILIATE) TO TAKE PRIMARY AND PREVENTIVE CARE TO SMALL RURAL COMMUNITIES IN LOGAN COUNTY VIA THE H.O.P.E. MOBILE. A NURSE PRACTITIONER AND PUBLIC HEALTH NURSE STAFF THIS MOBILE UNIT, WHICH MAKES WEEKLY VISITS TO OUTLYING RURAL COMMUNITIES IN LOGAN COUNTY. THIS PROGRAM, ESTABLISHED IN 1998, IS ESPECIALLY BENEFICIAL TO RURAL SENIORS: OVER 30% OF THE PATIENTS ARE AGED 61-80 YEARS OLD, AND OVER 40% ARE OVER THE AGE OF 81. IN FY2011, THE H.O.P.E. MOBILE PROVIDED 403 DENTAL APPOINTMENTS FOR LOW-INCOME CHILDREN AND PREGNANT WOMEN, AND 1,993 OTHER PRIMARY- AND PREVENTIVE-CARE MEDICAL SERVICES. ABRAHAM LINCOLN MEMORIAL HOSPITAL EMPLOYS THE PROGRAM COORDINATOR AND OVERSEES MAINTENANCE OF THE UNIT. ABRAHAM LINCOLN HEALTHCARE FOUNDATION CONTRIBUTES FUNDING AND ONGOING SUPPORT THAT MAKES THE PROGRAM POSSIBLE.TAYLORVILLE MEMORIAL HOSPITAL USES SURPLUS FUNDS TO CONTINUALLY IMPROVE PATIENT CARE. IN MARCH 2011 THE HOSPITAL OPENED A 32,000-SQUARE-FOOT FACILITY THAT IS HOME TO A NEW EMERGENCY DEPARTMENT, RADIOLOGY SERVICES AND OUTPATIENT SURGERY CENTER. THE NEW FACILITY IS DESIGNED FOR OUTPATIENT SERVICES, OFFERS CLOSE PARKING, AND IMPROVES PATIENT SAFETY. THE NEW EMERGENCY DEPARTMENT OFFERS 10 TREATMENT ROOMS, INCLUDING TWO LEVEL-TWO TRAUMA BAYS AND AN ISOLATION ROOM WITH NEGATIVE AIR FLOW FOR PATIENTS WHO ARE AT RISK OF AIRBORNE TRANSMISSION OF CONTAGIOUS DISEASES. CONVENIENTLY NEAR THE EMERGENCY DEPARTMENT IS THE NEW RADIOLOGY SERVICES AREA, WHICH ADDED A NEW MRI UNIT. FOR THE PAST 20 YEARS THE HOSPITAL RELIED ON A MOBILE MRI THAT HAD LIMITED AVAILABILITY. OTHER SERVICES OFFERED INCLUDE CT, DIGITAL MAMMOGRAPHY, ECHOCARDIOLOGY, ULTRASOUND/SONOGRAPHY AND NUCLEAR MEDICINE. THE NEW OUTPATIENT SURGERY CENTER OFFERS THREE OPERATING ROOMS WITH ADVANCED TECHNOLOGY AND NEW EQUIPMENT FOR A VARIETY OF OUTPATIENT SURGICAL PROCEDURES. TWO INDIVIDUAL PATIENT ASSESSMENT ROOMS OFFER A PLACE FOR PRIVATE INTERVIEWS. AN ADDITIONAL INVESTMENT THE HOSPITAL MADE WAS IMPROVING SAFETY IN ACCESSING THE HOSPITAL. A NEW ROADWAY NOW DIRECTLY CONNECTS THE HOSPITAL WITH ROUTE 29, PROVIDING AMBULANCES A MORE DIRECT AND SAFER ROUTE, AND DIVERTING THE MAJORITY OF THE HOSPITAL TRAFFIC AWAY FROM THE RESIDENTIAL AND SCHOOL AREA THAT PREVIOUSLY WAS THE ONLY WAY TO ACCESS THE HOSPITAL.
    PART VI, LINE 7: MEMORIAL HEALTH SYSTEM, A 501(C)(3) CORPORATION, IS THE SOLE CORPORATE MEMBER OF ABRAHAM LINCOLN MEMORIAL HOSPITAL, A RURAL CRITICAL ACCESS HOSPITAL; TAYLORVILLE MEMORIAL HOSPITAL, A RURAL CRITICAL ACCESS HOSPITAL; AND MEMORIAL MEDICAL CENTER, A 500-BED TERTIARY CARE HOSPITAL THAT OFFERS A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES. OTHER AFFILIATES INCLUDE: MEMORIAL PHYSICIAN SERVICES, A PRIMARY CARE PHYSICIAN NETWORK THAT INCLUDES SEVERAL CLINICS LOCATED IN MEDICALLY UNDERSERVED OR HEALTH MANPOWER SHORTAGE AREAS; MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS, A MULTI-COUNTY OUTPATIENT MENTAL HEALTH NETWORK THAT PROVIDES SERVICE BASED ON A SLIDING-SCALE FEE SCHEDULE AND FREE CARE TO A WIDE RANGE OF PATIENTS WITH PSYCHIATRIC DISORDERS; MEMORIAL HOME SERVICES, A MULTI-COUNTY HOME CARE AND HOSPICE PROGRAM; A CHILD CARE CENTER; AND THREE HOSPITAL FOUNDATIONS, ALL OF WHICH ARE 501(C)(3) ENTITIES. HEALTH SYSTEM AFFILIATES INTEGRATE SERVICES TO PROVIDE IMPROVED ACCESS AND STREAMLINED TRANSITIONS BETWEEN THE DOCTORS OFFICES, HOSPITAL, HOME HEALTH AGENCY, NURSING HOME AND MENTAL HEALTH CLINICS. MEMORIAL HEALTH SYSTEM'S AFFILIATES ENGAGE IN A WIDE RANGE OF COMMUNITY BENEFIT ACTIVITIES. IN ADDITION TO THE HOSPITAL ACTIVITIES FOR MEMORIAL MEDICAL CENTER, ABRAHAM LINCOLN MEMORIAL HOSPITAL AND TAYLORVILLE MEMORIAL HOSPITAL MENTIONED IN PART VI, LINE 5, OTHER AFFILIATE COMMUNITY BENEFITS INCLUDE THE FOLLOWING. MENTAL HEALTH CENTER'S OF CENTRAL ILLINOIS PROVIDES NUMEROUS COMMUNITY BENEFITS. JUST A FEW OF THESE INCLUDE PSYCHIATRIC CRISIS INTERVENTION WITH LOCAL SCHOOLS DEALING WITH SUICIDE OR OTHER TRAUMATIC EVENTS; CRISIS INTERVENTION TRAINING FOR LOCAL LAW ENFORCEMENT DEALING WITH MENTALLY ILL INDIVIDUALS; AND MENTALLY ILL HOMELESS PERSONS ADVOCACY AND COUNSELING. IN FY11, MHCCI DEVELOPED A SUICIDE PREVENTION TRAINING/WEBINAR FOR SCHOOL PERSONNEL AND ALSO RAISED AWARENESS ABOUT MENTAL ILLNESS THROUGH COMMUNITY EVENTS AND PRESENTATIONS. MHCCI IS COLLABORATING WITH LOCAL PARTNERS ON A PROJECT TO DEVELOP A PLAN FOR A COMMUNITY-BASED SYSTEM OF CARE THAT WILL TRANSFORM AND IMPROVE THE WAY MENTAL HEALTH SERVICES ARE PROVIDED TO CHILDREN AND YOUTH IN SPRINGFIELD.MEMORIAL PHYSICIAN SERVICES PROVIDES MEDICAL EDUCATION OPPORTUNITIES FOR PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. A PHYSICIAN FROM MPS WORKED WITH THE SPRINGFIELD SCHOOL DISTRICT TO PROVIDE STRESS COPING TRAINING FOR TEACHER (FUNDING CAME FROM THE MEMORIAL MEDICAL CENTER FOUNDATION).MEMORIAL HOME SERVICES PROVIDES HOME HOSPICE CARE IN 14 ILLINOIS COUNTIES, OFFERING MEDICAL, SPIRITUAL AND EMOTIONAL SUPPORT FOR BOTH PATIENTS AND THEIR FAMILIES. MEMORIAL HOME SERVICES ALSO PROVIDED 129 FREE HEALTH SCREENING EVENTS THROUGHOUT THE YEAR, OFFERING 2,342 FREE BLOOD PRESSURE AND 1,000 GLUCOSE SCREENINGS IN A WIDE VARIETY OF COMMUNITY LOCATIONS; 21% OF THE BLOOD PRESSURE SCREENINGS AND 12% OF THE GLUCOSE SCREENINGS WERE ABNORMAL. THOSE PARTICIPANTS ARE REFERRED TO THEIR PHYSICIANS FOR FOLLOW-UP CARE. MEMORIAL HOME SERVICES ALSO DONATES WHEELCHAIRS AND OXYGEN TANKS FOR MULTIPLE LAND OF LINCOLN HONOR FLIGHTS, WHICH TAKE WORLD WAR II AND KOREAN WAR VETERANS ON FREE TOURS OF WAR MEMORIALS IN WASHINGTON, D.C.THE MEMORIAL MEDICAL CENTER FOUNDATION (MMCF) PROVIDES GRANTS FOR PATIENT CARE, EDUCATION AND RESEARCH. ELEVEN GRANTS WERE AWARDED IN FY11. THESE GRANTS INCLUDED FUNDING FOR A STROKE TELEMEDICINE PROGRAM FOR RURAL PATIENTS; A STUDY TO PREDICT AND TEST FOR THE PRESENCE OF CHLAMYDIA AND GONORRHEA IN WOMEN WHO VISIT THE MEDICAL CENTER'S EMERGENCY DEPARTMENT; SUPPORT FOR AN INDIGENT PHARMACEUTICAL PROGRAM; MEDICATION RECONCILIATIONS FOR SENIOR CITIZENS DISCHARGED FROM HOSPITALIZATION; A STUDY COMPARING RESULTS OF SURGICAL AND NON-SURGICAL TREATMENTS OF HAND FRACTURES; PURCHASE OF A PORTABLE PERIPHERAL BONE DENSITOMETER TO USE IN COMMUNITY HEALTH SCREENINGS; AND TRAINING FOR ELEMENTARY SCHOOL TEACHERS TO TEACH THEIR STUDENTS CRITICAL COPING SKILLS FOR CLASSROOM READINESS. MANY OF THE RESEARCH GRANTS WERE PROVIDED TO SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. THE FOUNDATION ALSO ADMINISTERS A CANCER PATIENT ASSISTANCE FUND THAT ASSISTS CANCER PATIENTS WITH UTILITIES, RENT AND OTHER BASIC EXPENSES WHILE UNDERGOING CANCER TREATMENT AND A TRANSPLANT PATIENT ASSISTANCE FUND THAT ASSISTS KIDNEY TRANSPLANT PATIENTS WITH THE COSTS OF ANTI-REJECTION MEDICATIONS. IN FY11, MMCF SUPPORTED A COMMUNITY-WIDE WOMEN'S HEALTH FAIR TO PROVIDE A VARIETY OF HEALTH SCREENINGS AND TO EDUCATE WOMEN ABOUT HEALTH ISSUES RANGING FROM CANCER TO BLOOD PRESSURE. THE ABRAHAM LINCOLN HEALTHCARE FOUNDATION (ALHF) UNDERWRITES THE OPERATING EXPENSES OF THE LOGAN COUNTY HEALTHY COMMUNITIES PARTNERSHIP AND THE H.O.P.E. MOBILE. IN VISITING RURAL COMMUNITIES, 1,993 PRIMARY AND PREVENTIVE HEALTH SERVICES WERE PROVIDED BY THE H.O.P.E MOBILE IN FY11. DENTAL APPOINTMENTS FOR LOW-INCOME CHILDREN AND PREGNANT WOMEN WERE ALSO PROVIDED BY THE H.O.P.E. MOBILE. THE HEALTHY COMMUNITIES PARTNERSHIP ALSO COLLABORATIVELY ADDRESSES ALCOHOL AND DRUG USE, TEEN PREGNANCY, DOMESTIC ABUSE, SENIOR HEALTH ISSUES, PARISH NURSING AND EDUCATION ON THE LOCAL COMMUNITY LEVEL. ALHF'S CONTRIBUTION TO THE HEALTHY COMMUNITIES PARTNERSHIP IN FY2011 WAS $104,231. THE ABRAHAM LINCOLN HEALTHCARE FOUNDATION ALSO PROVIDED $5,500 IN HEALTHCARE SCHOLARSHIPS TO LOCAL RESIDENTS PREPARING FOR A PHARMACY AND A NURSING DEGREE, $8,863 FOR PAIN MEDICATION FOR HOSPICE PATIENTS, $10,000 IN SUPPORT FOR A MEDI-CAR TRANSPORTATION SERVICE FOR WHEELCHAIR-BOUND RESIDENTS, AND PROVIDED OVER $9,600 IN PHARMACEUTICAL ASSISTANCE TO DISCHARGED PATIENTS WHO COULD NOT AFFORD TO FILL THEIR PRESCRIPTIONS. AN ACTIVE LIFELINE PROGRAM, WHICH PLACES EMERGENCY CALL AND RESPONSE UNITS IN THE HOMES OF SENIORS, IS MANAGED BY ALMH STAFF AND FUNDED BY THE FOUNDATION. TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION CONTINUES TO SUPPORT PROGRAMS WHICH ASSIST IN THE TRAINING OF FUTURE HEALTHCARE PROVIDERS IN OUR SERVICES AREA. IN ADDITION, A WIDE RANGE OF COMMUNITY HEALTH SCREENINGS, CLASSES, AND OTHER EDUCATIONAL EVENTS ARE REGULARLY UNDERTAKEN.
REPORTS FILED WITH STATES PART VI, LINE 7 IL
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number
90-0756744
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINEPO BOX 19620
SPRINGFIELD,IL62794 		37-6005961 115 891,774       SOUTHERN ILLINOIS SCHOOL OF MEDICINE WITH THE PURPOSE THAT THE FUNDS WILL BE USED FOR MEDICAL RESEARCH. THE POST-TERTIARY CLINICAL SERVICES FUND APPLICATION EXPLICITLY LISTED THREE SOUTHERN ILLINOIS SCHOLL OF MEDICINE CANCER PROGRAMS. MEMORIAL MEDICAL CENTER IS THE PASS THROUGH AGENCY FOR THESE PROGRAM-RESTRICTED FUNDS AND THE SOUTHERN ILLINOIS SCHOOL OF MEDICINE'S CANCER PROGRAMS ARE LISTED AS THE BENEFICIARIES.
(2) MEMORIAL MEDICAL CENTER FOUNDATION1 MEMORIAL PLAZA
SPRINGFIELD,IL62781 		37-1110301 501 (C) (3) 18,000       AS A SPECIAL REMEMBRANCE, MEMORIAL MEDICAL CENTER MAKES A DONATION TO THE MEMORIAL MEDICAL CENTER FOUNDATION IN MEMORY OF EMPLOYEES AND CERTAIN EMPLOYEE FAMILY MEMBERS UPON THEIR DEATH.
(3) CITY OF LINCOLN315 EIGHTH STREET
LINCOLN,IL62656 		37-6001283 CITY OF LINCOLN   99,360 BOOK LAND DONATION OF LAND
(4) AMERICAN HEART ASSOCIATION2524 FARRAGUT DRIVE SUITE A
SPRINGFIELD,IL62704 		37-0673511 501 (C) (3) 25,000       SPONSOR OF ANNUAL HEART WALK AND START WALKING INITIATIVES TO HELP EDUCATE AND IMPROVE THE CARDIOVASCULAR HEALTH OF THE PEOPLE AND COMMUNITIES SERVED.
(5) SANGAMON COUNTY MEDICAL SOCIETY230 WEST CARPENTER STREET
SPRINGFIELD,IL62702 		37-6027693 501 (C) (3) 50,000       FUNDING OF CATCH PROGRAM THAT PROVIDES SERVICES TO UNINSURED PATIENTS IN SANGAMON COUNTY.
(6) LINCOLN ELEMENTARY SCHOOL DISTRICT NO 27304 8TH ST
LINCOLN,IL62656 		37-6003668 LINCOLN SCHOOL DISTR   98,466 BOOK LAND DONATION OF A BUILDING AND LAND
(7) SIU SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 10,150       3D ULTRA SOUND FOR TENDONS.
(8) SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 6,015       STUDY EFFECT OF HBO ON HINDLIMB TRANSPLANTATION.
(9) SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 63,307       HAND FRACTURE BEST PRATICES.
(10) MEMORIAL PHYSICAN SERVICES3132 OLD JACKSONVILLE ROAD STE 200
SPRINGFIELD,IL62704 		37-9999999 501 (C) (3) 48,200       PROVIDE COPING SKILLS TRAINING FOR TEACHERS.
(11) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 10,693       PROVIDE COMFORT KITS FOR PSYCHIATRIC PATIENTS.
(12) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 75,940       DEVELOP STROKE TELEMEDICINE PROGRAM.
(13) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 10,090       PURCHASE BONE DENSITOMETER FOR JOINTWORKS PROGRAM.
(14) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 50,300       PROVIDE SUPPORT FOR NURSING DEVELOPMENT.
(15) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 16,982       PROVIDE GENERAL SUPPORT.
(16) MEMORIAL HEALTH SYSTEM701 NORTH FIRST STREET
SPRINGFIELD,IL62703 		37-8888888 501 (C) (3) 7,010       PROJECT CPR ANYTIME.
(17) SIU SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 26,314       PROVIDE STD SCREENING IN THE EMERGENCY ROOM.
(18) SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 19,184       RESOLVE PRESCRIPTION DISCREPANCIES FOR SENIORS.
(19) SIU SCHOOL OF MEDICINE801 NORTH RUTLEDGE
SPRINGFIELD,IL62702 		37-6005961 115 5,553       PROVIDE GENERAL SUPPORT.
(20) KUMLER OUTREACH MINISTRIES303 NORTH GRAND AVENUE EAST
SPRINGFIELD,IL62702 		37-0695489 501 (C) (3) 16,000       PROVIDE PRESCRIPTIONS TO INDIGENT PATIENTS.
(21) MEMORIAL HOME SERVICES720 NORTH BOND STREET
SPRINGFIELD,IL62702 		37-0714225 501 (C) (3) 8,724       PROVIDE GENERAL SUPPORT.
(22) NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE303 EAST CHICAGO AVENUE
CHICAGO,IL60611 		36-2167817 501 (C) (3) 75,000       PARTICIPATION IN THE BOOST MENTORING PROGRAM.
(23) KUMLER OUTREACH MINISTRIES303 NORTH GRAND AVENUE EAST
SPRINGFIELD,IL62702 		37-0695489 501 (C) (3) 22,000       TO ASSIST IN THE PHARMACEUTICAL ASSISTANCE PROGRAM.
(24) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 48,107       PROVIDE EQUIPMENT AND SUPPLIES.
(25) MEMORIAL MEDICAL CENTER701 NORTH FIRST STREET
SPRINGFIELD,IL62781 		37-0661220 501 (C) (3) 74,139       PROVIDE SUPPORT FOR EDUCATION.
(26) ABRAHAM LINCOLN MEMORIAL HOSPITAL315 EIGHTH STREET
LINCOLN,IL62656 		37-0723793 501 (C) (3) 136,448       VARIOUS INCLUDING SCHOLORSHIPS, CARE-A-VAN, MEDICAL TECHNOLOGIES, PATIENT PHARMACY.
(27) MEMORIAL HOME SERVICES315 EIGHTH STREET
LINCOLN,IL62656 		37-0714225 501 (C) (3) 8,863       UNDERWRITE COST OF PAIN MEDICATION FOR HOSPICE PATIENTS.
(28) TAYLORVILLE MEMORIAL HOSPITAL201 E PLEASANT
TAYLORVILLE,IL62568 		37-0661250 501 (C) (3) 40,465       TO BE USED IN THE PURCHASE OF SPECIFIC MEDICAL EQUIPMENT AND THE CONSTRUCTION OF THE CENTER.
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
 
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) EDUCATIONAL GRANTS 153 653,666      
(2) TUITION REIMBURSEMENT 135 253,045      
(3) SCHOLARSHIPS FOR EMPLOYEES 24 91,730      
(4) EMPLOYEE ASSISTANCE WITH CATASTROPHIC EVENTS 28 28,908      
(5) SHELTER AND UTILITY ASSISTANCE FOR PATIENTS 23 9,915      
(6) DIRECT CASH ASSISTANCE TO PATIENTS 8 3,992      
(7) PRESCRIPTION DRUG ASSISTANCE 21 6,208      
(8) SCHOLARSHIPS 5 4,000      
(9) EDUCATION SCHOLARSHIPS 2 5,500      

Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS AND ASSISTANCE ARE PROVIDED TO LOCALLY MANAGED, NON-PROFIT 501(C)(3) ORGANIZATIONS OR EMPLOYEES WHO MEET THE CRITERIA FOR FINANCIAL ASSISTANCE. EMPLOYEES ASSIST IN OVERSITE AS VOLUNTEER MEMBERS OF LOCAL AGENCY BOARD OF DIRECTORS. THE CAMPUS OF SIU SCHOOL OF MEDICINE IS ADJACENT TO THE MEMORIAL MEDICAL CENTER CAMPUS. GRANTS AND ASSISTANCE PROVIDED TO THE MEDICAL SCHOOL ARE MONITORED BY THE EXECUTIVE DIRECTOR OF MEMORIAL MEDICAL CENTER FOUNDATION.
Schedule I (Form 990) 2010


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) RICHARD BIVIN MD (i)
(ii)		 175,457
0 		2,453
0 		71,859
0 		16,844
0 		32,925
0 		299,538
0 		0
0
(2) ELAINE YOUNG (i)
(ii)		 0
190,359 		0
51,971 		0
4,857 		0
25,047 		0
19,435 		0
291,669 		0
0
(3) KEVIN ENGLAND (i)
(ii)		 0
233,351 		0
64,775 		0
15,614 		0
31,355 		0
37,419 		0
382,514 		0
0
(4) THOMAS WESTRICK (i)
(ii)		 157,728
0 		21,725
0 		690
0 		0
0 		11,227
0 		191,370
0 		0
0
(5) DOLAN DALPOAS (i)
(ii)		 203,547
0 		54,953
0 		6,613
0 		26,783
0 		19,573
0 		311,469
0 		0
0
(6) DANIEL RAAB (i)
(ii)		 180,647
0 		50,050
0 		14,204
0 		24,142
0 		18,527
0 		287,570
0 		0
0
(7) EDGAR CURTIS (i)
(ii)		 0
640,422 		0
0 		0
26,505 		0
452,498 		0
6,036 		0
1,125,461 		0
0
(8) ROBERT KAY (i)
(ii)		 0
364,084 		0
0 		0
46,364 		0
201,735 		0
29,892 		0
642,075 		0
0
(9) MARK HANSEN MD (i)
(ii)		 405,664
0 		58,768
0 		156,638
0 		42,796
0 		50,676
0 		714,542
0 		0
0
(10) MARSHALL HALE MD (i)
(ii)		 285,649
0 		13,870
0 		1,318
0 		19,058
0 		39,633
0 		359,528
0 		0
0
(11) PAUL KASA MD (i)
(ii)		 203,143
0 		8,836
0 		1,244
0 		11,671
0 		31,573
0 		256,467
0 		0
0
(12) DOUGLAS RAHN (i)
(ii)		 383,574
0 		146,896
0 		20,355
0 		64,489
0 		31,544
0 		646,858
0 		0
0
(13) JANICE GAMBACH (i)
(ii)		 0
132,074 		0
19,119 		0
1,290 		0
0 		0
16,680 		0
169,163 		0
0
(14) CHARLES CALLAHAN (i)
(ii)		 208,214
0 		57,603
0 		21,695
0 		27,704
0 		22,456
0 		337,672
0 		0
0
(15) TRAVIS DOWELL (i)
(ii)		 189,187
0 		53,625
0 		7,217
0 		26,014
0 		21,062
0 		297,105
0 		0
0
(16) ELENA KEZELIS (i)
(ii)		 141,049
0 		19,839
0 		459
0 		0
0 		14,273
0 		175,620
0 		0
0
(17) MARSHA PRATER (i)
(ii)		 240,984
0 		0
0 		18,220
0 		128,573
0 		15,775
0 		403,552
0 		0
0
(18) SCOTT KIRIAKOS (i)
(ii)		 233,410
0 		64,336
0 		9,915
0 		31,377
0 		25,324
0 		364,362
0 		0
0
(19) DAVID J JOERGER (i)
(ii)		 159,431
0 		22,837
0 		1,290
0 		0
0 		15,057
0 		198,615
0 		0
0
(20) FERINAND SALVACION MD (i)
(ii)		 462,511
0 		154,000
0 		450
0 		90,857
0 		26,179
0 		733,997
0 		0
0
(21) DAVID SANDERCOCK MD (i)
(ii)		 301,033
0 		57,176
0 		4,175
0 		29,063
0 		43,970
0 		435,417
0 		0
0
(22) JAMES GILDNER MD (i)
(ii)		 502,737
0 		27,926
0 		8,009
0 		56,247
0 		53,934
0 		648,853
0 		0
0
(23) STEVEN LILLPOP MD (i)
(ii)		 347,626
0 		17,601
0 		8,064
0 		35,975
0 		45,021
0 		454,287
0 		0
0
(24) VIRGINIA DOLAN MD (i)
(ii)		 209,452
0 		55,000
0 		69,620
0 		18,223
0 		38,395
0 		390,690
0 		0
0
(25) ROBERT CLARKE (i)
(ii)		 0
0 		0
0 		0
382,201 		0
0 		0
0 		0
382,201 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 4B PART I, LINE 4B THE ORGANIZATION PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO THE FOLLOWING OFFICERS AND KEY EMPLOYEES: EDGAR J. CURTIS, $353,433, ROBERT W. KAY, $184,860, DOUGLAS L. RAHN, $48,372, FORREST G. HESTER, $25,781, MITCHELL L. JOHNSON, $18,515, ELAINE L. YOUNG, $21,527, KEVIN R. ENGLAND, $12,884, ANNA N. EVANS, $38,780, MARK E. WEAVER, M.D., $69,501, AND DAVID GRAHAM, M.D., $33,625. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A "SUBSTANTIAL RISK OF FORFEITURE." THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. 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 MHS 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.
  PART I, LINE 7 MEMBERS OF SENIOR MANAGEMENT RECEIVE INCENTIVE COMPENSATION UNDER THE ANNUAL INCENTIVE COMPENSATION PLANS SPONSORED BY MEMORIAL HEALTH SYSTEM. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). THE PLANS ARE DESIGNED TO CONDITION A PORTION OF COMPENSATION ON PERFORMANCE AGAINST PRE-DETERMINED ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM. THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD HAS REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SUSAN K CURTIS SUNLEY EMPLOYEE; DAUGHTER OF EDGAR J. CURTIS, CEO OF MEMORIAL HEALTH SYSTEM 47,447 MEMORIAL MEDICAL CENTER PAID COMPENSATION OF $47,447 AND BENEFITS OF $8,563 TO SUSAN K. CURTIS SUNLEY RELATED TO EMPLOYMENT SERVICES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010. THE COMPENSATION PAID WAS NEGOTIATED AT ARM'S LENGTH AND REPRESENTS FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(2) SANGAMON EYE ASSOCIATES INC
  		OWNER'S WIFE IS A BOARD MEMBER 543,320 MEMORIAL MEDICAL CENTER LEASED PROPERTY FROM SANGAMON EYE ASSOCIATES, INC. FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $543,320. THE OWNER OF SANGAMON EYE ASSOCIATES, INC. IS THE HUSBAND OF CAROL J. HANSEN POSEGATE, A MEMBER OF THE MEMORIAL MEDICAL CENTER'S BOARD OF DIRECTORS. THE LEASE IS UNDERTAKEN AT ARM'S LENGTH AND IS AT FAIR MARKET VALUE.   No
(3) SORLING NORTHRUP HANNA CULLEN & COCHRAN
  		BOARD MEMBER IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN 140,240 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF SORLING, NORTHRUP, HANNA, CULLEN & COCHRAN, LTD. FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $140,240. WILLIAM R. ENLOW, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN, LTD. ALL FEES ARE NEGOIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(4) SPRINGFIELD CLINIC
  		BOARD MEMBER IS EMPLOYEE OF SPRINGFIELD CLINIC 1,267,774 MEMORIAL MEDICAL CENTER PAID FEES TO SPRINGFIELD CLINIC, LLP FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $1,267,774. A PHYSICIAN OF THIS COMPANY, MICHAEL A. PICK, M.D., IS ALSO A MEMBER OF MEMORIAL MEDICAL CENTER'S BOARD OF DIRECTORS. ALL FEES ARE NEGOTIATED AT ARMS LENGTH AND ARE AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(5) SORLING NORTHRUP HANNA CULLEN & COCHRAN
  		BOARD MEMBER IS A PARTNER AT SORLING, NORTHRUP, HANNA, CULLEN, & COCHRAN 140,240 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF SORLING, NORTHRUP, CULLEN & COCHRAN, LTD FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $140,240. MARK H. FERGUSON, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT SOLING, NORTHRUP, CULLEN & COCHRAN, LTD. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(6) GRANTS MEADOWS ASSOCIATES
  		CURRENT DIRECTOR, MARSHAL HALE, M.D. HAS A 33.33% OWNERSHIP INTEREST 118,268 GRANTS MEADOW ASSOCIATES LEASES A MEDICAL OFFICE BUILDING LOCATED AT 1602 WEST LAFAYETTE, JACKSONVILLE, ILLINOIS TO THE REPORTING ORGANIZATION. THE AMOUNTS TRANSACTED BETWEEN THE REPORTING ORGANIZATION AND GRANTS MEADOW ASSOCIATES REFLECT THE FAIR MARKET VALUE OF GOODS AND SERVICES RECEIVED.   No
(7) BROWN HAY & STEPHENS
  		PAST BOARD MEMBER IS A PARTNER OF BROWN, HAY & STEPHENS LLP 534,500 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF BROWN, HAY & STEPHENS LLP, LTD FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $534,500. DWIGHT H. O'KEEFE, A PAST MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT BROWN, HAY & STEPHENS LLP. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(8) MIDWEST EMERGENCY DEPARTMENT SPECIALISTS
  		BOARD MEMBER IS A KEY EMPLOYEE OF MIDWEST EMERGENCY DEPARTMENT SPECIALISTS 4,279,087 MEMORIAL MEDICAL CENTER PAID FEES TO MIDWEST EMERGENCY DEPARTMENT SPECIALISTS FOR EMERGENCY ROOM SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $4,279,087. DAVID L. GRIFFEN, MD, PHD, A MEMBER OF THE BOARD OF DIRECTORS, IS A KEY EMPLOYEE AT MIDWEST EMERGENCY DEPARTMENT SPECIALISTS. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(9) CRAWFORD MURPHY & TILLY INC
  		BOARD MEMBER IS A PARTNER AT CRAWFORD MURPHY & TILLY 254,598 MEMORIAL MEDICAL CENTER PAID FEES TO THE LAW OFFICE OF CRAWFORD, MURPHY & TILLY, INC FOR LEGAL SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2011 IN THE AMOUNT OF $254,598. CLIFTON R. BAXTER, A MEMBER OF THE BOARD OF DIRECTORS, IS A PARTNER AT CRAWFORD MURPHY & TILLY, INC. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2   MARK H. FERGUSON AND WILLIAM R. ENLOW, BOTH MEMORIAL MEDICAL CENTER BOARD MEMBERS, ARE PARTNERS AT THE SAME LAW FIRM, SORLING, NORTHRUP, HANNA, CULLEN & COCHRAN, LTD.
FORM 990, PART VI, SECTION A, LINE 6   MEMORIAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF THE AFFILIATES REPORTED IN THIS GROUP RETURN. MEMORIAL HEALTH SYSTEM CORPORATION CONTAINS 105 INDIVIDUAL MEMBERS WHO ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11   A FINAL DRAFT COPY OF THE MHS GROUP FORM 990 AND ALL ATTACHMENTS IS PROVIDED TO ALL OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS AND A BOARD COMMITTEE PRIOR TO FILING. AT THE BOARD MEETING, A PRESENTATION IS MADE BY THE CFO TO THE BOARD, FOLLOWED BY A QUESTION AND ANSWER SESSION. PRESENTATIONS ARE MADE TO THE AFFILIATE MEMBERS' BOARDS IN THE SAME TIME FRAME, ALTHOUGH COPIES OF THE COMPLETE FORM 990 AND ALL ATTACHMENTS ARE NOT PROVIDED PRIOR TO THOSE MEETINGS, EXCEPT TO BOARD MEMBERS WHO REQUEST COMPLETE COPIES. ALL QUESTIONS AND COMMENTS ARISING FROM THESE REVIEWS ARE ADDRESSED PRIOR TO SUBMISSION OF THE RETURN TO THE APPROPRIATE TAXING AUTHORITIES.
  FORM 990, PART VI, SECTION B, LINE 12C MEMORIAL HEALTH SYSTEM AND ITS SUBORDINATES MONITOR AND ENFORCE THEIR CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING AGENDA IS PREPARED. 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 MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE MADE UP OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, 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 BOARD 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, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERTO, 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.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -14,492,815. CHANGE IN MINIMUM PENSION LIABILITY 28,385,974. TRANSFERS 3,530,000. OTHER 182,404. TOTAL TO FORM 990, PART XI, LINE 5: 17,605,563.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM GROUP RETURN
 
Employer identification number

90-0756744
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) MEMORIAL EXPRESSCARE LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400528 		PROVIDES NON-EMERGENCY CARE SEVEN DAYS A WEEK WITHOUT APPOINTMENT IL -1,294,013 1,143,614 N/A
(2) HEALTHCARE NETWORK PROPERTIES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
37-1379377 		OWNS MEDICAL OFFICE BUILDINGS IL 5,791,739 26,290,822 N/A
(3) KOKE MILL MEDICAL ASSOCIATESLLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400594 		HEALTHCARE SERVICES IL 10,487,232 1,585,300 N/A
(4) FAMILY MEDICAL CENTER OF CHATHAM LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3405168 		HEALTHCARE SERVICES IL 2,587,460 329,135 N/A
(5) WOMEN'S HEALTHCARE LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400814 		HEALTHCARE SERVICES IL 4,364,809 717,100 N/A
(6) NORTH DIRKSEN MEDICAL ASSOCIATES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-4655201 		HEALTHCARE SERVICES IL 495,822 60,989 N/A
(7) SOUTH SIXTH MEDICAL ASSOCIATES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-4655135 		HEALTHCARE SERVICES IL 342,155 56,072 N/A
(8) CAPITOL HEALTHCARE MEDICAL ASSOCIATES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-4326512 		HEALTHCARE SERVICES IL 2,320,356 347,421 N/A
(9) FAMILY MEDICAL CENTER OF LINCOLN LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400406 		HEALTHCARE SERVICES IL 5,480,236 701,623 N/A
(10) MENARD MEDICAL CENTER LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400715 		HEALTHCARE SERVICES IL 1,710,095 258,369 N/A
(11) JACKSONVILLE LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3400645 		HEALTHCARE SERVICES IL 4,220,639 682,967 N/A
(12) JACKSONVILLE PEDIATRIC ASSOCIATES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
26-3405138 		HEALTHCARE SERVICES IL 2,165,976 290,481 N/A
(13) VINE STREET CLINICAL ASSOCIATES LLC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
45-3180104 		PSYCHIATRIC HEALTHCARE SERVICES IL 0 0 N/A
Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

710 NORTH EIGHTH STREET

SPRINGFIELD,IL62702
37-0646367 		TO SERVE THE MENTALLY ILL, DEVELOPMENTALLY DISABLED, AND THEIR FAMILIES IL 501(C)(3) 170(B)(1)(A)(VI) N/A
 
No












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) HEALTHCARE NETWORK ASSOCIATES OF SANGAMON INC
720 NORTH BOND STREET
SPRINGFIELD,IL62702
36-4156479 		HEALTHCARE ACTIVITIES IL N/A
 C     100.000 %
(2) HEALTHCARE NETWORK ASSOCIATES OF LINCOLN INC
720 NORTH BOND STREET
SPRINGFIELD,IL62702
37-1331904 		HEALTHCARE ACTIVITIES IL N/A
 C     100.000 %
(3) HEALTHCARE NETWORK ASSOCIATES OF CENTRAL ILLINOIS INC
720 NORTH BOND STREET
SPRINGFIELD,IL62702
37-1331905 		HEALTHCARE ACTIVITIES IL N/A
 C     100.000 %
(4) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS INC
701 NORTH FIRST STREET
SPRINGFIELD,IL62781
37-1190216 		PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTS IL N/A
 C 662,483 9,403,015 100.000 %






Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS INC

 N 723,105 COST BASIS
(2) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS INC

 J 165,796 COST - RENTAL EQUIPMENT
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No
(1) RUTLEDGE JOINT VENTURES LLC

115 WEST JEFFERSON SUITE 401BLOOMINGTON,IL61702
37-1359387 		LONG TERM CARE, SKILLED NURSING AND SUB-ACUTE CARE IL
 
No
 2,368,002
 
No
 8,603
 
No
(2) PRAIRIE DIAGNOSTIC CENTER LLC

619 E MASON ST SUITE 4P57SPRINGFIELD,IL62701
20-1258207 		FREE STANDING OUTPATIENT DIAGNOSTIC CARDIOVASCULAR IMAGING FACILITY IL
 
No
 0
 
No
 257
 
No
(3) ORTHOPAEDIC SURGERY CENTER OF ILLINOIS LLC

720 NORTH BOND STREETSPRINGFIELD,IL62702
37-1366377 		AMABULATORY SURGICAL TREATMENT CENTER IL
 
No
 1,283,101
 
No
 12,366
 
No


























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version:  






TY 2010 AffiliateListing
Name:
MEMORIAL HEALTH SYSTEM GROUP RETURN
EIN: 90-0756744

Name Address EIN Name control
MEMORIAL MEDICAL CENTER 701 NORTH FIRST STREET
SPRINGFIELD,  IL  62781
37-0661220
 MEMO
THE ABRAHAM LINCOLN MEMORIAL HOSPITAL 200 STAHLUT DRIVE
LINCOLN,  IL  62656
37-0723793
 ABRA
TAYLORVILLE MEMORIAL HOSPITAL 201 EAST PLEASANT
TAYLORVILLE,  IL  62568
37-0661250
 TAYL
MEMORIAL HEALTH VENTURES 701 NORTH FIRST STREET
SPRINGFIELD,  IL  62781
36-3492266
 MEMO
MEMORIAL HOME SERVICES 720 NORTH BOND
SPRINGFIELD,  IL  62702
37-0714225
 MEMO
MEMORIAL PHYSICIAN SERVICES 701 NORTH FIRST STREET
SPRINGFIELD,  IL  62781
37-1181194
 MEMO
MEMORIAL MEDICAL CENTER FOUNDATION 1 MEMORIAL PLAZA
SPRINGFIELD,  IL  62781
37-1110301
 MEMO
ABRAHAM LINCOLN HEALTHCARE FOUNDATION 200 STAHLUT DRIVE
LINCOLN,  IL  62656
36-3492268
 ABRA
TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION INC 201 EAST PLEASANT
TAYLORVILLE,  IL  62568
37-1337485
 TAYL
SPRINGFIELD RESIDENTIAL SERVICES 710 NORTH EIGHTH STREET
SPRINGFIELD,  IL  62702
37-1298589
 SPRI