TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) STEVEN SOBOL MD DIRECTOR/PHY	40.00	X		1,390,492	15,863
(2) KENNETH SMITHMIER DIRECTOR/PRE	40.00	X	X	717,262	15,863
(3) LARRY ALTENBAUMER DIRECTOR	2.00	X		0	0
(4) JAMES DAHL PHD DIRECTOR	2.00	X		0	0
(5) WALTER SMITH DIRECTOR	2.00	X		0	0
(6) JOHN W FUNK DIRECTOR	2.00	X		0	0
(7) JONATHON T LOCKE MD DIRECTOR	2.00	X		0	0
(8) ROY MOSSER JR DIRECTOR	2.00	X		0	0
(9) JULIAN L MARSH DIRECTOR	2.00	X		0	0
(10) THOMAS KOWA DIRECTOR	2.00	X		0	0
(11) DAVID SMITH DIRECTOR	2.00	X		0	0
(12) ROBIN KING DIRECTOR	2.00	X		0	0
(13) BRAD WIKE DIRECTOR	2.00	X		0	0
(14) SCOTT G STRIGLOS DIRECTOR	2.00	X		0	0
(15) DAVID TYROLT DIRECTOR	2.00	X		0	0
(16) RON DRANE DIRECTOR	2.00	X		0	0
(17) PAULA EISSFELDT DIRECTOR	2.00	X		0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) EDWARD ELLIOT MD DIRECTOR	2.00	X				0	0	0
(19) TIMOTHY D STONE JR EXEC. VP/COO	40.00		X			416,420	0	15,863
(20) MICHAEL ZIA MD VICE PRES.	40.00		X			291,977	0	15,846
(21) LINDA FAHEY VP/CHIEF NUR	40.00		X			244,228	0	3,835
(22) JOHN RIDLEY VICE PRES.	40.00		X			134,351	0	2,256
(23) GARY G PEACOCK SR. VP & CFO	40.00		X			67,503	0	1,935
(24) STEVEN WEBER MD PHYSICIAN	40.00			X		1,425,495	0	15,863
(25) THOMAS FULBRIGHT MD PHYSICIAN	40.00			X		837,975	0	8,153
(26) JOHN WATERS MD PHYSICIAN	40.00			X		816,460	0	15,863
(27) ROBERT KRAUS MD	40.00			X		799,763	0	15,863
(28) MOHAMMED HASNAIN MD PHYSICIAN	40.00			X		758,063	0	15,863
(29) DAVID OPPENLANDER SENIOR VP &	40.00				X	244,958	0	2,452

(A) Name and business address	(B) Description of services	(C) Compensation
DECATUR EMERGENCY MEDICAL SERVICES 334 W ELDORADO DECATUR,IL62522	PHYSICIAN FEES	1,220,000
DENMAN LINEN SERVICES 1801 N 43RD QUINCY,IL62305	LINEN SERVICES	1,178,810
CONSOCIATE GROUP PO 1068 DECATUR,IL62525	INSURANCE SERV	864,704
EXECUTIVE HEALTH RESOURCE PO BOX 822688 PHILADELPHIA,PA19182	CLAIMS REVIEW	743,796
MIDWEST CREDIT 306 W ELDORADO PO BOX 445 DECATUR,IL62525	COLLECTIONS	662,880
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 153

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 United States. See Part IV, line 21	1,400,928	1,400,928
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	3,565,847	1,446,699	2,119,148
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	9,816,614	9,768,537	48,077
7	Other salaries and wages	102,130,700	84,588,945	17,541,755
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,535,214	1,271,529	263,685
9	Other employee benefits .......	19,610,751	16,242,450	3,368,301
10	Payroll taxes ...........	7,292,088	6,039,614	1,252,474
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	714,614		714,614
c	Accounting ...........	781,677		781,677
d	Lobbying ...........	55,784		55,784
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	21,219,270	10,233,104	10,986,166
12	Advertising and promotion ....	961,536	613,039	348,497
13	Office expenses .......	50,899,171	47,357,251	3,541,920
14	Information technology ......	4,663,393	4,275,092	388,301
15	Royalties ..	14,974	14,974
16	Occupancy ...........	10,013,684	6,519,457	3,494,227
17	Travel ............	841,130	616,502	224,628
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	417,214	219,450	197,764
20	Interest ...........	2,421,441	1,576,491	844,950
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	21,645,830	13,582,758	8,063,072
23	Insurance ..............	2,508,375	1,073,029	1,435,346
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	PROVISION FOR BAD DEBT	20,294,160	20,294,160
b	STATE MEDICAID TAX	5,074,056	5,074,056
c	MISCELLANEOUS EXPENSE	2,645,477	2,032,750	612,727
d
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	290,523,928	234,240,815	56,283,113	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	8,707	1	9,347
2	Savings and temporary cash investments .......	20,245,027	2	7,859,163
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	39,437,191	4	43,967,363
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 .............		7
8	Inventories for sale or use ..............	3,323,072	8	3,127,753
9	Prepaid expenses and deferred charges ............	4,750,858	9	3,674,503
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	374,923,477
b	Less: accumulated depreciation. .....	10b	254,746,674	120,095,270	10c	120,176,803
11	Investments—publicly traded securities ..........	168,524,645	11	182,904,905
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	5,638,838	15	6,773,714
16	Total assets. Add lines 1 through 15 (must equal line 34)...	362,023,608	16	368,493,551
	17	Accounts payable and accrued expenses .	35,002,654	17	35,013,222
18	Grants payable ..........		18
19	Deferred revenue ..........	157,437	19	146,195
20	Tax-exempt bond liabilities ..........	40,659,393	20	15,147,000
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	26,976,845	25	30,818,140
26	Total liabilities. Add lines 17 through 25.....	102,796,329	26	81,124,557
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	220,760,235	27	236,946,363
28	Temporarily restricted net assets .....	26,097,630	28	35,813,819
29	Permanently restricted net assets .....	12,369,414	29	14,608,812
	Organizations that do not follow SFAS 117, check here 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 .....	259,227,279	33	287,368,994
34	Total liabilities and net assets/fund balances .....	362,023,608	34	368,493,551

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

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) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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 (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... 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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2

Name of organization DECATUR MEMORIAL HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization DECATUR MEMORIAL HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose 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

(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

(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

(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) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2011

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 if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

23,006

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

32,778

Total. Add lines 1c through 1i ...............................

55,784

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
	SCHEDULE C, PART II-B, LINE 1	A PORTION OF THE MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE ILLINOIS HOSPITAL ASSOCIATION ARE DESIGNATED AS LOBBYING EXPENSES. THE AMOUNT REPORTED ON SCHEDULE C, PART II-B, LINE 1I REPRESENTS THE AMOUNTS SO DESIGNATED.

Schedule C (Form 990 or 990EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

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 .......

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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
1a	Beginning of year balance ....	12,369,414	11,963,360	10,910,741	17,589,403
b	Contributions ........
c	Net investment earnings, gains, and losses ...	3,817,049	406,054	1,977,035	505,233
d	Grants or scholarships .....	504,333		75,407	50,010
e	Other expenditures for facilities and programs ........	1,073,318		849,009	7,133,885
f	Administrative expenses ....
g	End of year balance ......	14,608,812	12,369,414	11,963,360	10,910,741

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,337,264		1,337,264
b	Buildings ................	174,787,426	101,685,663	73,101,763
c	Leasehold improvements ............	2,033,382	10,981	2,022,401
d	Equipment ................	187,777,569	147,358,513	40,419,056
e	Other .................	8,987,836	5,691,517	3,296,319
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				120,176,803

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes
CAPITAL LEASE OBLIGATIONS		14,125,001
MALPRACTICE INSURANCE		6,256,473
PENSION LIABILITY		4,464,806
DEFERRED TRUST		3,767,157
FUTURE RENT PAYMENTS		917,917
RETIREE HEALTH PLAN		736,727
RESERVE FOR A/R NOT ON BOOKS		550,059
DEFERRED ILLINOIS PROVIDER TAX
CAPTIVE INSURANCE
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		30,818,140
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) 2011

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 through 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 must 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 must 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
INTENDED USES FOR ENDOWMENT FUNDS	SCHEDULE D, PAGE 2, PART V, LINE 4	THE ENDOWMENT FUNDS ARE USED FOR CAPITAL PURCHASES, SCHOLARSHIPS, AND ASSISTING INDIGENT PEOPLE WITH THEIR HOSPITAL BILLS.
LIABILITY UNDER FIN 48 FOOTNOTE	SCHEDULE D, PAGE 3, PART X	THE SYSTEM HAD NO UNCERTAIN POSITIONS IN INCOME TAX LIABILITIES OR EXPENSES.

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2011

Open to Public Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other 600.000 %

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	12,281,839		12,281,839	4.540 %
b Medicaid (from Worksheet 3, column a) .....	29,771,344	10,599,981	19,171,363	7.090 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....	42,053,183	10,599,981	31,453,202	11.630 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	690,322		690,322	0.260 %
f Health professions education (from Worksheet 5) ..	2,076,635		2,076,635	0.770 %
g Subsidized health services (from Worksheet 6) ..	1,387,738		1,387,738	0.510 %
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	20,800		20,800	0.010 %
jTotal Other Benefits ...	4,175,495		4,175,495	1.550 %
kTotal. Add lines 7d and 7j. ..	46,228,678	10,599,981	35,628,697	13.180 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members	500	500
6	Coalition building
7	Community health improvement advocacy	38,000	38,000	0.010 %
8	Workforce development
9	Other	61,280	61,280	0.020 %
10	Total	99,780	99,780	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense........

5,956,336

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

162,398

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

Enter total revenue received from Medicare (including DSH and IME).....

75,441,549

Enter Medicare allowable costs of care relating to payments on line 5.....

76,183,567

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-742,018

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1DECATUR DIG DISEASE	AMBULATORY ENDOSCOPY CENTER	50.000 %	50.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

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Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	DECATUR MEMORIAL HOSPITAL 2300 N EDWARD ST DECATUR,IL62526	X	X	X	ACUTE CARE & LONG TERM CARE

Schedule H (Form 990) 2011

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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)

DECATUR MEMORIAL HOSPITAL

Name of Hospital Facility:

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 2011)
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	Yes
	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 the community health 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 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 10
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	Yes
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		No
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5	Yes
	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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and the reasons why it has not addressed such needs. ....		7	Yes
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

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Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 600.0% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

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Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	DMH MEDICAL GROUP 2300 N EDWARD ST DECATUR,IL62526	OUTPATIENT CLINICS
2	SOUTH SHORES IMAGING CENTER 1689 S FRANKLIN ST DECATUR,IL62521	DIAGNOSTIC CENTER
3	CENTRAL ILLINOIS SURGERY CENTER 304 W HAY SUITE 114 DECATUR,IL62526	AMBULATORY SURGERY CENTER
4	FORSYTH IMAGING CENTER 389 W WEAVER ROAD FORSYTH,IL62535	DIAGNOSTIC CENTER
5	DECATUR DIGESTIVE DISEASE CENTER 2 MEMORIAL DR PHYS PLAZA WEST SUITE 102 DECATUR,IL62526	AMBULATORY ENDOSCOPY CENTER
6	DMH CORPORATE HEALTH SERVICES 2122 NORTH 27TH ST DECATUR,IL62526	OUTPATIENT CLINIC
7	DMH HOME HEALTH CARE 3122 BRETTWOOD CIRCLE DECATUR,IL62526	HOME HEALTH AGENCY
8	SPORTS ENHANCEMENT CENTER 2122 NORTH 27TH ST DECATUR,IL62526	PHYSICAL THERAPY
9	DMH HOSPICE 3122 BRETTWOOD CIRCLE DECATUR,IL62526	HOSPICE AGENCY
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE	PART I LINE 3C	AS INDICATED THE HOSPITAL USES FEDERAL POVERTY GUIDELINES ADDITIONALLY THERE MAY BE INSTANCES WHERE PATIENTS HAVE INCURRED A FINANCIAL HARDSHIP BUT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE GUIDELINES SUCH CASES ARE REVIEWED INDIVIDUALLY AND WHERE DEEMED APPROPRIATE EARNINGS ON RESTRICTED FUNDS ARE USED TO PAY THE PATIENTS BILLS
RELATED ORGANIZATION INFORMATION	PART I LINE 6A	THE HOSPITAL PREPARES THE ANNUAL COMMUNITY BENEFIT REPORT UNDER ITS OWN NAME
SUBSIDIZED HEALTH SERVICES EXPLANATION	PART I LINE 7G	THE HOSPITAL DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE	PART I LINE 7 COLUMN F	BAD DEBT EXPENSE INCLUDED ON FORM 990 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON LINE 7 COLUMN F IS 20294160
COSTING METHODOLOGY EXPLANATION	PART I LINE 7	THE HOSPITAL DERIVED ALL NUMBERS IN LINE 7 FROM THE APPLICABLE IRS WORKSHEETS USING THE RATIO OF PATIENT COSTTOCHARGES
COMMUNITY BUILDING ACTIVITIES	PART II	PART VI LINE 5 LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS DMH IS AN AVID SUPPORTER OF DEVELOPING LEADERS IN OUR COMMUNITY FOR EXAMPLE DMH DONATED 500 TO SCOUTREACH THE SCOUTREACH DIVISION OF THE BOY SCOUTS OF AMERICA EMPHASIZES SERVICE TO RURAL AND URBAN AREAS AND TO MINORITY POPULATIONS COMMUNITY HEALTH IMPROVEMENT ADVOCACY DMH DONATED 38000 TO QUALITY QUEST HEALTH OF ILLINOIS INC A NOTFORPROFIT INDEPENDENT SOURCE OF UNBIASED INFORMATION ON LOCAL HEALTHCARE QUALITY QUEST IDENTIFIES BEST PRACTICE CARE STANDARDS CARE THAT IS PROVEN BY SCIENCE TO BE EFFECTIVE BENEFICIAL AND VALUABLE AND THEY MEASURE PERFORMANCE TO DETERMINE HOW LOCAL HEALTHCARE PROVIDERS COMPARE AGAINST STANDARDS OF CARE THE GOAL IS TO IMPROVE THE QUALITY OF CARE IN OUR STATE REDUCE WASTE AND GET THE BEST VALUE FOR THE MONEY SPENT ON HEALTHCARE OTHER DMH SUPPORTS THE LOCAL HOMELESS SHELTER BY PROVIDING 61480 IN FOOD CONTRIBUTIONS OVER THE FISCAL YEAR DMH UNDERSTANDS THAT FEEDING THE HUNGRY SUPPORTS THE HEALTH OF THE INDIVIDUALS SERVED BY THE HOMELESS SHELTER DMH SUPPORTED THE LOCAL MACON COUNTY HEALTH DEPARTMENT BY DONATING AN EXAM TABLE VALUED AT 800
BAD DEBT EXPENSE EXPLANATION	PART III LINE 4	FOOTNOTE DESCRIBING BAD DEBT NOTE THAT THE AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A SEPARATE FOOTNOTE WHICH APPLIED SOLELY TO BAD DEBT THE FOLLOWING IS AN EXCERPT FROM A BROADER FOOTNOTE CONTAINED IN THE FINANCIAL STATEMENTS THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDING PROVISIONS FOR BAD DEBT MANAGEMENT RELIES ON HISTORICAL EXPERIENCE ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES AND RECOMMENDATIONS MADE BY THE SYSTEMS EXTERNAL ADVISORS AND ACTUARIES IN MAKING JUDGMENTS AND ESTIMATES ACTUAL RESULTS COULD DIFFER FROM THOSE ESTIMATES LINE 2 OF PART III WAS CALCULATED USING THE HOSPITAL WIDE COSTTOCHARGE RATIO FROM THE APPLICABLE IRS WORKSHEET PROVISIONS FOR BAD DEBT EXPENSE ARE CALCULATED BY TAKING THE NET ACCOUNTS RECEIVABLE BY PAYOR CLASS WHICH IS SEGREGATED INTO 10 TIME PERIOD BUCKETS AND MULTIPLYING EACH BUCKET BY A CALCULATED PRIOR YEAR ACTUAL BAD DEBT EXPENSE PERCENT LINE 3 OF PART III WAS CALCULATED AS FOLLOWS THE HOSPITAL USED 20072011 AMERICAN COMMUNITY 5 YEAR ESTIMATES DATA FROM THE CENSUS BUREAU TO ESTIMATE THE PERCENTAGE OF ITS PATIENT POPULATION WHOSE HOUSEHOLD INCOME WAS UNDER ITS FULL CHARITY CARE ELIGIBILITY CRITERIA OF 200 OF THE FEDERAL POVERTY GUIDELINES FPG THIS PERCENTAGE WAS APPLIED TO THE HOSPITALS CHARGES TO ESTIMATE THE AMOUNT OF GROSS CHARGES THAT MET ITS FINANCIAL ASSISTANCE GUIDELINES THE HOSPITAL THEN SUBTRACTED THE CHARGES RELATED TO THE PATIENTS THAT WERE ELIGIBLE FOR GOVERNMENTAL ASSISTANCE PROGRAMS SUCH AS MEDICAID HOSPITAL CHARITY CARE ADJUSTMENTS WERE ALSO REMOVED BECAUSE THEY TOO WOULD NOT HAVE RESULTED IN BAD DEBTS THE REMAINING CHARGES RELATED TO UNINSURED PATIENTS WITH HOUSEHOLD INCOMES BELOW 200 OF FPG AND IT IS REASONABLE TO ASSUME THAT THEY RESULTED IN BAD DEBTS THIS TOTAL WAS THEN MULTIPLIED BY THE RATIO OF COSTSTOCHARGES FROM THE APPLICABLE IRS WORKSHEET TO CALCULATE THE COST OF PROVIDING THESE SERVICES THE HOSPITALS METHODOLOGY MOST LIKELY RESULTED IN A VERY CONSERVATIVE ESTIMATE FOR A NUMBER OF REASONS FIRST IT EXCLUDES THE PATIENTS ABOVE 200 OF THE FPG THAT WERE ELIGIBLE FOR PARTIAL CHARITY ASSISTANCE FURTHERMORE THE ACTUAL 2011 PERCENTAGE OF THE HOSPITALS PATIENT BASE BELOW THE 200 OF FPG WAS LIKELY HIGHER THAN CENSUS ESTIMATES USED IN THIS CALCULATION DUE TO THE IMPACT OF THE RECENT RECESSION THEREFORE THE AMOUNT REPORTED IN PART III LINE 3 IS VERY CONSERVATIVE AND LIKELY LESS THAN THE THE ACTUAL AMOUNT OF BAD DEBT EXPENSE THAT COULD HAVE QUALIFIED FOR CHARITY ASSISTANCE HAD THE HOSPITAL RECEIVED A CHARITY CARE APPLICATION FURTHER FOR THIS TAX YEAR THE AMERICAN COMMUNITY 5 YEAR ESTIMATE OF HOUSEHOLDS BELOW 200 FPG DROPPED FROM 157 TO 15 WHICH IS A 446 DECREASE WHILE THE MEDICAID AND CHARITY CARE CHARGES DROPPED ONLY 26 THESE CHANGES SIGNIFICANTLY REDUCED LINE 3 OF PART III FOR THIS TAX YEAR
MEDICARE EXPLANATION	PART III LINE 8	THE HOSPITAL USED THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT IN CALCULATING THE AMOUNT ON LINE 6 OF PART III THE HOSPITAL DID RECOGNIZE THE SHORTFALL REPORTED IN PART III LINE 7 IN ITS COMMUNITY BENEFIT REPORT THE SHORTFALL IS INCLUDED IN THE GOVERNMENTSPONSORED PROGRAM SERVICES LINE OF THE COMMUNITY BENEFIT REPORT THE GOVERNMENTSPONSORED PROGRAM SERVICES LINE IS NOT INCLUDED IN SCHEDULE H
COLLECTION PRACTICES EXPLANATION	PART III LINE 9B	THE HOSPITAL WILL NOT SEND A PATIENTS ACCOUNT TO A THIRDPARTY COLLECTION AGENCY PRIOR TO MAKING GOOD FAITH EFFORTS TO DETERMINE A PATIENTS ELIGIBILITY FOR FINANCIAL ASSISTANCE THE HOSPITAL WILL USE GOOD FAITH EFFORTS TO DETERMINE WHETHER A PATIENT IS INSURED PRIOR TO INITIATING ANY COLLECTION ACTION THE HOSPITAL WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF BILLS FOR ANY PATIENT RECEIVING FINANCIAL ASSISTANCE SO LONG AS SUCH PATIENT IS MAKING PAYMENTS IN ACCORDANCE WITH HISHER ESTABLISHED PAYMENT PLAN AS SET FORTH IN A PAYMENT AGREEMENT IN THE EVENT THE PATIENT IS UNABLE TO MAINTAIN SUCH PAYMENTS THE HOSPITAL WILL CONTACT THE PATIENT TO DETERMINE WHETHER AN ADJUSTMENT IS APPROPRIATE NOTWITHSTANDING THE FOREGOING THE HOSPITAL MAY TAKE LEGAL ACTION AGAINST PATIENTS RECEIVING FINANCIAL ASSISTANCE TO ENFORCE THE TERMS OF AN EXISTING PAYMENT PLAN WHERE THERE IS EVIDENCE THAT THE PATIENT OR HISHER FAMILY ANDOR GUARANTOR IF APPLICABLE HAS SUFFICIENT INCOME AND ASSETS TO MEET HISHER OBLIGATIONS UNDER THE EXISTING PAYMENT PLAN PROVIDED HOWEVER THE HOSPITAL WILL NOT PURSUE LEGAL ACTION FOR NONPAYMENT OF BILLS AGAINST ANY PATIENT RECEIVING FINANCIAL ASSISTANCE WHO HAS CLEARLY DEMONSTRATED THAT SHE DOES NOT HAVE SUFFICIENT INCOME AND ASSETS TO MEET HISHER FINANCIAL OBLIGATIONS TO THE HOSPITAL NOTWITHSTANDING THE FOREGOING THE HOSPITALS DEBT COLLECTION POLICY PLACES A MAXIMUM AMOUNT BASED UPON ANNUAL HOUSEHOLD PRETAX INCOME AND CASH BENEFITS FROM ALL SOURCES WITH CERTAIN ADJUSTMENTS THAT THE HOSPITAL OR ITS DESIGNATED THIRDPARTY COLLECTION AGENCY MAY COLLECT IN ANY TWELVE 12 MONTH PERIOD FOR HOSPITAL SERVICES FROM A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE
NEEDS ASSESSMENT	PART VI	PART VI LINE 2 NEEDS ASSESSMENT DECATUR MEMORIAL HOSPITAL HAS PROVIDED PERSONNEL TIME AND RESOURCES TO ASSIST IN THE MACON COUNTY HEALTH DEPARTMENT PLANNING PROCESSES INFORMATION DEFINING OUR SPECIFIC HEALTH ISSUES HAS BEEN OBTAINED THROUGH VARIOUS COMMUNITY MEETINGS AND ASSESSMENTS AS WELL AS INPUT FROM OUR PUBLIC AND COMMUNITY BOARD OF DIRECTORS FURTHER INFORMATION IS COLLECTED FROM CENSUS SURVEYS NATIONAL AND LOCAL HEALTH SURVEYS AND VARIOUS REPORTS PUBLISHED THROUGHOUT THE YEAR EMPLOYEES OF THE HOSPITAL VOLUNTEER TIME TO SERVE ON MANY LOCAL HEALTH COMMITTEES AND VOLUNTEER TO PARTICIPATE IN HEALTH FAIRS COMMUNITY HEALTH EVENTS AND OTHER COMMUNITY ORGANIZATIONS INCLUDING LEADERSHIP POSITIONS ON NOTFORPROFIT AND CIVIC BOARDS OF DIRECTORS SUCH AS THE UNITED WAY MACON COUNTY HEALTH DEPARTMENT DECATUR ECONOMIC DEVELOPMENT BOARD CENTRAL ILLINOIS HEALTH INFORMATION EXCHANGE BOARD OBESITY PREVENTION COALITION OF MACON COUNTY COME TOGETHER LETS WALK AND THE AMERICAN CANCER SOCIETY RELAY FOR LIFE FOR THE PAST FIFTEEN YEARS DMH HAS SPONSORED A DAY FOR HEARTS WITH SCREENINGS AND HEART EDUCATION FOR THE COMMUNITY ALL THESE INTERACTIONS CONTRIBUTE TO OUR UNDERSTANDING OF THE VARIOUS HEALTH CARE NEEDS OF OUR COMMUNITY COLON PROSTATE AND BREAST CANCER AWARENESS AND SCREENING PROGRAMS ATTEMPT TO IMPROVE CANCER SCREENING EARLY DIAGNOSIS AND IMPROVED OUTCOMES THE HEALTH ASSESSMENTS WE HAVE PERFORMED OVER THE PAST SEVERAL YEARS HAVE ALL INDICATED THE FOLLOWING SIGNIFICANT HEALTH CARE ACCESS AND PROVISION NEEDS WITHIN THE COMMUNITY ACCESS TO PRIMARY CARE PHYSICIANS AND SPECIALTISTS EVALUATION OF THE PHYSICIAN POPULATION RATIOS IN MACON COUNTY INDICATE THAT DECATUR IS UNDERSERVED IN SEVERAL SPECIALISTS BASED ON THIS INFORMATION DECATUR MEMORIAL HOSPITAL HAS RECRUITED AND CONTINUES TO RECRUIT PRIMARY AND SPECIALIST PHYSICIANS TO THE COMMUNITY COSTS OF RECRUITMENT ARE GENERALLY BORN BY THE HOSPITAL AND AMOUNTED TO SEVERAL HUNDRED THOUSAND DOLLARS LAST YEAR LAST YEAR THE HOSPITAL RECRUITED FIVE PHYSICIANS AND FIVE MIDLEVEL PRACTIONERS TO THE COMMUNITY DECATUR MEMORIAL HOSPITAL ALSO SIGNIFICANTLY SUPPORTS THE SOUTHERN ILLINOIS UNIVERSITY FAMILY PRACTICE RESIDENCY PROGRAM WHICH GRADUATES UP TO SIX FAMILY PRACTITIONERS PER YEAR THE RETENTION RATE OF THE GRADUATES WITHIN CENTRAL ILLINOIS AREA HAS BEEN VERY HIGH SUPPORT FOR THE RESIDENCY PROGRAM COSTS IN EXCESS OF 3000000 A YEAR OUR EMPLOYED PHYSICIANS CONTRIBUTE VOLUNTEER TEACHING HOURS TOWARDS RESIDENT TRAINING IN ADDITION TO PHYSICIANS IT HAS BECOME APPARENT OTHER HEALTH CARE PROFESSIONALS ARE ALSO IN VERY SHORT SUPPLY PROVISION OF ADEQUATE COMMUNITY HEALTH DEPENDS ON AN ADEQUATE SUPPLY OF SUCH PROFESSIONALS AS SUCH DECATUR MEMORIAL HOSPITAL HAS VOLUNTEERED HOURS ON PLANNING AND CURRICULUM DESIGN AT OUR TWO NURSING SCHOOLS AND CONTRIBUTES OVER 2500 HOURS OF UNCOMPENSATED TEACHING AND CLINICAL EXPERIENCE TO NURSING STUDENTS IN THE DECATUR NURSING PROGRAMS ADDITIONAL TRAINING PROGRAMS FOR OTHER ALLIED HEALTH PROFESSIONALS HAVE ALSO BEEN UNDERTAKEN AND SUPPORTED BY DECATUR MEMORIAL HOSPITAL THE HOSPITAL ALSO SUPPORTS THE PARISH NURSE PROGRAM THIS PROGRAM HAS SUBSTANTIALLY IMPROVED THE ABILITY OF COMMUNITY MEMBERS TO OBTAIN BASIC HEALTH INFORMATION AND SCREENING FROM TRAINED PARISH NURSES CARDIAC SCREENINGS RECOGNIZING THAT CORONARY HEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN MACON COUNTY DECATUR MEMORIAL HOSPITAL OFFERS FREE BLOOD PRESSURE AND CHOLESTEROL SCREENINGS TO THE COMMUNITY FURTHER TO ASSIST THOSE PATIENTS WHO ARE LIVING WITH THE DIAGNOSIS OF HEART FAILURE DMH PROVIDES A FREE HEART FAILURE PROGRAM THE HEART FAILURE PROGRAM UTILIZIES TELEMONITORING IN ORDER TO TRACK DAILY WEIGHTS BLOOD PRESSURE OXYGEN READINGS OF 7080 HEART FAILURE PATIENTS WITH A GOAL OF IMPROVED CHRONIC DISEASE MANAGEMENT AND REDUCED HOSPITALIZATIONS THE EQUIPMENT IS DELIVERED TO THE HOME AND CLIENTS ARE TRAINED TO TAKE DAILY REDINGS WHICH ARE TRANSMITTED VIA ACCESS POINT TO A SECURE INTERNET WEBSITE A TRAINED NURSE ACCESSES THE WEBSITE DAILY TO EVALUATE EACH CLIENTS READINGS FOR THE DAY A CALL IS MADE IF THERE ARE CHANGES IN THE DATA AND QUESTIONS ASKED ABOUT ASSOCIATED SYMPTOMS IF THERE IS A NEED FOR FURTHER EDUCATION IT IS PROVIDED IN A WAY THAT IS RELEVANT TO THE CLIENTS SITUATION IF IT IS DETERMINED TO BE A SIGN OF RELAPSE A CALL IS MADE TO THE PHYSICIAN FOR FURTHER ACTION A MONTLY SUMMARY OF EACH CLIENTS READINGS AND ACTIVITY IS FAXED TO THE PHYSICIAN AT THE FIRST OF EACH MONTH IN ADDITION TO DAILY MONITORING A QUARTERLY NEWSLETTER IS SENT TO CLIENTS TO PROVIDE FURTHER EDUCATION ABOUT THE CONDITION TREATMENT AND SYMPTOMS OF HEART FAILURE THIS PROGRAM IS PROVIDED TO PATIENTS WITH HEART FAILURE WHO ARE REFERRED BY THEIR PHYSICIAN AT NO COST TO THE PATIENT ANOTHER PART OF THE HEART FAILURE PROGRAM INVOLVES COLLABORATION WITH THE PROJECT BOOST TEAM IN EVALUATION OF INPATIENTS WHO HAVE THE DIAGNOSIS OF HEART FAILURE WHEN APPROPRIATE THE TELEMONITOR IS OFFERED TO THE PATIENT FOR THE PATIENT RETURNING HOME AFTER HOSPITALIZATION WITHOUT HOME HEALTH CARE OR THE TELEMONITOR A PHONE CALL IS MADE TO REINFORCE EDUCATION GIVEN IN THE HOSPITAL AND ENSURE THE PATIENT UNDERSTANDS MEDICATIONS SIGNS AND SYMPTOMS OF EXACERBATION LOW SALT DIET AND FLUID INTAKE AND TO CONFIRM THAT FOLLOW UP APPOINTMENTS ARE MADE OBESITY MACON COUNTY HAS THE HIGHEST OBESITY STATISTICS IN THE STATE OF ILLINOIS THE INCIDENCE OF OBESITY IN MACON COUNTY AS WELL AS THROUGHOUT THE COUNTRY IS ON THE RISE DECATUR MEMORIAL HOSPITAL PROVIDES EDUCATIONAL PROGRAMS RELATED TO WEIGHT AND WEIGHT CONTROL AND HAS INSTITUTED A COMPREHENSIVE WEIGHT MANAGEMENT AND BARIATRIC PROGRAM TO ASSIST THE MEMBERS OF THE COMMUNITY IN APPROPRIATE WEIGHT LOSS METHODS PROFESSIONAL DMH STAFF MEMBERS ATTEND NUMEROUS HEALTH FAIR EVENTS THROUGHOUT THE YEAR AND ARE AVAILABLE TO PROVIDE INFORMATIONAL TOPICS ON WEIGHT MANAGEMENT AND HEALTHY LIFESTYLES TO AREA RESIDENTS DMH OFFERS MONTHLY SUPPORT GROUPS FOR WEIGHT MANAGEMENT AND BARIATRIC PATIENTS THE DMH WELLNESS CENTER HOLDS A 5K RACE FOR WEIGHT MANAGEMENT CLIENTS AND COMMUNITY MEMBERS AS AN ANNUAL EXERCISE EVENT DIABETES LIFETIME RISK FOR DEVELOPING DIABETICS IN THIS COUNTRY IS NOW APPROACHING 40 LOWER SOCIAL ECONOMIC GROUPS HAVE ADDITIONAL CHALLENGES IN TERMS OF APPROPRIATE DIET CONTROL AND EDUCATION DECATUR MEMORIAL HOSPITAL PROVIDES DIABETIC EDUCATION AND COMMUNITY PROGRAMS DMH OFFERS A 10HOUR COMPREHENSIVE DIABETES EDUCATION PROGRAM THAT IS ACCREDITED BY THE AMERICAN DIABETES ASSOCIATION OUR DIABETES EDUCATORS ARE AVAILABLE TO OFFER EDUCATIONAL PRESENTATIONS TO COMMUNITY MEMBERS AND ATTEND VARIOUS HEALTH FAIRS IN THE COMMUNITY TO SHARE INFORMATION ABOUT DIABETES AND TO GIVE INFORMATION ABOUT OUR PROGRAMS THAT ARE AVAILABLE FOR DIABETES EDUCATION THE DIABETES EDUCATORS HAVE DEVELOPED A PREDIABETES EDUCATION PROGRAM AND HAVE PARTNERED WITH THE DECATUR YMCA TO OFFER A SIXWEEK PROGRAM THERE AS WELL AS AT DMH DMH ALSO OFFERS A MONTHLY DIABETES SUPPORT GROUP FOR COMMUNITY MEMBERS INDIGENT OUTPATIENT LONGITUDINAL CARE DECATUR MEMORIAL HOSPITAL HAS SUPPORTED THE COMMUNITY HEALTH IMPROVEMENT CENTER CHIC THEIR PRIMARY PATIENT BASE IS THE LOWER SOCIAL ECONOMIC GROUP OF PATIENTS OUR HOSPITALIST SERVICE CARES FOR ALL CHIC PEDIATRIC INPATIENTS AS WELL AS NEWBORNS WITHOUT A PHYSICIAN THE COST OF AMBULANCE AND TAXI FARES ARE PAID BY DMH WHEN SUCH TRANSPORTATION IS REQUIRED FOR THE CARE OF PATIENTS WITHOUT THE MEANS TO PAY FOR SUCH SERVICES ALSO FOR A NOMINAL 10 PER YEAR MEMBERS OF OUR COMMUNITY MAY ACCESS ALL THE SERVICES OF OUR PRIME TIME PROGRAM INCLUDING VAN TRANSPORTATION DUE TO THE HIGH PERCENTAGE OF INDIGENT PATIENTS SEEN IN OUR EMERGENCY ROOM DECATUR MEMORIAL HOSPITAL PROVIDES A SUBSTANTIAL SUBSIDY TO THE EMERGENCY ROOM PHYSICIANS IN ORDER TO ALLOW THEM TO PROVIDE COMPETITIVE SALARIES TO THE PROVIDERS ONCOLOGY SCREENINGS HEALTH FAIRS AND MORE DECATUR MEMORIAL HOSPITAL PARTICIPATES IN A LOCALLY SPONSORED EVENT CALLED COME TOGETHER LETS WALK THIS EVENT WHICH WAS CREATED OUT OF A GRASSROOTS EFFORT BY LOCAL VOLUNTEERS SERVES AS A FUNDRAISER FOR BREAST OVARIAN AND CERVICAL CANCER PATIENTS PROCEEDS FROM THIS EVENT ARE USED TO HELP FINANCE CANCER PREVENTION AND SCREENING PROGRAMS FOR WOMEN IN OUR COMMUNITY DMH CANCER RESEARCH AND DMH WOMENS HEALTH CENTER ALSO RECEIVE SUPPORT FROM THESE FUNDS FOR OUTREACH PROGRAMS THE DMH CANCER CARE INSTITUTE ALONG WITH CARPENTERS LOCAL 742 AND THE MACON COUNTY HEALTH DEPARTMENT SPONSOR A FREE PROSTATE CANCER SCREENING EVENT EVERY YEAR IN SEPTEMBER FOR PROSTATE CANCER AWARENESS MONTH APPROXIMATELY 300 MEN RECEIVE PSA BLOOD TESTING AND DIGITAL RECTAL EXAMS FREE OF CHARGE RESULTS ARE SCREENED AND SENT TO THE PATIENTS PHYSICIAN OF CHOICE THE DMH CANCER CARE INSTITUTE PARTICIPATES IN SEVERAL CORPORATE HEALTH FAIRS DURING THE YEAR WHERE CANCER PREVENTION EDUCATIONAL MATERIALS ARE HANDED OUT THE DMH CANCER CARE INSTITUTE ALSO PROVIDES AWARENESS OF SKIN CANCER USING THE DERMASCAN SCREENING TOOL THIS UNIT ALLOWS PARTICIPANTS TO VI
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	PART VI	PART VI LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE DECATUR MEMORIAL HOSPITALS BUSINESS OFFICE HAS FOUR FINANCIAL COUNSELORS WHO REVIEW PATIENT ACCOUNTS FOR POSSIBLE CHARITYFINANCIAL ASSISTANCE CONSIDERATION THE HOME PAGE OF THE HOSPITALS WEBSITE WWWDMHCARESCOM CONTAINS LINKS TO ALL INFORMATION CONCERNING THE CHARITY CARE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE POLICIES PATIENT FINANCIAL WORKSHEET FORMS AND PAYMENT AGREEMENT FORMS POSTERS ARE PLACED IN OUR PATIENT REGISTRATION AREA IN VISIBLE LOCATIONS WHERE PATIENTS AND THEIR FAMILIES CAN SEE THEM THESE POSTERS ARE 24 BY 31 IN ADDITION TO OUR PATIENT REGISTRATION AREA IN KIRKLAND LOBBY WE ALSO PLACED POSTERS IN OUR EMERGENCY CARE CENTER AND IN OUR IMAGING CENTERS IN SOUTH SHORES AND FORSYTH TENT CARDS AND PATIENT BROCHURES ARE PLACED IN THE PATIENT REGISTRATION BOOTHS ACCESSIBLE TO ALL PATIENTS AND THEIR FAMILIES PATIENT ACCOUNT STATEMENTS INCLUDE THE PHONE NUMBER FOR THE FINANCIAL COUNSELORS TO DISCUSS PAYMENT PLAN OPTIONS
COMMUNITY INFORMATION	PART VI	PART VI LINE 4 POPULATIONS AND COMMUNITIES SERVED DECATUR MEMORIAL HOSPITAL IS LOCATED IN DECATUR ILLINOIS THE CITY HAS A 2010 CENSUS POPULATION OF 76000 WHICH REPRESENTS A POPULATION DECLINE OF 58 SINCE 2000 MACON COUNTY WITHIN WHICH IT RESIDES HAS A POPULATION OF APPROXIMATELY 110750 THE OVERALL MARKET AREA FOR DECATUR MEMORIAL HOSPITAL INCLUDES APPROXIMATELY 250000 RESIDENTS THE DEMOGRAPHICS OF MACON COUNTY INDICATE AN AGING POPULATION PROJECTIONS FOR THE NEXT TEN YEARS SUGGEST RELATIVELY FLAT POPULATION GROWTH WITH A CONTINUED GRADUAL INCREASE IN THE AGED POPULATION THERE ARE APPROXIMATELY 20000 MEDICAID RECIPIENTS LOCATED IN MACON COUNTY MEDICAID ELIGIBLE PERSONS ARE EXPECTED TO INCREASE BY APPROXIMATELY 6000 WITH THE EXPANDED CRITERIA OF HEALTHCARE REFORM MEDICARE IS THE LARGEST INPATIENT CARE PAYOR CATEGORY THE UNEMPLOYMENT RATE IN THE DECATUR METRO AREA TENDS TO BE HIGHER THAN THE US AVERAGE RECENT JOB GROWTH WAS 034 THE POVERTY RATE FOR MACON COUNTY IS 150 AND 209 FOR DECATUR COMPARED TO AN ILLINOIS STATE RATE OF 131
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE	PART VI	PART VI LINE 5 BACKGROUND DECATUR MEMORIAL HOSPITAL SINCE ITS INCEPTION IN 1916 HAS CONTINUOUSLY RESPONDED TO THE HEALTH CARE NEEDS OF COMMUNITIES IT SERVES AS AN INDEPENDENT COMMUNITY HOSPITAL WITH A LOCAL COMMUNITY BOARD OF DIRECTORS THE HOSPITAL HAS ALWAYS HAD AS ITS PRIMARY FOCUS THE HEALTH CARE NEEDS OF DECATUR MACON COUNTY AND SURROUNDING COUNTIES AS PART OF ITS OVERALL MISSION DECATUR MEMORIAL HOSPITAL HAS CONTINUOUSLY PROVIDED BOTH INTELLECTUAL AND FINANCIAL RESOURCES TO OUR COMMUNITIES FOR EXPERTISE AND ASSISTANCE IN ASSESSMENT OF HEALTH CARE NEEDS SUPPORT OF VARIOUS COMMUNITY SERVICES AND AGENCIES IN ADDRESSING THE IDENTIFIED NEEDS AND THE CONTINUAL HEALTH EDUCATION OF PATIENTS THE COMMUNITY AND THE OTHER RELEVANT PUBLICS DECATUR MEMORIAL HOSPITAL HAS PARTICIPATED DIRECTLY IN CHARITY AND INDIGENT CARE FOR A SIGNIFICANT SEGMENT OF OUR COMMUNITY GOALS AND OBJECTIVES FOR PROVIDING COMMUNITY BENEFITS DECATUR MEMORIAL HOSPITAL HAS EMBRACED THE PHILOSOPHY THAT TO IMPROVE THE HEALTH OF PEOPLE AN ORGANIZATION MUST BECOME INVOLVED IN THE EDUCATION AWARENESS AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT A PERSONS HEALTH STATUS WE STRIVE TO GIVE COMMUNITY RESIDENTS TOOLS TO EMPOWER THEM TO MAKE LIFESTYLE DECISIONS THAT WILL MAINTAIN AND ENHANCE A DESIRABLE QUALITY OF LIFE TO HELP PEOPLE REACH THIS GOAL DECATUR MEMORIAL HOSPITAL SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE COMMUNITY WE ACTIVELY SUPPORT LOCAL HEALTH CARE EDUCATION PROGRAMS HEALTH FAIRS SCREENINGS AND LOCAL ACCESS TO ADVANCED CARE DECATUR MEMORIAL HOSPITAL IS AND ALWAYS HAS BEEN VERY MINDFUL OF ITS MISSION REGARDING CHARITY CARE BY HOSPITAL POLICY THE THRESHOLD FOR THE PROVISION OF CHARITY CARE IS VERY LIBERAL AND WAS FURTHER EXPANDED IN FISCAL 2009 TO SIX TIMES THE FEDERAL POVERTY GUIDELINES FOR PATIENTS WHOSE INCOME IS ABOVE THESE THRESHOLDS WE REVIEW THE PERTINENT FACTORS INCLUDING THE MAGNITUDE OF THE BILL AND THE INDIVIDUALS FINANCIAL SITUATION AND OFFER A SLIDING SCALE DISCOUNT AND EXTENDED PAYMENT TERMS TO THOSE INDIVIDUALS APPROVAL OR DENIAL OF THESE GUIDELINES IS MADE WITHOUT REGARD TO RACE CREED NATIONAL ORIGIN SEX OR AGE THE HOSPITAL DOES NOT PLACE LIMITS ON THE AGGREGATE AMOUNTS OF CHARITY CARE PROVIDED IN ANY YEAR SEE ALSO RESPONSE TO PART VI LINE 2 ABOVE FOR EXAMPLES OF MANY WAYS IN WHICH THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY
AFFILIATED HEALTH CARE INFORMATION	PART VI	PART VI LINE 6 AS INDICATED THE HOSPITAL AND ITS RELATED FACILITIES PROVIDE COMPREHENSIVE INPATIENT OUTPATIENT AND PHYSICIAN SERVICES ALL OF WHICH BENEFIT AND PROMOTE THE HEALTH OF THE COMMUNITY THE HOSPITAL IS AFFILIATED WITH DMH HEALTH SYSTEMS INC WHICH SUPPORTS AND BENEFITS THE HOSPITAL BY PROVIDING FINANCIAL AND MANAGEMENT ASSISTANCE IN CONNECTION WITH THE ACTIVITIES OF THE HOSPITAL AND ITS AFFILIATES AND BY HOLDING TITLE TO CERTAIN ASSETS USED IN CONNECTION WITH HOSPITAL ACTIVITIES THE HOSPITAL IS ALSO AFFILIATED WITH DECATUR MEMORIAL FOUNDATION WHOSE MISSION IS TO SUPPORT AND BENEFIT THE HOSPITAL BY CONDUCTING FUND DEVELOPMENT ACTIVITIES HOLDING TITLE TO CERTAIN ASSETS AND OVERSEEING THEIR PRUDENT AND EFFECTIVE INVESTMENT AND MANAGEMENT TOGETHER THE ACTIVITIES OF THE HOSPITAL AND ITS AFFILIATES EFFECTIVELY AND EFFICIENTLY ADDRESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED	PART VI	ILLINOIS
DECATUR MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 3	PART V LINE 3	THE HOSPITAL CONDUCTED A FOCUS GROUP CONSISTING OF 19 PARTICIPANTS REPRESENTING KEY COMMUNITY AGENCIES AND ORGANIZATIONS INCLUDING EMPLOYERS HEALTHCARE WORKERS EDUCATORS CHURCHES AND THE CITY THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE FOCUS GROUP MIKE CASSELL DMH DIRECTOR OF MARKETING TINA CLONEY RD RHD MILLIKIN UNIVERSITY DEBBIE DURBIN RN MACON COUNTY HEALTH DEPARTMENT BEN ESPARAZ MD DMH MEDICAL STAFF LINDA FAHEY RN DMH VP AND CHIEF NURSING EXECUTIVE BILL FRANCISCO DECATUR TRADES AND LABOR LEE HALL PSYD PSYCHOLOGY SPECIALISTS PATRICK HOBAN ECONOMIC DEVELOPMENT COUNCIL RYAN MCCRADY CITY OF DECATUR JULIE MOORE DECATUR CITY COUNCIL MARTIN OPKALIKE MD DMH MEDICAL GROUP DAVID OPPENLANDER DMH SENIOR VP AND CFO DANA RAY MD CHIC CLINIC NICOLE ROPP DMH SIX SIGMA MASTER BLACK BELT DAN SMALLWOOD CARPENTERS LOCAL UNION TIMOTHY STONE DMH EXECUTIVE VP AND COO JULIE TRUEBLOOD DMH ADMINISTRATIVE ASSISTANT OVERSEER THOMAS WALKER DECATUR CHURCHES MICHAEL ZIA MD DMH VP OF QUALITY MEDICAL AFFAIRS
DECATUR MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 11H	PART V LINE 11H	DMH USES INCOME LEVEL AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE THE MAXIMUM QUALIFYING INCOME LEVEL INCREASES WITH THE SIZE OF THE FAMILY
DECATUR MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 19D	PART V LINE 19D	DMH COMPLIES WITH THE ILLINOIS HOSPITAL UNINSURED PATIENT DISCOUNT ACT AND 501R OF THE INTERNAL REVENUE CODE AS ENACTED BY SECTION 9007A OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT BY PROVIDING FINANCIAL ASSISTANCE EITHER FREE CARE OR REDUCED PATIENT FINANCIAL OBLIGATIONS FOR HOSPITAL SERVICES TO PATIENTS WHO I ARE NOT COVERED UNDER A POLICY OF HEALTH INSURANCE AND ARE NOT BENEFICIARIES UNDER A PUBLIC OR PRIVATE HEALTH INSURANCE HEALTH BENEFIT OR OTHER COVERAGE PROGRAM INCLUDING HIGH DEDUCTIBLE HEALTH INSURANCE PLANS WORKERS COMPENSATION ACCIDENT LIABILITY INSURANCE OR OTHER THIRD PARTY LIABILITY II FAIL TO QUALIFY FOR GOVERNMENTAL ASSISTANCE FOR EXAMPLE MEDICARE OR MEDICAID AND III COOPERATE WITH THE HOSPITAL IN PROVIDING THE REQUESTED INFORMATION REGARDING INCOME ASSETS AND RESIDENCY

Schedule H (Form 990) 2011

Additional Data

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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

2011

Open to Public
Inspection

Name of the organization
DECATUR MEMORIAL HOSPITAL

Employer identification number
37-0661199

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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	(h) Purpose of grant or assistance
(1) SIU DECATUR FAMILY PRACTICE CENTER250 W KENWOOD DECATUR,IL62526	37-6005961	501	1,362,928	GENERAL SUPPORT
(2) QUALITY QUEST HEALTH OF IL416 MAIN ST SUITE 717 PEORIA,IL61602	26-3896631	501	38,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

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

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
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES	SCHEDULE I, PAGE 1, PART I, LINE 2	SOUTHERN ILLINOIS UNIVERSITY (SIU) SCHOOL OF MEDICINE SPONSORS AN ACGME-ACCREDITED FAMILY RESIDENCY PROGRAM FOR WHICH DMH SERVES AS A PRIMARY PARTICIPATING INSTITUTION. AS PART OF THE PROGRAM, SIU OPERATES A FAMILY MEDICINE CLINIC ADJACENT TO THE DMH CAMPUS. THE EXISTENCE AND OPERATION OF THE CLINIC BENEFITS DMH AND ITS SERVICE AREA BY ENHANCING THE RECRUITMENT OF APPROPRIATELY-TRAINED PHYSICIANS TO THE COMMUNITY, ASSISTING DMH IN PROVIDING UNDERSERVED POPULATIONS WITH ACCESS TO PRIMARY CARE MEDICAL SERVICES, AND PROVIDING OTHER SERVICES TO AND FOR THE BENEFIT OF DMH'S PATIENT POPULATION. IN RECOGNITION OF THE ABOVE, DMH SUPPORTS THE PROGRAM BY PROVIDING A BUDGETED, AGREED-UPON AMOUNT FOR EACH ACADEMIC YEAR TO FUND MEDICAL EDUCATION AND RESEARCH THROUGH THE PROGRAM, INCLUDING COSTS INCURRED BY SIU TO SUPERVISE AND TEACH THE RESIDENTS ON-SITE AT THE CLINIC AND AT DMH. THE AMOUNT IS AGREED UPON PRIOR TO THE START OF EACH YEAR. UPON COMPLETION OF EACH ACADEMIC YEAR, SIU REPORTS BACK TO DMH REGARDING HOW FUNDS WERE ACTUALLY EXPENDED IN CONNECTION WITH THE PROGRAM. QUALITY QUEST HEALTH OF ILLINOIS IS A SEC. 501(C)(3) ORGANIZATION WHICH IDENTIFIES BEST PRACTICE CARE STANDARDS - CARE THAT IS PROVEN BY SCIENCE TO BE EFFECTIVE, BENEFICIAL AND VALUABLE. THEY MEASURE PERFORMANCE TO DETERMINE HOW LOCAL HEALTHCARE PROVIDERS COMPARE AGAINST STANDARDS OF CARE WITH THE GOAL OF IMPROVING THE QUALITY OF CARE IN THE STATE, REDUCE WASTE, AND GET THE BEST VALUE FOR THE MONEY SPENT ON HEALTHCARE. THE GRANT FROM DMH WAS USED FOR GENERAL SUPPORT OF QUALITY QUEST. DMH OFFICER TIM STONE IS ALSO ON THE BOARD OF QUALITY QUEST HEALTH OF ILLINOIS AND RECEIVES MONTHLY FINANCIAL INFORMATION RELATED TO QUALITY QUEST, INCLUDING INFORMATION RELATED TO USE OF GRANT FUNDS.

Schedule I (Form 990) 2011

Additional Data

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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

2011

Open to Public Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Yes

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? ....

Yes

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) STEVEN SOBOL MD	(i) (ii)	995,060	395,432		3,675	12,188	1,406,355
(2) KENNETH SMITHMIER	(i) (ii)	717,262			3,675	12,188	733,125
(3) TIMOTHY D STONE JR	(i) (ii)	416,420			3,675	12,188	432,283
(4) MICHAEL ZIA MD	(i) (ii)	291,977			3,675	12,171	307,823
(5) LINDA FAHEY	(i) (ii)	244,228			3,080	755	248,063
(6) STEVEN WEBER MD	(i) (ii)	905,288	520,207		3,675	12,188	1,441,358
(7) THOMAS FULBRIGHT MD	(i) (ii)	832,975	5,000		3,675	4,478	846,128
(8) JOHN WATERS MD	(i) (ii)	816,460			3,675	12,188	832,323
(9) ROBERT KRAUS MD	(i) (ii)	619,633	180,130		3,675	12,188	815,626
(10) MOHAMMED HASNAIN MD	(i) (ii)	545,388	212,675		3,675	12,188	773,926
(11) DAVID OPPENLANDER	(i) (ii)	244,958				2,452	247,410

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
FRINGE OR EXPENSE EXPLANATION	SCHEDULE J, PAGE 1, PART I, LINE 1A	DURING THE YEAR, DMH PAID FOR CHARTER TRAVEL IN TWO INSTANCES. IN BOTH INSTANCES, DMH SHARED WITH SEVERAL OTHER HOSPITALS THE COST OF A CHARTER PLANE HIRED TO PICK UP THEIR RESPECTIVE REPRESENTATIVES (IN DMH'S CASE, TIMOTHY STONE) TO TRAVEL TO A VHA BOARD MEETING IN KANSAS CITY, MO; THE DECISION TO USE THIS MEANS OF TRAVEL WAS BASED UPON COST AND AVAILABILITY OF COMMERCIAL FLIGHTS. DMH MAINTAINS A CORPORATE MEMBERSHIP IN THE DECATUR CLUB, IN THE NAME OF DMH. THE INVOICE FOR ANNUAL DUES IS SENT TO DMH. THE INVOICE FOR MONTHLY DUES IS SENT TO DMH, ATTN: KEN SMITHMIER (CEO). DMH PAYS THE MONTHLY DUES DIRECTLY. ALL USAGE OF THE DECATUR CLUB MEMBERSHIP IS FOR BUSINESS PURPOSES, WHETHER BY MR. SMITHMIER OR OTHER EXECUTIVES, WITH MONTHLY STATEMENTS DOCUMENTING ACTUAL USAGE. NEITHER MR. SMITHMIER NOR ANY OTHER DMH EXECUTIVE MAKE ANY PERSONAL USE OF THE DECATUR CLUB MEMBERSHIP.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS	SCHEDULE J, PAGE 1, PART I, LINE 4	DAVID OPPENLANDER 48,077 0 0

Schedule J (Form 990) 2011

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
DECATUR MEMORIAL HOSPITAL

Employer identification number
37-0661199

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	CITY OF DECATUR MACON COUNTY IL	37-6001308		12-22-2010	6,280,000	REFUND 1996 ISSUE		X		X		X
B	CITY OF DECATUR MACON COUNTY IL	37-6001308		12-22-2010	5,000,000	REFUND 1996 ISSUE		X		X		X
C	CITY OF DECATUR MACON COUNTY IL	37-6001308		12-22-2010	4,405,000	REFUND 1996 ISSUE		X		X		X
D	CITY OF DECATUR MACON COUNTY IL	37-6001308		12-22-2010	2,675,000	REFUND 1996 ISSUE		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	1,099,000		875,000		770,875		468,125
2 Amount of bonds legally defeased . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . .	6,280,000		5,000,000		4,405,000		2,675,000
4 Gross proceeds in reserve funds . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . .
8 Credit enhancement from proceeds . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . .
11 Other spent proceeds . . . . . . . . . . .	6,280,000		5,000,000		4,405,000		2,675,000
12 Other unspent proceeds . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .	X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2011

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .		X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .		X		X		X		X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .		X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X		X		X		X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X		X		X
2 Is the bond issue a variable rate issue?	X		X		X		X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . .
c Term of hedge . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .		X		X		X		X
b Name of provider . . . . . .
c Term of GIC . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .		X		X		X		X
6 Did the bond issue qualify for an exception to rebate? .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X		X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . . YesNo

Part VI

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
ADDITIONAL INFORMATION	SCHEDULE K	CITY OF DECATUR MACON COUNTY IL PART I COLUMN C NONE OF THE BOND ISSUES IN PART I HAD A CUSIP NUMBER AND THEREFORE THE RESPONSE IN COLUMN C FOR EACH IS NONE ACCORDING TO IRS INSTRUCTIONS HOWEVER ENTERING NONE IN COLUMN C CREATES AN EFILE ERROR THEREFORE COLUMN C HAS BEEN LEFT BLANK BUT AS INDICATED SHOULD BE NONE FOR EACH ISSUE SCHEDULE K OTHER INFORMATION AS INDICATED IN COLUMN G EACH ISSUE IN PART I WAS A CURRENT REFUNDING ISSUE USED TO REFINANCE 1996 BONDS ALL PROCEEDS OF EACH ISSUE WERE USED EXCLUSIVELY FOR THIS PURPOSE

Schedule K (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

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?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2011

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) HICKORY POINT BANK	SEE PART V	10,892	INTEREST INCOME		No
(2) STRIGLOS COMPANIES	SEE PART V	231,793	OFFICE SUPPLIES		No
(3) CANCER CARE SPECIALISTS OF CENT IL	SEE PART V	137,047	MED SERVICES		No
(4) CANCER CARE SPECIALISTS OF CENT IL	SEE PART V	45,480	EMR SUPPORT REV		No
(5) BAKERS DOZEN LLC	SEE PART V	479,594	OFFICE SPACE RENTAL		No
(6) ROY MOSSER	SEE PART V	1,630,584	OFFICE SPACE RENTAL		No
(7) HICKORY POINT BANK	SEE PART V	761,396	BANK FEES, INTEREST		No
(8) JOHN FAHEY MD	SEE PART V	204,859	COMPENSATION/BENEFIT		No
(9) MILLIKIN UNIVERSITY	SEE PART V	473,978	CLINIC & NURSING REV		No
(10) MILLIKIN UNIVERSITY	SEE PART V	36,733	NURSING EDUCATION		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
ADDITIONAL INFORMATION	SCHEDULE L PART V	PART IV LINES 1B 7B DIRECTORS KENNETH SMITHMIER AND DAVID SMITH ARE ON THE HICKORY POINT BANK BOARD OF DIRECTORS PART IV LINE 2B DIRECTOR SCOTT STRIGLOS OWNS STRIGLOS COMPANIES INC PART IV LINES 3B 4B 5B DIRECTOR EDWARD ELLIOTT IS AN OWNER OF CANCER CARE SPECIALISTS OF CENTRAL ILLINOIS HE IS ALSO AN OWNER OF BAKERS DOZEN LLC PART IV LINE 6B ROY MOSSER IS A DIRECTOR OF DMH PART IV LINE 8B JOHN FAHEY MD IS THE SPOUSE OF DMH OFFICER LINDA FAHEY PART IV LINES 9B 10B DIRECTOR JAMES DAHL IS A DEAN OF MILLIKIN UNIVERSITY

Schedule L (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public
Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

Identifier	Return Reference	Explanation
ADDITIONAL INFORMATION	FORM 990	FORM 990, PART I, ITEM 1 AND FORM 990, PART III, ITEM 1: DMH'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE OF CENTRAL ILLINOIS, RELYING ON ITS CORE FOUNDATIONS OF COMMITTED PHYSICIANS, CONSTRUCTIVE CULTURE, RESPONSIBLE GOVERNANCE, PROCESS INNOVATION, MANAGERIAL COMPETENCE, AND ENGAGED EMPLOYEES. WITH A HISTORY DATING BACK TO 1916, DMH TODAY ENCOMPASSES TWELVE STATE-OF-THE-ART CENTERS OF EXCELLENCE WHICH FOCUS ON THE CUTTING EDGE OF MEDICINE TODAY AND PROVIDE THE COMMUNITY WITH AWARD-WINNING HEALTH CARE. APPROXIMATELY 250,000 PERSONS RESIDE IN DMH'S SERVICE AREA, INCLUDING SUBSTANTIAL NUMBERS OF MEDICARE AND MEDICAID BENEFICIARIES, AS WELL AS PERSONS WHO DO NOT QUALIFY FOR EITHER PROGRAM AND THUS SEEK CARE PURSUANT TO DMH'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM. THE LOCAL COMMUNITY HAS BEEN HIT HARD BY THE RECENT ECONOMIC DECLINES. IN RESPONSE TO THESE CONDITIONS, DMH HAS EXPANDED ITS THRESHOLD FOR PROVISION OF FINANCIAL ASSISTANCE TO SIX TIMES THE FEDERAL POVERTY GUIDELINES; FOR THESE AND OTHER PATIENTS, DMH OFFERS SLIDING SCALE DISCOUNTS AND EXTENDED PAYMENT TERMS IN AN EFFORT TO ENSURE THAT PATIENTS ARE ABLE TO OBTAIN NECESSARY MEDICAL CARE. DURING THE FISCAL YEAR, DMH PROVIDED SIGNIFICANT FREE OR DISCOUNTED SERVICES TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE AS WELL AS OTHER FORMS OF COMMUNITY BENEFIT PROGRAMS, GRANTS AND SERVICES. SEE SCHEDULE H FOR MORE DETAIL.
ALL OTHER ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4D	EDUCATION AND OUTREACH: DMH HAS CONCLUDED THAT, TO FULFILL ITS MISSION OF IMPROVING HEALTH, IT MUST BECOME INVOLVED IN THE EDUCATION, AWARENESS AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT HEALTH STATUS. IN AN EFFORT TO GIVE COMMUNITY RESIDENTS THE TOOLS NECESSARY TO MAKE HEALTHY LIFESTYLE DECISIONS, DMH SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE LOCAL COMMUNITY, THROUGH MEASURES RANGING FROM PROGRAMS FOR LOCAL SCHOOLS TO DMH'S POPULAR "PRIME TIME" PROGRAM FOR SENIORS. IN RECENT YEARS, DMH HAS PARTICIPATED IN VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES, AS A RESULT OF WHICH DMH HAS IDENTIFIED SIGNIFICANT CONCERNS SUCH AS ACCESS TO PRIMARY CARE PHYSICIANS AND SPECIALISTS, CARDIAC SCREENINGS AND PROGRAMS, OBESITY, DIABETES, INDIGENT OUTPATIENT LONGITUDINAL CARE, ONCOLOGY SCREENINGS, AND INFANT MORTALITY. WITH THE LEADERSHIP OF A MULTIDISCIPLINARY COMMUNITY BENEFITS COMMITTEE, INCLUDING PARTICIPATION BY A DIVERSE GROUP OF COMMUNITY REPRESENTATIVES, DMH HAS TAKEN A PRIMARY ROLE IN CONFRONTING THESE ISSUES. AS JUST ONE EXAMPLE, DMH IS SPONSORING A LOCAL VERSION OF THE PREVENTION PLAN CHALLENGE, A NATIONAL WELLNESS INITIATIVE THAT FOCUSES ON PREVENTIVE CARE TO HELP PEOPLE LIVE HEALTHIER AND LOWER HEALTHCARE COSTS WITHIN THE COMMUNITY; THROUGH THIS COMPETITION AMONG LOCAL EMPLOYERS, DMH HOPES TO SPUR COMPANIES TO BUILD HEALTHIER WORKFORCES.
RELATED PARTY INFORMATION AMONG OFFICERS	FORM 990, PAGE 6, PART VI, LINE 2	KENNETH SMITHMIER ROBIN KING DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER LARRY ALTENBAUMER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER DAVID SMITH DIRECTOR DIRECTOR BUSINESS RELATIONSHIP KENNETH SMITHMIER PAULA EISSFELDT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP LARRY ALTENBAUMER KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP LARRY ALTENBAUMER ROBIN KING DIRECTOR DIRECTOR BUSINESS RELATIONSHIP LARRY ALTENBAUMER PAULA EISSFELDT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP LARRY ALTENBAUMER JONATHON LOCKE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP LARRY ALTENBAUMER JOHN FUNK DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT ROBIN KING DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT RON DRANE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID TYROLT JAMES DAHL DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID SMITH PAULA EISSFELDT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP DAVID SMITH KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROY MOSSER, JR. RON DRANE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP RON DRANE DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP RON DRANE ROY MOSSER, JR. DIRECTOR DIRECTOR BUSINESS RELATIONSHIP RON DRANE THOMAS KOWA DIRECTOR DIRECTOR BUSINESS RELATIONSHIP THOMAS KOWA RON DRANE DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JAMES DAHL DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP PAULA EISSFELDT KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP PAULA EISSFELDT DAVID SMITH DIRECTOR DIRECTOR BUSINESS RELATIONSHIP PAULA EISSFELDT LARRY ALTENBAUMER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROBIN KING LARRY ALTENBAUMER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROBIN KING KENNETH SMITHMIER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP ROBIN KING DAVID TYROLT DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JONATHON LOCKE LARRY ALTENBAUMER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP JOHN FUNK LARRY ALTENBAUMER DIRECTOR DIRECTOR BUSINESS RELATIONSHIP
CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PAGE 6, PART VI, LINE 6	THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS DMH HEALTH SYSTEMS, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS BEING DESCRIBED IN SEC. 501 (C)(3), IRC.
ELECTION OF MEMBERS AND THEIR RIGHTS	FORM 990, PAGE 6, PART VI, LINE 7A	AS THE SOLE CORPORATE MEMBER OF DMH, DMH HEALTH SYSTEMS HAS THE RIGHT TO APPROVE ALL DIRECTORS OF DMH, AND TO REMOVE ANY DIRECTOR SO APPROVED.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PAGE 6, PART VI, LINE 7B	THE DMH BOARD OF DIRECTORS GENERALLY OVERSEES AND DIRECTS ALL ACTIVITIES, ASSETS AND OPERATIONS OF DMH, SUBJECT TO THE RIGHTS AND AUTHORITY SPECIFICALLY RESERVED TO DMH HEALTH SYSTEMS, AS THE SOLE CORPORATE MEMBER, IN THE DMH BYLAWS. THESE RIGHTS PERTAIN TO THE APPOINTMENT AND REMOVAL OF DIRECTORS, ELECTION OF THE PRESIDENT AND TREASURER, NOMINATION OF OTHER OFFICERS, AMENDMENT OF ARTICLES AND BYLAWS, APPROVAL OF BUDGETS AND LONG RANGE PLANS, APPROVAL OF ANY MERGER OR CONSOLIDATION, APPROVAL OF SIGNIFICANT TRANSACTIONS, APPROVAL OF DISSOLUTION, CREATION OF ANY SUBSIDIARIES OR AFFILITATES, AND APPOINTMENT OF THE INDEPENDENT AUDITOR.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF THE FORM 990, ALONG WITH AN EXPLANATORY NOTE, IS PROVIDED FOR REVIEW TO THE BOARD VIA AN INTRANET SITE PRIOR TO FILING. ALSO, THE FORM 990 IS REVIEWED AND DISCUSSED AT A REGULARLY SCHEDULED BOARD MEETING PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST DISCLOSURE TO THE CEO. A LIST OF POTENTIAL CONFLICTS IS PREPARED AND IS AVAILABLE FOR REFERENCE PRIOR TO EACH BOARD AND COMMITTEE MEETING. THE CFO'S OFFICE MONITORS AND PERIODICALLY REVIEWS TRANSACTIONS BETWEEN THE ORGANIZATION AND BOARD MEMBERS OR ENTITIES WITH WHICH THEY ARE AFFILIATED.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE BOARD OF DIRECTORS OF DMH HEALTH SYSTEMS (THE SOLE CORPORATE MEMBER OF DMH) HAS ADOPTED AN EXECUTIVE COMPENSATION POLICY AND PROCEDURE SETTING FORTH THE AUTHORITY AND PROCESS REGARDING COMPENSATION DETERMINATIONS FOR THE TOP EXECUTIVES OF DMH AND ITS AFFILIATES (THE CEO AND FIVE OTHER EXECUTIVES). PURSUANT TO THE POLICY, THE BOARD HAS DELEGATED TO THE EXECUTIVE COMMITTEE THE RESPONSIBILITY TO REVIEW INDEPENDENT MARKET DATA, ASSESS THE COMPARABILITY OF SUCH DATA, AND MAKE RECOMMENDATIONS TO THE BOARD REGARDING COMPENSATION PROPOSED TO BE PAID. IN CARRYING OUT THEIR RESPECTIVE COMPENSATION-RELATED RESPONSIBILITIES, THE BOARD AND EXECUTIVE COMMITTEE EXCLUDE ANY PERSON DEEMED TO HAVE A CONFLICT OF INTEREST WITHIN THE MEANING OF APPLICABLE TREASURY REGULATIONS (INCLUDING ANY PHYSICIANS EMPLOYED BY DMH OR ON ITS MEDICAL STAFF). AS PROVIDED IN THE POLICY, THE EXECUTIVE COMMITTEE CONDUCTS AN IN-DEPTH TOTAL COMPENSATION ANALYSIS USUALLY EVERY TWO YEARS WITH THE ASSISTANCE OF AN INDEPENDENT NATIONALLY-RECOGNIZED COMPENSATION CONSULTING FIRM. IN THE OFF-YEARS BETWEEN IN-DEPTH REVIEWS, THE COMMITTEE TYPICALLY HAS OBTAINED FROM ITS CONSULTING FIRM AN UPDATED ASSESSMENT TO CONFIRM CONTINUED COMPARABILITY WITH MARKET DATA. CONSISTENT WITH THE FOREGOING, IN AUGUST 2012, DMH OBTAINED SUCH AN UPDATE REPORT FROM ITS INDEPENDENT COMPENSATION CONSULTING FIRM, COVERING THE FOLLOWING INDIVIDUALS: SMITHMIER (CEO), STONE (COO), PEACOCK (CFO), ZIA (VPMA), FAHEY (CNO), AND RIDLEY (VPPS). ALL DETERMINATIONS OF THE BOARD AND EXECUTIVE COMMITTEE ARE THOROUGHLY AND TIMELY DOCUMENTED IN APPROPRIATE MINUTES AND SUPPORTING MATERIALS.
COMPENSATION PROCESS FOR OFFICERS	FORM 990, PAGE 6, PART VI, LINE 15B	SEE RESPONSE TO FORM 990, PART VI.B, LINE 15A ABOVE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL INFORMATION OF DMH ARE AVAILABLE TO THE PUBLIC UPON SPECIFIC REQUEST TO DMH ADMINISTRATION.
ADDITIONAL INFORMATION	FORM 990, PART VII	GARY PEACOCK (SENIOR VP AND CFO) RETIRED IN JANUARY 2010. IN SEPTEMBER 2011 MR. PEACOCK WAS REHIRED AS INTERIM SENIOR VP & CFO UNDER A THREE MONTH AGREEMENT BEGINNING IN OCTOBER THAT PAID 27,248 A MONTH. THE CONTRACT ALSO AGREED TO PAY FOR MR. PEACOCK'S COMMUTE TO AND FROM GEORGETOWN, TEXAS; LODGING WHILE STAYING IN DECATUR; AND USE OF A RENTAL CAR. DMH PAID 14,628 OVER THE CONTRACT PERIOD FOR MR. PEACOCK'S EXPENSES. MR. PEACOCK HANDLED ALL CFO DUTIES AND WAS CHARGED WITH THE RESPONSIBILITY OF ASSISTING WITH FINDING A NEW CFO. IN OCTOBER 2011 MR. PEACOCK WAS HIRED AS THE PERMANENT CFO. DMH PAID 14,009 TO MOVE MR. PEACOCK TO DECATUR. MR. PEACOCK RETIRED IN SEPTEMBER 2012. IN MARCH 2012 JOHN RIDLEY WAS PROMOTED TO VICE PRESIDENT FOR PROFESSIONAL SERVICES. DMH PAID 9,216 TO MOVE JOHN AND HIS FAMILY TO DECATUR.
OTHER CHANGES IN NET ASSETS EXPLANATION	FORM 990, PART XI, LINE 5	OTHER CHANGES IN NET ASSETS CONSIST OF THE FOLLOWING: BOOK/TAX DIFFERENCES IN INCOME FROM PARTNERSHIPS (INCREASE 600,607); BOOK/TAX DIFFERENCES IN INCOME BETWEEN GAAP AND THE 990 (INCREASE 283,000); CHANGE IN MINIMUM PENSION LIABILITY (DECREASE 1,321,082); TRANSFER OF CAPITAL FROM AFFILIATES (INCREASE 6,719,777); CHANGE IN VALUE OF FUNDS HELD IN TRUST (INCREASE 10,602,170); AND UNREALIZED GAINS ON INVESTMENTS (15,039,886). THE NET RESULT OF ALL THESE OTHER CHANGES IN NET ASSETS IS AN INCREASE OF 31,924,358.
ADDITIONAL INFORMATION	FORM 990, PART XII	DECATUR MEMORIAL HOSPITAL WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF DMH HEALTH SYSTEMS AND AFFILIATED ORGANIZATIONS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

DECATUR MEMORIAL HOSPITAL

Employer identification number

37-0661199

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

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
(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	Yes	No
(1) DMH HEALTH SYSTEMS 2300 N EDWARD ST DECATUR,IL625264163 37-1169606	SUPP. DMH	IL	501C3	11A	NA		No
(2) DECATUR MEMORIAL FOUNDATION 2300 N EDWARD ST DECATUR,IL625264163 37-1169605	SUPP. DMH	IL	501C3	11A	NA		No
(3) HEARTLAND RISK MANAGEMENT 2300 N EDWARD ST DECATUR,IL625264163 45-4256254	SUPP. DMH	AZ	501C3	11A	NA		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) DECATUR DIGESTIVE DISEASE CENTER 2 MEMORIAL DRIVE SUITE 102 DECATUR,IL62526 16-1678954	ENDOSCOPY	IL	NA	RELATED	240,076	194,318		No			No	50.000 %

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
(1) DMH WORLDWIDE LTD 2300 N EDWARD ST DECATUR,IL62526 27-1901157	CONSULTING	IL	N/A

Schedule R (Form 990) 2011

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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) DECATUR MEMORIAL FOUNDATION	C	7,925,890	CASH TRANSFER
(2) HEARTLAND RISK MANAGEMENT	B	600,000	CASH TRANSFER
(3) DECATUR MEMORIAL FOUNDATION	J	1,442,806	CASH PAYMENT
(4) DECATUR MEMORIAL FOUNDATION	N	158,427	CASH PAYMENT
(5) DECATUR DIGESTIVE DISEASE CENTER	N	473,646	CASH PAYMENT
(6) DMH WORLDWIDE LTD	P	303,405	CASH PAYMENT
(7) DECATUR MEMORIAL FOUNDATION	P	104,276	CASH PAYMENT
(8) DECATUR DIGESTIVE DISEASE CTR LLC	R	315,000	CASH TRANSFER
(9) HEARTLAND RISK MANAGEMENT	L	1,633,314	CASH PAYMENT
(10) DECATUR MEMORIAL FOUNDATION	C	7,925,890	CASH TRANSFER
(11) HEARTLAND RISK MANAGEMENT	B	600,000	CASH TRANSFER
(12) DECATUR MEMORIAL FOUNDATION	J	1,442,806	CASH PAYMENT
(13) DECATUR MEMORIAL FOUNDATION	N	158,427	CASH PAYMENT
(14) DECATUR DIGESTIVE DISEASE CENTER	N	473,646	CASH PAYMENT
(15) DMH WORLDWIDE LTD	P	303,405	CASH PAYMENT
(16) DECATUR MEMORIAL FOUNDATION	P	104,276	CASH PAYMENT
(17) DECATUR DIGESTIVE DISEASE CTR LLC	R	315,000	CASH TRANSFER
(18) HEARTLAND RISK MANAGEMENT	L	1,633,314	CASH PAYMENT

Schedule R (Form 990) 2011

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

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:

1	Briefly describe the organization’s mission or most significant activities: DMH SERVES THE HEALTHCARE NEEDS OF THE PEOPLE OF CENTRAL ILLINOIS THROUGH OPERATION OF A 280-BED ACUTE CARE HOSPITAL AND RELATED FACILITIES PROVIDING COMPREHENSIVE INPATIENT, OUTPATIENT AND PHYSICIAN SERVICES. (SCHEDULE 0).
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,623
6	Total number of volunteers (estimate if necessary) ....	6	607
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	3,343,720
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	708,896

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,264,148	3,678,004
9	Program service revenue (Part VIII, line 2g) .........	265,058,381	264,095,992
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,572,691	5,240,859
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	10,521,720	13,726,430
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	285,416,940	286,741,285
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,351,778	1,400,928
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	132,904,012	143,951,214
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	153,506,049	145,171,786
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	287,761,839	290,523,928
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,344,899	-3,782,643
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	362,023,608	368,493,551
21	Total liabilities (Part X, line 26).............	102,796,329	81,124,557
22	Net assets or fund balances. Subtract line 21 from line 20.....	259,227,279	287,368,994

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 127,033,023 including grants of $ 1,362,928 ) (Revenue $ 166,602,865 )
	OUTPATIENT SERVICES: DMH PROVIDES A FULL RANGE OF OUTPATIENT SERVICES (DIAGNOSTIC TESTS AND MEDICAL PROCEDURES NOT REQUIRING AN OVERNIGHT STAY). DMH DEPARTMENTS PROVIDING THE MOST SUBSTANTIAL SERVICES DURING THE YEAR INCLUDED CARDIOLOGY, LABORATORY, RADIOLOGY, ONCOLOGY, PHYSICAL THERAPY, SLEEP DISORDERS, SURGERY, GERIATRIC AND EMERGENCY MEDICINE. DURING THE FISCAL YEAR, PATIENTS MADE APPROXIMATELY 49,500 VISITS TO DMH'S EMERGENCY CARE CENTER AND RECEIVED APPROXIMATELY 273,500 OUTPATIENT TESTS.

4b	(Code: ) (Expenses $ 54,473,760 including grants of $ ) (Revenue $ 71,441,931 )
	INPATIENT SERVICES: WITH 280 BEDS CURRENTLY IN SERVICE,DMH PROVIDED 45,985 DAYS OF INPATIENT CARE DURING THE FISCAL YEAR. DMH'S INPATIENTS INCLUDED THE YOUNG (NEWBORN INFANTS IN THE LEVEL I OR LEVEL II NURSERY), THE OLD (FOR EXAMPLE, PERSONS RECEIVING CARE THROUGH DMH'S SENIOR HEALTH AND WELLNESS CENTER OF EXCELLENCE), AND THE IN-BETWEEN. AREAS OF INPATIENT SERVICE INCLUDED GENERAL MEDICAL, SURGERY, ORTHOPEDICS, CARDIOLOGY, GERIATRICS,PEDIATRICS, INTENSIVE CARE, DIALYSIS, OBSTETRICS AND GYNECOLOGY, NURSERY, LONG-TERM CARE, AND TELEMETRY MONITORING. INPATIENT CARE WAS PROVIDED BY DMH'S TEAM OF HIGHLY-QUALIFIED, TALENTED STAFF (TODAY NUMBERING OVER 2,200 IN ALL), INCLUDING HOSPITALISTS, NURSES, AIDES, DIETICIANS, CASE MANAGEMENT STAFF, SOCIAL WORKERS, AND CHAPLAINS.

4c	(Code: ) (Expenses $ 52,546,342 including grants of $ ) (Revenue $ 36,101,285 )
	PROFESSIONAL SERVICES: AS THE EMPLOYER OF APPROXIMATELY 81 PHYSICIANS PLUS A COMPLEMENT OF OTHER PROVIDERS (PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS), DMH OFFERS A WIDE RANGE OF PROFESSIONAL PATIENT CARE AT APPROXIMATELY 38 OFFICES LOCATED THROUGHOUT THE SERVICE AREA. THESE SITES INCLUDE THREE "EXPRESS CARE" LOCATIONS OFFERING CARE FOR CASES THAT ARE TIME-SENSITIVE BUT NOT LIFE-THREATENING OR EMERGENT.

	(Code: ) (Expenses $ 187,690 including grants of $ 38,000 ) (Revenue $ )
	EDUCATION AND OUTREACH: DMH HAS CONCLUDED THAT, TO FULFILL ITS MISSION OF IMPROVING HEALTH, IT MUST BECOME INVOLVED IN THE EDUCATION, AWARENESS AND PREVENTION OF DISEASE AND ILLNESS THAT NEGATIVELY IMPACT HEALTH STATUS. IN AN EFFORT TO GIVE COMMUNITY RESIDENTS THE TOOLS NECESSARY TO MAKE HEALTHY LIFESTYLE DECISIONS, DMH SEEKS OUT OPPORTUNITIES AND ACTIVELY INVOLVES ITSELF IN THE LOCAL COMMUNITY, THROUGH MEASURES RANGING FROM PROGRAMS FOR LOCAL SCHOOLS TO DMH'S POPULAR "PRIME TIME" PROGRAM FOR SENIORS. IN RECENT YEARS, DMH HAS PARTICIPATED IN VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENT INITIATIVES, AS A RESULT OF WHICH DMH HAS IDENTIFIED SIGNIFICANT CONCERNS SUCH AS ACCESS TO PRIMARY CARE PHYSICIANS AND SPECIALISTS, CARDIAC SCREENINGS AND PROGRAMS, OBESITY, DIABETES, INDIGENT OUTPATIENT LONGITUDINAL CARE, ONCOLOGY SCREENINGS, AND INFANT MORTALITY. WITH THE LEADERSHIP OF A MULTIDISCIPLINARY COMMUNITY BENEFITS COMMITTEE, INCLUDING PARTICIPATION BY A DIVERSE GROUP OF COMMUNITY REPRESENTATIVES, DMH HAS TAKEN A PRIMARY ROLE IN CONFRONTING THESE ISSUES. AS JUST ONE EXAMPLE, DMH IS SPONSORING A LOCAL VERSION OF THE PREVENTION PLAN CHALLENGE, A NATIONAL WELLNESS INITIATIVE THAT FOCUSES ON PREVENTIVE CARE TO HELP PEOPLE LIVE HEALTHIER AND LOWER HEALTHCARE COSTS WITHIN THE COMMUNITY; THROUGH THIS COMPETITION AMONG LOCAL EMPLOYERS, DMH HOPES TO SPUR COMPANIES TO BUILD HEALTHIER WORKFORCES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 187,690 including grants of $ 38,000 ) (Revenue $ )
4e	Total program service expenses$ 234,240,815

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	8,144,947	145,518

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		17,383
e	Government grants (contributions)1e		2,325,171

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,335,450
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,678,004
			Business Code
2a	INPATIENT, OUTPATIENT, & PHYS		900,099	263,856,571	263,856,571
b	DECATUR DIGESTIVE DISEASE CTR		621,990	239,421	239,421
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			264,095,992
3	Investment income (including dividends, interest
	and other similar amounts).....			4,081,820			4,081,820
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross rents	332,621
b	Less: rental expenses
c	Rental income or (loss)	332,621
d	Net rental income or (loss).......			332,621			332,621
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	31,437,520	369,604
b	Less: cost or other basis and sales expenses	30,339,793	308,292
c	Gain or (loss)	1,097,727	61,312
d	Net gain or (loss)..........			1,159,039			1,159,039
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
10a	Gross sales of inventory, less returns and allowances .
	a		2,747,223
b	Less: cost of goods sold ..b		1,294,466
c	Net income or (loss) from sales of inventory..			1,452,757		1,452,757
Miscellaneous Revenue			Business Code
11a	OTHER EXEMPT FUNCTION INC		900,099	10,050,089	10,050,089
b	WELLNESS & COSMETIC SERVICES		900,099	824,454		824,454
c	ADMIN & SUPPORT SERVICES		561,000	488,054		488,054
d	All other revenue ....			578,455		578,455
e	Total. Add lines 11a–11d ......			11,941,052
12	Total revenue. See Instructions....			286,741,285	274,146,081	3,343,720	5,573,480


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			8,707	1	9,347
2	Savings and temporary cash investments .......			20,245,027	2	7,859,163
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			39,437,191	4	43,967,363
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 .............				7
8	Inventories for sale or use ..............			3,323,072	8	3,127,753
9	Prepaid expenses and deferred charges ............			4,750,858	9	3,674,503
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	374,923,477
b	Less: accumulated depreciation. .....	10b	254,746,674	120,095,270	10c	120,176,803
11	Investments—publicly traded securities ..........			168,524,645	11	182,904,905
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			5,638,838	15	6,773,714
16	Total assets. Add lines 1 through 15 (must equal line 34)...			362,023,608	16	368,493,551
17	Accounts payable and accrued expenses .			35,002,654	17	35,013,222
18	Grants payable ..........				18
19	Deferred revenue ..........			157,437	19	146,195
20	Tax-exempt bond liabilities ..........			40,659,393	20	15,147,000
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 ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			26,976,845	25	30,818,140
26	Total liabilities. Add lines 17 through 25.....			102,796,329	26	81,124,557
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			220,760,235	27	236,946,363
28	Temporarily restricted net assets .....			26,097,630	28	35,813,819
29	Permanently restricted net assets .....			12,369,414	29	14,608,812
	Organizations that do not follow SFAS 117, check here 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 .....			259,227,279	33	287,368,994
34	Total liabilities and net assets/fund balances .....			362,023,608	34	368,493,551