TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(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) EUGENE BASANTA........................................................................ Vice Chair	2.00 .......................2.00	X	X	300	0
(2) MARLENE SIMPSON........................................................................ Secretary	2.00 .......................1.00	X	X	450	0
(3) REX BUDDE........................................................................ President/CEO	34.00 .......................6.00	X	X	519,978	257,504
(4) STEVE SABENS........................................................................ Chair	2.00 .......................2.00	X	X	450	0
(5) ANAD SALEM MD........................................................................ Trustee Resigned	2.00 .......................1.00	X		150	0
(6) BOB MEES........................................................................ Trustee	2.00 .......................1.00	X		200	0
(7) DEBRA MCMORROW........................................................................ Trustee	2.00 .......................1.00	X		300	0
(8) DR TERRENCE GLENNON........................................................................ Trustee	2.00 .......................2.00	X		3,260	0
(9) GEORGE O'NEILL........................................................................ Trustee	2.00 .......................2.00	X		400	0
(10) HAROLD BARDO........................................................................ Trustee	2.00 .......................2.00	X		250	0
(11) KATHLEEN FRALISH........................................................................ Trustee	2.00 .......................2.00	X		300	0
(12) MARSHA RYAN MD........................................................................ Trustee	2.00 .......................2.00	X		4,885	0
(13) MIKE ABSHER........................................................................ Trustee	2.00 .......................1.00	X		50	0
(14) MORTON LEVINE........................................................................ Trustee	2.00 .......................1.00	X		400	0
(15) PHIL NORDSTROM........................................................................ Trustee Resigned	2.00 .......................1.00	X		200	0
(16) DAVID HOLLAND........................................................................ VP/ Info Systems	32.00 .......................8.00		X	297,435	103,822
(17) JAMES MILLER MD........................................................................ CMO	33.00 .......................7.00		X	390,484	66,333

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) JOHN B MILLSTEAD........................................................................ VP/ Administrator	40.00 .......................0	X		418,987	165,556
(19) JOHN BROTHERS........................................................................ Administrator/ VP	40.00 .......................0	X		177,117	17,506
(20) JULIE FIRMAN........................................................................ VP/CNO	40.00 .......................0	X		274,103	96,418
(21) MIKE KASSER........................................................................ VP/CFO/Treasurer	28.00 .......................12.00	X		324,238	135,872
(22) PAM HENDERSON........................................................................ VP/ HR	36.00 .......................0	X		272,950	78,726
(23) PHILIP SCHAEFER........................................................................ VP/ Ambulatory Services	10.00 .......................30.00	X		373,998	160,713
(24) SCOTT SEABORN........................................................................ VP/ Administrator	40.00 .......................0	X		494,016	31,357
(25) TERRENCE FARRELL........................................................................ VP/ Administrator	40.00 .......................0	X		268,412	100,619
(26) WILLIAM SHERWOOD........................................................................ VP/ General Counsel	28.00 .......................12.00	X		476,366	170,455
(27) WILLIAM THORNE........................................................................ VP/ Community Benefits	25.00 .......................0	X		180,266	99,257
(28) BRIAN LANCE........................................................................ Pharmacist	40.00 .......................0		X	183,571	34,121
(29) CLAUDIA CREWS........................................................................ Pharmacist	40.00 .......................0		X	174,365	44,564
(30) LEAH MACFARLANE........................................................................ Pharmacist	40.00 .......................0		X	167,467	20,923
(31) SHELLY PIERCE........................................................................ Corp Director PT Relations	40.00 .......................0		X	180,279	35,942
(32) THOMAS HENTRICH........................................................................ Pharmacist	40.00 .......................0		X	184,884	44,305

(A) Name and business address	(B) Description of services	(C) Compensation
BRIGHAM ANESTHESIA SOUTH LLC35 ALBANY RD STE CCARBONDALEIL62901	MEDICAL AND HEALTHCARE PAYMENTS	3,231,927
MEDICAL STAFFING NETWORKPO BOX 203000DALLASTX72445	MEDICAL AND HEALTHCARE PAYMENTS	2,103,096
LABORATORY CORP OF AMERICAPO BOX 12140BURLINGTONNC272162140	MEDICAL AND HEALTHCARE PAYMENTS	1,623,261
AOS LLC1885 BOWLESE AVEFENTONMO63026	IT SERVICES	1,399,763
PRAIRIE CARDIOVASCULARPO BOX 19420SPRINGFIELDIL62794	MEDICAL AND HEALTHCARE PAYMENTS	1,321,057
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 35

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	444,462	444,462
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	1,440	1,440
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	6,390,986	827,338	5,563,648	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	52,538	52,538	0	0
7	Other salaries and wages	121,707,635	100,376,134	21,195,101	136,400
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,683,238	1,093,380	1,586,857	3,001
9	Other employee benefits .......	27,964,798	24,809,223	3,126,445	29,130
10	Payroll taxes ...........	8,776,213	7,160,431	1,606,060	9,722
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	313,652	47,857	265,795	0
c	Accounting ...........	188,030	0	188,030	0
d	Lobbying ...........	74,138	0	74,138	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	465,105	0	465,105	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	51,130,143	42,260,367	8,869,776	0
12	Advertising and promotion ....	838,214	23,869	814,345	0
13	Office expenses .......	8,531,600	7,527,246	992,690	11,664
14	Information technology ......	6,779,618	5,329,037	1,450,581	0
15	Royalties ..	0
16	Occupancy ...........	6,176,518	5,227,263	949,255	0
17	Travel ............	712,234	441,405	270,829	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0	0	0	0
19	Conferences, conventions, and meetings ....	989,646	568,088	421,558	0
20	Interest ...........	6,760,114	6,724,221	35,893	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	25,242,988	17,066,819	8,176,169	0
23	Insurance ..............	8,403,358	8,158,833	244,525	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	65,106,973	65,106,973	0	0
b	PROVIDER TAX	5,854,768	5,854,768	0	0
c	EQUIPMENT RENTAL	5,367,804	4,881,826	485,978	0
d	HOSPITAL AUXILIARY	614,872	614,872	0	0
e	All other expenses	1,785,715	1,082,089	703,626	0
25	Total functional expenses. Add lines 1 through 24e	363,356,800	305,680,479	57,486,404	189,917
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).	0

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	6,447	1	6,859
2	Savings and temporary cash investments .........	4,966,236	2	4,075,871
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	77,150,828	4	83,950,513
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6	0
7	Notes and loans receivable, net .............	1,319,798	7	1,100,268
8	Inventories for sale or use ..............	6,238,647	8	7,876,596
9	Prepaid expenses and deferred charges ..........	4,618,976	9	5,080,193
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	376,661,017
b	Less: accumulated depreciation .....	10b	206,963,227	161,803,612	10c	169,697,790
11	Investments—publicly traded securities ..........	278,002,054	11	310,962,871
12	Investments—other securities. See Part IV, line 11 .....	3,283,090	12	3,014,093
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	13,580,145	15	21,349,206
16	Total assets. Add lines 1 through 15 (must equal line 34)......	550,969,833	16	607,114,260
	17	Accounts payable and accrued expenses .........	38,279,251	17	45,777,524
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	134,407,000	20	135,345,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22	0
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....................	30,846,058	25	29,898,956
26	Total liabilities. Add lines 17 through 25.........	203,532,309	26	211,021,480
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	346,929,346	27	395,765,997
28	Temporarily restricted net assets ...........	508,178	28	326,783
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	347,437,524	33	396,092,780
34	Total liabilities and net assets/fund balances ........	550,969,833	34	607,114,260

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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

2012

Open to Public
Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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 described in 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. See section 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 - Non-functionally integrated

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a 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—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization SOUTHERN ILLINOIS HOSPITAL SERVICES

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization SOUTHERN ILLINOIS HOSPITAL SERVICES

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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) (2012)

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

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

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

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 SchCMd Bullet

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 SchCMd Bullet

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable 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) 2012

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

74,138

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

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

Yes

69,796

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

143,934

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, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Description of the activities reported on Lines 1a through 1i	Schedule C, Part II-B, Line 1	A PORTION OF DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION IS USED FOR LOBBYING BY THAT ASSOCIATION IN THE AMOUNT OF $69,796.
DIRECT CONTACT WITH LEGISLATORS	SCHEDULE C, PART II-B, LINE 1G	THE ORGANIZATION HAS HIRED A PROFESSIONAL SERVICES FIRM TO CONDUCT LOBBYING ON BEHALF OF THE ORGANIZATION. IN ADDITION, SEVERAL MEMBERS OF THE ORGANIZATION'S MANAGEMENT HAVE SPENT A PORTION OF THEIR TIME LOBBYING.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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 section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

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)

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

3a(ii)

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

Describe in Part XIII 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 .................	11,127,417		11,127,417
b	Buildings ................	105,863,901	53,172,363	52,691,538
c	Leasehold improvements ............	12,655,229	8,284,278	4,370,951
d	Equipment ................	238,732,061	145,506,586	93,225,475
e	Other .................	8,282,409		8,282,409
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				169,697,790

Schedule D (Form 990) 2012

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		0
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS		8,731,874
ACCRUED BOND INTEREST		588,320
MEDICAL PROFESSIONAL LIABILITY		4,352,067
ASBESTOS LIABILITY		276,009
LONG TERM EXECUTIVE RETIREMENT PLAN		307,956
EMPLOYEES HELPING EMPLOYEES FUNDS		35,858
DUE TO AFFILIATE - RIC		240,912
INTEREST RATE SWAP CONTRACT		15,006,798
RSP MATCH LIABILITY		88,569
DUE TO AFFILIATE - SIHE		270,593
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		29,898,956
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI 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 XIII.) ............	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 XIII.) ...........	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 XII 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 XIII.) ............	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 XIII.) ............	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 XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION REALIZED CERTAIN INCOME WHICH THE INTERNAL REVENUE SERVICE CONSIDERS TO BE UNRELATED BUSINESS INCOME SUBJECT TO INCOME TAX. FOR THE YEARS ENDED MARCH 31, 2013 AND 2012, NO TAX WAS DUE RELATED TO THESE OPERATIONS. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE MATTERS SUCH AS THE TAX EXEMPT ENTITY TAKING A TAX POSITION THAT AN ORGANIZATION IS TAX EXEMPT WITHOUT OBSERVING CORRESPONDING PROOF OF TAX EXEMPTION FROM FEDERAL AND STATE TAXING AUTHORITIES AND THERE IS MATERIAL NET INCOME GENERATED BY THE ENTITY OR EGREGIOUS COMPENSATION PAID TO INSIDERS THAT COULD RESULT IN REVOCATION OF EXEMPT STATUS (OUTSIDE THE SCOPE OF INTERMEDIATE SANCTIONS EXCISE TAX PENALTIES). THE TAX POSITION IS TO CONSIDER THAT THESE COMPENSATORY ARRANGEMENTS DO NOT JEOPARDIZE TAX EXEMPTION. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC 740 OR AT MARCH 31, 2013 AND 2012. THE CORPORATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE CORPORATION WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN MISCELLANEOUS EXPENSES. TAX RETURNS FILED BY THE CORPORATION ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE CORPORATION ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED MARCH 31, 2009 AND PRIOR.

Schedule D (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.

For grantmakers. 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

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	120,000
















3a	Sub-total .....
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0		120,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012

Schedule F (Form 990) 2012

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2012

Schedule F (Form 990) 2012Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2012

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2012

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation
Method used to account for expenditures on organization's financial statements	Schedule F, Part I, Line 3	CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL
Method used to account for expenditures on organization's financial statements	Schedule F, Part I, Line 3	CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL

Schedule F (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

2012

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 %

If the organization used factors other than FPG in determining 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, as a factor in determining 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

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			12,426,403		12,426,403	3.420 %
b	Medicaid (from Worksheet 3, column a) ....			64,543,361	41,823,108	22,720,253	6.250 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	76,969,764	41,823,108	35,146,656	9.670 %
Other Benefits				771,288		771,288	0.210 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..			771,288		771,288	0.210 %
f	Health professions education (from Worksheet 5) ..			2,551,508	581,562	1,969,946	0.540 %
g	Subsidized health services (from Worksheet 6) ..			3,250,953	2,214,741	1,036,212	0.280 %
h	Research (from Worksheet 7)			138,944		138,944	0.040 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			480,233		480,233	0.130 %
j	Total. Other Benefits ..	0	0	7,192,926	2,796,303	4,396,623	1.200 %
k	Total. Add lines 7d and 7j .	0	0	84,162,690	44,619,411	39,543,279	10.870 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

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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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building			113,659		113,659	0.030 %
7	Community health improvement advocacy			493,177		493,177	0.140 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	606,836	0	606,836	0.160 %

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

10,363,971

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

2,285,686

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

130,780,697

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

135,661,148

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

-4,880,451

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(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1PHYSCIAN'S SURGERY CENTER	SURGERY CENTER	55 %	2 %	41 %
2SOUTHERN ILLINOIS ORTHOPEDICS CENTER	MEDICINE	34 %	0 %	66 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?3 Name, address, and primary website address							Other (Describe)	Facility reporting group
1	MEMORIAL HOSPITAL OF CARBONDALE 405 WEST JACKSON STREET CARBONDALE,IL62901 WWW.SIH.NET	X	X	X		X		A
2	HERRIN HOSPITAL 201 SOUTH 14TH STREET HERRIN,IL62948 WWW.SIH.NET	X	X			X	ACUTE REHAB	A
3	ST JOSEPH MEMORIAL HOSPITAL 800 NORTH 2ND STREET MURPHYSBORO,IL62966 WWW.SIH.NET	X	X		X	X		A

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Yes

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Yes

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	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?.......	15	Yes
16	Check all of the following 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)
17	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?..........	17		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)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

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?18
Name and address		Type of Facility (describe)
1	SLEEP CENTER 8305 EXPRESS DRIVE MARION,IL62959	SLEEP STUDIES
2	THE HANDS OF HOPE MEDICAL CLINIC 808 W PRAIRIE ST MARION,IL62959	PRIMARY AND LIMITED SPECIALITY HEALTH CARE
3	BREAST CENTER 1237 EAST MAIN STREET CARBONDALE,IL62901	MAMMOGRAPHY FACILITY
4	MINERS MEMORIAL HEALTH CENTER 2553 KEN GRAY BLVD WEST FRANKFORT,IL62896	FAMILY PRACTICE, RADIOLOGY AND LAB SERVICES, AND SPECIALTY CLINICS
5	REHAB UNLIMITED 305 WEST JACKSON CARBONDALE,IL62901	PHYSICAL THERAPY
6	CANCER CARE CENTER 3117 WILLIAMSON COUNTY PARKWAY MARION,IL62959	CANCER TREATMENT SERVICES
7	LOGAN PARK RADIOLOGY AND LAB 405 RUSHING DRIVE HERRIN,IL62948	RADIOLOGY SERVICES, LABORATORY SERVICES
8	REHAB UNLIMITED AND FIT FOR WORK 515 EAST VIENNA STREET ANNA,IL62906	PHYSICAL THERAPY SERVICES
9	PHYSICIANS SURGERY CENTER 2601 WEST MAIN ST CARBONDALE,IL62901	SURGERY CENTER
10	WOUND CARE 315 SOUTH 13TH ST HERRIN,IL62948	WOUND CARE
11	REHAB UNLIMITED 6 EAST SHAWNEE DRIVE MURPHYSBORO,IL62864	PHYSICAL THERAPY SERIVCES
12	RIC PHYSICIAN PRACTICES 3224 SOUTH PARK AVENUE HERRIN,IL62948	REHABILITATION SERVICES
13	RIC AND SIH REHABILITATION SERVICES LLC PO BOX 3988 CARBONDALE,IL62901	REHABILITATION SERVICES
14	FRANKLIN MEDICAL ARTS 203 BAILEY LANE BENTON,IL62912	LAB AND IMAGING SERVICES
15	WOMEN'S CENTER 315 SOUTH 13TH ST HERRIN,IL62948	MAMMOGRAPHY SERVICE
16	FIT FOR WORK 101 SOUTH PARK AVENUE HERRIN,IL62948	PHYSICAL THERAPY SERVICES
17	LPC WF IMAGING AND LAB 502 ST LOUIS STREET WEST FRANKFORT,IL62896	RADIOLOGY SERVICES, LABORATORY SERVICES
18	REFERENCE LAB 500 LINCOLN DRIVE HERRIN,IL62948	LAB SERVICES

Schedule H (Form 990) 2012

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; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
BAD DEBT EXPENSE	SCHEDULE H, PART I, LINE 7	THE ORGANIZATION IS REQUIRED FOR GAAP TO RECORD BAD DEBT EXPENSE AS A CONTRA-REVENUE ACCOUNT. THEREFORE ON THE TAX RETURN THE BAD DEBT EXPENSE IS INCLUDED IN PART VIII AND NOT PART IX OF THE CORE FORM 990. THEREFORE THERE IS NO BAD DEBT EXPENSE TO REMOVE FROM TOTAL EXPENSES FOR PURPOSES OF CALCULATING CHARITY CARE AND COMMUNITY BENEFIT PERCENTAGES.
Costing Methodology used to calculate financial assistance	Schedule H, Part I, Line 7	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET NUMBER 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF CHARITY CARE PROVIDED AND WORKSHEET NUMBER 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE WAS UTILIZED FOR CALCULATING PORTIONS OF THE SUBSIDIZED HEALTH SERVICES. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE ENCOMPASSES ALL PATIENT TYPES, SERVICES, AND PAYORS. THE COST ASSOCIATED WITH A SERVICE ARE REVIEWED AND UPDATED ANNUALLY TO PROVIDE THE MOST ACCURATE COST POSSIBLE. BOTH DIRECT AND INDIRECT COSTS ARE CONSIDERED WHEN ENTERED INTO THE SYSTEM. ACTUAL COST OF HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH EDUCATION, RESEARCH PROGRAMS, SOME SUBSIDIZED HEALTH SERVICES AND DONATIONS ARE STATED AT ACTUAL COST. THE COSTS OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE.
Bad Debt Expense excluded from financial assistance calculation	Schedule H, Part I, Line 7, column(f)	0
Subsidized Health Services	Schedule H, Part I, Line 7g	A FAMILY PRACTICE CENTER IS INCLUDED IN SUBSIDIZED HEALTH SERVICES. THE COST OF PROVIDING THIS CENTER WAS $628,336.
Community Building Activities	Schedule H, Part II	THROUGH COMMUNITY BUILDING ACTIVITIES, SOUTHERN ILLINOIS HOSPITAL SERVICES ADDRESSES THE CAUSES OF HEALTH PROBLEMS THROUGH PROGRAMS THAT ADVOCATE FOR COMMUNITY HEALTH IMPROVEMENTS. THESE PROGRAMS INCLUDE: HEALTHY COMMUNITIES - THE FOCUS OF THE WORK IN THE AREA OF HEALTHY COMMUNITIES IS TO INCREASE THE CAPACITY OF LOCAL AGENCIES TO WORK COLLABORATIVELY TO ADDRESS THE UNMET HEALTH NEEDS WITHIN THE COMMUNITIES SERVED BY SIH HOSPITALS. DEPARTMENT STAFF WORKS TO IMPROVE COMMUNITY HEALTH THROUGH THE ASSESSMENT OF COMMUNITY NEEDS AND THE PLANNING, IMPLEMENTATION, AND EVALUATION OF COMMUNITY-BASED HEALTH PROMOTIONS, EDUCATION, PREVENTION PROGRAMS, AND SERVICES. IN FY13 AN INCREASED FOCUS WILL BE DIRECTED ON INITIATIVES ADDRESSING CARDIOVASCULAR DISEASE AND CANCER, THE DEVELOPMENT OF STRATEGIES, PROGRAMMING, AND INTERVENTIONS TO REDUCE METHAMPHETAMINE USAGE, AND THE CONTINUATION OF EFFORTS TO EXPAND ACCESS TO CARE FOR THE UNINSURED AND UNDER-INSURED. SIH IS ACTIVE IN TWO HEALTHY COMMUNITIES COALITIONS IN LOCAL COUNTIES. THESE COALITIONS ARE COMPRISED OF HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CITIZENS AND OTHER INTERESTED COMMUNITY GROUPS. COORDINATED SCHOOL HEALTH - "HEALTHY STUDENTS- READY TO LEARN" - THROUGH THE COORDINATED SCHOOL HEALTH PROGRAM, THE PARTNERS IN HEALTH TEAM WORKS WITH SCHOOL DISTRICTS TO ENSURE THAT THE LEARNING ENVIRONMENT IS STRUCTURALLY SAFE AS WELL AS FREE FROM FEAR. POLICIES, SCHOOL SAFETY PLANS AND LESSONS FOCUSING ON VIOLENCE PREVENTION CONTRIBUTE TO A SAFE SCHOOL ENVIRONMENT. COMPREHENSIVE, SKILL-BASED HEALTH EDUCATION, PHYSICAL EDUCATION IN SCHOOL THAT EMPHASIZES IMPROVED FITNESS, THE DEVELOPMENT OF A LIFELONG INTEREST IN HEALTH AND WELLNESS, AND DEVELOPING EXPANDED AND SUSTAINABLE HEALTH SERVICES IN SCHOOLS ARE FOCUS AREAS OF THIS PROGRAM. THE "PARTNERS IN HEALTH" INITIATIVE NOW INVOLVES 41 SCHOOLS, 21,000 STUDENTS AND 1,100 FACULTY AND STAFF. THE COMPONENTS OF A COORDINATED SCHOOL HEALTH PROGRAM INCLUDE HEALTH INSTRUCTION, PHYSICAL EDUCATION, HEALTH SERVICES, NUTRITION SERVICES, DEVELOPMENT OF A HEALTHY SCHOOL ENVIRONMENT, HEALTH PROMOTION FOR STAFF, PSYCHOLOGICAL AND SOCIAL SERVICES, AND FAMILY/COMMUNITY INVOLVEMENT. IN ADDITION TO THE PARTNERS IN HEALTH, SOUTHERN ILLINOIS HOSPITAL SERVICES IS WORKING COLLABORATIVELY TO ESTABLISH SCHOOL-BASED HEALTH CENTERS IN THE COMMUNITIES OF CARBONDALE, MARION, WEST FRANKFORT, AND BENTON. THIS IS A COLLABORATION OF MULTIPLE COMMUNITY PARTNERS WHOSE GOAL IS TO ALLEVIATE THE OVERALL HEALTH DISPARITIES BETWEEN CHILDREN THAT RECEIVE REGULAR PRIMARY CARE, SCREENINGS AND SPECIALIZED SERVICES AND THOSE WHO DO NOT EXPERIENCE SUCH CARE. BY OFFERING HEALTH SERVICES FOR CHILDREN IN SCHOOL SETTINGS, IMPROVED COORDINATION OF CARE WITH PRIMARY PHYSICIANS WILL BE ENHANCED, CHRONIC CONDITIONS CAN BE BETTER MANAGED, AND ACCESS WILL BE INCREASED TO THOSE LACKING A PRIMARY CARE PROVIDER. CURRENT EFFORTS INCLUDE PLANNED PARTNERSHIPS BETWEEN THE SCHOOLS AND WOULD INVOLVE MULTIPLE COLLABORATIVE ENTITIES SUCH AS COMMUNITY HEALTH CENTERS, COMMUNITY MENTAL HEALTH AGENCIES, LOCAL HEALTH DEPARTMENTS, RURAL HEALTH CLINICS AND SIH COMMUNITY BENEFITS. PATIENT SUPPORT INITIATIVE - SOUTHERN ILLINOIS HOSPITAL SERVICES PROVIDES A PATIENT SUPPORT INITIATIVE (PSI) WITH THE GOAL OF PROVIDING PATIENTS WITH ADEQUATE CARE AND COMPENSATING PHYSICIANS AT REASONABLE RATES FOR PATIENTS THAT DO NOT HAVE RESOURCES AVAILABLE TO PAY THEIR HEALTH CARE BILLS. SIHS COMPENSATES PHYSICIANS FOR THE CARE OF PATIENTS THAT ENTER THE HEALTHCARE SYSTEM VIA THE EMERGENCY DEPARTMENTS AT SIHS FACILITIES AND ARE ASSIGNED TO PHYSICIANS BASED UPON THE ON-CALL ROTATION COVERAGE. PSI IS DESIGNED FOR PHYSICIAN/PATIENT CONTACT THAT OCCURS IN A HOSPITAL BASED SETTING WHEN THERE WAS NO PREVIOUS RELATIONSHIP BETWEEN THE PATIENT AND THE PHYSICIAN OR THE PHYSICIAN'S PRACTICE. PSI PAYS COMPENSATION FOR PROFESSIONAL FEES ONLY, RELATING DIRECTLY TO THE EPISODE OF CARE BEGUN IN THE EMERGENCY DEPARTMENT, NOT TO EXCEED 30 DAYS. INDIGENT CARE FUNDING - SOUTHERN ILLINOIS HOSPITAL SERVICES PROVIDES FUNDING TO PURCHASE PRESCRIPTIONS, MEDICAL SUPPLIES AND TRANSPORTATION TO PATIENTS DEEMED FINANCIALLY INDIGENT ON A CASE-BY- CASE BASIS.
Bad debt expense - methodology used to estimate amount	Schedule H, Part III, Line 2	IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE CORPORATION REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE PROVISION FOR BAD DEBT. COSTING METHODOLGY OF BAD DEBT EXPENSE THE COST TO CHARGE RATIO IS CALCULATED UTILIZING WORKSHEET 2 INCLUDED IN THE INTERNAL REVENUE SERVICE'S FORM 990 SCHEDULE H INSTRUCTIONS. THIS COST TO CHARGE RATIO IS APPLIED TO THE CHARGES THAT ARE WRITTEN OFF PER THE ABOVE METHODOLOGY.
Bad debt expense - methodology used to estimate amount as community benefit	Schedule H, Part III, Line 3	COSTING METHODOLOGY TO ESTIMATE CHARITY CARE IN BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF CARE THAT WAS WRITTEN OFF AS BAD DEBT EXPENSE THAT WOULD HAVE BEEN ELIGIBLE FOR CHARITY UNDER OUR POLICY THE FOLLOWING STEPS WERE TAKEN: - THE NUMBER OF ENCOUNTERS BY COUNTY AT EACH OF OUR 3 FACILITIES WAS OBTAINED FROM OUR REGISTRATION SYSTEM. THE PERCENTAGE OF PATIENTS FROM EACH COUNTY VARIES BY FACILITY DUE TO THE LOCATION OF THE FACILITY. - THE AMOUNT OF BAD DEBT EXPENSE BY COUNTY AT EACH HOSPITAL WAS ESTIMATED BY APPLYING THE PERCENTAGES OBTAINED ABOVE TO THE AMOUNT OF TOTAL CHARGES WRITTEN OFF AT EACH FACILITY. - THE POVERTY RATE OF EACH COUNTY WAS THEN APPLIED TO THESE ALLOCATED CHARGES TO ESTIMATE THE AMOUNT OF CHARGES THAT WOULD HAVE BEEN ELIGIBLE UNDER OUR CHARITY POLICY BASED ON POVERTY LEVEL GUIDELINES. - THE COST TO CHARGE RATIO AS CALCULATED UTILIZING WORKSHEET 2 FROM THE SCHEDULE H INSTRUCTIONS WAS THEN USED TO DETERMINE THE COST OF THESE CHARGES.
Bad debt expense - financial statement footnote	Schedule H, Part III, Line 4	BAD DEBT EXPENSE FOOTNOTE IN FINANCIAL STATEMENTS "PATIENT RECEIVABLES DUE DIRECTLY FROM PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. A PATIENT RECEIVABLE IS CONSIDERED PAST DUE WHEN THE AMOUNT BILLED REMAINS UNPAID FOR MORE THAN 30 DAYS SUBJECT TO THIRD-PARTY PAYOR'S AGREED UPON TERMS, IF APPLICABLE. THE HOSPITALS DO NOT CHARGE INTEREST ON PATIENT RECEIVABLE ACCOUNTS WHICH ARE PAST DUE. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED."
Community benefit & methodology for determining medicare costs	Schedule H, Part III, Line 8	THE EXPENSES FROM THE AUDITED FINANCIAL STATEMENTS ARE ADJUSTED PER MEDICARE REGULATIONS. OVERHEADS ARE ALLOCATED BASED ON THE STEP-DOWN METHOD BY USING MEDICARE APPROVED STATISTICS. MEDICARE COSTS ARE DETERMINED BY MULTIPLYING THE DAYS OR CHARGES TIMES THE PER DIEM AMOUNT OR THE COST TO CHARGE RATIO APPLICABLE TO THE DEPARTMENT. HOME OFFICE EXPENSES ARE ALLOCATED TO THE FACILITIES BASED ON THE HOME OFFICE COST REPORT. STATISTICS USED ON THE HOME OFFICE COST REPORT ARE APPROVED BY THE MEDICARE INTERMEDIARY. ONE HUNDRED PERCENT OF THE SHORTFALL OF MEDICARE ALLOWABLE COSTS OVER MEDICARE REVENUE IS CONSIDERED TO BE A COMMUNITY BENEFIT.
Collection practices for patients eligible for financial assistance	Schedule H, Part III, Line 9b	THE FOLLOWING IS INCLUDED IN OUR POLICY - PATIENT FAIR BILLING AND COLLECTIONS, POLICY # SY-PF-128: PURSUING COLLECTION ACTION: SIH AND ITS AGENTS MAY PURSUE COLLECTION ACTION AGAINST AN UNINSURED PATIENT ONLY WHEN THE FOLLOWING CONDITIONS ARE MET: A. SIH HAS GIVEN THE UNINSURED PATIENT THE OPPORTUNITY TO: 1) ASSESS THE ACCURACY OF THE BILL. 2) APPLY FOR FINANCIAL ASSISTANCE IN ACCORDANCE WITH SIH'S HEALTHCARE ASSISTANCE POLICY (HAP) POLICY. 3) AVAIL THEMSELVES OF A REASONABLE PAYMENT PLAN BASED UPON THEIR ACCOUNT(S) BALANCE OR UPON THE PATIENT'S AVAILABLE INCOME AND ASSETS, THE AMOUNT OWED AND ANY PRIOR PAYMENTS. B. IF THE UNINSURED PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT, SIH OR PMD WILL OFFER THE PATIENT A REASONABLE PAYMENT PLAN. 1) SIH OR PMD MAY REQUIRE THE UNINSURED PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT. C. WHEN THE CIRCUMSTANCES OF THE UNINSURED PATIENT SUGGEST THE POTENTIAL FOR HAP ELIGIBILITY, THE UNINSURED PATIENT WILL BE GIVEN AT LEAST 60 DAYS FOLLOWING THE DATE OF DISCHARGE OR RECEIPT OF OUTPATIENT CARE TO SUBMIT A HAP APPLICATION. D. THE UNINSURED PATIENT HAS FAILED TO MAKE PAYMENTS IN ACCORDANCE WITH A REASONABLE PAYMENT PLAN PREVIOUSLY AGREED TO WITH SIH OR PMD. E. THE UNINSURED PATIENT INFORMS SIH THAT HE OR SHE HAS APPLIED FOR HEALTHCARE COVERAGE UNDER MEDICAID, KIDCARE OR OTHER GOVERNMENT SPONSORED HEALTHCARE PROGRAM (AND THERE IS A REASONABLE BASIS TO BELIEVE THE PATIENT WILL QUALIFY FOR SUCH PROGRAM) BUT THE PATIENT'S APPLICATION IS DENIED. SIH DOES NOT REFER A BILL, OR PORTION THEREOF, TO A COLLECTION AGENCY OR ATTORNEY FOR COLLECTION ACTION AGAINST THE INSURED PATIENT, WITHOUT FIRST OFFERING THE PATIENT THE OPPORTUNITY TO REQUEST A REASONABLE PAYMENT PLAN FOR THE AMOUNT PERSONALLY OWED BY THE PATIENT. A) THIS OPPORTUNITY IS AVAILABLE FOR THE 30 DAYS FOLLOWING THE INITIAL BILL DATE. B) IF THE INSURED PATIENT REQUESTS A REASONABLE PAYMENT PLAN, BUT FAILS TO AGREE TO A PLAN WITHIN 30 DAYS OF THE REQUEST, SIH MAY PROCEED WITH COLLECTION ACTION AGAINST THE PATIENT. NO COLLECTION AGENCY, LAW FIRM OR INDIVIDUAL MAY INITIATE LEGAL ACTION FOR NON-PAYMENT OF A HOSPITAL BILL AGAINST A PATIENT WITHOUT THE WRITTEN APPROVAL OF THE CFO OR CORPORATE DIRECTOR OF PFS WHO REASONABLY BELIEVES THE CONDITIONS FOR PURSUING COLLECTION HAVE BEEN MET. SIH MAY ENGAGE AN OUTSIDE THIRD PARTY COLLECTION AGENCY, FIRM OR INDIVIDUAL TO MANAGE THE PROCESS OF IMPLEMENTING SIH'S FINANCIAL ASSISTANCE AND REASONABLE PAYMENT PLAN PROGRAMS AND POLICIES SO LONG AS SUCH AGENCY, FIRM OR INDIVIDUAL IS CONTRACTUALLY BOUND TO COMPLY WITH THE TERMS OF PUBLIC ACT 094-0885 (PATIENT FAIR BILLING ACT). COLLECTION LIMITATIONS: SIH SHALL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF A HOSPITAL BILL AGAINST UNINSURED PATIENTS WHO HAVE CLEARLY DEMONSTRATED THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS PROVIDED THE PATIENT HAS MET THEIR RESPONSIBILITIES AS LISTED BELOW. A. PATIENT RESPONSIBILITIES: 1) TO RECEIVE THE PROTECTION AND BENEFITS OF THE PATIENT FAIR BILLING ACT, A PATIENT RESPONSIBLE FOR PAYING A HOSPITAL BILL MUST ACT REASONABLY AND COOPERATE IN GOOD FAITH WITH SIH BY PROVIDING SIH WITH ALL OF THE REASONABLY REQUESTED FINANCIAL AND OTHER RELEVANT INFORMATION AND DOCUMENTATION NEEDED TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER HAP OR REASONABLE PAYMENT PLAN OPTIONS WITHIN 30 DAYS OF A REQUEST FOR SUCH INFORMATION. 2) TO RECEIVE THE PROTECTION AND BENEFITS OF THE PATIENT FAIR BILLING ACT, A PATIENT RESPONSIBLE FOR PAYING A HOSPITAL BILL SHALL COMMUNICATE TO SIH ANY MATERIAL CHANGE IN THE PATIENT'S FINANCIAL SITUATION THAT MAY AFFECT THE PATIENT'S ABILITY TO ABIDE BY THE PROVISIONS OF AN AGREED UPON REASONABLE PAYMENT PLAN OR QUALIFICATION FOR HAP WITHIN 30 DAYS OF THE CHANGE.
Community Served by Needs Assessment	Schedule H, Part V Section B, Line 3	(1) MEMORIAL HOSPITAL OF CARBONDALE - THE BROAD INTERESTS OF THE COMMUNITY WE SERVE WERE INCORPORATED BY INCLUDING INPUT FROM RESIDENTS, PATIENT GROUPS, HEALTH CARE PRACTITIONERS, LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY ORGANIZATIONS AND PARTNERS. PARTICIPANTS CONTRIBUTED TO THIS ASSESSMENT BY: IDENTIFYING AND PRIORITIZING NEEDS; HIGHLIGHTING CURRENT SUCCESSFUL AND ONGOING ACTIVITIES; IDENTIFYING GAPS WHERE ATTENTION IS NEEDED; FOSTERING COLLABORATION, PURSUING OPPORTUNITIES FOR INNOVATION AND SUSTAINABILITY; AND DEVELOPING PLANS TO ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. THE PROCESS WAS GUIDED BY A STEERING COMMITTEE COMPOSED OF AN INTERNAL TEAM OF SIH REPRESENTATIVES AND AN EXTERNAL TEAM OF COMMUNITY STAKEHOLDERS KNOWLEDGEABLE ABOUT HEALTH, NEEDS ASSESSMENT, AND THE LOCAL COMMUNITY. THE PROCESS INCLUDED A PRIMARY SURVEY OF OUR COMMUNITY'S HEALTH PRIORITIES, A PATIENT FOCUS GROUP, AND FACILITATED GROUP DISCUSSIONS WITH LOCAL PUBLIC HEALTH DEPARTMENT STAFF, HEALTH AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY MEMBERS. ACTIVE PARTICIPATION IN LOCAL HEALTH COMMUNITY COALITIONS ALSO PROVIDED INSIGHT INTO THE NEEDS AND PRIORITIES OF OUR COMMUNITY MEMBERS. ;
Other Hospital Facilities included in Needs Assessment	Schedule H, Part V Section B, Line 4	(1) MEMORIAL HOSPITAL OF CARBONDALE - HERRIN HOSPITAL, HERRIN, IL ST JOSEPH MEMORIAL HOSPITAL, MURPHYSBORO, IL MEMORIAL HOSPITAL OF CARBONDALE, CARBONDALE, IL;
Needs assessment.	Schedule H, Part VI, Line 2	A COMPLETE COPY OF THE ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTP://WWW.SIH.NET/ABOUT/COMMUNITY-BENEFITS/
Patient education of eligibility for assistance.	Schedule H, Part VI, Line 3	THE FOLLOWING EXCERPT IS FROM OUR POLICY # SY-PF-128 PATIENT FAIR BILLING AND COLLECTIONS: PATIENT NOTIFICATION: 7.1 NOTICES ARE PLACED IN EACH PATIENT INTAKE OFFICE AND IN ALL AREAS WHERE PATIENT REGISTRATION TAKES PLACE THAT STATES SIH ACCEPTS MEDICARE, MEDICAID, AND ALL HEALTH INSURANCES, INCLUDING AUTOMOBILE AND LIABILITY. 7.2 NOTICES ARE PLACED IN EACH PATIENT INTAKE OFFICE, IN ALL AREAS WHERE PATIENT REGISTRATION TAKES PLACE AND THE EMERGENCY DEPARTMENT WAITING ROOMS THAT STATES "YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE TERMS AND CONDITIONS THE HOSPITAL OFFERS TO QUALIFIED PATIENTS." THE SIGNAGE IS IN ENGLISH AND SPANISH. 7.3 SIH'S WEBSITE PROMINENTLY POSTS A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE THROUGH HAP ALONG WITH A DESCRIPTION OF THE HAP APPLICATION PROCESS AND A COPY OF THE HAP APPLICATION. 7.4 INFORMATION (BROCHURE, HAP APPLICATION AND ANY OTHER APPLICABLE WRITTEN MATERIAL) REGARDING HAP IS AVAILABLE IN ALL PATIENT INTAKE OFFICES AND IN ALL AREAS WHERE PATIENT REGISTRATION TAKES PLACE. IN ADDITION, A STATEMENT REGARDING HOW AN UNINSURED PATIENT MAY APPLY FOR CONSIDERATION UNDER THE ORGANIZATION'S HEALTHCARE ASSISTANCE PROGRAM IS ATTACHED TO EACH HOSPITAL BILL. FINANCIAL COUNSELORS ARE AVAILABLE TO MEET OR DISCUSS WITH PATIENTS THE PAYMENT OF THEIR BILL INCLUDING REVIEWING MEDICAID AND / OR FINANCIAL ASSISTANCE ELIGIBILITY. FINANCIAL COUNSELORS WILL PROVIDE A COPY OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATION UPON REQUEST.
Community information.	Schedule H, Part VI, Line 4	THE PRIMARY SERVICE AREA OF SOUTHERN ILLINOIS HEALTHCARE IS A SEVEN-COUNTY REGION BETWEEN THE MISSISSIPPI AND OHIO RIVERS IN SOUTHERN ILLINOIS THAT INCLUDES PERRY, JACKSON, FRANKLIN, WILLIAMSON, UNION, JOHNSON, AND SALINE COUNTIES. THE COMBINED POPULATION OF THIS AREA IS APPROXIMATELY 244,000. SIH FACILITIES ARE LOCATED IN COMMUNITIES THAT ARE ADJACENT TO RT. 13, THE PRIMARY EAST-WEST STATE HIGHWAY THROUGH THE REGION, AND ON INTERSTATE I-57, THE MAIN NORTH-SOUTH TRANSPORTATION ARTERY. THESE COUNTIES ARE VERY RURAL: WILLIAMSON COUNTY, THE MOST DENSELY POPULATED COUNTY IN THE SIH SERVICE TERRITORY, CONTAINS 158 PERSONS PER SQUARE MILE. JOHNSON COUNTY, THE LEAST DENSELY POPULATED, CONTAINS 37 PERSONS PER SQUARE MILE. THE AVERAGE NUMBER OF PERSONS PER SQUARE MILE IN ILLINOIS IS 231. COLLECTIVELY, THE RESIDENTS OF EACH OF THESE COUNTIES HAVE MEDIAN HOUSEHOLD INCOMES THAT ARE SUBSTANTIALLY LESS THAN THE STATEWIDE AVERAGE OF $ 55,735. OF THE SEVEN COUNTIES, JOHNSON'S MEDIAN HOUSEHOLD INCOME IS THE HIGHEST AT $ 41,619 AND JACKSON COUNTY'S IS THE LOWEST AT $ 32,169. MORE OF THE RESIDENTS IN THESE COUNTIES LIVE IN POVERTY THAN THE STATE AVERAGE OF 12.6% WITH THE HIGHEST PERCENTAGE BEING 28.5% IN JACKSON COUNTY AND THE LOWEST OF 13.6% IN JOHNSON COUNTY. FURTHER EVIDENCE OF THE ECONOMIC DISTRESS OF THE REGION IS REFLECTED IN THE DEGREE OF CHILDHOOD POVERTY. NOT SURPRISINGLY, THESE COUNTIES RANK AMONG THE POOREST OF ILLINOIS' 102 COUNTIES BASED UPON THE PERCENTAGE OF CHILDREN LIVING IN POVERTY. JACKSON COUNTY HAS THE HIGHEST RATE, 32.1%, OF CHILDHOOD POVERTY RANKING 98TH IN THE STATE. FRANKLIN, UNION, WILLIAMSON, AND SALINE COUNTIES FALL CLOSELY BEHIND WITH RANKINGS OF 97TH, 92ND, 89TH, AND 83RD RESPECTIVELY. IN 2011, 19% OF PATIENTS IN THE SIH SERVICE AREA WHERE INSURED BY MEDICAID, 3% WERE DUAL-ELIGIBLE, 3% HAD PRIVATE-DIRECT INSURANCE, 31% WERE PRIVATE-EMPLOYER SELF-INSURED, AND 28% WERE UNINSURED. THE POPULATION OF THIS AREA IS LARGELY HOMOGENEOUS WITH A RACIAL MAKEUP THAT IS PREDOMINATELY WHITE, 95%+. JACKSON COUNTY IS THE MOST DIVERSE OF THE COUNTIES WITH 78.5% OF THE POPULATION BEING WHITE AND 14.7% AFRICAN AMERICAN. ALL SEVEN COUNTIES IN THE SIH PRIMARY SERVICE AREA ARE IN MEDICALLY UNDERSERVED AREAS. IN ADDITION, SIX OF THE SEVEN COUNTIES ARE ENTIRELY DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS BY THE HEALTH RESOURCES AND SERVICE ADMINISTRATION. OTHER HOSPITALS IN THE AREA INCLUDE UNION COUNTY HOSPITAL, SOUTHEAST HEALTH, AND ST. MARY'S GOOD SAMARITAN.
Promotion of community health	Schedule H, Part VI, Line 5	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) IS DEDICATED TO PROMOTING THE HEALTH AND WELL BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS GUIDED BY OUR VALUES: COMPASSION, COLLABORATION, QUALITY, STEWARDSHIP, INTEGRITY, ACCOUNTABILITY AND RESPECT. OVER 3,000 EMPLOYEES, ALONG WITH PHYSICIANS AND VOLUNTEERS, ARE WORKING TOGETHER TO ACHIEVE OUR MISSIONS AND ENSURE THAT THE HEALTH CARE NEEDS OF THOSE WE SERVE ARE MET BY TREATING PATIENTS IN SIHS FACILITIES, BY OFFERING SERVICES IN RURAL CLINICS, BY COLLABORATING WITH SOME OF AMERICA'S BEST HOSPITALS AND BY IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITIES WITH OUR CHARITABLE COMMUNITY BENEFITS PROGRAMS. SIHS PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. SIHS OPERATES 3 COMMUNITY HOSPITALS WITH A COMBINED TOTAL OF 240 BEDS. EACH HOSPITAL OPERATES A FULL TIME EMERGENCY ROOM. NO ONE IS DENIED CARE OR TREATMENT WITHIN THE HOSPITALS OR EMERGENCY ROOMS. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SERVICES PROVIDED AT EACH FACILITY. THE BOARD OF TRUSTEES OF SIHS IS COMPRISED OF 13 MEMBERS. THESE MEMBERS ARE COMPRISED OF LOCAL COMMUNITY LEADERS, PHYSICIANS AND OUR CEO AND A MAJORITY OF THE BOARD ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF SIH. SIHS INVESTS EXCESS FUNDS FROM OPERATIONS INTO THE EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, REPAYMENT OF DEBT AND IMPROVEMENT IN PATIENT CARE. SOUTHERN ILLINOIS HOSPITAL SERVICES HAS ALSO EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. ANNUALLY OPERATING FUNDS ARE ALLOCATED SPECIFICALLY TO BRING HEALTH-RELATED PROGRAMS TO THE AREAS IN WHICH THEY ARE MOST NEEDED. OUR GOAL IS TO REACH OUT TO COMMUNITIES TO LEARN HOW SIHS CAN HELP IN COMPLETING THE HEALTH CARE PICTURE. CURRENTLY, THE COMMUNITY BENEFITS DEPARTMENT OF SIHS COLLABORATES WITH SOUTHERN ILLINOIS SCHOOLS TO PROVIDE SCHOOL NURSING SERVICES AND A COMPREHENSIVE SCHOOL HEALTH EDUCATION PROGRAM. ADDITIONALLY, THE DEPARTMENT HAS UNDERTAKEN EFFORTS TO SUPPORT INCREASED ACCESS TO QUALITY HEALTH CARE IN THE REGION THROUGH A NUMBER OF INITIATIVES, INCLUDING THE DIRECT FINANCIAL SUPPORT OF THREE FREE HEALTH CLINICS. INCLUDED IN THESE AND OTHER DEPARTMENTAL INITIATIVES ARE EFFORTS TO ADDRESS DISPARITIES IN LOCAL RESIDENTS' HEALTH STATUS AND HEALTH OUTCOMES. A HEALTH MINISTRY INITIATIVE, AIDING THE REGION'S FAITH COMMUNITIES THROUGH THE TRAINING AND SUPPORT OF PARISH NURSES, IS AN ONGOING EFFORT OF THE DEPARTMENT. OVER 100 PARISH NURSES HAVE BEEN TRAINED AND ARE BEING SUPPORTED IN THE HEALTH PROMOTION WORK OF THEIR RESPECTIVE FAITH COMMUNITIES TO DATE. ALSO THE DEPARTMENT IS ACTIVE IN THE CREATION AND FACILITATION OF HEALTHY COMMUNITY COALITIONS. THESE GROUPS INCLUDE HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CONCERNED CITIZENS AND OTHER COMMUNITY GROUPS INTERESTED IN IMPROVING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. THE GROUPS SEEK TO MEET LOCALLY IDENTIFIED COMMUNITY HEALTH NEEDS THROUGH THE IMPLEMENTATION OF PROGRAMS THAT ADDRESS THE DEMONSTRATED UNMET HEALTH NEEDS OF THE RESIDENTS OF THE COMMUNITIES SERVED. THESE COALITIONS MAKE A SIGNIFICANT IMPACT ON THE LIVES OF THOSE WITHIN THE COMMUNITIES SERVED BY SIHS.
Affiliated health care system	Schedule H, Part VI, Line 6	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) IS PART OF A LARGER SYSTEM THAT PROVIDES HEALTH SERVICES TO THE POPULATION OF SOUTHERN ILLINOIS. SIHS PROVIDES CARE THROUGH ITS THREE HOSPITALS AND ONE COMMUNITY HEALTH CENTER. SOUTHERN ILLINOIS MEDICAL SERVICES (SIMS) PROVIDES CARE THROUGH PHYSICIAN PRACTICES. THESE PRACTICES ARE COMPRISED OF THE CENTER FOR MEDICAL ARTS, LOGAN PRIMARY CARE, INDIVIDUAL PHYSICIAN PRACTICES, HOSPITAL PHYSICIANS AND EMERGENCY ROOM PHYSICIANS. SIHS AND SIMS WORK TOGETHER IN PROVIDING CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED. BOTH PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.
State filing of community benefit report	Schedule H, Part VI, Line 7	IL

Schedule H (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

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

2012

Open to Public
Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number
37-0618939

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. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) LAND OF LINCOLN LEGAL ASSISTANCE FOUNDATION 509 S UNIVERSITY AVE 3RD FLOOR CARBONDALE,IL62901	37-0958448	501(C)(3)	80,000		N/A	N/A	GENERAL PROGRAM FUNDING
(2) SHAWNEE HEALTH SERVICES 109 CALIFORNIA STREET PO BOX 577 CARTERVILLE,IL62918	37-0966854	501(C)(3)	84,084		N/A	N/A	GENERAL PROGRAM FUNDING
(3) SOUTHERN ILLINOIS UNIVERSITY 1235 DOUGLAS DRIVE CARBONDALE,IL62901	37-6024575	501(C)(3)	95,000		N/A	N/A	GENERAL PROGRAM FUNDING
(4) AMERICAN HEART ASSOCIATION PO BOX 40022902 DES MOINES,IA503402902	13-5613797	501(C)(3)	15,000		N/A	N/A	GENERAL PROGRAM FUNDING
(5) JACKSON COUNTY HEALTH DEPARTMENT 415 HEALTH DEPARTMENT ROAD MURPHYSBORO,IL62956	37-6001092	501(C)(3)	18,612		N/A	N/A	GENERAL PROGRAM FUNDING
(6) AMERICAN CANCER SOCIETY 4503 WEST DEYOUNG SUITE 200 C MARION,IL62959	13-1788491	501(C)(3)	12,000		N/S	N/A	GENERAL PROGRAM FUNDING
(7) REHAB INSTITUTE OF CHICAGO 345 EAST SUPERIOR CHICAGO,IL60016	37-2256036	501(C)(3)	5,500		N/A	N/A	GENERAL PROGRAM FUNDING
(8) SOUTHERN IL REGIONAL SOCIAL SERVICES 604 EAST COLLEGE CARBONDALE,IL62901	37-0795898	501(C)(3)	14,584		N/A	N/A	GENERAL PROGRAM FUNDING
(9) WOMEN FOR HEALTH & WELLNESS 700 LOGAN COLLEGE ROAD CARTERVILLE,IL62918	37-1331447	501(C)(3)	20,000		N/A	N/A	GENERAL PROGRAM FUNDING
(10) HERRIN CHAMBER OF COMMERCE 3 SOUTH PARK AVENUE SUITE A HERRIN,IL62948	37-0618499	501(C)(6)	7,500		N/A	N/A	GENERAL PROGRAM FUNDING
(11) ILLINOIS POISON CENTER 222 SOUTH RIVERSIDE PLAZA SUITE 1900 CHICAGE,IL60606	36-2167008	501(C)(3)	18,468		N/A	N/A	GENERAL PROGRAM FUNDING
(12) UNION COUNTY AMBULANCE PO BOX 37 JONESBORO,IL62952	37-6002199	UNION COUNTY IL GOV	10,000		N/A	N/A	GENERAL PROGRAM FUNDING
(13) NATIVE AMERICAN HERITAGE ASSOCIATION 830F JOHN MARSHALL HIGHWAY FRONT ROYAL,VA22630	46-0414390	501(C)(3)		31,731	FIXED COST PER POUND	MEDICAL SUPPLIES	PROGRAM USE

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

Cat. No. 50055P

Schedule I (Form 990) 2012

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.
Part III can be duplicated 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, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
Procedures for monitoring use of grant funds	Schedule I, Part I, Line 2	ALL GRANTS MADE ARE UNRESTRICTED AND CAN BE USED IN ANY WAY THE DONEE ORGANIZATION SEES FIT TO FURTHER ITS EXEMPT PURPOSE.

Schedule I (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

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

2012

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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 of the expenses described above? If "No," complete Part III to explain....

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? .......

Indicate which, if any, of the following the filing organization used 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? .........

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2012

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 (E) amounts for that individual.

(A) Name and Title		(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 and Title		(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)BRIAN LANCEPHARMACIST	(i) (ii)	175,484 0	1,396 0	6,691 0	7,317 0	26,804 0	217,692 0	0 0
(2)CLAUDIA CREWSPHARMACIST	(i) (ii)	151,582 0	797 0	21,986 0	6,428 0	38,136 0	218,929 0	0 0
(3)DAVID HOLLANDVP/ INFO SYSTEMS	(i) (ii)	212,717 0	109 0	84,609 0	82,593 0	21,229 0	401,257 0	74,946 0
(4)JAMES MILLER MDCMO	(i) (ii)	300,253 0	109 0	90,122 0	27,000 0	39,333 0	456,817 0	78,774 0
(5)JOHN B MILLSTEADVP/ ADMINISTRATOR	(i) (ii)	321,659 0	109 0	97,219 0	124,872 0	40,684 0	584,543 0	86,603 0
(6)JOHN BROTHERSADMINISTRATOR/ VP	(i) (ii)	164,550 0	114 0	12,453 0	2,875 0	14,631 0	194,623 0	0 0
(7)JULIE FIRMANVP/CNO	(i) (ii)	191,970 0	109 0	82,024 0	77,366 0	19,052 0	370,521 0	72,752 0
(8)LEAH MACFARLANEPHARMACIST	(i) (ii)	166,956 0	340 0	171 0	6,764 0	14,159 0	188,390 0	0 0
(9)MIKE KASSERVP/CFO/TREASURER	(i) (ii)	297,101 0	985 0	26,152 0	101,497 0	34,375 0	460,110 0	0 0
(10)PAM HENDERSONVP/ HR	(i) (ii)	201,427 0	109 0	71,414 0	74,426 0	4,300 0	351,676 0	59,595 0
(11)PHILIP SCHAEFERVP/ AMBULATORY SERVICES	(i) (ii)	278,935 0	109 0	94,954 0	113,728 0	46,985 0	534,711 0	83,956 0
(12)REX BUDDEPRESIDENT/CEO	(i) (ii)	471,744 0	109 0	48,125 0	201,539 0	55,965 0	777,482 0	32,657 0
(13)SCOTT SEABORNVP/ ADMINISTRATOR	(i) (ii)	222,274 0	839 0	270,903 0	9,058 0	22,299 0	525,373 0	253,629 0
(14)SHELLY PIERCECORP DIRECTOR PT RELATIONS	(i) (ii)	178,176 0	114 0	1,989 0	20,874 0	15,068 0	216,221 0	0 0
(15)TERRENCE FARRELLVP/ ADMINISTRATOR	(i) (ii)	252,053 0	109 0	16,250 0	72,363 0	28,256 0	369,031 0	0 0
(16)THOMAS HENTRICHPHARMACIST	(i) (ii)	167,594 0	5,641 0	11,649 0	7,253 0	37,052 0	229,189 0	0 0
(17)WILLIAM SHERWOODVP/ GENERAL COUNSEL	(i) (ii)	245,665 0	109 0	230,592 0	128,798 0	41,657 0	646,821 0	217,765 0
(18)WILLIAM THORNEVP/ COMMUNITY BENEFITS	(i) (ii)	165,590 0	114 0	14,562 0	61,475 0	37,782 0	279,523 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
Severance or change-of-control payment	Schedule J, Part I, Line 4a	BECKY ASHTON, VP/ADMINSTRATOR RECEIVED SEVERANCE PAYMENTS OF $237,144.
Supplemental nonqualified retirement plan	Schedule J, Part I, Line 4b	THE ORGANIZATION MADE THE FOLLOWING SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS/CONTRIBUTIONS: REX BUDDE - $32,657 PAYMENT, $191,539 DEFERRED COMPENSATION BECKY ASHTON-$90,484 PAYMENT, $83,315 DEFERRED COMPENSATION PAM HENDERSON - $59,595 PAYMENT, $66,309 DEFERRED COMPENSATION DAVE HOLLAND - $74,946YMENT, $74,327DEFERRED COMPENSATION MIKE KASSER - NO PAYMENT, $91,497 DEFERRED COMPENSATION JAMES MILLER - $78,774 PAYMENT, $17,000 DEFERRED COMPENSATION BART MILLSTEAD - $86,603 PAYMENT, $114,872 DEFERRED COMPENSATION PHIL SCHAEFER - $83,956 PAYMENT; $103,728 DEFERRED COMPENSATION SCOTT SEABORN - $253,629 PAYMENT, NO DEFERRED COMPENSATION BILL SHERWOOD - $217,765 PAYMENT, $118,798 DEFERRED COMPENSATION JULIE FIRMAN - $72,752 PAYMENT, $70,646 DEFERRED COMPENSATION WILLIAM THORNE - NO PAYMENT. $54,479 DEFERRED COMPENSATION TERENCE FARRELL - NO PAYMENT, $68,010 DEFERRED COMPENSATION SHELLY PIERCE - NO PAYMENET, $14,232 DEFERRED COMPENSATION

Schedule J (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

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

2012

Open to Public
Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number
37-0618939

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	ILLINOIS FINANCE AUTHORITY	86-1091967	45200FS42	02-18-2010	68,985,878	DEEMED REISSUANCE OF 2005 BONDS		X		X		X
B	ILLINOIS FINANCE AUTHORITY	86-1091967	45200FSD2	11-16-2011	52,750,000	DEEMED REISSUANCE OF 2008 VARIABLE RATE DEMAND REVENUE BONDS		X		X		X
C	ILLINOIS FINANCE AUTHORITY	86-1091967		10-27-2011	14,420,000	REFUNDING 1998 BOND ISSUE		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	0		995,000		3,830,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	68,985,878		52,750,000		14,420,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0		0		0
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	0		0		282,518
8 Credit enhancement from proceeds . . . . . . . . . . .	0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		0		0
11 Other spent proceeds . . . . . . . . . . . . . .	68,985,878		52,750,000		14,137,482
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2010		2011		2011
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2012

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
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
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		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
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 . .	0.0000%		0.0000%		0.0000%		%
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 . . . . . . .	0.0000%		0.0000%		0.0000%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.0000%		0.0000%		0.0000%		%
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0.000000%		0.000000%		0.000000%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X
9 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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X		X		X
b Exception to rebate? . . . . . . . .		X		X		X
c No rebate due? . . . . . . . . . .		X		X		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X	X			X
b Name of provider . . . . . . . . .	MORGAN STANLEY CAPITAL SERVICES		MORGAN STANLEY CAPITAL SERVICES
c Term of hedge . . . . . . . . . .	0.0		27.3		0.0
d Was the hedge superintegrated? . . . . . .		X		X		X
e Was a hedge terminated? . . . . . . .		X		X		X

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .	0.0		0		0.0
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .		X		X		X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 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?	X		X		X

Part VI

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

Identifier	Return Reference	Explanation
EXPLANATION OF BOND ISSUE	SCHEDULE K, PART I	THE BOND ISSUE REFERRED TO IN PART I, LINE A RELATES TO 2005 MULTI-MODAL BONDS THAT WERE CONVERTED TO A FLOATING INDEX RATE INTEREST MODE AND DEEMED REISSUED FOR PURPOSES OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, ON 11/5/2008. THE BOND WAS THEN CONVERTED TO A FIXED INTEREST RATE AND DEEMED REISSUED FOR PURPOSES OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, ON 02/18/2010.
WRITTEN POLICY	SCHEDULE K, PART V	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES WHICH DICTATE HOW MANAGEMENT TIMELY IDENTIFIES AND CORRECTS VIOLATIONS OF FEDERAL TAX REQUIREMENTS USING THE VOLUNTARY CLOSING AGREEMENT PROGRAM PROVIDED BY THE IRS WHEN SELF-REMEDIATION IS NOT AVAILABLE TO THE ORGANIZATION. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. IN THE EVENT A VIOLATION IS IDENTIFIED THE ORGANIZATION'S POLICY IS TO CORRECT THE VIOLATION AS SOON AS POSSIBLE, WHILE WORKING WITH THE FEDERAL AUTHORITIES AS NECESSARY TO ENSURE THAT SUFFICIENT CONTROLS ARE PRESENT WHICH WILL GUARD AGAINST FUTURE VIOLATIONS.

Schedule K (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)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 assistance	(d) Type of assistance	(e) Purpose of assistance
(1) LIAM FARREL	SON OF TERENCE FARRELL (OFFICER)	5,322	GRANT	NURSING SCHOLARSHIP

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

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) JILL KASSER	SPOUSE OF VP/CFO, MIKE KASSER	28,814	EMPLOYEE COMPENSATION		No
(2) LIAM FARRELL	SON OF VP/ADMINISTRATOR TERENCE FARRELL	23,724	EMPLOYEE COMPENSATION		No

Part V

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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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

2012

Open to Public
Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	(CONTINUED FROM PART III) OVER 3,000 EMPLOYEES, ALONG WITH PHYSICIANS AND VOLUNTEERS, ARE WORKING TOGETHER TO ACHIEVE OUR MISSION AND ENSURE THAT THE HEALTH CARE NEEDS OF THOSE WE SERVE ARE MET BY TREATING PATIENTS IN SIHS FACILITIES, BY OFFERING SERVICES IN RURAL CLINICS, BY COLLABORATING WITH SOME OF AMERICA'S BEST HOSPITALS AND BY IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITIES WITH OUR CHARITABLE COMMUNITY BENEFITS PROGRAMS. OUR SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.
HOSPITAL SERVICES	FORM 990, PART III, LINE 4A	(CONTINUED FROM PART III) THE FACILITIES THAT MAKE UP SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) INCLUDE: MEMORIAL HOSPITAL OF CARBONDALE: OPENED IN 1950, MEMORIAL HOSPITAL OF CARBONDALE IS THE LARGEST FACILITY AND A REGIONAL MEDICAL CENTER WITH 140 LICENSED BEDS. IT IS HOME TO THE FIRST OPEN HEART SURGERY PROGRAM IN THE IMMEDIATE SOUTHERN ILLINOIS AREA AND OFFERS HIGH-QUALITY CARDIAC SERVICES. THE HOSPITAL IS ALSO HOME TO A REGIONAL CANCER TREATMENT CENTER, THE ONLY LEVEL II PLUS NEO-NATAL INTENSIVE CARE UNIT, AND THE ONLY PEDIATRIC UNIT IN THE IMMEDIATE SOUTHERN ILLINOIS AREA. THE HOSPITAL IS AFFILIATED WITH SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL THROUGH ITS FAMILY PRACTICE RESIDENCY PROGRAM. HERRIN HOSPITAL: OPENED IN 1913, HERRIN HOSPITAL WAS THE FIRST HOSPITAL OWNED AND OPERATED BY THE ORGANIZATION. HERRIN HOSPITAL CURRENTLY OPERATES 75 LICENSED BEDS. IT IS ALSO HOME TO THE 29 BED ACUTE REHABILITATION CENTER, AN AFFILIATE PROGRAM WITH THE REHABILITATION INSTITUTE OF CHICAGO, RECOGNIZED AS THE TOP REHABILITATION HOSPITAL IN AMERICA. THROUGH THIS AFFILIATION, PATIENTS RECOVERING FROM STROKE AND INJURY RECEIVE THE BEST POSSIBLE CARE IN THE REGION. ST. JOSEPH MEMORIAL HOSPITAL: A 25 LICENSED BED ACUTE CARE CATHOLIC HOSPITAL FACILITY; ST JOSEPH MEMORIAL HOSPITAL IS LOCATED IN MURPHYSBORO, ILLINOIS. ST. JOSEPH OPENED ON OCTOBER 1, 1960 AND WAS ACQUIRED BY SOUTHERN ILLINOIS HOSPITAL SERVICES ON JANUARY 5, 1995. ST JOSEPH'S CATHOLIC IDENTITY HAS BEEN RETAINED BY SIHS SINCE THE PURCHASE. ST. JOSEPH IS HOME TO THE SLEEP DISORDERS CENTER, WHICH IS DEDICATED TO THE DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS. MINERS MEMORIAL HEALTH CENTER: WEST FRANKFORT, ILLINOIS IS HOME TO MINERS MEMORIAL HEALTH CENTER. THE HEALTH CENTER HOUSES A PHYSICIAN SPECIALTY CLINIC THAT OFFERS VISITING SPECIALISTS INCLUDING UROLOGY, PODIATRY AND CARDIOLOGY. IT IS ALSO HOME TO WEST FRANKFORT FAMILY MEDICINE, WITH FAMILY MEDICINE AND OBSTETRIC PHYSICIANS FROM SIU SCHOOL OF MEDICINE, AND OFFERS MAMMOGRAPHY, X-RAY, ULTRASOUND, BONE DENSITOMETRY, AND LABORATORY SERVICES. SERVICES PROVIDED: DURING THIS REPORTING PERIOD, OUR HOSPITALS RECORDED 60,723 ADULT AND CHILD PATIENT DAYS AND 3,116 NEWBORN PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 311,723 WITH 67,985 OF THESE REGISTRATIONS BEING EMERGENCY ROOM VISITS. APPROXIMATELY 59.67% OF THESE DAYS AND REGISTRATIONS PROVIDED CARE THAT WAS CLASSIFIED AS EITHER UNCOMPENSATED CHARITY CARE OR UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. AN ADDITIONAL 3.2% OF THE CARE PROVIDED IN THESE DAYS AND REGISTRATIONS WERE WRITTEN OFF AS BAD DEBT. ROUTINE INPATIENT CARE AND OUTPATIENT PROCEDURES ARE PROVIDED AT ALL THREE OF OUR FACILITIES. EACH FACILITY ALSO HAS ITS OWN UNIQUE PROGRAMS AND PATIENT CARE UNITS. OUR TWO LARGER FACILITIES, CARBONDALE MEMORIAL HOSPITAL AND HERRIN HOSPITAL BOTH HOUSE INTENSIVE CARE UNITS. THESE TWO LARGER FACILITIES EACH HAVE SPECIALTY UNITS WITHIN THEIR RESPECTIVE FACILITIES. CARBONDALE MEMORIAL HOSPITAL PROVIDES OBSTETRICAL, PEDIATRICS, AND A NEONATAL NURSERY. HERRIN HOSPITAL PROVIDES THE ACUTE REHABILITATION CENTER. PATIENTS IN THE ACUTE REHABILITATION CENTER ARE GIVEN THERAPY TO RECOVER FROM STROKE, CARDIAC EVENTS, SURGERIES, AND INJURIES. SURGICAL SERVICES ARE OFFERED AT ALL FACILITIES, WITH CARBONDALE MEMORIAL HOSPITAL PROVIDING OPEN-HEART AND CARDIAC SERVICES. TWO UNIQUE PROGRAMS OF ST. JOSEPH MEMORIAL HOSPITAL ARE THE SLEEP DISORDERS CENTER AND THE SENIOR RENEWAL PROGRAM. THE SLEEP DISORDERS CENTER OFFERS TWO LOCATIONS TO DIAGNOSE SLEEP DISORDERS. THE SENIOR RENEWAL PROGRAM OFFERS OUTPATIENT BEHAVIORAL HEALTH TREATMENT THROUGH A COMBINATION OF GROUP PSYCHOTHERAPY, INDIVIDUAL AND/OR FAMILY THERAPY AND INTENSIVE NURSING EDUCATION. SIHS HAS ALSO PROVIDED SUBSIDIZED HEALTH CARE SERVICES. SUBSIDIZED HEALTH SERVICES INCLUDE, BUT ARE NOT LIMITED TO PHYSICIAN REFERRAL CENTERS, FAMILY PRACTICE CENTERS, SENIOR MEMBERSHIP, ETC. THESE HEALTH CARE SERVICES ARE PROVIDED IN RESPONSE TO COMMUNITY NEEDS. THESE HEALTH SERVICES MUST BE SUBSIDIZED FROM OTHER REVENUE SOURCES IN ORDER TO BE PROVIDED. SIHS PROVIDES MEDICAL EDUCATION THROUGH AN AFFILIATION WITH THE SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL FAMILY PRACTICE RESIDENCY PROGRAM.
COMMUNITY BENEFITS	FORM 990, PART III, LINE 4B	(CONTINUED FROM PART III) THE COMMUNITY BENEFITS DEPARTMENT'S PRIMARY FUNCTIONS THAT ARE PERFORMED ON BEHALF OF SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) INCLUDE: - COORDINATE SYSTEM-WIDE COMMUNITY HEALTH ASSESSMENTS AND COMMUNITY BENEFIT PLANNING; - PLAN, IMPLEMENT, AND EVALUATE DEPARTMENTALLY INITIATED COMMUNITY HEALTH PROMOTION PROGRAMS AND SERVICES; - INITIATE AND PARTICIPATE IN COLLABORATIVE PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS TO DEVELOP AND IMPLEMENT SOLUTIONS TO UNMET HEALTH NEEDS; - CONVENE COMMUNITY-BASED ORGANIZATIONS AND PUBLIC SECTOR ENTITIES TO FOCUS ON PERVASIVE ISSUES AND TO DEVELOP HEALTH INITIATIVES; AND - IDENTIFY FUNDING OPPORTUNITIES/GRANT PROGRAMS THAT FUND COMMUNITY-BASED HEALTH PROGRAMS AND PUBLIC/PRIVATE HEALTH INITIATIVES. COMMUNITY BENEFITS SERVICES TARGET THE FOLLOWING COMMUNITIES AND POPULATIONS: - UNINSURED, UNDERINSURED AND UNDER-SERVED; - POPULATIONS THAT ARE VULNERABLE DUE TO A RANGE OF SOCIO-ECONOMIC BARRIERS SUCH AS POVERTY, EDUCATION LEVELS, EMPLOYMENT STATUS, AND/OR RACIAL DISPARITIES IN HEALTH CARE; - POPULATIONS THAT ARE HARD TO REACH DUE TO LANGUAGE AND CULTURAL CHALLENGES; - POPULATIONS WITH IDENTIFIED NEEDS THAT CAN BE EFFICIENTLY REACHED THROUGH THE LEVERAGING OF COMMUNITY LINKAGES (I.E. FAITH-BASED, SCHOOLS, NEIGHBORHOODS, COMMUNITIES, ETC.); - THE WORKING POOR; AND - POPULATIONS AT RISK OF EXPERIENCING ADVERSE HEALTH CONDITIONS OR OUTCOMES. IN ORDER TO ACCOMPLISH THE ORGANIZATION'S MISSION, THE COMMUNITY BENEFITS DEPARTMENT OF SIHS IMPLEMENTS A NUMBER OF DIRECTED INITIATIVES. PROGRAMS DURING THE REPORTING YEAR INCLUDE: HEALTH MINISTRY -- THE HEALTH MINISTRY PROGRAM COLLABORATES WITH SOUTHERN ILLINOIS FAITH COMMUNITIES TO IMPROVE THE HEALTH AND WELLNESS OF PEOPLE IN THE COMMUNITIES THEY SERVE. EMPHASIZING WHOLENESS OF BODY, MIND AND SPIRIT, FAITH COMMUNITIES WITH A HEALTH MINISTRY OFFER HEALTH PROMOTION AND EDUCATION ACTIVITIES; ADVOCACY AND REFERRAL; AND CARING SPIRITUAL SUPPORT. HEALTHY COMMUNITIES -- THE FOCUS OF THE WORK IN THE AREA OF HEALTHY COMMUNITIES IS TO INCREASE THE CAPACITY OF LOCAL AGENCIES TO WORK COLLABORATIVELY TO ADDRESS THE UNMET HEALTH NEEDS WITH THE COMMUNITIES SERVED BY SIHS. STAFF WILL WORK TO IMPROVE COMMUNITY HEALTH THROUGH THE ASSESSMENT OF COMMUNITY NEEDS AND THE PLANNING, IMPLEMENTATION, AND EVALUATION OF COMMUNITY BASED HEALTH PROMOTIONS, EDUCATION, PREVENTION PROGRAMS, AND SERVICES. AN INCREASED FOCUS OF THESE ACTIVITIES WILL BE DIRECTED TO INITIATIVES ADDRESSING CARDIOVASCULAR DISEASE AND CANCER, AND THE DEVELOPMENT OF STRATEGIES, PROGRAMMING, AND INTERVENTIONS TO REDUCE SUBSTANCE ABUSE, AND THE CONTINUATION OF EFFORTS TO EXPAND ACCESS TO CARE FOR THE UNINSURED AND THE UNDER-SERVED. HEALTHY COMMUNITY COALITIONS ARE THE FORMAL GATHERING OF HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CONCERNED CITIZENS, AND OTHER COMMUNITY GROUPS INTERESTED IN IMPROVING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. SIHS IS ACTIVE IN TWO SUCH COALITIONS, ONE IN JACKSON COUNTY, AND THE OTHER IN FRANKLIN AND WILLIAMSON COUNTIES.
SCHOOL BASED HEALTH SERVICES	FORM 990, PART III, LINE 4C	(CONTINUED FROM PART III) THE FOLLOWING IS A SUMMARY OF THE PROGRAMS DURING THIS REPORTING YEAR: PARTNERS IN HEALTH -- A COLLABORATIVE INITIATIVE, PARTNERING WITH REGIONAL SCHOOLS, PROMOTING AND ASSISTING IN THE IMPLEMENTATION OF COORDINATED SCHOOL HEALTH PROGRAMMING IN SCHOOLS BY SUPPLYING CURRICULUM, MATERIALS, SUPPLIES, TEACHER TRAINING, AND ONGOING SUPPORT IN SOUTHERN ILLINOIS SCHOOLS. STAFF ASSISTS SCHOOL PERSONNEL WITH ASSESSMENT, PROGRAM PLANNING, IMPLEMENTATION, AND EVALUATION WITHIN THE EIGHT AREAS OF THE COORDINATED SCHOOL HEALTH MODEL. INVOLVED IN THIS PROGRAM ARE FIVE COLLABORATING PARTNERS, 53 SCHOOLS, 25,000 STUDENTS, AND APPROXIMATELY 1100 FACULTY AND STAFF. HEALTHY STUDENTS - READY TO LEARN -- SCHOOLS PROVIDE AN IDEAL LOCATION WHERE A RANGE OF HEALTH SERVICES CAN BE DELIVERED TO THE ADOLESCENT POPULATION EFFECTIVELY AND EFFICIENTLY. THE SCHOOL BASED HEALTH CENTER IS A PLANNED PARTNERSHIP BETWEEN THE SCHOOL DISTRICT AND LOCAL HEALTH CARE PROVIDERS TO DELIVER PRIMARY HEALTH CARE AND SOCIAL SERVICES. THROUGH THE COLLABORATIVE RELATIONSHIP WITH EXISTING HEALTH CARE PROVIDERS, SCHOOL DISTRICTS PLAN, DELIVER, AND EVALUATE SERVICES THAT SERVE THE UNMET HEALTH NEEDS OF THE STUDENTS WITH THE GOAL OF IMPROVED OVERALL ACADEMIC AND SOCIAL OUTCOMES. SERVICES PROVIDED AT THE SCHOOL BASED HEALTH CENTER INCLUDE PRIMARY CARE, IMMUNIZATIONS, VISION SCREENING, SOCIAL SERVICE REFERRALS, MENTAL HEALTH COUNSELING, AND NUTRITION COUNSELING. COLLABORATIVE AGENCIES ARE WORKING TO SERVE THE HEALTH NEEDS OF 9,900 STUDENTS AND 670 IN NEWLY DEVELOPED SCHOOL BASED HEALTH CENTERS IN 6 SCHOOL DISTRICTS. HEALTHY FITNESS ZONE -- PROMOTES LIFELONG FITNESS BY SUPPORTING QUALITY PHYSICAL EDUCATION IN SOUTHERN ILLINOIS SCHOOLS AND ASSISTING CHILDREN TO MEET THE SURGEON GENERAL'S RECOMMENDATION FOR 60 MINUTES OF DAILY PHYSICAL ACTIVITY. THIS INITIATIVE IS BASED UPON CURRENT LOCAL RESEARCH AND NATIONAL PHYSICAL EDUCATION STANDARDS PUBLISHED BY THE NATIONAL ASSOCIATION FOR SPORTS AND PHYSICAL EDUCATION (NASPE). PROGRAM COMPONENTS ASSIST SCHOOLS IN DEVELOPING A QUALITY PHYSICAL EDUCATION PROGRAM THAT HELPS STUDENTS SET AND WORK TOWARD GOALS; PRACTICE SELF-ASSESSMENT; AND LEARN THE BENEFITS OF LIFELONG PHYSICAL ACTIVITY. FITNESSGRAM WAS DEVELOPED BY THE COOPER INSTITUTE AND UNLIKE OTHER ASSESSMENT TOOLS, IS DESIGNED TO ENCOURAGE YOUTH TO SET GOALS TO IMPROVE THEIR OWN PERSONAL FITNESS LEVELS. NATIONAL PHYSICAL EDUCATION GUIDELINES RECOMMEND THE USE OF FITNESSGRAM FOR PHYSICAL FITNESS ASSESSMENTS. CATCH (COORDINATED APPROACH TO CHILD HEALTH) -- CATCH IS A PROGRAM DESIGNED TO PROMOTE PHYSICAL ACTIVITY, HEALTHY FOOD CHOICES, AND PREVENT TOBACCO USE IN ELEMENTARY SCHOOL AGED CHILDREN. CATCH EMPLOYS A COORDINATED APPROACH TO CHILD HEALTH PROMOTION BY TARGETING MULTIPLE ASPECTS OF THE SCHOOL ENVIRONMENT AND INVOLVING CLASSROOM TEACHERS, SCHOOL FOOD SERVICE STAFF, PHYSICAL EDUCATION (PE) TEACHERS, STUDENTS' FAMILIES, AND THE BROADER SCHOOL COMMUNITY IN A RANGE OF HEALTH PROMOTING ACTIVITIES FOR ALL CHILDREN IN GRADES K-5, SIMILAR TO THE CDC'S COORDINATED SCHOOL HEALTH PROGRAM MODEL. THE FOUR CORE COMPONENTS OF CATCH INCLUDE: (1) THE EAT SMART SCHOOL NUTRITION PROGRAM, (2) A CLASSROOM PHYSICAL ACTIVITY AND HEALTHY EATING CURRICULA, (3) THE CATCH PHYSICAL EDUCATION PROGRAM, AND (4) A FAMILY EDUCATION AND INVOLVEMENT PROGRAM. THE COORDINATION OF HEALTH MESSAGES AND ACTIVITIES BETWEEN THESE FOUR COMPONENT AREAS IS CRITICAL TO POSITIVELY IMPACTING CHILDREN'S KNOWLEDGE, SKILLS, AND BEHAVIOR. SOUTHERN ILLINOIS HEALTHCARE HAS PILOTED CATCH IN 15 ELEMENTARY SCHOOLS, REACHING 8000 STUDENTS. NEW PROGRAMS WERE PILOTED IN EARLY CHILDHOOD IN 4 SCHOOLS AND AFTER SCHOOL CURRICULUMS IN 5 SETTINGS.
Delegate broad authority to a committee	Form 990, Part VI, Section A, Line 1a	THE BOARD HAS A GOVERNANCE COMMITTEE CONSISTING OF 5 TRUSTEES. THE PURPOSE OF THE GOVERNANCE COMMITTEE IS TO ASSURE THE BOARD OF TRUSTEES THAT THE RESPECTIVE PROGRAMS ARE FUNCTIONAL TO FULFILL THE RESPONSIBILITIES OF THE BOARD OF TRUSTEES: · DEVELOP AND MAINTAIN EFFECTIVE COMPENSATION AND BENEFIT POLICIES AND PRACTICES; REVIEW AND RECOMMEND IN ADVANCE ALL EXECUTIVE COMPENSATION ARRANGEMENTS; PROVIDE FOR THE EVALUATION OF THE PERFORMANCE OF THE CEO AND OTHER SYSTEM OFFICERS; REVIEW AND RECOMMEND ANNUAL PERFORMANCE OBJECTIVES FOR SYSTEM OFFICERS; PROVIDE FOR CONDUCT OF A PERIODIC SELF-EVALUATION OF THE BOARD OF TRUSTEES. · ASSURE THAT THE PROGRAMS WHICH ADDRESS NEW BOARD MEMBER ORIENTATION, CONTINUING EDUCATION, MENTORING, AND FACILITATE UNDERSTANDING OF CURRENT TRENDS IN HEALTHCARE AND MEDICAL TERMINOLOGY, ARE FUNCTIONAL. · IDENTIFY COMPETENT, HIGHLY QUALIFIED INDIVIDUALS TO SERVE AS MEMBERS OF THE BOARD OF TRUSTEES; RECOMMEND INDIVIDUALS TO SERVE IN LEADERSHIP POSITIONS ON THE BOARD; AND FACILITATE AND INTERVIEW POTENTIAL BOARD MEMBERS. · ACT FOR THE BOARD OF TRUSTEES IN ALL MATTERS AS SPECIFICALLY AUTHORIZED BY RESOLUTION OF THE BOARD OR WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	THE ORGANIZATION'S SOLE MEMBER IS SOUTHERN ILLINOIS HOSPITAL ENTERPRISES, INC., A RELATED TAX-EXEMPT ORGANIZATION. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO THE BOARD OF TRUSTEES AND APPROVE SOME DECISIONS OF THE BOARD.
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES, HAS THE EXCLUSIVE RIGHT TO ELECT TRUSTEES TO THE ORGANIZATION'S BOARD OF TRUSTEES.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATIONS BYLAWS. EXCEPT FOR TRANSFERS IDENTIFIED IN THE BUDGET OF THE ORGANIZATION APPROVED BY THE CORPORATE MEMBER, THE ORGANIZATION MAY NOT TRANSFER ASSETS TO ENTITIES OTHER THAN THE CORPORATE MEMBER OR ENTITIES THAT THE CORPORATE MEMBER CONTROLS (THE "CORPORATE MEMBER AFFILIATES"), WITHOUT THE APPROVAL OF THE CORPORATE MEMBER. THE CORPORATE MEMBER HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO TRANSFER ASSETS TO THE EXTENT NECESSARY TO ACCOMPLISH THE CORPORATE MEMBER'S GOALS AND OBJECTIVES. THE CORPORATE MEMBER ALSO HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF THE CORPORATE MEMBER OR A CORPORATE MEMBER AFFILIATE. THE ORGANIZATION CANNOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS IN COMPLYING WITH ANY ASSET TRANSFERS DIRECTED BY THE CORPORATE MEMBER. IN ADDITION, THE FOLLOWING MATTERS MUST BE SUBMITTED TO AND RECEIVE THE APPROVAL OF THE CORPORATE MEMBER: 1. CAPITAL EXPENDITURES IN EXCESS OF $500,000; 2. THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF REAL PROPERTY BELONGING TO THE CORPORATION OR ANY OF ITS SUBSIDIARIES; 3. THE ESTABLISHMENT OR DISCONTINUANCE OF ANY MAJOR SERVICES; INCLUDING SERVICES REQUIRING CERTIFICATES OF NEED; 4. LONG-RANGE STRATEGIC PLANS; 5. MASTER FACILITIES AND SITE PLANS; 6. THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. JOINT VENTURE OR AFFILIATION AGREEMENTS; 8. THE INCURRENCE OF INDEBTEDNESS IN EXCESS OF $500,000; 9. SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE ORGANIZATION'S ARTICLES OF INCORPORATION, OR BY ITS BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 10. DELEGATION OF THE FUNCTIONS, POWERS, DUTIES AND RESPONSIBILITIES OF ANY OFFICER OF THE CORPORATION, AND; 11. ANY OTHER MATTER WHICH MAY BE SPECIFIED FROM TIME TO TIME BY THE CORPORATE MEMBER. IN ADDITION, THE CORPORATE MEMBER RETAINS THE RIGHT TO APPROVE ALL CHANGES TO THE ORGANIZATION'S BYLAWS.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE CEO, CFO AND CERTAIN VICE-PRESIDENTS OF THE CORPORATION FOR THEIR REVIEW AND COMMENTS. A DRAFT COPY WAS PRESENTED TO THE FINANCE COMMITTEE BY THE CFO AND THE ORGANIZATION'S TAX ADVISORS FOR REVIEW AND COMMENTS. AFTER THE REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	ANNUALLY, THE GENERAL COUNSEL SENDS OUT A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, AND MANAGER TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. DURING EVERY BOARD MEETING, THE GENERAL COUNSEL REMINDS THE TRUSTEES THAT THE BOARD HAS A CONFLICT OF INTEREST POLICY, THAT THE GENERAL COUNSEL HAS REVIEWED THE AGENDA FOR ANY CONFLICTS, BUT THAT THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVER-LOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. INTERESTED PERSONS MAY ALSO BE ASKED, IN RARE SITUATIONS, TO RESIGN THEIR POSITION ON THE BOARD.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2012.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF ALL OFFICERS FOR THE FULL BOARD. ONLY THE COMMITTEE WILL HAVE THE AUTHORITY TO APPROVE THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND WILL REPORT IT'S ACTIONS TO THE BOARD. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2012.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104; THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
Other Expenses	Form 990, Part IX, Line 11g	PHYSICIAN FEES - TOTAL EXPENSE: 23739058, PROGRAM SERVICE EXPENSE: 23623971, MANAGEMENT AND GENERAL EXPENSES: 115087, FUNDRAISING EXPENSES: 0; CONSULTING FEES - TOTAL EXPENSE: 3201934, PROGRAM SERVICE EXPENSE: 534884, MANAGEMENT AND GENERAL EXPENSES: 2667050, FUNDRAISING EXPENSES: 0; CREDIT AND COLLECTION FEES - TOTAL EXPENSE: 741708, PROGRAM SERVICE EXPENSE: 65840, MANAGEMENT AND GENERAL EXPENSES: 675868, FUNDRAISING EXPENSES: 0; CLINICAL SERVICE FEES - TOTAL EXPENSE: 5510409, PROGRAM SERVICE EXPENSE: 5510409, MANAGEMENT AND GENERAL EXPENSES: 0, FUNDRAISING EXPENSES: 0; ENGINEERING FEES - TOTAL EXPENSE: 154972, PROGRAM SERVICE EXPENSE: 153538, MANAGEMENT AND GENERAL EXPENSES: 1434, FUNDRAISING EXPENSES: 0; ARCHITECT FEES - TOTAL EXPENSE: 311809, PROGRAM SERVICE EXPENSE: 303870, MANAGEMENT AND GENERAL EXPENSES: 7939, FUNDRAISING EXPENSES: 0; RECRUITMENT FEES - TOTAL EXPENSE: 419647, PROGRAM SERVICE EXPENSE: 161258, MANAGEMENT AND GENERAL EXPENSES: 258389, FUNDRAISING EXPENSES: 0; AGENCY STAFFING - TOTAL EXPENSE: 1995649, PROGRAM SERVICE EXPENSE: 1995649, MANAGEMENT AND GENERAL EXPENSES: 0, FUNDRAISING EXPENSES: 0; OTHER PROFESSIONAL FEES - TOTAL EXPENSE: 1258252, PROGRAM SERVICE EXPENSE: 1046557, MANAGEMENT AND GENERAL EXPENSES: 211695, FUNDRAISING EXPENSES: 0; PURCHASED SERVICES - TOTAL EXPENSE: 8762294, PROGRAM SERVICE EXPENSE: 3829980, MANAGEMENT AND GENERAL EXPENSES: 4932314, FUNDRAISING EXPENSES: 0; PHYSICIAN SERVICES - TOTAL EXPENSE: 5034411, PROGRAM SERVICE EXPENSE: 5034411, MANAGEMENT AND GENERAL EXPENSES: 0, FUNDRAISING EXPENSES: 0;
Other changes in net assets or fund balances	Form 990 , Part XI, Line 9	CHANGE IN FAIR VALUE OF INTEREST RATE SWAP - -290259; GAIN/LOSS ON DERIVITIVE - -425492; EQUITY TRANSFERS - -1430202;
REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133	FORM 990, PART XII, LINE 3A	AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2013 SOUTHERN ILLINOIS HEALTHCARE SERVICES AND AFFILIATES RECEIVED AN AUDIT FOR THE 2012 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

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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

2012

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) QUALITY HEALTH PARTNERS LLC 1239 E MAIN ST CARBONDALE,IL62901 45-4435852	ADMINISTRATIVE SERVICES	IL	191,000	6,305	SOUTHERN ILLINOIS HOSPITAL SERVICES

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
(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) SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES INC PO BOX 3988 CARBONDALE,IL62902	LEASING OF MEDICAL SPACE	IL	501(C)(3)	11 - Type II	NA		No
(2) SOUTHERN ILLINOIS MEDICAL SERVICES NFP 1239 EAST MAIN STREET CARBONDALE,IL62901	MEDICAL SERVICES	IL	501(C)(3)	3	SOUTHERN ILLINOIS HOSPITAL SERVICES	Yes
(3) SIH FOUNDATION NFP 1239 EAST MAIN STREET CARBONDALE,IL62901	FUNDRAISING	IL	501(C)(3)	11 - Type I	SOUTHERN ILLINOIS HOSPITAL SERVICES	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) RIC AND SIHS REHABILITATION SERVICES LLC PO BOX 3988 CARBONDALE,IL62902 36-4566925	MEDICAL SERVICES	IL	SIHS	RELATED	1,427,532	999		No			No	99.9 %
(2) PHYSICIANS' SURGERY CENTER LLC 2601 WEST MAIN STREET CARBONDALE,IL62901 26-0425547	MEDICAL SERVICES	IL	SIHS	RELATED		1,534,097		No			No	56.12 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) SIH CAYMAN SPC GROUP LTD PO BOX 1051 CAYMAN ISLANDSKY1-1102 CJ 98-0611605	FINANCING	CJ	SIHS	C CORPORATION	5,836,340	25,040,496	100 %	Yes
(2) HEALTH SERVICES OF SOUTHERN ILLINOIS INC PO BOX 3988 CARBONDALE,IL62902 37-1115061	INACTIVE	IL	NA	C CORPORATION				Yes
(3) HIDK PROPERTIES LAND TRUST 1239 EAST MAIN STREET CARBONDALE,IL62901 46-6693066	RENTAL PROPERTIES	IL	SIHS	TRUST	0	0	100 %	Yes

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

Yes

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

Yes

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

Yes

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

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

Yes

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

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) SOUTHERN ILLINOIS MEDICAL SERVICES	J	479,417	FMV
(2) SOUTHERN ILLINOIS MEDICAL SERVICES	R	1,430,202	FMV
(3) SOUTHERN ILLINOIS MEDICAL SERVICES	A	108,913	FMV
(4) SIH FOUNDATION	C	149,694	FMV

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) 2012

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:	12000266
Software Version:	v2012.1.0

1	Briefly describe the organization’s mission or most significant activities: SOUTHERN ILLINOIS HOSPITAL SERVICES' (SIHS) MISSION STATEMENT IS "WE ARE DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES WE SERVE."
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	3,175
6	Total number of volunteers (estimate if necessary) .............	6	274
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	751,843
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-26,278

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,068,541	3,321,897
9	Program service revenue (Part VIII, line 2g) .........	343,588,590	380,496,986
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	10,335,865	18,270,190
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,696,843	4,682,486
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	357,689,839	406,771,559
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	288,044	445,902
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	156,740,524	167,575,408
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 189,917
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	177,757,336	195,335,490
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	334,785,904	363,356,800
19	Revenue less expenses. Subtract line 18 from line 12.......	22,903,935	43,414,759
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	550,969,833	607,114,260
21	Total liabilities (Part X, line 26).............	203,532,309	211,021,480
22	Net assets or fund balances. Subtract line 21 from line 20.....	347,437,524	396,092,780

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 303,856,455 including grants of $ ) (Revenue $ 383,124,770 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THROUGH DAILY OPERATIONS, SIHS' HOSPITALS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE, UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE, SUBSIDIZED HEALTH SERVICES AND MEDICAL EDUCATION. THE PRIMARY SERVICE AREA OF SIHS IS A VERY RURAL SEVEN-COUNTY REGION WITH A COMBINED POPULATION OF APPROXIMATELY 244,000. THE RESIDENTS OF THESE COUNTIES' MEDIAN HOUSEHOLD INCOMES ARE BELOW THE STATE AVERAGE, PLUS THE POVERTY RATE IS HIGHER THAN THE STATE AVERAGE. (CONTINUED IN SCHEDULE O)

4b	(Code: ) (Expenses $ 1,694,097 including grants of $ 445,902 ) (Revenue $ 0 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. THE COMMUNITY BENEFITS DEPARTMENT OF SIHS WAS INSTITUTED IN 1994 WITH AN OPERATING BUDGET SPECIFICALLY ALLOCATED TO BRING HEALTH-RELATED PROGRAMS TO THE AREAS IN WHICH THEY WERE MOST NEEDED. COMMUNITY BENEFITS HAS UNDERTAKEN A WIDE VARIETY OF SUCCESSFUL PROGRAMS SINCE ITS INCEPTION. (CONTINUED IN SCHEDULE O)

4c	(Code: ) (Expenses $ 129,927 including grants of $ ) (Revenue $ 0 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE CHILDREN AND ADOLESCENTS ATTENDING SOUTHERN ILLINOIS SCHOOLS. (CONTINUED IN SCHEDULE O)

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses305,680,479

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	5,370,511	0	1,663,993

				(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		149,694
e	Government grants (contributions)1e		2,213,617

f	All other contributions, gifts, grants, and similar amounts not included above1f		958,586

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,321,897
			Business Code
2a	PATIENT REVENUE		622110	378,705,933	378,705,933	0	0
b	PARTNERSHIP INCOME		900099	1,682,140	1,682,140	0	0
c	LEASEHOLD REVENUE FROM RELATED ORGANIZATIONS		531120	108,913	108,913	0	0
d				0
e				0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			380,496,986
3	Investment income (including dividends, interest, and other similar amounts).......			10,335,023	0	0	10,335,023
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	622,488
b	Less: rental expenses	591,364
c	Rental income or (loss)	31,124	0
d	Net rental income or (loss).......			31,124	0	0	31,124
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	145,899,914	24,916
b	Less: cost or other basis and sales expenses	137,734,006	255,657
c	Gain or (loss)	8,165,908	-230,741
d	Net gain or (loss)..........			7,935,167	0	0	7,935,167
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..			0
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...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA/VENDING/HOSPITAL AUXILIARY		900099	1,803,003	531,268	0	1,271,735
b	MEDICAL RECORDS/X-RAY/INTERNET PHYSICIANS		621300	484,013	154,481	329,532	0
c	REFERENCE LAB		621500	422,311	0	422,311	0
d	All other revenue ....			1,942,035	1,942,035	0	0
e	Total. Add lines 11a–11d ......			4,651,362
12	Total revenue. See Instructions......			406,771,559	383,124,770	751,843	19,573,049


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			6,447	1	6,859
2	Savings and temporary cash investments .........			4,966,236	2	4,075,871
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			77,150,828	4	83,950,513
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net .............			1,319,798	7	1,100,268
8	Inventories for sale or use ..............			6,238,647	8	7,876,596
9	Prepaid expenses and deferred charges ..........			4,618,976	9	5,080,193
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	376,661,017
b	Less: accumulated depreciation .....	10b	206,963,227	161,803,612	10c	169,697,790
11	Investments—publicly traded securities ..........			278,002,054	11	310,962,871
12	Investments—other securities. See Part IV, line 11 .....			3,283,090	12	3,014,093
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			13,580,145	15	21,349,206
16	Total assets. Add lines 1 through 15 (must equal line 34)......			550,969,833	16	607,114,260
17	Accounts payable and accrued expenses .........			38,279,251	17	45,777,524
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			134,407,000	20	135,345,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22	0
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....................			30,846,058	25	29,898,956
26	Total liabilities. Add lines 17 through 25.........			203,532,309	26	211,021,480
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			346,929,346	27	395,765,997
28	Temporarily restricted net assets ...........			508,178	28	326,783
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			347,437,524	33	396,092,780
34	Total liabilities and net assets/fund balances ........			550,969,833	34	607,114,260

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................	Yes	No