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) GERALD J MCSHANE MD........................................................................ Pres/CEO OSFMG, board member	40.0 .......................5.0	X			580,097	47,802
(2) JAMES W GIRARDY MD........................................................................ BOARD MEMBER	3.0 .......................	X			148,726	0
(3) KEVIN D SCHOEPLEIN........................................................................ Vice Chairperson; CEO	40.0 .......................5.0	X	X		2,580,248	301,320
(4) SISTER AGNES JOSEPH WILLIAMS OSF........................................................................ Assistant Secretary	40.0 ........................5	X	X		4,480	0
(5) SISTER DIANE MARIE MCGREW OSF........................................................................ PRESIDENT/TREASURER	40.0 .......................1.0	X	X		4,480	0
(6) SISTER JUDITH ANN DUVALL OSF........................................................................ Chairperson	40.0 ........................5	X	X		4,480	0
(7) SISTER MARIA ELENA PADILLA OSF........................................................................ Board Member	40.0 .......................	X			0	0
(8) SISTER ROSE THERESE MANN OSF........................................................................ Board Member	40.0 .......................	X			0	0
(9) SISTER THERESA ANN BRAZEAU OSF........................................................................ Secretary	40.0 .......................1.0	X	X		4,480	0
(10) VANCE C PARKHURST........................................................................ Senior VP, Board Member	40.0 ........................5	X			396,411	45,767
(11) SUSAN CAMPBELL........................................................................ SENIOR VP, BOARD MEMBER	40.0 .......................	X			317,589	17,625
(12) DANIEL E BAKER........................................................................ Senior VP, CFO	40.0 .......................5.0		X		581,054	239,060
(13) DANIEL R FASSETT MD........................................................................ Physician, Neurosurgery	0.0 .......................40.0			X	1,780,345	17,862
(14) DALE M GEISS MD........................................................................ Physician, Vascular Surgery	0.0 .......................40.0			X	1,018,289	6,054
(15) JEFFREY D KLOPFENSTEIN MD........................................................................ Physician, Neurosurgery	0.0 .......................40.0			X	1,254,464	32,860
(16) SYED M HUSSAIN MD........................................................................ Physician, Vascular Surgery	0.0 .......................40.0			X	1,016,900	33,154
(17) DONGWOO J CHANG MD........................................................................ Physician, Neurosurgery	0.0 .......................40.0			X	946,275	32,526

(A) Name and business address	(B) Description of services	(C) Compensation
UNIV OF IL COLLEGE OF MEDICINE, PO BOX 4196SPRINGFIELDIL627084196	TEACHING PHYSICIANS	21,510,286
HINSHAW CULBERTSON LLP, 8142 SOLUTIONS CENTER DRCHICAGOIL606778001	LEGAL	8,190,476
ASSOC ANESTHESIOLOGISTS SC, 8600 N STATE RT 91 SUITE 250PEORIAIL616159452	ANESTHESIOLOGY SVS	2,709,650
ROCKFORD ANESTHESIOLOGISTS ASSOC, 2202 HARLEM RD STE 200LOVES PARKIL611112754	ANESTHESIOLOGY SVS	1,579,005
THE ADVISORY BOARD COMPANY, 2445 M STREET NWWASHINGTONDC20037	CONSULTING SERVICES	1,430,584
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 69

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	591,058	591,058
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	131,732	131,732
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 ....	5,857,944		5,857,944
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	738,173,637	670,526,564	66,048,315	1,598,758
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	57,655,638	50,816,102	6,839,536
9	Other employee benefits .......	102,713,338	94,121,631	8,578,776	12,931
10	Payroll taxes ...........	50,084,960	45,183,244	4,901,716
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	4,732,982	1,879,527	2,853,455
c	Accounting ...........	575,643	439,345	136,298
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	63,549,225	57,434,245	6,114,221	759
12	Advertising and promotion ....	5,491,837	5,328,716	46,264	116,857
13	Office expenses .......	9,256,457	8,215,318	984,559	56,580
14	Information technology ......	20,858,721	2,467,751	18,390,970
15	Royalties ..	0
16	Occupancy ...........	13,913,064	13,252,162	654,281	6,621
17	Travel ............	5,970,713	4,546,158	1,400,229	24,326
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	2,328,788	1,802,240	501,934	24,614
20	Interest ...........	33,992,790	166,738	33,826,052
21	Payments to affiliates .......	-58,291,423	-48,059,447	-10,231,976
22	Depreciation, depletion, and amortization .....	80,755,925	61,458,296	19,297,629
23	Insurance ..............	23,152,088	23,069,446	82,642
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	SUPPLIES	277,680,485	276,000,429	1,419,162	260,894
b	EQUIP RENTAL & MAINT	159,164,547	146,551,983	12,314,647	297,917
c	BAD DEBT	76,594,657	76,594,657	0	0
d	MEDICAID FEES	54,026,195	54,026,195	0	0
e	All other expenses	58,407,690	42,699,006	12,813,924	2,894,760
25	Total functional expenses. Add lines 1 through 24e	1,787,368,691	1,589,243,096	192,830,578	5,295,017
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).	1,278,498	1,101,384	175,132	1,982

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	0	1	0
2	Savings and temporary cash investments .........	88,078,588	2	228,577,361
3	Pledges and grants receivable, net ...........	9,660,264	3	0
4	Accounts receivable, net .............	437,391,995	4	328,401,689
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	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
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	20,605,960	8	20,627,513
9	Prepaid expenses and deferred charges ..........	6,604,229	9	5,310,827
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,827,294,957
b	Less: accumulated depreciation .....	10b	979,773,691	822,336,159	10c	847,521,266
11	Investments—publicly traded securities ..........	687,533,607	11	731,470,692
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	35,193,736	13	41,235,804
14	Intangible assets ...............	6,631,798	14	22,041,175
15	Other assets. See Part IV, line 11 ...........	304,668,066	15	260,454,937
16	Total assets. Add lines 1 through 15 (must equal line 34)......	2,418,704,402	16	2,485,641,264
	17	Accounts payable and accrued expenses .........	150,349,952	17	163,230,943
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	845,650,526	20	840,264,115
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
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..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
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....................	697,779,960	25	526,291,758
26	Total liabilities. Add lines 17 through 25.........	1,693,780,438	26	1,529,786,816
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	683,656,289	27	901,237,483
28	Temporarily restricted net assets ...........	28,093,608	28	38,199,005
29	Permanently restricted net assets ...........	13,174,067	29	16,417,960
	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 ...........	724,923,964	33	955,854,448
34	Total liabilities and net assets/fund balances ........	2,418,704,402	34	2,485,641,264

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

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

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

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:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

OMB No. 1545-0047

2012

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

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 OSF Healthcare System

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 OSF Healthcare System

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
OSF Healthcare System

Employer identification number

37-0813229

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:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

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

OSF Healthcare System

Employer identification number

37-0813229

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

Yes

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

644,003

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

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

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

644,003

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
Mailing Expenses	Part II-B, Line 1d	The only cost of mailing related to lobbying expenses related to the cost of stamps. The total expenditures related to mailing is minor and the actual dollar amount is not readily available.
Legislative Contacts	Part II-B, Line 1g	Schedule C, Part II-B, Line 1g includes lobbying expenses paid to various national health associations as part of dues and subscriptions in the amount of $204,003. It also includes direct contact with legislators, their staffs, government officials, and legislative bodies relating to the hospital, physician payment reform, critical access, MDH hospital rate protection, ACO activities and adoption in Medicare. This amounted to $440,000.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

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 ....	22,865,122	17,139,873	7,390,433	5,655,845	2,718,442
b	Contributions ........	10,590,634	2,735,884	10,371,045	1,551,108	2,914,621
c	Net investment earnings, gains, and losses		3,093,976	-557,661	526,674	32,954
d	Grants or scholarships .....	4,165,914	-71,508	-63,944	-343,194	-10,172
e	Other expenditures for facilities and programs ........	-75,284	-33,103
f	Administrative expenses ....	-231,947
g	End of year balance ......	37,314,439	22,865,122	17,139,873	7,390,433	5,655,845

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

Board designated or quasi-endowment SchDMd Bullet

64.040 %

Permanent endowment SchDMd Bullet

30.210 %

Temporarily restricted endowment SchDMd Bullet

5.750 %

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 .................	16,699,352		16,699,352
b	Buildings ................	1,053,546,324	456,271,512	597,274,812
c	Leasehold improvements ............	8,196,354	6,704,066	1,492,288
d	Equipment ................	687,824,524	497,882,674	189,941,850
e	Other .................	61,028,403	18,915,439	42,112,964
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				847,521,266

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
(1) BOND INSURANCE FEES				7,398,670
(2) WORKERS' COMP ESCROW DEPOSITS				4,051,881
(3) THIRD PARTY WITHHOLDINGS				18,662,150
(4) DUE FROM FOUNDATION				2,682,078
(5) ASSETS - LIMITED OR RESTRICTED				54,616,964
(6) FUNDS LIMITED AS TO USE				150,481,997
(7) OTHER ACCOUNTS				22,561,197


Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				260,454,937

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ESTIMATED SELF INSURANCE LIABILITIES		141,562,757
RETIRE OBLIG - ASBESTOS		3,003,189
ACCRUED PENSION LIABILITY		264,398,000
MARKET VALUATION OF SWAP		39,225,327
THIRD PARTY SETTLEMENT PAYABLE		74,825,646
DEFERRED COMPENSATION		3,276,839



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		526,291,758
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
SUPPLEMENTAL INFORMATION		OSF adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an interpretation of FASB statement No. 109. The interpretation addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, OSF must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of September 30, 2012 and 2013, OSF does not have any uncertain tax positions.
Part V, Line 4		The organization's endowment funds are used to provide scholarships to nursing students, acquire equipment and support programs of various medical departments of the OSF Healthcare System hospitals.

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

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 600 %

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		(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) ..	90,130,720	0	90,130,720	5.270 %
b	Medicaid (from Worksheet 3, column a) ....	281,302,581	266,659,960	14,642,621	0.860 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	371,433,301	266,659,960	104,773,341	6.130 %
Other Benefits		2,116,781	794,808	1,321,973	0.080 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	2,116,781	794,808	1,321,973	0.080 %
f	Health professions education (from Worksheet 5) ..	69,119,744	28,056,434	41,063,310	2.400 %
g	Subsidized health services (from Worksheet 6) ..	38,666,858	21,116,901	17,549,957	1.030 %
h	Research (from Worksheet 7)	1,591,455	141,737	1,449,718	0.080 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	556,315	0	556,315	0.030 %
j	Total. Other Benefits ..	112,051,153	50,109,880	61,941,273	3.620 %
k	Total. Add lines 7d and 7j .	483,484,454	316,769,840	166,714,614	9.750 %

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

Schedule H (Form 990) 2012

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	23,210	23,210
8	Workforce development
9	Other
10	Total	23,210	23,210

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

22,049,402

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. ......

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).....

466,865,524

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

559,177,628

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

-92,312,104

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 %
1NONE
2
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?7 Name, address, and primary website address
1	Saint Francis Medical Center 530 NE Glen Oak Avenue Peoria,IL61637	X	X	X	X		X	X
2	Saint Anthony Medical Center 5666 East State Street Rockford,IL61108	X	X		X		X	X
3	St Joseph Medical Center 2200 East Washington Street Bloomington,IL61701	X	X					X
4	St Mary Medical Center 3333 North Seminary Street Galesburg,IL61401	X	X					X
5	St Francis Hospital 3401 Ludington Street Escanaba,MI49829	X				X		X
6	SAINT JAMES HOSPITAL 2500 W REYNOLDS STREET PONTIAC,IL61764	X	X					X
7	OSF HOLY FAMILY MEDICAL CENTER 1000 W HARLEM AVENUE MONMOUTH,IL61462	X				X		X

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)

	Saint Francis Medical Center
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 13

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 ........

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: 600.% 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 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)

	Saint Anthony Medical Center
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 13

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

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 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: 600.% 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

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)

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 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)

	St Joseph Medical Center
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 13

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

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 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: 600.% 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

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)

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 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)

	St Mary Medical Center
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 13

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 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

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)

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 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)

	St Francis Hospital
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 13

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

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 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

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)

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 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)

	SAINT JAMES HOSPITAL
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 13

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

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 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

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)

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 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)

	OSF HOLY FAMILY MEDICAL CENTER
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 13

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 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

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)

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?39
Name and address		Type of Facility (describe)
1	Outpatient Rehabilitation Randolph Building Suite 100 NERan Peoria,IL61606	Rehab
2	Outpatient Audiology Randolph Building Suite 100 NERan Peoria,IL61606	Audiology
3	PM&R Associates Randolph Building Suite 100 NERan Peoria,IL61606	Rehab
4	Center for Industrial Rehab 506 High Point Lane East Peoria,IL61611	Rehab
5	Out Patient Rehabilitation Pennsylvania Medical Building 200 E Peoria,IL61603	Rehab
6	Pekin Cancer Treatment Center 603 Thirteenth Street Pekin,IL61554	EKG, Echo cardiology, Nuclear stress test, Vascular ultrasound, Treadmill stress T
7	ObstetricsGynecology Clinic 320 E Armstrong Peoria,IL61603	OB/GYNE Services
8	Internal Medicine 320 E Armstrong Peoria,IL61603	Ambulatory Internal Medicine
9	Pediatric Ambulatory Clinic 320 E Armstrong Peoria,IL61603	Ambulatory Pediatric Medicine
10	Saint Clare Family Health Center 10 Saint Clare Court Washington,IL61571	Lab, EKG, Radiology
11	OSF Center for Health 8600-8800 Rt 91 North North Peoria,IL61615	Diagnostic Imaging/Lab/Voice & Swallowing Services
12	OSF Saint Francis Riverplex 600 N E Water Street Peoria,IL61602	Rehab
13	OSF Saint Francis Heart Hospital 5405 N Knoxville Avenue Peoria,IL61614	Nuclear Med, CT Scan, Vascular ultrasound, Echo cardiology, Chest X-Ray, Stress test
14	OSF Heart Hospital Diagnostic Center 610 Park Avenue Pekin,IL615544650	EKG, Nuclear stress test, Vascular ultrasound, Echo cardiology, Chest X-Ray,Stress
15	OSF SF Radiation Oncology 8948 N Wood Sage Road Peoria,IL61615	Radiation oncology
16	OSF Saint Francis Morton Health Center 435 Maxine Dr Morton,IL61550	Radiology, Lab, EEG, EKG, Sleep lab
17	Saint Francis Medical INI Rehabilitation Five Points Washington 360 Wilmor R Washington,IL615711252	Rehab
18	OSF Saint Francis Center for Health Glen 5114 Glen Park Place Peoria,IL616144686	Diagnostic Imaging/Lab
19	Southridge Laboratory 4423 Manchester Drive Rockford,IL61109	Diagnostic Lab
20	Outpatient Rehabilitation Services 5510 E State Street Rockford,IL61108	Rehab
21	Diabetes Education Center 5510 E State Street Rockford,IL61108	Education
22	Wound Healing Center State and Roxbury 5668 E State Street Rockford,IL61108	Hyperbaric Oxygen Therapy
23	Rockford Cardiovascular Associates 444 Roxbury Road Rockford,IL61107	Cardiac and Pulmonary Rehab / Radiology and Diagnostic Services / Sleep Center
24	OSF Center for Health-Rock Cut Crossing 9951 Rock Cut Crossing Loves Park,IL611111999	Diagnostic Imaging/Lab
25	Illinois Neurological Institute at OSF 535 Roxbury Road Rockford,IL61108	No procedures are done at this location at this time
26	OSF St Francis Hospital and Medical Gro N 15995 Main St Powers,MI49870	Diagnostic Lab
27	St Francis Hospital - Powers Clinic N 15995 Main St Powers,MI49870	Diagnostic X-Ray
28	OSF St Francis Hospital Medical Group 128 Michigan Gladstone,MI49837	Diagnostic X-Ray/Lab
29	OSF St Francis Hospital Medical Group 3409 Ludington St Escanaba,MI49829	Diagnostic X-Ray/Lab
30	St Francis Hospital- Rehab Services 704 Superior Avenue Gladstone,MI49837	Rehab
31	OSF Saint James Rehabilitation 106 South First Street Fairbury,IL61739	Rehab
32	OSF Saint James Rehabilitation 105 John Street Dwight,IL60420	Rehab
33	Center for Health at Ft Jesse 2200 Ft Jesse Road Normal,IL61761	Physical Therapy; Occupational Therapy; Audiology; Industrial Rehab; Pain Clinic; Wound Care
34	OSF St Joseph Medical Center-College Av 1701 East College Avenue Bloomington,IL61704	Diagnostic Imaging
35	OSF St Joseph Medical Center - Rehabili 1701 East College Avenue Bloomington,IL61704	Rehab
36	Eastland Medical Plaza I 1505 Eastland Avenue Bloomington,IL61704	Rehab
37	OSF Holy Family Clinic 1000 West Harlem Ave Monmouth,IL61462	cardiology, general, neru, pediatric, podiatry sleep center
38	Outpatient Medical Imaging 3375 North Seminary St Galesburg,IL61401	mammo, ultrasound, bone density, limited x-ray
39	Convenient Care 1701 East College Ave Bloomington,IL61704	PROMPT CARE FACILITY

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
PART I, LINE 2:		For all OSF Healthcare System hospitals, charges are discounted consistently by the applicable percentage identified by the OSF HealthCare Charity Assistance Guidelines. However, the OSF Healthcare System Charity Assistance policy includes the Illinois Uninsured Patient Discount Act criteria. Under that act, for hospitals other than Rural or Critical Access Hospitals, an Uninsured Patient who applies for a discount meets the criteria if the Family Income is not more than 600% of the Federal Poverty Income Guidelines. PART I, LINE 3C: THE CORPORATION PROVIDES FREE CARE AND DISCOUNTED CARE TO HOSPITAL PATIENTS AND ALL OTHER PATIENTS IN THE FOLLOWING WAYS: - FREE CHARITY CARE FOR PATIENTS WHOSE FAMILY INCOME IS LESS THAN 200% OF FEDERAL POVERTY GUIDELINES (FPG) FOR THEIR FAMILY SIZE. - DISCOUNTED CHARITY CARE ON A SLIDING SCALE FOR PATIENTS WHOSE FAMILY INCOME IS BETWEEN 200% AND 600% OF FPG FOR THEIR FAMILY SIZE. - CATASTROPHIC CHARITY CARE REGARDLESS OF INCOME OR ASSET LEVELS FOR MEDICALLY NECESSARY SERVICES WHICH EXCEED 25% OF ANNUAL FAMILY INCOME. NO PATIENT PAYS MORE THAN 25% OF ANNUAL FAMILY INCOME IN A 12-MONTH PERIOD REGARDLESS OF INCOME OR ASSET LEVELS. - 20% DISCOUNT FOR ALL UNINSURED PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FREE, DISCOUNTED, OR CATASTROPHIC CHARITY CARE. - ALL PATIENTS RECEIVE THE GREATEST REQUESTED DISCOUNT AVAILABLE UNDER ANY OF THESE PROGRAMS. NO ASSET TESTS ARE USED. - EXCEPT AS OTHERWISE NOTED, THESE POLICIES APPLY BOTH TO UNINSURED PATIENTS AND TO INSURED PATIENTS WITH RESPECT TO THE PATIENT RESPONSIBILITY AMOUNT.
PART I, LINE 7:		COSTS REPORTED ON LINES 7 a, b, and c ARE CALCULATED USING THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2. COSTS REPORTED ON LINES 7 e,f,g,h, and i ARE COSTS DERIVED FROM GENERAL LEDGER ACCOUNTS AND HOSPITAL DEPARTMENT COST CENTER REPORTS WHICH INCLUDE BOTH DIRECT AND INDIRECT COSTS LESS REVENUE. LINE 7g REPRESENTS ALL PAYERS EXCLUDING MEDICARE, MEDCAID AND SELF-PAY.
PART I, LINE 7G:		NET COSTS (TOTAL EXPENSE LESS REVENUE) OF THIRTEEN PHYSICIAN CLINICS ARE INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART I, LINE 7g. SUCH NET COSTS TOTAL $5,695,100.
PART I, LINE 7, COLUMN F:		BAD DEBT EXPENSE IN THE AMOUNT OF $76,594,657 IS INCLUDED ON FORM 990, PART IX, LINE 24c, COLUMN (A), BUT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II COMMUNITY BUILDING ACTIVITIES: THE CORPORATION'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED IN THE FOLLOWING WAYS: - WELLNESS SCREENINGS AND FIRST AID STATIONS AT COMMUNITY EVENTS SUCH AS STATE FAIRS AND SENIORS CONVENTIONS. - CORPORATE EXECUTIVES VOLUNTEER TO SERVE ON BOARDS AND COMMITTEES OF COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY AND OTHERS. - TRANSPORTATION VOUCHERS ARE GIVEN TO INDIGENT PERSONS FOR THEIR PERSONAL TRANSPORTATION NEEDS (OTHER THAN TO OR FROM THE CORPORATION'S FACILITIES).
PART III, LINE 4:		IN GENERAL, AND IN ACCORDANCE WITH MEDICARE REGULATIONS, PATIENT ACCOUNT BALANCES ARE WRITTEN OFF TO BAD DEBT EXPENSE AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY OR LAW FIRM. Patients' accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectibility of patients' accounts receivable, OSF analyzes it's past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, OSF analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with patient responsibility(which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the patients are screened against the OSF charity care policy and uninsured discount policy. For any remaining patient responsibility balance, OSF records a 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 difference between the standard rates(or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Bad debt expense of $76,594,657 on Form 990, Part IX, Line 24c is based upon accrual accounting required by generally accepted accounting principles. This amount consequently differs from the bad debt expense of $22,049,402 on Schedule H, Part III, Line 2 which requires the organization to report aggregate bad debt at cost. BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS therefore CALCULATED BY MULTIPLYING GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE TIMES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2. DISCOUNTS, INCLUDING ANY APPLICABLE THIRD PARTY PAYER CONTRACTUAL ALLOWANCES AND ANY CHARITY CARE DISCOUNTS (VALUED AT GROSS CHARGES), ARE APPLIED TO PATIENT ACCOUNT GROSS CHARGES TO DETERMINE THE ACCOUNT BALANCE BEFORE PATIENT PAYMENTS. THE AGGREGATE AMOUNT OF ALL PATIENT PAYMENTS IS THEN APPLIED TO THE ACCOUNT BALANCE. WHEN DETERMINATION IS MADE THAT NO FURTHER AMOUNTS CAN BE COLLECTED IN ACCORDANCE WITH THE CORPORATION'S BAD DEBT POLICY, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. THE CORPORATION UTILIZES A PRESUMPTIVE CHARITY PROCEDURE FOR ALL PATIENTS WHO FAIL TO PROVIDE FINANCIAL INFORMATION NORMALLY CONSIDERED IN MAKING CHARITY ELIGIBILITY DETERMINATIONS BUT FOR WHOM THE CORPORATION IS ABLE TO OBTAIN COMPARABLE INFORMATION FROM INDEPENDENT SOURCES, INCLUDING CONTRACT SERVICE PROVIDERS WHO COMPILE CREDIT BUREAU AND OTHER INFORMATION. WHEN SUCH INDEPENDENT VERIFICATION OF A PATIENT'S FINANCIAL INFORMATION IS OBTAINED, THE CORPORATION APPLIES THE SAME CHARITY DISCOUNT IT WOULD HAVE PROVIDED IF THE PATIENT HAD COMPLETED A CHARITY APPLICATION AND SUBMITTED SUCH FINANCIAL INFORMATION. SUCH PRESUMPTIVE CHARITY DETERMINATIONS MAY BE MADE AT ANY TIME THE NECESSARY FINANCIAL INFORMATION BECOMES AVAILABLE TO THE CORPORATION, AND PATIENTS ARE NOTIFIED IN WRITING OF THE CHARITY DISCOUNT AMOUNTS SO DETERMINED AND APPLIED. THEREFORE, THE CORPORATION DOES NOT BELIEVE THAT BAD DEBT EXPENSE REPORTED ON PART III, LINE 3 INCLUDES ANY AMOUNTS THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY UNDER THE CORPORATION'S CHARITY CARE POLICY.
PART III, LINE 8:		100% OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. OSF IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY MULTIPLYING MEDICARE CHARGES BY THE PATIENT CARE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UNREIMBURSED COSTS TO THE HEALTH SYSTEM FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY.
PART III, LINE 9B:		THE CORPORATION HAS A FAIR BILLING/COLLECTION POLICY WHICH APPLIES FOR ALL PATIENTS. THE POLICY INCLUDES: - REQUIRED INFORMATION PROVIDED IN BILLS TO PATIENTS (INCLUDING A REQUIREMENT THAT INFORMATION BE PROVIDED ON HOW THE PATIENT MAY APPLY FOR CHARITY CARE). - PROCESS FOR PATIENTS TO INQUIRE ABOUT OR DISPUTE A BILL, INCLUDING TOLL-FREE TELEPHONE NUMBER, ADDRESS, CONTACT NAME, AND E-MAIL ADDRESS. - REQUIREMENTS FOR TIMELY RESPONSE TO PATIENT INQUIRIES. - CONDITIONS WHICH MUST BE SATISFIED AND VERIFIED BY AN AUTHORIZED HOSPITAL REPRESENTATIVE BEFORE THE ACCOUNT OF AN UNINSURED PATIENT MAY BE SENT TO A COLLECTION AGENCY OR ATTORNEY. - THE CORPORATION'S HOSPITALS ARE REQUIRED TO OFFER A REASONABLE PAYMENT PLAN (BASED ON STATE WAGE GARNISHMENT LIMITS) TO UNINSURED PATIENTS. - LEGAL ACTION FOR NON-PAYMENT OF A PATIENT BILL MAY NOT BE INITIATED UNTIL AN AUTHORIZED HOSPITAL OFFICIAL HAS DETERMINED THAT ALL CONDITIONS IN THE CORPORATION'S POLICY (INCLUDING ALL OF THE FOREGOING POLICY PROVISIONS) HAVE BEEN SATISFIED FOR INITIATING LEGAL ACTION. - LEGAL ACTION MAY NOT BE PURSUED AGAINST UNINSURED PATIENTS WHO HAVE DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS - EVEN IF SUCH PATIENTS ARE NOT ELIGIBLE FOR CHARITY CARE ASSISTANCE. - THE CORPORATION SHALL NOT FILE A JUDGMENT LIEN AGAINST THE PRIMARY RESIDENCE OF ANY DEBTOR (EXCEPTIONS MAY BE APPROVED IN RARE CASES BY SENIOR OFFICERS OF THE CORPORATION ONLY). - THE CORPORATION SHALL NOT OBTAIN A BODY ATTACHMENT AGAINST ANY PATIENT OR GUARANTOR. - THE CORPORATION SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS, SUCH AS SUBMITTING REPORTS TO CREDIT AGENCIES BEFORE REASONABLE ATTEMPTS TO DETERMINE ELIGIBILITY FOR CHARITY CARE ASSISTANCE HAVE BEEN COMPLETED.
PART V SECTION B NUMBER 3 - ALL FACILITIES		OSF hospitals took into account the input of the community members by having these individuals help prioritize the identified needs within each community. In addition, each facility obtained and used resources from or resources provided by these community members.
PART V SECTION B NUMBER 4		SAINT FRANCIS MEDICAL CENTER - Peoria, IL The Tri-County Community Health-Needs Assessment is a collaborative undertaking by UnityPoint Health - Methodist, OSF Saint Francis Medical Center and Proctor Hospital. ST. MARY MEDICAL CENTER - Galesburg, IL The Knox and Warren Counties Community Health-Needs Assessment is a collaborative undertaking by St. Mary Medical Center and OSF Holy Family Medical Center. OSF HOLY FAMILY MEDICAL CENTER The Knox and Warren Counties Community Health-Needs Assessment is a collaborative undertaking by St. Mary Medical Center and OSF Holy Family Medical Center.
Explained the basis for calculating amounts charged to patients:	Part V - LINE 12H	Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: Please refer to the response to Schedule H, Part I, Line 3C for a description of how the above mentioned facilities explained the basis for calculating amounts charged to patients.
amounts billed to uninsured or underinsured individuals:	part v, line 20d	Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: THE HOSPITAL DETERMINED THE AMOUNTS BILLED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE FOLLOWING WAYS. THE AMOUNT BILLED TO THE INDIVIDUAL WAS THE LOWEST AMOUNT DETERMINED UNDER ANY OF THE FOLLOWING METHODS WHICH APPLY TO THE INDIVIDUAL: - FOR ILLINOIS RESIDENTS WHO INCUR GROSS CHARGES IN EXCESS OF $300 FOR ANY ONE INPATIENT ADMISSION OR OUTPATIENT ENCOUNTER, WHO APPLY FOR FINANCIAL ASSISTANCE, AND WHO'S FAMILY INCOME IS 600% OR LESS OF THE FEDERAL POVERTY GUIDELINE FOR THEIR FAMILY SIZE, THE AMOUNT BILLED IS CALCULATED BY MULTIPLYING GROSS CHARGES TIMES THE HOSPITAL'S COST TO CHARGE RATIO DETERMINED FROM ITS MOST RECENTLY FILED MEDICARE COST REPORT AND THEN MULTIPLYING THAT PRODUCT TIMES 135%. - THE AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY UNINSURED PATIENT WHO APPLIES AND DOES NOT OTHERWISE QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE IS LIMITED TO 80% OF GROSS CHARGES. - THE MAXIMUM AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY PATIENT WHO APPLIES FOR FINANCIAL ASSISTANCE DOES NOT EXCEED 25% OF FAMILY INCOME. -The maximum charge to any patient who qualifies for financial assistance under the hospital's charity policy will not exceed the average dollar amount which would be payable(including any patient or plan participant responsibility amount) for the same services under the terms of the three contracts in effect between the OSF facility providing medical care and private insurance companies on the first day of the fiscal year in which the patient's discharge occurs and which result in the lowest payment amounts. No insurance company contract which includes provisions for interim payments subject to later reconciliation shall be included in the calculation of the maximum charge. The amount billed to a patient eligible for charity assistance under this policy will be less than the amount of the gross charges. St. Francis Hospital: THE HOSPITAL DETERMINED THE AMOUNTS BILLED TO INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE FOLLOWING WAYS. THE AMOUNT BILLED TO THE INDIVIDUAL WAS THE LOWEST AMOUNT DETERMINED UNDER ANY OF THE FOLLOWING METHODS WHICH APPLY TO THE INDIVIDUAL: - THE MAXIMUM AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY PATIENT WHO MEETS THE ELIGIBILITY CRITERIA OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DOES NOT EXCEED 25% OF FAMILY INCOME. DESCRIPTION AND REQUIRMENTS OF FINANCIAL ASSISTANCE POLICY ARE FOUND IN OSF HEALTHCARE SYSTEM POLICY AC-31. - THE AMOUNT BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE TO ANY UNINSURED PATIENT WHO APPLIES BUT DOES NOT OTHERWISE QUALIFY FOR FINANCIAL OR CHARITY ASSISTANCE IS LIMITED TO 92.5% OF GROSS CHARGES.
charges for medical care:	part v, line 21	Saint Francis Medical Center, Saint Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center, St. Francis Hospital: Charges to patients who were eligible for assistance under the hospital's financial assistance policy were determined in the manners described for Part I, Line 3c and Part V, Line 20d above. It is possible, although unusual, that a patient who was eligible for financial assistance could have been charged more than the amounts generally billed to individuals who had insurance covering such care.
patients charged amount equal to the gross charge for services provided:	part v, line 22	Saint Francis Medical Center, St. Anthony Medical Center, St. Joseph Medical Center, St. Mary Medical Center, Saint James Hospital, OSF Holy Family Medical Center: None of the hospitals charged any patient who was eligible for financial assistance an amount equal to the gross charges associated with emergency or other medically necessary care. In the following limited instances, however the hospital charged patients an amount equal to gross charges: - patients receiving elective medical services other than emergency or other medically necessary care, such as elective cosmetic surgery performed to improve one's appearance and not related to a trauma or disfiguration. - uninsured patients who did not qualify for financial or charity assistance and who failed to request the 20% discount offered by the hospital to all such patients who request the discount. [The hospital's billing system is not capable of automatically applying this discount]. - patients whose medical bills are the responsibility of a third party pursuant to a claim brought by the patient against the third party. St. Francis Hospital: The hospital charged its patients an amount equal to gross charges in the following circumstances: - patients rceiving elective medical services other than emergency or other medically necessary care, such as elective cosmetic surgery performed to improve one's appearance and not related to a trauma or disfiguration. - uninsured patients who did not qualify for financial or charity assistance and who failed to request the 7.5% discount offered by the hospital to all such patients who request the discount. [The hospital's billing system is not capable of automatically applying the discount]. - patients whose medical bills are the responsibility of a third party pursuant to a claim brought by the patient against the third party. Schedule H - Part VI Supplemental Information - CHNA The Health System commenced work during its fiscal year 2012 on conducting a community health needs assessment ("CHNA") for each of its hospitals, as required by Internal Revenue Code Section 501(r)(3). The CHNA process continued into fiscal year 2013 and culminated in a final CHNA for each of the Health System's hospitals being approved and adopted by the System's Board of Directors on July 29, 2013. Subsequent to fiscal year 2013 and in response to the significant community health needs identified in each respective hospital's CHNA, the hospitals completed an Implementation Strategy to address these critical health needs. The narrative below includes an outline of each respective hospital's goals for fiscaly year 2014 as part of the Implementation Strategy approved and adopted by the Board of Directors. Saint Francis Medical Center - Peoria, IL The CHNA that was approved and adopted for Saint Francis Medical Center identified the following as the community's most significant health needs: ACCESS TO HEALTHCARE This need is based on results from survey respondents defined as living in deep poverty who indicated that access to healthcare services is limited. This includes medical, prescription medications, dental and mental healthcare. Access to medical care, dental care, prescription medication and counseling is limited for those living in deep poverty. Only half of people living in deep poverty seek medical services at a clinic or doctor's office. For this segment of the population, it is very common to seek medical services from an emergency department, or even more concerning is that 13% of this segment of the population will not seek any medical services at all. RISKY BEHAVIORS/SUBSTANCE ABUSE This need is based on the prevalence of alcohol, tobacco and marijuana in our community. In the Tri-County region, among 8th graders, the average age at first use of alcohol, tobacco and marijuana is 13, 11.5 and 12.4 years respectively. The same average age for 12th graders is 15.9, 14 and 14.9 years respectively. Peoria County is much higher for marijuana use compared to state averages, especially among 12th graders (33% vs. 21%). ASTHMA This need is based on an increase in inpatient admissions for Asthma. Inpatient admissions to the Peoria area hospitals including UnityPoint Health - Methodist, Saint Francis Medical Center, Proctor, and Pekin, increased by 26.7%. DIABETES By evaluating magnitude of morbidities and growth rates of morbidities, this need is based on an increase in inpatient admissions for diabetes and an increase in the prevalence of diabetes in the general population. Type I and Type II Diabetes are increasing and all three counties are higher than state averages. HEALTHY BEHAVIORS This need based on results from survey respondents defined as living in deep poverty indicated that there are limited efforts at proactively managing one's own health. This includes limited exercise, poor eating habits and increased incidence of smoking. Only 15% of the population engages in exercise at least 5 times a week. Less than 5% of the population consumes at least the minimum recommended servings of fruits/vegetables in a day. Yet, in terms of self-perceptions of physical and mental health, almost 90% of the population indicated that they were in average or good physical health. CANCER (SPECIFICALLY LUNG CANCER) This need is based on an increase in inpatient admissions for all Cancer diagnoses. While some types of cancer have experienced decreased growth rates in recent years, lung cancer has been steadily increasing. MENTAL HEALTH This need looks at the percent of patients that reported they had experienced 1-7 days with poor mental health per month between 2007 and 2009. This includes mental disabilities, depression and self-perceptions of mental health. Approximately 25% of residents in the Tri-County region reported they had experienced 1-7 days with poor mental health per month between 2007 and 2009. These percentages are greater than the State of Illinois average for the same time frame and represent a modest increase compared to 2006. OBESITY This need is based on an increase in the prevalence of obesity in our community population. Research strongly suggests that obesity is a significant problem facing youth and adults nationally, in Illinois, and within the Tri-County region. In terms of obesity, the Tri-County area as a whole is significantly higher than the state average. Considering that Illinois is the 6th worse state in the U.S. in terms of obesity, this is an important issue. *NEEDS NOT ADDRESSED The CHNA Conducted by the Hospital in 2013 also indentified "Sexual Health", and "Heart Disease" amongst the many important community health needs. A collaborative team recognized the impact of Sexual Health, and Heart Disease on the population of patients we serve. As a health care organization we continue to focus resources on patient education, early detection and care, but we understand that we also need to have a greater focus in our communities on those risk factors that contribute to Sexual Health, and Heart Disease. We anticipate that the greatest overall long term health impact will come from a broader prevention strategy focusing on obesity, healthy behaviors, exercise and smoking, rather on just Sexual Health, and Heart Disease. Fiscal Year Goals 2014 The needs of those in areas of low income populations are exacerbated by poverty, waiting too long for medical attention and transportation. It is for these reasons that we established and continue to support clinics that are convenient and financially accessible. The needs of those in sparsely populated rural areas and small communities with few medical resources pose other challenges that we have met by becoming a regional center and working closely with local providers. The following are the goals being pursued in FY 2014: 1. Imbed healthcare education and services within the indigent population in conjunction with existing community resources. 2. Increase awareness of asthma prevention strategies. 3. Increase compliance with asthma action plans. 4. Reduce asthma related PromptCare/emergency room visits and admissions. 5. Promote prevention, screening and early therapy for the major cancers of the tri-county area: Lung, breast, colon, and prostrate. 6. Promote prevention, screening and early therapy for metabolic syndrome, hyperglycemia and diabetes for the tri-county area. 7. Increase the awareness in and engagement of population on the importance of health behaviors: 8. Sleep hygiene, nutrition, exercise, healthy weight, safety, spirituality, and avoidance of substance use. 9. Increase screening and intervention in mental health issues including depression, anxiety, and abuse. 10. Promote obesity prevention and healthy lifestyles in the Tri-county region. 11. Increase awareness at the Junior High and High School level of the consequences of using alcohol, tobacco and marijuana. 12. Raise awareness on the importance of substance abuse avoidance. Saint Anthony Medical Center - Rockford,
Schedule H - Part VI SUPPLEMENTAL INFORMATION - CHNA CONTINUED		St. Joseph Medical Center - Bloomington, IL The CHNA that was approved and adopted for St. Joseph Medical Center identified the following as the community's most significant health needs: ACCESS TO HEALTHCARE This health need is based on results from survey respondents defined as living in deep poverty who indicated that access to healthcare services is limited. This includes medical, prescription medications, dental and mental healthcare. Poverty is a key factor, as 24% of people living in poverty in McLean County consider the Emergency Department their primary source of health care. Furthermore, 44% of people in poverty were unable to obtain medical care when they needed it in the past year. Results also suggest a strong correlation between ethnicity and one's ability to obtain medical care, as survey data suggest individuals who identify as Black are more likely to use the emergency department, as well as young men, low education and homelessness. With regard to prescription drugs, 46% of individuals living in poverty in McLean County were unable to fill a prescription in the past year because they lacked health care coverage. With regard to dental care, 44% of individuals living in poverty in McLean County needed dental care and were unable to obtain it last year and 25% of individuals living in poverty in McLean County needed counseling and were unable to obtain it in the last year. "Affordability" was cited as the leading impediment to various types of health care. RISKY BEHAVIORS/SUBSTANCE ABUSE This health need is based on the prevalence of alcohol, tobacco and marijuana in our community. Risky behaviors are defined as activities that include addiction, chemical dependency and risky sexual behaviors. Note that youth substance usage in McLean County exceeds the State of Illinois averages for 12th graders in terms of alcohol usage. HEALTHY BEHAVIORS This health need based on results from survey respondents defined as living in deep poverty, indicated that there are limited efforts at proactively managing one's own health. This includes limited exercise, poor eating habits and increased incidence of smoking. Only 17% of the McLean County population engages in exercise 5 or more times per week. Note that residents with higher education and higher income are more likely to engage in exercise. With regard to healthy eating, only 7% of the population consumes the minimum recommended servings of fruits/vegetables in a day. Those more likely to have healthy eating habits include women, older people, people with higher education and more income. Homeless people are less likely to exhibit healthy eating habits. Finally, smoking is on the decline, however, less educated people, men, younger people, non-White residents, those with lower income and homeless people are still more likely to smoke. MENTAL HEALTH This health need looks at the percent of patients that reported they had experienced 1-7 days with poor mental health per month between 2007 and 2009. This includes mental disabilities, depression and self-perceptions of mental health. Approximately 23% of residents in McLean County reported they had experienced 1-7 days with poor mental health per month between 2007 and 2009. Approximately 11% of residents in McLean County reported they had experienced 8-30 days with poor mental health per month between 2007 and 2009. For both segments of residents (those experiencing 1-7 days and 8-30 days with poor mental health per month), each was below the state average for the same time frame. OBESITY This health need is based on an increase in the prevalence of obesity in our community population. Research strongly suggests that obesity is a significant problem facing youth and adults nationally, in Illinois, and within the McLean County region. In terms of obesity, the McLean County area as a whole is higher than the state average and growing rapidly. There was a 13% increase in the growth of McLean County residents reporting they were overweight between 2006 (35.0%) and 2009 (39.5%). Considering that Illinois has the 6th highest obesity rate in the U.S., this is an important issue. Dental This health need is based on a person's perception of the ability to obtain dental care in their community. While significant research exists linking dental care to numerous diseases, including heart disease, only 51% of the aggregate McClean County population had a checkup in the last year. Specifically men, younger respondents, non-white ethnicities, less educated people, lower household income and the homeless were less likely to visit a dentist. NEEDS NOT ADDRESSED The CHNA Conducted by the Hospital in 2013 also indentified "Cancer", "Heart Disease", "Respiratory Issues", "Diabetes", "Community Misperceptions", and "Woman's Health" amongst the many important community health needs. A collaborative team recognized the impact of Cancer, Heart Disease, Respiratory Issues, Diabetes, Community Misperceptions, and Woman's Health on the population of patients we serve. As a health care organization we continue to focus resources on patient education, early detection and care, but we understand that we also need to have a greater focus in our communities on those risk factors that contribute to Cancer, Heart Disease, Respiratory Issues, Diabetes, Community Misperceptions, and Woman's Health. We anticipate that the greatest overall long term health impact will come from a broader prevention strategy focusing on obesity, healthy behaviors, exercise and smoking, rather on just Cancer, Heart Disease, Respiratory Issues, Diabetes, Community Misperceptions, and Woman's Health. Fiscal Year Goals 2014 OSF St. Joseph medical center in bloomington has been bringing quality healthcare to the residents of mclean county and surrounding communities since 1880. our services begin at birth and continue throughout life. With 1028 employees and a medical staff of 325 we offer a level II trauma center; a level II nursery for ill babies; medical, surgical, pediatric, obstetric, orthopedic, neuroscience, intensive care and post-intensive care units; a skilled nursing facility; and a wide range of speciality services at our hospital campus, outpatient clinics in bloomington, normal, heyworth, el paso, and clinton (Dewitt County) and through affiliations with providers throughout the state. The following are the goals being pursued in FY 2014: 1. Educating community about accessing appropriate care at appropriate time. 2. Link community to lower cost care resources. 3. Increase use of evidence-based interventions for smoking cessation. 4. Link community to existing resources for mental health care 5. Access to affordable nutrition/physical activity education 6. Increase awareness of resources for providers & community 7. Decrease alcohol use among youth 8. Improvement of dental health in McLean County St. Mary Medical Center - Galesburg, IL The CHNA that was approved and adopted for St. Mary Medical Center identified the following as the community's most significant health needs: ACCESS TO HEALTH CARE SERVICES This health need based on results from survey respondents defined as living in deep poverty indicated that access to healthcare services is limited. This includes medical, prescription medications, dental and mental healthcare. Poverty is a key factor, as 13% of people living in poverty in Knox and Warren Counties consider the Emergency Department their primary source of health care. Furthermore, 23% of people in poverty were unable to obtain medical care when they needed it. Results also suggest a strong correlation between ethnicity and socioeconomic status and one's ability to obtain medical care. Survey data suggest individuals who identify as Black, possessing less education, and of lower income are more likely to use the emergency department. Furthermore, residents residing in Knox County are more likely to use the emergency department. With regard to prescription drugs, 28% of individuals living in poverty in Knox and Warren Counties were unable to fill a prescription because they lacked health care coverage. With regard to dental care, 35% of individuals living in poverty in Knox and Warren Counties needed dental care and were unable to obtain it and 15% of individuals living in poverty in Knox and Warren Counties needed counseling and were unable to obtain it. "Affordability" was cited as the leading impediment to various types of health care. *Diabetes This Health need is based on an increase in inpatient admissions for diabetes and an increase in the prevlance of diabetes in the general population. There was a 33% increase in teh relative percentage of Knox County residents reporting they were informed they had type II diabetes between 2006 (8.0%) and 2009 (10.6%). For comparison, the percentage of Illinois residents reporting they were informed they had diabetes remained steady between 2006 (8.2%) and 2009 (8.2%). Rates in knox county now exceed the sta
Schedule H - Part VI SUPPLEMENTAL INFORMATION - CHNA CONTINUED		St. Francis Hospital - Escanaba, MI The CHNA that was approved and adopted for St. Francis Hospital identified the following as the communities most significant health needs: RISKY BEHAVIORS - SUBSTANCE ABUSE This health need is based on the prevalence of alcohol, tobacco and marijuana in our community. In Delta County, 25% of respondents engage in binge drinking versus 18% in the State of Michigan. Both figures exceed the US national 90th percentile benchmark of 8%. There has also been a 4.5% increase for those identifying themselves as smokers in Delta County between 2005-2007 and 2008-2010. In contrast, there was a decrease for those identifying themselves as smokers for the State of Michigan during same time frame. Thus, Delta County is currently 8.5% higher than State of Michigan averages. Additionally, according to survey respondents, for both Delta County's aggregate population and those living in poverty, drug and alcohol abuse were perceived as the two most important unhealthy behaviors in the community. DIABETES This health need is based on an increase in inpatient admissions for diabetes and an increase in the prevalence of diabetes in the general population. It is estimated that 90-95% of individuals with diabetes have Type II diabetes (previously known as adult-onset diabetes). Diabetes is the leading cause of kidney failure, adult blindness and amputations and is a leading contributor to strokes and heart attacks. Data from the Michigan Behavioral Risk Factor Surveillance System indicate that nearly 10% of Delta County Region residents have diabetes. Compared to data from the State of Michigan (9.5%), the prevalence of diabetes now exceeds the state average. Community Misperceptions This Health need is based on results from the survey where respondents incorrectly perceived certain behaviors as being relatively unimportant health concerns in the community. This health need observes the gap between patient perceptions of community needs and the actual top causes of mortality in their community. While the response of those living in deep poverty misinterprets some of the most critical needs of the community based on actual mortality data, there is much to be learned from their responses. These persons perceptions are their reality and forces to acknowledge that we must never lose focus on the individual as we improve the health of the community. OSF Healthcare system has developed a care management program to provide those in need with the help they need to improve their individual health and overcome barriers to health. Based on results from the survey, respondents incorrectly perceived, "diabetes", "Heart Disease", and "Dental" as being relatively less important health concerns to the community. These results conflict with mortality data that suggests diabetes rates in delta county are higher than rates across the state of Michigan. Mortality data indicates heart disease is the leading cause of death in delta county, and dental data illustrates delta county residents have undergone annual dental checkups at a lower rate (62.8%) than rates for the state of Michigan (73.8%) and have higher rates of lost teeth due to tooth decay or gum disease (19.9%) versus rates for the state of Michigan (13.8%). Moreover, for those respondents living in poverty, misperceptions of programs such as medicaid and financial assistance programs is evident given that respondents do not seek necessary medical care because they believe they cannot afford to pay. Finally, there are misperceptions with respondents' self perceptions of their own health, as 94% felt that they are either average or above average overall. MENTAL HEALTH This health need looks at the percent of patients that reported they had experienced 1-7 days with poor mental health per month between 2007 and 2009. This includes mental disabilities, depression and self-perceptions of mental health. While there was a slight decrease in average number of mentally unhealthy days indicated by Delta County residents between 2010 and 2012 from 4 to 3.5 days in the last month, it is 30% higher when compared to the U.S. 90th percentile. Moreover, among people living in poverty, mental health was rated as the most important health concern. OBESITY This health need is based on an increase in the prevalence of obesity in our community population. Research strongly suggests that obesity is a significant problem facing youth and adults nationally, as it has been linked to numerous morbidities (e.g., type II diabetes, hypertension, cardiovascular disease, cancer, etc.). In Delta County, the rate of obesity has increased from 26.1% to 29.6% in a three-year period. During the same time frame, the percentage of the population that is defined as overweight has risen from 38.6% to 41%. Note that this is almost 6% higher than State of Michigan averages. NEEDS NOT ADDRESSED The CHNA Conducted by the Hospital in 2013 also indentified "Cancer", "Heart Disease", "Respiratory Issues", "Poverty - Healthy Behaviors", "Access to Health" and "Dental" amongst the many important community health needs. A collaborative team recognized the impact of Cancer, Heart Disease, Respiratory Issues, Poverty - Healthy Behaviors, Access to Health and Dental on the population of patients we serve. As a health care organization we continue to focus resources on patient education, early detection and care, but we understand that we also need to have a greater focus in our communities on those risk factors that contribute to Cancer, Heart Disease, Respiratory Issues, Poverty - Healthy Behaviors, Access to Health and Dental. We anticipate that the greatest overall long term health impact will come from a broader prevention strategy focusing on obesity, exercise and smoking, rather on just Cancer, Heart Disease, Respiratory Issues, Poverty - Healthy Behaviors, Access to Health and Dental. Fiscal Year Goals 2014 The following are the goals being pursued in FY 2014: 1. Increase community awareness of identified key health concerns and their affect on individuals and our community 2. Perform free blood sugar screenings at community events 3. Enhance educational efforts within community to increase awareness of meetings 4. Provide education and training with regard to management/prevention of diabetes 5. Maintain substance abuse prevention efforts in the Medical Group clinics 6. Continue to support efforts of Delta County Substance Abuse & Violence Education (SAVE) Council through Public Health Saint James Hospital - Pontiac, IL The CHNA that was approved and adopted for Saint James Hospital identified the following as the community's most significant health needs: COMMUNITY MISPERCEPTIONS This need is based on results from the survey where respondents incorrectly perceived certain behaviors as being relatively unimportant health concerns in the community. This need obeserves the gap between patient perceptions of community needs and the actual top causes of mortality in their community. While the response of those living in deep poverty misinterprets some of the most critical needs of the community based on actual mortality data, there is much to be learned from their responses. These people's perceptions are their reality and forces to acknowledge that we must never lose focus on the individual as we improve the health of the community. OSF Healthcare system has developed a care management program to provide those in need with the help they need to improve their individual health and overcome barriers to health. Based on results from the survey, respondent's incorrectly perceived "Diabetes", "Heart Disease", "Teen Pregnancy", and "Dental" as being relatively less important health concerns to the community. These results conflict with mortality data that suggests diabetes growth rates in livingston county are higher than growth rates across the state of Illinois; mortality data that indicates heart disease is the leading cause of death in Livingston county; teen pregnancy rates in Livingston County (11.9%) exceed the state of Illinois Rate of (9.6%) for 2009; and the aforementioned dental data suggests (22.3%) of Livingston county residents have not seen a dentist in two or more years. RISKY BEHAVIORS - SUBSTANCE ABUSE This need is based on the prevalence of alcohol, tobacco and marijuana in our community. Youth substance usage in Livingston County exceeds the State of Illinois averages for 12th graders (alcohol and tobacco usage). There was a 3% increase in the growth rate for the percentage of Livingston County residents reporting they were at risk for binge drinking between 2006 (22.0%) and 2009 (22.7%). For comparison, there was a 10% decrease in the growth rate for Illinois residents reporting they were at risk for binge drinking between 2006 (19.4%) and 2009 (17.5%). There was an 18% increase in the growth rate of Livingston County residents reporting they were current smokers between 2006 (24.3%) and 2009 (28.7%).
Schedule H - Part VI SUPPLEMENTAL INFORMATION - CHNA CONTINUED		Summary We believe the objectives listed above will help us focus on our communities' most pressing health care needs not only for our FY 2014 but beyond as well. OSF HealthCare exists to care for others, in particular their health and medical related needs. At all levels of OSF there is a very strong commitment to our Mission ("to serve persons with the greatest care and love") and in carrying out our Mission in the context of our Values. Cited earlier, our first Value, "Justice: Personal worth and dignity of every person we serve regardless of race, color, religion and ability to pay." specifically addresses those who are uninsured or under-insured. The Sisters of the Third Order of St. Francis started their healing ministry in 1877 and have been actively growing that ministry in each of the last three centuries because of the healthcare needs of all those in our six service areas. Additionally, our leadership throughout OSF is committed to continuing to address unmet health care needs in our service areas by working with their respective county health departments and local social/community service organizations like their United Way Organizations. There is much to be done, but through collaboration "many hands will make light work."
SCHEDULE H - PART VI - 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE		THE CORPORATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE CORPORATION'S CHARITY ASSISTANCE POLICY IN THE FOLLOWING WAYS: - SIGNS ARE POSTED IN PATIENT REGISTRATION AREAS (INCLUDING EMERGENCY DEPARTMENT REGISTRATION) INFORMING PATIENTS OF THE AVAILABILITY OF CHARITY ASSISTANCE AND THE AVAILABILITY OF FINANCIAL ASSISTANCE REPRESENTATIVES. - PRINTED BROCHURES ARE DISTRIBUTED TO PATIENTS AT REGISTRATION INFORMING THEM OF THE AVAILABILITY OF CHARITY ASSISTANCE AND UNINSURED PATIENTS DISCOUNTS (FOR BOTH INSURED AND UNINSURED PATIENTS), AND FINANCIAL ASSISTANCE REPRESENTATIVES (INCLUDING CONTACT INFORMATION). - A NOTICE OF AVAILABILITY OF THE CORPORATION'S CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICIES IS PROMINENTLY AVAILABLE ON THE CORPORATION'S WEB SITE (AND SEPARATE WEB SITES OF ITS HOSPITAL FACILITIES). THE APPLICATION FORM WITH INSTRUCTIONS IS AVAILABLE FOR DOWNLOAD. - A NOTE REGARDING THE AVAILABILITY OF CHARITY AND FINANCIAL ASSISTANCE (TOGETHER WITH CONTACT PHONE NUMBERS) APPEARS ON EVERY PATIENT BILL AND STATEMENT. - FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND BY PHONE TO ASSIST PATIENTS IN COMPLETING CHARITY AND FINANCIAL ASSISTANCE APPLICATIONS AND IN DETERMINING ELIGIBILITY AND APPLYING FOR GOVERNMENT PROGRAM BENEFITS, INCLUDING MEDICAID. - THE CORPORATION'S CHARITY CARE POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC.
SCHEDULE H - PART VI -4 - COMMUNITY INFORMATION - AS NOTED IN CHNA		Saint Francis Medical Center is located in Peoria County in Illinois and serves those in the counties of Peoria, Tazewell, and Woodford. Peoria County is a metropolitan statistical area and its population in 2010 was 186,494. For Peoria County, the median household income in 2010 was $49,819 and the percent of persons below poverty level was 15.4%. Tazewell County is a metropolitan statistical area and its population in 2010 was 135,394. For Tazewell County, the median household income in 2010 for was $54,078 and the percent of persons below poverty level was 8.5%. Woodford County is a metropolitan statistical area and its population in 2010 was 38,664. For Woodford County, the median household income in 2010 was $65,342 and the percent of persons below poverty level was 7.2%. Saint Anthony Medical Center is located in Winnebago County. Winnebago County is a metropolitan statistical area and its population in 2010 was 295,266. For Winnebago County, the median household income in 2010 was $45,611 and the percent of persons below poverty level was 12.7%. St. Joseph Medical Center is located in McLean County in Illinois. McLean County is a metropolitan statistical area and its population in 2010 was 169,572. For McLean County, the median household income in 2010 was $58,365 and the percent of persons below poverty level was 11%. Saint James hospital is located in Livingston County in Illinois. Livingston County is a metropolitan statistical area and its population in 2010 was 38,950. For Livingston County, the median household income in 2010 was $53,745 and the percent of persons below poverty level was 11.0%. St. Mary Medical Center is located in Knox County in Illinois. Knox County is a metropolitan statistical area and its population in 2010 was 52,919. For Knox County, the median household income in 2010 was $38,535 and the percent of persons below poverty level was 15.5%. OSF Holy Family Medical Center is located in Warren County in Illinois. Warren County is a metropolitan statistical area and its population in 2010 was 17,707. For Warren County, the median household income in 2010 was $42,773 and the percent of persons below poverty level was 13.4%. St. Francis Hospital is located in Delta County in Michigan. Delta County is a metropolitan statistical area and its population in 2010 was 37,069. For Delta County, the median household income in 2010 was $40,496 and the percent of persons below poverty level was 12.7%.
SCHEDULE H - PART VI - 5 - PROMOTION OF COMMUNITY HEALTH:		THE CORPORATION'S SPONSORING ORGANIZATION IS A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS. IN ACCORDANCE WITH CANON LAW OF THE ROMAN CATHOLIC CHURCH AND FEDERAL TAX LAW APPLICABLE TO SUPPORTING ORGANIZATIONS, A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION ARE PROFESSED MEMBERS OF THE SPONSORING RELIGIOUS CONGREGATION. EACH HOSPITAL OPERATED BY THE CORPORATION HAS A COMMUNITY ADVISORY BOARD CONSISTING OF MEMBERS OF THE COMMUNITY WHO ARE NOT DIRECTORS, OFFICERS, OR CONTRACTORS OF THE CORPORATION. EXCEPT FOR HOSPITAL DEPARTMENTS WHICH HAVE BEEN CLOSED, OR IN WHICH CLINICAL PRIVILEGES HAVE BEEN RESTRICTED, FOR CLINICAL OR QUALITY OF CARE REASONS BY ACTIONS OF THE HOSPITAL'S MEDICAL STAFF AND THE BOARD OF DIRECTORS, THE CORPORATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE CORPORATION'S SURPLUS FUNDS WERE USED DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2013 FOR IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH IN THE FOLLOWING WAYS: - CAPITAL EXPENDITURES OF APPROXIMATELY $124,082,374 WERE MADE DURING THE FISCAL YEAR FOR CONSTRUCTION AND RENOVATION OF PATIENT CARE FACILITIES AND ACQUISITION OF MEDICAL EQUIPMENT AND OTHER EQUIPMENT USED IN PATIENT CARE AND RELATED SUPPORT SERVICES. - THE CORPORATION INCURRED NET COSTS (EXPENSES MINUS REVENUES) OF APPROXIMATELY $31,760,119 DURING THE FISCAL YEAR FOR ACCREDITED PHYSICIAN RESIDENCY PROGRAMS AND NET COSTS OF APPROXIMATELY $9,303,191 FOR UNDERGRADUATE AND GRADUATE NURSING EDUCATION PROGRAMS AND OTHER MEDICAL EDUCATION PROGRAMS. SEE SCHEDULE O, FORM 990, PART III, LINE 4D FOR A DESCRIPTION OF SUCH PROGRAMS. - THE CORPORATION INCURRED NET COSTS (EXPENSES MINUS REVENUES) OF APPROXIMATELY $1,449,717 DURING THE FISCAL YEAR FOR CLINICAL RESEARCH PROGRAMS AND ACTIVITIES. ALL OF THE CORPORATION'S HOSPITALS MEET THE REQUIREMENTS OF REVENUE RULING 69-545 BY: - OPERATING EMERGENCY DEPARTMENTS WHICH ARE STAFFED 24 HOURS PER DAY BY QUALIFIED PHYSICIANS AND OTHER MEDICAL PERSONNEL AND WHICH ARE OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY. - HAVING MEDICAL STAFFS WHICH ARE OPEN TO ALL QUALIFIED PHYSICIANS, MID-LEVEL PROVIDERS, PODIATRISTS, AND DENTISTS IN THE COMMUNITY (EXCEPT WHERE RESTRICTED IN RARE CASES FOR CLINICAL QUALITY REASONS BY ACTION OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS). - ACCEPTING MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAM PATIENTS. - ACCEPTING ALL PATIENTS, INCLUDING UNINSURED PATIENTS, WITHOUT REGARD TO THEIR ABILITY TO PAY. - USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. THE FOLLOWING PROVIDES A SUMMARY OF SERVICES FOR EACH OSF HOSPITAL: Saint Francis Medical Center ("Saint Francis Medical Center") is a 609 licensed bed tertiary acute care teaching hospital located near downtown Peoria, Illinois. Saint Francis Medical Center operates several hospital-based outpatient facilities in and around Peoria, Illinois. In addition to its regular hospital accreditation, Saint Francis Medical Center has received disease specific certification from The Joint Commission for its primary stroke network and its myocardial infarction and acute coronary syndrome programs. The University of Illinois College of Medicine at Peoria, founded in 1970, maintains its primary teaching affiliation with Saint Francis Medical Center and has established 14 fully accredited residency and fellowship programs at Saint Francis Medical Center. Currently, 217 residents and fellows are in training at Saint Francis Medical Center. In addition to providing the full range of primary, secondary and tertiary services, Saint Francis Medical Center provides certain specialized services, including Level I (highest level) trauma services, life flight helicopter transport services (using the helicopters owned by OSF Aviation), adult and pediatric open heart surgery, pancreas and kidney transplantation services, neurosurgery and neurology, Level III (highest level) perinatal services, radiation oncology (including gamma knife and the Varian Trilogy unit), and specialized services of the Children's Hospital of Illinois (which is operated as a part of Saint Francis Medical Center). Saint Anthony Medical Center ("Saint Anthony") is a 254 licensed bed acute care hospital located on the east side of Rockford, Illinois. Saint Anthony provides primary, secondary and tertiary care. Saint Anthony provides certain specialized services, including Level 1(highest level) Trauma services, helicopter services (using helicopters owned by OSF Aviation), adult open heart surgery, a regional burn unit, neurosurgery, and neurology, and radiation oncology (including varian true beam and stereotactic radio-surgery). St. Joseph Medical Center ("St. Joseph") in Bloomington, Illinois, and OSF Saint James-John W. Albrecht Medical Center ("Saint James") in Pontiac, Illinois are located approximately 35 miles apart and serve partially overlapping markets. St. Joseph is a 137 licensed acute care bed and 12 bed skilled nursing care hospital located on the east side of Bloomington, Illinois. St. Joseph provides primary, secondary and tertiary care, including open heart surgery. Saint James has 42 licensed acute care beds which are also Medicare swing bed approved. This hospital facility is located on the west side of Pontiac, Illinois, near Interstate 55. Saint James is the only acute care hospital located in Livingston County, Illinois. St. Mary Medical Center ("St. Mary") in Galesburg, Illinois, and OSF Holy Family Medical Center ("Holy Family") in Monmouth, Illinois are located approximately 19 miles apart and serve partially overlapping markets. Residents of Monmouth and its surrounding areas frequently travel to Galesburg to receive health care services. St. Mary is a 90 licensed bed acute care hospital located on the northeast side of Galesburg, Illinois. In addition to primary and secondary care, including diagnostic cardiac catheterization services, St. Mary has designations from the State of Illinois as a Level II Trauma Center, a Trauma Network Resource Hospital, a Level II perinatal center and a Hemophilia Emergency Treatment Center. Holy Family is a 23 licensed acute bed facility located in Monmouth, Illinois. All of its acute beds are also Medicare approved swing beds. St. Francis Hospital ("St. Francis Hospital") is a 25 licensed bed critical access hospital located on the west side of Escanaba, Michigan. As the only hospital in Delta County, Michigan, St. Francis Hospital provides a range of inpatient and outpatient hospital, diagnostic, therapeutic and ancillary services.
PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ROLES:	THE CORPORATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM (THE "OSF SYSTEM") WHICH PROVIDES INTEGRATED HEALTH CARE SERVICES THROUGHOUT CENTRAL ILLINOIS, PARTS OF NORTHERN ILLINOIS, AND PARTS OF THE UPPER PENNINSULA OF MICHIGAN. THE OSF SYSTEM INCLUDES THE OTHER CORPORATIONS LISTED BELOW, ALL OF WHICH ARE CONTROLLED, DIRECTLY OR INDIRECTLY, BY THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS (THE "CONGREGATION"). ALL AFFILIATED CORPORATIONS (WHETHER TAXABLE OR EXEMPT) APPLY AND FOLLOW THE CHARITY CARE POLICY OF THE CORPORATION AND ARE OPERATED IN FURTHERANCE OF THE MISSION OF THE CONGREGATION TO PROVIDE COMPREHENSIVE, INTEGRATED, QUALITY CARE, INCLUDING PREVENTIVE, PRIMARY, ACUTE, CONTINUOUS AND REHABILITATIVE HEALTH SERVICES TO THE COMMUNITIES SERVED BY THE CORPORATION AND THE OSF SYSTEM. SPECIAL EMPHASIS IS PLACED ON MEETING THE PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL NEEDS OF EVERYONE WHO IS CARED FOR IN THE OSF SYSTEM REGARDLESS OF RACE, COLOR, RELIGION AND ABILITY TO PAY. THE AFFILIATED CORPORATIONS ARE: - THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, WHICH HOLDS THE ASSETS OF THE RELIGIOUS CONGREGATION AND DIRECTS ALL OTHER CORPORATIONS IN THE AFFILIATED HEALTH CARE SYSTEM THROUGH BOARD REPRESENTATION AND THE EXERCISE OF RESERVED POWERS. - OSF SAINT FRANCIS, INC., WHICH PROVIDES HOME INFUSION AND DURABLE MEDICAL EQUIPMENT SERVICES, MOBILE MEDICAL IMAGING SERVICES, MEDICAL EQUIPMENT MAINTENANCE AND REPAIR SERVICES, MEDICAL STAFFING SERVICES, BILLING SERVICES, AND OTHER SERVICES IN SUPPORT OF THE AFFILIATED HEALTH CARE SYSTEM. - OSF AVIATION, LLC, WHICH IS AN FAA PART 135 CERTIFIED CARRIER PROVIDING EMS HELICOPTER SERVICES THROUGHOUT CENTRAL ILLINOIS AND PARTS OF NORTHERN ILLINOIS. - OSF LIFELINE AMBULANCE, LLC, WHICH PROVIDES GROUND AMBULANCE TRANSPORTATION SERVICES IN PARTS OF NORTHERN ILLINOIS. - OSF MULTISPECIALTY GROUP - PEORIA, LLC, WHICH PROVIDES PEDIATRIC CARDIOLOGY PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - ILLINOIS NEUROLOGICAL INSTITUTE - PHYSICIANS, LLC, WHICH PROVIDES PHYSICIAN NEUROSURGERY SERVICES IN CENTRAL ILLINOIS. - HEARTCARE MIDWEST, LTD., WHICH PROVIDES CARDIOLOGY AND CARDIOVASCULAR SURGERY PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - CARDIOVASCULAR INSTITUTE AT OSF, LLC, WHICH PROVIDES CARDIOLOGY AND CARDIOVASCULAR SURGERY PHYSICIAN SERVICES IN PARTS OF NORTHERN ILLINOIS. - OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC, WHICH PROVIDES PRIMARY AND SPECIALTY PHYSICIAN SERVICES IN PARTS OF CENTRAL ILLINOIS. - ILLINOIS PATHOLOGIST SERVICES, LLC, WHICH PROVIDES PROFESSIONAL PATHOLOGY SERVICES IN PARTS OF NORTHERN ILLINOIS. - ILLINOIS SPECIALTY PHYSICIAN SERVICES AT OSF, LLC, WHICH PROVIDES PULMONOLOGY AND CRITICAL CARE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - OSF PERINATAL ASSOCIATES, LLC, WHICH PROVIDES MATERNAL FETAL MEDICINE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. - OSF MULTISPECIALTY GROUP - WESTERN REGION, LLC, WHICH PROVIDES PRIMARY AND SPECIALTY PHYSICIAN SERVICES IN WESTERN ILLINOIS. - OSF CHILDREN'S MEDICAL GROUP- CONGENITAL HEART CENTER, LLC WHICH PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESSES IN NORTHERN ILLINOIS. - PREFERRED EMERGENCY PHYSICIANS OF ILLINOIS, LLC WHICH PROVIDES PHYSICIAN COVERAGE FOR EMERGENCY DEPARTMENTS. - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC, WHICH PROVIDES AMBULATORY SURGERY SERVICES IN CENTRAL ILLINOIS. - EASTLAND MEDICAL PLAZA SURGICENTER, LLC, WHICH PROVIDES AMBULATORY SURGERY SERVICES IN CENTRAL ILLINOIS. - FORT JESSE IMAGING CENTER, LLC, WHICH PROVIDES MEDICAL IMAGING SERVICES IN CENTRAL ILLINOIS. - SLEEP CENTER OF CENTRAL ILLINOIS, LLC, WHICH PROVIDES MEDICAL TREATMENT FOR SLEEP DISORDERS IN CENTRAL ILLINOIS. - OSF PERINATAL ASSOCIATES, LLC, WHICH PROVIDES PERINATOLOGY SERVICES IN CENTRAL ILLINOIS.
PART VI, LINE 7	ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:	IL, MI

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- 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
OSF Healthcare System

Employer identification number
37-0813229

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	(h) Purpose of grant or assistance
(1) Heartland Community Health 1701 W Garden Street Peoria,IL61605	37-1270794	501(c)(3)	250,000	support of clinic operations
(2) Quality Quest for Heart of Illinois 416 Main St Ste 717 Peoria,IL61602	26-3896631	501(c)(3)	100,000	SUPPORT OF ORG OPERATIONS
(3) KishHealth System One Kish Hospital Drive DeKalb,IL60115	36-3649080	501(c)(3)	10,000	support of org Operations
(4) American Heart Association Inc 7272 Greenville Avenue Dallas,TX75231	13-5613797	501(c)(3)	10,000	support of org Operations
(5) University of Illinois Foundation 1305 W Green St Urbana,IL618012962	37-6006007	501(c)(3)	40,000	support of org Operations
(6) Focus Forward CI Fund 331 Fulton Street Peoria,IL616021449	37-1185713	501(c)(3)	50,000	support of org Operations
(7) Peoria Promise Foundation 331 Fulton Street Peoria,IL616021449	13-4353454	501(c)(3)	25,000	Provide college assistance
(8) Boy Scouts of America Council 138 614 NE Madison Peoria,IL61603	37-0661188	501(c)(3)	25,000	support to Peoria area Boy Scouts

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
(1) SCHOLARSHIPS	131	131,732

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
SUPPLEMENTAL INFORMATION		Procedures for Monitoring Grants Part I, Line 2 THE CORPORATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES IN A VARIETY OF WAYS. FOR EDUCATIONAL SCHOLARSHIPS, THE CORPORATION TRACKS AND REVIEWS THE STUDENT'S GRADES AND SUCCESSFUL COURSE COMPLETION EACH SEMESTER. IN SOME CASES, THE CORPORATION'S CHIEF FINANCIAL OFFICER OR OTHER REPRESENTATIVE OF THE CORPORATION SERVES ON THE BOARD OF DIRECTORS OR ON THE FINANCE COMMITTEE OF THE GRANTEE ORGANIZATION AND RECEIVES DIRECT INFORMATION REGARDING USE OF GRANT FUNDS IN SUCH CAPACITY. IN OTHER CASES, THE CORPORATION RECEIVES WRITTEN REPORTS AND/OR FINANCIAL STATEMENTS FROM THE GRANTEE ORGANIZATION WHICH INCLUDE INFORMATION REGARDING USE OF GRANT FUNDS. Requirements for Saint Francis Medical Center Scholarship All scholarships are approved by the scholarship committee. Nursing Minimum Requirements: - GPA 2.5/4.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center RN staff position within 60 days of graduation and remain employed in a 72-80 hours/pay for two years following completion of the 90 day unit nursing orientation. Radiology, Radiation Therapist & Sonography Minimum Requirements: - GPA 2.5/4.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center Diagnostic Radiology Technologist staff position within 30 days of graduation and remain employed for two years following completion of the department orientation. Pharmacy Minimum Requirements: - Interview - GPA 2.5/4.0 or 3.125/5.0 scale - Two favorable academic references from clinical instructors - Two favorable employer references - Completed scholarship application form - Acceptance of the scholarship requires the student to secure and start in an OSF Saint Francis Medical Center R.Ph. position within 30 days of graduation and remain employed for two years or three years, depending on the monies received, following completion of the Pharmacy orientation. Respiratory Therapy Minimum Requirements: For External Candidates: - Meet all Illinois Central College's (ICC) minimum requirements for admission - GPA 3.0/4.0 scale - Pass a Wonderlic Test score of a 3 on the verbal section and a 2 on the math portion - Two favorable academic references from clinical instructors - Two favorable employer references - A brief 1-2 page typed essay explaining interest and desire to enroll the scholarship program - Interview For OSF Saint Francis Medical Center Employees: - Meet all Illinois Central College's (ICC) minimum requirements for admission - GPA 3.0/4.0 scale - Pass a Wonderlic Test score of a 3 on the verbal section and a 2 on the math portion - Must not be on any current formal levels of discipline - Two favorable supervisor/manager or director references - A brief 1-2 page typed essay explaining interest and desire to enroll the scholarship program - Interview Merit Scholarship Requirement: - GPA 3.4/4.0 scale - Dean's List in the semester previous to posting on students account Institutional Scholarship Requirement: - College of Nursing student in good academic standing and in financial need President's Scholarship Requirement: - GPA 3.55/4.0 scale Requirements for Saint Anthony Medical Center Scholarships Scholarships are awarded based on 50% academics, 30% financial need, and 20% community service. The awards are approved by the Saint Anthony College of Nursing Financial Aid Committee. The Alumni Memorial Scholarship are awarded based on 60% academics, 30% financial need, and 10% community service. Minimum requirements for all scholarships: - GPA 2.5/4.0 scale - Resume - Two favorable letters of recommendation, at least one from a clinical instructor - A brief typed essay explaining interest and desire to enroll the scholarship program Requirements for Holy Family Medical Center Scholarships - Application for assistance from OSF Holy Family Medical Center signifies a desire to work at OSF HFMC at the completion of the educational course work. - Meeting deadlines is the responsibility of the applicant. All application materials must reach OSF HFMC by April 1. Awards will be made by May 31. - Funds may only be used for health care-related coursework at the bachelor's degree level or below. - Recipients must reside in Warren or Henderson County, Illinois, be employees of OSF Holy Family Medical Center, or related to employees of OSF HFMC. - The maximum available amount of educational assistance is $3,500 annually. This amount will be distributed for tuition, books, and lab fees. Funds may not be used for living expenses or transportation - Each disbursement of funds requires the recipient sign a "Student Loan Promissory Note" which is forgiven when the student borrower becomes employed at OSF HFMC at completion of the educational program within specified time constraints. This means each request for funds requires a personal appearance by the student. (According to tax law, disbursements are taxable income.) - When funds have been distributed for a given semester, additional funds will not be paid until OSF HFMC has been furnished with a copy of prior semester grades, giving proof of successful completion of course work. A cumulative 3.0 grade point average or higher is required. - Recipients must reapply annually if they desire funds for subsequent years. While funds for subsequent years are not guaranteed, serious consideration will be given to those students who have excelled academically. - Receipt of educational assistance does not guarantee the recipient will be offered employment at the completion of the educational program. An appropriate position may not be available at that time. If an appropriate position is available, the recipient must accept the position or be prepared to repay any funds received. - With mutual agreement, the requirement to accept a position at OSF HFMC may be met by accepting employment at other OSF facilities.

Schedule I (Form 990) 2012

Additional Data

Software ID:
Software Version:

- 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

OSF Healthcare System

Employer identification number

37-0813229

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....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......

Yes

Indicate which, if any, of the following the 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? ................

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)DANIEL R FASSETT MDPhysician, Neurosurgery	(i) (ii)	474,884 0	1,288,414 0	17,047 0	17,850 0	12 0	1,798,207 0	0 0
(2)DALE M GEISS MDPhysician, Vascular Surgery	(i) (ii)	468,878 0	546,162 0	3,249 0	5,902 0	152 0	1,024,343 0	0 0
(3)GERALD J MCSHANE MDPres/CEO OSFMG, board member	(i) (ii)	416,692 0	100,682 0	62,723 0	35,700 0	12,102 0	627,899 0	0 0
(4)JEFFREY D KLOPFENSTEIN MDPhysician, Neurosurgery	(i) (ii)	482,084 0	758,330 0	14,050 0	17,850 0	15,010 0	1,287,324 0	0 0
(5)KEVIN D SCHOEPLEINVice Chairperson; CEO	(i) (ii)	852,823 0	1,625,954 0	101,471 0	284,558 0	16,762 0	2,881,568 0	0 0
(6)SYED M HUSSAIN MDPhysician, Vascular Surgery	(i) (ii)	288,997 0	691,730 0	36,173 0	18,145 0	15,009 0	1,050,054 0	0 0
(7)DONGWOO J CHANG MDPhysician, Neurosurgery	(i) (ii)	908,445 0	0 0	37,830 0	18,100 0	14,426 0	978,801 0	0 0
(8)VANCE C PARKHURSTSenior VP, Board Member	(i) (ii)	290,213 0	51,678 0	54,520 0	35,004 0	10,763 0	442,178 0	0 0
(9)DANIEL E BAKERSenior VP, CFO	(i) (ii)	435,045 0	75,087 0	70,922 0	228,005 0	11,055 0	820,114 0	0 0
(10)SUSAN CAMPBELLSENIOR VP, BOARD MEMBER	(i) (ii)	222,320 0	42,339 0	52,930 0	11,902 0	5,723 0	335,214 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
Schedule J, Part I, Line 1a		THE CORPORATION REIMBURSES CERTAIN EXECUTIVES FOR SOCIAL CLUB DUES PAID BY SUCH EXECUTIVES. ELIGIBILITY FOR CLUB DUES REIMBURSEMENT IS DETERMINED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS AND IS TAKEN INTO CONSIDERATION BY THE COMMITTEE IN DETERMINING FAIR MARKET COMPENSATION. SEE FORM 990 - SCHEDULE O - PART VI - LINES 15A AND 15B FOR AN EXPLANATION OF THE ROLE OF THE HUMAN RESOURCES COMMITTEE AND THE MANNER IN WHICH FAIR MARKET COMPENSATION IS DETERMINED. CLUB DUES ARE NOT ELIGIBLE FOR REIMBURSEMENT IF THE CLUB IN QUESTION DISCRIMINATES ON THE BASIS OF RACE, RELIGION, SEX, NATIONAL ORIGIN, OR OTHER PROHIBITED FACTORS. DUES REIMBURSEMENT IS TREATED AND REPORTED AS TAXABLE COMPENSATION. Schedule J, Part I, Line 3 See explanation in Schedule O, Part VI, Line 15a for details regarding the process to establish the compensation of the organization's CEO. Schedule J, Part I, Line 4b OSF healthcare System has a deferred compensation plan for select key executives. This plan was developed to assist with attracting and retaining certain key executives in the corporation. The plan is designed to encourage the participants to stay until a certain retirement date. If the participants terminate prior to their target retirement date, they forfeit what is in the plan. The Corporation determines the required deposits for the plan at a consolidated level. During FY13, $695,941 was deposited into the plan. The participants of the plan are Kevin Schoeplein and Dan Baker. Mr. Schoeplein received a distribution from the plan during the year of $1,402,316 while Mr. Baker did not receive a distribution.

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- 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
OSF Healthcare System

Employer identification number
37-0813229

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	45200B8E1	08-29-2007	461,801,780	SEE PART VI		X		X		X
B	ILLINOIS FINANCE AUTHORITY	86-1091967	45200FWD7	03-31-2009	249,074,230	SEE PART VI		X		X		X
C	ILLINOIS FINANCE AUTHORITY	86-1091967		08-18-2009	70,000,000	SEE PART VI		X		X		X
D	ILLINOIS FINANCE AUTHORITY	86-1091967	45200F3R8	06-29-2010	158,535,888	SEE PART VI		X		X		X
	ILLINOIS FINANCE AUTHORITY	86-1091967	45203HLH3	09-26-2012	191,360,304	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	219,440,000		2,395,000		29,623,911		6,025,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0		39,430,000		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	461,801,780		249,074,230		70,000,000		158,535,888
4 Gross proceeds in reserve funds . . . . . . . . . . . .	35,414		7,986		11,092		2,483
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	3,319,397		3,114,169		0		2,080,292
8 Credit enhancement from proceeds . . . . . . . . . . .	8,846,375		126,677		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	285,706,088		0		70,000,000		28,000,000
11 Other spent proceeds . . . . . . . . . . . . . .	0		0		0		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2010				2010		2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X			X	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

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

For 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		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? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
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 . .	0.00000%		0.00000%		0.00000%		0.00000%
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 . . . . . . .	0.00000%		0.00000%		0.00000%		0.00000%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.00000%		0.00000%		0.00000%		0.00000%
7 Does the bond issue meet the private security or payment test? . . . . .		X		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		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	%		%		%		%
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		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		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		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X						X
b Exception to rebate? . . . . . . . .
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			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider . . . . . . . . .	MERRILL LYNCH		0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .		X
e Was a hedge terminated? . . . . . . .	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		X
b Name of provider . . . . . . . . .	0		0		0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X			X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		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		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
SUPPLEMENTAL INFORMATION 1	0	SCHEDULE K - PART I - BOND ISSUES ILLINOIS FINANCE AUTHORITY - 08/29/2007 Cusip# 45200B8E1 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2007 BONDS WHICH INCLUDED FIXED RATE BONDS, AUCTION BONDS AND VARIABLE RATE BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS TO (I) FINANCE OR REFINANCE THE COST OF THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF THE PROJECT; (II) PAY CAPITALIZED INTEREST WITH RESPECT TO A PORTION OF THE SYSTEMWIDE BONDS; (III) FUND DEBT SERVICE RESERVE FUNDS FOR CERTAIN OF THE SYSTEMWIDE BONDS; (IV) REFINANCE THE PRIOR INDEBTDEDNESS DESCRIBED BELOW AND (V) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 03/31/2009 Cusip# 45200FWD7, 4500FWG0, 45200FWE5, 45200FWF2 THE CORPORATION USED THE PROCEEDS OF THE SYSTEMWIDE BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (I) REFINANCE AND REDEEM THE PRIOR BONDS DESCRIBED BELOW; (II) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2009 BONDS; AND (III) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 08/18/2009 NO CUSIP# (PRIVATE PLACEMENTS) THE CORPORATION USED THE PROCEEDS OF THE SERIES 2009EFG TO PAY OR REIMBURSE THE CORPORATION FOR THE PROJECTS. ILLINOIS FINANCE AUTHORITY - 06/29/2010 CUSIP# 45200F3R8 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2010A BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (i) REFINANCE AND REDEEM, THE ILLINOIS HEALTH FACILITY AUTHORITY VARIABLE DEMAND REVENUE BONDS, SERIES 1985B (REVOLVING FUND POOLED FINANCING PROGRAM)IN THE AMOUNT OF $75,000,000, ILLINOIS FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2001 IN THE AMOUNT OF $46,050,000, AND THE ILLINOIS FINANCE AUTHORITY REVENUE BONDS, SERIES 2007D IN THE AMOUNT OF $20,050,000; (ii) PAY OR REIMBURSE THE CORPORATION FOR THE PROJECT; (iii) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2010A BONDS; AND PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2010A BONDS AND THE REFINANCING OF THE SERIES 1985B BONDS, THE SERIES 2001 BONDS AND THE SERIES 2007D BONDS. ILLINOIS FINANCE AUTHORITY - 09/26/2012 CUSIP #45203HLH3, 45203HLG5 The Corporation used the proceeds of the Series 2012 bonds to (i) pay or reimburse the corporation or ottawa regional hospital & healthcare center for the costs of the project, (ii) advance refund all of the illinois finance authority revenue bonds, series 2004, (iii) current refund a portion of the illinois finance authority insured variable rate demand revenue bonds, series 2007f, (iv) currently refund all of the illinois finance authority variable rate demand revenue bonds, series 2007g, (v) advance refund a portion of the illinois finance authority revenue bonds, series 2009a, (vi) currently refund all of the illinois finance authority revenue bonds, series 2009f, (vii) refinance the pnc bank loan, and (viii) pay certain expenses incurred in connection with the issuance of the bonds and the refunding of the prior bonds and pnc bank loan. Illinois Finance Authority - September 26, 2013 (Substitution Date) CUSIP # 45203HVM1, 45203HVN0 The Series 2007E & F Variable Rate Demand Revenue Bonds were reissued with irrevocable transferable letters of credit.
SUPPLEMENTAL INFORMATION 2	0	SCHEDULE K - PART II - LINE 7 BOND ISSUANCE COSTS BOND ISSUANCE COST CREDIT ENHANCEMENT TOTAL A $3,319,397 $8,846,375 $12,165,772 B $3,114,169 $126,677 $3,240,846 C $0 $0 $0 D $2,080,292 $0 $2,080,292 E $2,402,586 $0 $2,402,586
SUPPLEMENTAL INFORMATION 3	0	SCHEDULE K - PART IV - LINE 2C DATE THE REBATE COMPUTATION WAS PERFORMED A NOVEMBER 28, 2011 B MAY 30, 2014 C JUNE 3, 2014
SUPPLEMENTAL INFORMATION 4	0

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- 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
OSF Healthcare System

Employer identification number
37-0813229

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	45200B8E1	08-29-2007	461,801,780	SEE PART VI		X		X		X
B	ILLINOIS FINANCE AUTHORITY	86-1091967	45200FWD7	03-31-2009	249,074,230	SEE PART VI		X		X		X
C	ILLINOIS FINANCE AUTHORITY	86-1091967		08-18-2009	70,000,000	SEE PART VI		X		X		X
D	ILLINOIS FINANCE AUTHORITY	86-1091967	45200F3R8	06-29-2010	158,535,888	SEE PART VI		X		X		X
	ILLINOIS FINANCE AUTHORITY	86-1091967	45203HLH3	09-26-2012	191,360,304	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	219,440,000		2,395,000		29,623,911		6,025,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0		39,430,000		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	461,801,780		249,074,230		70,000,000		158,535,888
4 Gross proceeds in reserve funds . . . . . . . . . . . .	35,414		7,986		11,092		2,483
5 Capitalized interest from proceeds . . . . . . . . . . .	0		0		0		0
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	3,319,397		3,114,169		0		2,080,292
8 Credit enhancement from proceeds . . . . . . . . . . .	8,846,375		126,677		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	285,706,088		0		70,000,000		28,000,000
11 Other spent proceeds . . . . . . . . . . . . . .	0		0		0		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		0		0
13 Year of substantial completion . . . . . . . . . . . .	2010				2010		2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X			X	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

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

For 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		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? . . . . . . . . . . . . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .
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 . .	0.00000%		0.00000%		0.00000%		0.00000%
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 . . . . . . .	0.00000%		0.00000%		0.00000%		0.00000%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.00000%		0.00000%		0.00000%		0.00000%
7 Does the bond issue meet the private security or payment test? . . . . .		X		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		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	%		%		%		%
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		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		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		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X						X
b Exception to rebate? . . . . . . . .
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			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider . . . . . . . . .	MERRILL LYNCH		0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .		X
e Was a hedge terminated? . . . . . . .	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		X
b Name of provider . . . . . . . . .	0		0		0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X			X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		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		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
SUPPLEMENTAL INFORMATION 1	0	SCHEDULE K - PART I - BOND ISSUES ILLINOIS FINANCE AUTHORITY - 08/29/2007 Cusip# 45200B8E1 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2007 BONDS WHICH INCLUDED FIXED RATE BONDS, AUCTION BONDS AND VARIABLE RATE BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS TO (I) FINANCE OR REFINANCE THE COST OF THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF THE PROJECT; (II) PAY CAPITALIZED INTEREST WITH RESPECT TO A PORTION OF THE SYSTEMWIDE BONDS; (III) FUND DEBT SERVICE RESERVE FUNDS FOR CERTAIN OF THE SYSTEMWIDE BONDS; (IV) REFINANCE THE PRIOR INDEBTDEDNESS DESCRIBED BELOW AND (V) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 03/31/2009 Cusip# 45200FWD7, 4500FWG0, 45200FWE5, 45200FWF2 THE CORPORATION USED THE PROCEEDS OF THE SYSTEMWIDE BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (I) REFINANCE AND REDEEM THE PRIOR BONDS DESCRIBED BELOW; (II) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2009 BONDS; AND (III) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SYSTEMWIDE BONDS AND THE REFINANCING. ILLINOIS FINANCE AUTHORITY - 08/18/2009 NO CUSIP# (PRIVATE PLACEMENTS) THE CORPORATION USED THE PROCEEDS OF THE SERIES 2009EFG TO PAY OR REIMBURSE THE CORPORATION FOR THE PROJECTS. ILLINOIS FINANCE AUTHORITY - 06/29/2010 CUSIP# 45200F3R8 THE CORPORATION USED THE PROCEEDS OF THE SERIES 2010A BONDS, TOGETHER WITH CERTAIN OTHER AVAILABLE FUNDS, TO (i) REFINANCE AND REDEEM, THE ILLINOIS HEALTH FACILITY AUTHORITY VARIABLE DEMAND REVENUE BONDS, SERIES 1985B (REVOLVING FUND POOLED FINANCING PROGRAM)IN THE AMOUNT OF $75,000,000, ILLINOIS FINANCE AUTHORITY VARIABLE RATE REVENUE BONDS, SERIES 2001 IN THE AMOUNT OF $46,050,000, AND THE ILLINOIS FINANCE AUTHORITY REVENUE BONDS, SERIES 2007D IN THE AMOUNT OF $20,050,000; (ii) PAY OR REIMBURSE THE CORPORATION FOR THE PROJECT; (iii) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2010A BONDS; AND PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2010A BONDS AND THE REFINANCING OF THE SERIES 1985B BONDS, THE SERIES 2001 BONDS AND THE SERIES 2007D BONDS. ILLINOIS FINANCE AUTHORITY - 09/26/2012 CUSIP #45203HLH3, 45203HLG5 The Corporation used the proceeds of the Series 2012 bonds to (i) pay or reimburse the corporation or ottawa regional hospital & healthcare center for the costs of the project, (ii) advance refund all of the illinois finance authority revenue bonds, series 2004, (iii) current refund a portion of the illinois finance authority insured variable rate demand revenue bonds, series 2007f, (iv) currently refund all of the illinois finance authority variable rate demand revenue bonds, series 2007g, (v) advance refund a portion of the illinois finance authority revenue bonds, series 2009a, (vi) currently refund all of the illinois finance authority revenue bonds, series 2009f, (vii) refinance the pnc bank loan, and (viii) pay certain expenses incurred in connection with the issuance of the bonds and the refunding of the prior bonds and pnc bank loan. Illinois Finance Authority - September 26, 2013 (Substitution Date) CUSIP # 45203HVM1, 45203HVN0 The Series 2007E & F Variable Rate Demand Revenue Bonds were reissued with irrevocable transferable letters of credit.
SUPPLEMENTAL INFORMATION 2	0	SCHEDULE K - PART II - LINE 7 BOND ISSUANCE COSTS BOND ISSUANCE COST CREDIT ENHANCEMENT TOTAL A $3,319,397 $8,846,375 $12,165,772 B $3,114,169 $126,677 $3,240,846 C $0 $0 $0 D $2,080,292 $0 $2,080,292 E $2,402,586 $0 $2,402,586
SUPPLEMENTAL INFORMATION 3	0	SCHEDULE K - PART IV - LINE 2C DATE THE REBATE COMPUTATION WAS PERFORMED A NOVEMBER 28, 2011 B MAY 30, 2014 C JUNE 3, 2014
SUPPLEMENTAL INFORMATION 4	0

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

Identifier	Return Reference	Explanation
FORM 990 - PART III - LINE 4A:	INPATIENT SERVICES:	OSF HEALTHCARE SYSTEM OWNS AND OPERATES ACUTE CARE HOSPITALS IN ESCANABA, MICHIGAN; ROCKFORD, ILLINOIS; PONTIAC, ILLINOIS; BLOOMINGTON, ILLINOIS; PEORIA, ILLINOIS; GALESBURG, ILLINOIS; AND MONMOUTH, ILLINOIS; AND OWNed AND OPERATEd ONE LONG-TERM CARE FACILITY IN PEORIA HEIGHTS, ILLINOIS until it was sold on February 1, 2013. AS OF THE CLOSE OF THE REPORTING PERIOD ON SEPTEMBER 30, 2013, THESE EIGHT FACILITIES HAD A COMBINED TOTAL OF 1,192 LICENSED INPATIENT AND RESIDENT BEDS AND OPERATED A COMBINED TOTAL OF 1,206 STAFFED INPATIENT AND RESIDENT BEDS. THEY HAD COMBINED TOTALS OF 58,059 INPATIENT AND RESIDENT DISCHARGES AND 288,869 INPATIENT AND RESIDENT DAYS, INCLUDING 10,192 NEWBORN INPATIENT DAYS. THE SEVEN ACUTE CARE HOSPITALS COLLECTIVELY SERVED 48 COUNTIES. THEY HAD A COMBINED TOTAL OF APPROXIMATELY 2,221 PHYSICIANS ON THEIR MEDICAL STAFFS; INCLUDING APPROXIMATELY 1,253 PHYSICIANS ON THEIR ACTIVE OR ASSOCIATE MEDICAL STAFFS. ONE OF THE HOSPITALS IS A SOLE COMMUNITY HOSPITAL AND two are CRITICAL ACCESS HOSPITALs. THE CORPORATION'S HOSPITALS OFFER A BROAD RANGE OF INPATIENT SERVICES. THREE OF THE HOSPITALS PROVIDE OPEN HEART SURGERY SERVICES, TWO OFFER LEVEL II NEONATAL SERVICES, ONE OFFERS LEVEL III NEONATAL SERVICES (HIGHEST LEVEL), AND ONE OFFERS KIDNEY AND PANCREAS ORGAN TRANSPLANT SERVICES. THE CORPORATION HAS ORGANIZED AND OPERATES COMPREHENSIVE CARDIAC AND STROKE CARE NETWORKS IN CENTRAL AND NORTHERN ILLINOIS AND OPERATES THE ONLY COMPREHENSIVE CHILDREN'S HOSPITAL IN CENTRAL ILLINOIS
FORM 990 - PART III - LINE 4B:	OUTPATIENT SERVICES:	THE SEVEN ACUTE CARE HOSPITALS OWNED AND OPERATED BY OSF HEALTHCARE SYSTEM COLLECTIVELY PROVIDED 938,598 OUTPATIENT VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013, INCLUDING 49,406 OUTPATIENT SURGERY VISITS BUT EXCLUDING EMERGENCY DEPARTMENT VISITS. THE CORPORATION'S HOSPITALS OFFER A BROAD RANGE OF OUTPATIENT THERAPEUTIC AND DIAGNOSTIC SERVICES, INCLUDING OUTPATIENT SURGERY AND ADVANCED MEDICAL IMAGING.
FORM 990 - PART III - LINE 4C:	Physcian Services	PHYSICIANS EMPLOYED BY OSF HEALTHCARE SYSTEM PROVIDED 1,089,661 OFFICE VISITS (NOT INCLUDING SERVICES PROVIDED TO HOSPITAL INPATIENTS AND OUTPATIENTS) AT OFFICES IN 78 SEPARATE LOCATIONS THROUGHOUT CENTRAL AND NORTHERN ILLINOIS AND THE UPPER PENINSULA OF MICHIGAN.
FORM 990 - PART III - LINE 4D:	Home Health Services:	(EXPENSES $49,013,534 INCLUDING GRANTS OF $NONE)(REVENUE $45,141,521) THE five HOME HEALTH AGENCIES OWNED AND OPERATED BY THE CORPORATION COLLECTIVELY SERVE 32 COUNTIES IN ILLINOIS AND MICHIGAN, ENROLLED 26,904 HOME HEALTH PATIENTS, AND PROVIDED 185,717 HOME HEALTH VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013. THE Four HOSPICE PROGRAMS OWNED AND OPERATED BY THE CORPORATION COLLECTIVELY SERVE 33 COUNTIES IN ILLINOIS AND MICHIGAN, ENROLLED 2,959 HOSPICE PATIENTS, AND PROVIDED 95,752 HOSPICE DAYS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013.
FORM 990 - PART III - LINE 4D:	EMERGENCY DEPARTMENT SERVICES:	(EXPENSES $71,730,584 INCLUDING GRANTS OF $ NONE) (REVENUE $90,404,273) ALL OF THE SEVEN ACUTE CARE HOSPITALS OF THE CORPORATION PROVIDE 24-HOUR EMERGENCY DEPARTMENT SERVICES. ALL ARE STAFFED BY PHYSICIANS WHO ARE PREDOMINANTLY (BUT NOT ENTIRELY) CERTIFIED IN EMERGENCY MEDICINE BY NATIONAL SPECIALTY BOARDS. THE EMERGENCY DEPARTMENTS OF THE CORPORATION'S ACUTE CARE HOSPITALS PROVIDED 211,649 PATIENT VISITS DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013.
FORM 990 - PART III - LINE 4D:	RESIDENCY PROGRAMS:	(EXPENSES $50,727,541 INCLUDING GRANTS OF $ NONE) (REVENUE $98,584) OSF HEALTHCARE SYSTEM HAS ENTERED INTO A MAJOR AFFILIATION AGREEMENT WITH THE UNIVERSITY OF ILLINOIS PROVIDING SIGNIFICANT FINANCIAL AND TEACHING SUPPORT FOR PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS SPONSORED BY THE UNIVERSITY. THE CORPORATION EMPLOYED 217 RESIDENTS AND FELLOWS IN THESE PROGRAMS DURING THE REPORTING PERIOD.
FORM 990 - PART III - LINE 4D	COLLEGES OF NURSING PROGRAMS:	(EXPENSES $11,998,030 INCLUDING GRANTS OF $131,732) (REVENUE $14,726,297) TWO OF THE CORPORATION'S HOSPITALS OPERATE ACCREDITED COLLEGES OF NURSING WHICH AWARD BACCALAUREATE, MASTERS, AND DOCTORATE DEGREES. THERE WERE 2,310 ENROLLEES IN THESE PROGRAMS DURING THE THREE SEMESTERS FALLING WITHIN THE REPORTING PERIOD (FALL 2012, SPRING 2013, AND SUMMER 2013)
FORM 990 - PART III - LINE 4D;	TRAUMA SERVICES (LEVEL 1):	(EXPENSES $8,920,922 INCLUDING GRANTS OF $ NONE) (REVENUE $1,980,112) TWO OF THE CORPORATION'S SEVEN HOSPITALS HAVE BEEN DESIGNATED AS LEVEL I (HIGHEST LEVEL) TRAUMA CENTERS, AND TWO HAVE BEEN DESIGNATED AS LEVEL II TRAUMA CENTERS. LEVEL I TRAUMA CENTERS ARE CONTINUOUSLY STAFFED WITH IN-HOUSE TRAUMA SURGEONS, ANESTHESIA PROVIDERS, AND OTHER SPECIALIZED HEALTH CARE PROFESSIONALS IN ORDER TO PROVIDE IMMEDIATE TRAUMA SURGERY AND OTHER TREATMENT SERVICES TO TRAUMA PATIENTS. THE EXPENSES ABOVE REFLECT THESE STAFFING COSTS. LEVEL I TRAUMA CENTERS ALSO HAVE SPECIAL RESPONSIBILITIES FOR FORMING AND CARRYING OUT AREA-WIDE DISASTER PREPAREDNESS AND EMERGENCY RESPONSE PLANS AND FOR COORDINATING AREA-WIDE TRAUMA SERVICES IN THE EVENT OF MAJOR DISASTERS.
FORM 990 - PART III - LINE 4D:	EMS FLIGHT & GROUND TRANSPORT SERVICES:	(EXPENSES $21,402,021 INCLUDING GRANTS OF $ NONE) (REVENUE $12,467,962) THE CORPORATION PROVIDES EMERGENCY HELICOPTER TRANSPORT SERVICES TO PATIENTS IN NORTHERN AND CENTRAL ILLINOIS USING A FLEET OF FOUR EMS CONFIGURED HELICOPTERS. 2,261 EMS HELICOPTER PATIENT TRANSPORTS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013. A SUBSIDIARY OF THE CORPORATION PROVIDES GROUND AMBULANCE PATIENT TRANSPORT SERVICES IN NORTHERN ILLINOIS. 9,094 GROUND AMBULANCE PATIENT TRANSPORTS PLUS 4,103 WHEELCHAIR PATIENT TRANSPORTS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013.
FORM 990 - PART III - LINE 4D:	COMMUNITY CLINIC, Outreach, and Other Educational PROGRAMS:	(EXPENSES $6,932,164 INCLUDING GRANTS OF $ NONE) (REVENUE $2,526,755) OSF COMMUNITY PRENATAL CLINIC - BLOOMINGTON, ILLINOIS: THIS CLINIC SERVES UNINSURED AND UNDERINSURED PREGNANT WOMEN IN THE BLOOMINGTON-NORMAL, ILLINOIS COMMUNITIES AND SURROUNDING AREA. THE CLINIC PROVIDES SPANISH-SPEAKING STAFF TO ASSIST PATIENTS WHO HAVE LANGUAGE BARRIERS. PRENATAL SERVICES AND DELIVERIES WERE PROVIDED TO 44 WOMEN DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013. OSF SISTERS COMMUNITY HEALTHCARE CLINICS - PEORIA, ILLINOIS: THIS CLINIC IS A PRIMARY CARE HOSPITAL BASED RESIDENCY CLINIC WHERE UNINSURED AND UNDERINSURED PATIENTS OF ALL AGES ARE SEEN BY RESIDENT PHYSICIANS UNDER THE DIRECTION OF AN ATTENDING PHYSICIAN. PROFESSIONAL SERVICES INCLUDE ADULT INTERNAL MEDICINE, PEDIATRIC AMBULATORY CARE, AND OBSTETRICS/GYNECOLOGY. OTHER SERVICES INCLUDE X-RAY, LABORATORY, SONOGRAPHY, COUMADIN MANAGEMENT, ADULT AND PEDIATRIC SOCIAL SERVICES, AND FINANCIAL ADVISORY SERVICES. 26,675 PATIENT VISITS WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013. PARISH NURSING PROGRAM - PEORIA, ILLINOIS: THIS PROGRAM PROVIDES PROFESSIONAL SUPERVISION AND CLINICAL SUPPORT FOR VOLUNTEER NURSES WHO FURNISH MEDICAL SCREENING, EDUCATION AND NURSING SERVICES TO MEMBERS OF CHURCH CONGREGATIONS IN AND AROUND PEORIA, ILLINOIS. PERINATAL OUTREACH PROGRAM - PEORIA, ILLINOIS: THIS PROGRAM PROVIDES PROFESSIONAL EDUCATION AND TRAINING TO CLINICIANS IN COMMUNITY HOSPITALS THROUGHOUT CENTRAL ILLINOIS REGARDING CLINICALLY APPROPRIATE MANAGEMENT AND REFERRAL OF WOMEN WITH HIGH RISK PREGNANCIES. 1,102 HOURS OF EDUCATION AND TRAINING WERE PROVIDED DURING THE REPORTING PERIOD ENDED SEPTEMBER 30, 2013. COMMUNITY TRAINING CENTER - ROCKFORD, ILLINOIS AND PEORIA, ILLINOIS: THE COMMUNITY TRAINING CENTERS PROVIDE TRAINING TO THE PUBLIC SO THEY ARE PREPARED TO DO BASIC LIFE SUPPORT IN AN EMERGENCY. CLASSES INCLUDE CPR CERTIFICATION AND TRAINING FOR THE AMERICAN HEART ASSOCIATION CERTIFICATIONS SUCH AS BASIC LIFE SUPPORT AND ADVANCED LIFE. PARAMEDICAL EDUCATION - ROCKFORD, ILLINOIS: THIS PROGRAM PROVIDES PRIMARY AND CONTINUING EDUCATION AT NUMEROUS LEVELS OF CERTIFICATION AND LICENSURE PER IDPH RULES AND REGULATIONS. EDUCATION IN AREAS SUCH AS CPR, EMERGENCY MEDICAL RESPONDER, EMT BASIC, EMT INTERMEDIATE AND EMT PARAMEDIC TO NAME A FEW ARE PROVIDED TO OUR SERVICE AREA FIRE AND POLICE FIRST RESPONDERS, BOTH PAID AND VOLUNTEER AS WELL AS TO THE GENERAL PUBLIC. MUCH OF THIS TRAINING IS PROVIDED ON SITE THROUGHOUT OUR SERVICE AREA BUT IS ALSO SUPPORTED BY A STANDALONE OSF EMS TRAINING FACILITY IN ROCKFORD, ILLINOIS. THIS COMMITMENT DEMANDS THOUSANDS OF HOURS THROUGHOUT OUR EMS SYSTEM ANNUALLY. EMT EDUCATION - PEORIA, ILLINOIS: THIS INCLUDES CLASSES PROVIDED TO THE AMBULANCE AND RESCUE SQUADS OF THE CENTRAL ILLINOIS AREA FOR THE TRAINING AND UPDATING OF THE EMPLOYEES AND VOLUNTEERS OF THE SQUADS. THIS SERVICE PROVIDES HUNDREDS OF HOURS OF ONGOING TRAINING THROUGHOUT THE REGION TO FIRST RESPONDERS. MEDICAL TECH EDUCATION - ROCKFORD, ILLINOIS AND PEORIA, ILLINOIS: AT PEORIA THIS IS A YEAR LONG PROGRAM FOR SCIENCE MAJOR STUDENTS THAT WILL BECOME TECHNICIANS IN A HOSPITAL LAB. THIS IS A REQUIRED PROGRAM FOR THE STUDENTS TO COMPLETE THE BACHELOR'S DEGREE AND BE ABLE TO FUNCTION IN THE LAB. THERE ARE USUALLY TEN STUDENTS PER YEAR. ROCKFORD'S CLINICAL LAB HAS AN EXCLUSIVE AFFILIATION WITH THE NORTHERN ILLINOIS UNIVERSITY MEDICAL LABORATORY SCIENCE PROGRAM. THE LAB SERVES AS A CLINICAL TRAINING SITE FOR FOUR STUDENTS ANNUALLY WHO COMPLETE A 33-WEEK CLINICAL ROTATION WHERE THEY ARE ONSITE FOR 24 HOURS EACH WEEK. RADIOLOGY TECH EDUCATION - PEORIA, ILLINOIS: THIS IS A TWO YEAR PROGRAM FOR STUDENTS THAT WISH TO BECOME IMAGING TECHNICIANS IN ANY OF SEVERAL AREAS (DIAGNOSTIC, MRI, CT, SONS, ETC). UPON GRADUATION THE STUDENT IS ABLE TO PROVIDE THE PROCEDURES IN A CLINICAL SETTING. THERE ARE APPROXIMATELY TWENTY STUDENTS PER YEAR. DIETETIC EDUCATION - PEORIA, ILLINOIS: THIS IS A YEAR LONG PROGRAM THAT IS REQUIRED FOR A STUDENT TO BECOME A REGISTERED DIETITIAN. THE STUDENTS ARE PROVIDED TRAINING IN THE PREPARATION OF DIETS, COUNSELING, RESEARCH, AND EXPOSURE TO THE OPERATIONS OF A FOOD SERVICE AREA. THERE ARE APPROXIMATELY TEN STUDENTS PER YEAR. OTHER PROGRAM SERVICES (EXPENSES $7,415,143 INCLUDING GRANTS OF $ NONE) (REVENUE $5,696,048) Form 990 - Part VI - Line 1a: By adopting certain provisions of the corporate bylaws, the board of directors has delegated broad authority to the executive committee of the board. The bylaws provide that the executive committee shall be authorized to take such action as may be necessary on behalf of the corporation during periods when the board of directors is not in session.
FORM 990 - PART VI - LINE 6 & 7A:		OSF HEALTHCARE SYSTEM HAS NO CORPORATE STOCK OR STOCKHOLDERS. ITS SOLE MEMBER IS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, AN ILLINOIS NOT FOR PROFIT CORPORATION, WHICH IS CONTROLLED BY MEMBERS OF A RELIGIOUS CONGREGATION OF THE CATHOLIC CHURCH ALSO KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS. THE GOVERNING BOARD OF THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, AN ILLINOIS NOT FOR PROFIT CORPORATION AND THE SOLE MEMBER OF OSF HEALTHCARE SYSTEM, HOLDS RESERVED POWERS TO ELECT AND REMOVE ALL OF THE MEMBERS OF THE BOARD OF DIRECTORS OF OSF HEALTHCARE SYSTEM.
FORM 990 - PART VI - LINE 7B:		AS GOVERNED BY CANONICAL AND CIVIL GUIDELINES PERTAINING TO ROMAN CATHOLIC CHURCH PROPERTIES AND AS PROVIDED IN THE BYLAWS, CERTAIN TRANSACTIONS OF OSF HEALTHCARE SYSTEM MAY BE AUTHORIZED ONLY BY VOTE OF THE GOVERNING BOARD OF THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS, WHICH VOTE IS TO BE TAKEN ONLY AFTER CONSIDERING THE ADVICE OF THE BOARD OF DIRECTORS OF OSF HEALTHCARE SYSTEM. THESE TRANSACTIONS ARE AS FOLLOWS: - TO ESTABLISH THE PHILOSOPHY AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. - TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. - TO ELECT AND REMOVE WITH OR WITHOUT CAUSE THE DIRECTORS OF THE CORPORATION. - TO MERGE OR DISSOLVE THE CORPORATION. - TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE REAL PROPERTY OF THE CORPORATION. - TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. - TO APPROVE ANY BORROWING OR DEBT FINANCING IN EXCESS OF A SPECIFIED LIMIT (CURRENTLY $1,000,000) ESTABLISHED BY RESOLUTION OF THE MEMBER. - TO APPOINT (OR APPROVE THE APPOINTMENT OF) OR REMOVE THE CORPORATION'S CHAIRPERSON, CHIEF EXECUTIVE OFFICER, PRESIDENT, REGIONAL PRESIDENT/CHIEF EXECUTIVE OFFICERS, AND THE LOCAL PRESIDENT/CHIEF EXECUTIVE OFFICER OF EACH HEALTH CARE FACILITY AND OPERATING DIVISION OWNED, OPERATED OR CONTROLLED BY THE CORPORATION. - TO APPROVE STRATEGIC PLANS, MANAGEMENT OBJECTIVES AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. - TO APPROVE ANY PURCHASE OR OTHER ACQUISITION IN EXCESS OF A SPECIFIED LIMIT (CURRENTLY $1,000,000) ESTABLISHED BY RESOLUTION OF THE MEMBER. - TO REQUIRE A CERTIFIED AUDIT OF THE CORPORATION'S FINANCES AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. - TO APPROVE THE ENGAGEMENT OF ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS AND THE DISMISSAL OF ANY CURRENT LEGAL COUNSEL REPRESENTING THE CORPORATION ON A REGULAR BASIS. - TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WILL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY.
FORM 990 - PART VI - LINE 9:		JAMES W. GIRARDY, M.D. 5666 East State Street ROCKFORD, IL 61108
FORM 990 - PART VI - LINE 11B:		THE INITIAL DRAFT FORM 990 AND ALL REQUIRED SCHEDULES ARE PREPARED USING A MULTI-DISCIPLINARY PROCESS WHICH INCLUDES CORPORATE FINANCE AND ACCOUNTING, CORPORATE LEGAL, CORPORATE COMPLIANCE, AND CORPORATE MARKETING AND COMMUNICATIONS PERSONNEL WHO FOCUS INITIALLY ON SPECIFIC PORTIONS OF THE RETURN. THE COMPLETED DRAFT FORM 990 AND ALL SCHEDULES ARE THEN REVIEWED BY THIS SAME MULTI-DISCIPLINARY TEAM TO ENSURE ACCURACY AND INTEGRATION OF THE INDIVIDUAL PARTS AND SCHEDULES. IN ADDITION, THE INFORMATION AND SCHEDULES OF THE RETURN ARE SENT TO THE CORPORATION'S OUTSIDE AUDITORS, KPMG LLP FOR REVIEW AND COMMENT. KPMG REVIEWS THE INFORMATION AND SCHEDULES AND PREPARES AND SIGNS THE FINAL RETURN. COMMENTS FROM THE MULTI-DISCIPLINARY TEAM AND FROM THE AUDITORS ARE INCORPORATED INTO A PROPOSED FINAL VERSION OF FORM 990 AND ALL SCHEDULES. THIS PROPOSED FINAL VERSION IS THEN SENT VIA E-MAIL TO ALL OFFICERS AND MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES FOR FILING.
FORM 990 - PART VI - LINE 12C:		DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTING DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION ABOUT THE INTEREST. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANAGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM.
FORM 990 - PART VI - LINE 15A:		THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE CHIEF EXECUTIVE OFFICER ("CEO") IS NOT A MEMBER OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITTEE. THE COMMITTEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS THE BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED.
FORM 990 - PART VI - LINE 15B:		THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. SOME KEY EMPLOYEES LISTED IN PART VII ARE PRACTICING PHYSICIANS WHO ARE LISTED AS KEY EMPLOYEES AS A RESULT OF THE COMPENSATION THEY RECEIVE AND NOT DUE TO ANY EXECUTIVE OR MANAGEMENT POSITION WHICH THEY HOLD. SUCH PHYSICIANS GENERALLY ARE NOT PARTICIPANTS IN THE EXECUTIVE COMPENSATION PLAN, AND THEIR COMPENSATION, INCLUDING BASE SALARY, BENEFITS, AND ANY APPLICABLE BONUS OR INCENTIVE COMPENSATION, IS ESTABLISHED IN ACCORDANCE WITH NATIONALLY RECOGNIZED PHYSICIAN COMPENSATION SURVEYS AND IS SET FORTH IN WRITTEN EMPLOYMENT AGREEMENTS WHICH ARE APPROVED BY THE BOARD OF DIRECTORS OR ITS EXECUTIVE COMMITTEE.
FORM 990 - PART VI - LINE 18:		OSF HEALTHCARE SYSTEM MAKES ITS FORM 990, ITS FORM 990-T, AND DOCUMENTATION OF ITS EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE CODE AVAILABLE FOR PUBLIC INSPECTION AND COPYING UPON REQUEST IN ACCORDANCE WITH SECTION 6104 OF THE INTERNAL REVENUE CODE. NAMES AND ADDRESSES OF CONTRIBUTORS ARE NOT DISCLOSED. REQUESTS MAY BE MADE IN PERSON, IN WRITING, OR BY TELEPHONE. REQUESTS MADE IN PERSON ARE ACCEPTED AT THE CORPORATE OFFICE AND AT EACH HOSPITAL FACILITY OF THE CORPORATION. REQUESTS MADE IN WRITING OR BY TELEPHONE TO ANY FACILITY OR LOCATION OF THE CORPORATION ARE FORWARDED TO THE CORPORATE FINANCE AND ACCOUNTING DIVISION, WHICH THEN PROVIDES COPIES OF THE REQUESTED DOCUMENTS IN THE MANNER REQUESTED (IF SUCH DELIVERY METHOD IS AVAILABLE TO THE CORPORATION).
FORM 990 - PART VI - LINE 19:		THE CORPORATION MAKES ITS ARTICLES OF INCORPORATION, CORPORATE BYLAWS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. ALL REQUESTS ARE FORWARDED TO THE CORPORATE LEGAL DIVISION, WHICH THEN PROVIDES COPIES OF THE REQUESTED DOCUMENTS IN THE MANNER REQUESTED (IF SUCH DELIVERY METHOD IS AVAILABLE TO THE CORPORATION). IN ADDITION, THE CORPORATION'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE FROM THE OFFICE OF THE ILLINOIS SECRETARY OF STATE OR FROM THE RECORDER OF DEEDS IN WOODFORD COUNTY, ILLINOIS, SITE OF THE CORPORATION'S REGISTERED OFFICE. FINANCIAL STATEMENTS OF THE CORPORATION ARE PUBLICLY AVAILABLE ON THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE OF THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB)AND FROM THE ILLINOIS ATTORNEY GENERAL AS PART OF THE CORPORATIONS COMMUNITY BENEFIT REPORT. FORM 990 - PART VII - Section A: Reportable compensation in Part VII was determined from a review of payroll queries from the Organization's and related organization's payroll and general ledger modules, yearly payroll reports, and W-2 filings.
FORM 990 - PART XI - LINE 9:	OTHER CHANGES IN FUND BALANCE INCLUDE:	CHANGE IN UNREALIZED MARKET VALUE OF SWAPS 17,707,453 NET ASSETS RELEASED FROM RESTRICTION (5,252,861) INCREASE IN PERMANETLY RESTRICTED ASSETS 17,019,872 REVERSAL OF MINIMUM PENSION LIABILITY 156,684,824 SFI & SUBSIDIAIRY INCOME (1,244,370) MINORiTY INTEREST 421,264 INVESTMENT IN HEALTHCARE MIDWEST (20,532,387) EQUITY TRANSFERS (43,564,865) EARLY EXTINGUISHMENT OF DEBT (738,097) TRANSFER TO PARENT (250,000) TRANSFER TO OTTAWA (2,250,000) NET SETTLEMENT OF DERIVATIVE INSTRUMENT 1,363,798 LOSS ON DISCONTINUED OPERATIONS OF SAINT CLARE HOME (1,171,045) PRIOR YEAR FOUNDATION CORRECTION (8,696,735) Other 10,165 ------------ TOTAL CHANGES IN NET ASSETS OR FUND BALANCE 109,507,016
SCHEDULE R - PART I - (B) PRIMARY ACTIVITY:		OSF LIFELINE AMBULANCE, LLC OWNS ten AMBULANCES AND FOUR WHEEL CHAIR VANS CONFIGURED AND EQUIPPED FOR PATIENT TRANSPORT AND PROVIDES GROUND AMBULANCE SERVICES IN NORTHERN ILLINOIS.
SCHEDULE R - PART II - (B) PRIMARY ACTIVITY:		THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS IS THE SOLE MEMBER OF THE CORPORATION AND IS ENGAGED IN ACTIVITIES RELATED TO GOVERNANCE OF THE CORPORATION. OSF HEALTHCARE FOUNDATION RAISES FUNDS TO SUPPORT THE ACTIVITIES OF THE CORPORATION. St. Francis Community clinic provides free comprehensive health care services to the indigent population of the area. Ottawa regional hospital & healthcare center operates an acute care hospital in Ottawa that provides efficient and quality healthcare services consistent with the needs of the commnunity. Ottawa regional hospital foundation supports and encourages healthcare services in furtherance of the support of and in assistance to Ottawa Regional Hospital & Healthcare Center through providing financial and fundraising assistance. Ottawa regional hospital auxiliary operates to promote and advance the welfare of Ottawa regional hospital & healthcare center. Ottawa regional hospital & healthcare liability loss fund provides a vehicle for self-insuring risks arising from the operation and maintenance of the Ottawa regional hospital & healthcare center. OSF multi-specialty group has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to comprehensive inpatient and outpatient care. it has not yet commenced operations. OSF Heart & Vascular Institute has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to cardiovascular care and treatment. It has not yet commenced operations. Children's hospital of Illinois Medical group has been organized to support the mission of OSF healthcare system in future years through the provision of quality of healthcare services related to comprehensive inpatient and outpatient care for children. It has not yet commenced operations. Illinois Neuroscience Institute has been organized to support the mission of OSF healthcare system in future years through the provision of quality healthcare services related to research center for diagnosis and treatment of brain disorders. it has not yet commenced operations.
SCHEDULE R - PART III - (B) PRIMARY ACTIVITY:		CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC OPERATES A MULTISPECIALTY AMBULATORY SURGICAL CENTER IN PEORIA, ILLINOIS. STATE AND ROXBURY, LLC OPERATES A REAL ESTATE MANAGEMENT ORGANIZATION IN ROCKFORD, ILLINOIS. EASTLAND MEDICAL PLAZA SURGICENTER, LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY TREATMENT CENTER IN BLOOMINGTON, ILLINOIS. FORT JESSE IMAGING CENTER, LLC OPERATES A STAND-ALONE MEDICAL IMAGING CENTER IN BLOOMINGTON, ILLINOIS. SLEEP CENTER OF CENTRAL ILLINOIS, LLC OPERATES A STAND-ALONE SLEEP DISORDER DIAGNOSTIC CENTER IN BLOOMINGTON, ILLINOIS. Radiation Oncology of Northern Illinois, LLC operates a radiation oncology center. Ottawa regional cardinal sleep center, LLC was created to be a sleep diagnostic center. It was dissolved on 8/28/2013.
SCHEDULE R - PART IV - (B) PRIMARY ACTIVITY:		OSF SAINT FRANCIS, INC. PROVIDES HEALTHCARE RELATED SERVICES SUCH AS MEDICAL PRACTICE MANAGEMENT, RETAIL PHARMACIES, MOBILE MEDICAL SYSTEMS, DURABLE MEDICAL EQUIPMENT, HOME THERAPEUTICS, REAL ESTATE RENTAL AND EQUIPMENT TECHNOLOGY SERVICES. HEARTCARE MIDWEST, LTD. IS A PHYSICIAN GROUP OF CARDIOVASCULAR SPECIALISTS SERVING CENTRAL ILLINOIS. CARDIOVASCULAR INSTITUTE AT OSF, LLC IS A PHYSICIAN GROUP OF CARDIOVASCULAR SPECIALISTS SERVING NORTHERN ILLINOIS. ILLINOIS PATHOLOGIST SERVICES, LLC PROVIDES PATHOLOGY SERVICES IN NORTHERN ILLINOIS. OSF MULTISPECIALTY GROUP - EASTERN REGION, LLC IS A MULTISPECIALTY CLINIC SERVING EASTERN ILLINOIS, OFFERING SERVICES IN ADULT MEDICINE, BEHAVIORAL FAMILY MEDICINE, GENERAL SURGERY, NEUROLOGY, OBSTETRICS, GYNECOLOGY, PEDIATRICS, PHYSIATRY, PULMONOLOGY, RADIOLOGY AND UROLOGY. OSF MULTISPECIALTY GROUP - PEORIA, LLC PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESSES. ILLINOIS NEUROLOGICAL INSTITUTE - PHYSICIANS, LLC PROVIDES A FULL SPECTRUM OF ADULT AND PEDIATRIC CARE FOR ILLNESSES AFFECTING THE BRAIN, SPINAL CORD, AND PERIPHERAL NERVES. ILLINOIS SPECIALTY PHYSICIAN SERVICES AT OSF, LLC PROVIDES PULMONOLOGY AND CRITICAL CARE SERVICES IN CENTRAL ILLINOIS. OSF PERINATAL ASSOCIATES, LLC PROVIDES MATERNAL FETAL MEDICINE PHYSICIAN SERVICES IN CENTRAL ILLINOIS. OSF Multispecialty group - western region, LLC is a multispecialty clinic serving western Illinois, offering services in a wide variety of general and specialty medical categories. OSF CHILDREN'S MEDICAL GROUP - CONGENITAL HEART CENTER, LLC PROVIDES PEDIATRIC CARE FOR CARDIOVASCULAR ILLNESS IN NORTHERN ILLINOIS. PREFERRED EMERGENCY PHYSICIANS OF ILLINOIS, LLC PROVIDES PHYSICIAN COVERAGE FOR EMERGENCY DEPARTMENTS. Ottawa regional healthcare affiliates, inc. is a holding company for Ottawa regional cardinal sleep centr, llc and ottawa regional medical center, inc. Ottawa regional medical center, inc. provides outpatient medical and diagnostic services. OSF Perinatal Associates, LLC Provides Perinatology services in central Illinois.

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:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

OSF Healthcare System

Employer identification number

37-0813229

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) OSF Lifeline Ambulance LLC 318 Roxbury Road Rockford,IL61107 20-0080542	SCHEDULE O	IL	-730,652	996,386	OSF

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) Sisters of The Third order of St Franci 800 NE Glen OAK Ave Peoria,IL61603 37-1259286	SCHEDULE O	IL	501(c)(3)	Ln11 TypeII	NA		No
(2) OSF Healthcare Foundation 800 NE Glen OAk Ave Peoria,IL61603 37-1259284	SCHEDULE O	IL	501(c)(3)	Ln11 TypeII	NA		No
(3) St Francis Community Clinic 530 NE Glen Oak Ave Peoria,IL61603 37-0661235	SCHEDULE O	IL	501(c)(3)	Ln7	sis 3rd osf		No
(4) Ottawa Regional Hospital & Healthcare Ce 1100 East Norris Drive Ottawa,IL61350 36-2604009	SCHEDULE O	IL	501(c)(3)	Ln3	OSF		No
(5) Ottawa Regional Hospital Foundation 1100 East Norris Drive Ottawa,IL61350 36-4007569	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	orhhc		No
(6) Ottawa Regional Hospital Auxiliary 1100 East Norris Drive Ottawa,IL61350 36-3854788	SCHEDULE O	IL	501(c)(3)	LN11C Tpiii	NA		No
(7) Ottawa Regional Hospital & Healthcare Ce 1100 East Norris Drive Ottawa,IL61350 36-3612653	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	orhhc		No
(8) OSF Multi-Speciality Group 800 NE Glen Oak Avenue Peoria,IL61603 38-3852646	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	OSF		No
(9) OSF Heart & Vascular Institute 800 NE Glen Oak Avenue Peoria,IL61603 35-2422385	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	OSF		No
(10) Children's Hospital of Illinois Medical 800 NE Glen Oak Avenue Peoria,IL61603 32-0353954	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	OSF		No
(11) Illinois Neuroscience Institute 800 NE Glen Oak Avenue Peoria,IL61603 36-4709999	SCHEDULE O	IL	501(c)(3)	LN11A TYPE1	OSF		No

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) Center for Health Ambulatory Surgery Cen 8800 Route 91 North Peoria,IL61615 20-5557171	SCHEDULE O	IL	OSF	Related	3,631,463	2,381,433		No			No	60.250 %
(2) State and Roxbury LLC 5668 E State Street Rockford,IL61108 26-1728983	SCHEDULE O	IL	OSF	Related	-41,643	1,769,773		No			No	51.000 %
(3) Eastland Medical Plaza Surgicenter LLC 1505 Eastland Drive Bloomington,IL61701 37-1400643	SCHEDULE O	IL	OSF	Related	3,298,377	6,513,464		No			No	52.550 %
(4) Fort Jesse Imaging Center LLC 220 Ft Jesse Road Suite B Normal,IL61761 46-0515604	SCHEDULE O	IL	OSF	Related	616,717	281,908		No			No	50.100 %
(5) Sleep Center of Central Illinois LLC 2204 Eastland Drive Suite 100 Bloomington,IL61704 81-0581886	SCHEDULE O	IL	OSF	Related	220,090	190,493		No			No	50.050 %
(6) Radiation Oncology of Northern Illinois 1200 Starfire Drive Ottawa,IL61350 75-3247165	SCHEDULE O	IL	ORHHC	Related	377,266	1,029,517		No			No	57.000 %
(7) Ottawa Regional Cardinal Sleep Center 1601 Mercury Circle Suite 2 Ottawa,IL61350 27-3625479	SCHEDULE O	IL	ORHHC	Related	0	0		No			No	100.000 %

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) OSF Saint Francis Inc 800 NE Glen Oak Ave Peoria,IL61603 36-3484677	SCHEDULE O	IL	OSF	C	-567,073	141,524,503	100.000 %	Yes
(2) Heartcare Midwest LTD 5405 N Knoxville Avenue Peoria,IL61614 37-0996868	SCHEDULE O	IL	OSF	C	-20,532,387	5,619,043	100.000 %	Yes
(3) Cardiovascular Institute at OSF LLC 444 Roxbury Road Rockford,IL61107 26-4225726	SCHEDULE O	IL	OSF	C	-7,590,247	782,694	100.000 %	Yes
(4) Illinois Pathologist Services LLC 5666 East State Street Rockford,IL61108 80-0439081	SCHEDULE O	IL	OSF	C	160,744	607,514	100.000 %	Yes
(5) OSF Multispeciality Group-Eastern Region 1701 E College Avenue Bloomington,IL61704 30-0561892	SCHEDULE O	IL	OSF	C	-12,836,626	3,203,768	100.000 %	Yes
(6) OSF Multispeciality Group-Peoria LLC 530 NE Glen Oak Avenue Peoria,IL61637 26-2800379	SCHEDULE O	IL	OSF	C	-2,870,335	185,435	100.000 %	Yes
(7) Ill Neurological Institute-Phy LLC 719 N William Kumpf Blvd Peoria,IL61605 26-3109118	SCHEDULE O	IL	OSF	C	-5,081,552	850,056	100.000 %	Yes
(8) Ill Spec Phy Svcs at OSF LLC 1001 Main Street Suite 200 Peoria,IL61606 80-0462209	SCHEDULE O	IL	OSF	C	-5,269,406	256,527	100.000 %	Yes
(9) OSF Perinatal Associates LLC 4911 Executive Drive Suite 200 Peoria,IL61614 80-0498373	SCHEDULE O	IL	OSF	C	-1,484,613	140,222	100.000 %	Yes
(10) OSF Multispeciality Group-Western Region 3315 North Seminary Street Galesburg,IL61401 80-0608541	SCHEDULE O	IL	OSF	C	-7,754,911	879,202	100.000 %	Yes
(11) OSF Children's Medical Group - Congenita 5701 Strathmoor Drive Suite 1 Peoria,IL61603 90-0714643	SCHEDULE O	IL	OSF	C	-1,077,155	146,830	100.000 %	Yes
(12) Preferred Emergency Physicians of Illino 800 NE Glen Oak Avenue Peoria,IL61603 90-0749855	SCHEDULE O	IL	OSF	C	-454,910	-265,928	100.000 %	Yes
(13) Ottawa Regional Healthcare Affiliates 1100 East Norris Drive Ottawa,IL61350 26-3937519	SCHEDULE O	IL	ORHHC	C	-3,436,294	5,579,330	100.000 %		No
(14) Ottawa Regional Medical Center Inc 1614 East Norris Drive Ottawa,IL61350 27-1036071	SCHEDULE O	IL	ORHHC	C	-3,436,294	5,579,330	100.000 %		No

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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) . . . . . . . . . . . . . . . . . . . .

Yes

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

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type (a-s)	(c) Amount involved
(1) Ottawa Regional Hospital & Healthcare Center	a(i)	35,625
(2) Center for Health Ambulatory Surgery Center	a(iv)	722,193
(3) Eastland Medical Plaza Surgicenter LLC	a(iv)	567,317
(4) Heartcare Midwest Ltd	a(iv)	231,609
(5) OSF Multispecialty Group - Peoria LLC	a(iv)	245,866
(6) OSF Perinatal Associates LLC	a(iv)	68,973
(7) Illinois Neurological Institute - Physicians	a(iv)	23,143
(8) OSF Saint Francis Inc	a(iv)	543,079
(9) Illinois Pathologist Services LLC	a(iv)	11,628
(10) OSF Multispecialty Group-Western Region LLC	a(iv)	3,035
(11) OSF Children's Medical Group - Congenital Hea	a(iv)	32,025
(12) OSF Multispecialty Group-Peoria LLC	b	2,660,000
(13) Illinois Neurological Institute - Physicians	b	5,900,000
(14) Cardiovascular Institute at OSF LLC	b	6,400,000
(15) OSF Multispecialty Group-Eastern Region LLC	b	12,700,000
(16) Illinois Specialty Physician Services at OSF	b	5,030,000
(17) OSF Multispecialty Group-Western Region LLC	b	7,735,000
(18) OSF Perinatal Associates LLC	b	1,860,000
(19) OSF Children's Medical Group - Congenital Hea	b	1,220,000
(20) HeartCare Midwest Ltd	b	21,000,000
(21) Ottawa Regional Hospital & Healthcare Center	b	2,250,000
(22) State and Roxbury LLC	d	500,000
(23) Ottawa Regional Hospital & Healthcare Center	d	3,000,000
(24) OSF Saint Francis Inc	k	5,729,065
(25) Cardiovascular Institute at OSF LLC	k	552,241
(26) State and Roxbury LLC	k	397,519
(27) Heartcare Midwest Ltd	k	468,106
(28) Ottawa Regional Hospital & Healthcare Center	k	897
(29) OSF Saint Francis Inc	l	10,556,413
(30) Heartcare Midwest Ltd	l	254,683
(31) OSF Multispecialty Group-Eastern RegionLLC	l	14,418,707
(32) Cardiovascular Institute at OSF LLC	l	8,668,718
(33) Illinois Pathologist Services LLC	l	1,212,505
(34) Illinois Specialty Physician Services at OSF	l	5,529,237
(35) OSF Perinatal Associates LLC	l	2,100,957
(36) OSF Multispecialty Group-Peoria LLC	l	4,930,416
(37) Illinois Neurological Institute - Physicians	l	8,307,307
(38) OSF Multispecialty Group-Western Region LLC	l	8,930,940
(39) OSF Children's Medical Group - Congenital Hea	l	875,558
(40) Preferred emergency physicians of illinois	l	3,027,129
(41) Ottawa Regional Hospital & Healthcare Center	l	4,809,128
(42) OSF Saint Francis Inc	m	92,493,248
(43) OSF Saint Francis Inc	p	3,156,091
(44) Heartcare Midwest Ltd	p	1,342,263
(45) OSF Multispecialty Group-Eastern Region LLC	p	21,713,936
(46) Cardiovascular Institute at OSF LLC	p	7,867,469
(47) Illinois Pathologist Services LLC	p	787,326
(48) Illinois Specialty Physician Services at OSF	p	4,191,268
(49) OSF Perinatal Associates LLC	p	1,336,963
(50) OSF Multispecialty Group-Peoria LLC	p	3,432,774
(51) Illinois Neurological Institute - Physicians	p	7,378,870
(52) OSF Multispecialty Group-Western Region LLC	p	11,389,020
(53) OSF Children's Medical Group - Congenital Hea	p	1,386,184
(54) Preferred emergency physicians of illinois l	p	194,555
(55) ottawa regional hospital & healthcare center	p	413,132
(56) Eastland Medical Plaza Surgicenter LLC	s	3,221,393
(57) Sleep Center of Central Illinois LLC	s	179,690
(58) Fort Jesse Imaging Center LLC	s	415,153
(59) Center for Health Ambulatory Surgery Center	s	4,214,417
(60) OSF Multispecialty Group-Eastern Region LLC	s	900,000
(61) Cardiovascular Institute at OSF LLC	s	1,551,537
(62) Illinois Pathologist Services LLC	s	2,178,670
(63) Illinois Specialty Physician Services at OSF	s	325,000
(64) OSF Perinatal Associates LLC	s	1,040,000
(65) OSF Multispecialty Group-Peoria LLC	s	589,000
(66) Illinois Neurological Institute - Physicians	s	3,179,000
(67) OSF Multispecialty Group-Western Region LLC	s	3,850,000
(68) osf children's medical group-congenital heart	s	1,126,000
(69) preferred emergency physicians of illinois l	s	3,025,000
(70) OSF Saint Francis Inc	s	130,360,481

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:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OSF Healthcare System is a Catholic Integrated health care delivery system. During FY2013 osf operated 7 hospitals, 1 nursing home, 5 home health agencies, 4 hospices and employed approximately 630 physicians.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	15,094
6	Total number of volunteers (estimate if necessary) .............	6	1,999
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	6,335,755
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	53,637,086	20,136,064
9	Program service revenue (Part VIII, line 2g) .........	1,752,743,785	1,797,771,173
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	36,513,922	37,761,912
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	32,275,538	37,379,708
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	1,875,170,331	1,893,048,857
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,895,004	722,790
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)	919,657,664	954,485,517
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 5,295,017
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	796,169,733	832,160,384
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,717,722,401	1,787,368,691
19	Revenue less expenses. Subtract line 18 from line 12.......	157,447,930	105,680,166
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,418,704,402	2,485,641,264
21	Total liabilities (Part X, line 26).............	1,693,780,438	1,529,786,816
22	Net assets or fund balances. Subtract line 21 from line 20.....	724,923,964	955,854,448

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 598,438,739 including grants of $ 591,058 ) (Revenue $ 859,769,747 )
	Inpatient services - SEE Schedule O

4b	(Code: ) (Expenses $ 493,571,933 including grants of $ ) (Revenue $ 699,794,962 )
	Outpatient Services - SEE Schedule O

4c	(Code: ) (Expenses $ 269,092,486 including grants of $ ) (Revenue $ 97,657,313 )
	Physician Services - SEE Schedule O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 228,139,938 including grants of $ 131,732 ) (Revenue $ 173,041,552 )
4e	Total program service expenses1,589,243,096

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	10,638,318	0	774,030

				(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		5,945,447
e	Government grants (contributions)1e		11,710,657

f	All other contributions, gifts, grants, and similar amounts not included above1f		2,479,960

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			20,136,064
			Business Code
2a	NET PATIENT SERVICE REVENUE		900099	1,791,796,362	1,791,796,362
b	LAB		621500	3,927,642		3,927,642
c	COLLECTION FEE		900099	1,963		1,963
d	AFFILIATIED PURCHASING PROGRAM		561499	1,474,270		1,474,270
e	INTEREST		900099	88,584		88,584
f	All other program service revenue .			482,352		482,352
g	Total. Add lines 2a–2f........			1,797,771,173
3	Investment income (including dividends, interest, and other similar amounts).......			37,051,790			37,051,790
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	2,505,663
b	Less: rental expenses	2,462,259
c	Rental income or (loss)	43,404	0
d	Net rental income or (loss).......			43,404			43,404
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		1,614,313
b	Less: cost or other basis and sales expenses		904,191
c	Gain or (loss)		710,122
d	Net gain or (loss)..........			710,122			710,122
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	TUITION		900099	11,145,813	11,145,813
b	PHYSICIANS/RNS/STAFF CONTRACT SERVICES		900099	4,111,722	4,111,722
c	INCOME FROM JOINT VENTURES		900099	2,347,783	2,347,783
d	All other revenue ....			19,730,986	16,361,353	360,944	3,008,689
e	Total. Add lines 11a–11d ......			37,336,304
12	Total revenue. See Instructions......			1,893,048,857	1,825,763,033	6,335,755	40,814,005


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			0	1	0
2	Savings and temporary cash investments .........			88,078,588	2	228,577,361
3	Pledges and grants receivable, net ...........			9,660,264	3	0
4	Accounts receivable, net .............			437,391,995	4	328,401,689
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	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
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			20,605,960	8	20,627,513
9	Prepaid expenses and deferred charges ..........			6,604,229	9	5,310,827
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,827,294,957
b	Less: accumulated depreciation .....	10b	979,773,691	822,336,159	10c	847,521,266
11	Investments—publicly traded securities ..........			687,533,607	11	731,470,692
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			35,193,736	13	41,235,804
14	Intangible assets ...............			6,631,798	14	22,041,175
15	Other assets. See Part IV, line 11 ...........			304,668,066	15	260,454,937
16	Total assets. Add lines 1 through 15 (must equal line 34)......			2,418,704,402	16	2,485,641,264
17	Accounts payable and accrued expenses .........			150,349,952	17	163,230,943
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			845,650,526	20	840,264,115
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
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..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
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....................			697,779,960	25	526,291,758
26	Total liabilities. Add lines 17 through 25.........			1,693,780,438	26	1,529,786,816
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			683,656,289	27	901,237,483
28	Temporarily restricted net assets ...........			28,093,608	28	38,199,005
29	Permanently restricted net assets ...........			13,174,067	29	16,417,960
	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 ...........			724,923,964	33	955,854,448
34	Total liabilities and net assets/fund balances ........			2,418,704,402	34	2,485,641,264