Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
MEMORIAL HEALTH SYSTEM
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
701 NORTH FIRST STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRINGFIELD, IL627810001
D Employer identification number

37-1110690
E Telephone number

G Gross receipts $ 150,267,641
F Name and address of principal officer:
EDGAR J CURTIS
701 NORTH FIRST STREET
SPRINGFIELD,IL627810001
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MHSIL.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1981
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 273
6 Total number of volunteers (estimate if necessary) ............. 6 18
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 557,980
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 58,582,417 67,659,615
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,307,224 2,859,039
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,224,555 620,857
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 62,114,196 71,139,511
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 312,973 2,577,271
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) 29,687,353 31,130,967
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 32,729,723 39,414,435
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 62,730,049 73,122,673
19 Revenue less expenses. Subtract line 18 from line 12....... -615,853 -1,983,162
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 221,282,146 245,015,648
21 Total liabilities (Part X, line 26)............. 127,596,945 130,539,740
22 Net assets or fund balances. Subtract line 21 from line 20..... 93,685,201 114,475,908
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 35,806,265 including grants of $   ) (Revenue $ 10,386,109 )
INFORMATION TECHNOLOGYMEMORIAL HEALTH SYSTEM IS PROACTIVE IN IMPLEMENTING TECHNOLOGY THAT BOTH IMPROVES PATIENT SAFETY, QUALITY AND CLINICAL EFFECTIVENESS, AND IMPROVES MEMORIAL HEALTH SYSTEM'S BUSINESS PROCESSES. MEMORIAL HEALTH SYSTEM'S STAFF OF EXPERIENCED INFORMATION TECHNOLOGY PROFESSIONALS IS ON THE CUTTING EDGE OF MEDICAL AND BUSINESS TECHNOLOGY. THEY SUPPORT A VAST ARRAY OF PATIENT CARE AND BUSINESS APPLICATIONS. DURING FY14 SIGNIFICANT INFORMATION TECHNOLOGY PROJECTS INCLUDED COMPLETION OF MIGRATION OF OVER 5000 PCS TO WINDOWS 7, EMS ED AMBULANCE COMMUNICATION UPGRADE, MUTARE OR FAMILY COMMUNICATION PROJECT, THE IMPLEMENTATION OF BEDSIDE BARCODE MEDICATION ADMINISTRATION, VIDEO SECURITY PROJECT, CITRIX UPGRADE 2008 FOR CERNER MILLENNIUM, WIRELESS CONTROLLER UPGRADE. THE IMPLEMENTATION OF PATIENT EDUCATION SYSTEM (TIGR), HUGS INFANT SECURITY SYSTEM MIGRATION, LAPTOP AND EMAIL ENCRYPTION, VOICE RECOGNITION SOFTWARE IN HOSPITAL AND AMBULATORY CLINICS, MAINTAINED MEANINGFUL USE STAGE 1(PREPARING FOR STAGE 2), DATA CENTER REFRESH AT ALMH AND TMH, BROUGHT JACKSONVILLE MOB AND VINE STREET CLINIC ONTO THE ENTERPRISE NETWORK, FINALIZED THE DESIGN OF SECONDARY DATA CENTER, PATHNET (MIGRATION FROM CLASSIC LAB), IRHN NETWORK, SEPSIS RULE FOR CARE IMPROVEMENT.
4b (Code:   ) (Expenses $ 7,740,192 including grants of $   ) (Revenue $ 3,149,815 )
BUILDING AND FACILITY EXPANSION AND IMPROVEMENTSMEMORIAL HEALTH SYSTEM'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. SAFE, FUNCTIONAL FACILITIES ARE THE FOUNDATION OF THE HEALTHCARE SERVICES WE PROVIDE. DEVELOPING ADDITIONAL CAPACITY TO SERVE THE COMMUNITY IS A PRIMARY OBJECTIVE TO FULFILLING OUR MISSION BOTH IN THE SHORT TERM AS WELL AS IN THE LONG TERM. IN 2014, MEMORIAL MEDICAL CENTER, AN AFFILIATE OF MEMORIAL HEALTH SYSTEM, CONTINUED WORK ON THE MOST SIGNIFICANT EXPANSION PROJECT IN THE 113 YEAR HISTORY OF THE ORGANIZATION. THE TOTAL PROJECT, KNOWN AS ADVANCING CARE BY DESIGN, COSTS APPROXIMATELY $152M AND ENCOMPASSES FOUR SPECIFIC COMPONENTS. THE PATIENT CARE TOWER EXPANSION WILL PROVIDE 114 PRIVATE PATIENT ROOMS. THIS ADDITION WILL ENABLE THE MEDICAL CENTER TO ONE DAY PROVIDE ALL PRIVATE ROOMS TO ITS PATIENTS. EVIDENCE HAS SHOWN IMPROVED HEALTHCARE OUTCOMES FOR PATIENTS STAYING IN PRIVATE ROOMS DUE TO REDUCED HOSPITAL ACQUIRED INFECTION RATES AND A MORE PEACEFUL HEALING ENVIRONMENT. THE SECOND COMPONENT IS A SURGICAL SUITE EXPANSION PROVIDING 6 NEW OPERATING ROOMS TO MEET INCREASING CASE VOLUMES. MEMORIAL HEALTH SYSTEM IS ALSO DEVELOPING A CENTER FOR LEARNING AND INNOVATION, SET TO OPEN IN 2015, DESIGNED TO PROVIDE STATE OF THE ART CLINICAL TRAINING FACILITIES FOR PHYSICIANS, RESIDENTS, MEDICAL STUDENTS, NURSING STAFF, AND ALL OTHER EMPLOYEES. THIS FACILITY WILL ALSO BE USED TO IMPROVE MEDICAL EDUCATION THROUGH PARTNERSHIP WITH THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. FINALLY, THE MEMORIAL MEDICAL CENTER PHYSICAL PLANT CONTINUES TO UNDERGO A MODERNIZATION TO MEET THE INCREASED DEMAND OF THE AFOREMENTIONED EXPANSION WHILE RETROFITTING EQUIPMENT TO IMPROVE UTILITY CONSUMPTION EFFICIENCY. OTHER PROJECTS COMPLETED FOR THE MEDICAL CENTER INCLUDE:-AIR HANDLER UNIT (AHU) REPLACEMENT - A BUILDING. AT A COST OF APPROXIMATELY $1.2M, THE AHU REPLACED THE ORIGINAL THAT WAS INSTALLED IN 1958.-NORTH DIRKSEN SOLAR PANELS INSTALLATION - THE LONG TERM USE OF THIS PHOTOVOLTAIC TECHNOLOGY WILL GENERATE ELECTRICITY FROM SUNLIGHT AND INCREASE THE USE OF RENEWABLE ENERGY. AT AN APPROXIMATE COST OF $200K.-SPRINGFIELD CLINIC 1ST EXPANSION - MAIN OFFICE BUILDING - AT A COST OF APPROXIMATELY $45M.CLINICAL PROJECTS THAT BEGAN IN FY14:-DEMOLITION OF OR ROOM 1 (CYSTO ROOM) TIED TO THE ADVANCING CARE BY DESIGN CORRIDOR CONSTRUCTION-ALL PHASE I SURGERY EXPANSION PROJECTS BEGAN, INCLUDING 1E AND PACU.-STERILE PROCESSING EXPANSION
4c (Code:   ) (Expenses $ 5,426,354 including grants of $   ) (Revenue $ 51,551,492 )
SENIOR LEADERSHIPGUIDED BY THE VALUES OF MEMORIAL HEALTH SYSTEM, SENIOR LEADERSHIP IS RESPONSIBLE FOR STRATEGIC PLANNING, PRIORITIZING AMONG COMPETING ISSUES AND ENGAGING IN DIALOGUE AND DECISION-MAKING THAT WILL ENABLE MEMORIAL HEALTH SYSTEM TO ACHIEVE ITS MISSION AND VISION AND ACCOMPLISH ITS STRATEGIC GOALIN FY14, MHS SENIOR LEADERSHIP REVIEWED AND CONFIRMED THE ORGANIZATION'S STRATEGIC PLAN, 5 YEAR GOALS AND MEASURES OF SUCCESS TO REFLECT EMERGING PRIORITIES RELATED TO HEALTH REFORM, QUALITY IMPROVEMENT, POPULATION HEALTH AND CARE COORDINATION. IN ADDITION, HEALTH SYSTEM ACTION PLAN MONITORING AND REPORTING WAS COMPLETED. THE MIDWEST HEALTHCARE QUALITY ALLIANCE, LLC WAS DEVELOPED AND LAUNCHED, IN PARTNERSHIP WITH THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. GROUNDWORK WAS ALSO LAID FOR THE CREATION OF A PATIENT SAFETY ORGANIZATION TO BE LAUNCHED IN FY15.IN THE AREA OF INFORMATION SYSTEMS, A NEW ELECTRONIC PATIENT SAFETY EVENT REPORTING NAMED SENSOR WAS IMPLEMENTED ACROSS ALL MHS SITES. A NEW COST ACCOUNTING SYSTEM WAS IMPLEMENTED AS WERE ELECTRONIC HEALTH RECORD (EHR) IMPROVEMENTS IN BEDSIDE BARCODE MEDICATION ADMINISTRATION AT MEMORIAL MEDICAL CENTER AND PATIENT PORTALS AT MMC AND ABRAHAM LINCOLN MEMORIAL HOSPITAL (ALMH). FY14 EHR MILESTONES FOR ANESTHESIA, ONCOLOGY, THERAPY AND RADIATION ONCOLOGY AND SURGINET PROJECTS WERE ALSO ACHIEVED. IN THE AREA OF SYSTEM FACILITY PLANNING AND MANAGEMENT A NEW MEDICAL OFFICE BUILDING OCCUPIED BY SPRINGFIELD CLINIC PHYSICIANS AND CLINICAL STAFF WAS COMPLETED ALONG WITH AN ATTACHED 500-CAR PARKING GARAGE TO IMPROVE ACCESS FOR PATIENTS SERVED BY THIS FACILITY. A VASCULAR LABORATORY WAS COMPLETED FOR THE SIU SCHOOL OF MEDICINE VASCULAR PROGRAM AND APPROVAL WAS SECURED TO PURCHASE THE SIU FAMILY AND COMMUNITY MEDICINE CLINIC BUILDING AND ADJACENT LAND TO EXPAND THAT PROGRAM AND ITS FEDERALLY QUALIFIED HEALTH CENTER. ANOTHER OFFICE BUILDING WAS PURCHASED THAT WILL PROVIDE SIU ADMINISTRATIVE SUPPORT SPACE SO THAT MEMORIAL MEDICAL CENTER CAN REPURPOSE EXISTING SPACE WITHIN THE MAIN HOSPITAL FOR CLINICAL USE. CONSTRUCTION CONTINUED ON THE LARGEST FACILITY EXPANSION IN THE HISTORY OF MEMORIAL MEDICAL CENTER. THIS ADVANCING CARE BY DESIGN PROJECT INCLUDES 114 NEW PRIVATE PATIENT ROOMS, EXPANSION OF SURGICAL FACILITIES, CREATION OF A CENTER FOR LEARNING AND INNOVATION AND INFRASTRUCTURE UPGRADES THAT WILL ENABLE ENERGY CONSERVATION FOR OUR ENTIRE CAMPUS. THIS PROJECT WILL IMPROVE PATIENT ACCESS, SAFETY AND QUALITY OF CARE FOR DECADES TO COME AT OUR FLAGSHIP HOSPITAL. PHASE ONE OF THE CONSTRUCTION WILL BE COMPLETED IN FY15 AND THE ENTIRE PROJECT WILL BE COMPLETED IN FY16. TO CONTINUE TO IMPROVE THE ORGANIZATION'S POPULATION HEALTH, CHRONIC DISEASE MANAGEMENT AND CARE COORDINATION CAPABILITIES AND INFRASTRUCTURE, A CLINICAL INTEGRATION LEGAL VEHICLE, MEMORIAL HEALTH PARTNERS LLC (MHP) WAS INCORPORATED. MEMORIAL CARE COORDINATION SERVICES (MCCS) WAS ALSO LAUNCHED. ENROLLMENT OF COMPLEX PATIENTS INTO MEMORIAL CARE COORDINATION SERVICES IS ON-GOING. FOR PATIENTS SERVED BY MCCS, QUALITY MEASURES IMPROVED AND INITIAL COST ESTIMATES SHOW PER MEMBER PER MONTH EXPENDITURES OF ENGAGED MEMBERS DROPPED BY $100, VERSUS THOSE WHO DECLINED PARTICIPATION RISING BY $100. SEVERAL STRATEGIES WERE EMPLOYED TO ASSURE ACCESS TO MHS PROVIDERS FOR NEWLY INSURED MEDICAID AND COMMERCIAL PATIENTS ACCESSING THE ILLINOIS HEALTH INSURANCE MARKETPLACE (GET COVERED ILLINOIS). MHS PROVIDERS PARTICIPATE IN ALL THREE AVAILABLE ENROLLMENT OPTIONS. MEMORIAL PHYSICIAN SERVICES (MPS) PROVIDERS ARE OPEN TO ALL EXISTING MEMBERS PLUS A DESIGNATED NUMBER OF NEW MEMBERS. MHS SERVED AS A FOUNDING MEMBER OF ILLINOIS PARTNERSHIP FOR HEALTH (IPH) A MEDICAID ACCOUNTABLE CARE ENTITY THAT WAS APPROVED BY THE STATE OF ILLINOIS FOR MEDICAID PATIENTS ENROLLED THROUGH THE GET COVERED ILLINOIS MARKETPLACE. OTHER KEY SUCCESSES THIS YEAR DIRECTLY RELATED TO STRONG LEADERSHIP INCLUDE STRONG PERFORMANCE IN THE MEDICARE VALUE-BASED PURCHASING PROGRAM RELATED TO CLINICAL QUALITY AND PATIENT SATISFACTION OUTCOMES, AMONG THE LOWEST MEDICARE RE-ADMISSION RATES IN ILLINOIS, REAFFIRMATION OF MHS' A+/A1 BOND RATING BY MOODY'S AND STANDARD AND POOR'S, MHS EMPLOYEE ENGAGEMENT SCORES AT THE 97TH PERCENTILE OF THE NATIONAL COMPARISON GROUP AND POSITIVE CAHPS SATISFACTION SCORES AT ALL THREE MHS HOSPITALS, MPS AND MEMORIAL HOME SERVICES. THE ONGOING SUCCESS OF OUR MHS' GREAT PATIENT EXPERIENCE INITIATIVE RESULTED IN NINE OF OUR 13 PATIENT SATISFACTION SURVEYS ACROSS THE HEALTH SYSTEM SCORING AT OR ABOVE THE 75TH PERCENTILE OF THEIR RESPECTIVE NATIONAL PEER GROUPS. PHYSICIAN SATISFACTION RATINGS WERE AT THE 87TH PERCENTILE OF OUR NATIONAL PHYSICIAN PEER GROUP. DURING FY14, ALL 12 MPS PRIMARY CARE PHYSICIAN CLINICS RETAINED THE HIGHEST POSSIBLE LEVEL 3 PATIENT CENTERED MEDICAL HOME DESIGNATION FROM THE NATIONAL COMMISSION ON QUALITY ASSURANCE (NCQA). IN FY14 THE MPS BOARD APPROVED AN MPS STRATEGIC QUALITY PLAN AND EXPRESSCARE SITES WERE INTEGRATED WITH MPS. THIS FACILITATES THE CONNECTION OF EXPRESSCARE PATIENTS WHO HAVE NO ESTABLISHED RELATIONSHIP WITH A PRIMARY CARE PHYSICIAN WITH AN MPS MEDICAL HOME. TO HELP ADDRESS THE SEVERE SHORTAGE OF PSYCHIATRISTS IN THE COMMUNITY, MPS VINE STREET SIGNED FOUR PSYCHIATRISTS TO JOIN FOUR EXISTING MDS. MHS' SENIOR LEADERSHIP TEAM ALSO LED A SYSTEM-WIDE INITIATIVE TO IMPROVE PROCESSES AND REDUCE COSTS WHILE IMPROVING QUALITY FOR PATIENTS THAT IS CALLED STRENGTHEN OUR FUTURE. THROUGH THIS INITIATIVE, COSTS WERE REDUCED OVER $12 MILLION IN FY14 AND AN ADDITIONAL $20.6 MILLION IN SAVINGS OPPORTUNITIES HAS BEEN IDENTIFIED FOR FY15. THIS IS A PART OF THE OVERALL STRATEGY TO IMPROVE QUALITY WHILE REDUCING COSTS. TOWARDS THIS END, MHS SAVED OVER $2.5 MILLION IN FY14 THROUGH THE NEW BJC COLLABORATIVE FORMED IN FY13 THAT INVOLVES FOUR LEADING HEALTH SYSTEMS IN MISSOURI AND ILLINOIS. IN FY14 PASSAVANT AREA HOSPITAL (PAH) IN JACKSONVILLE, ILLINOIS BECAME THE FOURTH MEMORIAL HEALTH SYSTEM HOSPITAL AFFILIATE FOLLOWING BOARD AND REGULATORY APPROVALS. THIS STRENGTHENS PAH AND IMPROVES ACCESS TO MHS SERVICES FOR PATIENTS LIVING IN THE WESTERN PORTION OF THE SERVICE AREA. TO ASSURE THAT MHS HAS THE BEST WORKFORCE AVAILABLE TO MEET PATIENT NEEDS, A SYSTEM WIDE EMPLOYEE CORE COMPETENCY MODEL WAS DEVELOPED AND IMPLEMENTED IN FY14. THE COMPETENCY MODEL HAS ALSO BEEN INTEGRATED INTO RECRUITING, RETENTION, AND DEVELOPMENT OF EMPLOYEES. THE MHS EMPLOYEE HEALTH PLAN WAS ALSO REDESIGNED TO PROVIDE BETTER INCENTIVES AND SUPPORT FOR EMPLOYEE ENGAGEMENT, ILLNESS PREVENTION AND WELLNESS. LEAN SIX SIGMA PROCESS IMPROVEMENT TRAINING WAS IMPLEMENTED FOR PHYSICIAN AND ADMINISTRATIVE LEADERS THROUGHOUT THE ORGANIZATION. THIS REVISED STRUCTURE RESULTED IN SEVERAL QUALITY IMPROVEMENTS INCLUDING A PROJECT TITLED "LEAN SIX SIGMA METHODOLOGIES REDUCE RED BLOOD CELL TRANSFUSIONS BY 32% IN A TERTIARY MEDICAL CENTER" FOR WHICH MEMORIAL HEALTH SYSTEM WAS AWARDED THE SOLE TERTIARY MEDICAL CENTER QUALITY EXCELLENCE ACHIEVEMENT AWARD BY THE ILLINOIS HOSPITAL ASSOCIATION INSTITUTE FOR INNOVATIONS IN CARE AND QUALITY IN SEPTEMBER, 2014.
(Code:   ) (Expenses $ 5,478,318 including grants of $ 2,577,271 ) (Revenue $ 42,603 )
4d Other program services (Describe in Schedule O.)
(Expenses $ 5,478,318 including grants of $ 2,577,271 ) (Revenue $ 42,603 )
4e Total program service expensesMediumBullet54,451,129
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
36
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
273
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletROBERT W KAY SENIOR VP & CFO701 NORTH FIRST STREETSPRINGFIELDIL627810001 (217) 788-3198
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JOSEPH HURWITZ........................................................................
BOARD MEMBER
2.00
.......................  
X           0 0 0
(2) JAMES BRUNER........................................................................
CHAIR (THRU DEC 13)
1.70
.......................  
X   X       0 0 0
(3) JOHN BLACKBURN........................................................................
1ST VICE CHAIR (THRU DEC 13)/CHAIR
1.70
.......................  
X   X       0 0 0
(4) CAROL HANSEN POSEGATE........................................................................
SECRETARY
.80
.......................  
X   X       0 0 0
(5) MARK FERGUSON........................................................................
BOARD MEMBER
1.60
.......................  
X           0 0 0
(6) DALE BECKER........................................................................
TREASURER
1.50
.......................  
X   X       0 0 0
(7) RICHARD LEVI........................................................................
BOARD MEMBER
.80
.......................  
X           0 0 0
(8) RANDALL GERMERAAD........................................................................
2ND V CHAIR (THRU DEC 13)1ST V CHAIR
.80
.......................  
X   X       0 0 0
(9) NINA HARRIS........................................................................
BOARD MEMBER
1.00
.......................  
X           0 0 0
(10) HOWARD PETERS III........................................................................
BOARD MEMBER
.70
.......................  
X           0 0 0
(11) DIANE RUTLEDGE PHD........................................................................
BOARD MEMBER
1.00
.......................  
X           0 0 0
(12) SERGIO PECORI........................................................................
BOARD MEMBER
1.10
.......................  
X           0 0 0
(13) WILLIAM PUTMAN MD........................................................................
BOARD MEMBER
.90
.......................  
X           0 0 0
(14) MICHAEL NEUMEISTER MD........................................................................
BOARD MEMBER
.70
.......................  
X           0 0 0
(15) DEAN ROBERT JR........................................................................
BOARD MEMBER
.70
.......................  
X           0 0 0
(16) GEOFFREY ISRINGHAUSEN........................................................................
BOARD MEMBER
.70
.......................  
X           0 0 0
(17) REGINALD BENTON........................................................................
BOARD MEMBER (FROM JAN 14)
.70
.......................  
X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (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)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JANET TERRY........................................................................
BOARD MEMBER (FROM JAN 14)
.70
.......................  
X           0 0 0
(19) EDGAR CURTIS EX-OFFICIO........................................................................
PRESIDENT & CEO
25.00
.......................25.00
X   X       1,096,598 0 1,058,445
(20) ROBERT KAY........................................................................
SVP & CFO & ASST TREASURER
25.00
.......................25.00
    X       574,877 0 213,525
(21) MITCHELL JOHNSON........................................................................
SVP & CHIEF STRATEGY OFFICER
25.00
.......................25.00
      X     379,635 0 115,712
(22) DAVID GRAHAM MD........................................................................
SVP & CIO
25.00
.......................25.00
      X     491,801 0 98,670
(23) RAJESH GOVINDAIAH MD........................................................................
SVP & CMO
25.00
.......................25.00
      X     360,555 0 206,281
(24) ELAINE YOUNG........................................................................
VP FINANCE (THRU JAN 2013)
25.00
.......................25.00
      X     541,048 0 -22,789
(25) BRADLEY WARREN........................................................................
SVP & CPO (THRU JAN 2013)
25.00
.......................25.00
      X     305,822 0 13,809
(26) DOUGLAS RAHN DBA........................................................................
EVP & COO
25.00
.......................25.00
      X     0 544,472 364,074
(27) MELISSA MCGLASSON........................................................................
VP FINANCE (FROM FEB 2013)
25.00
.......................25.00
      X     209,159 22,715 33,921
(28) KEVIN ENGLAND........................................................................
VP BUSINESS DEVELOPMENT
25.00
.......................25.00
      X     389,969 0 242,599
(29) ANNA EVANS JD........................................................................
GEN COUNSEL/VP INT AUDIT & COMPL
25.00
.......................25.00
      X     366,061 0 138,346
(30) AIMEE ALLBRITTON PHD........................................................................
INTERIM CHRO MHS (2013), VP & CLO
25.00
.......................25.00
      X     361,168 0 65,117
(31) GARY CROMPTON........................................................................
VP IS OPERATIONS (THRU FEB 2013)
50.00
.......................  
        X   175,296 0 11,243
(32) EDWARD MCDOWALL........................................................................
VP MRKTG & COMM (THRU SEPT 2013)
50.00
.......................  
        X   244,485 0 55,171
(33) LAURA COSSEY........................................................................
SYS DIR INT AUDIT/COMPL
50.00
.......................  
        X   172,442 0 30,704
(34) MADONNA CROMPTON........................................................................
SYS DIR CLINICAL INFORMATICS
50.00
.......................  
        X   165,977 0 23,294
(35) JERRY MILLER........................................................................
ADMIN IS OPERATIONS
50.00
.......................  
        X   161,642 0 23,763
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,996,535 567,187 2,671,885
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet42
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
HAROLD O'SHEA BUILDERS INC3401 CONSTITUTION DRSPRINGFIELDIL62711 CONSTRUCTION 19,083,480
CERNER CORPORATIONPO BOX 412702KANSAS CITYMO64141 IT CONSULTING SERVICES 4,253,624
MAINLINE INFORMATION SYSTEMS INCPO BOX 402989ATLANTAGA30384 IT MAINTENANCE 1,733,219
BSA LIFESTRUCTURE INCPO BOX 6069INDIANAPOLISIN46206 ARCHITECTURAL 1,472,200
JONES-BLYTHE CONSTRUCTION1030 W REYNOLDS ST PO BOX 5113SPRINGFIELDIL62702 CONSTRUCTION 1,420,410
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 MediumBullet48
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet  
 Program Service RevenueAmt Business Code
2a MANAGEMENT FEES 900099 52,060,829 51,551,492 509,337  
b IT REIMBURSED EXPENSES 900099 10,386,109 10,386,109    
c PROGRAM RELATED RENT 900099 5,212,677 5,212,677    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 67,659,615
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,112,280     1,112,280
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 6,099,555  
b Less: rental expenses 8,102,067  
c Rental income or (loss) -2,002,512  
d Net rental income or (loss).......MediumBullet -2,002,512 -2,062,862 3,043 57,307
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 72,592,822 180,000
b Less: cost or other basis and sales expenses 70,988,196 37,867
c Gain or (loss) 1,604,626 142,133
d Net gain or (loss)..........MediumBullet 1,746,759     1,746,759
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..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a BILLING SERVICE 561000 2,580,766   45,600 2,535,166
b RELATED PARTNERSHIP IN 900099 40,085 40,085    
c            
d All other revenue .... 2,518 2,518    
e Total. Add lines 11a–11d ...... MediumBullet 2,623,369
12 Total revenue. See Instructions......MediumBullet 71,139,511 65,130,019 557,980 5,451,512
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 2,511,771 2,511,771
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 65,500 65,500
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 5,426,354 5,426,354    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 20,476,369 12,431,145 8,045,224  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,264,048 770,193 493,855  
9 Other employee benefits ....... 2,503,208 1,280,971 1,222,237  
10 Payroll taxes ........... 1,460,988 878,883 582,105  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,086,828   1,086,828  
c Accounting ........... 355,612   355,612  
d Lobbying ........... 75,000   75,000  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 267,206   267,206  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 5,945,927 2,623,544 3,322,383  
12 Advertising and promotion .... 562,857   562,857  
13 Office expenses ....... 2,922,439 1,506,824 1,415,615  
14 Information technology ...... 16,843,095 16,785,097 57,998  
15 Royalties ..        
16 Occupancy ........... 2,632,915 1,777,418 855,497  
17 Travel ............ 168,891 91,895 76,996  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 149,163 85,149 64,014  
20 Interest ........... 1,123,369 1,123,369    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 6,750,012 6,695,969 54,043  
23 Insurance .............. 118,502   118,502  
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 MINOR PROJECT COSTS 223,144 223,144    
b REPAIRS & MAINTENANCE 175,152 169,224 5,928  
c
d
e All other expenses 14,323 4,679 9,644  
25 Total functional expenses. Add lines 1 through 24e 73,122,673 54,451,129 18,671,544 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing .............   1  
2 Savings and temporary cash investments ......... 15,358,108 2 2,952,632
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 1,546,433 4 2,811,321
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges .......... 5,740,150 9 5,678,010
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 254,281,825
b Less: accumulated depreciation ..... 10b 78,212,364 148,865,309 10c 176,069,461
11 Investments—publicly traded securities .......... 43,376,335 11 48,829,768
12 Investments—other securities. See Part IV, line 11 ..... 1,343,353 12 1,479,549
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 5,052,458 15 7,194,907
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 221,282,146 16 245,015,648
Liabilities 17 Accounts payable and accrued expenses ......... 14,466,777 17 16,751,428
18 Grants payable .................   18  
19 Deferred revenue ................ 18,003 19 18,363
20 Tax-exempt bond liabilities ............. 14,064,575 20 13,621,684
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 77,095,000 23 73,882,548
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 21,952,590 25 26,265,717
26 Total liabilities. Add lines 17 through 25......... 127,596,945 26 130,539,740
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 93,685,201 27 114,475,908
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 93,685,201 33 114,475,908
34 Total liabilities and net assets/fund balances ........ 221,282,146 34 245,015,648
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
71,139,511
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
73,122,673
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-1,983,162
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
93,685,201
5
Net unrealized gains (losses) on investments ...............
5
1,033,429
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
21,740,440
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
114,475,908
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
(A) MEMORIAL MEDICAL CENTER
 
370661220 3   No Yes   Yes   0
(B) PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
 
370661230 3   No Yes   Yes   0
(C) ABRAHAM LINCOLN MEMORIAL HOSPITAL
 
370723793 3   No Yes   Yes   0
(D) TAYLORVILLE MEMORIAL HOSPITAL
 
370661250 3   No Yes   Yes   0
(E) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
 
370646367 7   No Yes   Yes   0
(F) SPRINGFIELD RESIDENTIAL SERVICES
 
371298589 7   No Yes   Yes   0
(G) ABRAHAM LINCOLN HEALTHCARE FOUNDATION
 
363492268 7   No Yes   Yes   0
(H) MEMORIAL MEDICAL CENTER FOUNDATION
 
371110301 7   No Yes   Yes   0
(I) MEMORIAL HOME SERVICES
 
370714225 7   No Yes   Yes   0
Total 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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).  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2010 (b) 2011 (c) 2012 (d) 2013 (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) 2013


Schedule C (Form 990 or 990-EZ) 2013
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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
75,000
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
75,000
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) 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."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
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.
Return Reference Explanation
PART II-B, LINE 1: MEMORIAL HEALTH SYSTEM ENGAGES LOBBYISTS TO ASSIST IT IN SECURING FEDERAL GRANTS AND MONITORING STATE REGULATIONS IN SUPPORT OF FURTHERING THE MEMORIAL HEALTH SYSTEM MISSION WHICH IS "TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE". THIS INCLUDES ASSISTING MEMORIAL HEALTH SYSTEM IN DEVELOPING PRESENTATIONS TO THE ILLINOIS CONGRESSIONAL DELEGATION, REQUESTING APPROPRIATIONS FOR PRIORITY PROJECTS INVOLVING LOCAL PATIENT SAFETY, QUALITY IMPROVEMENT AND IMPROVED LOCAL ACCESS TO MEDICAL CARE. THE LOBBYISTS ALSO ASSIST MEMORIAL IN COMMUNICATING THE IMPORTANCE OF ADEQUATE MEDICAID FUNDING IN SUPPORT OF THE SUBSTANTIAL SERVICES MEMORIAL'S AFFILIATES PROVIDE TO THOSE IN POVERTY AND IN MONITORING LEGISLATIVE AND REGULATORY DEVELOPMENTS THAT WOULD AFFECT MEMORIAL HEALTH SYSTEM'S ABILITY TO CONTINUE DELIVERING ITS SUBSTANTIAL COMMUNITY BENEFIT.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
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.
1a
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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part 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 .... 8,666,004 8,179,460 7,271,242 7,410,408 5,942,467
b Contributions ........ 27,768 211,378 22,786 48,483 1,050,046
c Net investment earnings, gains, and losses 1,052,498 723,768 1,148,366 -47,525 599,812
d Grants or scholarships ..... 123,660   31,300   35,500
e Other expenditures for facilities
and programs ........
304,976 374,978 170,435 42,758 107,317
f Administrative expenses .... 80,062 73,624 61,199 97,366 39,100
g End of year balance ...... 9,237,572 8,666,004 8,179,460 7,271,242 7,410,408
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet14.000 %
b
Permanent endowment SchDMd Bullet56.000 %
c
Temporarily restricted endowment SchDMd Bullet30.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 460,501 21,931,253 22,391,754
b Buildings ................ 111,456,305 55,156,369 31,635,418 134,977,256
c Leasehold improvements ............        
d Equipment ................ 1,600,028 53,295,390 45,300,090 9,595,328
e Other ................. 849,435 9,532,544 1,276,856 9,105,123
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 176,069,461
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DEFERRED COMPENSATION 11,391,728
WORKERS' COMPENSATION 209,125
RESERVE FOR POST EMPLOYMENT BENEFITS 2,926,666
DUE TO AFFILIATES 58,578
SWAP LIABILITY 2,769,659
RESTORATION PLAN 6,909,961
CONTRIBUTION PAYABLE 2,000,000


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 26,265,717
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 71,477,011
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 1,033,429
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 555,992
e Add lines 2a through 2d ..................... 2e 1,589,421
3 Subtract line 2e from line 1..................... 3 69,887,590
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 267,206
b Other (Describe in Part XIII.) ........... 4b 984,715
c Add lines 4a and 4b....................... 4c 1,251,921
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 71,139,511
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 71,655,514
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 -1,199,953
e Add lines 2a through 2d...................... 2e -1,199,953
3 Subtract line 2e from line 1..................... 3 72,855,467
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 267,206
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c 267,206
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 73,122,673
Part XIII
Supplemental Information
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.
Return Reference Explanation
PART V, LINE 4: THE MEMORIAL MEDICAL CENTER FOUNDATION'S ENDOWMENT CONSISTS OF 36 INDIVIDUAL DONOR-RESTRICTED FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE MEMORIAL MEDICAL CENTER FOUNDATION (MMCF) HAS A POLICY OF APPROPRIATING FOR DISTRIBUTION EACH YEAR 5% OF ITS ENDOWMENT FUND'S MOVING AVERAGE FAIR VALUE OVER THE PRIOR 36 MONTHS AS OF SEPTEMBER 30 OF THE PRECEDING FISCAL YEAR IN WHICH THE DISTRIBUTION IS PLANNED. IN ESTABLISHING THIS POLICY, MMCF CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENTS. ACCORDINGLY, OVER THE LONG TERM, THE FOUNDATION EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT AN AVERAGE OF THE LONG TERM RATE OF INFLATION. THE PURPOSE OF MEMORIAL HOME SERVICES' ENDOWMENT FUND IS FOR THE INCOME TO BE USED FOR OPERATING EXPENSES. THE PURPOSE OF TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION'S ENDOWMENT FUND IS FOR EDUCATION SCHOLARSHIPS FOR STUDENTS SEEKING A CAREER IN HEALTHCARE.
PART X, LINE 2: THE AUTHORITATIVE GUIDANCE IN ASC 740, INCOME TAXES, CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF THIS GUIDANCE, TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. EACH OF MEMORIAL HEALTH SYSTEM'S SUBSIDIARIES, EXCLUDING THOSE DESCRIBED IN THE FOLLOWING PARAGRAPH, IS A SEPARATELY INCORPORATED NOT-FOR-PROFIT CORPORATION AS DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE AND IS TAX-EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY DO, HOWEVER, OPERATE CERTAIN PROGRAMS THAT MAY RESULT IN UNRELATED BUSINESS INCOME. UPON REVIEW AS REQUIRED BY ASC 740, NO TAX PROVISION WAS RECORDED FOR THE YEARS ENDED SEPTEMBER 30, 2014 OR 2013. MEMORIAL PROPERTIES (MP) AND MEMORIAL HEALTH PARTNERS (MHP) ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES AND ARE EXEMPT FROM INCOME TAX. MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS (MHSCI) IS A TAXABLE FOR-PROFIT CORPORATION AND PASSAVANT PHYSICIAN ASSOCATION (PPA) IS A TAXABLE NOT-FOR-PROFIT CORPORATION. BOTH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES.
PART XI, LINE 2D - OTHER ADJUSTMENTS: NONOPERATING CHANGE IN FV OF INT RATE SWAPS 555,992.
PART XI, LINE 4B - OTHER ADJUSTMENTS: REIMBURSED IT EXPENSES 10,386,109. RENTAL EXPENSES REPORTED IN F/S AS EXPENSE 990 AS NET -8,102,067. RELATED PARTNERSHIP INCOME BOOK/TAX DIFFERENCE 45,719. REIMBURSED EXEC SALARIES IN MGMT FEE -1,345,046.
PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED IN F/S AS EXPENSE 990 AS NET 8,102,067. REIMBURSED IT EXPENSES -10,386,109. NONOPERATING OTHER EXPENSE 1,084,089.
Schedule D (Form 990) 2013

Additional Data


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Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) UNITED WAY OF CENTRAL ILLINOIS INC
1999 WEST WABASH AVENUE SUITE 107
SPRINGFIELD,IL62704
37-0716060 501(C)(3) 143,884       SUPPORT FOR UNITED WAY COMMUNITY FUND.
(2) GREATER SPRINGFIELD CHAMBER OF COMMERCE
1011 S SECOND STREET
SPRINGFIELD,IL62704
37-0710280 501(C)(6) 90,000       SEE PART IVPARTICIPATE IN A PUBLIC AND PRIVATE ECONOMIC GROWTH PARTNERSHIP LED BY THE CHAMBER OF COMMERCE.
(3) HOSPITAL SISTERS MISSION OUTREACH
PO BOX 1665
SPRINGFIELD,IL62705
35-2271729 501(C)(3) 15,000       SEE PART IV RESPONDS TO THE SICK, POOR AND NEEDY THROUGH MEDICAL EQUIPMENT AND SUPPLY RECOVERY AND DISTRIBUTION PROGRAM AND EDUCATION AND AWARENESS OPPORTUNITIES.
(4) PREGNANCY CARE CENTER OF SPRINGFIELD INC
700 N 7TH STREET SUITE B
SPRINGFIELD,IL62702
37-1064806 501(C)(3) 5,000       SEE PART IVPROVIDE SUPPORT FOR THE PREGNANCY CARE CENTER TO PROVIDE PRENATAL CARE TO NEEDY INDIVIDUALS TO HELP THEM DELIVER HEALTHY BABIES, AND ASSIST THEM IN PREPARING FOR PARENTHOOD.
(5) KIDZEUM OF HEALTH AND SCIENCE
PO BOX 9863
SPRINGFIELD,IL62791
37-1320003 501(C)(3) 40,000       SEE PART IVPROVIDE SUPPORT FOR THE KIDZEUM HEALTH AND SCIENCE MUSEUM WHICH HAS A VERY STRONG HEALTH EDUCATION COMPONENT FOR CHILDREN.
(6) CENTRAL ILLINOIS FOODBANK INC
1937 E COOK ST
SPRINGFIELD,IL62703
37-1106465 501(C)(3) 9,500       SEE PART IVPROVIDE SUPPORT TO COLLECT AND DISTRIBUTE FOOD TO CHARITABLE AGENCIES THAT SERVE PEOPLE IN NEED.
(7) UNIVERSITY OF ILLINOIS FOUNDATION
1305 WEST GREEN STREET MC-386
URBANA,IL618012962
37-6006007 501(C)(3) 2,000,000       SEE PART IVPROVIDE SUPPORT OF THE ESTABLISHMENT OF A SPRINGFIELD REGIONAL CAMPUS OF THE UNIVERSITY OF ILLINOIS AT CHICAGO SCHOOL OF NURSING AND FOR SCHOLARSHIPS FOR STUDENTS ENROLLED AT THE UNIVERSITY OF ILLINOIS AT SPRINGFIELD WHO INTEND TO PURSUE A NURSING BSN DEGREE.
(8) PRAIRIE COUNCIL ON AGING
200 WEST DOUGLAS AVENUE
JACKSONVILLE,IL62650
37-0979932 501(C)(3)   180,000 FMV DONATION OF PROPERTY AT 800 W STATE, JACKSONVILLE,IL DONATION OF PROPERTY
(9) SPRINGFIELD URBAN LEAGUE INC
100 NORTH ELEVENTH STREET
SPRINGFIELD,IL62703
37-0765550 501(C)(3) 10,000       SEE PART IVPROVIDE SUPPORT TO ASSIST INDIVIDUALS AND COMMUNITIES TO REACH THEIR FULLEST POTENTIAL AND TO CLOSE EQUALITY GAPS FOR PEOPLE AT ALL ECONOMIC LEVELS AND STAGES OF LIFE.






2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance
(1) EDUCATIONAL GRANT - MEMORIAL HEALTH SYSTEM'S EDUCATIONAL GRANT PROGRAM PROVIDES THE OPPORTUNITY FOR BOTH EMPLOYEES AND EXTERNAL CANDIDATES TO PURSUE ADDITIONAL EDUCATION IN EXCHANGE FOR A WORK COMMITMENT ONCE THE EDUCATION IS COMPLETED. EDUCATIONAL GRANTS ARE AVAILABLE TO THOSE PURSUING HEALTH CARE CAREERS THAT ARE DEEMED CRITICAL TO THE ORGANIZATION'S PRESENT OR PROJECTED STAFFING NEEDS (I.E. NURSING, RADIOLOGY, ETC.). GRANT APPLICATIONS FOR ALL OTHER CAREERS WILL BE REVIEWED ON A CASE-BY-CASE BASIS WITH A FINAL DETERMINATION TO BE MADE BY THE CHIEF HUMAN RESOURCES OFFICER. 2 65,500      












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: MHS PROVIDES GRANTS PRIMARILY TO LOCALLY MANAGED 501(C)(3) ORGANIZATIONS THAT SUPPORT OR SHARE THE MISSION OF MHS. REQUESTS TO SUPPORT INITIATIVES IN LINE WITH MHS'S COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES RECEIVE SPECIAL CONSIDERATION. SENIOR LEADERSHIP MUST APPROVE ALL GRANTS. MHS EMPLOYEES ARE VOLUNTEER BOARD MEMBERS OR PARTICIPATE AS VOLUNTEERS FOR SOME OF THE ORGANIZATIONS THAT MHS ASSISTS. WHEN AN ORGANIZATION IS GIVEN A DONATION, IT EITHER AGREES TO RESTRICT THE DONATION TO THE PURPOSE FOR WHICH IT WAS REQUESTED OR IT RECEIVES A LETTER DIRECTING THAT DONATION MAY BE USED ONLY FOR THE APPROVED GRANT'S PURPOSE. ADDITIONALLY, EMPLOYEES FREQUENTLY ATTEND MANY OF THE SPONSORED EVENTS OR MHS RECEIVES ACKNOWLEDGEMENT FROM THE ORGANIZATION ABOUT THE PROGRAM THAT WAS SUPPORTED BY THE GRANT.
Schedule I (Form 990) 2013


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)EDGAR CURTIS EX-OFFICIOPRESIDENT & CEO (i)
(ii)
701,528
0
1,767
0
393,303
0
1,067,579
0
-9,134
0
2,155,043
0
0
0
(2)ROBERT KAYSVP & CFO & ASST TREASURER (i)
(ii)
393,877
0
154,042
0
26,958
0
237,344
0
-23,819
0
788,402
0
11,508
0
(3)MITCHELL JOHNSONSVP & CHIEF STRATEGY OFFICER (i)
(ii)
261,211
0
102,889
0
15,535
0
119,995
0
-4,283
0
495,347
0
0
0
(4)DAVID GRAHAM MDSVP & CIO (i)
(ii)
344,049
0
134,124
0
13,628
0
80,411
0
18,259
0
590,471
0
0
0
(5)RAJESH GOVINDAIAH MDSVP & CMO (i)
(ii)
342,596
0
0
0
17,959
0
199,322
0
6,959
0
566,836
0
0
0
(6)ELAINE YOUNGVP FINANCE (THRU JAN 2013) (i)
(ii)
5,332
0
0
0
535,716
0
14,152
0
-36,941
0
518,259
0
57,992
0
(7)BRADLEY WARRENSVP & CPO (THRU JAN 2013) (i)
(ii)
10,408
0
0
0
295,414
0
12,012
0
1,797
0
319,631
0
62,752
0
(8)DOUGLAS RAHN DBAEVP & COO (i)
(ii)
0
430,152
0
83,994
0
30,326
0
343,387
0
20,687
0
908,546
0
0
(9)MELISSA MCGLASSONVP FINANCE (FROM FEB 2013) (i)
(ii)
145,272
20,333
56,100
0
7,787
2,382
26,519
5,201
1,830
371
237,508
28,287
0
0
(10)KEVIN ENGLANDVP BUSINESS DEVELOPMENT (i)
(ii)
261,052
0
73,291
0
55,626
0
185,192
0
57,407
0
632,568
0
0
0
(11)ANNA EVANS JDGEN COUNSEL/VP INT AUDIT & COMPL (i)
(ii)
280,016
0
79,808
0
6,237
0
114,301
0
24,045
0
504,407
0
0
0
(12)AIMEE ALLBRITTON PHDINTERIM CHRO MHS (2013), VP & CLO (i)
(ii)
230,318
0
90,851
0
39,999
0
49,982
0
15,135
0
426,285
0
0
0
(13)GARY CROMPTONVP IS OPERATIONS (THRU FEB 2013) (i)
(ii)
26,198
0
0
0
149,098
0
10,046
0
1,197
0
186,539
0
44,471
0
(14)EDWARD MCDOWALLVP MRKTG & COMM (THRU SEPT 2013) (i)
(ii)
137,107
0
49,988
0
57,390
0
39,147
0
16,024
0
299,656
0
0
0
(15)LAURA COSSEYSYS DIR INT AUDIT/COMPL (i)
(ii)
147,172
0
21,564
0
3,706
0
12,392
0
18,312
0
203,146
0
0
0
(16)MADONNA CROMPTONSYS DIR CLINICAL INFORMATICS (i)
(ii)
149,082
0
10,437
0
6,458
0
20,571
0
2,723
0
189,271
0
0
0
(17)JERRY MILLERADMIN IS OPERATIONS (i)
(ii)
144,342
0
16,610
0
690
0
4,313
0
19,450
0
185,405
0
0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
PART I, LINE 3 COMPENSATION AND BENEFITS RECEIVED BY EDGAR CURTIS, PRESIDENT AND CEO OF MEMORIAL HEALTH SYSTEM, WAS COMPRISED OF THE FOLLOWING COMPONENTS; BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER COMPENSATION, RETIREMENT/DEFERRED COMPENSATION AND OTHER NONTAXABLE BENEFITS. BASE COMPENSATION FOR MR. CURTIS WAS DETERMINED BASED ON THE METHODS DESCRIBED IN PART I, LINE 3 CONDUCTED BY INDEPENDENT COMPENSATION CONSULTANTS. BASE COMPENSATION LEVELS WERE SET BY THE MHS BOARD AT THE 50TH PERCENTILE OF THE RELEVANT COMPENSATION RANGE, AS DETERMINED BY THE INDEPENDENT COMPENSATION CONSULTANTS. INCENTIVE COMPENSATION WAS CONTINGENT ON THE ACHIEVEMENT OF FOUR SPECIFIC PERFORMANCE METRICS OF MHS, AS DEFINED BY THE MHS BOARD. OTHER COMPENSATION IS COMPRISED PRIMARILY OF DEFERRED COMPENSATION PAYOUTS MADE DURING THE YEAR FOR COMPENSATION PREVIOUSLY EARNED IN PRIOR YEARS. RETIREMENT COMPENSATION REFLECTS AN INCREASE IN RETIREMENT BENEFITS OWED BY MHS UPON RETIREMENT OF MR. CURTIS. THIS INCREASE WAS DRAMATICALLY IMPACTED BY ACTUARIAL ASSUMPTIONS OF THE RETIREMENT PLAN, WHICH HAVE HISTORICALLY INCLUDED DRAMATIC CHANGES IN THE DISCOUNT RATE. NORMAL RETIREMENT COMPENSATION FOR THE YEAR WAS $155,527. IN 2013, MR. CURTIS ELECTED TO DEFER HIS INCENTIVE COMPENSATION OF $338,842 INTO HIS 457(F) PLAN. LASTLY, NONTAXABLE BENEFITS REFLECT THE VALUE OF HEALTH (MEDICAL, DENTAL, LIFE INSURANCE) BENEFITS RECEIVED DURING THE YEAR AS WELL AS CHANGES IN ACTUARIAL VALUE OF THE POSTRETIREMENT HEALTH CARE INSURANCE REIMBURSEMENT PLAN.
PART I, LINES 4A-B DURING 2013, THE FOLLOWING LISTED INDIVIDUALS RECEIVED SEVERANCE OR SEPARATION PAYMENTS AFTER TERMINATION OF EMPLOYMENT, AND THESE AMOUNTS ARE INCLUDED IN THE AMOUNTS REPORTED ON SCHEDULE J FOR SUCH INDIVIDUALS: ELAINE YOUNG, $193,720; BRADLEY WARREN, $183,609; GARY CROMPTON, $86,678. CERTAIN INDIVIDUALS LISTED IN SCHEDULE J ARE OR MAY BE ELIGIBLE TO RECEIVE SEVERANCE PAY UPON CERTAIN TYPES OF EMPLOYMENT TERMINATIONS. THESE ARRANGEMENTS ARE REVIEWED FROM TIME TO TIME TO ASSURE THAT THE POTENTIAL SEVERANCE PAY IS REASONABLE AND CONSISTENT WITH MARKET DATA FOR INDIVIDUALS IN SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS. EXECUTIVE SEVERANCE ARRANGEMENTS REQUIRE THE SATISFACTION OF CONDITIONS AND ONGOING RESTRICTIVE COVENANTS THAT PROTECT THE INTERESTS OF THE ORGANIZATION. THE COMPENSATION REPORTED FOR THE LISTED INDIVIDUAL EDWARD MCDOWALL INCLUDES AN INCENTIVE COMPENSATION PAYMENT OF $49,988 WHICH WAS EARNED DURING ACTIVE EXECUTIVE EMPLOYMENT, AND WHICH WAS PAID IN ACCORDANCE WITH A VOLUNTARY SEPARATION AGREEMENT BETWEEN THE INDIVIDUAL AND THE ORGANIZATION. THE ORGANIZATION OR A RELATED ORGANIZATION, MEMORIAL MEDICAL CENTER, PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO THE FOLLOWING OFFICERS AND KEY EMPLOYEES: AIMEE ALLBRITTON, PH.D., $32,187, GARY CROMPTON, $2,042, EDGAR CURTIS, $1,034,929, KEVIN ENGLAND, $159,975, ANNA EVANS, J.D., $96,651, RAJESH GOVINDAIAH, M.D., $181,291, DAVID GRAHAM, M.D., $72,911, MITCHELL JOHNSON, $87,903, ROBERT KAY, $209,694, EDWARD MCDOWALL, $16,924, MELISSA MCGLASSON, $20,666, DOUGLAS RAHN, D.B.A., $325,737, BRADLEY WARREN, $702, AND ELAINE YOUNG, $115. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A "SUBSTANTIAL RISK OF FORFEITURE." THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. THE FOLLOWING CURRENT OR FORMER OFFICERS AND KEY EMPLOYEES RECEIVED DEFERRED COMPENSATION PAYOUTS IN THE CALENDAR YEAR FROM THE ORGANIZATION OR A RELATED ORGANIZATION, MEMORIAL MEDICAL CENTER: GARY CROMPTON, $53,537, EDGAR CURTIS, $340,089, KEVIN ENGLAND, $30,902, BRADLEY WARREN, $72,012, AND ELAINE YOUNG, $295,113. TO BECOME ENTITLED TO THE BENEFITS PROVIDED, EACH COVERED EMPLOYEE MUST MEET SUBSTANTIAL REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES AND NOT MET THESE SUBSTANTIAL REQUIREMENTS, THESE SUPPLEMENTAL RETIREMENT BENEFITS WOULD HAVE BEEN FORFEITED. THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ACCORDINGLY, ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE. THE LEADERSHIP COMPENSATION COMMITTEE OF THE MHS BOARD APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER SENIOR LEADERS, IN A MANNER INTENDED TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL INCOME TAX LAW.
PART I, LINE 7 MEMBERS OF SENIOR MANAGEMENT RECEIVE INCENTIVE COMPENSATION UNDER THE ANNUAL INCENTIVE COMPENSATION PLANS SPONSORED BY MEMORIAL HEALTH SYSTEM. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(II). THE PLANS ARE DESIGNED TO CONDITION A PORTION OF COMPENSATION ON PERFORMANCE AGAINST PRE-DETERMINED ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM. THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD HAS REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED.
SCHEDULE J, PART II, COLUMN (D) MEMORIAL HEALTH SYSTEM PROVIDES A POSTRETIREMENT HEALTH CARE INSURANCE REIMBURSEMENT PLAN TO CERTAIN EXECUTIVES AND PHYSICIANS TO REIMBURSE HEALTH INSURANCE COSTS INCURRED BY THE RETIREES AND THEIR SPOUSES. THE CHANGE IN THE ACTUARIAL VALUE OF THE PLAN IS REPORTED ON SCHEDULE J, PART II, COLUMN (D) AS A NONTAXABLE BENEFIT. A NEGATIVE TOTAL FOR SCHEDULE J, PART II, COLUMN (D) INDICATES A DECREASE IN THE ACTUARIAL VALUE OF THE PLAN DUE TO CHANGES IN THE DISCOUNT RATE AND/OR OTHER ACTUARIAL ASSUMPTIONS. SCHEDULE J, PART II, COLUMN (D) ALSO INCLUDES OTHER NONTAXABLE BENEFITS SUCH AS MEDICAL, DENTAL, AND LIFE INSURANCE.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet 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.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
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
Yes No Yes No Yes No
A ILLINOIS HEALTH FACILITIES AUTHORITY
 
36-2780046 45200P2U4 12-17-2003 31,000,000 SEE PART VI   X   X   X
B ILLINOIS FINANCE AUTHORITY
 
86-1091967 45200FJ59 12-22-2009 147,401,639 SEE PART VI   X   X   X
C ILLINOIS FINANCE AUTHORITY
 
86-1091967 45203HYQ9 01-30-2014 60,465,495 SEE PART VI   X   X   X
D ILLINOIS FINANCE AUTHORITY
 
86-1091967   05-15-2014 60,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 7,955,000 3,160,000    
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 31,100,606 147,556,074 60,471,350 60,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 329,438 1,350,000    
8 Credit enhancement from proceeds . . . . . . . . . . . 110,306      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 19,254,302 146,206,074 60,471,350 100,000
11 Other spent proceeds . . . . . . . . . . . . . . 11,406,560     59,900,000
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2004 2011
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) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X     X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X     X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
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 . . SchKMediumBullet 0 % 0 % 0 % 0 %
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 . . . . . . . SchKMediumBullet 0.250 % 2.070 % 0 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.250 % 2.070 % 0 % 0 %
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? . . . . . . . . . . . . .                
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 X   X  
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   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 . . . . . . . . . US BANCORP PIPER
JAFFRAY FINANCIAL
 
 
 
 
 
 
c Term of hedge . . . . . . . . . . 18.800000000000      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . .   X            
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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 . . . . . . . . .  
 
 
 
 
 
 
 
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
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. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K SUPPLENTAL INFORMATION SCHEDULE K: ONE SCHEDULE K WAS COMPLETED AT THE PARENT LEVEL ONLY. HOWEVER, EACH AFFILIATE IS STILL SHOWING ITS ALLOCATION OF THE LIABILITY ON THE BALANCE SHEET, AS CAN BE SEEN ON THE GROUP RETURN. SCHEDULE K PART I, COLUMN (F) CONTINUATIONS: ONE PURPOSE OF THE 2003 ISSUE WAS TO CURRENT REFUND $10,980,000 OF THE 1993 SERIES BONDS ISSUED ON 8/5/93 IN THE AMOUNT OF $21,245,000. PROCEEDS WERE ALSO USED TO PAY ISSUANCE EXPENSES AND TO PURCHASE EQUIPMENT AND SOFTWARE FOR MEMORIAL HEALTH SYSTEM. PROCEEDS WERE ALSO USED FOR CONSTRUCTION AND HEALTHCARE BUILDING IMPROVEMENTS AND TO CONSTRUCT AND EQUIP AN OUTPATIENT PSYCHIATRIC FACILITY. THE PURPOSE OF THE 2009 ISSUE WAS TO PAY ISSUANCE COSTS, CONSTRUCT AND EQUIP A REPLACEMENT HOSPITAL FACILITY FOR ABRAHAM LINCOLN MEMORIAL HOSPITAL, RENOVATE AND REMODEL TAYLORVILLE MEMORIAL HOSPITAL, RENOVATE, REMODEL, AND EQUIP MEMORIAL MEDICAL CENTER, CONSTRUCT A PARKING GARAGE ADJACENT TO MEMORIAL MEDICAL CENTER, CONSTRUCT AND EQUIP A WOUND CARE CENTER, RENOVATE A PAIN CLINIC, CONSTRUCT AND EQUIP A CONSOLIDATED IMAGING SERVICES AREA, PURCHASE VARIOUS PARCELS OF REAL PROPERTY IN SPRINGFIELD, IL AND TAYLORVILLE, IL FOR FUTURE EXPANSION OF EXISTING FACILITIES, CONSTRUCT AND EQUIP A SPACE FOR PHYSICAL THERAPY OWNED BY MEMORIAL MEDICAL CENTER AND LOCATED WITHIN THE NEW YMCA IN SPRINGFIELD, IL, AND ROUTINE CAPITAL EXPENDITURES. THE PURPOSE OF THE 2014A ISSUE WAS (A) TO REPAY TAXABLE DEBT IN THE AMOUNT OF $25,057,493 USED FOR PAYMENT OF THE COST OF ACQUIRING, CONSTRUCTING, RENOVATING, REMODELING AND EQUIPPING HEALTH FACILITIES AT MEMORIAL MEDICAL CENTER, AND (B) FOR PAYING ADDITIONAL COSTS OF THOSE PROJECTS NOT PREVIOUSLY FINANCED WITH THE TAXABLE DEBT. THE PURPOSE OF THE 2014B ISSUE WAS FOR THE PAYMENT OF ACQUIRING, CONSTRUCTING, RENOVATING, REMODELING AND EQUIPPING HEALTH FACILTIES AT MEMORIAL MEDICAL CENTER. PART II LINES 10D AND 11D FOR THE SERIES 2014B BONDS REFLECT THE FACT THAT THESE BONDS WERE ISSUED IN A DRAW-DOWN STRUCTURE WITH AN ISSUE PRICE OF $60,000,000, OF WHICH THE FIRST TRANCHE WAS TAKEN DOWN IN THE AMOUNT OF $100,000 TO PAY CERTAIN CAPITAL EXPENDITURES FOR THE FINANCED PROJECTS. DURING THE FISCAL YEAR COVERED BY THIS SCHEDULE, THIS WAS THE ONLY AMOUNT OF THE 2014B BONDS DRAWN DOWN, BUT SUBSEQUENT TO THE END OF THE FISCAL YEAR COVERED BY THIS SCHEDULE, ADDITIONAL AMOUNTS HAVE BEEN DRAWN DOWN AND IMMEDIATELY APPLIED TO PAY CAPITAL COSTS OF THE FINANCED PROJECTS. SCHEDULE K PART II, LINE 3: TOTAL PROCEEDS ISSUED AMOUNT IN COLUMNS A, B, & C DOESN'T TIE TO PART I COLUMN (E) DUE TO INVESTMENT EARNINGS INCLUDED IN PART II, LINE 3. SCHEDULE K PART II LINE 13 (C & D) THE 2014A ISSUE AND 2014B ISSUE RELATED PROJECTS WERE NOT SUBSTANTIALLY COMPLETE AS OF 9/30/2014. SCHEDULE K PART III, LINE 3B & 3D: MEMORIAL HEALTH SYSTEM'S INTERNAL COUNSEL, AS WELL AS EXTERNAL BOND COUNSEL, ROUTINELY REVIEWS MANAGEMENT AND SERVICE CONTRACTS AND RESEARCH AGREEMENTS RELATING TO FINANCED PROPERTY . SCHEDULE K PART IV, LINE 1: THE ARBITRAGE REBATE FILING IS ONLY REQUIRED EVERY 5 YEARS, AND NO REBATABLE ARBITRAGE HAS BEEN EARNED FOR ISSUES AT SUCH 5 YEAR ANNIVERSARIES. SCHEDULE K PART IV, LINE 2C: THE REBATE COMPUTATION FOR COLUMN A WAS PERFORMED ON 12/17/2013. THE REBATE COMPUTATION FOR COLUMN B WAS PERFORMED ON 12/22/2014, AND NO REBATABLE ARBITRAGE HAS BEEN EARNED FOR THESE ISSUES AT SUCH 5 YEAR ANNIVERSARIES. SCHEDULE K PART IV, LINE 4B: THE PROVIDER'S FULL NAME FOR COLUMN A IS U.S. BANCORP PIPER JAFFRAY FINANCIAL PRODUCTS INC.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) HURWITZ ENTERPRISES LLC
 
SEE PART V BOARD MEMBER IS OWNER OF HURWITZ ENTERPRISES, LLC 319,238 SEE PART VMEMORIAL HEALTH SYSTEM PAID FEES TO HURWITZ ENTERPRISES, LLC FOR REAL ESTATE DEVELOPMENT, BROKERAGE, AND CONSULTING SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2014 IN THE AMOUNT OF $319,238. JOSEPH M. HURWITZ IS A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS AND IS OWNER OF HURWITZ ENTERPRISES, LLC. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(2) LEVI RAY AND SHOUP INC
 
SEE PART V BOARD MEMBER IS OWNER OF LEVI, RAY AND SHOUP, INC. 181,865 SEE PART VMEMORIAL HEALTH SYSTEM PAID FEES TO LEVI, RAY AND SHOUP, INC. FOR SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2014 IN THE AMOUNT OF $181,865. RICHARD H. LEVI IS A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS AND IS OWNER OF LEVI, RAY AND SHOUP, INC. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(3) SPRINGFIELD CLINIC LLP
 
PART V BOARD MEMBER IS EMPLOYEE AND BOARD MEMBER OF SPRINGFIELD CLINIC, LLP 926,427 SEE PART VMEMORIAL HEALTH SYSTEM PAID FEES TO SPRINGFIELD CLINIC, LLP FOR THE YEAR ENDED SEPTEMBER 30, 2014 IN THE AMOUNT OF $926,427. A PHYSICIAN AND BOARD MEMBER OF THIS COMPANY, WILLIAM D. PUTMAN, M.D., IS ALSO A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS. ALL FEES ARE NEGOTIATED AT ARM'S LENGTH AND ARE AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2 MEMORIAL HEALTH SYSTEM BOARD MEMBERS JAMES BRUNER, RICHARD LEVI, AND SERGIO PECORI ARE ALL ON THE ILLINOIS NATIONAL BANK BOARD OF DIRECTORS. MEMORIAL HEALTH SYSTEM BOARD MEMBER NINA HARRIS AND MEMORIAL HEALTH SYSTEM KEY EMPLOYEE MITCHELL JOHNSON ARE BOTH ON SECURITY BANK'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 4 MEMORIAL HEALTH SYSTEM BECAME THE SOLE CORPORATE MEMBER OF PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION IN JACKSONVILLE, IL. BYLAWS HAVE BEEN UPDATED TO REFLECT THIS CHANGE. AS A RESULT OF THIS TRANSACTION, AN ADDITIONAL 2 MEMBERS HAVE BEEN ADDED TO THE BOARD OF DIRECTORS FOR A TOTAL OF 19 BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION CONTAINS 105 INDIVIDUAL MEMBERS WHO ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A THE INDIVIDUAL MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT THE CORPORATION'S BOARD OF DIRECTORS, AS WELL AS THE POWER AND AUTHORITY TO REMOVE MEMBER ELECTED DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B INDIVIDUAL MEMBERS OF THE CORPORATION HAVE NO VOTING RIGHTS WITH RESPECT TO THE MANAGEMENT, CONTROL OR OPERATION OF THE AFFAIRS AND PROPERTIES OF THE CORPORATION. ONLY THE BOARD OF DIRECTORS CAN MAKE DECISIONS IN THAT REGARD.
FORM 990, PART VI, SECTION B, LINE 11 A FINAL DRAFT COPY OF THE MHS FORM 990 AND ALL ATTACHMENTS IS PROVIDED TO ALL OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS AND A BOARD COMMITTEE PRIOR TO FILING. AT THE BOARD MEETING, A PRESENTATION IS MADE BY THE CFO TO THE BOARD, FOLLOWED BY A QUESTION AND ANSWER SESSION. ALL QUESTIONS AND COMMENTS ARISING FROM THESE REVIEWS ARE ADDRESSED PRIOR TO SUBMISSION OF THE RETURN TO THE APPROPRIATE TAXING AUTHORITIES.
FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE CORPORATION ARE REQUIRED TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A SPECIFIC DISCLOSURE STATEMENT WHICH IS ATTACHED TO THE POLICY. MEMORIAL HEALTH SYSTEM MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING AGENDA IS PREPARED. ANY OFFICER OR DIRECTOR WHO HAS A CONFLICT IS NOTIFIED OF SUCH CONFLICT, AS WELL AS THEIR OBLIGATION TO ABSTAIN FROM THE DISCUSSION AND VOTE ON ANY CONFLICTED ISSUES(S). SUCH ABSTENTION(S), IF REQUIRED, ARE DOCUMENTED IN THE MINUTES OF EACH MEETING. BOARD MEMBERS ARE ALSO REQUIRED TO UPDATE THEIR CONFLICT OF INTEREST DISCLOSURE STATEMENTS PROMPTLY IN THE EVENT OF ANY CHANGE IN PERSONAL OR BUSINESS ACTIVITIES THAT WOULD REQUIRE SUCH DISCLOSURE.
FORM 990, PART VI, SECTION B, LINE 15 THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE MADE UP OF PAST AND PRESENT INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, AND HAS DELEGATED TO IT THE RESPONSIBILITY OF ADMINISTERING, OVERSEEING AND APPROVING ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE LEADERSHIP, INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER AND OTHER SENIOR VICE PRESIDENTS, WHO ARE KEY EMPLOYEES. THE BOARD HAS ADOPTED A LEADERSHIP COMPENSATION PHILOSOPHY STATEMENT DESCRIBING THE ROLE AND RESPONSIBILITIES OF THE COMMITTEE. THIS PHILOSOPHY EXPRESSLY STATES THE COMMITTEE'S INTENT, ON BEHALF OF THE CORPORATION, TO TAKE ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE ANALYZES EVERY ELEMENT OF COMPENSATION (INCLUDING CURRENT, INCENTIVE AND DEFERRED COMPENSATION) AND BENEFITS (INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS). THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. IN CONNECTION WITH THE MOST RECENT REVIEW AND APPROVAL PROCESS, THE COMMITTEE RECEIVED PROFESSIONAL ADVICE FROM AN INDEPENDENT CONSULTANT AND OUTSIDE LEGAL COUNSEL. THE COMMITTEE CONSISTS ENTIRELY OF PAST AND PRESENT DISINTERESTED MEMBERS OF THE BOARD OR DISINTERESTED COMMITTEE MEMBERS WHO UNDER STATE CORPORATE LAW MAY SERVE ON SUCH A COMMITTEE. THE COMMITTEE WORKS WITH ITS COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES.
FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF MEMORIAL HEALTH SYSTEM, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D).
FORM 990, PART XI, LINE 9: NONOPERATING RECONCILING ITEMS -528,098. CHANGE IN UNRESTRICTED NET ASSETS 20,969,211. EXEC SALARIES IN MGMT FEE INCOME 1,345,046. RELATED PARTNERSHIP INCOME BOOK/TAX VARIANCE -45,719.
SCHEDULE R, PART V, LINE 2 MEMORIAL HEALTH SYSTEM COLLECTED RENTAL INCOME FROM AFFILIATES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2014. THE VALUES LISTED IN SCHEDULE R, PART V, LINE 2 WERE DETERMINED USING FAIR MARKET VALUE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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) MEMORIAL HEALTH PARTNERS LLC
701 NORTH 1ST STREET
SPRINGFIELD,IL62781
46-3947269
TO COORDINATE PATIENT CARE ACTIVITIES ACROSS THE HEALTHCARE CONTINUUM IL 0 0 MEMORIAL HEALTH SYSTEM
 










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) MEMORIAL MEDICAL CENTER

701 NORTH FIRST ST

SPRINGFIELD,IL627810001
37-0661220
HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM
 
Yes
 
(2) MEMORIAL HEALTH VENTURES

701 NORTH FIRST ST

SPRINGFIELD,IL627810001
36-3492266
HEALTHCARE ACTIVITIES IL 501(C)(3) 509(A)(3) TYPE II MEMORIAL HEALTH SYSTEM
 
Yes
 
(3) ABRAHAM LINCOLN MEMORIAL HOSPITAL

200 STAHLHUT DR

LINCOLN,IL62656
37-0723793
HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM
 
Yes
 
(4) TAYLORVILLE MEMORIAL HOSPITAL

201 EAST PLEASANT

TAYLORVILLE,IL62568
37-0661250
HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM
 
Yes
 
(5) MEMORIAL HOME SERVICES

720 NORTH BOND ST

SPRINGFIELD,IL627024915
37-0714225
HOME HEALTH, HOSPICE, AND CONTINUOUS CARE SERVICES IL 501(C)(3) 170(B)(1)(A) (VI) MEMORIAL HEALTH SYSTEM
 
Yes
 
(6) MEMORIAL PHYSICIAN SERVICES

701 NORTH FIRST ST

SPRINGFIELD,IL627810001
37-1181194
HEALTH CLINICS IL 501(C)(3) 509(A)(3) TYPE II MEMORIAL HEALTH SYSTEM
 
Yes
 
(7) MEMORIAL MEDICAL CENTER FOUNDATION

701 NORTH FIRST ST

SPRINGFIELD,IL62781
37-1110301
GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) 170(B)(1)(A) (VI) MEMORIAL MEDICAL CENTER
 
Yes
 
(8) TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION

201 EAST PLEASANT

TAYLORVILLE,IL62568
37-1337485
GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 509(A)(3)TYPE III-FI N/A
 
No
(9) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

710 NORTH EIGHTH ST

SPRINGFIELD,IL627026395
37-0646367
TRAINING, PSYCHIATRIC, AND RESIDENT SERVICES FOR MENTALLY ILL AND DISABLED IL 501(C)(3) 170(B)(1)(A) (VI) MEMORIAL HEALTH SYSTEM
 
Yes
 
(10) ABRAHAM LINCOLN HEALTHCARE FOUNDATION

200 STAHLHUT DR

LINCOLN,IL62656
36-3492268
GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 170(B)(1)(A) (VI) MEMORIAL HEALTH SYSTEM
 
Yes
 
(11) SPRINGFIELD RESIDENTIAL SERVICES

710 NORTH EIGHTH ST

SPRINGFIELD,IL62702
37-1298589
RESIDENTIAL HUD HOUSING PROJECT FOR MENTALLY ILL IL 501(C)(3) 170(B)(1)(A) (VI) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
 
Yes
 
(12) PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION

1600 WEST WALNUT

JACKSONVILLE,IL62650
37-0661230
HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM
 
Yes
 
(13) PASSAVANT AREA HOSPITAL FOUNDATION

1600 WEST WALNUT

JACKSONVILLE,IL62650
46-1037396
GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 509(A)(3)TYPE II PASSAVANT MEM AREA HOSPITAL ASSOCIATION
 
Yes
 
(14) JACKSONVILLE CRNA'S INC

1600 WEST WALNUT

JACKSONVILLE,IL62650
27-3083265
CRNA SERVICES IL 501(C)(3) 509(A)(3)TYPE I PASSAVANT MEM AREA HOSPITAL ASSOCIATION
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS INC

701 NORTH FIRST ST
SPRINGFIELD,IL62781
37-1190216
PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTS IL MEMORIAL HOME SERVICES
 
C       Yes  
(2) PASSAVANT PHYSICIAN ASSOCIATION

1600 WEST WALNUT
JACKSONVILLE,IL62650
26-1200566
PHYSICIAN SERVICES IL PASSAVANT MEM AREA HOSPITAL ASSOCIATION
 
C       Yes  










Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) MEMORIAL HEALTH VENTURES

A 423,001 FMV
(2) MEMORIAL HOME SERVICES

A 117,638 FMV
(3) MEMORIAL MEDICAL CENTER

A 2,426,892 FMV
(4) MEMORIAL PHYSICIAN SERVICES

A 1,992,754 FMV
(5) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS

A 6,587 FMV
(6) MEMORIAL PHYSICIAN SERVICES

B 12,593,804 FMV
(7) MEMORIAL HEALTH VENTURES

J 423,001 FMV
(8) MEMORIAL HOME SERVICES

J 117,638 FMV
(9) MEMORIAL MEDICAL CENTER

J 2,426,892 FMV
(10) MEMORIAL PHYSICIAN SERVICES

J 1,992,754 FMV
(11) MEMORIAL MEDICAL CENTER

K 148,172 FMV
(12) MEMORIAL PHYSICIAN SERVICES

K 458,352 FMV
(13) MEMORIAL MEDICAL CENTER

L 44,021,167 FMV
(14) ABRAHAM LINCOLN MEMORIAL HOSPITAL

L 2,478,738 FMV
(15) TAYLORVILLE MEMORIAL HOSPITAL

L 2,289,313 FMV
(16) MEMORIAL PHYSICIAN SERVICES

L 3,682,290 FMV
(17) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

L 530,244 FMV
(18) MEMORIAL HOME SERVICES

L 819,127 FMV
(19) MEMORIAL HEALTH VENTURES

L 404,511 FMV
(20) MEMORIAL HEALTH VENTURES

L 305,439 FMV
(21) MEMORIAL HEALTH VENTURES

Q 158,603 FMV
(22) MEMORIAL MEDICAL CENTER

P 5,904,339 FMV
(23) MEMORIAL MEDICAL CENTER

O 3,299,920 FMV
(24) MEMORIAL MEDICAL CENTER

M 418,173 FMV
(25) MEMORIAL MEDICAL CENTER

L 303,588 FMV
(26) MEMORIAL MEDICAL CENTER

Q 9,981,331 FMV
(27) MEMORIAL HOME SERVICES

Q 118,743 FMV
(28) MEMORIAL PHYSICIAN SERVICES

Q 1,582,523 FMV
(29) MEMORIAL PHYSICIAN SERVICES

L 1,921,339 FMV
(30) MEMORIAL PHYSICIAN SERVICES

P 1,196,016 FMV
(31) ABRAHAM LINCOLN MEMORIAL HOSPITAL

O 117,037 FMV
(32) ABRAHAM LINCOLN MEMORIAL HOSPITAL

Q 168,917 FMV
(33) TAYLORVILLE MEMORIAL HOSPITAL

Q 133,034 FMV
(34) TAYLORVILLE MEMORIAL HOSPITAL

O 116,055 FMV
(35) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

Q 78,440 FMV
(36) MEMORIAL HOME SERVICES

B 417,662 COST BASIS
(37) MEMORIAL MEDICAL CENTER

C 33,279,439 FMV
(38) PASSAVANT AREA MEMORIAL HOSPITAL ASSOCIATION

C 417,662 COST BASIS
(39) MEMORIAL MEDICAL CENTER

N 916,701 FMV
(40) MEMORIAL HOME SERVICES

N 117,638 FMV
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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 V?UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: