TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) R BRAD RINGHOFER MD........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(2) LESLIE MEHRTENS........................................................................ DIRECTOR	0.5 .......................0.8	X		0	0	0
(3) EDWARD HOERING........................................................................ DIRECTOR	0.5 .......................1.2	X		0	0	0
(4) LARY ECKERT........................................................................ DIRECTOR	0.5 .......................1.2	X		0	0	0
(5) THOMAS LIPPERT........................................................................ DIRECTOR	0.5 .......................0.8	X		0	0	0
(6) EDWARD ROSE MD........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(7) ROLAND THOUVENOT........................................................................ CHAIRMAN, DIRECTOR	0.5 .......................0.85	X		0	0	0
(8) ROBERT WANLESS MD........................................................................ DIRECTOR	0.5 .......................0.5	X		0	288,124	26,226
(9) SCOTT GIVENS........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(10) MARQUITA WILEY........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(11) JEFFRY LUTZ........................................................................ DIRECTOR	0.5 .......................1.2	X		0	0	0
(12) REV ROB DYER........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(13) ROBERT GRAEBE........................................................................ DIRECTOR	0.5 .......................0.5	X		0	0	0
(14) KEITH COOK........................................................................ DIRECTOR	0.5 .......................0.85	X		0	0	0
(15) MARK TURNER........................................................................ PRESIDENT	55.0 .......................5.62		X	544,046	0	137,324
(16) JOE LANIUS........................................................................ VP FINANCE	23.0 .......................37.62		X	0	310,394	45,486
(17) NANCY WESTON........................................................................ VP NURSING SERVICES	65.0 .......................0.0		X	326,236	0	35,380

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) RUTH HOLMES........................................................................ ADMINISTRATOR MEMORIAL EAST	10.0 .......................60.0	X		0	202,212	33,668
(19) CHERYL CREASY........................................................................ VP RISK MANAGEMENT	49.0 .......................1.0	X		145,105	0	28,424
(20) JAMES DAVIS........................................................................ VP PHYSICIAN SERVICES	1.0 .......................59.0	X		0	179,367	31,213
(21) WILLIAM CASPERSON MD........................................................................ VP MEDICAL AFFAIRS	60.0 .......................0.0	X		329,374	0	61,039
(22) AMY THOMAS........................................................................ VICE PRESIDENT FINANCE	60.0 .......................0.0	X		203,590	0	33,226
(23) JOHN ZIEGLER........................................................................ VP HUMAN RESOURCES	55.0 .......................5.0	X		182,719	0	31,673
(24) MICHAEL MCMANUS........................................................................ CHIEF OPERATING OFFICER	55.0 .......................0.0	X		279,423	0	40,608
(25) LINDA FRITSCHE........................................................................ TELEMETRY NURSE	60.0 .......................0.0		X	135,115	0	19,706
(26) MARIA GHORMLEY........................................................................ EMERGENCY NURSE	60.0 .......................0.0		X	149,525	0	16,363
(27) STARLA ELLER........................................................................ DIRECTOR SURGICAL SERVICES	60.0 .......................0.0		X	180,855	0	17,484
(28) JENNIFER MEINKOTH........................................................................ DIRECTOR INFORMATION TECHNOLOG	55.0 .......................0.0		X	189,817	0	27,296
(29) GLEN KOHNZ........................................................................ DIRECTOR PHARMACY	60.0 .......................0.0		X	145,727	0	14,946

(A) Name and business address	(B) Description of services	(C) Compensation
CALIFORNIA EMERGENCY PHYSICIANS, 2100 POWELL ST EMERYVILLE,CA94608	PHYSICIAN SERVICES	3,824,475
CROTHALL HEALTHCARE, 13028 COLLECTION CTR DR CHICAGO,IL60693	CONSULTING SERVICES	3,584,347
ANESTHESIA ASSOCIATES, 4500 MEMORIAL DR BELLEVILLE,IL62226	ANESTHESIA SERVICES	3,106,982
HURON CONSULTING SERVICES, 550 W VAN BUREN CHICAGO,IL60607	CONSULTING SERVICES	2,416,440
ARUP LABORATORIES, 500 CHIPETA WAY SALT LAKE CITY,UT84108	LAB TEST SERVICES	963,552
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 73

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 domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............	0
4	Benefits paid to or for members ....	0
5	Compensation of current officers, directors, trustees, and key employees ....	2,378,167		2,378,167
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	38,605	38,605
7	Other salaries and wages ....	90,495,886	83,007,377	7,488,509
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,105,945	2,777,164	328,781
9	Other employee benefits .......	24,756,291	22,135,705	2,620,586
10	Payroll taxes ...........	7,009,863	6,267,832	742,031
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	373,630		373,630
c	Accounting ...........	94,024		94,024
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	25,198,927	17,902,993	7,295,934
12	Advertising and promotion ....	1,054,968		1,054,968
13	Office expenses .......	41,794,452	41,127,783	666,669
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	3,988,184	3,566,013	422,171
17	Travel ............	97,411	54,512	42,899
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	1,151,695		1,151,695
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	14,736,720	13,204,489	1,532,231
23	Insurance ..............	2,299,763	1,995,659	304,104
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	REPAIRS & MAINTENANCE	7,595,442	5,366,171	2,229,271
b	ASSOCIATION DUES	315,112		315,112
c	MICROFILMING	42,000		42,000
d	MEDICAL WASTE DISPOSAL	285,569	285,569
e	All other expenses	12,528,232	10,729,547	1,798,685
25	Total functional expenses. Add lines 1 through 24e	239,340,886	208,459,419	30,881,467	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	4,200	1	4,200
2	Savings and temporary cash investments .........	9,781,616	2	30,783,994
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	47,450,427	4	44,254,007
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	2,882,714	8	2,834,468
9	Prepaid expenses and deferred charges ..........	3,405,134	9	3,543,952
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	236,543,632
b	Less: accumulated depreciation .....	10b	175,641,838	67,789,386	10c	60,901,794
11	Investments—publicly traded securities ..........	31,115,810	11	33,316,897
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	12,110,181	13	13,131,080
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	19,125,124	15	30,418,101
16	Total assets. Add lines 1 through 15 (must equal line 34)......	193,664,592	16	219,188,493
	17	Accounts payable and accrued expenses .........	45,778,407	17	48,004,576
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	15,586,237	20	15,350,155
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	16,808,256	25	17,172,629
26	Total liabilities. Add lines 17 through 25.........	78,172,900	26	80,527,360
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	103,381,511	27	125,530,053
28	Temporarily restricted net assets ...........	12,110,181	28	13,131,080
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	115,491,692	33	138,661,133
34	Total liabilities and net assets/fund balances ........	193,664,592	34	219,188,493

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
11	Total support Add lines 7 through 10.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization Protestant Memorial Medical Center Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization Protestant Memorial Medical Center Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(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) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

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

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

88,570

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

88,570

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

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

Part IV

Supplemental Information

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1I	PROTESTANT MEMORIAL MEDICAL CENTER, INC. PAID MEMBERSHIP DUES TO ILINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THESE ORGANIZATIONS ESTIMATED EXPENSES ALLOCATED TO LOBBYING ACTIVITIES TO BE 39.5% OF MEMBERSHIP DUES. PROTESTANT MEMORIAL MEDICAL CENTER, INC. ENGAGED AND PAID KANE CONSULTING $48,000 TO ASSIST MEMORIAL HOSPITAL WORKING WITH THE ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES (DHFS) ON THE MEDICAL CENTER'S MEDICAID REIMBURSEMENTS.

Return Reference

Explanation

PART II-B, LINE 1I

PROTESTANT MEMORIAL MEDICAL CENTER, INC. PAID MEMBERSHIP DUES TO ILINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THESE ORGANIZATIONS ESTIMATED EXPENSES ALLOCATED TO LOBBYING ACTIVITIES TO BE 39.5% OF MEMBERSHIP DUES. PROTESTANT MEMORIAL MEDICAL CENTER, INC. ENGAGED AND PAID KANE CONSULTING $48,000 TO ASSIST MEMORIAL HOSPITAL WORKING WITH THE ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES (DHFS) ON THE MEDICAL CENTER'S MEDICAID REIMBURSEMENTS.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

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 value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No

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


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	1,486,451		1,486,451
b	Buildings ................	37,670,663	30,779,881	6,890,782
c	Leasehold improvements ............	5,097,425	3,985,294	1,112,131
d	Equipment ................	191,416,169	140,876,663	50,539,506
e	Other .................	872,924		872,924
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				60,901,794

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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
(1) NET ASSETS OF MEMORIAL FOUNDAT	13,131,080	F








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	13,131,080

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
(1) AUXILIARY OTHER ASSETS				151,498
(2) DUE FROM AFFILIATED CORPS				13,093,974
(3) DUE FROM INSURANCE AFFILIATE				17,172,629






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				30,418,101

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		0
ESTIMATED PROFESSIONAL LIABILI		17,172,629








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		17,172,629
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) 2014

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	262,404,076
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-425,764
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	287,331
e	Add lines 2a through 2d .....................			2e	-138,433
3	Subtract line 2e from line 1.....................			3	262,542,509
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	262,542,509

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	242,285,977
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	2,945,091
e	Add lines 2a through 2d......................			2e	2,945,091
3	Subtract line 2e from line 1.....................			3	239,340,886
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	239,340,886

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	SCHEDULE D, PART V HAS NOT BEEN COMPLETED. THE ORGANIZATION ONLY REPORTS SUCH FUNDS ON THE BALANCE SHEET DUE TO AN AUDIT REQUIREMENT THAT THE INTEREST IN A RELATED FOUNDATION BE RECOGNIZED ON THE BOOKS. THE FUNDS HAVE BEEN ANALYZED ON FORM 990 OF MEMORIAL FOUNDATION, INC. (EIN#37-1186034).
PART X, LINE 2-FIN 48	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
PART XI, LINE 2D	$287,331 OF INVESTMENT INCOME OF MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND (EIN#37-1064809), A RELATED 501(C)(3) ORGANIZATION IS INCLUDED ON THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC.
PART XII, LINE 2D	$219,181 OF EXPENSES OF MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND (EIN#37-1064809), A RELATED 501(C)(3) ORGANIZATION ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. $2,725,910 OF INSURANCE EXPENSES ON THE AUDITED FINANCIAL STATEMENTS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. ARE INCLUDED IN OTHER CHANGES IN NET ASSETS ON THIS FORM 990 PART XI LINE 9 AND REPRESENT AN INSURANCE RELATIONSHIP WITH MEMORIAL CAPTIVE INSURANCE COMPANY (EIN#98-1082415), A RELATED ORGANIZATION.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other 249 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	2,521,442		2,521,442	1.050 %
b	Medicaid (from Worksheet 3, column a) ....	29,628,737	19,334,047	10,294,690	4.300 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	32,150,179	19,334,047	12,816,132	5.350 %
Other Benefits		1,260,615		1,260,615	0.530 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	1,260,615		1,260,615	0.530 %
f	Health professions education (from Worksheet 5) ..
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	271,944		271,944	0.110 %
j	Total. Other Benefits ..	1,532,559		1,532,559	0.640 %
k	Total. Add lines 7d and 7j .	33,682,738	19,334,047	14,348,691	5.990 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

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

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

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

11,276,742

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

1,691,511

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

Section B. Medicare

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

86,531,071

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

95,958,249

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

-9,427,178

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	MEMORIAL HOSPITAL 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 WWW.MEMHOSP.COM 0001461	X	X	X

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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

Yes

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

Hospital facility’s website (list url): SEE SCHEDULE H, PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): SEE SCHEDULE H, PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 249.%
and FPG family income limit for eligibility for discounted care of 350.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): X

The FAP application form was widely available on a website (list url): X

A plain language summary of the FAP was widely available on a website (list url):
X

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5	PERSONS WHO REPRESENT THE COMMUNITY THE MAPP ASSESSMENT TEAMS CONDUCTED A COMPREHENSIVE ASSESSMENT OF THE ENTIRE POPULATION THROUGH THE USE OF COMMUNITY SURVEYS, A REVIEW OF POPULATION TRENDS, HEALTH OUTCOMES AND BEHAVIORS OVER THE LAST 5 YEARS. SECONDARY ASSESSMENTS OCCURRED AMONG KEY INFORMANTS AND FOCUS GROUPS FOR SELECT SEGMENTS OF THE POPULATION REPRESENTED BY PARTICIPATING HEALTH AND HUMAN SERVICE ORGANIZATIONS (I.E. THE HOMEBOUND ELDERLY, PERSONS WITH DISABILITIES, SENIOR CITIZENS, RESIDENTS OF COUNTY HOUSING AUTHORITIES, THE FAITH COMMUNITY, HEALTH ADVOCACY GROUPS, MEDICALLY MANAGED INDIVIDUALS AND THOSE PERSON WITH SERIOUS MENTAL ILLNESS). SEE COMMUNITY HEALTH NEEDS ASSESSMENT FOR LISTING OF HEALTHCARE COMMISSION MEMBERS AND AFFILIATES CONSULTED.
PART V, SECTION B, LINE 7, 10, 11	CHNA MADE WIDELY AVAILABLE THE HOSPITAL FACILITY POSTS THE CHNA, ALONG WITH ITS IMPLEMENTATION STRATEGY AT THE FOLLOWING SITE: http://memhosp.com.jtsite.com/media/uploads/Patient-Visitor/community_heal th_needs_assessment_2012.pdf THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA AND HOW THEY ARE BEING MET ARE DESCRIBED IN THE IMPLEMENTATION STRATEGY. THE ORGANIZATION DOES NOT HAVE ANY IDENTIFIED NEEDS THAT ARE NOT BEING ADDRESSED.
PART V, SECTION B, LINE 22D	ATTACHMENT A TO THE FINANCIAL ASSISTANCE POLICY DESCRIBED IN THE NOTE FOR PART I, LINE 3, AND THE UNINSURED DISCOUNT POLICY FOUND IN PART VI, PROVIDE THE FACTORS FOR DETERMINING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE PATIENTS.
PART V, SECTION B, LINES 16A-C	ACCESS THE FOLLOWING WEBSITE FOR THE THREE QUESTIONS LISTED ABOVE: HTTP://MEMHOSP.COM.JTSITE.COM/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	MEMORIAL CARE CENTER 4315 MEMORIAL DRIVE BELLEVILLE,IL62226	SKILLED NURSING FACILITY
2	BELLEVILLE HEALTH & SPORTS CENTER 1001 SOUTH 74TH STREET BELLEVILLE,IL62223	SPORTS FACILITY
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2014

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C	FINANCIAL ASSISTANCE (CHARITY CARE) I. PURPOSE To describe the guidelines and process by which Memorial will grant charity care to patients. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. Individuals who need financial assistance and do not possess sufficient resources to pay all or a portion of Memorial's bill may be eligible for charity care according to the guidelines set forth in this policy. Charity care is available for all services provided by Memorial with the exception of the following: 1. Elective cosmetic surgery, elective sterilization and reverse sterilization procedures and screening tests 2. Any services not covered by Medicare. 3. Memorial Care Center services for long-term residential care. 4. Services not billed by Memorial (e.g., ambulance services, physician services, etc.) Patients who do not qualify for assistance pursuant to this policy may be eligible for discounts pursuant to AP 740 (Uninsured Patient Discount Policy). III. GUIDELINES 1. Eligibility for financial assistance will be based upon income guidelines approved by the Board of Directors, as well as the size of the patient's bill relative to the patient's household income. A. Eligibility based on income. Eligibility for financial assistance will be based upon income guidelines approved by the Memorial Board of Directors, based on federal poverty guidelines published by the United States Department of Health & Human Services ("Income Eligibility"). The Income Eligibility Guidelines, as amended from time to time by the Board of Directors, are set forth in Attachment A to this policy. B. Eligibility based on catastrophic medical expenses. Eligibility for financial assistance also will be based on the size of the patient's bill relative to the patient's household income. Payment responsibility for patients qualifying for Income Eligibility will be capped at ten percent (10%) of annual family income, as determined in the application process. Uninsured patients who face extraordinary medical expenses and who do not qualify for charity care based on Income Eligibility will qualify for financial assistance if their self-pay balances exceed ten percent (10%) of annual family income ("Medical Expense Eligibility"). Patients eligible on the basis of Medical Expense Eligibility will be responsible for the portion of the self-pay balance up to 10% of annual family income. Charity care will be granted to cover the excess amount. C. Eligibility based on Presumptive Mandated Categories. Eligibility for financial assistance also will be based on the following presumptive categories: Homelessness; deceased with no estate; mental incapacitation with no one to act on behalf; Medicaid eligibility, but not covered on date of service or non-covered service; Women, Infants, Children (WIC); Supplemental Nutrition Assistance Program (SNAP); Free Lunch and Breakfast Program; Low Income Home Energy Assistance Program (LIHEAP); Grant assistance for medical services; and Community medical care programs to low income. 2. Memorial will identify patients requiring financial assistance either prior to or and at any time during the billing and collection process. Memorial's Point of Service program will help to identify patients qualifying for financial assistance prior to service. Patients in the presumptive mandated categories may also be identified as eligible prior to receiving services. In addition, circumstances relating to a patient's (or a responsible party's) ability to pay may change subsequent to the rendering of medical services. Accordingly, a charity care determination can be made for a patient prior to, at the time of service or at any time during the billing and collection process. 3. The availability of charity care will be communicated to patients through a variety of means to ensure that Memorial's policy reaches persons in need of assistance. Communications to patients regarding the availability of charity care will be clear and concise and will include, but not be limited to, information provided by registration personnel, statements included on consent forms and patient statements, patient handbooks, signage within the hospital and publication on Memorial's website. Copies of Memorial's Application for Financial Assistance form ("Application Form") will be available for distribution in the Patient Access & Financial Services Department. Recognizing the sensitivity of patients and their families regarding the need for charity, all publications, forms, etc. will use the term "financial assistance" in lieu of "charity care" or "charity assistance." 4. Patients' specific questions about financial assistance should be directed to the Revenue Cycle Director or his/her designee. 5. All patients seeking financial assistance will be requested to complete an Application Form except for the patients in the presumptive financial categories (see section III Ic). Each patient or a patient representative will be requested to complete the Application Form in order for Memorial to determine eligibility for financial assistance on the basis of either Income Eligibility or Medical Expense Eligibility, provided that patients who demonstrate eligibility for any of the presumptive financial categories will be deemed eligible for charity assistance without an Application Form. It is the responsibility of the person seeking assistance to provide Memorial with sufficient and complete financial information to evaluate any request for charity care. Memorial personnel are available to assist with completion of the Application Form by telephone or in person. If translation is needed to facilitate completion of applications, it will be provided. Confidentiality of information and preservation of privacy shall be maintained for all patients who seek charity care. No information obtained in the application process will be released to third parties without the patient's written consent. 6. The patient or responsible party must apply to any local, state or federal government program for which the patient may be eligible for medical payment assistance when applicable. Memorial personnel will assist the patient or responsible party in the completion of any required application(s). A government application form may be substituted for the Application Form. 7. Any insurance benefit or third party obligation that is available for covering the cost of Memorial's services must be considered prior to the determination of charity care. This includes any medical liability, no-fault or insurance benefits. Memorial reserves the right to recover any amount previously approved for charity care that is subsequently paid by such insurance benefit or third party. 8. Memorial may consider the availability of liquid assets in determining charity care. In determining whether a patient qualifies for charity care, Memorial may also consider the extent to which the person has liquid assets (cash and investments) that could be used to meet the financial obligation. The patient's primary residence, automobile, pension assets and other personal property are specifically exempted from consideration in the determination of financial need. 9. A determination of the patient's eligibility for charity care will be made within fifteen (15) business days from the receipt of a completed Application Form, and collection efforts will be suspended pending such determination and otherwise in compliance with AP 730 (Billing and Collections Policy). Patients will be notified in writing of Memorial's decision to grant or to deny financial assistance. Charity care will be extended for any open account at the time of application and may continue for a period of six (6) months unless a change in patient financial status is determined. 10. Memorial offers payment plan options to patients eligible for charity care to successfully retire self-pay balances. Charity care patients are offered interest free payment plans to assist them in retiring their outstanding hospital bills. 11. Memorial will offer patients the opportunity to apply for charity care prior to referring an outstanding hospital bill to collection. Memorial will offer to conduct a financial assessment or will arrange for an alternative payment plan prior to sending a bill to collection. (Refer to AP 730 Billing and Collections Policy). 12. Memorial will train its Patient Access and Financial Services Department staff with regard to the availability of financial assistance under this policy. 13. Memorial will periodically evaluate its charity care program and will file annual reports as appropriate. Management will make periodic reports to the Board of Directors regarding charity care. This policy will be reviewed periodically by senior managers for possible revision. Any revisions recommended by management will be submitted to the Board of Direct
PART I, LINE 6A	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT FILED WITH ILLINOIS OFFICE OF ATTORNEY GENERAL PREPARED BY PMMCI
PART I, LINE 7, COLUMN (F)	THE COST OF CHARITY AND OTHER COMMUNITY BENEFITS WERE DIVIDED BY ORGANIZATION'S TOTAL OPERATING EXPENSES, WHICH DID NOT INCLUDE BAD DEBT EXPENSE.
PART I, LINE 7	CHARITY CARE AND OTHER COMMUNITY BENEFITS WERE CALCULATED IN ACCORDANCE WITH STATE OF ILLINOIS REQUIREMENTS FOR COMMUNITY BENEFITS REPORT. THE MEDICARE COST TO CHARGE RATIO WAS USED FROM THE MEDICARE COST REPORT.
PART III, LINE 4	THE AMOUNT ON LINE 2 REPRESENTS THE AMOUNT WRITTEN OFF TO BAD DEBT EXPENSE DURING 2014. THE ORGANIZATION DID NOT EMPLOY A METHODOLOGY TO ITS ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE AS THERE ARE NO SUPPORTING STATISTICS AVAILABLE. RATHER, THE AMOUNT INCLUDED ON LINE 3 REPRESENTS AN ESTIMATED 15% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2. FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS: "ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."
PART III, LINE 8	MEDICARE COST REPORT IS FILED FOLLOWING COST REPORT GUIDELINES. MEDICARE PAYMENT SHORTFALLS SHOULD BE REFLECTED AS COMMUNITY BENEFIT AS THE FEDERAL GOVERNMENT PROSPECTIVELY SETS THE HOSPITAL PAYMENT RATES; THE RATES ARE NOT NEGOTIABLE AND CONSEQUENTLY NO LONGER COVER THE HOSPITAL'S COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES.
PART III, LINE 9B	BILLING AND COLLECTIONS I. PURPOSE To insure billing and collection efforts are fair, consistent and in accordance with applicable law. II. POLICY Memorial Hospital and Memorial Care Center (collectively, "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. Accordingly, Memorial shall pursue patient accounts fairly and consistently pursuant to the law and only after offering patients the opportunity to apply for charity care pursuant to AP 700 ("Financial Assistance Policy") and/or applying a discount pursuant to AP 740 ("Uninsured Patient Discount Policy"). III. GUIDELINES 1. Bill Information. When Memorial bills a patient for health care services, it shall provide the following information: (a) the date or dates that health care services were provided to the patient; (b) a brief description of the services; (c) the amount owed for services; (d) contact information for addressing billing inquiries to Memorial; (e) notice that the patient may obtain an itemized bill upon request; and (f) a statement regarding how an uninsured patient may apply for consideration under the Financial Assistance Policy on or with each Memorial bill sent to an uninsured patient. 2. Bill Inquiries. Memorial will provide patients with a telephone number to inquire about or dispute a bill. Memorial will return calls made by patients promptly, and in any case no later than two business days after receipt. If Memorial receives correspondence from the patient regarding a bill, Memorial will respond within ten business days of receipt. 3. Collections; Limitation on Collections. (a) In General. Memorial and its agents will not pursue a collection action against a patient until the patient has had the opportunity to assess the accuracy of the bill and apply for financial assistance under the Financial Assistance Policy or establish a reasonable payment plan under the Financial Assistance Policy or this policy. (b) Approval of Collection Actions. Memorial will not refer an account to collections, and will not permit any collection agency, law firm or individual to initiate legal action for non-payment of a hospital bill against a patient, without the written approval of the Revenue Cycle Director or his/her designee. Such action will only be approved if it is reasonably believed that the conditions for pursuing the action under this Policy are met. (c) Special Considerations for Uninsured Patients. An uninsured patient will have sixty days following the date of discharge or receipt of care or thirty days following the initial bill (whichever is longer) to submit an application for financial assistance or to request a reasonable payment plan. Thereafter, Memorial may pursue collection action against an uninsured patient only when: (i) the patient has not paid his or her bill (as adjusted pursuant to the Uninsured Patient Discount Policy) during such time and has not contacted Memorial about payment; (ii) the patient has informed Memorial that he or she has applied for a government sponsored healthcare program but the patient's application has been denied; (iii) the patient has agreed to a reasonable payment plan with Memorial and the patient has failed to make payments in accordance with that reasonable payment plan; or (iv) the patient requests a reasonable payment plan but fails to agree to a plan within thirty days of that request. (d) Other Considerations. (i) Memorial will not pursue legal action for non-payment of bills against patients who qualify for financial assistance and who have clearly demonstrated that they have neither sufficient income nor assets to meet their financial obligation. (ii) Legal action may be taken by Memorial to enforce the terms of the payment plan when there is evidence that the responsible party has sufficient income and/or assets to meet his or her financial obligation. (iii) Memorial will not place a lien on the primary residence of a patient receiving financial assistance unless the value of the property clearly indicates an ability to assume significant financial obligations. Further, Memorial will not execute a lien by forcing the sale or foreclosure of the primary residence of a patient receiving financial assistance to pay for an outstanding medical bill. (iv) Memorial will not use body attachment to require any person, whether receiving financial assistance or not, to appear in court. (e) Adoption of Standards by Collection Agencies. Memorial will ensure that the guidelines outlined above are adhered to by any external collection agency, law firm or individual engaged to assist in obtaining payment on outstanding bills from patients. 4. Periodic Review. Memorial will review this policy periodically for compliance with the federal Fair Debt Collection Practices Act, the Illinois Fair Patient Billing Act and the Illinois Hospital Uninsured Patient Discount Act.
PART V	1 HOSPITAL & 1 SKILLED NURSING FACILITY ILLINOIS
NEEDS ASSESSMENT	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT REGARDING COMMUNITY NEEDS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	FINANCIAL ASSISTANCE IS COMMUNICATED VIA SIGNS POSTED THROUGHOUT THE HOSPITAL, NEWSPAPER, BROCHURES, WEBSITE, AND PATIENT BILLING STATEMENTS.
COMMUNITY INFORMATION	SEE SCHEDULE O - COMMUNITY BENEFIT REPORT FOR DESCRIPTION OF THE GEOGRAPHIC AND DEMOGRAPHIC PROFILES OF PATIENTS SERVED.
PROMOTION OF COMMUNITY HEALTH	SEE SCHEDULE O - COMMUNITY BENEFIT REPORT REGARDING SUBSIDIZED COMMUNITY OUTREACH, COMMUNITY EDUCATION, SUPPORT GROUPS AND SCREENINGS
OTHER INFORMATION REQUIRED	SEE SCHEDULE O - COMMUNITY BENEFITS REPORT FOR A DESCRIPTION OF ACTIVITIES THAT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. ADDITIONALLY, THE FOLLOWING IS THE UNINSURED PATIENT DISCOUNT POLICY: UNINSURED PATIENT DISCOUNT I. PURPOSE To describe the guidelines and process by which Memorial will grant uninsured patients a discount from billed charges. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. In an effort to provide affordable health care services, patients who lack private or public health insurance will receive an automatic discount from Memorial's billed charges. Memorial will discuss financial responsibility with patients prior to services being provided pursuant to the Point of Service Policy (AP 750). The uninsured patient discount is available for all services provided by Memorial with the exception of the following: 1. Elective cosmetic surgery, elective sterilization and reverse sterilization procedures and procedures or other services not covered by Medicare. 2. Memorial Care Center services for long-term residential care. 3. Non-medical services (e.g., social and vocational services). 4. Services not billed by Memorial (e.g., ambulance services, physician services etc.) This policy will be interpreted and applied in a manner consistent with the Illinois Hospital Uninsured Patient Discount Act. III. GUIDELINES 1. Eligibility for the discount. An "uninsured patient" is defined as: Any patient who is not covered under a policy of health insurance and is not a beneficiary under a public or private health insurance, health benefit, or other health coverage program, including high deductible health insurance plans, workers' compensation, accident liability insurance or other third party liability or no fault insurance. Patients that are insured but not covered for a particular service do not qualify for the uninsured patient discount. The availability of the uninsured discount is contingent upon the uninsured patient applying, at Memorial's request, for coverage under public programs (i.e., Medicare, Medicaid, etc.) if Memorial determines there is a basis to believe the patient may be eligible for such programs. 2. Calculation of the discount. The discount is calculated as the difference between billed charges and one hundred thirty-five percent (135%) of cost, using the total cost-to-charge ratio from Memorial's most recently filed Medicare cost report (Worksheet C, Part I). 3. Maximum annual collection. The maximum amount collected from an eligible patient in a twelve-month period is twenty-five percent (25%) of the family's annual household income. The twelve-month period begins as of the first date of service eligible for discount. For subsequent services to be counted toward the maximum, the patient must inform Memorial that he/she had received prior discounted services from Memorial. The annual cap is applicable only to services provided at Memorial and does not include services provided at other hospital facilities. 4. Communication to Patients. Memorial will include a statement on all patient bills that financial assistance may be available on the remaining account balance, pursuant to AP 700 (Financial Assistance Policy). POINT OF SERVICE I. PURPOSE To describe the guidelines and process by which Memorial will collect patient payments prior to service. II. POLICY Memorial Hospital and Memorial Care Center (collectively "Memorial") are not-for-profit healthcare facilities established to meet the health care needs of the community. As healthcare continues to evolve it is necessary to educate patients regarding their financial liability prior to service. Discussing financial responsibility before service is provided will improve the patient experience as well as increase revenue and reduce costs for the organization. III. GUIDELINES 1. Patient responsibility will be determined using payment estimation software or communication (online or phone call) to the patient's benefit administrator. 2. Guidelines for the payment of the patient's responsibility are based on estimated amount due. a. All patients will be asked to pay 100% of estimated balance due. b. Patients that pay their total estimated amount due prior to service being rendered will receive a 10% prompt pay discount. c. Patients with an estimated balance due of $100.00 or less and who do not pay 100% will be asked to establish a payment plan of at least $25.00 per month until the balance is paid in full. d. Patients whose estimated balance due is more than $100.00 and who cannot pay 100% will be asked to pay 50% with an automated payment plan for the remaining balance not to exceed 12 months. e. Patients whose estimated balance due is more than $100.00 and who cannot pay 100% or 50% will set up an automated payment plan for the entire estimated balance not to exceed 12 months. 3. Patients will be offered payment options of cash, check, credit/debit card, or electronic funds transfer. 4. Patients will be pre-screened for financial assistance based on information they provide to staff regarding income and presumptive eligibility per Financial Assistance Charity Care Policy (AP700). 5. Uninsured patients will receive up-front estimates of patient liability per Uninsured Patient Discount Policy (AP 740). 6. Patients that refuse to either pay their estimated balance or fail to cooperate in establishing a payment plan within the above guidelines will be notified that their test may be postponed. a. An exception to postponement will be made if the ordering physician determines that a delay in testing would be harmful to the patient's health. b. Emergency services will not be delayed based on a patient's ability to pay. 7. Patients will be billed per the collection guidelines included in the Billing and Collections Policy (AP 730). 8. If the actual patient responsibility is less than the original estimate the patient paid, the patient will be refunded if there are no other outstanding accounts. Otherwise, the credit will be applied towards any outstanding balance(s).
STATE FILING OF COMMUNITY BENEFIT REPORT	IL,

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

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

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2014

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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MARK TURNERPRESIDENT	(i) (ii)	526,546 ............................... 0	0 ............................... 0	17,500 ............................... 0	117,420 ............................... 0	19,904 ............................... 0	681,370 ............................... 0	0 ............................... 0
2JOE LANIUSVP FINANCE	(i) (ii)	0 ............................... 292,894	0 ............................... 0	0 ............................... 17,500	0 ............................... 29,320	0 ............................... 16,166	0 ............................... 355,880	0 ............................... 0
3NANCY WESTONVP NURSING SERVICES	(i) (ii)	308,736 ............................... 0	0 ............................... 0	17,500 ............................... 0	24,610 ............................... 0	10,770 ............................... 0	361,616 ............................... 0	0 ............................... 0
4RUTH HOLMESADMINISTRATOR MEMORIAL EAST	(i) (ii)	0 ............................... 195,368	0 ............................... 0	0 ............................... 6,844	0 ............................... 14,837	0 ............................... 18,831	0 ............................... 235,880	0 ............................... 0
5ROBERT WANLESS MDDIRECTOR	(i) (ii)	0 ............................... 283,999	0 ............................... 0	0 ............................... 4,125	0 ............................... 11,407	0 ............................... 14,819	0 ............................... 314,350	0 ............................... 0
6CHERYL CREASYVP RISK MANAGEMENT	(i) (ii)	139,461 ............................... 0	0 ............................... 0	5,644 ............................... 0	9,819 ............................... 0	18,605 ............................... 0	173,529 ............................... 0	0 ............................... 0
7JAMES DAVISVP PHYSICIAN SERVICES	(i) (ii)	0 ............................... 170,390	0 ............................... 0	0 ............................... 8,977	0 ............................... 14,266	0 ............................... 16,947	0 ............................... 210,580	0 ............................... 0
8WILLIAM CASPERSON MDVP MEDICAL AFFAIRS	(i) (ii)	311,874 ............................... 0	0 ............................... 0	17,500 ............................... 0	47,046 ............................... 0	13,993 ............................... 0	390,413 ............................... 0	0 ............................... 0
9LINDA FRITSCHETELEMETRY NURSE	(i) (ii)	135,115 ............................... 0	0 ............................... 0	0 ............................... 0	4,073 ............................... 0	15,633 ............................... 0	154,821 ............................... 0	0 ............................... 0
10MARIA GHORMLEYEMERGENCY NURSE	(i) (ii)	149,525 ............................... 0	0 ............................... 0	0 ............................... 0	3,684 ............................... 0	12,679 ............................... 0	165,888 ............................... 0	0 ............................... 0
11AMY THOMASVICE PRESIDENT FINANCE	(i) (ii)	186,090 ............................... 0	0 ............................... 0	17,500 ............................... 0	16,504 ............................... 0	16,722 ............................... 0	236,816 ............................... 0	0 ............................... 0
12JOHN ZIEGLERVP HUMAN RESOURCES	(i) (ii)	165,219 ............................... 0	0 ............................... 0	17,500 ............................... 0	13,030 ............................... 0	18,643 ............................... 0	214,392 ............................... 0	0 ............................... 0
13STARLA ELLERDIRECTOR SURGICAL SERVICES	(i) (ii)	180,855 ............................... 0	0 ............................... 0	0 ............................... 0	9,584 ............................... 0	7,900 ............................... 0	198,339 ............................... 0	0 ............................... 0
14JENNIFER MEINKOTHDIRECTOR INFORMATION TECHNOLOG	(i) (ii)	189,817 ............................... 0	0 ............................... 0	0 ............................... 0	10,612 ............................... 0	16,684 ............................... 0	217,113 ............................... 0	0 ............................... 0
15MICHAEL MCMANUSCHIEF OPERATING OFFICER	(i) (ii)	261,923 ............................... 0	0 ............................... 0	17,500 ............................... 0	19,736 ............................... 0	20,872 ............................... 0	320,031 ............................... 0	0 ............................... 0
16GLEN KOHNZDIRECTOR PHARMACY	(i) (ii)	145,727 ............................... 0	0 ............................... 0	0 ............................... 0	7,046 ............................... 0	7,900 ............................... 0	160,673 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

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 II, 4B

DEFERRED COMPENSATION AND RETIREMENT CONTRIBUTIONS PER PART II(C): ROBERT WANLESS, DIRECTOR: RETIREMENT CONTRIBUTION - $11,407 DEFERRED COMPENSATION - NONE MARK TURNER, PRESIDENT: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $101,300 JOE H. LANIUS, VICE PRESIDENT FINANCE: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $13,200 CHERYL CREASY, VICE PRESIDENT RISK MANAGEMENT: RETIREMENT CONTRIBUTION - $6,996 DEFERRED COMPENSATION - $2,823 WILLIAM CASPERSON, VICE PRESIDENT MEDICAL AFFAIRS: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $30,926 NANCY WESTON, VICE PRESIDENT NURSING SERVICES: RETIREMENT CONTRIBUTION - $13,634 DEFERRED COMPENSATION - $10,976 RUTH HOLMES, ADMINISTRATOR MEMORIAL EAST: RETIREMENT CONTRIBUTION - $11,414 DEFERRED COMPENSATION - $3,423 JAMES DAVIS, VICE PRESIDENT PHYSICIAN SERVICES: RETIREMENT CONTRIBUTION - $9,776 DEFERRED COMPENSATION - $4,490 AMY THOMAS, VICE PRESIDENT FINANCE: RETIREMENT CONTRIBUTION - $10,607 DEFERRED COMPENSATION - $5,897 JOHN ZIEGLER, VICE PRESIDENT HUMAN RESOURCES: RETIREMENT CONTRIBUTION - $10,546 DEFERRED COMPENSATION - $2,484 MICHAEL MCMANUS, CHIEF OPERATING OFFICER: RETIREMENT CONTRIBUTION - $16,120 DEFERRED COMPENSATION - $3,616 JENNIFER MEINKOTH, DIRECTOR INFORMATION TECHNOLOGY: RETIREMENT CONTRIBUTION - $10,612 DEFERRED COMPENSATION - NONE LINDA FRITSCHE, TELEMETRY NURSE: RETIREMENT CONTRIBUTION - $4,073 DEFERRED COMPENSATION - NONE STARLA ELLER, DIRECTOR SURGICAL SERVICES: RETIREMENT CONTRIBUTION - $9,584 DEFERRED COMPENSATION - NONE MARIA GHORMLEY, EMERGENCY NURSE: RETIREMENT CONTRIBUTION - $3,684 DEFERRED COMPENSATION - NONE GLEN KOHNZ, DIRECTOR PHARMACY RETIREMENT CONTRIBUTION - $7,046 DEFERRED COMPENSATION - $0

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Protestant Memorial Medical Center Inc

Employer identification number
37-0635502

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	SOUTHWEST ILLINOIS DEVELOPMENT AUTH	37-1234684	84553AAE2	12-06-2013	156,712,718	CAPITAL BUILDING PROJECTS		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	0
2 Amount of bonds legally defeased . . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . . .	15,586,237
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0
5 Capitalized interest from proceeds . . . . . . . . . . .	0
6 Proceeds in refunding escrows . . . . . . . . . . . .	114,474
7 Issuance costs from proceeds . . . . . . . . . . . .	0
8 Credit enhancement from proceeds . . . . . . . . . . .	0
9 Working capital expenditures from proceeds . . . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . . .	0
11 Other spent proceeds . . . . . . . . . . . . . .	15,471,763
12 Other unspent proceeds . . . . . . . . . . . . . .	0
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

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

Cat. No. 50193E

Schedule K (Form 990) 2014

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
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		X
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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X
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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X
b Exception to rebate? . . . . . . . .
c No rebate due? . . . . . . . .
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .	0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

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
b Name of provider . . . . . . . . .	0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	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

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
SCHEDULE K, PART II	ON DECEMBER 6, 2013, SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY ISSUED TO MEMORIAL GROUP, INC. REVENUE BONDS IN THE ORIGINAL PAR AMOUNT OF $156,712,718. OF THE TOTAL INDEBTEDNESS, $15,586,237 WAS ALLOCATED TO PROTESTANT MEMORIAL MEDICAL CENTER, INC. AND $16,763,777 WAS ALLOCATED TO SOUTHWEST ILLINOIS HEALTH VENTURES, INC. MEMORIAL GROUP, INC. WAS ALLOCATED $124,362,704.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

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

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefiting 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) 2014

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SUSAN MCMANUS	COO FAMILY MEMBER	38,605	EMPLOYMENT		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) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ 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

2014

Open to Public
Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

Return Reference	Explanation
FORM 990, PART 1, LINE 1	BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES: PROTESTANT MEMORIAL MEDICAL CENTER OPERATES AN ACUTE CARE HOSPITAL AND SKILLED NURSING FACILITY WHOSE MISSION IS TO PROVIDE EXCEPTIONAL HEALTHCARE AND COMPASSIONATE SERVICE TO THE RESIDENTS OF SOUTHWEST ILLINOIS.
COMMUNITY BENEFIT INFORMATION	I. SUMMARY The value of community benefits provided by Memorial Hospital during 2014 exceeded $35.0 million. Community Benefit Value ------------------------- Unpaid Costs of Medicaid and Medicare $19,721,868 Bad Debts 11,276,742 Charity Care 2,521,442 Volunteer Services 421,203 Subsidized Health Services 133,762 Education 652,063 Donations 271,944 Language Assistant Services 43,007 Other Community Activities 10,580 Total Community Benefits for 2014 $35,052,591 In 2015 Memorial Hospital will continue to provide a comprehensive range of quality healthcare services to residents of the communities it serves throughout Southwestern Illinois, continue its charity care assistance program, and improve communication with community partners and patients regarding the health resources and patient care. II. MISSION STATEMENT Provide exceptional healthcare and compassionate service. III. VISION STATEMENT Memorial, in partnership with its medical staff, employees, volunteers, and the community, is committed to being the healthcare provider of choice by: -Delivering extraordinary care and compassionate service to patients every day -Continually identifying performance improvement opportunities -Expanding services based on community need and enhancing accessibility to care -Providing physical facilities and acquiring the advanced technology to exceed patient and physician expectations -Being the employer of choice, continuing to recruit and retain skilled staff committed to providing service excellence to patients, visitors, and co-workers IV. COMMUNITY BENEFITS PROVIDED IN 2014 During 2014 Memorial provided the following community outreach services to area residents at no or minimal cost:
COMMUNITY BENEFIT INFORMATION (CONT)	Service Persons Served ------------------------------ ---------------- 1. Community Health Education -Smart Driver Program 39 -Healthy Conversation-Heart Health 15 -Healthy Conversation-Fabulous and Fit Over 50 10 2. Wellness Programs -Healthy Lifesyle 53 -Lively Lungs Participants 112 -Cardiac Wellness/Rehab Program 9,721 -Belleville East Health Education Club 200 -Parish Nurses 15 3. Speakers Bureau (Topics) -Nutrition (Benefits of Healthy Eating) 407 -Pharmacy Participants -Cardiac Rehabilitation in -Heart Health Speakers -Obstetrics Bureau -Heat Related Issues-Signs,Symptoms,Prevention -Dehydration and Heat Exhaustion -Health, Wellness, and Faith -Breast Health -Diabetes Education -Pain Management -EPI Pen Training -Belleville Health and Sports Center -CPR -Cancer Awareness and Prevention 4. Clinics, Screenings, and Services -Diabetes Alert Day 50 -Kidney Mobile 30 -Skin Cancer Screening at Memorial Hospital 109 -Skin Cancer Screening at St. Clair County Office 40 -Stress and Mediatation Class 20 Blood Drive Donations: -Memorial Blood Drives 309 -New Donors 26 5. Support Groups -Diabetes 161 -Pulmonary Rehab 350 -Mended Hearts 49 -Hope Blooms 67 -AWAKE 140 -Stroke 240 -Alzheimer's 144 -Heart Failure 60 -Spinal Cord Injury 180 6. Special Events and Partnerships -Healthy Kids Day at the YMCA 200 -Healthy Living Expo 250 -Mingle and Mammograms 56 -Salute to Scott 3,000 -Get Up and Go Biathlon 500 -Back Pack to School 500 -Maternity Fair 175 -Dominate Your Diabetes 100 -Zumba for Heart Health 50 -Zumba for Breast Cancer 50 -Making Strides Against Breast Cancer Kick-Off 50 -Day of Play at St. Clair Square 50 -Heart and Vascular Screenings 28 -East Belleville YMCA 120 -Passport to Wellness 150 -Law Day Run 200 -Mckendree Involvement Fair 1,000 Health Fairs and Screenings: -Belleville East High School (3) -Casino Queen (2) -Monroe County Employees -Collinsville Middle School -Madison County Government (2) -Allsup -Scott Air Force Base -American Legion O'Fallon -Atrium Senior Apartments -Signal Hill -Cedars of Lebanon -Hospice of Southern Illinois -New Antioch Baptist Church -Mckendree University -The National Shrine of Our Lady of the Snows -St. Nicholas Church-O'Fallon -Holy Trinity Catholic Church-Fairview Heights -Nick 5K Run -Dupo High School -Monroe County Electric -Zoar UCC-Waterloo, IL -Clergy Day -Freize Harley Davidson -O'Fallon Township High School -St. Teresa's School -St. Clair County Office of Aging -Fairview Heights VFW -SWIC -Bluffview Elementary School -City of O'Fallon -Metro East Air and Health Forum Healthy Direction (Wellness Vehicle) -Belleville East High School -Casino Queen -Madison County Government -Memorial Medical Group-Nashville, IL -Scout Event-Dupo, IL -Program and Services for Older Persons -MetroLink (2) -McKendree University -St. Teresa's Catholic Church -Plummer Johnson -Scott Credit Union -Memorial Medical Group-Columbia, IL -Beacon 5K -Monroe County YMCA -Village of Dupo -Cedarhurst-Shiloh, IL -Freeburg Township -St. Nicholas Catholic Church-O'Fallon, IL -Knollwood Retirement Center Screenings Provided Include: -Screening Mammography (Healthy Direction Wellness Vehicle) -Blood Pressure -BMI with Body Fat Percentage -Cholesterol/Glucose -Lipid panels -PSAs -Forced Vital Capacity -Pulse Oximetry -Colorectal Screenings -Skin Cancer Screening -Cardiac Risk Profiles Other -Heart Walk - Memorial and its employees participated in the American Heart Association Heart Walk and have been represented on various committees. -March of Dimes Walk America - Memorial has been a check point sponsor for this event the past several years and has had representation on its board via a nursery nurse. Memorial has been the host site for this event since 2009. -Making Strides Against Breast Cancer - Memorial has supported this event through sponsorship, participation, and other in-kind support. -American Diabetes Association Run/Walk - As a certified Center for Diabetic Education, Memorial served a major sponsor for this run/walk through participation and in-kind support. -Get Up & Go - Memorial Hospital supports the Get Up & Go initiative to promote health/wellness in St. Clair County as well as is a key supporter of its annual biathlon. TOTAL COMMUNITY BENEFITS Total community benefits, including outreach programs, totaled $35,052,591 during 2014. Below is a summary of these activities: 1. Unpaid costs of providing care to Medicaid and Medicare patients a. Target Populations - Medicaid and Medicare enrollees b. Objectives - Provide needed inpatient and outpatient services to the community. c. Costs and Outcomes - $19,721,868 2. Bad Debts a. Target Populations - Broad community b. Objectives - Provide needed inpatient and outpatient services to the community. c. Costs and Outcomes - $11,276,742 3. Charity Care a. Target Populations - Low income uninsured, underinsured residents b. Objectives - Provide medical services to patients unable to pay for care. c. Costs and Outcomes - $2,521,422 4. Volunteer Services a. Target Populations - Memorial patients, family, visitors and board community. b. Objectives - Promote employee and volunteer participation in community benefit activities. c. Community Partners - Various non-profit agencies d. Costs and Outcomes - $421,203 over 33,000 volunteer hours 5. Community Outreach: Education, Screenings, Support Groups, Self Help Program a. Target Populations - Broad community, the uninsured, low income residents, residents without a primary care physician. b. Objectives - Provide health and wellness, safety, early disease detection, disease maintenance/support c. Community Partners - Various local groups d. Costs and Outcomes - $133,762 6. Health Care Education a. Target Populations - Potential health care workers, scholarships, student training opportunities b. Objectives - Address workforce shortage with universities c. Community Partners - Area colleges and universities d. Costs and Outcomes - $652,063
COMMUNITY BENEFIT INFORMATION (CONT)	7. Cash and In Kind Donations a. Target Populations - Broad community, low income residents b. Objectives - provide funds, services, staff, equipment, supplies, space to support local agencies and community programs. c. Community Partners - Social service agencies, churches, schools, health care providers d. Costs and Outcome - $271,944 8. Language Assistant Services a. Target Populations - Non-English speaking residents b. Objectives - Provide communication assistants c. Community Partners - Social service agencies d. Costs and Outcome - $43,007 9. Other Community Benefits a. Costs and Outcomes - $10,580 IV. 2015 COMMUNITY BENEFIT PLAN This section describes the communities served by Memorial, the health needs identified, program goals and objectives for 2015, and program priorities. A. Populations and Communities Served by Memorial Hospital 1. 2014 Adult & Pediatric Inpatient Discharges by County of Residence County Number Percent of Total St. Clair 12,860 83.58% Madison 973 6.32 Monroe 333 2.16 Randolph 377 2.45 Clinton 279 1.81 Washington 181 1.18 Other 383 2.50 -------- --------- Total 15,386 100.0% 2. More than half of Memorial's inpatients reside in five cities: Belleville, O'Fallon, Fairview Heights, East St. Louis, and Cahokia. 2014 Adult & Pediatric Inpatient Discharges by Zip Code of Residents Zip Code City # of Discharges Percent of Total 62226 Belleville 1,969 12.4% 62221 Belleville 1,242 8.2 62223 Belleville 1,249 7.9 62269 O'Fallon 1,169 7.9 62208 Fairview Heights 898 6.1 62206 Cahokia 885 5.9 62220 Belleville 777 5.1 62205 East St. Louis 586 3.6 ------- ------ Total 8,775 57.1 62234 Collinsville 512 3.3 62203 East St. Louis 515 3.3 62232 Caseyville 493 3.2 ------- ------ Total 1,520 9.8 All Other 5,091 33.1 Total 15,386 100% 3. Medical and surgical patients account for 89.5 percent of Memorial's inpatients. 2014 Adult & Pediatric Inpatient Discharges by Clinical Service Service Type Number Percent of Total Medical 10,520 68.37% Surgery 3,259 21.18 Obstetrics 1,596 10.38 Pediatrics 5 0.03 Oral/Dental 6 0.04 ------- -------- Total 15,386 100.0% 4. Patients enrolled in government-sponsored healthcare programs account for 58% of Memorial's inpatients. Self-pay patients, from whom Memorial receives limited payment, account for 3% of admissions. 2014 Adult & Pediatric Discharges by Financial Class Financial Class Number Percent of Total Medicare 6,869 44.64% Medicaid 1,764 11.46 TRICARE 332 2.16 ------- ------- 8,965 58.26 Managed Care & Commercial 5,594 36.36 Self-pay 410 2.66 Other 417 2.72 ------- ------- Total 15,386 100.0% 5. Just over 50% percent of Memorial's inpatients are adults age 65 and over. 2014 Adult & Pediatric Inpatient Discharges by Age Group Age Group Number Percent of Total 0 - 14 7 0.04% 15 - 44 3,396 22.07 45 - 64 4,414 28.69 65 - 74 2,832 18.41 75+ 4,737 30.79 --------- --------- Total 15,386 100.0% 6. While adults comprise the majority of Emergency Department outpatient visits, children under 15 account for 15% of the visits. 2014 Emergency Department Visits by Age Group (Excludes Admitted Patients) Service Number Percent of Total 0 - 14 8,728 15.39% 15 - 44 27,747 48.93 45 - 64 12,616 22.25 65 - 74 3,290 5.80 75+ 4,323 7.63 --------- -------- Total 56,704 100.0% 7. Over 53% of Emergency Department outpatients are enrolled in government-sponsored programs while roughly 15% are self-pay. 2014 Emergency Department Visits by Financial Class (Excludes Admitted Patients) Financial Class Number Percent of Total Medicare 7,985 14.08% Medicaid 15,289 26.96 TRICARE 2,740 4.84 -------- --------- Total 26,014 45.88 Managed Care/ Commercial 24,765 43.67 Self-pay 5,236 9.23 Other 689 1.22 --------- -------- Total 56,704 100.0% In summary, the above data shows that Memorial primarily serves the residents of St. Clair County, particularly those living in Belleville and adjacent communities. Target populations within the county include the elderly, children, Medicare and Medicaid enrollees and the uninsured.
COMMUNITY BENEFIT INFORMATION (CONT)	B. Healthcare Needs Assessment 1. The following table below shows that St. Clair County ranks 86th in health outcomes among 102 counties in Illinois for the lowest health outcomes and health factors, moving up three places for last year's 89th ranking. Length of life dropped from 87 years to 80 in the latest rankings. Health Outcomes St Clair 2014 Illinois 2014 US 2014 1. Length of Life 8,341 6,349 5,200 -Premature Death- 2. Morbidity -Poor or Fair Health- 16% 15% 10% -Poor Physical Health 4.0 3.4 2.5 Days- -Poor Mental Health 3.5 3.3 2.3 Days- -Low Birthweight- 9.2% 8.4% 5.9% Health Factors: Health Behaviors -Adult Smoking- 22% 18% 14% -Adult Obesity- 31% 27% 25% -Food Environment Index- 5.9 7.8 8.4 -Physical Inactivity- 28% 23% 20% -Access to Exercise 82% 89% 92% Opportunities- -Excessive Drinking- 19% 20% 10% -Alcohol Impaired 41% 37% 14% Driving Deaths- -Teen Births- 48 35 20 -Sexually Transmitted Infection- 789 526 138 Clinical Care -Uninsured- 12% 15% 11% -Primary Care Physicians- 1,670:1 1,266:1 1,045:1 -Dentists- 1,517:1 1,453:1 1,377:1 -Mental Health Providers- 1,271:1 604:1 386:1 -Preventable Hospital Stays- 68 65 41 -Diabetic Screening- 82% 85% 90% -Mammography Screening- 61.8% 64.4% 70.7% Social and Economic Factors -High School Graduation- 81% 82% -Some College- 67.2% 66.7% 71% -Unemployment- 9.5% 9.2% 4.0% -Children In Poverty- 27% 21% 13% -Income inequality- 5.2% 4.8% 3.7% -Children-Single Parent 45% 32% 20% Households- -Violent Crime Rate- 904 430 59 -Injury Deaths- 70 50 50 Physical Environment -Air Pollution-Particulate 12.1 12.5 9.5 Matter- -Drinking Water Violations- 4% 2% 0% -Severe Housing Problems- 16% 19% 9% -Driving Alone To Work- 81% 74% 71% -Long Commute-Driving Alone- 31% 40% 15% Source: www.countyhealthrankings.org/illinois/st-clair-2015 2. A statewide comparison reveals that St. Clair County has more African-American residents but fewer Hispanic residents, and fewer not proficient in English. Demographic Characteristics of St. Clair County Characteristic St. Clair County Illinois Population 265,729 12,880,580 % Under 18 years of age 24.3% 23.5% % 65 and older 13.5% 13.5% % White 65.7% 77.7% % African-American 30.4% 14.7% % Asian 1.4% 5.1% % Hispanic or Latino 3.7% 16.5% % Language other than English 5.8% 22.3% % Foreign Born 2.7% 13.8% Source: U.S. Census Bureau (2011) Based on Memorial's Community Health Needs Assessment and analysis, the following health issues for St. Clair County residents have been identified in addition to the stated goals and objectives. C. 2015 Goals and Objectives Priority health issues for St. Clair County, as identified through Memorial's Community Health Needs Assessment include: 1. Lung Cancer 2. Chronic Obstructive Pulmonary Disease (COPD) 3. Diabetes 4. Cardiovascular Disease Memorial Hospital plans to provide the following community benefits in 2015: 1. Provide free or discounted healthcare services through Memorial's uninsured patient discount and charity care policies to persons who are unable to pay. 2. Provide minimal or no cost needed health services, such as community health screenings, health education and support groups to residents in the communities served. 3. Serve the residents of St. Clair County and surrounding counties as the area's IDPH Resource Hospital and Regional Hospital Coordination Center. 4. Work closely with local, state, and federal disaster preparedness agencies as the IDPH Hospital in St. Clair County and nine surrounding counties and coordinate necessary disaster response and relief activities in case of severe emergency events. 5. Assure access to primary care and specialty physicians for area residents through continued recruitment efforts.
COMMUNITY BENEFIT INFORMATION (CONT)	D. Community Benefit Program Priorities Based on the populations served by Memorial Hospital and the assessment of healthcare needs, the following priorities are identified for the 2015 Community Benefit Program: 1. Access: Access to healthcare services is the number one priority due to the high percentage of the service area population that is uninsured or insured through public programs such as Medicaid and Medicare. Memorial is committed to providing healthcare services to patients in the service area regardless of ability to pay. Memorial does not discriminate based on race, sex, religion, color, or national origin. Additionally, Memorial will continue its efforts to provide charity care to those in need by: -Communicating the availability of charity care to patients. -Quickly identifying patients requiring financial assistance. -Assisting patients in completing appropriate applications for financial assistance. 2. Physician Recruitment: Memorial will continue to invest in physician recruitment to improve access to primary and specialty healthcare services for area residents. 3. Age-Specific Programs: Adults, seniors, and children differ in terms of health conditions, health behaviors, sources of financing, and other issues of access. Programs will be targeted for specific age groups, particularly seniors and children, and will include the following: -Children -Visits to schools and an onsite health fair to acquaint children with the hospital, car seat safety checks, health fairs, and screening for school sports participants. -Seniors - Older adult driving course, health fairs for seniors, Senior Care outpatient mental health program, skilled nursing care in Memorial Care Center, cooperation and support of various community agencies serving seniors. 5. Disease Management: Chronic illnesses such as diabetes, heart disease and hypertension affect many St. Clair County residents. According to the Centers for Disease Control, premature mortality rates (per 100,000) for leading chronic disease conditions in St. Clair County are: Cardiovascular Disease 136.6 COPD 83.5 Diabetes 36.6 Lung Cancer 58.1 Efforts are ongoing to enhance self-management of chronic conditions to benefit individuals and their families, such as: -Heart disease - Presentations by physicians and dietitians, smoking cessation counseling, cholesterol and blood pressure checks, health fairs, CPR classes, cardiac support groups and rehabilitation exercise programs, meditation classes and a Heart Failure Program. -COPD and Lung Cancer-Smoking cessation consultations, education to school-aged children, COPD/Pulmonary Rehab program and support group, and exercise programs. -Diabetes - Diabetes Education Program, nutritional classes, support groups, health fairs, weight management classes. -Hypertension - Blood pressure checks, nutritional counseling, meditation and weight management classes. 5. Healthy Lifestyles: Many healthcare problems are the result of individual lifestyle choices which ultimately cause chronic conditions, hospitalization, and death. Memorial will work collaboratively with schools, community agencies, and others to promote healthy lifestyles and a safe community through: -Employee Wellness Program - Continue to educate and promote healthy living by providing resources and incentives to achieve a healthy balanced life among employees. Employees participate in biometric health screenings annually. Those who participate also receive daily health tips via email. -For the fourth consecutive year, Memorial was named a Platinum Level Fit Friendly Worksite by the American Heart Association. -Self-help programs - Smoking cessation counseling, weight management. -Education - Older adult driving course through AARP, family safety, car seat safety checks, nutrition, partnerships with local Farmers' Markets to promote healthy lifestyles to students as well as with local high school health education clubs. 6. Screenings: Regular, easily accessible screenings are essential to detect disease in its early stages and to facilitate responsibility for disease management by the individual. Many in St. Clair County do not use the formal healthcare system on a regular basis due to access issues. Memorial will continue to conduct screening programs, targeted by condition and age to reach the community. These programs include: -Healthy Direction, Memorial's wellness vehicle will continue to provide health screening services such as vein screenings, diabetes and cholesterol screenings, pulse oximeters as well as a variety of other health screenings and exams. -Screenings for heart disease, diabetes, hypertension, skin cancer, and colorectal screening. 7. Other Activities: In addition to the above priorities, Memorial is Engaged in the following 2015 initiatives to improve care for the residents in the communities it serves throughout Southwest Illinois: -Gather information for the 2015/2016 Community Health Needs Assessment -Work collaboratively with the St. Clair County Health Department to identify community health needs issues -Conduct a Consumer Perception Study -Continue to develop and promote the Heart and Vascular Center of Excellence to educate people about the quality of cardiovascular care conveniently available. A risk assessment tool will be added to the site in 2015. -Continue to promote the Heart Failure Clinic to reduce patient mortality and readmission. -Promote and further develop a comprehensive disease management center for Heart Failure, Diabetic Education and Nutrition Counseling. -Continue to implement and Electronic Medical Record system to improve patient care and safety. Functionality includes physician order entry and physician documentation. -Continue to promote the services available in The Center for Orthopedic and Neurosciences located on Memorial's main campus. The 85,000-square-foot facility houses outpatient services including physical, occupation, speech and hand therapy; pain management; sports medicine; an open MRI and CT scanner. -Promote the Joint Replacement Center of Excellence as part of Memorial's Orthopedic and Neurosciences Center. -Promote Onsite Neonatal Partners as part of the Family Care Birthing Center services. This service allows us to reduce transfers of special care babies. -Package and promote the Women's Health Services available at Memorial to include but not limited to Family Care Birthing Center, Breast Health Center, Minimally-invasive surgery using Robotics, Vein treatment -Plan for the opening of Memorial Hospital-East, a 94-bed satellite hospital in nearby Shiloh. This facility, anticipated to open in April 2016, will provide for all private beds at both the Belleville and Shiloh hospital locations. -Explore strategic affiliation opportunities with BJC Healthcare -Further develop Memorial's Breast Health Center of Excellence to provide an integrated multi-disciplinary delivery of breast care in the Metro East. Launch website memorialbreasthealth.com in 2015 as part of this initiative -Continue to promote the MyMemorial patient portal for access to test results and appointment information. -Continue ONECall centralized scheduling line allowing first-time patients and physician's assistance in making appointments for an array of services. -Continue to promote the Direct Call Transfer Line to assist facilities in outlying communities in making facility to facility transfers in accordance with established prototcols.
FORM 990, PART VI, LINES 6, 7A, 7B	GOVERANCE AND DISCLOUSRE: PROTESTANT MEMORIAL MEDICAL CENTER, INC. HAS TWO CLASSES OF MEMBERS - COMMUNITY AND CORPORATE. COMMUNITY MEMBERS, WHICH INCLUDE BOTH INDIVIDUALS AND LOCAL AREA CHURCHES, HAVE THE EXCLUSIVE POWER TO APPROVE NOMINEES FOR ELECTION AS ELECTED DIRECTORS. THE CORPORATE MEMBER, MEMORIAL GROUP, INC HAS THE POWER TO ELECT, REMOVE, AND REPLACE ANY DIRECTOR, APPROVE AMMENDMENTS TO GOVERNING DOCUMENTS AND TO MAKE INVESTMENT POLICY.
FORM 990, PART VI, LINE 11A	REVIEW PROCESS: DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER , INC. ARE PROVIDED A COPY OF THE TAX RETURN PRIOR TO FILING FOR REVIEW. ANY DISCREPANCIES OR QUESTIONS ARE THEN SUBMITTED TO THE VICE PRESIDENT OF FINANCE.
FORM 990, PART VI, LINE 12C	CONFLICT OF INTEREST POLICY: OFFICERS AND DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. TRANSACTIONS DISCLOSED ON THE STATEMENTS ARE REVIEWED BY THE BOARD. THE BOARD OR A DULY CONSTITUTED COMMITTEE THEREOF SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE.
FORM 990, PART VI, LINE 15A & 15B	COMPENSATION POLICIES: THE COMPENSATION COMMITTEE UTILIZES THE SERVICES OF AN INDEPENDENT CONSULTANT TO DEVELOP HOSPITAL SURVEY DATA TO COMPARE SALARIES AND BENEFITS FOR MEMORIAL'S CORPORATE OFFICERS (CEO AND VICE PRESIDENTS). BASED ON THE SURVEY RESULTS, THE COMPENSATION COMMITTEE ESTABLISHES COMPENSATION FOR THE ENSUING YEAR.
FORM 990, PART VI, LINES 18 & 19	PUBLIC DISCLOSURE: UPON FILING FORM 990 AND SUPPORTING SCHEDULES, PUBLIC DISCLOSURE COPIES ARE AVAILABLE FOR PUBLIC INSPECTION IN THE OFFICE OF THE PRESIDENT OF PROTESTANT MEMORIAL MEDICAL CENTER, INC. DURING REGULAR BUSINESS HOURS OF 8:30AM-5:00PM. COPIES ARE PROVIDED UPON REQUEST FOR A NOMINAL FEE. WRITTEN REQUESTS ARE HONORED WITHIN 30 DAYS. REQUESTS IN PERSON ARE PROVIDED ON THE DAY OF REQUEST. PROTESTANT MEMORIAL MEDICAL CENTER, INC. PROVIDES FOR PUBLIC INSPECTION THE MOST RECENT THREE YEARS OF FILINGS. PROTESTANT MEMORIAL MEDICAL CENTER, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VI, LINE 2	GOVERANCE & DISCLOSURE: MARK TURNER, WILLIAM CASPERSON, AND LARY ECKERT ALL HAVE A BUSINESS RELATIONSHIP AS A RESULT OF ALSO SERVING AS OFFICERS OR DIRECTORS OF MEMORIAL CAPTIVE INSURANCE COMPANY, A RELATED TAXABLE ENTITY.
FORM 990, PART IX, LINE 11G	STATEMENT OF FUNCTIONAL EXPENSES - OTHER FEES FOR SERVICES PHYSICIAN FEES $11,379,872 CONSULTING FEES $4,151,665 TESTS PERFORMED BY OUTSIDE COMPANIES $3,858,900 PURCHASED SERVICES $3,706,652 COLLECTION FEES $2,101,838 TOTAL OTHER FEES FOR SERVICES $25,198,927
FORM 990, PART XI, LINE 9	RECONCILIATION OF NET ASSETS - LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: ($540,909) FUND BALANCE TRANSFER TO MEMORIAL GROUP, INC., A RELATED 501(C)(3) ORGANIZATION. ($210,600) FUND BALANCE TRANSFER TO MEMORIAL HOSPITAL SELF INSURANCE TRUST FUND, A REALTED 501(C)(3) ORGANIZATION. $1,020,898 NET CHANGE IN INTEREST IN MEMORIAL FOUNDATION, INC., A RELATED 501(C)(3) ORGANIZATION. $269,389 TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Protestant Memorial Medical Center Inc

Employer identification number

37-0635502

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

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) MEMORIAL HOSP SELF INSURANCE TRUST FUND 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 37-1064809	INSURANCE	IL	501(C)(3)	11-TYPE I	MGI		No
(2) MEMORIAL FOUNDATION INC 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 37-1186034	FUNDRAISING	IL	501(C)(3)	11-TYPE I	MGI		No
(3) SOUTHWEST ILLINOIS HEALTH VENTURES INC 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 37-1413286	MANAGEMENT	IL	501(C)(3)	11-TYPE I	MGI		No
(4) MEMORIAL GROUP INC 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 37-1186035	MANAGEMENT	IL	501(C)(3)	11-III-FI	NA		No
(5) METRO EAST SERVICES INC 4500 MEMORIAL DRIVE BELLEVILLE,IL62226 46-0838901	HEALTHCARE	IL	501(C)(3)	3	MGI		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2014

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) MEMORIAL CAPTIVE INSURANCE CO 1850 N CENTRAL AVENUE STE 1700 PHOENIX,AZ85004 20-1267507	INSURANCE	AZ	MGI	C CORP	0	0	0 %		No
(2) MEMORIAL CAPTIVE INSURANCE COMPANY 94 SOLARIS 2ND FLOOR GEORGETOWN,CAYMAN ISLANDS CJ 98-1082415	INSURANCE	CJ	MGI	C-CORP	0	0	0 %		No

Schedule R (Form 990) 2014

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2014

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2014

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) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	2,724
6	Total number of volunteers (estimate if necessary) .............	6	323
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	133,364
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	186,420	87,600
9	Program service revenue (Part VIII, line 2g) .........	252,678,468	257,400,765
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,726,809	953,390
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,886,245	4,100,754
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	258,477,942	262,542,509
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	138,681,634	127,784,757
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	116,440,853	111,556,129
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	255,122,487	239,340,886
19	Revenue less expenses. Subtract line 18 from line 12.......	3,355,455	23,201,623
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	193,664,592	219,188,493
21	Total liabilities (Part X, line 26).............	78,172,900	80,527,360
22	Net assets or fund balances. Subtract line 21 from line 20.....	115,491,692	138,661,133

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 199,384,372 including grants of $ ) (Revenue $ 247,601,599 )
	GENERAL SHORT TERM ACUTE CARE HOSPITAL: 316 BEDS, 15,403 PATIENTS ADMITTED, 64,238 PATIENT DAYS, 68,063 EMERGENCY ROOM VISITS, 30,460 MEDICARE PATIENT DAYS, 348,620 OUTPATIENT DEPARTMENT VISITS, AND 12,921 MEDICAID PATIENT DAYS. SEE SCHEDULE O FOR ADDITIONAL STATISTICS AND VALUE OF COMMUNITY BENEFITS PROVIDED DURING 2014.

4b	(Code: ) (Expenses $ 9,075,047 including grants of $ ) (Revenue $ 10,273,149 )
	SKILLED NURSING FACILITY-MEMORIAL CARE CENTER: 108 BEDS, 1,025 PATIENTS ADMITTED, 22,895 PATIENT DAYS, 15,294 MEDICARE PATIENT DAYS, 52 MEDICAID PATIENT DAYS.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses208,459,419

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,811,532	980,097	600,062

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		87,600
e	Government grants (contributions)1e

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			87,600
			Business Code
2a	PATIENT SERVICES -
b	ACUTE CARE HOSP.		621110	247,127,616	246,994,252	133,364
c	PATIENT SERVICES -
d	SKILLED NURS. FAC		621110	10,273,149	10,273,149
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			257,400,765
3	Investment income (including dividends, interest, and other similar amounts).......			937,156			937,156
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	49,056
b	Less: rental expenses
c	Rental income or (loss)	49,056	0
d	Net rental income or (loss).......			49,056			49,056
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	3,757,718
b	Less: cost or other basis and sales expenses	3,741,484
c	Gain or (loss)	16,234
d	Net gain or (loss)..........			16,234			16,234
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA/COFFEE SHOP SALES		722210	1,573,801			1,573,801
b	VHA PATRONAGE PROG		621110	473,983	473,983
c	EMR INCENTIVE PAYMENT		900099	1,596,119			1,596,119
d	All other revenue ....			407,795			407,795
e	Total. Add lines 11a–11d ......			4,051,698
12	Total revenue. See Instructions......			262,542,509	257,741,384	133,364	4,580,161


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			4,200	1	4,200
2	Savings and temporary cash investments .........			9,781,616	2	30,783,994
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			47,450,427	4	44,254,007
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			2,882,714	8	2,834,468
9	Prepaid expenses and deferred charges ..........			3,405,134	9	3,543,952
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	236,543,632
b	Less: accumulated depreciation .....	10b	175,641,838	67,789,386	10c	60,901,794
11	Investments—publicly traded securities ..........			31,115,810	11	33,316,897
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			12,110,181	13	13,131,080
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			19,125,124	15	30,418,101
16	Total assets. Add lines 1 through 15 (must equal line 34)......			193,664,592	16	219,188,493
17	Accounts payable and accrued expenses .........			45,778,407	17	48,004,576
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			15,586,237	20	15,350,155
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			16,808,256	25	17,172,629
26	Total liabilities. Add lines 17 through 25.........			78,172,900	26	80,527,360
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			103,381,511	27	125,530,053
28	Temporarily restricted net assets ...........			12,110,181	28	13,131,080
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			115,491,692	33	138,661,133
34	Total liabilities and net assets/fund balances ........			193,664,592	34	219,188,493