TY 2015 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Donna Greene...................................................................... Immediate Past Chair	0.5 ................. 2.45	X			0	0
(2) Guy Hall...................................................................... Chair of Board	1.5 ................. 4.7	X	X		0	0
(3) Kenneth Aronson MD...................................................................... SECRETARY OF BOARD	5.0 ................. 35.0	X	X		380,166	34,580
(4) Phillip Blankenburg...................................................................... Trustee (Thru September 2015)	0.2 ................. 2.2	X			0	0
(5) J Michael Martin...................................................................... Trustee	0.75 ................. 3.25	X			23,000	0
(6) Paul Tender MD...................................................................... Trustee & Physician	1.0 ................. 39.0	X			427,218	34,782
(7) Brenda Timmons...................................................................... Vice Chair of Board	0.5 ................. 3.2	X	X		0	0
(8) Karl Appelquist...................................................................... Trustee	1.0 ................. 1.2	X			0	0
(9) Matthew Gibb MD...................................................................... Exec VP & CMO	18.4 ................. 21.6		X		725,406	199,371
(10) James C Leonard MD...................................................................... Ex-Officio, President & CEO	5.0 ................. 35.0		X		2,019,291	460,012
(11) John Snyder...................................................................... Exec VP & COO	5.0 ................. 35.0		X		1,191,997	276,330
(12) Dennis Hesch...................................................................... Exec VP & CFO	12.0 ................. 28.0		X		995,505	243,060
(13) Laurence Fallon...................................................................... Exec VP-Legal Affairs & HR	11.0 ................. 29.0			X	750,214	192,695
(14) Pamela Bigler...................................................................... SVP-Nursing & CNO	15.0 ................. 25.0			X	451,350	98,106
(15) Lynette Barnes...................................................................... SVP-Hosp Ops & HVI	32.0 ................. 8.0			X	461,945	96,110
(16) JULIANNA SELLETT...................................................................... VP-DIAGNOSTIC & TRANS'L CARE	30.0 ................. 10.0			X	238,880	78,386
(17) DAWN WALDEN...................................................................... VP-REVENUE CYCLE OPS	16.0 ................. 24.0			X	337,844	87,848

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Blair Rowitz MD........................................................................ Med Dir- Surgical Services	20.0 .......................20.0	X			0	782,027	40,571
(19) Malec Mokraoui MD........................................................................ Med Dir- HVI	20.0 .......................20.0	X			0	645,493	36,954
(20) Andy Arwari MD........................................................................ Med Dir- Hospital Medicine	40.0 .......................0.0	X			0	520,444	41,494
(21) Matthew Kolb........................................................................ VP-Neuro & HVI	20.0 .......................20.0	X			0	236,817	57,768
(22) Caleb Miller........................................................................ VP-Surgical Services	30.0 .......................10.0	X			0	206,602	56,707
(23) LINDA FRED........................................................................ INPT PHARM DIRECTOR	20.0 .......................20.0		X		200,491	0	39,218
(24) JOEL LOVE........................................................................ PHYSICIST	40.0 .......................0.0		X		189,387	0	38,766
(25) KHANDAKER ISLAM........................................................................ PHYSICIST	40.0 .......................0.0		X		169,831	0	34,247
(26) VIJAY BAVDA........................................................................ PHARMACIST-INPT RX	35.8 .......................4.2		X		167,379	0	34,844
(27) Matthew Pike........................................................................ Pharmacist-Inpt Rx	40.0 .......................0.0		X		161,317	0	34,134
(28) Cora E Musial Phd MD........................................................................ Sec/Treas of Board - Former	0.0 .......................40.0			X	0	277,328	23,685
(29) R Bruce Wellman MD........................................................................ EX-OFFICIO, CEO OF CPG-FORMER	30.0 .......................10.0			X	0	671,645	24,185
(30) Joseph Barkmeier MD........................................................................ Key Employee - Former	0.0 .......................40.0			X	0	360,789	87,922
(31) STEPHANIE BEEVER........................................................................ Key Employee - Former	5.0 .......................35.0			X	0	487,657	117,449
(32) KIM JOHNSTON........................................................................ Key Employee - Former	30.0 .......................10.0			X	0	324,924	72,101

(A) Name and business address	(B) Description of services	(C) Compensation
FOCUSONE SOLUTIONS LLC, PO BOX 3037 OMAHA,NE681030037	STAFFING	3,447,228
MAYO COLLABORATIVE SERVICES INC, PO BOX 9146 MINNEAPOLIS,MN55480	LABORATORY SERVICES	2,716,728
GE HEALTHCARE INC, PO BOX 640200 PITTSBURGH,PA152640200	EQUIPMENT MAINT	1,962,221
PHILLIPS ELECTRONICS NORTH AMERICA, PO BOX 100355 ATLANTA,GA303840355	EQUIPMENT MAINT	1,567,919
SIEMENS MEDICAL SOLUTIONS HEALTH SE, DEPARTMENT CH 14195 PALATINE,IL600554195	EQUIPMENT MAINT	1,496,065
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 45

- 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

2015

Open to Public
Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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 (Form 990 or 990-EZ))

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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—2014. 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Page 6

Part V

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

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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) 2015

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

2015

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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 other 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization The Carle Foundation Hospital

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization The Carle Foundation Hospital		Employer identification number 37-1119538

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization The Carle Foundation Hospital			Employer identification number 37-1119538
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.) $ 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) (2015)

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

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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

The Carle Foundation Hospital

Employer identification number

37-1119538

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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) 2012	(b) 2013	(c) 2014	(d) 2015	(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) 2015

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 on 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

7,549

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

7,549

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
SCHED C, PART II-B, LINE (I)	DESCRIPTION OF OTHER LOBBYING ACTIVITIES $2,900 - PORTION OF AMERICAN MEDICAL GROUP ASSOC (AMGA) DUES ATRIBUTED TO LOBBYING $986 - PORTION OF ILLINOIS HOMECARE & HOSPICE COUNCIL (IHHC) DUES ATTRIBUTED TO LOBBYING. $3,663 - PORTION OF DUES PAID TO MISCELLANEOUS HEALTH CARE ORGANIZATIONS ATTRIBUTED TO LOBBYING.

Schedule C (Form 990 or 990EZ) 2015

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," on 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

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(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 on 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" on 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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...
b	Buildings	204,609	70,278	134,331
c	Leasehold improvements	2,686,863	1,883,962	802,901
d	Equipment ...	146,449,216	76,468,624	69,980,592
e	Other ...	6,070,892	1,059,709	5,011,183
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				75,929,007

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) INTER-COMPANY RECEIVABLE				239,773,919
(2) OTHER RECEIVABLES				4,715,638
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				244,489,557

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
ESTIMATED THIRD PARTY SETTLEMENTS	50,784,454
COMPENSATION AND PAID LEAVE ACCRUAL	29,962,656
ESTIMATED LIABILITY SELF INSURED LO	2,407,107
INCOME TAX PAYABLE	269,147
SALES TAX PAYABLE	63,677
ACCOUNTS RECEIVABLE CREDIT BALANCES	3,382
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	83,490,423
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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
FIN 48 (ASC740) FOOTNOTE	THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2015 AND 2014.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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 400 %

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? . . . . . .

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	19,144,160		19,144,160	3.240 %
b	Medicaid (from Worksheet 3, column a) . . . . .	107,574,937	109,551,357
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	126,719,097	109,551,357	19,144,160	3.240 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	434,535		434,535	0.070 %
f	Health professions education (from Worksheet 5) . . .	10,770,960	26,240	10,744,720	1.820 %
g	Subsidized health services (from Worksheet 6) . . . .	9,616,471		9,616,471	1.630 %
h	Research (from Worksheet 7) .	6,969,087	1,974,926	4,994,161	0.850 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,099,723		2,099,723	0.360 %
j	Total. Other Benefits . .	29,890,776	2,001,166	27,889,610	4.730 %
k	Total. Add lines 7d and 7j .	156,609,873	111,552,523	47,033,770	7.970 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development	38,328	38,328
3	Community support	26,149	26,149
4	Environmental improvements	432	432
5	Leadership development and training for community members
6	Coalition building	1,210	1,210
7	Community health improvement advocacy	4,067	4,067
8	Workforce development	82,185	82,185
9	Other	11,629	11,629
10	Total	164,000	164,000

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

-1,598,384

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

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

Section B. Medicare

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

134,772,597

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

140,973,909

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

-6,201,312

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) 2015

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	THE CARLE FOUNDATION HOSPITAL 611 W Park St Urbana,IL61801 carle.org 0003798	X	X	X	X	X

Schedule H (Form 990) 2015

Page 4

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)

	THE CARLE FOUNDATION 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 14

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

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): carle.org/chna

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 14

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

Yes

If "Yes" (list url): carle.org/chna

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

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE CARLE FOUNDATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 400.% and FPG family income limit for eligibility for discounted care of 400.%

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):

carle.org

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

CARLE.ORG

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

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

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) 2015

Page 6

Part VFacility Information (continued)

	THE CARLE FOUNDATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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 19. (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) 2015

Page 7

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
SCHEDULE H, PART V SUPPLEMENTAL INFORMATION	COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY INPUT (PART V, SECT B, LINE 5) USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) MODEL, A COMMUNITY-BASED MODEL THAT NECESSITATES COMMUNITY ENGAGEMENT AT ALL LEVELS, WE ASSESSED THE CURRENT HEALTH STATUS OF THE COMMUNITY, IDENTIFIED NEEDS, AND CREATED A COMPREHENSIVE COMMUNITY HEALTH IMPROVEMENT PLAN TO IMPROVE OUR COMMUNITY'S HEALTH BY ACQUIRING INPUT FROM COMMUNITY PARTNERS, PLANNERS, ELECTED OFFICIALS, AND RESIDENTS. OVER 60 INDIVIDUALS REPRESENTING MORE THAN 30 DIFFERENT AGENCIES ACROSS CHAMPAIGN COUNTY CONTRIBUTED TO THIS PROCESS; FURTHER, WE SURVEYED OVER 1,000 COMMUNITY RESIDENTS THROUGH SURVEYS, FOCUS GROUPS, AND COMMUNITY MEETINGS. THE MAPP PROCESS IS COMPOSED OF FOUR ASSESSMENTS. AFTER PERFORMING THESE, OVER 50 COMMUNITY LEADERS MET TO REVIEW THE RESULTS, SET A VISION, AND IDENTIFY PRIORITIES AND GOALS FOR THE UPCOMING YEARS. JENNY TUMBA, AVICENNA COMMUNITY HEALTH CENTER; BHARAT GOPAL, MD, EVA PALMER, SUSAN RUWE AND MIKE BILLIMACK, the CARLE FOUNDATION HOSPITAL; DEB BUSEY, CHAMPAIGN COUNTY ADMINISTRATOR; AL KURTZ, CHAMPAIGN COUNTY BOARD CHAIR; KARLY COMBEST, CHAMPAIGN COUNTY CHAMBER OF COMMERCE; DUANE NORTHRUP, CHAMPAIGN COUNTY CORONER; CLAUDIA LENNHOFF, CHAMPAIGN COUNTY HEALTHCARE CONSUMERS; ASHLEE MCLAUGHLIN, CHAMPAIGN COUNTY REGIONAL PLANNING COMMISSION; GABRIEL LEWIS AND RITA MOROCOIMA-BLACK, CHAMPAIGN COUNTY REGIONAL PLANNING COMMISSION; LT. JOHN HOCKING, CHAMPAIGN FIRE DEPARTMENT; JAMEEL JONES CHAMPAIGN PARK DISTRICT; CHIEF ANTHONY COBB, CHAMPAIGN POLICE DEPARTMENT; MARGEE POOLE, CHAMPAIGN UNIT 4 SCHOOL DISTRICT; AMY ROBERTS, AWAIS VAID, BRANDON MELINE, CANDI CRAUSE, DEB FRUITT, JAMIE PERRY, JEFF KEMP-RINDERLE, JULIE PRYDE, NICKI HILLIER AND PAT ROBINSON, CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT; JEAN SMITH, CHRISTIE CLINIC; LT. TODD HITT, CITY OF CHAMPAIGN FIRE DEPARTMENT; LIBBY TYLER, CITY OF URBANA COMMUNITY DEVELOPMENT SERVICES; CHIEF PATRICK CONNOLLY, CITY Of URBANA; SHEILA FERGUSON, COMMUNITY ELEMENTS; CYNTHIA HOYLE, Champaign/urbana MASS TRANSIT DISTRICT 5; MEGAN BERRY, champaign urbana public health district (cuphd)-INFECTIOUS DISEASE; ANNIE CLAY, CHARLES MORTON, TAMMY RUFF AND TONYA CRAWLEY, HOUSING AUTHORITY OF CHAMPAIGN COUNTY; VALERIE MCWILLIAMS, LAND OF LINCOLN legal assistance foundation; MAUREEN MALEE AND ROBERT PALINKAS, MCKINLEY HEALTH CENTER; DIANE ZELL, NATIONAL ALLIANCE ON MENTAL ILLNESS; BONITA BURGESS, CARMEN ZYCH AND JUNE BIRCH, PARKLAND COLLEGE; LINDA TAUBER-OLSEN, PRESENCE COVENANT CENTER FOR HEALTHY LIVING; JACOB OZIER, JOLENE BOWEN AND SHERI ERVIN, PRESENCE COVENANT MEDICAL CENTER; NANCY GREENWALT, PROMISE HEALTHCARE; NICOLE BRIDGES, PROSPERITY GARDENS INC.; JONATHAN MANUEL, SOIL AND WATER CONSERVATION DISTRICT; SUE GREY, UNITED WAY OF CHAMPAIGN COUNTY; BILL BROWN, JACK HERRMANN, JANET KROENCKE, KRISTA JONES, MARGARET HELMS, PETER MULHALL, SHERRIE FAULKNER, YVETTE JOHNSON-WALKER AND HILLARY KLONOFF-COHEN, UNIVERSITY OF ILLINOIs; IAN BROOKS, UNIVERSITY OF ILLINOIS NCSA; TODD SHORT, UNIVERSITY OF ILLINOIS POLICE; SCOTT HAYS, UNIVERSITY OF ILLINOIS-Center for Prevention Research and Development; NATALIE KENNY MARQUEZ, URBANA MARKET AT THE SQUARE; CORKY EMBERSON, URBANA PARK DISTRICT; SANDY MARTIN, URBANA SCHOOL DISTRICT 116.
OTHER HOSPITAL FACILITIES (PART V, SECT B, LINE 6A)	PRESENCE COVENANT MEDICAL CENTER
OTHER ORGANIZATIONS (PART V, SECT B, LINE 6B)	CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT, CHAMPAIGN COUNTY REGIONAL PLANNING COMMISSION, AND UNITED WAY OF CHAMPAIGN COUNTY
SIGNIFICANT HEALTH NEEDS (PART V, SECT B, LINE 11)	THE CARLE FOUNDATION HOSPITAL HAS IDENTIFIED THE FOLLOWING HEALTH AREAS AS SIGNIFICANT NEEDS: 1.) ACCESS TO CARE 2.) BEHAVIORAL HEALTH 3.) OBESITY 4.) VIOLENCE PLEASE SEE PART VI, LINE 2 FOR A DESCRIPTION AS TO HOW THE CARLE FOUNDATION HOSPITAL IS ADDRESSING THESE SIGNIFICANT NEEDS. WHILE THERE WERE A NUMBER OF ADDITIONAL NEEDS IDENTIFIED BY THE DATA AND INPUT FROM COMMUNITY LEADERS, CARLE DOES NOT HAVE THE RESOURCES TO ADDRESS ALL OF THEM. THE ISSUES THAT WILL NOT BE ADDRESSED IN THIS IMPLEMENTATION PLAN ARE LOWER PRIORITY BECAUSE THE NEED WAS NOT AS SIGNIFICANT; THEY ARE NOT CENTRAL TO THE HOSPITAL'S MISSION; AND CARLE HAS DETERMINED IT DOES NOT HAVE THE ABILITY TO MAKE A MEASURABLE IMPACT IN THOSE AREAS. CARLE WILL NOT FOCUS THIS COMMUNITY BENEFIT IMPLEMENTATION PLAN ON ADDRESSING COMMUNITY HEALTH CHALLENGES RELATED TO ECONOMIC ISSUES, POVERTY, TRANSPORTATION INFRASTRUCTURE, LAW ENFORCEMENT ISSUES, AND LEGAL/POLITICAL ISSUES. ALTHOUGH THERE WILL BE SOME RESOURCES DEDICATED, CARLE WILL HAVE LIMITED FOCUS ON VIOLENCE AND BEHAVIORAL HEALTH DUE TO MISALIGNMENT WITH ITS CORE MISSION AND/OR LIMITED ABILITY TO MAKE A MEASUREABLE IMPACT.
CHARGES TO FAP-ELIGIBLE INDIVIDUALS (PART V, SECT B, LINE 22D)	THE CARLE FOUNDATION HOSPITAL ESTABLISHES A STANDARDIZED FEE SCHEDULE USING A NATIONAL DATABASE OF FEE INFORMATION, WHICH BLENDS THE RELATIVE VALUE OF A SERVICE WITH STATISTICAL PROFILING OF ACTUAL CHARGE DATA SPECIFIC TO THIS REGION. THIS IS THE SAME METHODOLOGY USED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) TO SET MEDICARE FEES. THIS ALLOWS US TO ESTABLISH A FAIR FEE THAT REPRESENTS THE COST OF DELIVERING THE SERVICES. CHARGES FOR PAtients WHO APPLY AND ARE IDENTIFIED AS QUALIFIED FOR FINANCIAL ASSISTANCE ARE DISCOUNTED BASED UPON THEIR DISCOUNT LEVEL. DISCOUNTS FOR THE CARLE FOUNDATION HOSPITAL'S COMMUNITY CARE DISCOUNT PROGRAM ARE APPLIED AT 25%, 50%, 75% OR 100% BASED UPON THE APPLICANT'S FEDERAL POVERTY LEVEL AT THE TIME OF APPLICATION AND APPROVAL.

Schedule H (Form 990) 2015

Page 8

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?3
Name and address		Type of Facility (describe)
1	Carle Therapy Services 810 W Anthony Dr Urbana,IL61801	Physical and Occupational Therapy
2	CARLE SURGICENTER - DANVILLE 2300 NORTH VERMILION ST DANVILLE,IL61832	Outpatient Surgery
3	CARLE SURGICENTER - CHAMPAIGN 1702 SOUTH MATTIS AVE CHAPAIGN,IL61822	OUTPATIENT SURGERY
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

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
1. REQUIRED DESCRIPTIONS	EXPLANATION OF COSTING METHODOLOGY (PART I, LINE 7 AND PART III, LINE 2 & 8) TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUALS FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. PART I, Line 7g none of the amount included on line 7g is for subsidized physician offices. COMMUNITY BUILDING EXPLANATION (PART II) ALTHOUGH COMMUNITY BUILDING ITEMS ARE NOT COUNTED AS COMMUNITY BENEFIT, THIS SUPPORT IS AN IMPORTANT ASPECT OF CONTRIBUTING TO THE ECONOMIC VIABILITY OF THE COMMUNITY. In TOTAL, CARLE CONTRIBUTED NEARLY $500,000, with additional contributions from the shared services cost center of the Carle Foundation, which covers facilities. The Carle Foundation Hospital alone contributed $164,000 to this effort. ECONOMIC DEVELOPMENT (PART II) ANOTHER LARGE PORTION OF The Carle Foundation Hospital's COMMUNITY-BUILDING ACTIVITIES ($38,328) FOCUSED ON ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN CHAMPAIGN COUNTY. IN ADDITION TO THE MORE THAN $30,000 IN CASH DONATIONS, LEADERSHIP PROVIDED IN-KIND SUPPORT BY SERVING ON BOARDS FOR THE CHAMPAIGN COUNTY CHAMBER OF COMMERCE AND THE ECONOMIC DEVELOPMENT CORPORATION. COMMUNITY SUPPORT / EMERGENCY MANAGEMENT (shared services; grant funds) (PART II) EMERGENCY MANAGEMENT CONTINUED TO BE A PRIORITY OF The CARLE FOUNDATION HOSPITAL. INITIATIVES IN THIS AREA INCLUDE TRAINING THE FACILITY AND COMMUNITY LEADERSHIP IN PLANNING COMMUNITY-WIDE RESPONSES TO VARIOUS SCENARIOS AND STATE-LEVEL LEADERSHIP FOR THE 21-COUNTY REGIONAL HOSPITAL COORDINATING CENTER REGION. OUR FOCUS IS TO PREPARE OUR HOSPITAL AND SURROUNDING REGIONAL HOSPITALS TO BE READY TO RESPOND TO ANY NATURAL DISASTER, PANDEMIC OR ACT OF TERRORISM. CARLE ALSO BEGAN PREPARATIONS TO ADDRESS EBOLA VIRUS NEEDS AND HAS CONTINUED THIS WORK IN COLLABORATION WITH LOCAL, COUNTY, STATE AND FEDERAL AGENCIES. IN ADDITION, CARLE CONTINUED PREPARATIONS TO TREAT ANY PERSON WHO MIGHT BE CARRYING THE EBOLA VIRUS OR ANY OTHER HIGHLY CONTAGIOUS DISEASE. IN 2015, CARLE BUILT A TWO-PERSON ISOLATION SUITE TO HOUSE EBOLA PATIENTS AWAY FROM THE GENERAL HOSPITAL POPULATION. A DEDICATED EBOLA CARE TEAM TRAINED AND DRILLED FOR POTENTIAL EBOLA SCENARIOS SEVERAL TIMES THROUGHOUT THE YEAR. CARLE IS CURRENTLY AN IDPH-DESIGNATED EBOLA ASSESSMENT CENTER WITH PLANS TO BECOME THE STATES DOWNSTATE EBOLA TREATMENT CENTER. MORE THAN $4,000 IN IN-KIND SERVICES WAS DEVOTED TO EBOLA VIRUS TRAINING AND PREPARATION. PREVIOUSLY, CARLE HAD DIRECTLY RECEIVED AN office of the assistant secretary for preparedness and response (ASPR) GRANT TO PUT TOWARDS REGIONAL PROJECTS FOR EMERGENCY MANAGEMENT WITHIN THE COMMUNITY. AS OF 2015, THOSE EXTRA FUNDS ARE NOW CONSIDERED rEGIONAL COALITION FUNDS, AND ARE OVERSEEN BY THE EMERGENCY MANAGEMENT DIRECTOR FOR USE IN THE REGION. IN 2015, CARLE OVERSAW THE ALLOCATION OF MORE THAN $172,000 OF GRANT FUNDS TO COMMUNITY BENEFIT PROGRAMMING IN THE REGION, INCLUDING: - $83,378: LAB EQUIPMENT FOR AN INFECTIOUS DISEASE SUITE INTENDED TO SERVE AS AN EBOLA TREATMENT CENTER ONCE APPROVED - $50,272 TO HOSPITALS IN THE REGION, INCLUDING PORTABLE TOILETS, TABLES, AND CHAIRS FOR TEMPORARY MEDICAL TREATMENT CENTERs; ACTIVE SHOOTER TRAINING; N-95 MASKS TO REPLACE THOSE THAT WERE EXPIRED; STARCOM RADIO BATTERIES; AND WEBSITE/FACEBOOK DEVELOPMENT FOR HOSPITAL EMERGENCY MANAGEMENT - $14,255: EVACUATION CHAIRS, USED IN HOSPITAL EVACUATIONS AT BOTH PARIS, il AND SHELBYVILLE, il HOSPITALS - $11,805: HAM RADIO REPEATERS TO STRENGTHEN COMMUNICATIONS IN FORD AND COLES COUNTIES in illinois - $8,150 to CHAMPAIGN COUNTY, il, INCLUDING SUPPLIES FOR THE CHAMPAIGN COUNTY CORONERS FATALITY MANAGEMENT TRAILER AND AN ACCOUNTABILITY AND TRACKING SYSTEM to be USEd DURING DISASTERS by THE CHAMPAIGN COUNTY Emergency management agency - $4,819: DISASTER TRAILER TO THE HOOPESTON, IL emergency management agency, AVAILABLE FOR REGIONAL USE IF NEEDED, AS WELL AS AN automated external defibrillator FOR THE HOOPESTON POLICE DEPARTMENT CARLE ALSO PROVIDED THE COMMUNITY AND REGION WITH MORE THAN $5,700 OF IN-KIND SERVICES FOR EMERGENCY MANAGEMENT IN 2015, OVER AND ABOVE WHAT WAS REQUIRED. PART III, SECTION A, LINE 3 THE CARLE FOUNDATION HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. IN THE CURRENT YEAR, NO BAD DEBT WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIATION'S FINANCIAL ASSISTANCE POLICY. PART III, SECTION A, LINE 4 ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR ESTIMATED CONTRACTUAL ADJUSTMENTS AND AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE hospital ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS. THE hospital RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE ESTABLISHED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. EXPLANATION OF MEDICARE COST REPORT COSTING METHODOLOGY (PART III, LINE 8) THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE DESIGNED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. AS AN ILLINOIS-BASED HOSPITAL, WE ARE REQUIRED BY THE COMMUNITY BENEFIT ACT OF 2003 TO REPORT TO THE OFFICE OF THE ATTORNEY GENERAL COMMUNITY BENEFITS PROVIDED. FOR THAT REPORT, ILLINOIS LAW DEFINES GOVERNMENT-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. TO REDUCE PUBLIC CONFUSION CAUSED BY VARIATIONS IN OUR REPORTS, FOR CONSISTENCY, WE HAVE PREVIOUSLY INCLUDED A MEDICARE SHORTFALL IN ALL OF OUR COMMUNITY BENEFIT RELATED REPORTS. IN 2015 THE UNPAID COSTS OF MEDICARE WERE $1,390,070. WHEN THERE IS A SHORTFALL, WE BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, WHERE 10.8% ARE 65 YEARS OF AGE AND OLDER IN CHAMPAIGN COUNTY ALONE. ACCORDING TO FAMILY SERVICE OF CHAMPAIGN COUNTY, THOSE 85 AND OLDER THE FASTEST GROWING DEMOGRAPHIC IN THE COUNTY HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES DETERMINED 20 YEARS AGO. DEBT COLLECTION PRACTICES (PART III, LINE 9B) PATIENTS ARE INFORMED ABOUT THE COMMUNITY CARE DISCOUNT PROGRAM (CCDP) ON MULTIPLE OCCASIONS. IT IS THE RESPONSIBILITY OF THE PATIENT TO REQUEST AND COMPLETE AN APPLICATION. IF A PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FRANCES NELSON HEALTH CENTER (PROMISE HEALTHCARE Federally qualified health center) DISCOUNT REFERRAL, AND MEDICAID TITLE XIX.
2. NEEDS ASSESSMENT (PART VI, LINE 2)	THE CARLE FOUNDATION HOSPITAL USED EXISTING DATA, INFORMAL DISCUSSIONS, AND A COMPREHENSIVE QUALITATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) MODEL, A COMMUNITY-BASED MODEL THAT NECESSITATES COMMUNITY ENGAGEMENT AT ALL LEVELS. WE ASSESSED THE CURRENT HEALTH STATUS OF THE COMMUNITY, IDENTIFIED NEEDS, AND CREATED A COMPREHENSIVE COMMUNITY HEALTH IMPROVEMENT PLAN BY ACQUIRING INPUT FROM COMMUNITY PARTNERS, PLANNERS, ELECTED OFFICIALS AND RESIDENTS. OVER 60 INDIVIDUALS REPRESENTING MORE THAN 30 AGENCIES ACROSS CHAMPAIGN COUNTY CONTRIBUTED TO THIS PROCESS; FURTHER, WE SURVEYED OVER 1,000 RESIDENTS THROUGH SURVEYS, FOCUS GROUPS AND COMMUNITY MEETINGS. WHILE THERE WERE A NUMBER OF ADDITIONAL NEEDS IDENTIFIED BY DATA AND INPUT FROM COMMUNITY LEADERS, THE FOLLOWING FOUR HEALTH AREAS WERE SELECTED AS TOP PRIORITIES: 1. ACCESS TO CARE 2. BEHAVIORAL HEALTH 3. OBESITY 4. VIOLENCE IN 2015, OUR COMMUNITY BENEFIT PLAN REFLECTED THE SECOND YEAR OF A THREE-YEAR PLAN AND PRIMARILY ADDRESSED NEEDS IDENTIFIED IN THE CHAMPAIGN-URBANA AREA. IT ALSO INCLUDED COMMUNITY BUILDING ACTIVITIES, AS WELL AS RESEARCH AND EDUCATION INITIATIVES-ALL OF WHICH ARE REVIEWED AND CONFIRMED THROUGH THE ANNUAL BUDGETING PROCESS.
3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE (Part VI, Line 3)	CARLE IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE, MAKING THAT A MAINSTAY OF OUR COMMUNITY BENEFIT EFFORTS, WITH A STRONG financial assistance PROGRAM BASED ON A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS AND BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITY'S RESOURCES. BY DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO provide assistance. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERE'S ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSITANCE. THE CARLE FOUNDATION HOSPITAL HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THIS INCLUDES: - PROMOTION TO EDUCATE THE COMMUNITY AND THOSE WHO MIGHT NEED CARLES COMMUNITY CARE DISCOUNT PROGRAM VIA APPROPRIATE COMMUNITY PUBLICATIONS, AND ON-SITE VIA DISPLAYS THROUGHOUT THE HOSPITAL AND CLINICS - SIMPLIFIED APPLICATION FORM, INCLUDING A VERSION IN SPANISH - INFORMATION ABOUT THE COMMUNITY CARE PROGRAM ON ALL STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS, AND BILLING ENVELOPES - COMMUNITY CARE INFORMATION AND APPLICATIONS AT ALL REGISTRATION POINTS, HOSPITAL MAIN LOBBY AND CARLE.ORG - STAFF AT FRANCES NELSON HEALTH CENTER OPERATED BY PROMISE HEALTHCARE, THE LOCAL FQHC, AND COMMUNITY FREE CLINICS EQUIPPED WITH A SUPPLY OF APPLICATIONS AND KNOWLEDGE TO ASSIST THEIR PATIENTS IN COMPLETING THEM - MEETINGS WITH LOCAL LEGISLATORS TO HELP THEM ASSIST CONSTITUENTS WITH HEALTHCARE NEEDS, INCLUDING FINANCIAL ASSISTANCE - EXPANSIVE PRESUMPTIVE QUALIFICATION LIST - SCREENING PATIENTS FOR KEY FINANCIAL INDICATORS TO PRESUME ELIGIBILITY OR CONTACT ABOUT ASSISTANCE PROGRAMS
4. COMMUNITY INFORMATION (Part VI, Line 4)	Carle's service area is generally defined as east central Illinois, including all or parts of more than 25 counties in east central Illinois and western Indiana. For the Community Benefit Implementation plan, research and remedies are directed towards community health issues identified in our primary service area, with the focus on Champaign County, il. Our reach extends into 14 adjoining, rural Illinois counties. These areas comprise nearly 50% of the Carle service area's population of approximately 1.3 million residents. Pockets of extreme poverty exist throughout this region. The programs within our community benefit plan generally have impact upon all the targeted communities, with certain programs directed at specific populations. The Carle Foundation Hospital serves as the region's only Level I Trauma Center and Level III Neonatal Intensive Care Unit. As provider of the region's perinatal services, Carle provides care to patients who live throughout the geographic area extending from Kankakee, il in the north to the southern-most tip of Illinois, and spanning from as far west as Decatur, il and east into western Indiana. For the purposes of our Community Care Discount Program, coverage encompasses this entire region - 40 counties in Illinois and Indiana.
5. PROMOTION OF COMMUNITY HEALTH (Part VI, Line 5)	the CARLE FOUNDATION HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY A COMMUNITY BOARD. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, BUILDING RENOVATION OR CONSTRUCTION, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. SURPLUS FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE. BECAUSE THE NEEDS ARE GREAT AND VARIED AND IT WOULD BE UNREASONABLE TO ADDRESS EACH AND EVERY IDENTIFIED NEED, WE SET PRIORITIES AND USE OUR RESOURCES TO FOCUS PRIMARILY ON IDENTIFIED NEEDS WITHIN THE COMMUNITY BENEFIT PRIORITIES SET. MANY OF THESE NEEDS ARE ADDRESSED THROUGH PARTNERSHIPS AND COLLABORATIVE EFFORTS. OUR PROGRESS IS SHOWN BELOW. ACCESS TO CARE FINANCIAL AND LEADERSHIP SUPPORT OF COMMUNITY PROGRAMS HAS BEEN CENTRAL TO PROVIDING ACCESS TO PRIMARY, DENTAL, PREVENTIVE AND MENTAL HEALTH SERVICES. CARLE HAS SOUGHT WAYS TO INITIATE AND EXPAND HEALTHCARE SERVICES FOR THE UNDERINSURED AND UNINSURED BY WORKING COLLABORATIVELY WITH COMMUNITY ORGANIZATIONS AND LEADERS. IN THE 2014-16 COMMUNITY HEALTH NEEDS ASSESSMENT, ACCESS TO CARE WAS THE TOP PRIORITY IDENTIFIED, AND AS PART OF CARLES PLAN TO IMPROVE ACCESS, THE ORGANIZATION IS RECRUITING HEALTHCARE PROVIDERS AND ALSO SUPPORTS COMMUNITY CLINICS. COMMUNITY CLINIC SUPPORT PROMISE HEALTHCARE AT FRANCES NELSON HEALTH CENTER $446,723 CARLE CONTINUED TO SUPPORT PROMISE HEALTHCARE AT FRANCES NELSON HEALTH CENTER (FNHC), A FEDERALLY QUALIFIED HEALTH CENTER, THROUGH FUNDING, LEADERSHIP SUPPORT, PATIENT CARE SERVICES, SUPPLIES AND MORE. IN 2005, CARLE PURCHASED A BUILDING AND RENOVATED FOR A TOTAL INVESTMENT OF $1.2 MILLION, CHARGING $1 RENT FOR THE FIRST THREE YEARS OF OCCUPANCY AND HAS SINCE PROVIDED SUPPORT FOR FACILITIES, LEADERSHIP AND CLINICAL SERVICES. IN 2015, THIS INCLUDED: - $418,928 IN CONTRIBUTIONS TO UNITED WAY OF CHAMPAIGN COUNTY, DESIGNATED FOR PROMISE HEALTHCARE TO ENHANCE SERVICES AND ACCESS TO CARE - CARLES ALL ABOUT BABY STAFF PROVIDES WEEKLY MEDICAL RESIDENT TRAINING AND PATIENT PRENATAL EDUCATION AT AN IN-KIND COST OF $20,006 - AN ADDITIONAL $7,789 FOR SUPPLIES, MEDICATION, BOARD INVOLVEMENT AND OTHER NEEDS - FRANCES NELSON HEALTH CENTER IS A RESIDENCY SITE FOR THE CARLE FAMILY MEDICINE RESIDENCY PROGRAM AND RESIDENTS PROVIDE CARE AS PART OF THEIR EDUCATION ALTHOUGH THE RESIDENTS TIME IS NOT REPORTED AS A COMMUNITY BENEFIT. CARLE HAS HAD A LONG COMMITMENT TO IMPROVING ACCESS TO THIS FACILITY. CHAMPAIGN COUNTY CHRISTIAN HEALTH CENTER $3,492 CARLE HELPS THE CHAMPAIGN COUNTY CHRISTIAN HEALTH CENTER FREE CLINIC FULFILL ITS MISSION TO PROVIDE QUALITY, HOLISTIC CARE AT NO COST TO AS MANY PEOPLE AS POSSIBLE. THE CLINIC PROVIDES PRIMARY CARE, DENTAL AND MENTAL HEALTH SERVICES. A NUMBER OF THE VOLUNTEER MEDICAL STAFF IS CARLE PHYSICIANS, NURSES AND TECHNICIANS WHO HAVE PERSONALLY CHOSEN TO SERVE THEIR COMMUNITY THROUGH THE CHAMPAIGN COUNTY CHRISTIAN HEALTH CENTER, AND WE ALSO PROVIDE IN-KIND BOARD SUPPORT. SINCE THIS CLINICS INCEPTION IN 2003, CARLE HAS PROVIDED MORE THAN $450,000 in support. ACCESS TO CARE THROUGH SUBSIDIZED SERVICES AT CARLE OVER THE YEARS, MULTIPLE CARLE INITIATIVES HAVE PROVIDED ADDITIONAL ACCESS TO CARE. BECAUSE THESE SERVICES CONTINUE TO MEET AN ENORMOUS NEED, THE PROGRAMS HAVE BEEN MAINTAINED, THOUGH SEVERAL OPERATE AT A LOSS. SOME OF THESE SUBSIDIZED SERVICES INCLUDE: COMMUNITY PARISH NURSE PROGRAM CARLE HAS ONE OF THE LARGEST PARISH NURSE GROUPS IN THE NATION, WITH 500 NURSES FROM 235 CONGREGATIONS IN 33 COUNTIES IN FOUR STATES. THE PROGRAM TRAINS NURSES FROM LOCAL CHURCHES TO EDUCATE CONGREGANTS AND ADVOCATE FOR THEIR HEALTHCARE INTERESTS. IN 2015, 10 RNS COMPLETED TRAINING, LOGGING MORE THAN 9,000 HOURS OF SERVICE TO THEIR CONGREGATIONS. THE GROUP ALSO DISTRIBUTED MORE THAN 1,000 VIALs OF LIFE KITS IN 2015; MORE THAN 22,000 TO DATE. CARLE BREASTFEEDING CLINIC CERTIFIED LACTATION SPECIALISTS HAVE HELPED THOUSANDS OF WOMEN SUCCESSFULLY BREASTFEED SINCE 1997. THIS SERVICE IS FREE AND AVAILABLE TO ANY NURSING MOTHER, REGARDLESS OF WHERE SHE RECEIVES CARE. LOCATED AT the CARLE FOUNDATION HOSPITAL AND CLINICS IN CHAMPAIGN AND URBANA, THE SERVICE INCLUDES 24/7 SUPPORT WHERE BREASTFEEDING MOTHERS CAN CALL AND SPEAK TO A NURSE. IN 2015, STAFF RESPONDED TO 6,637 CALLS FOR ASSISTANCE, AND HAD 10,187 INPATIENT VISITS, 1,301 OUTPATIENT VISITS TO THE IN-HOSPITAL CLINIC, AND 4,673 VISITS TO THE TWO CARLE REGIONAL OUTPATIENT FACILITIES. DURING THIS TIME, THE BREASTFEEDING CLINIC ALSO MADE SIGNIFICANT PROGRESS TOWARD ACHIEVING A BABY-FRIENDLY HOSPITAL DESIGNATION, WHICH THEY HOPE TO ACCOMPLISH IN 2017. LANGUAGE ASSISTANCE SERVICES A ROBUST LANGUAGE ASSISTANCE PROGRAM IS PROVIDED FOR PATIENTS WHO HAVE LIMITED ENGLISH PROFICIENCY OR WHO ARE HEARING IMPAIRED, AT BOTH THE HOSPITAL AND CLINIC LOCATIONS. Funded BY THE CARLE HEALTH SYSTEM AND WITHIN A SHARED SERVICES COST CENTER, THIS TOTAL expenditure OF $247,328 IN 2015 IS NOT INCLUDED IN the CARLE FOUNDATION HOSPITALS COMMUNITY BENEFIT REPORTING. EFFORTS TO ADDRESS ACCESS TO CARE IN THE REGION CARLE CONTINUED TO PROVIDE BOARD LEADERSHIP AND SUPPORT TO ADDRESS ACCESS TO CARE IN THE REGION. WITHIN COLES COUNTY, THAT INCLUDES THE FOLLOWING: - PHYSICIAN LEADERSHIP ON THE COLES COMMUNITY HEALTH CENTER FQHC BOARD OF GOVERNORS - PRESENCE ON THE REGIONAL HEALTHCARE COALITION, A GROUP PROVIDING RESOURCES FOR EMERGENCY SERVICES TO ADDRESS PUBLIC HEALTH RISKS AND INCIDENTS (PAID BY HOOPESTON REGIONAL HEALTH CENTER) - PHYSICIAN SUPPORT ON THE COLES COMMUNITY HEALTH COUNCIL THAT STARTED IN LATE 2014 WHEN EBOLA FIRST BECAME A PUBLIC HEALTH CONCERN PRESCRIPTION AFFORDABILITY AS A 340B PROVIDER, CARLE HAS CONTRACTED WITH CERTAIN AREA RETAIL PHARMACIES TO OFFER DISCOUNTED PRESCRIPTIONS FOR SELF-PAY PATIENTS. THOSE UNINSURED PATIENTS PURCHASING PRESCRIPTIONS OUT-OF-POCKET FROM A CONTRACTED 340B PHARMACY WILL RECEIVE DISCOUNTS THAT MAKE PRESCRIPTIONS MORE AFFORDABLE. IN ITS SECOND YEAR, THE PROGRAM SAW 9,313 PRESCRIPTIONS FILLED AT A TOTAL OUT-OF-POCKET SAVINGS OF $2,214,622 OVER THE USUAL AND CUSTOMARY RETAIL PRICE. NOT ONLY DOES THE PROGRAM LESSEN THE FINANCIAL BURDEN ON UNINSURED PATIENTS WITH REALIZED PRESCRIPTION DISCOUNTS, IT IMPROVES HEALTH OUTCOMES BY IMPROVING PATIENT COMPLIANCE WITH PHARMACEUTICAL THERAPY DUE TO IMPROVED AFFORDABILITY OF MEDICATIONS, AND HAS THE POTENTIAL TO REDUCE UNNECESSARY READMISSIONS AND/OR UNNECESSARY SPECIALTY VISITS DUE TO IMPROVED PATIENT COMPLIANCE WITH PRESCRIBED DRUG REGIMENS. PHYSICIAN AND ADVANCED PRACTICE PROVIDERS (APP) RECRUITMENT CARLE CONTINUES TO ACTIVELY RECRUIT NEW PRIMARY CARE PROVIDERS (PHYSICIANS AND APPS) TO INCREASE AVAILABLE CAPACITY FOR EXISTING PATIENTS AND NEW PATIENTS. CARLE HIRED 65 PHYSICIANS IN 2015 AND HAS PLANS TO RECRUIT 24 PRIMARY CARE AND 48 SPECIALTY PHYSICIANS IN 2016. OTHER ACCESS IMPROVEMENTS THE CARLE EMERGENCY DEPARTMENT CONTINUED TO SEE INCREASING VOLUMES IN 2015. CARLE CONVENIENT CARE EXPERIENCED INCREASED VOLUMES AS WELL. TOGETHER, THIS HELPS UNDERSCORE THE COMMUNITYS DEMAND FOR MORE ACCESS, WHICH IN PART DRIVES THE OVERALL RECRUITMENT PLAN. AS PART OF OUR RESPONSE TO THIS DEMAND, CARLE BEGAN TO OFFER E-VISITS THROUGH ITS PATIENT WEB PORTAL FOR SIMPLE MEDICAL CONDITIONS. THIS SERVICE ALLOWS FOR REMOTE VISITS VIA DIGITAL CHANNELS THAT ARE LESS EXPENSIVE AND MORE CONVENIENT. CARLE IS ALSO BEGINNING VIRTUAL VISITS AND TAKING STEPS TO REDESIGN THE CARE PROCESS IN WHICH TEAM-BASED CARE AND MEDICAL HOME MODELS WILL HELP INCREASE ACCESS AND EFFICIENCY OF CARE DELIVERY. BEHAVIORAL HEALTH CARLE IS WORKING TO ADDRESS BEHAVIORAL HEALTH ISSUES BY EXPANDING ITS CAPACITY AND SUPPORTING COMMUNITY PROGRAMS AND SERVICES TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES. CARLE FOUNDATION HOSPITAL WILL PURSUE THESE ADDITIONAL INITIATIVES TO IMPROVE BEHAVIORAL HEALTH OUTCOMES: 1. RECRUIT BEHAVIORAL HEALTH PROVIDERS TO ADD CAPACITY WITHIN THE COMMUNITY 2. SUPPORT COMMUNITY BEHAVIORAL/MENTAL HEALTH SERVICES THROUGH DONATIONS 3. SUPPORT EDUCATIONAL AND TRAINING PROGRAMS OF LOCAL PROVIDERS 4. SUPPORT DISCUSSIONS WITH LOCAL BEHAVIORAL HEALTH PROVIDERS ABOUT EXPANDING COMMUNITY ACCESS TO THEIR SERVICES 5. ESTABLISH AN INTERNAL BEHAVIORAL HEALTH WORKGROUP TO ADDRESS NEEDS AND ACTIONS FOR MANAGING PATIENTS FROM ACROSS THE CARLE SYSTEMS THAT HAVE BEHAVIORAL HEALTH NEEDS 6. SUPPORT A NEW UNIVERSITY OF ILLINOIS PSYCHIATRY RESIDENCY PROGRAM THAT WAS APPROVED IN 2015. THIS PROGRAM WILL HELP TRAIN MORE PROVIDERS AND POSSIBLY LEAD TO GRADUATES STAYING IN THE LOCAL AREA. MEASURES OF SUCCESS: - INCREASE NUMBER OF CARLE BEHAVIORAL HEALTH PROVIDERS - DONATION SUPPORT TO COMMUNITY ELEMENTS - CASH DONATIONS - USE OF SPACE - DONATION TO CHAMPAIGN COUNTY MENTAL HEALTH BOARD - COMMUNITY TRAINING PROGRAM SUPPORT - FINANCIAL SUPPORT OF COMMUNITY JAIL/ER DIVERSION PROJECT - IN COLES COUNTY, MAINTAIN A PRESENCE ON THE BOARD FOR LIFELINKS, A MENTAL HEALTH SERVICES
6. AFFILIATED HEALTH CARE SYSTEM (Part VI, Line 6)	THE carle foundation HOSPITAL AND ITS ASSOCIATED BUSINESS UNITS UNDER THE CARLE FOUNDATION UMBRELLA ALL (EXCEPT FOR HOOPESTON COMMUNITY MEMORIAL HOSPITAL, WHICH HAS ITS OWN SPECIFIC COMMUNITY BENEFIT PLAN) PARTICIPATE IN CARRYING OUT THE SAME ANNUAL COMMUNITY BENEFIT PLAN, PARTICIPATING IN PROGRAMS THAT FIT THEIR SPECIFIC MISSIONS.
7. STATE FILING OF COMMUNITY BENEFIT REPORT (PART VI, LINE 7)	IL

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
The Carle Foundation Hospital

Employer identification number
37-1119538

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) University of Illinois 505 S MATHEWS AVE URBANA,IL61801	37-6000511	501(c)(3)	1,319,308	Scholarships & Sponsorships
(2) United Way of Champaign County 404 W CHURCH ST CHAMPAIGN,IL61820	37-0662519	501(c)(3)	516,746	Campaign
(3) Parkland College Foundation 2400 West Bradley Ave Champaign,IL61821	37-0892090	501(c)(3)	260,000	Scholarships & Sponsorships
(4) PRAIRIE CENTER HEALTH SYSTEMS INC 718 KILLARNEY ST URBANA,IL61801	37-0917137	501(c)(3)	81,300	VIVITROL DRUG COURT PROJECT
(5) THE KIRBY FOUNDATION 1000 MEDICAL CENTER DR Monticello,IL61856	06-1836473	501(c)(3)	27,500	OPERATIONS AND FACILITIES
(6) CHAMPAIGN COUNTY CHAMBER OF COMMERCE 303 W KIRBY AVE Champaign,IL61820	37-1269310	501(c)(6)	12,900	ANNUAL CONTRIBUTION
(7) Vermilion County Advantage 28 W North St Danville,IL61832	37-0238000	501(c)(6)	8,250	Membership, program support
(8) DON MOYER BOYS & GIRLS CLUB 201 EAST PARK ST Urbana,IL61801	37-0906638	501(c)(3)	7,500	BOYS AND GIRLS PROGRAM SUPPORT
(9) BETH'S PLACE PO BOX 462 TUSCOLA,IL61953	37-1345315	501(c)(3)	5,987	PROGRAM SUPPORT-FY16 CAMPAIGN
(10) DAILY BREAD SOUP KITCHEN 124 W WHITE ST Champaign,IL61824	37-1200848	501(c)(3)	5,700	CAPITAL CAMPAIGN/PROG SUPPORT
(11) CHAMPAIGN COUNTY CASA 154 C LINCOLN SQUARE URBANA,IL61801	37-1325204	501(c)(3)	5,200	PROGRAM SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

FORM 990, SCHEDULE I

DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS ANY CHARITABLE ORGANIZATION WISHING TO REQUEST FUNDS IS ASKED TO SUBMIT THEIR REQUEST IN WRITING. EMAILED REQUESTS ARE ACCEPTABLE. THE REQUEST MUST INCLUDE A DESCRIPTION OF THE PURPOSE OF THE CONTRIBUTION AND OTHER RELEVANT INFORMATION SUCH AS REQUESTORS NAME, AMOUNT OF THE REQUEST, ETC. THE REQUESTS ARE REVIEWED, EVALUATED, AND ADMINISTERED BY THE PUBLIC RELATIONS DIRECTOR, SEEKING ADDITIONAL INFORMATION FROM THE REQUESTOR, AS NEEDED, AND INPUT FROM ANY APPROPRIATE CARLE ADMINISTRATOR OR DIRECTOR. A SET OF ESTABLISHED GUIDELINES DRIVE THESE DECISIONS WHILE MOST ARE MADE TO IMPROVE HEALTHCARE/ACCESS TO HEALTHCARE OR ARE IN LINE WITH OUR ROLE AS A CORPORATE CITIZEN. ASSESSED NEED IS A COMMON CRITERIA. IN THE CASE OF MOST DONATIONS OF $5,000 OR MORE, SUCH AS TO COLLEGES AND UNIVERSITIES OR COMMUNITY CLINICS, WRITTEN AGREEMENTS ARE IN PLACE AND WE HAVE REGULAR CONTACT WITH THOSE ORGANIZATIONS, OFTENTIMES THROUGH A CARLE CONTACT PERSON TO ASSURE THAT THE DONATIONS ARE BEING USED AS AGREED UPON. RECORDS ARE MAINTAINED EITHER IN ADMINISTRATION OR PUBLIC RELATIONS.

Schedule I (Form 990) 2015

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" on 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

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Yes

Were any amounts reported on 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" on 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) 2015

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 on 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 on 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)
1Kenneth Aronson MDSECRETARY OF BOARD	(i) (ii)	0 ------------- 333,363	0 ------------- 23,946	0 ------------- 22,857	0 ------------- 21,480	0 ------------- 13,100	0 ------------- 414,746	0 ------------- 0
2Matthew Gibb MDExec VP & CMO	(i) (ii)	0 ------------- 574,847	0 ------------- 141,405	0 ------------- 9,154	0 ------------- 196,109	0 ------------- 3,262	0 ------------- 924,777	0 ------------- 0
3Paul Tender MDTrustee & Physician	(i) (ii)	0 ------------- 423,209	0 ------------- 0	0 ------------- 4,009	0 ------------- 21,480	0 ------------- 13,302	0 ------------- 462,000	0 ------------- 0
4Cora E Musial Phd MDSec/Treas of Board - Former	(i) (ii)	0 ------------- 261,227	0 ------------- 0	0 ------------- 16,101	0 ------------- 21,480	0 ------------- 2,205	0 ------------- 301,013	0 ------------- 0
5James C Leonard MDEx-Officio, President & CEO	(i) (ii)	0 ------------- 1,170,106	0 ------------- 388,671	0 ------------- 460,514	0 ------------- 452,857	0 ------------- 7,155	0 ------------- 2,479,303	0 ------------- 424,300
6R Bruce Wellman MDEX-OFFICIO, CEO OF CPG-FORMER	(i) (ii)	0 ------------- 300,488	0 ------------- 10,948	0 ------------- 360,209	0 ------------- 21,480	0 ------------- 2,705	0 ------------- 695,830	0 ------------- 325,679
7John SnyderExec VP & COO	(i) (ii)	0 ------------- 723,420	0 ------------- 179,389	0 ------------- 289,188	0 ------------- 258,574	0 ------------- 17,756	0 ------------- 1,468,327	0 ------------- 258,109
8Dennis HeschExec VP & CFO	(i) (ii)	0 ------------- 621,077	0 ------------- 149,692	0 ------------- 224,736	0 ------------- 220,069	0 ------------- 22,991	0 ------------- 1,238,565	0 ------------- 193,630
9Laurence FallonExec VP-Legal Affairs & HR	(i) (ii)	0 ------------- 501,989	0 ------------- 119,936	0 ------------- 128,289	0 ------------- 170,362	0 ------------- 22,333	0 ------------- 942,909	0 ------------- 122,184
10Joseph Barkmeier MDKey Employee - Former	(i) (ii)	0 ------------- 260,805	0 ------------- 58,459	0 ------------- 41,525	0 ------------- 75,984	0 ------------- 11,938	0 ------------- 448,711	0 ------------- 34,418
11Pamela BiglerSVP-Nursing & CNO	(i) (ii)	0 ------------- 287,295	0 ------------- 62,215	0 ------------- 101,840	0 ------------- 91,925	0 ------------- 6,181	0 ------------- 549,456	0 ------------- 75,805
12Lynette BarnesSVP-Hosp Ops & HVI	(i) (ii)	0 ------------- 299,378	0 ------------- 63,406	0 ------------- 99,161	0 ------------- 96,110	0 ------------- 0	0 ------------- 558,055	0 ------------- 72,395
13STEPHANIE BEEVERKey Employee - Former	(i) (ii)	0 ------------- 317,759	0 ------------- 71,570	0 ------------- 98,328	0 ------------- 98,142	0 ------------- 19,307	0 ------------- 605,106	0 ------------- 71,158
14KIM JOHNSTONKey Employee - Former	(i) (ii)	0 ------------- 208,139	0 ------------- 39,212	0 ------------- 77,573	0 ------------- 61,384	0 ------------- 10,717	0 ------------- 397,025	0 ------------- 63,506
15JULIANNA SELLETTVP-DIAGNOSTIC & TRANS'L CARE	(i) (ii)	0 ------------- 185,264	0 ------------- 30,471	0 ------------- 23,145	0 ------------- 54,721	0 ------------- 23,665	0 ------------- 317,266	0 ------------- 0
16DAWN WALDENVP-REVENUE CYCLE OPS	(i) (ii)	0 ------------- 243,437	0 ------------- 38,002	0 ------------- 56,405	0 ------------- 68,809	0 ------------- 19,039	0 ------------- 425,692	0 ------------- 49,810
17LINDA FREDINPT PHARM DIRECTOR	(i) (ii)	178,504 ------------- 0	20,539 ------------- 0	1,448 ------------- 0	16,171 ------------- 0	23,047 ------------- 0	239,709 ------------- 0	0 ------------- 0
18JOEL LOVEPHYSICIST	(i) (ii)	187,564 ------------- 0	500 ------------- 0	1,323 ------------- 0	15,220 ------------- 0	23,546 ------------- 0	228,153 ------------- 0	0 ------------- 0
19KHANDAKER ISLAMPHYSICIST	(i) (ii)	168,795 ------------- 0	500 ------------- 0	536 ------------- 0	13,248 ------------- 0	20,999 ------------- 0	204,078 ------------- 0	0 ------------- 0
20VIJAY BAVDAPHARMACIST-INPT RX	(i) (ii)	160,802 ------------- 0	523 ------------- 0	6,054 ------------- 0	12,979 ------------- 0	21,865 ------------- 0	202,223 ------------- 0	0 ------------- 0
21Blair Rowitz MDMed Dir- Surgical Services	(i) (ii)	0 ------------- 745,940	0 ------------- 32,637	0 ------------- 3,450	0 ------------- 21,480	0 ------------- 19,091	0 ------------- 822,598	0 ------------- 0
22Malec Mokraoui MDMed Dir- HVI	(i) (ii)	0 ------------- 602,221	0 ------------- 34,008	0 ------------- 9,264	0 ------------- 21,480	0 ------------- 15,474	0 ------------- 682,447	0 ------------- 0
23Andy Arwari MDMed Dir- Hospital Medicine	(i) (ii)	0 ------------- 493,643	0 ------------- 18,213	0 ------------- 8,588	0 ------------- 21,480	0 ------------- 20,014	0 ------------- 561,938	0 ------------- 0
24Matthew KolbVP-Neuro & HVI	(i) (ii)	0 ------------- 214,586	0 ------------- 15,231	0 ------------- 7,000	0 ------------- 35,469	0 ------------- 22,299	0 ------------- 294,585	0 ------------- 0
25Caleb MillerVP-Surgical Services	(i) (ii)	0 ------------- 175,483	0 ------------- 18,099	0 ------------- 13,020	0 ------------- 44,956	0 ------------- 11,751	0 ------------- 263,309	0 ------------- 0
26Matthew PikePharmacist-Inpt Rx	(i) (ii)	160,581 ------------- 0	517 ------------- 0	219 ------------- 0	12,556 ------------- 0	21,578 ------------- 0	195,451 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

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
SUPPLEMENTAL COMPENSATION INFORMATION	SCHEDULE J, PART I, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF THE CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE.
FORM 990, SCHEDULE J, PART I, QUESTION 4B	THE 2015 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF THE CARLE FOUNDATION HOSPITAL, THAT ARE LISTED IN THE 990 PART VII INCLUDE JAMES LEONARD, MD, JOHN SNYDER, DENNIS HESCH, MATTHEW GIBB, MD, LAURENCE FALLON, LYNETTE BARNES, PAMELA BIGLER, DAWN WALDEN, JULIANNA SELLETT, MATTHEW KOLB, CALEB MILLER, STEPHANIE BEEVER, JOSEPH BARKMEIER, MD, AND KIM JOHNSTON. THE 2015 PAYMENTS FROM THE 457(F) PLAN WERE MADE TO JAMES LEONARD, MD ($424,300), JOHN SNYDER ($258,109), DENNIS HESCH ($193,630), LAURENCE FALLON ($122,184), LYNETTE BARNES ($72,395), PAMELA BIGLER ($75,805), DAWN WALDEN ($49,810), R. BRUCE WELLMAN, MD ($325,679), STEPHANIE BEEVER ($71,158), JOSEPH BARKMEIER, MD ($34,418), AND KIM JOHNSTON ($63,506).
FORM 990, SCHEDULE J, PART I, QUESTION 7	PART OF THE OVERALL EMPLOYEE'S COMPENSATION PROGRAM INCLUDES AN INCENTIVE COMPONENT THAT COVERS MOST EMPLOYEES AND IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.

Schedule J (Form 990) 2015

Additional Data

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Software Version:

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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

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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) 2015

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) SUZANNE RODAWIG	FAMILY MEMBER OF TRUSTEE	37,230	EMPLOYMENT		No
(2) JEANETTE GIBB	FAMILY MEMBER OF OFFICER	78,255	EMPLOYMENT		No

Part V

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

Return Reference	Explanation
RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION	FORM 990, SCHEDULE L, PART IV, COLUMN D SUZANNE RODAWIG IS AN EMPLOYEE OF THE CARLE FOUNDATION HOSPITAL AND has a family relationship with J. MICHAEL MARTIN WHO SERVES AS A TRUSTEE OF THE HOSPITAL. JEANETTE GIBB IS AN EMPLOYEE OF THE CARLE FOUNDATION HOSPITAL AND HAS A FAMILY RELATIONSHIP WITH MATTHEW GIBB WHO SERVES AS AN OFFICER OF THE HOSPITAL.

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( SEE PART II )	X	584	595,970	FMV
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference

Explanation

SCHEDULE M, PART I, COLUMN B

COLUMN B IS THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, LINE 25 REFRESHMENTS FOR SUPPORT GROUPS AND NOURISHMENT STATIONS, MAGAZINES, FACILITY RENTAL FEE, LANDSCAPING FOR OUTDOOR GARDEN SPACES, MEDICAL EQUIPMENT: Blood pressure MONITORS AND SCALES FOR HEART PATIENTS, POSITIONING AIDS FOR NICU, VECTRA IMAGING SYSTEM AND A TREADMILL FOR tHERAPY. BOOKS FOR PreSCRIPTION TO READ PROGRAMS, PIANO TUNING, VISION SCREENING SYSTEMS, LYMPHEDEMA EARLY DETECTION DEVICE, NICU WEBCAMS, EPINEPHRINE CABINETS, DIABETES BACKPACKS, SPEAKER EXPENSES/FOOD/MARKETING FOR COMMUNITY DIABETES EDUCATION EVENT. THE CARLE DEVELOPMENT FOUNDATION IS THE SOURCE OF ALL THESE CONTRIBUTIONS AND HAS A POLICY THAT MANDATES REVIEW OF ANY NON-STANDARD CONTRIBUTION.

Schedule M (Form 990) (2015)

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

2015

Open to Public
Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

Return Reference	Explanation
FORM 990, SUPPLEMENTAL INFORMATION	FORM 990, PART I, LINE I THE CARLE FOUNDATION HOSPITAL'S MISSION IS TO SERVE PEOPLE THROUGH HIGH QUALITY CARE, MEDICAL RESEARCH, AND EDUCATION. HEALTH CARE SERVICES ARE PROVIDED TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY.
FORM 990, PART VI, QUESTION 2	JAMES C. LEONARD, MD (EX-OFFICIO), PAUL TENDER, MD (TRUSTEE), MATTHEW GIBB, MD (OFFICER), JOHN SNYDER (OFFICER), PAM BIGLER (KEY EMPLOYEE) AND ANDY AWARI, MD (KEY EMPLOYEE) HAD A BUSINESS RELATIONSHIP. GUY HALL (CHAIR OF BOARD), DONNA GREENE (IMMEDIATE PAST CHAIR), J. MICHAEL MARTIN (TRUSTEE), KENNETH ARONSON, MD (TRUSTEE), PAUL TENDER, MD (TRUSTEE), JAMES C. LEONARD, MD (EX-OFFICIO), BRENDA TIMMONS (VICE CHAIR OF BOARD) AND KARL APPELQUIST (TRUSTEE) HAD A BUSINESS RELATIONSHIP. J. MICHAEL MARTIN (TRUSTEE), JAMES C. LEONARD, MD (EX-OFFICIO), MATTHEW GIBB, MD (OFFICER) AND JOHN SNYDER (OFFICER) HAD A BUSINESS RELATIONSHIP. JAMES C. LEONARD, MD (EX-OFFICIO), JOHN SNYDER (OFFICER), DENNIS HESCH (OFFICER) AND JOSEPH BARKMEIER, MD (FORMER KEY EMPLOYEE) HAD A BUSINESS RELATIONSHIP. GUY HALL (CHAIR OF BOARD), DONNA GREENE (IMMEDIATE PAST CHAIR), J. MICHAEL MARTIN (TRUSTEE), KENNETH ARONSON, MD (TRUSTEE), PAUL TENDER, MD (TRUSTEE), JAMES C. LEONARD, MD (EX-OFFICIO), BRENDA TIMMONS (VICE CHAIR OF BOARD), PHILLIP BLANKENBURG (IMMEDIATE PAST CHAIR) AND KARL APPELQUIST (TRUSTEE) HAD A BUSINESS RELATIONSHIP.
FORM 990, PART VI, QUESTION 6 & 7A	THE CARLE FOUNDATION HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES.
FORM 990, PART VI, QUESTION 7B	THE CARLE FOUNDATION HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF THE CORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $100,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; TO PLEDGE ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT; AND THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED.
FORM 990, PART VI, QUESTION 11B	THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY BY POSTING TO THE ORGANIZATION'S DIRECTOR COMMUNICATION PORTAL. ALSO BEFORE FILING, EACH TRUSTEE RECEIVED NOTIFICATION THAT THE FORM 990 WAS POSTED AND AVAILABLE FOR REVIEW AT HIS/HER DISCRETION, EACH TRUSTEE HAS THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS.
FORM 990, PART VI, QUESTION 12C	THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER, DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, QUESTIONS 15A & 15B	THE CARLE FOUNDATION HOSPITAL DOES NOT COMPENSATE ITS OFFICERS AND KEY EMPLOYEES. EMPLOYEE COMPENSATION FOR THESE INDIVIDUALS IS PAID BY THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, PARENT ORGANZATION OF THE CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE.
FORM 990, PART VI, QUESTIONS 18 & 19	THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF THE CARLE FOUNDATION HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND.COM. A COMMUNITY BENEFIT REPORT IS ALSO PUBLISHED AND DISTRIBUTED ANNUALLY TO THE COMMUNITY. QUARTERLY FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES.
PART VII, SECTION A, COLUMN B	THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK.
FORM 990, PART XI, LINE 9	THE CARLE FOUNDATION HOSPITAL SETTLED VARIOUS INTERCOMPANY RECEIVABLE/PAYABLE BALANCES THROUGH EQUAL OFFSETTING EQUITY TRANSFERS. THE INTERCOMPANY RECEIVABLE/PAYABLE BALANCE RESULTED FROM THE NORMAL COURSE OF OPERATIONS AND WERE PRIMARILY ATTRIBUTABLE TO CENTRALIZED CASH MANAGEMENT AND DISBURSEMENT ACTIVITIES. THESE INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS HELPED PROVIDE SUPPLEMENTAL FUNDING FOR CERTAIN RELATED ORGANIZATIONS TO FURTHER THEIR EXEMPT PURPOSES. EQUITY TRANSFERS (TO)/FROM AFFILIATES - (181,391,000) ROUNDING - 374 Reversal of contributions - (33,600) ------------- NET OTHER CHANGES IN NET ASSETS OR FUND BALANCES - (181,424,226) =============
FORM 990, PART XII, LINES 2A, B, C AND PART IV, LINES 12,12A	THE FINANCIAL STATEMENTS FOR THE CARLE FOUNDATION HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION has AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT or auditor.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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

2015

Open to Public Inspection

Name of the organization

The Carle Foundation Hospital

Employer identification number

37-1119538

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)THE CARLE FOUNDATION 611 W PARK ST URBANA,IL618012595 37-0673465	PARENT/INVMGT	IL	501(c)(3)	11C III-FI	NA		No
(2)The Carle Development Foundation 611 W Park St Urbana,IL618012595 37-1159978	Fundraising	IL	501(c)(3)	7	TCF	Yes
(3)Carle Health Care Incorporated 611 W Park St Urbana,IL618012595 37-1140016	Var MED Svcs	IL	501(c)(3)	9	TCF	Yes
(4)Carle Retirement Centers Inc 611 W Park St Urbana,IL618012595 37-1160033	RTRMT LIVING	IL	501(c)(3)	9	TCF	Yes
(5)Carle Community Health Corporation 611 W Park St Urbana,IL618012595 36-4458371	FDN MISSION	IL	501(c)(3)	11a Type I	TCDF	Yes
(6)HOOPESTON COMMUNITY MEMORIAL HOSPITAL 701 E ORANGE STREET HOOPESTON,IL609421801 36-3637465	HOSPITAL SERV	IL	501(c)(3)	3	TCF	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

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) Health Systems Insurance Limited Governors Sq 2nd FL Bldg 3 Grand Cayman KY1-1102 CJ	Insurance	CJ	na	C Corp				Yes
(2) Carle Holding Company Inc 611 W Park St Urbana,IL618012595 37-1188284	Holding CoMPANY	IL	na	C Corp				Yes
(3) eValiData Inc 611 W Park St Urbana,IL618012595 46-2022658	PHYS CREDENTIALS	IL	TCFH	C Corp	342,644	36,673	100.000 %	Yes
(4) Carle Risk Managment Company 611 W Park St Urbana,IL618012595 37-1217973	Risk ManagemeNT	IL	TCFH	C Corp	1,371,396	175,747	100.000 %	Yes
(5) Health Alliance Connect Inc 301 S Vine St Urbana,IL61801 46-4796891	HeaLth care coORD	IL	na	C Corp				Yes
(6) Health Alliance Medical Plans Inc 301 S VINE ST URBANA,IL61801 37-1260731	HEALTH COVERAGE	IL	na	C CORP				Yes
(7) CHA HOLDING INC 301 S VINE ST URBANA,IL618012295 47-1854275	HOLDING COMPANY	IL	NA	C CORP				Yes
(8) HEALTH ALLIANCE NORTHWEST HOLDING INC 820 N CHELAN AVE WENATCHEE,WA98801 46-1717578	HOLDING COMPANY	WA	NA	C CORP				Yes
(9) HEALTH ALLIANCE NORTHWEST HEALTH PLAN 820 N CHELAN AVE WENATCHEE,WA98801 46-1966323	HEALTH COVERAGE	WA	NA	C CORP				Yes
(10) HEALTH ALLIANCE-MIDWEST INC 301 S VINE ST URBANA,IL61801 37-1354502	HEALTH COVERAGE	IL	NA	C CORP				Yes

Schedule R (Form 990) 2015

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

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

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

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

Yes

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

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
(1) Carle Community Health Corporation	C	2,618,160	Accrual
(2) Carle Health Care Incorportated	l	2,012,539	Accrual
(3) Carle Development Foundation	C	1,397,824	Accrual
(4) Carle Health Care Incorporated	M	9,768,130	Accrual
(5) Health Alliance Medical Plans Inc	l	132,353,011	Accrual
(6) Carle Health Care Incorporated	R	1,316,874	Accrual
(7) Health Alliance Connect Inc	l	46,978,053	Accrual
(8) Carle Health Care Incorporated	P	372,270	Accrual
(9) Health Systems Insurance Limited	M	2,251,402	Accrual
(10) HOOPESTON COMMUNITY MEMORIAL HOSPITAL	L	472,541	ACCRUAL
(11) HOOPESTON COMMUNITY MEMORIAL HOSPITAL	M	54,721	ACCRUAL
(12) HOOPESTON COMMUNITY MEMORIAL HOSPITAL	R	2,132,501	ACCRUAL

Schedule R (Form 990) 2015

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) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation
Schedule R, Supplemental Information	SCHEDULE R, PART II CARLE HEALTH CARE INCORPORATED PRIMARY ACTIVITY: EMERGENCY TRANSPORT, DAY CARE, PHYSICIAN SERVICES.

Schedule R (Form 990) 2015

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	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	3,822
6	Total number of volunteers (estimate if necessary) .............	6	1,834
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,301,386
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) .........	5,412,037	5,767,114
9	Program service revenue (Part VIII, line 2g) .........	691,191,235	744,239,726
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	195,035	95,866
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,164,534	4,422,453
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	700,962,841	754,525,159
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,321,503	2,390,015
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)	195,260,688	203,514,559
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)....	350,027,875	384,890,552
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	547,610,066	590,795,126
19	Revenue less expenses. Subtract line 18 from line 12.......	153,352,775	163,730,033
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	461,332,351	447,932,530
21	Total liabilities (Part X, line 26).............	99,456,615	103,750,987
22	Net assets or fund balances. Subtract line 21 from line 20.....	361,875,736	344,181,543

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 549,345,313 including grants of $ 783,207 ) (Revenue $ 747,452,167 )
	SERVING PEOPLE THROUGH HIGH QUALITY MEDICAL CARE THE CARLE FOUNDATION HOSPITAL IS AN ILLINOIS NOT-FOR-PROFIT CORPORATION ESTABLISHED FOR THE PURPOSE OF OPERATING THE CARLE FOUNDATION'S 393-LICENSED BED HOSPITAL AND RELATED FACILITIES AND, CONDUCTING PATIENT CARE RELATED ACTIVITIES OF THE FOUNDATION. THE HOSPITAL, A LEVEL ONE TRAUMA CENTER, OFFERS A FULL RANGE OF INPATIENT AND OUTPATIENT DIAGNOSTIC AND THERAPEUTIC SERVICES FOR MEDICAL, SURGICAL, OBSTETRICAL AND GYNECOLOGICAL PATIENTS. THE HOSPITAL PROVIDES VARIOUS ANCILLARY SUPPORT SERVICES TO BOTH INPATIENTS AND OUTPATIENTS SUCH AS AUTOPSY, BLOOD BANK, EMERGENCY SERVICES, RESPIRATORY THERAPY, OPERATING ROOM, OCCUPATIONAL THERAPY, PASTORAL COUNSELING, SOCIAL SERVICES, PHARMACY AND PHYSICAL THERAPY. THE CARLE FOUNDATION HOSPITAL'S MISSION IS TO SERVE PEOPLE THROUGH HIGH QUALITY CARE, MEDICAL RESEARCH AND EDUCATION. WE MAKE SURE THOSE WHO NEED CARE, GET CARE, WHETHER OR NOT THEY CAN PAY. THROUGH OUR COMMUNITY CARE DISCOUNT PROGRAM FOR HOSPITAL SERVICES AND OUR PARTNERSHIPS WITH AREA HEALTH AGENCIES, ACCESS TO DENTAL, VISION AND GENERAL HEALTHCARE HAS BEEN IMPROVED FOR THOSE WHO ARE STRUGGLING FINANCIALLY. AS THE SECOND TENET IN OUR MISSION, RESEARCH GIVES US TOMORROW'S ANSWERS, TODAY. IN COLLABORATION WITH THE UNIVERSITY OF ILLINOIS SCIENTISTS AND THE CARLE PHYSICIAN GROUP PHYSICIANS, WE ARE TURNING THE LATEST MEDICAL KNOWLEDGE INTO PRACTICAL APPLICATIONS FOR THE BEDSIDE. WE ARE NOW CONDUCTING MORE THAN 150 ACTIVE AND PENDING STUDIES RELATING TO CANCER, GASTRO-INTESTINAL DISEASE, CARDIOVASCULAR DISEASE AND MORE. EDUCATIONAL PROGRAMS FOR BOTH OUR PROFESSIONALS AND THE COMMUNITY ENSURE EVERYONE IS BETTER PREPARED. FOR THE COMMUNITY, WE OFFER A MYRIAD OF OPPORTUNITIES LIKE BABYSITTING CERTIFICATION AND NEW DAD COURSES, ALONG WITH FREE CPR AND FIRST AID CLASSES. FOR OUR PROFESSIONALS, WE HAVE CONTINUING EDUCATION COURSES, THREE LEVELS OF MANAGEMENT TRAINING CLASSES AND COURSES FOR PHYSICIAN LEADERS. THE CARLE FOUNDATION HOSPITAL'S CONTINUED SUCCESS IS ROOTED IN OUR ABILITY TO ADAPT TO A CHANGING HEALTHCARE ENVIRONMENT, PLAN DILIGENTLY FOR OUR FUTURE AND MAINTAIN A COMMITMENT TO OUR PATIENTS AND COMMUNITY. NOT-FOR-PROFIT HOSPITALS HAVE A LONG STANDING PRACTICE OF PROVIDING SUPPORT, DONATIONS AND SERVICES TO THEIR COMMUNITIES. THIS STEMS NOT FROM ECONOMIC OPPORTUNITY, BUT RATHER FROM A RESPONSIBILITY TO ADDRESS AND IMPROVE THE HEALTH OF ALL THE PEOPLE THEY SERVE. AT THE CARLE FOUNDATION HOSPITAL, WE ALSO BELIEVE THAT WE HAVE AN OBLIGATION TO GENEROUSLY GIVE BACK TO OUR COMMUNITY IN EXCHANGE FOR OUR TAX EXEMPTION. ALL OF THESE FACTORS LEAD TO THE CARLE FOUNDATION HOSPITAL BEING A CHAMPION OF ACCESS TO HEALTHCARE AND A PILLAR OF COMMUNITY SUPPORT. COMMUNITY BENEFIT PROGRAMS ARE BASED ON ASSESSED NEEDS AND DESIGNED TO IMPROVE THE HEALTH OF THOSE WHO LIVE AND WORK IN OUR AREA, WITH A FOCUS ON SERVING THOSE LESS FORTUNATE. AREAS OF COMMUNITY BENEFIT INCLUDE: HOSPITAL SERVICES THAT OPERATE AT A LOSS, CASH AND IN-KIND DONATIONS, TRANSLATIONAL RESEARCH, COMMUNITY EDUCATION, COMMUNITY-BUILDING ACTIVITIES AND WORKFORCE DEVELOPMENT. THE CARLE FOUNDATION HOSPITAL STRIVES TO ELIMINATE BARRIERS THAT KEEP AREA RESIDENTS FROM RECEIVING THE CARE THEY NEED. THE CARLE FOUNDATION HOSPITAL'S COMMUNITY CARE DISCOUNT PROGRAM IS ONE OF THE MOST GENEROUS FINANCIAL ASSISTANCE DISCOUNT PROGRAMS IN THE COUNTRY. WE WANT TO MAKE SURE THAT THE PEOPLE WHO QUALIFY KNOW ABOUT THEIR OPTIONS. OUR ADVERTISING THROUGHOUT THE REGION IS TARGETED TO REACH PEOPLE WHO QUALIFY SO THEY ARE AWARE FINANCIAL ASSISTANCE IS AVAILABLE. AS A NOT-FOR-PROFIT HOSPITAL, IT IS OUR OBLIGATION TO REACH OUT TO THOSE WHO CANNOT AFFORD HEALTHCARE.

4b	(Code: ) (Expenses $ 19,144,160 including grants of $ ) (Revenue $ )
	THE CARLE COMMUNITY CARE DISCOUNT PROGRAM (FINANCIAL ASSISTANCE) AS A TAX-EXEMPT ORGANIZATION, CARLE PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR THAT CARE OR SOURCE OF PAYMENT. WE ALSO RECOGNIZE THAT SOME PATIENTS NEED HELP TO PAY THEIR BILLS. THE CARLE FOUNDATION HOSPITAL'S COMMUNITY CARE DISCOUNT PROGRAM (FINANCIAL ASSISTANCE) PROVIDES DISCOUNTS OR FREE CARE TO THOSE WHO NEED IT. OUR COMMUNITY CARE DISCOUNT PROGRAM IS CONTINUALLY EVALUATED AND MANAGED AS NEEDED TO MEET THE NEEDS OF OUR COMMUNITY. EVALUATION INVOLVES INPUT FROM ADMINISTRATIVE LEADERS, PATIENT ACCOUNTS STAFF, LOCAL CONSUMER ADVOCACY GROUPS, AND PATIENTS. FOR THE TWELVE MONTHS ENDED DECEMBER 31, 2015 (CY15), FINANCIAL ASSISTANCE TOTALED $19,144,160 AND SERVED 25,756 PEOPLE.

4c	(Code: ) (Expenses $ 4,994,161 including grants of $ 1,606,808 ) (Revenue $ )
	RESEARCH AND EDUCATION INITIATIVES the CARLE FOUNDATION HOSPITAL HAS AN ACTIVE RESEARCH PROGRAM THAT BRINGS ADVANCED CLINICAL TRIALS TO OUR REGION, HELPS IMPROVE CLINICAL CARE AND DISCOVERs NEW SOLUTIONS TO HEALTH CHALLENGES. AT THE END OF 2015, MORE THAN 200 STUDIES WERE UNDERWAY. CARLE WORKS WITH INDUSTRY SPONSORS, FEDERAL AGENCIES, FOUNDATIONS AND START-UP COMPANIES ON A VARIETY OF CLINICAL TOPICS INCLUDING CANCER, NEUROSCIENCES, DIGESTIVE HEALTH, MATERNAL CHILD HEALTH, HEART AND VASCULAR DISEASE, SPORTS MEDICINE, OPHTHALMOLOGY AND HEARING DISORDERS. 2015 WAS A MOMENTOUS YEAR WHERE CARLE FINALIZED AGREEMENTS WITH UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN (uiuc) TO DEVELOP A NEW COLLEGE OF MEDICINE FOCUSED AT THE INTERSECTION OF MEDICINE AND ENGINEERING WITH A STRONG RESEARCH MISSION. BECAUSE OF THIS PARTNERSHIP, NEW COLLABORATIONS STARTED. IN ADDITION, CARLE HIRED A NEW VICE PRESIDENT FOR RESEARCH. RESEARCH HIGHLIGHTS INCLUDE: - NEUROSCIENCES: NEUROLOGIST GRAHAM HUESMANN, MD, PHD, AND NEUROSURGEON WILLIAM OLIVERO, MD COLLABORATED WITH Uiuc SCIENTISTS TO EVALUATE MAGNETIC RESONANCE IMAGING ELASTOGRAPHY FOR PLANNING EPILEPSY AND BRAIN TUMOR SURGERY. RESULTS ARE PROMISING AND HAVE BEEN SUBMITTED TO A MAJOR PEER REVIEWED JOURNAL FOR PUBLICATION. - KEN ARONSON, MD LAUNCHED A PATIENT RESEARCH REGISTRY FOR MILD TRAUMATIC BRAIN INJURY TO PROVIDE LONG TERM STUDY ON COGNITION AND NEUROLOGICAL FUNCTION. THIS IS A LITTLE STUDIED AREA. - OPHTHALMOLOGY: LEANNE LABRIOLA, OD AND UIuc PROFESSOR DIPANJAN PAN SUBMITTED A PATENT APPLICATION FOR A DEVICE THEY CO-DEVELOPED TO DETECT PENETRATING EYE INJURIES. - SEPSIS: ICU PHYSICIAN KAREN WHITE, MD AND UIuc PROFESSOR RASHID BASHIR ARE DEVELOPING A BEDSIDE DEVICE FOR EARLY DETECTION OF SEPSIS. PRELIMINARY FINDINGS SUGGEST THE ABILITY TO DETECT A TREND TOWARD SEPSIS EARLIER THAN THE STANDARD. CANCER CONTINUES TO BE ONE OF OUR MOST ACTIVE AREAS OF RESEARCH. IN 2015, CARLE AND uiuc PARTNERED TO FUND THREE GRADUATES STUDENTS. PROJECTS INCLUDED THE BENEFITS OF EXERCISE ON COGNITION OF SURVIVORS, IDENTIFICATION OF NEW BIOMARKERS AND THERAPEUTIC TARGETS AND DEVELOPING A RAPID SCREENING FOR PERSONALIZED SELECTION OF CANCER THERAPIES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses573,683,684

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	888,405	12,516,542	2,541,325

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,107,738
e	Government grants (contributions)		1e	1,659,376

f	All other contributions, gifts, grants, and similar amounts not included above		1f	0

g	Noncash contributions included in lines 1a-1f:$ 595,970
h Total.Add lines 1a-1f.......		5,767,114

			Business Code
2a	NET PATIENT CARE	621110	741,444,280	741,444,280
b	NET PATIENT CARE - ASC	621110	2,795,446	2,795,446
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			744,239,726

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			2,849			2,849
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents	8,006,659
b	Less: rental expenses	4,812,150
c	Rental income or (loss)	3,194,509	0
d	Net rental income or (loss)......			3,194,509		3,194,509
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	653,203
b	Less: cost or other basis and sales expenses	560,186
c	Gain or (loss)	93,017
d	Net gain or (loss).....			93,017		91,374	1,643
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		616,055
b	Less: cost of goods sold ..b		3,760,002
c	Net income or (loss) from sales of inventory..			-3,143,947		-3,143,947
Business Code			Miscellaneous Revenue
11a	INTERNAL MANAGEMENT FEES		900099	2,846,680	2,846,680
b	CLINICAL TRIALS/REF LAB REIMBURSEMENTS		611430	1,159,450	0	1,159,450
c	CAOS TUITION		900099	196,466	196,466
d	All other revenue ....			169,295	169,295
e	Total. Add lines 11a–11d ......			4,371,891
12	Total revenue. See Instructions......			754,525,159	747,452,167	1,301,386	4,492

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	2,390,015	2,390,015
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	115,485	115,485
7	Other salaries and wages	160,079,877	157,148,723	2,931,154
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,197,024	8,032,838	164,186
9	Other employee benefits .......	23,450,876	23,064,459	386,417
10	Payroll taxes ...........	11,671,297	11,459,092	212,205
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	7,549	7,332	217
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)	15,888,865	15,331,631	557,234
12	Advertising and promotion ....	133,899	132,083	1,816
13	Office expenses .......	15,456,790	14,303,125	1,153,665
14	Information technology ......	12,144,820	11,683,427	461,393
15	Royalties ..	0
16	Occupancy ...........	36,479,227	34,430,661	2,048,566
17	Travel ............	1,051,366	1,035,086	16,280
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	685,403	574,216	111,187
20	Interest ...........	85,007	36,867	48,140
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	16,600,179	15,583,218	1,016,961
23	Insurance ...	1,828,545	1,639,939	188,606
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	PATIENT CARE SUPPLIES	132,591,210	130,820,480	1,770,730
b	INTERNAL MANAGEMENT FEES	119,476,341	115,321,998	4,154,343
c	OTHER PURCHASED SERVICES	17,324,943	16,026,545	1,298,398
d	UNRELATED BUSINESS INCOME TAX	2,549	0	2,549
e	All other expenses	15,133,859	14,546,464	587,395
25	Total functional expenses. Add lines 1 through 24e	590,795,126	573,683,684	17,111,442	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).

1	Cash–non-interest-bearing ........			21,318	1	40,282
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	175,992
4	Accounts receivable, net .............			106,068,304	4	112,335,698
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 ........			9,423,748	8	9,216,146
9	Prepaid expenses and deferred charges ......			4,705,852	9	5,745,848
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	155,411,580
b	Less: accumulated depreciation	10b	79,482,573	74,215,826	10c	75,929,007
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			266,897,303	15	244,489,557
16	Total assets. Add lines 1 through 15 (must equal line 34)...			461,332,351	16	447,932,530

17	Accounts payable and accrued expenses .....	19,837,614	17	19,797,319
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	463,245
20	Tax-exempt bond liabilities .........	0	20	0
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	79,619,001	25	83,490,423
26	Total liabilities. Add lines 17 through 25..	99,456,615	26	103,750,987

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	361,875,736	27	344,181,543
28	Temporarily restricted net assets ...........	0	28	0
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 ...........	361,875,736	33	344,181,543
34	Total liabilities and net assets/fund balances ........	461,332,351	34	447,932,530