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)
(1) John T Rice MD Chair	1.0 .................	X	X	0	0
(2) Sloan S Shah MD Vice Chair (partial year)	1.0 .................	X	X	0	0
(3) Richard H Seall MD Board Member (partial year) / Vice Chair (partial year)	1.0 .................	X	X	0	0
(4) Daniel E Scherb MD BOARD MEMBER	1.0 .................	X		0	0
(5) Walter H Halloran MD BOARD MEMBER	1.0 .................	X		0	0
(6) ERIC D KNAPP DO BOARD MEMBER	1.0 .................	X		0	0
(7) BRIAN SUCHARETZA MD Board Member	1.0 .................	X		0	0
(8) Mark A Thompson MD Board Member	1.0 .................	X		0	0
(9) Bilal Ansari MD Board member	1.0 .................	X		0	0
(10) Samuel Borrelli MD Board Member	1.0 .................	X		0	0
(11) SAMUEL MILLIGAN BOARD MEMBER	1.0 .................	X		0	0
(12) BINH TRAN BOARD MEMBER	1.0 .................	X		0	0
(13) Henry Kim MD Board Member (partial year)	1.0 .................	X		0	0
(14) Diane Janowiak VP of Central Lab Operations	40.0 .................		X	231,504	21,377
(15) James Frain VP of Human Resources	40.0 .................		X	235,630	21,521
(16) Robert King Senior VP	40.0 .................		X	268,898	19,156
(17) Ann Sullivan VP of Finance	40.0 .................		X	234,834	25,687

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Robert Tomec MD president (partial year)	40.0 .......................	X			207,536	11,064
(19) Joyce Simpson MD EXECUTIVE VP (PARTIAL YEAR)/PRESIDENT (PARTIAL YEAR)	40.0 .......................	X			303,899	12,242
(20) Amobi Ezenekwe MD PATHOLOGIST (PARTIAL YEAR) / EXECUTIVE VP (PARTIAL YEAR)	40.0 .......................	X			268,733	26,025
(21) THOMAS LIDDELL VP - INFORMATION SYSTEMS (PARTIAL YEAR)	40.0 .......................	X			173,427	17,311
(22) Blair Chrenka MD PATHOLOGIST (PARTIAL YEAR)/VP - INFORMATION SYSTEMS (PARTIAL YEAR)	40.0 .......................	X			233,085	24,150
(23) Odeta Lapkus MD Pathologist	40.0 .......................		X		257,952	23,336
(24) Nita Gerig MD Pathologist	32.0 .......................		X		263,316	18,814
(25) Derrick Forchetti MD Pathologist	40.0 .......................		X		266,256	25,936
(26) David Jentz MD Pathologist	40.0 .......................		X		336,980	20,448
(27) Bobbie Sutton MD Pathologist	40.0 .......................		X		282,628	18,599
(28) John Landgraf MD Pathologist	40.0 .......................		X		264,855	20,448
(29) James Dyer MD Pathologist	40.0 .......................		X		252,280	11,447
(30) Joseph Prahlow MD Pathologist	40.0 .......................		X		146,393	13,143
(31) Ricky Hoover MD Pathologist	40.0 .......................		X		322,252	25,936
(32) Francisco Deogracias MD Pathologist	20.0 .......................		X		173,177	19,180
(33) Kristen Jacobs MD Pathologist	24.0 .......................		X		200,141	16,303
(34) Fred Busse MD Pathologist	24.0 .......................		X		163,155	17,009
(35) C K Kim MD Pathologist	20.0 .......................		X		171,763	17,328
(36) Nicole Anest MD Pathologist	40.0 .......................		X		232,588	17,804
(37) SHADIA ALAM MD PATHOLOGIST	40.0 .......................		X		183,595	9,070
(38) PRENTISS JONES DIRECTOR - TOXICOLOGY	40.0 .......................			X	149,608	18,232
(39) QING LI DIRECTOR - NEW TEST DEVELOPMENT	40.0 .......................			X	127,968	17,060
(40) PATRICIA MILLER-CANFIELD MD PATHOLOGIST	40.0 .......................			X	166,740	12,988
(41) CARRIE ROBINSON DIRECTOR - REGIONAL MARKETING	40.0 .......................			X	200,802	16,566
(42) DANIEL NUSSBAUM DIRECTOR - SALES AND MARKETING	40.0 .......................			X	112,810	21,800

(A) Name and business address	(B) Description of services	(C) Compensation
ASSOC REG AND UNIV PATHOLOGISTS PO BOX 27964 SALT LAKE CITY,UT84127	REFERENCE LAB	3,301,977
THERMO ASSET MANAGEMENT SERVICES INC 120 BISHOPS WAY BROOKFIELD,WI53005	EQUIPMENT MAINTENANCE / REPAIR	834,468
CERNER CORPORATION PO BOX 412702 KANSAS CITY,MO64141	SOFTWARE AND EQUIPMENT MAINTENANCE / REPAIR	792,838
MICHIANA HEALTH INFORMATION NETWORK LLC 220 W COLFAX AVE SUITE 300 SOUH BEND,IN46601	COMMUNITY BASED CLINICAL INFO SYSTEM	626,400
JAY D OSTROM P O BOX 533 GRANGER,IN46530	JANITORIAL SERVICE	342,934
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 20

- 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.
right arrow

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

South Bend Medical Foundation Inc

Employer identification number

35-0868178

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.") .		429,028	1,736	2,032	2,021	434,817
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......	97,034,819	99,026,282	99,699,838	94,707,654	90,903,792	481,372,385
3	Gross receipts from activities that are not an unrelated trade or business under section 513...	169,918	170,096	383,067	336,035	219,490	1,278,606
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
6	Total. Add lines 1 through 5.	97,204,737	99,625,406	100,084,641	95,045,721	91,125,303	483,085,808
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...	0	15,082	0	0	0	15,082
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.	0	0	0	0	0	0
c	Add lines 7a and 7b..	0	15,082	0	0	0	15,082
8	Public support. (Subtract line 7c from line 6.)						483,070,726

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...	97,204,737	99,625,406	100,084,641	95,045,721	91,125,303	483,085,808
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	60,573	123,674	302,005	155,693	101,397	743,342
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	60,573	123,674	302,005	155,693	101,397	743,342
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	415,690	497,425	468,990	629,322	604,138	2,615,565
13	Total support. (Add lines 9, 10c, 11, and 12.)..	97,681,000	100,246,505	100,855,636	95,830,736	91,830,838	486,444,715

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)) .........

99.31 %

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

99.40 %

Section D. Computation of Investment Income Percentage

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

0.15 %

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

0.12 %

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, Part III, Line 12 Other Income	DESCRIPTION - CLINICAL PATHOLOGY FEES, COLUMN A - 415690.0, COLUMN B - 451445.0, COLUMN C - 468990.0, COLUMN D - 629322.0, COLUMN E - 604138.0, COLUMN F - 2569585.0; DESCRIPTION - FUNDRAISING GROSS RECEIPTS, COLUMN A - 0.0, COLUMN B - 45980.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 0.0, COLUMN F - 45980.0;

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- 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

South Bend Medical Foundation Inc

Employer identification number

35-0868178

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 ...	1,115,906		1,115,906
b	Buildings	43,497,976	30,876,276	12,621,700
c	Leasehold improvements	785,533	611,641	173,892
d	Equipment ...	51,123,947	41,069,427	10,054,520
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				23,966,018

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
Fair value of interest rate swap	745,970
Accrued pension and postretirement benefits	21,665,539
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	22,411,509
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	86,224,584
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	303,172
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-4,057,243
e	Add lines 2a through 2d .....................			2e	-3,754,071
3	Subtract line 2e from line 1..................			3	89,978,655
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	1,850,723
c	Add lines 4a and 4b....................			4c	1,850,723
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	91,829,378

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	90,076,952
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	0
e	Add lines 2a through 2d....................			2e	0
3	Subtract line 2e from line 1...................			3	90,076,952
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	1,850,723
c	Add lines 4a and 4b.....................			4c	1,850,723
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	91,927,675

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
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	The Foundation is a not-for-profit organization pursuant to Section 501(c)(3) of the Internal Revenue Code and is exempt from federal and state income taxes pursuant to Section 501(a). Accordingly, no provision for income taxes is reflected in the Foundation's financial statements. The Foundation is subject to examination by federal and state taxing authorities for the years ended December 31, 2012 through 2015. The Foundation follows guidance issued by the Financial Accounting Standards Board with respect to accounting for uncertainty in income taxes. A tax position is a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Management has determined that there is no liability for uncertain tax positions and does not expect this to change over the next 12 months.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990	PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -4057243
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements	Financial assistance - 1850723
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements	Financial assistance - 1850723

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- 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
South Bend Medical Foundation Inc

Employer identification number
35-0868178

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) AMERICAN CANCER SOCIETY 130 RED COACH DRIVE MISHAWAKA,IN46545	13-1788491	501(C)(3)	13,650	GENERAL ASSISTANCE
(2) INDIANA UNIVERSITY FOUNDATION PO BOX 500 BLOOMINGTON,IN47402	35-6018940	501(C)(3)	20,000	GENERAL ASSISTANCE
(3) LOGAN COMMUNITY RESOURCES INC 2505 EAST JEFFERSON BLVD SOUTH BEND,IN46615	35-0965639	501(C)(3)	6,000	GENERAL ASSISTANCE
(4) THE FOUNDATION OF ST JOSEPH HEALTH SYSTEM 707 EAST CEDAR STREET SUITE 175 SOUTH BEND,IN46617	35-1654543	501(C)(3)	12,800	GENERAL ASSISTANCE
(5) UNITED WAY OF ST JOSEPH COUNTY INC 3517 EAST JEFFERSON BLVD SOUTH BEND,IN46615	35-1063368	501(C)(3)	5,000	GENERAL ASSISTANCE
(6) AMERICAN HEART ASSOCIATION 6100 West 96th Street Suite 200 Indianapolis,IN46278	13-5613797	501(c)(3)	5,000	GENERAL ASSISTANCE
(7) BOYS AND GIRLS CLUBS OF St JOSEPH COUNTY 502 E Sample Street South Bend,IN46601	35-1329625	501(c)(3)	5,000	GENERAL ASSISTANCE
(8) THE CHAMBER OF COMMERCE OF SJC FOUNDATION INC 401 East Colfax Suite 310 South Bend,IN46617	20-1837418	501(c)(3)	10,000	GENERAL ASSISTANCE

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) PATIENT MEDICAL ASSISTANCE	0	1,373,791	BOOK VALUE	FREE OR REDUCED MEDICAL CARE
(2) TIME OF SERVICE DISCOUNTS	0	476,932	BOOK VALUE	DISCOUNT PROVIDED AT TIME OF PAYMENT
(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

Schedule I, Part III, Column (b) NUMBER OF RECIPIENTS

CURRENTLY, SOUTH BEND MEDICAL FOUNDATION DOES NOT HAVE AN EFFECTIVE WAY TO TRACK THE UNDUPLICATED NUMBER OF PATIENTS THAT RECEIVE FREE OR REDUCED CARE AND TIME OF SERVICE DISCOUNTS.

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

South Bend Medical Foundation (SBMF) provides funding to other community not-for-profit organizations. Generally, these are unrestricted contributions that the receiving organization can use to further their mission and programs at their discretion. The use of these contributions is not monitored. SBMF also provides assistance to individuals in the form of free or reduced fee medical care at various locations throughout the communities served. These individuals meet SBMF's charity care eligibility requirements, or the requirements of the referring health care provider. Determination and monitoring of charity care is performed on a case-by-case basis. SBMF also provides discounts for payment at time of service to patients who do not have government provided insurance coverage or do not wish to have a claim filed with their commercial insurance carrier. There is no actual exchange of funds, as the discounts are credited directly to the patients' accounts. Time of service discounts are monitored at the organization level, in the aggregate.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- 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

South Bend Medical Foundation Inc

Employer identification number

35-0868178

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

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)
1Diane Janowiak VP of Central Lab Operations	(i) (ii)	231,504 ------------- 0	0 ------------- 0	0 ------------- 0	2,369 ------------- 0	19,008 ------------- 0	252,881 ------------- 0	0 ------------- 0
2James Frain VP of Human Resources	(i) (ii)	234,434 ------------- 0	0 ------------- 0	1,196 ------------- 0	2,369 ------------- 0	19,152 ------------- 0	257,151 ------------- 0	0 ------------- 0
3Robert King Senior VP	(i) (ii)	254,292 ------------- 0	0 ------------- 0	14,606 ------------- 0	2,600 ------------- 0	16,556 ------------- 0	288,054 ------------- 0	0 ------------- 0
4Ann Sullivan VP of Finance	(i) (ii)	233,638 ------------- 0	0 ------------- 0	1,196 ------------- 0	2,369 ------------- 0	23,318 ------------- 0	260,521 ------------- 0	0 ------------- 0
5Robert Tomec MD president (partial year)	(i) (ii)	201,541 ------------- 0	5,261 ------------- 0	734 ------------- 0	1,876 ------------- 0	9,188 ------------- 0	218,600 ------------- 0	0 ------------- 0
6Joyce Simpson MD EXECUTIVE VP (PARTIAL YEAR)/PRESIDENT (PARTIAL YEAR)	(i) (ii)	303,899 ------------- 0	0 ------------- 0	0 ------------- 0	2,600 ------------- 0	9,642 ------------- 0	316,141 ------------- 0	0 ------------- 0
7Amobi Ezenekwe MD PATHOLOGIST (PARTIAL YEAR) / EXECUTIVE VP (PARTIAL YEAR)	(i) (ii)	267,416 ------------- 0	0 ------------- 0	1,317 ------------- 0	2,600 ------------- 0	23,425 ------------- 0	294,758 ------------- 0	0 ------------- 0
8THOMAS LIDDELL VP - INFORMATION SYSTEMS (PARTIAL YEAR)	(i) (ii)	172,618 ------------- 0	0 ------------- 0	809 ------------- 0	1,766 ------------- 0	15,545 ------------- 0	190,738 ------------- 0	0 ------------- 0
9Blair Chrenka MD PATHOLOGIST (PARTIAL YEAR)/VP - INFORMATION SYSTEMS (PARTIAL YEAR)	(i) (ii)	233,085 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	24,150 ------------- 0	257,235 ------------- 0	0 ------------- 0
10Odeta Lapkus MD Pathologist	(i) (ii)	257,952 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	23,336 ------------- 0	281,288 ------------- 0	0 ------------- 0
11Nita Gerig MD Pathologist	(i) (ii)	261,961 ------------- 0	0 ------------- 0	1,355 ------------- 0	2,600 ------------- 0	16,214 ------------- 0	282,130 ------------- 0	0 ------------- 0
12Derrick Forchetti MD Pathologist	(i) (ii)	266,256 ------------- 0	0 ------------- 0	0 ------------- 0	2,600 ------------- 0	23,336 ------------- 0	292,192 ------------- 0	0 ------------- 0
13David Jentz MD Pathologist	(i) (ii)	335,625 ------------- 0	0 ------------- 0	1,355 ------------- 0	2,600 ------------- 0	17,848 ------------- 0	357,428 ------------- 0	0 ------------- 0
14Bobbie Sutton MD Pathologist	(i) (ii)	282,628 ------------- 0	0 ------------- 0	0 ------------- 0	2,600 ------------- 0	15,999 ------------- 0	301,227 ------------- 0	0 ------------- 0
15John Landgraf MD Pathologist	(i) (ii)	263,538 ------------- 0	0 ------------- 0	1,317 ------------- 0	2,600 ------------- 0	17,848 ------------- 0	285,303 ------------- 0	0 ------------- 0
16James Dyer MD Pathologist	(i) (ii)	251,005 ------------- 0	0 ------------- 0	1,275 ------------- 0	1,893 ------------- 0	9,554 ------------- 0	263,727 ------------- 0	0 ------------- 0
17Joseph Prahlow MD Pathologist	(i) (ii)	145,685 ------------- 0	0 ------------- 0	708 ------------- 0	1,475 ------------- 0	11,668 ------------- 0	159,536 ------------- 0	0 ------------- 0
18Ricky Hoover MD Pathologist	(i) (ii)	320,897 ------------- 0	0 ------------- 0	1,355 ------------- 0	2,600 ------------- 0	23,336 ------------- 0	348,188 ------------- 0	0 ------------- 0
19Francisco Deogracias MD Pathologist	(i) (ii)	171,917 ------------- 0	0 ------------- 0	1,260 ------------- 0	1,702 ------------- 0	17,478 ------------- 0	192,357 ------------- 0	0 ------------- 0
20Kristen Jacobs MD Pathologist	(i) (ii)	199,073 ------------- 0	0 ------------- 0	1,068 ------------- 0	2,028 ------------- 0	14,275 ------------- 0	216,444 ------------- 0	0 ------------- 0
21Fred Busse MD Pathologist	(i) (ii)	161,946 ------------- 0	0 ------------- 0	1,209 ------------- 0	1,663 ------------- 0	15,346 ------------- 0	180,164 ------------- 0	0 ------------- 0
22C K Kim MD Pathologist	(i) (ii)	170,503 ------------- 0	0 ------------- 0	1,260 ------------- 0	0 ------------- 0	17,328 ------------- 0	189,091 ------------- 0	0 ------------- 0
23Nicole Anest MD Pathologist	(i) (ii)	231,374 ------------- 0	0 ------------- 0	1,214 ------------- 0	902 ------------- 0	16,902 ------------- 0	250,392 ------------- 0	0 ------------- 0
24SHADIA ALAM MD PATHOLOGIST	(i) (ii)	183,595 ------------- 0	0 ------------- 0	0 ------------- 0	1,846 ------------- 0	7,224 ------------- 0	192,665 ------------- 0	0 ------------- 0
25PRENTISS JONES DIRECTOR - TOXICOLOGY	(i) (ii)	149,608 ------------- 0	0 ------------- 0	0 ------------- 0	1,525 ------------- 0	16,707 ------------- 0	167,840 ------------- 0	0 ------------- 0
26PATRICIA MILLER-CANFIELD MD PATHOLOGIST	(i) (ii)	160,925 ------------- 0	0 ------------- 0	5,815 ------------- 0	0 ------------- 0	12,988 ------------- 0	179,728 ------------- 0	0 ------------- 0
27CARRIE ROBINSON DIRECTOR - REGIONAL MARKETING	(i) (ii)	93,227 ------------- 0	100,522 ------------- 0	7,053 ------------- 0	1,199 ------------- 0	15,367 ------------- 0	217,368 ------------- 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
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	The organization has a supplemental nonqualified retirement plan that was designed to replace retirement benefits lost by individuals due to 1998 changes in pension laws and a redesign of the pension plan to maximize benefits for lower compensated employees. The organization's board of directors elected to freeze this plan, and therefore no benefits were provided during 2015.

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- 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

South Bend Medical Foundation Inc

Employer identification number

35-0868178

Return Reference	Explanation
Form 990, Part III, Line 1 ORGANIZATION'S MISSION (CONTINUED FROM PART III)	TO FULFILL OUR MISSION WE SHALL: (I) PROVIDE THE HOSPITALS WE SERVICE WITH THE HIGHEST QUALITY LABORATORY RESOURCES AND--TAKING INTO ACCOUNT THAT LENGTH OF STAY IS CRUCIAL FOR INPATIENT CARE--WITH THE SHORTEST RESPONSE TIME WHILE ACHIEVING A HIGH DEGREE OF COST EFFECTIVENESS. (II) PROVIDE OUR PHYSICIAN CUSTOMERS WITH THE HIGHEST QUALITY LABORATORY RESULTS UTILIZING THE LATEST TECHNOLOGY AND MAKING AVAILABLE TO THEM READILY ACCESSIBLE CONSULTATIVE OPPORTUNITIES IN THE MEDICAL AND ADMINISTRATIVE ASPECTS OF THEIR PRACTICES. (III) CREATE AND MAINTAIN A WORK ENVIRONMENT WHERE EMPLOYEES CAN GROW PERSONALLY AND PROFESSIONALLY WITH COMPENSATION AND BENEFIT SYSTEMS THAT ARE COMPETITIVE, EQUITABLE AND COST EFFECTIVE AS WELL AS AN ENVIRONMENT WHERE EMPLOYEES ARE PROVIDED STABLE EMPLOYMENT AND EACH INDIVIDUAL IS TREATED WITH RESPECT AND DIGNITY. (IV) PROVIDE TO THE PATIENT POPULATION IN THE COMMUNITIES WE SERVE READILY ACCESSIBLE, REASONABLY PRICED LABORATORY SERVICES, WITH AS WIDE A SCOPE AND VARIETY AS POSSIBLE TO MEET ALL THEIR NEEDS LOCALLY. (V) RECOGNIZING OUR SOCIAL RESPONSIBILITIES TO THE COMMUNITY, PROVIDE SERVICES WITHIN OUR MEANS TO THOSE LESS FORTUNATE, AND SUPPORT PUBLIC AND PRIVATE EFFORTS DIRECTED TO IMPROVE OUR HEALTH CARE ENVIRONMENT.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III)	THE ALTRUISTIC ACTIVITIES OF THE ORGANIZATION ARE INTENDED TO RELIEVE DISEASE, SUFFERING, AND CONSTRAINT. MANY SERVICES ARE PROVIDED AS CHARITY OR PRO BONO. THE AMOUNT OF CHARITY CARE, PROVIDED AT SBMF'S ESTABLISHED RATES, WAS APPROXIMATELY $587,000 FOR THE YEAR ENDED DECEMBER 31, 2015.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	The administrative committee shall consist of the officers of the corporation. Subject to the control of the board of directors, the administrative committee shall have full authority to act for and on behalf of the corporation and exercise all of the powers of the board of directors that may be lawfully delegated by such board to such committee except, however, the administrative committee shall have no power to donate any part of the assets of the corporation. The administrative committee shall receive status reports on other committee activities and discuss items of interest to the group as a whole or to individual officers for the performance of their duties. The administrative committee shall keep minutes of its meetings.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	BOB SUTTON (HUSBAND OF BOBBIE SUTTON) AND FRED BUSSE - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	THE ORGANIZATION CONSISTS OF ONE CLASS OF MEMBERS. EACH MEMBER MUST BE A PHYSICIAN, LICENSED TO PRACTICE MEDICINE AS SUCH IN EITHER THE STATE OF INDIANA OR THE STATE OF MICHIGAN AND RESIDING IN EITHER THE STATE OF INDIANA OR THE STATE OF MICHIGAN. EACH YEAR, AN INVITATION TO BECOME A MEMBER OF THE ORGANIZATION IS MAILED TO PHYSICIANS IN THE AREA. MEMBERS VOTE ON OPEN BOARD POSITIONS AND ARE ELIGIBLE FOR NOMINATION FOR OPEN BOARD POSITIONS.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	MEMBERS OF THE ORGANIZATION VOTE ON OPEN BOARD POSITIONS AND ARE ELIGIBLE FOR NOMINATION FOR OPEN BOARD POSITIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Prior to November 15, 2016, each board member was provided a copy of the return for their review and instructed to submit any questions or comments to the VP of Finance. After comments and questions are reviewed, the return was completed and filed with the IRS on or before November 15, 2016.
Form 990, Part VI, Line 12c Conflict of interest policy	Annual conflict of interest questionnaires are completed by all board members, officers, key employees, and highest compensated employees. The organization's Vice President of Finance and tax advisers review all responses to determine whether or not a potential or actual conflict of interest exists. If an actual conflict of interest is determined to exist, persons with a conflict are recused from voting on the conflicting issue.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	On an annual basis, the organization's compensation committee reviews and approves compensation for the President/Executive Vice President, as well as other officers, administrators, and professional staff, including key employees. The committee reviews current salaries and pay structures against various sources of comparability data, including: the College of American Pathology Pathologists Compensation Survey; pathology compensation data for pathologists, which outlines pathology and physician salaries by specialty, provided from Merritt Hawkins and Associates; the Guidestar National Compensation Report; and compensation reported on local area hospitals' Forms 990. After reviewing the comparability data, the committee discusses the current economy and financial position of the organization to determine the amount of any compensation increases and/or decreases, if any, that will be given. This process is documented in the compensation committee's meeting minutes.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	See narrative for Form 990, Part VI, Section B, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the public	Financial statements, conflict of interest policies, and governing documents are not required disclosures pursuant to IRC Section 6104. These documents are not made available to the public.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	MISCELLANEOUS REVENUE - Total Revenue: 13948, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 13948; LAB INFORMATION SUPPORT UPGRADE - Total Revenue: 62500, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 62500; REVENUE FROM MHIN - Total Revenue: 55000, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 55000; DEPOSITION INCOME - Total Revenue: 1560, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1560; PHLEBOTOMY POOL - Total Revenue: 3854, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3854;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	PENSION AND POSTRETIREMENT BENEFIT-RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST - -4057243;

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:	15000238
Software Version:	2015v2.1

1	Briefly describe the organization’s mission or most significant activities: South Bend Medical Foundation exists for the purpose of providing quality and cost effective laboratory and blood banking services to hospitals, physicians, and patients.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	869
6	Total number of volunteers (estimate if necessary) .............	6	13
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,032	2,021
9	Program service revenue (Part VIII, line 2g) .........	94,707,654	90,903,792
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	185,550	99,937
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	965,357	823,628
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	95,860,593	91,829,378
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,594,948	1,980,310
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	43,619,228	41,016,819
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	50,720,424	48,930,546
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	96,934,600	91,927,675
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,074,007	-98,297
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	46,470,813	43,264,513
21	Total liabilities (Part X, line 26).............	38,491,594	39,137,662
22	Net assets or fund balances. Subtract line 21 from line 20.....	7,979,219	4,126,851

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 76,960,881 including grants of $ 1,980,310 ) (Revenue $ 91,507,930 )
	SOUTH BEND MEDICAL FOUNDATION'S (SBMF) MORE THAN 800 EMPLOYEES PROVIDE A WIDE RANGE OF TOP-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES FOR COMMUNITIES IN INDIANA, MICHIGAN, KENTUCKY, OHIO, AND ILLINOIS. BY WORKING TOGETHER WITH LOCAL HEALTH CARE PROVIDERS, SBMF PRESERVES THE CRITICAL RELATIONSHIP BETWEEN LABORATORY, PHYSICIAN AND PATIENT. UNLIKE MANY LARGE COMMERCIAL LABORATORIES, SBMF OFFERS ITS SERVICES 24 HOURS A DAY, 365 DAYS A YEAR. SBMF PERSONNEL ARE DEDICATED TO BEING A TRUSTED PHYSICIAN RESOURCE, HANDLING EVERYTHING FROM ROUTINE OUTPATIENT ORDERS TO PROVIDING INPATIENT SERVICES AT HOSPITAL AND OTHER HEALTH CARE FACILITIES THROUGHOUT THE REGION. SBMF'S COMMITMENT TO DELIVERING CONSISTENT, RELIABLE, QUALITY MEDICAL CARE HAS PLAYED AN INSTRUMENTAL ROLE IN HELPING THE FOUNDATION ACHIEVE ITS POSITION OF LEADERSHIP AMONG THE NATION'S DIAGNOSTIC LABORATORIES. (CONTINUED IN SCHEDULE O)

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses76,960,881

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,432,805	0	539,980

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,021

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		2,021

			Business Code
2a	Net operating revenues	621500	90,903,792	90,903,792
b
c
d
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			90,903,792

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			101,397			101,397
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	17,866
b	Less: cost or other basis and sales expenses	19,326
c	Gain or (loss)	-1,460	0
d	Net gain or (loss).....			-1,460			-1,460
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..
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..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Clinical Pathology Fees		621500	604,138	604,138
b	Teaching Fees		611430	76,407			76,407
c	Records Retrieval Fees		900099	6,221			6,221
d	All other revenue ....			136,862	0	0	136,862
e	Total. Add lines 11a–11d ......			823,628
12	Total revenue. See Instructions......			91,829,378	91,507,930	0	319,427

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	129,587	129,587
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	1,850,723	1,850,723
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	7,007,138	5,253,754	1,753,384
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	26,235,485	20,884,947	5,350,538
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	155,030	128,409	26,621
9	Other employee benefits .......	5,432,239	4,319,616	1,112,623
10	Payroll taxes ...........	2,186,927	1,735,630	451,297
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	54,611		54,611
c	Accounting ...........	83,933		83,933
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,096,009	1,115,567	980,442	0
12	Advertising and promotion ....
13	Office expenses .......	1,954,468	1,037,972	916,496
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,003,179	1,827,887	175,292
17	Travel ............	82,950	56,216	26,734
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	473,955	435	473,520
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,346,596	3,043,279	303,317
23	Insurance ...	912,790	118,109	794,681
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Lab	22,711,440	22,150,970	560,470
b	Reference Lab	4,870,878	4,870,878
c	Bad Debt	4,305,471	4,305,471
d	Building Equipment/Maintenance	3,777,665	2,369,105	1,408,560
e	All other expenses	2,256,601	1,762,326	494,275	0
25	Total functional expenses. Add lines 1 through 24e	91,927,675	76,960,881	14,966,794	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 ........			1,250	1	1,250
2	Savings and temporary cash investments .........			3,490,177	2	3,819,451
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			12,679,569	4	11,614,102
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			1,365,902	8	1,749,280
9	Prepaid expenses and deferred charges ......			1,087,074	9	1,079,634
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	96,523,362
b	Less: accumulated depreciation	10b	72,557,344	26,827,670	10c	23,966,018
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			911,741	13	994,132
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			107,430	15	40,646
16	Total assets. Add lines 1 through 15 (must equal line 34)...			46,470,813	16	43,264,513

17	Accounts payable and accrued expenses .....	9,019,103	17	9,466,153
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	8,470,000	20	7,260,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	21,002,491	25	22,411,509
26	Total liabilities. Add lines 17 through 25..	38,491,594	26	39,137,662

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	7,979,219	27	4,126,851
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	7,979,219	33	4,126,851
34	Total liabilities and net assets/fund balances ........	46,470,813	34	43,264,513