Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 10-01-2014 , and ending 09-30-2015
BCheck if applicable:
CName of organization
MEMORIAL HEALTH SYSTEM
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
701 NORTH FIRST STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRINGFIELD, IL627810001
D Employer identification number

37-1110690
E Telephone number

G Gross receipts $ 146,941,244
F Name and address of principal officer:
EDGAR J CURTIS
701 NORTH FIRST STREET
SPRINGFIELD,IL627810001
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MHSIL.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5670
K Form of organization:
 
L Year of formation: 1981
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 17
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 2014 (Part V, line 2a) ...... 5 313
6 Total number of volunteers (estimate if necessary) ............. 6 16
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 470,956
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 67,659,615 67,631,433
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,859,039 1,734,629
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 620,857 -1,194,917
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 71,139,511 68,171,145
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 2,577,271 568,286
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) 31,130,967 35,658,710
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 39,414,435 34,016,763
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 73,122,673 70,243,759
19 Revenue less expenses. Subtract line 18 from line 12....... -1,983,162 -2,072,614
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 245,015,648 280,951,548
21 Total liabilities (Part X, line 26)............. 130,539,740 151,695,218
22 Net assets or fund balances. Subtract line 21 from line 20..... 114,475,908 129,256,330
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 33,233,537 including grants of $   ) (Revenue $ 1,559,320 )
INFORMATION TECHNOLOGYMEMORIAL HEALTH SYSTEM IS PROACTIVE IN IMPLEMENTING TECHNOLOGY THAT BOTH IMPROVES PATIENT SAFETY, QUALITY AND CLINICAL EFFECTIVENESS, AND IMPROVES MEMORIAL HEALTH SYSTEM'S BUSINESS PROCESSES. MEMORIAL HEALTH SYSTEM'S STAFF OF EXPERIENCED INFORMATION TECHNOLOGY PROFESSIONALS IS ON THE CUTTING EDGE OF MEDICAL AND BUSINESS TECHNOLOGY. THEY SUPPORT A VAST ARRAY OF PATIENT CARE AND BUSINESS APPLICATIONS. DURING FY2015 SIGNIFICANT INFORMATION TECHNOLOGY PROJECTS INCLUDED COMPLETION OF MIGRATION OF OVER 5000 PCS TO WINDOWS 7, EMS ED AMBULANCE COMMUNICATION UPGRADE, MUTARE OR FAMILY COMMUNICATION PROJECT, THE IMPLEMENTATION OF BEDSIDE BARCODE MEDICATION ADMINISTRATION, VIDEO SECURITY PROJECT, CITRIX UPGRADE 2008 FOR CERNER MILLENNIUM, WIRELESS CONTROLLER UPGRADE. THE IMPLEMENTATION OF PATIENT EDUCATION SYSTEM (TIGR), HUGS INFANT SECURITY SYSTEM MIGRATION, LAPTOP AND EMAIL ENCRYPTION, VOICE RECOGNITION SOFTWARE IN HOSPITAL AND AMBULATORY CLINICS, MAINTAINED MEANINGFUL USE STAGE 1(PREPARING FOR STAGE 2), DATA CENTER REFRESH AT ALMH AND TMH, BROUGHT JACKSONVILLE MOB AND VINE STREET CLINIC ONTO THE ENTERPRISE NETWORK, FINALIZED THE DESIGN OF SECONDARY DATA CENTER, PATHNET (MIGRATION FROM CLASSIC LAB), IRHN NETWORK, SEPSIS RULE FOR CARE IMPROVEMENT.
4b (Code:   ) (Expenses $ 7,761,387 including grants of $   ) (Revenue $ 1,099,418 )
BUILDING AND FACILITY EXPANSION AND IMPROVEMENTSMEMORIAL HEALTH SYSTEM'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. SAFE, FUNCTIONAL FACILITIES ARE THE FOUNDATION OF THE HEALTHCARE SERVICES WE PROVIDE. DEVELOPING ADDITIONAL CAPACITY TO SERVE THE COMMUNITY IS A PRIMARY OBJECTIVE TO FULFILLING OUR MISSION BOTH IN THE SHORT TERM AS WELL AS IN THE LONG TERM. IN 2015, MEMORIAL MEDICAL CENTER, AN AFFILIATE OF MEMORIAL HEALTH SYSTEM, CONTINUED WORK ON THE MOST SIGNIFICANT EXPANSION PROJECT IN THE 113 YEAR HISTORY OF THE ORGANIZATION. THE TOTAL PROJECT COST IS APPROXIMATELY $152M AND ENCOMPASSES FOUR SPECIFIC COMPONENTS. IN MARCH 2015, THE FIRST PHASE OF THE SURGICAL SUITE EXPANSION OPENED PROVIDING 4 OF THE PLANNED 6 NEW OPERATING ROOMS TO MEET INCREASING CASE VOLUMES. IN MAY 2015, MEMORIAL OPENED THE CENTER FOR LEARNING AND INNOVATION. THE "MCLI" (MEMORIAL CENTER FOR LEARNING AND INNOVATION) IS DESIGNED TO PROVIDE STATE OF THE ART CLINICAL TRAINING FACILITIES FOR PHYSICIANS, RESIDENTS, MEDICAL STUDENTS, NURSING STAFF, AND ALL OTHER EMPLOYEES. THIS FACILITY IS ALSO TO BE USED TO IMPROVE MEDICAL EDUCATION THROUGH PARTNERSHIP WITH THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. IN NOVEMBER 2015, THE PATIENT CARE TOWER EXPANSION WAS COMPLETED AND OPERATIONAL PROVIDING 114 PRIVATE PATIENT ROOMS. THIS ADDITION WILL ENABLE THE MEDICAL CENTER TO ONE DAY PROVIDE ALL PRIVATE ROOMS TO ITS PATIENTS. EVIDENCE HAS SHOWN IMPROVED HEALTHCARE OUTCOMES FOR PATIENTS STAYING IN PRIVATE ROOMS DUE TO REDUCED HOSPITAL ACQUIRED INFECTION RATES AND A MORE PEACEFUL HEALING ENVIRONMENT. FINALLY, THE MEMORIAL MEDICAL CENTER PHYSICAL PLANT MODERNIZATION WAS BROUGHT ON LINE INCREMENTALLY TO PROVIDE THE UTILITIES NEEDED TO SUPPORT THE EXPANDED CAPACITY AS WELL AS INCORPORATING HIGH EFFICIENCY RETROFITS TO ACHIEVE SUSTAINABILITY GOALS FOR THE FUTURE OF THE MEDICAL CENTER. CLINICAL PROJECTS THAT BEGAN IN FY2015: - 4TH & CARPENTER SIU CENTER FOR FAMILY MEDICINE ADDITION & RENOVATION - EXPANDING THE EXISTING FACILITY WITH A 30,315 SQUARE FEET ADDITION CONTAINING ALL NEW CLINICAL SPACE AND RENOVATING THE EXISTING BUILDING TO INCREASE OFFICE AND TRAINING SPACE FOR SIU FEDERALLY QUALIFIED HEALTH CENTER (FQHC). - 4C/4A ORTHOPEDIC INPATIENT REHAB RENOVATION - TO PROVIDE INPATIENT REHAB AN ADEQUATE SPACE FOR AN OPEN CONCEPT PATIENT PRACTICE GYM AS WELL AS STORAGE FOR ALL THEIR EQUIPMENT AND WHEELCHAIRS. ADDITIONALLY, BUILDING OFFICES FOR SUPPORT STAFF. - RESIDENT SLEEP ROOMS - PROVIDE 6 NEW RESIDENT SLEEP ROOMS AT MEMORIAL MEDICAL CENTER ON 4A TO SUPPORT CLINICAL OPERATIONS. OTHER PROJECTS COMPLETED FOR THE MEDICAL CENTER INCLUDE: - 201 E. MADISON ADMINISTRATIVE BUILDING - AT A COST OF APPROXIMATELY $14M. REMODELED AND ADDED AN INTERIOR STRUCTURAL ADDITION CONSISTING OF 20,000 SQUARE FEET OF STRUCTURAL FLOOR SYSTEM IN THE EXISTING WAREHOUSE, BUILD-OUT OF OFFICE SPACE, UPGRADED THE HVAC AND LIGHTING AND PARKING LOT IMPROVEMENTS. - MEMORIAL INFORMATION SYSTEMS BUILDING VARIABLE AIR VOLUME (VAV) BOX CONVERSION - A SUSTAINABILITY MEASURE TO REDUCE OPERATIONAL COST. AT A COST OF APPROXIMATELY $600K, REPLACED ALL VAV BOXES THAT WERE ORIGINAL TO THE BUILDING WITH DUAL DAMPER VAV BOXES THAT INCREASED EFFICIENCY.
4c (Code:   ) (Expenses $ 4,757,956 including grants of $   ) (Revenue $ 60,560,990 )
SENIOR LEADERSHIPGUIDED BY THE VALUES OF MEMORIAL HEALTH SYSTEM, SENIOR LEADERSHIP IS RESPONSIBLE FOR STRATEGIC PLANNING, PRIORITIZING AMONG COMPETING ISSUES AND ENGAGING IN DIALOGUE AND DECISION-MAKING THAT WILL ENABLE MEMORIAL HEALTH SYSTEM TO ACHIEVE ITS MISSION (TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE), ITS VISION (TO BE A NATIONAL LEADER FOR EXCELLENCE IN PATIENT CARE) AND ITS STRATEGIC GOALS (TO ACHIEVE GREAT PATIENT OUTCOMES, BE A GREAT PLACE TO WORK, BE A GREAT PARTNER FOR PHYSICIANS, PROVIDE A GREAT REGIONAL PRESENCE AND DEMONSTRATE GREAT FINANCIAL STEWARDSHIP.) IN FY2015, MHS SENIOR LEADERSHIP REVIEWED AND CONFIRMED THE ORGANIZATION'S STRATEGIC PLAN, 5 YEAR GOALS AND MEASURES OF SUCCESS TO REFLECT EMERGING PRIORITIES RELATED TO HEALTH REFORM, QUALITY IMPROVEMENT, POPULATION HEALTH, CARE COORDINATION AND THE RESULTS OF OUR COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. IN ADDITION, THE LEADERSHIP TEAM EXECUTED THE HEALTH SYSTEM STRATEGIC AND FISCAL YEAR ACTION PLANS AND REPORTED RESULTS TO ITS BOARD. TO FURTHER ACCELERATE ADVANCEMENTS IN QUALITY, PATIENT SAFETY AND CLINICAL INNOVATION IN FY2015, MHS EXPANDED THE MIDWEST HEALTH QUALITY ALLIANCE (MHQA) AND LAUNCHED THE QUALITY ALLIANCE PATIENT SAFETY ORGANIZATION (QAPSO) A SUBSIDIARY OF MHQA, BOTH OF WHICH ARE HOUSED IN THE NEW MEMORIAL CENTER FOR LEARNING AND INNOVATION (MCLI). THE MHQA ACHIEVED "MULTI-SPECIALTY PORTFOLIO APPROVAL" FROM THE AMERICAN BOARD OF MEDICAL SPECIALTIES. THIS DESIGNATION ALLOWS THE MHQA TO ASSIST PHYSICIANS IN A WIDE RANGE OF MEDICAL SPECIALTIES AND SUB-SPECIALTIES TO ACHIEVE AND MAINTAIN THEIR SPECIALTY CERTIFICATIONS BY PROVIDING CONTINUING MEDICAL EDUCATION (CME) CURRICULUM ON-SITE ON THE MEMORIAL CAMPUS. THIS YEAR THE MHQA ALSO BECAME THE UMBRELLA ORGANIZATION FOR THE SOUTHERN ILLINOIS UNIVERSITY (SIU) OUTCOMES AND ANALYTICAL RESEARCH (SOAR) PROGRAM. SOAR'S MISSION IS TO UTILIZE AN EVIDENCE-BASED APPROACH TO IMPROVE HEALTHCARE QUALITY FOR THE PEOPLE OF CENTRAL AND SOUTHERN ILLINOIS IN PARTNERSHIP BETWEEN SIU SURGERY AND MEMORIAL. IN FY15 THE MHQA PLANNED ITS FIRST NATIONAL PATIENT SAFETY CONFERENCE IN THE MCLI FEATURING INSTITUTE OF MEDICINE AND FEDERAL AVIATION EXPERTS. WHILE THE PLANNING FOR THIS EVENT WAS COMPLETED IN FY15, THE EVENT TITLED "FUNDAMENTALLY HUMAN - AN INNOVATIVE EXPLORATION OF PATIENT SAFETY" WAS HELD THE FIRST WEEK OF FY16 ON OCTOBER 7, 2015. MHQA WAS ALSO INVITED TO DELIVER THREE POSTER PRESENTATIONS AND ONE PODIUM PRESENTATION AT THE 39TH INTERNATIONAL HOSPITAL FEDERATION WORLD WIDE CONGRESS. THE MHQA PROJECT "IMPROVING THE SUCCESS OF STRATEGIC MANAGEMENT USING BIG DATA" WAS AWARDED TOP PRIZE FOR BEST PRESENTATION AMONG A FIELD OF 119 PRESENTATIONS FROM 19 COUNTRIES. THE AGENCY FOR HEALTHCARE QUALITY AND RESEARCH IN EARLY FY2015 OFFICIALLY CERTIFIED QAPSO AS A FEDERALLY CERTIFIED PATIENT SAFETY ORGANIZATION. THE FEDERAL PATIENT AND SAFETY AND QUALITY IMPROVEMENT ACT OF 2005 ESTABLISHED PATIENT SAFETY ORGANIZATIONS (PSOS) TO IMPROVE PATIENT SAFETY AND REDUCE THE INCIDENCE OF ADVERSE PATIENT SAFETY EVENTS THROUGH DATA SHARING SUPPORTED BY STRONG FEDERAL CONFIDENTIALITY AND PRIVILEGE PROTECTIONS.MHS AND SOUTHERN ILLINOIS UNIVERSITY HEALTHCARE(SIU)WERE THE FIRST QAPSO CLIENTS. SINCE ACHIEVING FEDERAL PSO CERTIFICATION, TWO OTHER HEALTH SYSTEMS, TWO AMBULANCE COMPANIES, AND FIVE SKILLED NURSING HOMES HAVE JOINED QAPSO TO ACCELERATE THEIR PATIENT SAFETY AND QUALITY IMPROVEMENT EFFORTS. THE LARGEST MULTI-SPECIALTY PHYSICIAN GROUP IN THE REGION WAS EXTENDED AN INVITATION TO ALSO JOIN QAPSO IN FY15 AND IS EXPECTED TO JOIN THE ORGANIZATION IN FY16. THE LEAN SIX SIGMA(LSS)PROCESS IMPROVEMENT PROGRAM GREW THIS YEAR WITH 43% GROWTH IN THE NUMBER OF CERTIFIED BLACK, GREEN AND WHITE BELTS, 32% GROWTH IN THE NUMBER OF LLS PROJECTS COMPLETED AND AN AVERAGE OF 43% IMPROVEMENT IN OUTCOMES. IN ADDITION TO IMPROVEMENTS IN QUALITY AND PATIENT SAFETY, THESE LSS PROJECTS REDUCED EXPENSES RELATED TO "REWORK AND "WASTE" BY $5,300,000. IN THE AREA OF SYSTEM FACILITY PLANNING AND MANAGEMENT CONSTRUCTION MHS'S FLAGSHIP HOSPITAL SUBSTANTIALLY COMPLETED THE NEW CONSTRUCTION PHASE OF ITS MULTI-YEAR EXPANSION PROJECT FOR SEVERAL KEY PROJECT COMPONENTS INCLUDING THE CREATION OF 114 NEW PRIVATE PATIENT ROOMS, EXPANSION OF SURGICAL FACILITIES, CREATION OF A CENTER FOR LEARNING AND INNOVATION AND INFRASTRUCTURE UPGRADES THAT WILL ENABLE ENERGY CONSERVATION FOR OUR ENTIRE CAMPUS. THE FINAL PHASE, THE OPENING OF THE NEW ENTRANCE AND FRONT LOBBY OCCURRED IN EARLY FY16. THE PROJECT TITLED "ADVANCING CARE BY DESIGN" IS IMPROVING PATIENT ACCESS, SAFETY, COMFORT, PRIVACY AND QUALITY OF CARE FOR THOSE WE SERVE AND WILL DO SO FOR DECADES TO COME. AS PART OF ADVANCING CARE BY DESIGN, THE NEW MEMORIAL CENTER FOR LEARNING AND INNOVATION WAS COMPLETED AND OPENED IN THE SPRING OF 2015. HEALTH PROFESSIONS EDUCATION AND COMMUNITY HEALTH EDUCATION IS BEING ENHANCED THROUGH THE MCLI WHICH OFFERS NEW AND ADVANCED PROFESSIONAL EDUCATIONAL OPPORTUNITIES FOR MEMORIAL STAFF, SIU SCHOOL OF MEDICINE FACULTY, RESIDENTS AND STUDENTS AND OTHER REGIONAL HEALTHCARE ACADEMIC PARTNERS. FOR EXAMPLE, THE MCLI INCLUDES A STATE-OF-THE ART CLINICAL SIMULATION CENTER FEATURING TRAUMA, EMERGENCY, AMBULANCE, OBSTETRICS, INPATIENT NURSING, HOME AND OTHER CARE SETTINGS SUCH AS SURGICAL SKILLS LABORATORIES. MEMORIAL HAS ALSO PARTNERED WITH THE UNIVERSITY OF ILLINOIS - SPRINGFIELD AND UNIVERSITY OF ILLINOIS - CHICAGO TO INTRODUCE A NEW BACHELOR'S OF SCIENCE NURSING DEGREE (BSN) IN SPRINGFIELD. THIS PARTNERSHIP, BASED IN THE MCLI, WILL HELP DOWNSTATE ILLINOIS MEET THE GROWING DEMAND FOR HIGHLY QUALIFIED REGISTERED NURSES TO SERVE THE COMMUNITY. MEMORIAL COLLABORATES WITH COMMUNITY PROVIDERS TO SERVE LOW INCOME AND UNINSURED POPULATIONS. IN FY2015, MEMORIAL PURCHASED ADJACENT LAND AND BEGAN CONSTRUCTION ON A FACILITY EXPANSION FOR THE SIU FAMILY AND COMMUNITY MEDICINE CLINIC FEDERALLY QUALIFIED HEALTH CENTER (FQHC). THIS EXPANSION WILL DRAMATICALLY INCREASE THE NUMBER OF POOR AND VULNERABLE PATIENTS SERVED BY THE FQHC. IN ADDITION TO FUNDING THE FACILITY EXPANSION, MEMORIAL MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT SERVICES TO ALL REFERRED SIU FQHC PATIENTS, REGARDLESS OF ABILITY TO PAY. MMC ASSISTS THESE PATIENTS TO APPLY FOR ANY INSURANCE PROGRAMS FOR WHICH THEY ARE ELIGIBLE AND ACCEPTS THE FQHC RECOMMENDED SLIDING SCALE FEE OR, IF THE PATIENT IS NOT ABLE TO PAY HIS/HER PORTION OF THE BILL, THE AMOUNT IS FORGIVEN UNDER THE HOSPITAL'S CHARITY CARE PROGRAM. ALSO IN FY2015, MEMORIAL RENOVATED A FORMER STATE OF ILLINOIS OFFICE BUILDING TO PROVIDE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE (SIUSM) ADMINISTRATIVE SUPPORT SPACE SO THAT MEMORIAL MEDICAL CENTER CAN REPURPOSE EXISTING SPACE WITHIN THE MAIN HOSPITAL FOR CLINICAL USE TO BETTER SERVE HOSPITAL PATIENTS. IN ADDITION, IN FY2015 MEMORIAL HEALTH SYSTEM COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IDENTIFIED ACCESS TO CARE, OBESITY AND MENTAL HEALTH AS TOP COMMUNITY HEALTH PRIORITIES. AS PART OF THE CHNA PROCESS MMC COMPLETED AN "ENOS PARK ACCESS COLLABORATIVE" IMPLEMENTATION PLAN IN PARTNERSHIP WITH HSHS ST. JOHN'S HOSPITAL IN SPRINGFIELD AND THE SIU SCHOOL OF MEDICINE DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE FEDERALLY QUALIFIED HEALTH CENTER. STARTING IN FY16, MMC AND HSHS ST. JOHN'S HOSPITAL WILL EACH PROVIDE 50% OF THE FUNDING FOR COMMUNITY HEALTH WORKERS (CHW) AND AN ELEMENTARY SCHOOL-BASED MENTAL HEALTH COUNSELOR TO WORK IN THE COMMUNITY. THESE CHW AND MENTAL HEALTH COUNSELORS WILL IDENTIFY HEALTH NEEDS (INCLUDING SOCIAL DETERMINANTS OF HEALTH) AND BARRIERS TO ACCESSING NEEDED SERVICES FOR THE MOST VULNERABLE POPULATIONS IN A TARGETED RESIDENTIAL NEIGHBORHOOD WITH SIGNIFICANT LEVELS OF POVERTY AND OTHER RISK FACTORS. THEY WILL ALSO WORK WITH LOCAL HEALTH AND SOCIAL SERVICE PROVIDERS TO OVERCOME IDENTIFIED BARRIERS TO RECEIVE THE HELP THEY NEED. IN THE AREA OF INFORMATION SYSTEMS, THE TOUCHWORKS ELECTRONIC AMBULATORY HEALTH RECORD WAS IMPLEMENTED AT SIU SCHOOL OF MEDICINE FOR PHYSICIANS SO THAT MEMORIAL PHYSICIAN SERVICES (MPS), SPRINGFIELD CLINIC AND SIU SHARE THE SAME AMBULATORY HEALTH RECORD. THIS PROVIDES REAL-TIME INFORMATION SHARING TO BETTER COORDINATE CARE ACROSS MULTIPLE SITES OF CARE. TO CONTINUE TO IMPROVE THE ORGANIZATION'S POPULATION HEALTH, CHRONIC DISEASE MANAGEMENT AND CARE COORDINATION CAPABILITIES AND INFRASTRUCTURE, A MEMORIAL AMBULATORY HEALTH STRATEGIC PLAN WAS COMPLETED THIS YEAR. THIS PLAN LAYS OUT A ROAD MAP FOR BETTER COORDINATING THE CARE PROVIDED BY OUR MENTAL HEALTH AFFILIATE, HOME SERVICES, HOSPICE, PRIMARY CARE PHYSICIAN OFFICES, DURABLE MEDICAL EQUIPMENT COMPANY, EXPRESSCARE CLINICS, MEMORIAL WEIGHT LOSS AND WELLNESS PROGRAM AND MEMORIAL CARE COORDINATION SERVICES. THE FOCUS OF THE PLAN IS TO STRENGTHEN OUR DATA AND WORKFLOWS AROUND THE POPULATION HEALTH BUILDING BLOCKS OF PHYSICIAN LEADERSHIP, WELLNESS AND PREVENTION, CLINICAL PROTOCOLS, CHRONIC DISEASE MANAGEMENT, P
(Code:   ) (Expenses $ 4,217,814 including grants of $ 568,286 ) (Revenue $ -197,119 )
OTHER REVENUE INCLUDES PARTNERSHIP INCOME AND MISCELLANEOUS INCOME FOR MHS AND MEMORIAL HEALTH PARTNERS (MHP). MHP IS A DISREGARDED ENTITY OWNED 100% BY MHS. FOR FY15, MHS RECORDED A LOSS IN THE BJC COLLABORATIVE, LLC AND IN MIDWEST HEALTHCARE QUALITY ALLIANCE, LLC (MHQA). MHS ALSO HAD MISCELLANEOUS INCOME FOR ENERGY REBATES AT THE NORTH DIRKSEN AND 2401 W JEFFERSON LOCATIONS, CARE COORDINATION PAYMENTS FOR MHP, AND A CHARGEBACK FOR STAFF TIME TO LINCOLN LAND HEALTH INFORMATION EXCHANGE, LLC IN WHICH MHS IS A 27.27% OWNER.
4d Other program services (Describe in Schedule O.)
(Expenses $ 4,217,814 including grants of $ 568,286 ) (Revenue $ -197,119 )
4e Total program service expensesMediumBullet49,970,694
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
28
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
313
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
No
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
17
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletROBERT W KAY SENIOR VP & CFO

701 NORTH FIRST STREET
SPRINGFIELD,IL627810001 (217) 788-3198
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JOSEPH HURWITZ........................................................................
BOARD MEMBER
 2.00
.......................   		X           0 0 0
(2) JAMES BRUNER........................................................................
BOARD MEMBER
 1.70
.......................   		X           0 0 0
(3) MARK FERGUSON........................................................................
BOARD MEMBER
 1.60
.......................   		X           0 0 0
(4) RICHARD LEVI........................................................................
BOARD MEMBER
 0.80
.......................   		X           0 0 0
(5) NINA HARRIS........................................................................
BOARD MEMBER (THRU DEC 14)
 1.00
.......................   		X           0 0 0
(6) HOWARD PETERS III........................................................................
BOARD MEMBER
 0.70
.......................   		X           0 0 0
(7) SERGIO PECORI........................................................................
BOARD MEMBER
 1.10
.......................   		X           0 0 0
(8) WILLIAM PUTMAN MD........................................................................
BOARD MEMBER
 0.90
.......................   		X           0 0 0
(9) MICHAEL NEUMEISTER MD........................................................................
BOARD MEMBER
 0.70
.......................   		X           0 0 0
(10) DEAN ROBERT JR........................................................................
BOARD MEMBER
 0.70
.......................   		X           0 0 0
(11) REGINALD BENTON........................................................................
BOARD MEMBER
 0.70
.......................1.40 		X           0 0 0
(12) JANET TERRY........................................................................
BOARD MEMBER
 0.70
.......................   		X           0 0 0
(13) JOHN BLACKBURN........................................................................
CHAIRMAN
 1.70
.......................   		X   X       0 0 0
(14) CAROL HANSEN POSEGATE........................................................................
SECRETARY (THRU DEC 14)
 0.80
.......................   		X   X       0 0 0
(15) DALE BECKER........................................................................
TREASURER
 1.50
.......................   		X   X       0 0 0
(16) RANDALL GERMERAAD........................................................................
1ST VICE CHAIR
 0.80
.......................   		X   X       0 0 0
(17) DIANE RUTLEDGE PHD........................................................................
2ND VICE CHAIR
 1.00
.......................   		X   X       0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) GEOFFREY ISRINGHAUSEN........................................................................
MEM (THRU DEC 14)/SEC (FROM JAN 15)
 0.70
.......................   		X   X       0 0 0
(19) EDGAR CURTIS EX-OFFICIO........................................................................
PRESIDENT & CEO
 25.00
.......................25.00 		X   X       1,223,546 0 1,084,551
(20) ROBERT KAY........................................................................
SVP & CFO & ASST TREASURER
 25.00
.......................25.00 		    X       371,032 0 484,865
(21) MITCHELL JOHNSON........................................................................
SVP & CHIEF STRATEGY OFFICER
 25.00
.......................25.00 		      X     401,156 0 197,768
(22) DAVID GRAHAM MD........................................................................
SVP & CIO
 25.00
.......................25.00 		      X     545,083 0 213,216
(23) RAJESH GOVINDAIAH MD........................................................................
SVP & CMO
 25.00
.......................25.00 		      X     549,528 0 73,600
(24) ROBERT SCOTT........................................................................
VP & CHRO
 25.00
.......................25.00 		      X     291,211 0 51,360
(25) DOUGLAS RAHN DBA........................................................................
EVP & COO (THRU MARCH 14)
 25.00
.......................25.00 		      X     526,877 145,288 291,895
(26) KEVIN ENGLAND........................................................................
VP BUSINESS DEVELOPMENT
 25.00
.......................25.00 		      X     343,704 0 266,480
(27) ANNA EVANS JD........................................................................
GEN COUNSEL/VP INT AUDIT & COMPL
 25.00
.......................25.00 		      X     407,065 0 171,844
(28) CHARLES CALLAHAN PHD........................................................................
EVP & COO (FROM APRIL 14)
 25.00
.......................25.00 		      X     0 557,424 91,923
(29) MELISSA MCGLASSON........................................................................
VP FINANCE
 25.00
.......................25.00 		        X   275,973 0 40,522
(30) AIMEE ALLBRITTON PHD........................................................................
VP & CLO
 25.00
.......................25.00 		        X   314,688 0 61,823
(31) LAURA COSSEY........................................................................
SYS DIR INT AUDIT/COMPL
 50.00
.......................   		        X   183,105 0 31,352
(32) MADONNA CROMPTON........................................................................
SYS DIR CLINICAL INFORMATICS
 50.00
.......................   		        X   172,542 0 31,077
(33) JERRY MILLER........................................................................
ADMIN IS OPERATIONS
 50.00
.......................   		        X   173,321 0 32,447
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,778,831 702,712 3,124,723
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet46
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
HAROLD O'SHEA BUILDERS INC

3401 CONSTITUTION DR
SPRINGFIELD,IL62711 		CONSTRUCTION 10,442,638
SIRIUS COMPUTER SOLUTIONS

PO BOX 202289
DALLAS,TX75320 		IT EQUIPMENT & SUPPORT SERVICES 4,373,030
BSA LIFESTRUCTURE INC

PO BOX 6069
INDIANAPOLIS,IN46206 		ARCHITECTURAL 2,737,792
CERNER CORPORATION

PO BOX 412702
KANSAS CITY,MO64141 		IT CONSULTING SERVICES 2,625,539
SPRINGFIELD CLINIC

1025 SOUTH SEVENTH ST
SPRINGFIELD,IL62703 		EHR-IT SUPPORT SERVICES 2,476,290
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet49
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a MANAGEMENT FEES 900099 60,990,719 60,560,990 429,729  
b PROGRAM RELATED RENT 900099 5,278,513 5,278,513    
c IT REIMBURSED EXPENSES 900099 1,559,320 1,559,320    
d MISCELLANEOUS INCOME 900099 170,439 170,439    
e RELATED PARTNERSHIP IN 900099 -367,558 -367,558    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 67,631,433
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,110,259     1,110,259
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 9,397,680  
b Less: rental expenses 13,525,148  
c Rental income or (loss) -4,127,468  
d Net rental income or (loss).......MediumBullet -4,127,468 -4,179,095 2,827 48,800
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 65,864,321 5,000
b Less: cost or other basis and sales expenses 65,244,951 0
c Gain or (loss) 619,370 5,000
d Net gain or (loss)..........MediumBullet 624,370     624,370
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a BILLING SERVICE 561000 2,751,181   38,400 2,712,781
b ENERGY REBATES 900099 181,370     181,370
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 2,932,551
12 Total revenue. See Instructions......MediumBullet 68,171,145 63,022,609 470,956 4,677,580
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 568,286 568,286
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 4,757,956 4,757,956    
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 .... 24,514,446 14,796,127 9,718,319  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,729,719 1,044,002 685,717  
9 Other employee benefits ....... 2,965,545 1,693,364 1,272,181  
10 Payroll taxes ........... 1,691,044 1,037,609 653,435  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 719,456   719,456  
c Accounting ........... 373,416   373,416  
d Lobbying ........... 75,000   75,000  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 252,159   252,159  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 5,086,719 2,375,551 2,711,168  
12 Advertising and promotion .... 856,038   856,038  
13 Office expenses ....... 3,189,191 1,540,034 1,649,157  
14 Information technology ...... 11,218,493 11,136,837 81,656  
15 Royalties ..        
16 Occupancy ........... 3,039,932 2,149,394 890,538  
17 Travel ............ 151,201 67,190 84,011  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 146,114 116,651 29,463  
20 Interest ........... 1,221,631 1,221,631    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 7,270,223 7,211,133 59,090  
23 Insurance .............. 148,561   148,561  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MINOR PROJECT COSTS 126,679 126,679    
b REPAIRS & MAINTENANCE 121,921 121,346 575  
c FOOD & DIETARY 19,054 6,308 12,746  
d SALES TAX 596 596    
e All other expenses 379   379  
25 Total functional expenses. Add lines 1 through 24e 70,243,759 49,970,694 20,273,065 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing .............   1  
2 Savings and temporary cash investments ......... 2,952,632 2 32,696,790
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 2,811,321 4 2,333,011
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges .......... 5,678,010 9 5,350,306
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 280,133,932
b Less: accumulated depreciation ..... 10b 92,794,718 176,069,461 10c 187,339,214
11 Investments—publicly traded securities .......... 48,829,768 11 46,667,818
12 Investments—other securities. See Part IV, line 11 ..... 1,479,549 12 1,663,711
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 7,194,907 15 4,900,698
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 245,015,648 16 280,951,548
Liabilities 17 Accounts payable and accrued expenses ......... 16,751,428 17 12,788,143
18 Grants payable .................   18  
19 Deferred revenue ................ 18,363 19 18,729
20 Tax-exempt bond liabilities ............. 13,621,684 20 13,162,349
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 .. 73,882,548 23 99,496,090
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.................... 26,265,717 25 26,229,907
26 Total liabilities. Add lines 17 through 25......... 130,539,740 26 151,695,218
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 114,475,908 27 129,256,330
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 114,475,908 33 129,256,330
34 Total liabilities and net assets/fund balances ........ 245,015,648 34 280,951,548
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
68,171,145
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
70,243,759
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,072,614
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
114,475,908
5
Net unrealized gains (losses) on investments ...............
5
-2,879,716
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
19,732,752
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
129,256,330
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations ............................. 11
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) MEMORIAL MEDICAL CENTER
  		370661220   Yes   0 0
(B) PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
  		370661230   Yes   0 0
(C) ABRAHAM LINCOLN MEMORIAL HOSPITAL
  		370723793   Yes   0 0
(D) TAYLORVILLE MEMORIAL HOSPITAL
  		370661250   Yes   0 0
(E) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
  		370646367   Yes   0 0
(F) SPRINGFIELD RESIDENTIAL SERVICES
  		371298589   Yes   0 0
(G) ABRAHAM LINCOLN HEALTHCARE FOUNDATION
  		363492268   Yes   0 0
(H) MEMORIAL MEDICAL CENTER FOUNDATION
  		371110301   Yes   0 0
(I) MEMORIAL HOME SERVICES
  		370714225   Yes   0 0
(J) MEMORIAL PHYSICIAN SERVICES
  		371181194   Yes   0 0
(K) MEMORIAL HEALTH VENTURES
  		363492266   Yes   0 0
Total : 1111 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
No
2
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).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
No
b
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....
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
No
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
No
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
No
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
No
9a
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.
9a
 
No
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
No
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
No
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
No
b
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
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
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
 
No
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
No
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

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

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
SECTION A, LINE 1 IN THE MEMORIAL HEALTH SYSTEM GOVERNING DOCUMENTS, THE SUPPORTED ORGANIZATIONS ARE NOT LISTED. HOWEVER, IN ALL SUPPORTED AFFILIATES, WITH THE EXCEPTION OF SPRINGFIELD RESIDENTAL SERVICES, THE CORPORATE MEMBER IS DESCRIBED IN THE SUPPORTED ORGANIZATIONS GOVERNING DOCUMENTS AS HAVING CERTAIN RESERVED POWERS. FOR SPRINGFIELD RESIDENTIAL SERVICES, IT IS JUST A HISTORICAL RELATIONSHIP WITH MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS.
SECTION C, LINE 1 MEMORIAL HEALTH SYSTEM SERVES AS THE SOLE CORPORATE MEMBER OF THE SUPPORTED ORGANIZATIONS. IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER, MEMORIAL HEALTH SYSTEM HAS CERTAIN RESERVED POWERS THAT PROVIDE CONTROL OVER THE SUPPORTED ORGANIZATIONS. FOR EXAMPLE, ALL CAPITAL AND OPERATING BUDGETS MUST BE APPROVED BY MEMORIAL HEALTH SYSTEM.
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

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

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
75,000
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
75,000
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: MEMORIAL HEALTH SYSTEM ENGAGES LOBBYISTS TO ASSIST IT IN MONITORING STATE REGULATIONS IN SUPPORT OF FURTHERING THE MEMORIAL HEALTH SYSTEM MISSION WHICH IS "TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE". THIS INCLUDES ASSISTING MEMORIAL HEALTH SYSTEM IN DEVELOPING PRESENTATIONS TO THE ILLINOIS CONGRESSIONAL DELEGATION, REQUESTING APPROPRIATIONS FOR PRIORITY PROJECTS INVOLVING LOCAL PATIENT SAFETY, QUALITY IMPROVEMENT AND IMPROVED LOCAL ACCESS TO MEDICAL CARE. THE LOBBYISTS ALSO ASSIST MEMORIAL IN COMMUNICATING THE IMPORTANCE OF ADEQUATE MEDICAID FUNDING IN SUPPORT OF THE SUBSTANTIAL SERVICES MEMORIAL'S AFFILIATES PROVIDE TO THOSE IN POVERTY AND IN MONITORING LEGISLATIVE AND REGULATORY DEVELOPMENTS THAT WOULD AFFECT MEMORIAL HEALTH SYSTEM'S ABILITY TO CONTINUE DELIVERING ITS SUBSTANTIAL COMMUNITY BENEFIT.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 1,451,239 23,098,249 24,549,488
b Buildings ................ 111,843,474 68,045,664 41,414,952 138,474,186
c Leasehold improvements ............        
d Equipment ................ 1,597,177 61,866,218 49,929,245 13,534,150
e Other ................. 859,329 11,372,582 1,450,521 10,781,390
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 187,339,214
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DEFERRED COMPENSATION 10,079,863
WORKERS' COMPENSATION 314,831
RESERVE FOR POST EMPLOYMENT BENEFITS 2,927,800
DUE TO AFFILIATES 21,422
SWAP LIABILITY 2,726,255
RESTORATION PLAN 8,559,736
CONTRIBUTION PAYABLE 1,600,000


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 26,229,907
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 78,818,548
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -2,879,716
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 43,404
e Add lines 2a through 2d ..................... 2e -2,836,312
3 Subtract line 2e from line 1..................... 3 81,654,860
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 252,159
b Other (Describe in Part XIII.) ........... 4b -13,735,874
c Add lines 4a and 4b....................... 4c -13,483,715
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 68,171,145
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 81,533,721
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 11,542,121
e Add lines 2a through 2d...................... 2e 11,542,121
3 Subtract line 2e from line 1..................... 3 69,991,600
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 252,159
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c 252,159
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 70,243,759
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: THE AUTHORITATIVE GUIDANCE IN ASC 740, INCOME TAXES, CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF THIS GUIDANCE, TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. EACH OF MEMORIAL HEALTH SYSTEM'S SUBSIDIARIES, EXCLUDING THOSE DESCRIBED IN THE FOLLOWING PARAGRAPH, IS A SEPARATELY INCORPORATED NOT-FOR-PROFIT CORPORATION AS DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE AND IS TAX-EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY DO, HOWEVER, OPERATE CERTAIN PROGRAMS THAT MAY RESULT IN UNRELATED BUSINESS INCOME. UPON REVIEW AS REQUIRED BY ASC 740, NO TAX PROVISION WAS RECORDED FOR THE YEARS ENDED SEPTEMBER 30, 2015 OR 2014. MEMORIAL PROPERTIES (MP) AND MEMORIAL HEALTH PARTNERS (MHP) ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES AND ARE EXEMPT FROM INCOME TAX. MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS (MHSCI) IS A TAXABLE FOR-PROFIT CORPORATION AND PASSAVANT PHYSICIAN ASSOCATION (PPA) IS A TAXABLE NOT-FOR-PROFIT CORPORATION. BOTH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES.
PART XI, LINE 2D - OTHER ADJUSTMENTS: NONOPERATING CHANGE IN FV OF INT RATE SWAPS 43,404.
PART XI, LINE 4B - OTHER ADJUSTMENTS: REIMBURSED IT EXPENSES 1,559,320. RENTAL EXPENSES REPORTED IN F/S AS EXPENSE 990 AS NET -13,525,148. RELATED PARTNERSHIP INCOME BOOK/TAX DIFFERENCE 268. REIMBURSED EXEC SALARIES IN MGMT FEE -1,770,314.
PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED IN F/S AS EXPENSE 990 AS NET 13,525,148. REIMBURSED IT EXPENSES -1,559,320. NONOPERATING OTHER EXPENSE -423,707.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) UNITED WAY OF CENTRAL ILLINOIS INC
1999 WEST WABASH AVENUE SUITE 107
SPRINGFIELD,IL62704 		37-0716060 501(C)(3) 151,603       SUPPORT FOR UNITED WAY COMMUNITY FUND.
(2) GREATER SPRINGFIELD CHAMBER OF COMMERCE
1011 S SECOND STREET
SPRINGFIELD,IL62704 		37-0710280 501(C)(6) 90,050       SEE PART IVPARTICIPATE IN A PUBLIC AND PRIVATE ECONOMIC GROWTH PARTNERSHIP LED BY THE CHAMBER OF COMMERCE.
(3) HOSPITAL SISTERS MISSION OUTREACH
PO BOX 1665
SPRINGFIELD,IL62705 		35-2271729 501(C)(3) 33,724       SEE PART IV RESPONDS TO THE SICK, POOR AND NEEDY THROUGH MEDICAL EQUIPMENT AND SUPPLY RECOVERY AND DISTRIBUTION PROGRAM AND EDUCATION AND AWARENESS OPPORTUNITIES.
(4) BOYS & GIRLS CLUBS OF CENTRAL ILLINOIS
300 S 15TH ST
SPRINGFIELD,IL62703 		37-0752849 501(C)(3) 50,000       SEE PART IV PROVIDE SUPPORT TO INSPIRE AND ENABLE ALL YOUNG PEOPLE TO REACH THEIR FULL POTENTIAL AS PRODUCTIVE, CARING, AND RESPONSIBLE CITIZENS.
(5) KIDZEUM OF HEALTH AND SCIENCE
PO BOX 9863
SPRINGFIELD,IL62791 		37-1320003 501(C)(3) 150,000       SEE PART IVPROVIDE SUPPORT FOR THE KIDZEUM HEALTH AND SCIENCE MUSEUM WHICH HAS A VERY STRONG HEALTH EDUCATION COMPONENT FOR CHILDREN.
(6) CENTRAL ILLINOIS FOODBANK INC
1937 E COOK ST
SPRINGFIELD,IL62703 		37-1106465 501(C)(3) 9,664       SEE PART IVPROVIDE SUPPORT TO COLLECT AND DISTRIBUTE FOOD TO CHARITABLE AGENCIES THAT SERVE PEOPLE IN NEED.
(7) ILLINOIS EXECUTIVE MANSION ASSOCIATION
410 E JACKSON STREET
SPRINGFIELD,IL62703 		23-7244796 501(C)(3) 10,000       SEE PART IVPROVIDE COMMUNITY SUPPORT FOR FUNDRAISING TO REPAIR THE STATE OF ILLINOIS EXECUTIVE MANSION AND RELIEVE THE BURDEN FOR GOVERNMENT/TAXPAYERS.
(8) SPARC
1 SPARC CENTER PLAZA 232 BRUNS LANE
LANE
SPRINGFIELD,IL62702 		37-0717761 501(C)(3) 10,000       SEE PART IVPROVIDE SUPPORT TO HELP INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES IMPROVE THE QUALITY OF THEIR LIVES.
(9) SPRINGFIELD URBAN LEAGUE INC
100 NORTH ELEVENTH STREET
SPRINGFIELD,IL62703 		37-0765550 501(C)(3) 10,000       SEE PART IVPROVIDE SUPPORT TO ASSIST INDIVIDUALS AND COMMUNITIES TO REACH THEIR FULLEST POTENTIAL AND TO CLOSE EQUALITY GAPS FOR PEOPLE AT ALL ECONOMIC LEVELS AND STAGES OF LIFE.
(10) AMERICAN LUNG ASSOCIATION OF THE UPPER MIDWEST
3000 KELLY LANE
SPRINGFIELD,IL62711 		20-4392201 501(C)(3) 9,900       SEE PART IVPROVIDE SUPPORT TO RAISE FUNDS AND AWARENESS FOR LUNG CANCER AND ASTHMA.
(11) OLD STATE CAPITOL FOUNDATION
PO BOX 502
SPRINGFIELD,IL62705 		37-1294171 501(C)(3) 9,000       SEE PART IVPROVIDE COMMUNITY SUPPORT FOR EDUCATION PROGRAM ON HISTORY OF MEDICAL CARE DURING THE CIVIL WAR AND THE PROGRESS OF MODERN MEDICINE.
(12) GIRLS ON THE RUN OF CENTRAL ILLINOIS
907 CLOCKTOWER DRIVE
SPRINGFIELD,IL62704 		27-1822009 501(C)(3) 7,500       SEE PART IVPROVIDE SUPPORT FOR POSITIVE YOUTH DEVELOPMENT FOR GIRLS 3RD-8TH GRADE. LIFE SKILLS ARE TAUGHT THROUGH DYNAMIC INTERACTIVE LESSONS AND RUNNING GAMES. THE GOAL OF THE PROGRAM IS TO UNLEASH CONFIDENCE THROUGH ACCOMPLISHMENT WHILE ESTABLISHING A LIFETIME APPRECIATION OF HEALTH AND FITNESS.
(13) ABRAHAM LINCOLN COUNCIL INC BSA
5231 S 6TH STREET
SPRINGFIELD,IL62703 		37-0661493 501(C)(3) 5,000       SEE PART IVPROVIDE SUPPORT TO PREPARE YOUNG PEOPLE TO MAKE ETHICAL CHOICES OVER THEIR LIFETIME BY INSTILLING IN THEM THE VALUES OF THE SCOUT OATH & LAW.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
12
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: MHS PROVIDES GRANTS PRIMARILY TO LOCALLY MANAGED 501(C)(3) ORGANIZATIONS THAT SUPPORT OR SHARE THE MISSION OF MHS. REQUESTS TO SUPPORT INITIATIVES IN LINE WITH MHS'S COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES RECEIVE SPECIAL CONSIDERATION. SENIOR LEADERSHIP MUST APPROVE ALL GRANTS. MHS EMPLOYEES ARE VOLUNTEER BOARD MEMBERS OR PARTICIPATE AS VOLUNTEERS FOR SOME OF THE ORGANIZATIONS THAT MHS ASSISTS. WHEN AN ORGANIZATION IS GIVEN A DONATION, IT EITHER AGREES TO RESTRICT THE DONATION TO THE PURPOSE FOR WHICH IT WAS REQUESTED OR IT RECEIVES A LETTER DIRECTING THAT DONATION MAY BE USED ONLY FOR THE APPROVED GRANT'S PURPOSE. ADDITIONALLY, EMPLOYEES FREQUENTLY ATTEND MANY OF THE SPONSORED EVENTS OR MHS RECEIVES ACKNOWLEDGEMENT FROM THE ORGANIZATION ABOUT THE PROGRAM THAT WAS SUPPORTED BY THE GRANT.
Schedule I (Form 990) 2014


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
No
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1EDGAR CURTIS EX-OFFICIOPRESIDENT & CEO (i)
(ii)		 743,747
...............................
0 		393,803
...............................
0 		85,996
...............................
0 		1,041,582
...............................
0 		42,969
...............................
0 		2,308,097
...............................
0 		0
...............................
0
2ROBERT KAYSVP & CFO & ASST TREASURER (i)
(ii)		 355,760
...............................
0 		0
...............................
0 		15,272
...............................
0 		466,001
...............................
0 		18,864
...............................
0 		855,897
...............................
0 		0
...............................
0
3MITCHELL JOHNSONSVP & CHIEF STRATEGY OFFICER (i)
(ii)		 270,158
...............................
0 		115,610
...............................
0 		15,388
...............................
0 		157,516
...............................
0 		40,252
...............................
0 		598,924
...............................
0 		0
...............................
0
4DAVID GRAHAM MDSVP & CIO (i)
(ii)		 373,189
...............................
0 		158,266
...............................
0 		13,628
...............................
0 		198,558
...............................
0 		14,658
...............................
0 		758,299
...............................
0 		0
...............................
0
5RAJESH GOVINDAIAH MDSVP & CMO (i)
(ii)		 370,799
...............................
0 		158,281
...............................
0 		20,448
...............................
0 		66,406
...............................
0 		7,194
...............................
0 		623,128
...............................
0 		0
...............................
0
6ROBERT SCOTTVP & CHRO (i)
(ii)		 213,671
...............................
0 		66,000
...............................
0 		11,540
...............................
0 		30,319
...............................
0 		21,041
...............................
0 		342,571
...............................
0 		0
...............................
0
7DOUGLAS RAHN DBAEVP & COO (THRU MARCH 14) (i)
(ii)		 324,344
...............................
119,496 		188,757
...............................
0 		13,776
...............................
25,792 		193,948
...............................
77,435 		15,277
...............................
5,235 		736,102
...............................
227,958 		0
...............................
0
8KEVIN ENGLANDVP BUSINESS DEVELOPMENT (i)
(ii)		 224,527
...............................
0 		82,352
...............................
0 		36,825
...............................
0 		213,478
...............................
0 		53,002
...............................
0 		610,184
...............................
0 		0
...............................
0
9ANNA EVANS JDGEN COUNSEL/VP INT AUDIT & COMPL (i)
(ii)		 302,277
...............................
0 		93,785
...............................
0 		11,003
...............................
0 		147,179
...............................
0 		24,665
...............................
0 		578,909
...............................
0 		0
...............................
0
10CHARLES CALLAHAN PHDEVP & COO (FROM APRIL 14) (i)
(ii)		 0
...............................
357,710 		0
...............................
161,616 		0
...............................
38,098 		0
...............................
69,971 		0
...............................
21,952 		0
...............................
649,347 		0
...............................
0
11MELISSA MCGLASSONVP FINANCE (i)
(ii)		 201,500
...............................
0 		61,200
...............................
0 		13,273
...............................
0 		37,449
...............................
0 		3,073
...............................
0 		316,495
...............................
0 		0
...............................
0
12AIMEE ALLBRITTON PHDVP & CLO (i)
(ii)		 215,233
...............................
0 		66,070
...............................
0 		33,385
...............................
0 		45,437
...............................
0 		16,386
...............................
0 		376,511
...............................
0 		0
...............................
0
13LAURA COSSEYSYS DIR INT AUDIT/COMPL (i)
(ii)		 154,946
...............................
0 		24,348
...............................
0 		3,811
...............................
0 		12,526
...............................
0 		18,826
...............................
0 		214,457
...............................
0 		0
...............................
0
14MADONNA CROMPTONSYS DIR CLINICAL INFORMATICS (i)
(ii)		 154,387
...............................
0 		11,784
...............................
0 		6,371
...............................
0 		21,434
...............................
0 		9,643
...............................
0 		203,619
...............................
0 		0
...............................
0
15JERRY MILLERADMIN IS OPERATIONS (i)
(ii)		 149,104
...............................
0 		23,527
...............................
0 		690
...............................
0 		9,851
...............................
0 		22,596
...............................
0 		205,768
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A CHARTER TRAVEL IS OCCASIONALLY PROVIDED FOR THE CONVENIENCE OF EXECUTIVES/KEY EMPLOYEES ATTENDING OFF-SITE BUSINESS RELATED MEETINGS. CHARTER TRAVEL IS NOT TAXABLE INCOME TO THE INDIVIDUAL BECAUSE IT IS RELATED TO BUSINESS TRAVEL. ROBERT SCOTT RECEIVED A TEMPORARY HOUSING ALLOWANCE IN CALENDAR YEAR 2014 IN THE AMOUNT OF $5,000, WHICH WAS TREATED AS TAXABLE COMPENSATION AND IS LISTED AS OTHER COMPENSATION ON SCHEDULE J, PART II, COLUMN (B)(III).
PART I, LINE 1B MEMORIAL HEALTH SYSTEM DOES HAVE A BUSINESS TRAVEL POLICY THAT DISCUSSES REIMBURSEMENT OF TRAVEL EXPENSES AND RELATED APPROVALS. THE POLICY IS NOT SPECIFIC TO CHARTER TRAVEL, HOWEVER REIMBURSEMENT FOR CHARTER TRAVEL MUST FOLLOW THE APPROPRIATE SIGNATORY GUIDELINES. A WRITTEN POLICY DOES NOT EXIST REGARDING THE ISSUANCE OF A HOUSING ALLOWANCE, HOWEVER A WRITTEN CONTRACT OUTLINING THE TERMS AND CONDITIONS OF SUCH HOUSING ALLOWANCE WAS EXECUTED BETWEEN THE PARTIES.
PART I, LINE 3 COMPENSATION AND BENEFITS RECEIVED BY EDGAR CURTIS, PRESIDENT AND CEO OF MEMORIAL HEALTH SYSTEM, WAS COMPRISED OF THE FOLLOWING COMPONENTS; BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER COMPENSATION, RETIREMENT/DEFERRED COMPENSATION AND OTHER NONTAXABLE BENEFITS. BASE COMPENSATION FOR MR. CURTIS WAS DETERMINED BASED ON THE METHODS DESCRIBED IN PART I, LINE 3 CONDUCTED BY INDEPENDENT COMPENSATION CONSULTANTS. BASE COMPENSATION LEVELS WERE SET BY THE MHS BOARD AT THE 50TH PERCENTILE OF THE RELEVANT COMPENSATION RANGE, AS DETERMINED BY THE INDEPENDENT COMPENSATION CONSULTANTS. INCENTIVE COMPENSATION WAS CONTINGENT ON THE ACHIEVEMENT OF FOUR SPECIFIC PERFORMANCE METRICS OF MHS, AS DEFINED BY THE MHS BOARD. OTHER COMPENSATION IS COMPRISED PRIMARILY OF A PORTION OF MR. CURTIS' PAID TIME OFF BANK CASHED IN AND PAID TIME OFF DONATED BACK TO MEMORIAL MEDICAL CENTER FOUNDATION'S ANNUAL FUNDRAISING CAMPAIGN. RETIREMENT COMPENSATION REFLECTS AN INCREASE IN RETIREMENT BENEFITS OWED BY MHS UPON RETIREMENT OF MR. CURTIS. THIS CHANGE IS DRAMATICALLY IMPACTED BY ACTUARIAL ASSUMPTIONS OF THE RETIREMENT PLAN, WHICH HAVE HISTORICALLY INCLUDED DRAMATIC CHANGES IN THE DISCOUNT RATE. NORMAL RETIREMENT COMPENSATION FOR THE YEAR WAS $163,606. LASTLY, NONTAXABLE BENEFITS REFLECT THE VALUE OF HEALTH (MEDICAL, DENTAL, LIFE INSURANCE) BENEFITS RECEIVED DURING THE YEAR AS WELL AS CHANGES IN ACTUARIAL VALUE OF THE POSTRETIREMENT HEALTH CARE INSURANCE REIMBURSEMENT PLAN.
PART I, LINE 4B THE ORGANIZATION OR A RELATED ORGANIZATION, MEMORIAL MEDICAL CENTER, PROVIDES CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS TO THE FOLLOWING OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES: AIMEE ALLBRITTON, PH.D., $24,887, CHARLES CALLAHAN, PH.D., $43,418, EDGAR CURTIS, $1,008,282, KEVIN ENGLAND, $187,960, ANNA EVANS, J.D., $129,404, RAJESH GOVINDAIAH, M.D., $51,100, DAVID GRAHAM, M.D., $180,558, MITCHELL JOHNSON, $124,471, ROBERT KAY, $437,801, MELISSA MCGLASSON, $20,808, DOUGLAS RAHN, D.B.A., $253,383, AND ROBERT SCOTT, $22,519. THESE BENEFITS ARE PROVIDED THROUGH A NONQUALIFIED DEFERRED COMPENSATION PLAN, UNDER WHICH THE BENEFITS BEING EARNED ARE SUBJECT TO A "SUBSTANTIAL RISK OF FORFEITURE." THE SUPPLEMENTAL RETIREMENT BENEFITS ARE STRUCTURED TO PROVIDE A RETENTION INCENTIVE THAT HAS BEEN DETERMINED BY THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM TO BE OF SUBSTANTIAL VALUE TO THE ORGANIZATION. THE FOLLOWING CURRENT OR FORMER OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES RECEIVED DEFERRED COMPENSATION PAYOUTS IN THE CALENDAR YEAR FROM THE ORGANIZATION OR A RELATED ORGANIZATION, MEMORIAL MEDICAL CENTER: KEVIN ENGLAND, $10,152, AND DOUGLAS RAHN, D.B.A., $12,055. TO BECOME ENTITLED TO THE BENEFITS PROVIDED, EACH COVERED EMPLOYEE MUST MEET SUBSTANTIAL REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES AND NOT MET THESE SUBSTANTIAL REQUIREMENTS, THESE SUPPLEMENTAL RETIREMENT BENEFITS WOULD HAVE BEEN FORFEITED. THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ACCORDINGLY, ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE. THE LEADERSHIP COMPENSATION COMMITTEE OF THE MHS BOARD APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER SENIOR LEADERS, IN A MANNER INTENDED TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL INCOME TAX LAW.
SCHEDULE J, PART II, COLUMN (D) MEMORIAL HEALTH SYSTEM PROVIDES A POSTRETIREMENT HEALTH CARE INSURANCE REIMBURSEMENT PLAN TO CERTAIN EXECUTIVES AND PHYSICIANS TO REIMBURSE HEALTH INSURANCE COSTS INCURRED BY THE RETIREES AND THEIR SPOUSES. THE CHANGE IN THE ACTUARIAL VALUE OF THE PLAN IS REPORTED ON SCHEDULE J, PART II, COLUMN (D) AS A NONTAXABLE BENEFIT. SCHEDULE J, PART II, COLUMN (D) ALSO INCLUDES OTHER NONTAXABLE BENEFITS SUCH AS MEDICAL, DENTAL, AND LIFE INSURANCE.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A ILLINOIS HEALTH FACILITIES AUTHORITY
  		36-2780046 45200P2U4 12-17-2003 31,000,000 SEE PART VI   X   X   X
B ILLINOIS FINANCE AUTHORITY
  		86-1091967 45200FJ59 12-22-2009 147,401,639 SEE PART VI   X   X   X
C ILLINOIS FINANCE AUTHORITY
  		86-1091967 45203HYQ9 01-30-2014 60,465,495 SEE PART VI   X   X   X
D ILLINOIS FINANCE AUTHORITY
  		86-1091967   05-15-2014 60,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 9,730,000 3,765,000    
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 31,100,606 147,556,074 60,471,350 60,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 329,438 1,350,000    
8 Credit enhancement from proceeds . . . . . . . . . . . 110,306      
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 19,254,302 146,206,074 60,471,350 60,000,000
11 Other spent proceeds . . . . . . . . . . . . . . 11,406,560      
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2004 2011 2015 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X     X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X     X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X     X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X     X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X          
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.340 % 1.840 % 0 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.340 % 1.840 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X X   X  
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   X     X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X     X   X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . US BANCORP PIPER
JAFFRAY FINANCIAL 		 
  		 
  		 
 
c Term of hedge . . . . . . . . . . 18.800000000000      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . .   X            
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K SUPPLENTAL INFORMATION SCHEDULE K: ONE SCHEDULE K WAS COMPLETED AT THE PARENT LEVEL ONLY. HOWEVER, EACH AFFILIATE IS STILL SHOWING ITS ALLOCATION OF THE LIABILITY ON THE BALANCE SHEET, AS CAN BE SEEN ON THE GROUP RETURN. SCHEDULE K PART I, COLUMN (F) CONTINUATIONS: ONE PURPOSE OF THE 2003 ISSUE WAS TO CURRENT REFUND $10,980,000 OF THE 1993 SERIES BONDS ISSUED ON 8/5/93 IN THE AMOUNT OF $21,245,000. PROCEEDS WERE ALSO USED TO PAY ISSUANCE EXPENSES AND TO PURCHASE EQUIPMENT AND SOFTWARE FOR MEMORIAL HEALTH SYSTEM. PROCEEDS WERE ALSO USED FOR CONSTRUCTION AND HEALTHCARE BUILDING IMPROVEMENTS AND TO CONSTRUCT AND EQUIP AN OUTPATIENT PSYCHIATRIC FACILITY. THE PURPOSE OF THE 2009 ISSUE WAS TO PAY ISSUANCE COSTS, CONSTRUCT AND EQUIP A REPLACEMENT HOSPITAL FACILITY FOR ABRAHAM LINCOLN MEMORIAL HOSPITAL, RENOVATE AND REMODEL TAYLORVILLE MEMORIAL HOSPITAL, RENOVATE, REMODEL, AND EQUIP MEMORIAL MEDICAL CENTER, CONSTRUCT A PARKING GARAGE ADJACENT TO MEMORIAL MEDICAL CENTER, CONSTRUCT AND EQUIP A WOUND CARE CENTER, RENOVATE A PAIN CLINIC, CONSTRUCT AND EQUIP A CONSOLIDATED IMAGING SERVICES AREA, PURCHASE VARIOUS PARCELS OF REAL PROPERTY IN SPRINGFIELD, IL AND TAYLORVILLE, IL FOR FUTURE EXPANSION OF EXISTING FACILITIES, CONSTRUCT AND EQUIP A SPACE FOR PHYSICAL THERAPY OWNED BY MEMORIAL MEDICAL CENTER AND LOCATED WITHIN THE NEW YMCA IN SPRINGFIELD, IL, AND ROUTINE CAPITAL EXPENDITURES. THE PURPOSE OF THE 2014A ISSUE WAS (A) TO REPAY TAXABLE DEBT IN THE AMOUNT OF $25,057,493 USED FOR PAYMENT OF THE COST OF ACQUIRING, CONSTRUCTING, RENOVATING, REMODELING AND EQUIPPING HEALTH FACILITIES AT MEMORIAL MEDICAL CENTER, AND (B) FOR PAYING ADDITIONAL COSTS OF THOSE PROJECTS NOT PREVIOUSLY FINANCED WITH THE TAXABLE DEBT. THE PURPOSE OF THE 2014B ISSUE WAS FOR THE PAYMENT OF ACQUIRING, CONSTRUCTING, RENOVATING, REMODELING AND EQUIPPING HEALTH FACILTIES AT MEMORIAL MEDICAL CENTER. SCHEDULE K PART II, LINE 3: TOTAL PROCEEDS ISSUED AMOUNT IN COLUMNS A, B, & C DOESN'T TIE TO PART I COLUMN (E) DUE TO INVESTMENT EARNINGS INCLUDED IN PART II, LINE 3. SCHEDULE K PART III, LINE 3B & 3D: MEMORIAL HEALTH SYSTEM'S INTERNAL COUNSEL, AS WELL AS EXTERNAL BOND COUNSEL, ROUTINELY REVIEWS MANAGEMENT AND SERVICE CONTRACTS AND RESEARCH AGREEMENTS RELATING TO FINANCED PROPERTY . SCHEDULE K PART IV, LINE 1: THE ARBITRAGE REBATE FILING IS ONLY REQUIRED EVERY 5 YEARS, AND NO REBATABLE ARBITRAGE HAS BEEN EARNED FOR ISSUES AT SUCH 5 YEAR ANNIVERSARIES. SCHEDULE K PART IV, LINE 2C: THE REBATE COMPUTATION FOR COLUMN A WAS PERFORMED ON 12/17/2013. THE REBATE COMPUTATION FOR COLUMN B WAS PERFORMED ON 12/22/2014, AND NO REBATABLE ARBITRAGE HAS BEEN EARNED FOR THESE ISSUES AT SUCH 5 YEAR ANNIVERSARIES. SCHEDULE K PART IV, LINE 4B: THE PROVIDER'S FULL NAME FOR COLUMN A IS U.S. BANCORP PIPER JAFFRAY FINANCIAL PRODUCTS INC.
Schedule K (Form 990) 2014

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) LEVI RAY AND SHOUP INC
  		SEE PART V BOARD MEMBER IS OWNER OF LEVI, RAY AND SHOUP, INC. 242,977 SEE PART VMEMORIAL HEALTH SYSTEM PAID FEES TO LEVI, RAY AND SHOUP, INC. FOR SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2015 IN THE AMOUNT OF $242,977. RICHARD H. LEVI IS A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS AND IS OWNER OF LEVI, RAY AND SHOUP, INC. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
(2) SPRINGFIELD CLINIC LLP
  		PART V BOARD MEMBER IS PARTNER AND BOARD MEMBER OF SPRINGFIELD CLINIC, LLP 2,234,338 SEE PART VMEMORIAL HEALTH SYSTEM PAID FEES TO SPRINGFIELD CLINIC FOR SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2015 IN THE AMOUNT OF $2,234,338. A PHYSICIAN AND BOARD MEMBER OF THIS COMPANY, WILLIAM D. PUTMAN, M.D. IS ALSO A BOARD MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2 MEMORIAL HEALTH SYSTEM BOARD MEMBERS JAMES BRUNER, RICHARD LEVI, AND SERGIO PECORI ARE ALL ON THE ILLINOIS NATIONAL BANK BOARD OF DIRECTORS. MEMORIAL HEALTH SYSTEM BOARD MEMBER NINA HARRIS AND KEY EMPLOYEE MITCHELL JOHNSON ARE BOARD MEMBERS OF SECURITY BANK. WILLIAM PUTMAN, M.D. IS A MHS BOARD MEMBER AND IS A BOARD MEMBER OF SPRINGFIELD CLINIC, LLP. TODD WISE AND DIANE RUTLEDGE, PH.D. ARE BOTH MMC BOARD MEMBERS. MR. WISE IS AN OFFICER AND DIRECTOR OF UNITED COMMUNITY BANK, WHERE MS. RUTLEDGE IS ALSO A UCB BOARD MEMBER.
FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION CONTAINS 101 INDIVIDUAL MEMBERS WHO ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A THE INDIVIDUAL MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT THE CORPORATION'S BOARD OF DIRECTORS, AS WELL AS THE POWER AND AUTHORITY TO REMOVE MEMBER ELECTED DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B INDIVIDUAL MEMBERS OF THE CORPORATION HAVE NO VOTING RIGHTS WITH RESPECT TO THE MANAGEMENT, CONTROL OR OPERATION OF THE AFFAIRS AND PROPERTIES OF THE CORPORATION. ONLY THE BOARD OF DIRECTORS CAN MAKE DECISIONS IN THAT REGARD.
FORM 990, PART VI, SECTION B, LINE 11 A FINAL DRAFT COPY OF THE MHS FORM 990 AND ALL ATTACHMENTS IS PROVIDED TO ALL OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS AND A BOARD COMMITTEE PRIOR TO FILING. ALL QUESTIONS AND COMMENTS ARISING FROM THESE REVIEWS ARE ADDRESSED PRIOR TO SUBMISSION OF THE RETURN TO THE APPROPRIATE TAXING AUTHORITIES.
FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE CORPORATION ARE REQUIRED TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A SPECIFIC DISCLOSURE STATEMENT WHICH IS ATTACHED TO THE POLICY. MEMORIAL HEALTH SYSTEM MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING AGENDA IS PREPARED. ANY OFFICER OR DIRECTOR WHO HAS A CONFLICT IS NOTIFIED OF SUCH CONFLICT, AS WELL AS THEIR OBLIGATION TO ABSTAIN FROM THE DISCUSSION AND VOTE ON ANY CONFLICTED ISSUES(S). SUCH ABSTENTION(S), IF REQUIRED, ARE DOCUMENTED IN THE MINUTES OF EACH MEETING. BOARD MEMBERS ARE ALSO REQUIRED TO UPDATE THEIR CONFLICT OF INTEREST DISCLOSURE STATEMENTS PROMPTLY IN THE EVENT OF ANY CHANGE IN PERSONAL OR BUSINESS ACTIVITIES THAT WOULD REQUIRE SUCH DISCLOSURE.
FORM 990, PART VI, SECTION B, LINE 15 THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE MADE UP OF PAST AND PRESENT INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, AND HAS DELEGATED TO IT THE RESPONSIBILITY OF ADMINISTERING, OVERSEEING AND APPROVING ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE LEADERSHIP, INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER AND OTHER SENIOR VICE PRESIDENTS, WHO ARE KEY EMPLOYEES. THE BOARD HAS ADOPTED A LEADERSHIP COMPENSATION PHILOSOPHY STATEMENT DESCRIBING THE ROLE AND RESPONSIBILITIES OF THE COMMITTEE. THIS PHILOSOPHY EXPRESSLY STATES THE COMMITTEE'S INTENT, ON BEHALF OF THE CORPORATION, TO TAKE ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE ANALYZES EVERY ELEMENT OF COMPENSATION (INCLUDING CURRENT, INCENTIVE AND DEFERRED COMPENSATION) AND BENEFITS (INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS). THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. IN CONNECTION WITH THE MOST RECENT REVIEW AND APPROVAL PROCESS, THE COMMITTEE RECEIVED PROFESSIONAL ADVICE FROM AN INDEPENDENT CONSULTANT AND OUTSIDE LEGAL COUNSEL. THE COMMITTEE CONSISTS ENTIRELY OF PAST AND PRESENT DISINTERESTED MEMBERS OF THE BOARD OR DISINTERESTED COMMITTEE MEMBERS WHO UNDER STATE CORPORATE LAW MAY SERVE ON SUCH A COMMITTEE. THE COMMITTEE WORKS WITH ITS COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES.
FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF MEMORIAL HEALTH SYSTEM, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D).
FORM 990, PART XI, LINE 9: NONOPERATING RECONCILING ITEMS 467,111. CHANGE IN UNRESTRICTED NET ASSETS 17,495,595. EXEC SALARIES IN MGMT FEE INCOME 1,770,314. RELATED PARTNERSHIP BOOK/TAX DIFF -268.
SCHEDULE R, PART V, LINE 2 MEMORIAL HEALTH SYSTEM COLLECTED RENTAL INCOME FROM AFFILIATES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2015. THE VALUES LISTED IN SCHEDULE R, PART V, LINE 2 WERE DETERMINED USING FAIR MARKET VALUE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


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

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) MEMORIAL HEALTH PARTNERS LLC
701 NORTH 1ST STREET
SPRINGFIELD,IL62781
46-3947269 		TO COORDINATE PATIENT CARE ACTIVITIES ACROSS THE HEALTHCARE CONTINUUM IL 115,440 0 MEMORIAL HEALTH SYSTEM
 










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


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

 		(f)
Direct controlling
entity

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

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

SPRINGFIELD,IL627810001
36-3492266 		HEALTHCARE ACTIVITIES IL 501(C)(3) 509(A)(2) MEMORIAL HEALTH SYSTEM
 
Yes
 
(3) ABRAHAM LINCOLN MEMORIAL HOSPITAL
200 STAHLHUT DR

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

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

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

SPRINGFIELD,IL627810001
37-1181194 		HEALTH CLINICS IL 501(C)(3) 509(A)(2) MEMORIAL HEALTH SYSTEM
 
Yes
 
(7) MEMORIAL MEDICAL CENTER FOUNDATION
701 NORTH FIRST ST

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

TAYLORVILLE,IL62568
37-1337485 		GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 170(B)(1)(A) (VI) N/A
 
No
(9) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
710 NORTH EIGHTH ST

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

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

SPRINGFIELD,IL62702
37-1298589 		RESIDENTIAL HUD HOUSING PROJECT FOR MENTALLY ILL IL 501(C)(3) 170(B)(1)(A) (VI) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
 
Yes
 
(12) PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
1600 WEST WALNUT

JACKSONVILLE,IL62650
37-0661230 		HOSPITAL SERVICES IL 501(C)(3) 170(B)(1)(A) (III) MEMORIAL HEALTH SYSTEM
 
Yes
 
(13) PASSAVANT AREA HOSPITAL FOUNDATION
1600 WEST WALNUT

JACKSONVILLE,IL62650
46-1037396 		GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) 509(A)(3)TYPE I PASSAVANT MEM AREA HOSPITAL ASSOCIATION
 
Yes
 
(14) JACKSONVILLE CRNA'S INC
1600 WEST WALNUT

JACKSONVILLE,IL62650
27-3083265 		CRNA SERVICES IL 501(C)(3) 509(A)(3)TYPE I PASSAVANT MEM AREA HOSPITAL ASSOCIATION
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No












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

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

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










Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MEMORIAL HEALTH VENTURES

 A 501,187 FMV
(2) MEMORIAL HOME SERVICES

 A 126,387 FMV
(3) MEMORIAL MEDICAL CENTER

 A 2,465,253 FMV
(4) MEMORIAL PHYSICIAN SERVICES

 A 1,928,655 FMV
(5) MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS

 A 6,643 FMV
(6) MEMORIAL PHYSICIAN SERVICES

 B 9,177,562 FMV
(7) MEMORIAL HEALTH VENTURES

 J 501,187 FMV
(8) MEMORIAL HOME SERVICES

 J 126,387 FMV
(9) MEMORIAL MEDICAL CENTER

 J 2,465,253 FMV
(10) MEMORIAL PHYSICIAN SERVICES

 J 1,928,655 FMV
(11) MEMORIAL MEDICAL CENTER

 K 150,373 FMV
(12) MEMORIAL PHYSICIAN SERVICES

 K 458,352 FMV
(13) MEMORIAL MEDICAL CENTER

 L 335,379 FMV
(14) MEMORIAL HEALTH VENTURES

 L 332,617 FMV
(15) MEMORIAL PHYSICIAN SERVICES

 L 2,039,985 FMV
(16) MEMORIAL MEDICAL CENTER

 M 548,970 FMV
(17) MEMORIAL MEDICAL CENTER

 N 892,010 FMV
(18) MEMORIAL HOME SERVICES

 N 126,387 FMV
(19) MEMORIAL MEDICAL CENTER

 O 4,325,351 FMV
(20) MEMORIAL PHYSICIAN SERVICES

 O 353,967 FMV
(21) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 O 133,284 FMV
(22) TAYLORVILLE MEMORIAL HOSPITAL

 O 121,880 FMV
(23) MEMORIAL MEDICAL CENTER

 P 6,364,333 FMV
(24) MEMORIAL PHYSICIAN SERVICES

 P 496,460 FMV
(25) MEMORIAL MEDICAL CENTER

 Q 4,678,708 FMV
(26) MEMORIAL HOME SERVICES

 Q 110,083 FMV
(27) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 Q 73,892 FMV
(28) MEMORIAL PHYSICIAN SERVICES

 Q 2,561,490 FMV
(29) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 Q 305,353 FMV
(30) TAYLORVILLE MEMORIAL HOSPITAL

 Q 227,729 FMV
(31) PASSAVANT AREA MEMORIAL HOSPITAL

 Q 180,781 FMV
(32) MEMORIAL MEDICAL CENTER

 C 29,624,835 FMV
(33) MEMORIAL MEDICAL CENTER

 H 183,114 FMV
(34) MEMORIAL HEALTH VENTURES

 B 2,500,000 FMV
(35) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 A 26,448 FMV
(36) MEMORIAL MEDICAL CENTER

 L 45,629,115 FMV
(37) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 L 2,389,613 FMV
(38) TAYLORVILLE MEMORIAL HOSPITAL

 L 2,174,641 FMV
(39) MEMORIAL PHYSICIAN SERVICES

 L 3,472,873 FMV
(40) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 L 530,244 FMV
(41) MEMORIAL HOME SERVICES

 L 775,522 FMV
(42) MEMORIAL HEALTH VENTURES

 L 411,098 FMV
(43) PASSAVANT AREA MEMORIAL HOSPITAL

 L 490,245 FMV
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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