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 07-01-2014 , and ending 06-30-2015
BCheck if applicable:
CName of organization
Sarah Bush Lincoln Health Center
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 372
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Mattoon, IL61938
D Employer identification number

23-7098532
E Telephone number

G Gross receipts $ 387,340,391
F Name and address of principal officer:
TIMOTHY A OLS
1000 HEALTH CENTER DRIVE
MATTOON,IL61938
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.sarahbush.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1977
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 27
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 20
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 2,320
6 Total number of volunteers (estimate if necessary) ............. 6 205
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 4,863,082
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 3,476,174 524,606
9 Program service revenue (Part VIII, line 2g) ......... 223,596,343 261,119,722
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 10,313,420 9,229,291
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 15,279,420 17,948,054
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 252,665,357 288,821,673
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 51,665 53,990
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 138,747,283 153,930,826
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).... 85,584,818 94,036,126
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 224,383,766 248,020,942
19 Revenue less expenses. Subtract line 18 from line 12....... 28,281,591 40,800,731
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 390,306,007 426,721,690
21 Total liabilities (Part X, line 26)............. 129,121,296 127,769,617
22 Net assets or fund balances. Subtract line 21 from line 20..... 261,184,711 298,952,073
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (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: THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. SARAH BUSH LINCOLN HEALTH CENTER PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF MATTOON AND CHARLESTON, ILLINOIS AND SURROUNDING COUNTIES.
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 $ 220,603,895 including grants of $ 53,990 ) (Revenue $ 265,982,804 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet220,603,895
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)? Click to see attachment...
2
Yes
 
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
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
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
 
No
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......... Click to see attachment
14b
Yes
 
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 IVClick to see attachment
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... Click to see attachment
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.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
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
Yes
 
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
 
No
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
 
No
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
139
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
2,320
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ , BD
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
 
 
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
27
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
20
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
 
No
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
 
No
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
 
 
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:
MediumBulletDENNIS J PLUARD CPA
1000 HEALTH CENTER DRIVE
MATTOON,IL61938 (217) 258-2102
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) MS JEANNE DAU........................................................................
CHAIRPERSON
 1.0
.......................3.0 		X   X       0 0 0
(2) MS LYLA MCGUIRE........................................................................
CHAIRPERSON-ELECT
 1.0
.......................3.0 		X   X       0 0 0
(3) MR MICHAEL SMITH........................................................................
IMMEDIATE PAST CHAIRPERSON
 1.0
.......................1.0 		X           0 0 0
(4) MR MICHAEL STANFIELD........................................................................
SECRETARY
 1.0
.......................1.0 		X   X       0 0 0
(5) MR STEVE WENTE........................................................................
TREASURER
 1.0
.......................1.0 		X   X       0 0 0
(6) DR GARY MIKEL........................................................................
PHYSICIAN OFFICER
 53.0
.......................2.0 		X           365,523 0 13,793
(7) MS LAUREL ALLENBAUGH........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(8) DR SHERYL ARTMANN........................................................................
DIRECTOR
 54.0
.......................1.0 		X           404,186 0 14,794
(9) MR CHRIS CONSIDINE........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(10) MR DON DAVIS........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(11) MR STEVE HONSELMAN........................................................................
DIRECTOR
 1.0
.......................2.0 		X           0 0 0
(12) DR KIRAN JOAG........................................................................
DIRECTOR
 54.0
.......................1.0 		X           513,964 0 14,660
(13) DR JOHN LAUER........................................................................
DIRECTOR
 54.0
.......................1.0 		X           429,718 0 12,684
(14) MR JIM LITTLEFORD........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(15) MR TIM MOONEY........................................................................
DIRECTOR
 1.0
.......................1.0 		X           0 0 0
(16) MR WILLIAM PERRY........................................................................
DIRECTOR
 1.0
.......................2.0 		X           0 0 0
(17) DR ALDO RUFFOLO........................................................................
DIRECTOR
 1.0
.......................1.0 		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) MS TINA STOVALL........................................................................
DIRECTOR
 1.0
.......................2.0 		X           0 0 0
(19) MR SCOTT WILSON........................................................................
DIRECTOR
 1.0
.......................2.0 		X           0 0 0
(20) DR JOSHUA W GARRETT........................................................................
DIRECTOR
 50.0
.......................0.0 		X           1,284,898 0 3,426
(21) MR DALE BOYER........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(22) MR TIMOTHY GOVER........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(23) MR HANK DAVIS........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(24) MS JANET GROVE........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(25) MR KEVIN LEWTON........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(26) MS DEE SCOTT........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(27) MR JAMIE PILSON........................................................................
COMMITTEE COMMUNITY MEMBER
 1.0
.......................0.0 		X           0 0 0
(28) MR CRAIG SHEAGREN........................................................................
FORMER VP FINANCE
 52.0
.......................3.0 		    X       356,890 0 19,698
(29) MR TIMOTHY A OLS........................................................................
PRESIDENT & CEO
 40.0
.......................15.0 		    X       644,667 0 15,261
(30) MR DENNIS J PLUARD........................................................................
VP FINANCE & OPERATIONS
 52.0
.......................3.0 		    X       387,986 0 28,982
(31) MR JERRY J ESKER........................................................................
VP PRACTICE MANAGEMENT
 55.0
.......................0.0 		    X       359,383 0 22,186
(32) MS MARY LOU WILD........................................................................
VP PATIENT CARE
 55.0
.......................0.0 		    X       349,577 0 17,566
(33) DR JAMES HILDEBRANDT........................................................................
VP MEDICAL AFFAIRS
 54.0
.......................1.0 		    X       501,808 0 13,109
(34) MR ERIC G BENSON........................................................................
VP HUMAN RESOURCES
 55.0
.......................0.0 		    X       286,667 0 26,984
(35) MS KIMBERLY A UPHOFF........................................................................
VP DEVELOPMENT & FOUNDATION
 27.0
.......................28.0 		    X       247,505 0 27,598
(36) MS MARGARETT A RATLIFF........................................................................
VP INFORMATION SYSTEMS
 55.0
.......................0.0 		    X       276,343 0 21,849
(37) AARON C EUBANKS MD........................................................................
PHYSICIAN
 50.0
.......................0.0 		        X   1,704,797 0 15,041
(38) LOUIS B MENDELLA MD........................................................................
PHYSICIAN
 50.0
.......................0.0 		        X   1,564,249 0 16,641
(39) MATTHEW D JONES MD........................................................................
PHYSICIAN
 50.0
.......................0.0 		        X   1,239,063 0 2,782
(40) CHARLY T NGUYEN MD........................................................................
PHYSICIAN
 50.0
.......................0.0 		        X   1,115,191 0 17,104
(41) CURTIS R GREEN MD........................................................................
PHYSICIAN
 50.0
.......................0.0 		        X   1,084,033 0 15,431
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 13,116,448 0 319,589
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet171
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
SM WILSON COMPANY,
2185 HAMPTON AVE PO BOX 5210
ST LOUIS,MO63139 		CONTRACTORS 11,929,014
PRAIRIE CARDIOVASCULAR CONSULTANTS,
619 EAST MASON ST
SPRINGFIELD,IL62701 		MED SPECIALIST FEES 2,311,855
BSA LIFESTRUCTURES,
DEPARTMENT 69 PO BOX 6069
INDIANAPOLIS,IN462066069 		PROF SVC/ENGINEERS 1,212,044
SOUTH BEND MEDICAL FOUNDATION INC,
PO BOX 2030
MISHAWAKA,IN465462030 		LABORATORY SERVICES 815,155
PEPCO ENERGY SERVICES - ESCO,
PO BOX 75620
BALTIMORE,MD212755620 		ENERGY CONSULTANTS 696,218
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet51
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 40,354
e Government grants (contributions)1e 466,503
f All other contributions, gifts, grants, and
similar amounts not included above1f 		17,749
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 524,606
Program Service RevenueAmt Business Code
2a NET PATIENT REV. 621110 212,990,890 212,990,890    
b OUTREACH REVENUE 541900 48,612 48,612    
c NET PROVIDER REVENUE 621110 48,080,220 48,080,220    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 261,119,722
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 2,308,637     2,308,637
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 363,804  
b Less: rental expenses    
c Rental income or (loss) 363,804 0
d Net rental income or (loss).......MediumBullet 363,804     363,804
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 105,396,565 42,807
b Less: cost or other basis and sales expenses 98,239,026 279,692
c Gain or (loss) 7,157,539 -236,885
d Net gain or (loss)..........MediumBullet 6,920,654     6,920,654
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 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a REFERENCE LAB. 621500 8,628,499   4,863,082 3,765,417
b PEACE MEAL PROGRAM REVENUE 900099 2,261,241     2,261,241
c CAFETERIA & CATERING 722320 822,456     822,456
d All other revenue .... 5,872,054     5,872,054
e Total. Add lines 11a–11d ...... MediumBullet 17,584,250
12 Total revenue. See Instructions......MediumBullet 288,821,673 261,119,722 4,863,082 22,314,263
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 .... 53,990 53,990
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 5,407,983   5,407,983  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 152,999   152,999  
7 Other salaries and wages .... 118,096,466 109,675,650 8,420,816  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,314,293 4,006,664 307,629  
9 Other employee benefits ....... 19,304,944 17,928,414 1,376,530  
10 Payroll taxes ........... 6,654,141 6,179,670 474,471 0
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 187,300   187,300  
c Accounting ........... 150,862   150,862  
d Lobbying ........... 38,110   38,110  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 16,238,065 15,482,860 755,205  
12 Advertising and promotion .... 1,002,328 1,002,328    
13 Office expenses ....... 38,697,463 35,938,158 2,759,305  
14 Information technology ...... 2,807,564 2,607,372 200,192  
15 Royalties .. 0      
16 Occupancy ........... 3,367,594 3,127,469 240,125  
17 Travel ............ 1,256,944 1,167,318 89,626  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 1,237,458 1,149,222 88,236  
20 Interest ........... 1,273,508 1,273,508    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 12,665,929 11,762,791 903,138  
23 Insurance .............. 5,600,989   5,600,989  
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 MAINTENANCE/PREVENTATIVE MAINT 2,935,872 2,726,531 209,341  
b IL HOSPITAL TAX ASSESSMENT 4,553,949 4,553,949    
c DUES AND SUBSCRIPTIONS 425,611 425,611    
d RECRUITMENT EXPENSES 836,693 836,693    
e All other expenses 759,887 705,697 54,190  
25 Total functional expenses. Add lines 1 through 24e 248,020,942 220,603,895 27,417,047 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 ............. 6,820 1 7,420
2 Savings and temporary cash investments ......... 102,230,734 2 107,231,328
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 31,918,043 4 33,726,218
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 4,092,610 8 4,180,615
9 Prepaid expenses and deferred charges .......... 2,440,646 9 3,008,721
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 242,357,655
b Less: accumulated depreciation ..... 10b 112,623,232 122,292,437 10c 129,734,423
11 Investments—publicly traded securities .......... 52,177,698 11 65,832,819
12 Investments—other securities. See Part IV, line 11 ..... 70,892,169 12 78,353,701
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 4,254,850 15 4,646,445
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 390,306,007 16 426,721,690
Liabilities 17 Accounts payable and accrued expenses ......... 38,977,235 17 39,792,787
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 37,370,000 20 34,790,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 52,774,061 25 53,186,830
26 Total liabilities. Add lines 17 through 25......... 129,121,296 26 127,769,617
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 .............. 261,184,711 27 298,952,073
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here 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 ........... 261,184,711 33 298,952,073
34 Total liabilities and net assets/fund balances ........ 390,306,007 34 426,721,690
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
288,821,673
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
248,020,942
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
40,800,731
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
261,184,711
5
Net unrealized gains (losses) on investments ...............
5
-3,033,369
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
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
298,952,073
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
Yes
 
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
Yes
 
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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
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 .............................  
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
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
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
 
 
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
 
 
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
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
Sarah Bush Lincoln Health Center
  		Employer identification number

23-7098532
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
Sarah Bush Lincoln Health Center
  		Employer identification number

23-7098532
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
Sarah Bush Lincoln Health Center
  		Employer identification number

23-7098532
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
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
 
38,110
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 ...............................
38,110
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
SCHEDULE C, PART II-B, LINE 1F LOBBYING ACTIVITIES: THIS IS THE PORTION OF THE IHHA/AHA DUES THAT IS OFFSET AND ALLOCATED TO LOBBYING PURPOSES. THE LOBBYING PERCENTAGE THAT WAS PUBLISHED BY THE AMERICAN HOSPITAL ASSOCIATION WAS DETERMINED TO BE 22.8% OF THE ANNUAL MEMBERSHIP DUES AND THE PERCENTAGE BY IHHA WAS DETERMINED TO BE 38.0% OF THEIR DUES.
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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
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 .... 3,873,031 3,440,394 3,157,288 65,660,868 44,179,288
b Contributions ........ 43,737 15,359 10 6,860 18,233,631
c Net investment earnings, gains, and losses 21,870 417,278 283,096 8,519 6,968,167
d Grants or scholarships .....         502,922
e Other expenditures for facilities
and programs ........ 		      62,518,959 3,217,296
f Administrative expenses ....          
g End of year balance ...... 3,938,638 3,873,031 3,440,394 3,157,288 65,660,868
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet1.193 %
b
Permanent endowment SchDMd Bullet64.662 %
c
Temporarily restricted endowment SchDMd Bullet34.144 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   3,405,746 3,405,746
b Buildings ................   135,009,878 43,265,246 91,744,632
c Leasehold improvements ............   607,552 319,126 288,426
d Equipment ................   93,466,561 64,743,886 28,722,675
e Other .................   9,867,918 4,294,974 5,572,944
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 129,734,423
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    
(3)Other
(A) SUPPLEMENTAL PENSION 		31,035,190 F

(B) DEFERRED COMPENSATION 		12,868,260 F

(C) HEDGE FUNDS 		34,450,251 F






Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 78,353,701
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 0
SUPPLEMENTAL PENSION 31,102,825
DEFERRED COMPENSATION 12,868,259
EST PROFESSIONAL LIABILITY CLA 9,215,746






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 53,186,830
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: ALL FUNDS ARE HELD BY A RELATED ORGANIZATION, SARAH BUSH LINCOLN HEALTH FOUNDATION. PER THE DONORS SPECIFIED INTENTIONS, PERMANENT AND TEMPORARY ENDOWMENT FUNDS MAY BE USED FOR CHARITABLE, BENEVOLENT, EDUCATIONAL, AND SCIENTIFIC PURPOSES TO SUPPORT SARAH BUSH LINCOLN HEALTH CENTER. THE PURPOSE OF THE BOARD DESIGNATED FUNDS IS TO PROVIDE FINANCIAL SUPPORT FOR ACTIVITIES OF THE SARAH BUSH LINCOLN HEALTH SYSTEM OR EXPENSES ASSOCIATED WITH MANAGING THE FOUNDATION.
SCHEDULE D, PART X, LINE 2 FIN 48 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D (Form 990) 2014

Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Investments   23,619,406
Central America and the Caribbean     Investments   85,468
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     23,704,874
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     23,704,874
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
SCHEDULE F, PART I, COLUMN F INVESTMENTS & EXPENDITURES: INVESTMENTS IN REGION: $ 23,619,406 EXPENDITURES IN REGION: 85,468 --------------- $ 23,704,874
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


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Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    3,814,284   3,814,284 1.540 %
b Medicaid (from Worksheet 3,
column a) .... 		    56,961,073 46,959,858 10,001,215 4.030 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    60,775,357 46,959,858 13,815,499 5.570 %
Other Benefits
     823,708   823,708 0.330 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    495,465   495,465 0.200 %
j Total. Other Benefits ..     1,319,173   1,319,173 0.530 %
k Total. Add lines 7d and 7j .     62,094,530 46,959,858 15,134,672 6.100 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     68,705   68,705 0.040 %
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     68,705   68,705 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,797,651
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
45,863,156
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
73,453,949
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-27,590,793
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SARAH BUSH LINCOLN HEALTH CENTER
1000 HEALTH CENTER DRIVE
MATTOON,IL61938
HTTP://WWW.SARAHBUSH.ORG
0003392 		X                  
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, LINE 5 AS PART OF THE COMMUNITY HEALTH ASSESSMENT, TWO FOCUS GROUPS WERE HELD ON JULY 24-25, 2012. FOCUS GROUPS WERE COMPRISED OF 14 KEY INFORMANTS, INCLUDING REPRESENTATIVES OF PUBLIC HEALTH, PHYSICIANS AND OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. SPECIFIC NAMES/TITLES OF THOSE PARTICIPATING ARE AVAILABLE UPON REQUEST. SCHEDULE H, PART V, SECTION B, LINE 7B CHNA REPORT: HTTP://MATTOON.HEALTHFORECAST.NET/REPORT.PDF
SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS NOT BEING ADDRESSED: (1)DIABETES: SBLHC FEELS THAT EFFORTS OUTLINED TO ADDRESS HEART DISEASE & STROKE WILL HAVE A POSITIVE IMPACT ON ADDRESSING DIABETES DEATHS AS WELL. THE AGE-ADJUSTED MORTALITY RATE FOR DIABETES IS LOWER THAN THE OTHER HEALTH NEEDS IDENTIFIED; THEREFORE WE ARE FOCUSING OUR RESOURCES ON THE NEEDS WITH THE HIGHER MAGNITUDE. (2) MENTAL HEALTH: SBLHC HAS LIMITED RESOURCES AND SERVICES AVAILABLE TO ADDRESS MENTAL HEALTH, SPECIFICALLY SUICIDE DEATHS. THE RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. (3) MATERNAL, INFANT AND CHILD HEALTH: SBLHC FEELS THAT OTHER HEALTH NEEDS IDENTIFIED ARE OF HIGHER PRIORITY THAN THE INFANT DEATH RATE DUE TO LOWER NUMBER OF ANNUAL INFANT DEATHS AND THE SMALL VARIANCE FROM THE BENCHMARK DATA. (4) CHRONIC KIDNEY DISEASE: SBLHC FEELS THAT EFFORTS OUTLINED TO ADDRESS HEART DISEASE & STROKE WILL HAVE A POSITIVE IMPACT ON ADDRESSING CHRONIC KIDNEY DISEASE DEATHS AS WELL. THE AGE-ADJUSTED MORTALITY RATE FOR CHRONIC KIDNEY DISEASE IS LOWER THAN THE OTHER HEALTH NEEDS IDENTIFIED; THEREFORE WE ARE FOCUSING OUR RESOURCES ON THE NEEDS WITH THE HIGHER MAGNITUDE. (5) INJURY & VIOLENCE PREVENTION: SBLHC HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS INJURY & VIOLENCE PREVENTION. OTHER COMMUNITY RESOURCES, SUCH AS LOCAL LAW ENFORCEMENT, HAVE THE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER SUPPORT THIS HEALTH NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. NEEDS BEING ADDRESSED: ACCESS TO HEALTH SERVICES - FY 14 - BUILT WALK-IN CLINIC LOCATION IN CHARLESTON, IL. FY 15 - ACQUIRED PRIMARY CARE CLINICS IN SHELBYVILLE, IL AND NEWTON, IL. FY 16 - BUILDING WALK-IN/PRIMARY CARE CLINIC IN TUSCOLA, HIRED 7 FAMILY MEDICINE PRIMARY CARE PROVIDERS, 1 PEDIATRICIAN, 2 CARDIOLOGISTS, 3 RADIOLOGISTS, 1 DERMATOLOGIST, 1 NEUROLOGIST, 1 PSYCHIATRIST, 1 UROLOGIST, 2 GASTROENTEROLOGISTS, IMPLEMENTED HOSPITALIST PROGRAM WHICH ALLOWS THE PRIMARY CARE PROVIDERS TO SPEND MORE TIME IN THEIR OFFICE PRACTICES. HEART DISEASE AND STROKE - BUILT THE CENTER FOR HEALTHY LIVING, IN FY 15 WE HAVE 939 MEMBERS (249 WERE MEDICAL PATIENTS). THE OTHER MEMBERSHIPS WERE SBL EMPLOYEE MEMBERSHIPS. WE HAVE WORKED WITH MATTOON YMCA TO DEVELOP A TRANSITION PLAN FOR PATIENTS ONCE THEY "GRADUATE" FROM THE CENTER FOR HEALTHY LIVING. MEDICAL PATIENTS CAN ONLY REMAIN IN THE SBL CENTER FOR HEALTHY LIVING FOR 120 DAYS THEN WE WORK WITH THEM TO FIND A COMMUNITY BASED CENTER TO CONTINUE THEIR EXERCISE ROUTINE. CANCER CARE - WORKED WITH ONCOLOGY SOLUTIONS (CONSULTANT) TO DEVELOP AN ENVIRONMENTAL ASSESSMENT AND NEEDS ASSESSMENT FOR THE CANCER CENTER. DEVELOPED CAPITAL AND OPERATIONAL PLAN FOR THE CANCER CENTER: INCLUDES CONSTRUCTION OF A NEW FREESTANDING BUILDING ON SBL CAMPUS, HIRING OF PATIENT NAVIGATORS TO ASSIST PATIENTS AND A CLINICAL RESEARCH COORDINATOR. HIGHLIGHTED CANCER CARE AWARENESS IN SBL HEALTH STYLES MAGAZINE THAT IS SENT TO HOMES THROUGHOUT OUR 7-COUNTY SERVICE AREA. TOBACCO USE - FY 15: ENROLLED 73 PEOPLE IN THE SMOKING CESSATION CLASSES. 55-60% QUIT RATE. NON-TOBACCO HIRING POLICY BEGAN IN 2015. ONGOING FOCUS ON SBL EMPLOYEE HEALTH INITIATIVES. CREATED HEALTH & WELLNESS PLAN INTEGRATOR TO ASSIST WITH WELLNESS INITIATIVES AND HEALTH PREVENTION FOR SBL EMPLOYEES (GOAL IS TO REDUCE EMPLOYEE HEALTH COSTS WHILE EVOLVING TO A HEALTHIER WORKFORCE). ORAL HEALTH- WE PARTNER WITH 70 SCHOOLS IN OUR 9 COUNTY SERVICE AREA TO BRING DENTAL SERVICES TO CHILDREN WITH NEED. FY15 = 8,161 TOTAL DENTAL TREATMENTS PERFORMED. WE PARTNER WITH 7 COMMUNITY DENTISTS WHO VOLUNTEER THEIR TIME AND OFFICE SPACE TO PROVIDE RESTORATIVE DENTAL CARE TO KIDS IN NEED. WE PARTNER WITH AREA SCHOOLS TO PROVIDE ORAL HEALTH EDUCATION TO STUDENTS. WE HAVE A FT ORAL HEALTH EDUCATOR THAT PERFORMS THESE PRESENTATIONS. IN ADDITION, WE ARE ACTIVELY INVOLVED AT HEALTH FAIRS AND OTHER COMMUNITY EVENTS TO PROMOTE THE IMPORTANCE OF PROPER ORAL HYGIENE.
SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION: HTTPS://WWW.SARAHBUSH.ORG/MEDIA/FILER_PUBLIC/C1/6F/C16F9321-8986-41BB-84A2 -002BE85777C0/2015_BROCHURE_FA.PDF (FINANCIAL ASSISTANCE - ENGLISH) HTTPS://WWW.SARAHBUSH.ORG/MEDIA/FILER_PUBLIC/73/BF/73BFF89F-6A28-4DA2-96F4 -B093BEDF05A2/2015_SPANISH_FA.PDF (FINANCIAL ASSISTANCE - SPANISH)
SCHEDULE H, PART V, SECTION B, LINE 22D PATIENTS WITHOUT INSURANCE AND WHO QUALIFY FOR FINANCIAL ASSISTANCE (OR HAVE PREVIOUSLY QUALIFIED FOR FINANCIAL ASSISTANCE) ARE GIVEN A DISCOUNT IN ACCORDANCE WITH HOSPITAL POLICY. AMOUNT GENERALLY BILLED (AGB) TEST: ANY PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE BILLED NO MORE THAN AN AMOUNT DETERMINED BY MULTIPLYING THE GROSS CHARGES FOR ALL EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY SERVICES PROVIDED TO SUCH INDIVIDUAL BY THE AMOUNT GENERALLY BILLED (AGB) PERCENTAGE. GUARANTORS WITH FAMILY INCOME LESS THAN 400% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR THE AGB DISCOUNT. THE AGB PERCENTAGE MEANS THE PERCENT CALCULATED ANNUALLY WHICH IS EQUAL TO (I) THE AGGREGATE DOLLAR AMOUNT OF CLAIMS PAID FOR ALL EMERGENCY MEDICAL CARE AND OTHER MEDICALLY NECESSARY SERVICES DURING THE TWELVE (12) MONTH PERIOD ENDED DECEMBER OF EACH YEAR BY BOTH MEDICARE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYERS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THOSE CLAIMS DUE FROM MEDICARE BENEFICIARIES OR INSURED PERSONS FOR CO-PAYMENTS, CO-INSURANCE OR DEDUCTIBLES PLUS ANY LUMP SUM OR ADJUSTMENT PAYMENTS RELATED TO THE CARE OF PATIENTS BY MEDICARE OR OTHER PAYERS DIVIDED BY (II) THE GROSS CHARGES APPLICABLE TO ALL CLAIMS INCLUDED IN CALCULATING THE AMOUNT UNDER CLAUSE (I). THE AGB PERCENTAGE SHALL BE APPLIED TO ALL ELIGIBLE APPLICANT'S ACCOUNTS EFFECTIVE THIRTY (30) DAYS FOLLOWING THE END OF THE TWELVE (12) MONTH PERIOD USED IN DETERMINING THE AGB PERCENTAGE. ONLY EMERGENCY OR MEDICALLY NECESSARY SERVICES WILL BE ELIGIBLE FOR CONSIDERATION IN THIS CALCULATION.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?13
Name and address Type of Facility (describe)
1 SBL ARCOLA CLINIC
241 W SPRINGFIELD RD
ARCOLA,IL61920 		CLINIC
2 SBL ARTHUR CLINIC
211 S WALNUT
ARTHUR,IL61911 		CLINIC
3 SBL CASEY CLINIC
412 NW 3RD ST
CASEY,IL62420 		CLINIC
4 SBL CHARLESTON FAMILY PRACTICE
116 WEST BUCHANAN AVE
CHARLESTON,IL61920 		CLINIC
5 SBL FAMILY MEDICAL CENTER
200 RICHMOND AVE
MATTOON,IL61928 		CLINIC
6 SBL NEOGA CLINIC
650 OAK AVE PO BOX 640
NEGOA,IL62447 		CLINIC
7 SBL SULLIVAN CLINIC
7 HAWTHORNE LANE
SULLIVAN,IL61951 		CLINIC
8 SBL TOLEDO CLINIC
168 COURTHOUSE SQUARE PO BOX 99
TOLEDO,IL62468 		CLINIC
9 SBL EFFINGHAM CLINIC
905 N MAPLE
EFFINGHAM,IL62401 		CLINIC
10 SBL MATTOON WALK-IN CLINIC
144 DETTRO DRIVE
MATTOON,IL61938 		CLINIC
11 SBL NEWTON CLINIC
910 SOUTH BUREN ST
NEWTON,IL62448 		CLINIC
12 SBL CHARLESTON WALK-IN CLINIC
2040 EAST LINCOLN
CHARLESTON,IL61920 		CLINIC
13 SBL ALTAMONT CLINIC
8 NORTH THIRD ST
ALTAMONT,IL62411 		CLINIC
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 6A IT IS PUBLISHED ON OUR WEBSITE (WWW.SARAHBUSH.ORG).
PART I, LINE 7, COLUMN F THE ORGANIZATION INCURRED BAD DEBT EXPENSE IN THE AMOUNT OF $8,090,373, HOWEVER, IT HAS BEEN DISREGARDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN.
PART I, LINE 7 THE COSTING METHODOLOGY THAT WAS USED TO CALCULATE THESE AMOUNTS WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 OF THE WORKING PAPERS.
PART II COLES TOGETHER, IS A NOT-FOR-PROFIT CORPORATION FOUNDED FOR AND TO PROMOTE ECONOMIC DEVELOPMENT FOR NEW AND EXISTING INDUSTRY IN OUR COUNTY, COLES COUNTY, ILLINOIS. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS BENEFIT OUR ORGANIZATION AS WELL AS OTHER ORGANIZATIONS IN OUR COMMUNITY THAT WOULD ULTIMATELY IMPACT AND KEEP OUR HOSPITAL A VIABLE ORGANIZATION. SUPPORT IS PROVIDED FINANCIALLY AND THROUGH PARTICIPATION ON THEIR BOARD. ADDITIONALLY, DONATIONS WERE MADE TO A VARIETY OF NON-PROFIT GROUPS TO HELP OUR COMMUNITY WITH ECONOMIC DEVELOPMENT.
PART III, LINE 2 USED THE RATIO OF PATIENT CARE COST TO CHARGES (0.3458) AS COMPUTED ON WORKSHEET 2 OF THE ACCOUNTING WORK PAPERS CALCULATE THE BAD DEBT EXPENSE (8,090,373) AT COST (2,797,651). WE REDUCE BAD DEBT EXPENSE BY THE DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS.
PART III, LINE 4 SEE THE PATIENT ACCOUNTS RECEIVABLE NOTE ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8 ALTHOUGH SBL DOES NOT TREAT SHORTFALL FOR MEDICARE AS A COMMUNITY BENEFIT, THERE COULD BE A CASE MADE THAT NOT BEING FULLY REIMBURSED FOR TREATING THE ELDERLY IS CONSIDERED TO BE THE PROVISION OF A BENEFIT TO THE COMMUNITY. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6, WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 AND ALSO DETAILED ON WORKSHEET C OF THE WORKING PAPERS.
PART III, LINE 9B ACCOUNTS WRITTEN OFF AS A BAD DEBT AND REFERRED TO A COLLECTION AGENCY BUT LATER DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE WILL BE PLACED ON HOLD AT THE COLLECTION AGENCY AND ADDED TO THE BALANCES CONSIDERED FOR FINANCIAL ASSISTANCE.
2. NEEDS ASSESSMENT EVERY THREE YEARS, SARAH BUSH LINCOLN ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH SURVEY THAT IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH A SERIES OF KEY INFORMANT FOCUS GROUPS. BASED ON THE RESULTS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, SBL DETERMINED TO FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE ACCESS TO HEALTH SERVICES, HEART DISEASE & STROKE, CANCER, TOBACCO USE AND ORAL HEALTH.
3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WHEN A PATIENT IS PRIVATE PAY (OR SHOWS CONCERN ABOUT PAYING THE BILL) OUR REGISTRATION CLERK INFORMS THEM OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION. ALL STAFF ARE ORIENTED AS TO HOW THE PROGRAM WORKS DURING NEW EMPLOYEE ORIENTATION. WE ALSO HAVE FINANCIAL ASSISTANCE REPRESENTATIVES AVAILABLE DURING NORMAL BUSINESS HOURS TO SPEAK WITH THE PATIENT IF THERE ARE QUESTIONS BEYOND THE REGISTRATION CLERK'S KNOWLEDGE. PATIENTS ARE INFORMED (NOT NECESSARILY AT REGISTRATION) THEY NEED TO APPLY FOR MEDICAID SHOULD THEY HAVE ANY PRE-QUALIFIERS FOR THE PROGRAM (IE: BLIND, DISABLED, DEPENDENT CHILDREN IN THE HOME, ETC). THIS INFORMATION IS IN THE FINANCIAL ASSISTANCE BROCHURE WITH THE APPLICATION AS WELL. IF A PATIENT NEEDS TO APPLY FOR MEDICAID PRIOR TO FINANCIAL ASSISTANCE, WE PROVIDE THEM THE INFORMATION AND ASSISTANCE TO APPLY AT THE PUBLIC AID OFFICE. ADDITIONALLY, OUR SBL FINANCIAL ASSISTANCE PROGRAM BROCHURES ARE IN EVERY DEPARTMENT AND CLINIC IN THE SYSTEM AND WIDELY AVAILABLE THROUGHOUT THE FACILITY. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE (INCLUDING APPOICATIONS) WITH A DEDICATED PHONE NUMBER.
4. COMMUNITY INFORMATION SARAH BUSH LINCOLN (SBL) SERVES RURAL COMMUNITIES IN EAST CENTRAL ILLINOIS. SBL'S MARKET AREA ENCOMPASSES 7 COUNTIES INCLUDING: CLARK, COLES, CUMBERLAND, DOUGLAS, EDGAR, MOULTRIE, AND SHELBY. THE POPULATION OF THE HOSPITAL'S SERVICE AREA IS ESTIMATED AT 157,198 PEOPLE. THE REGION IS PREDOMINANTLY WHITE, WITH FEWER THAN 4 PERCENT OF THE POPULATION IDENTIFYING THEMSELVES AS MEMBERS OF RACIAL MINORITY GROUPS. THE REGION IS RURAL, WITH MORE THAN 53 PERCENT OF THE POPULATION LIVING IN COMMUNITIES OF LESS THAN 2,500. THE MEDIAN AGE IN EACH COUNTY, EXCEPT COLES, IS HIGHER THAN THE ILLINOIS MEDIAN OF 36.2 YEARS. TWELVE PERCENT OF THE POPULATION HAS INCOMES BELOW THE FEDERAL POVERTY LEVEL. AN ESTIMATED 13.5 PERCENT OF ADULT POPULATION UNDER AGE 65 IS WITHOUT HEALTHCARE INSURANCE. ALTHOUGH SBL HAS HAD A POSITIVE IMPACT ON THE PHYSICIAN-TO-POPULATION RATIOS OF THE REGION, THE AREA IS MEDICALLY UNDERSERVED AS DETERMINED BY BOTH FEDERAL AND STATE GUIDELINES.
5. PROMOTION OF COMMUNITY HEALTH SARAH BUSH LINCOLN HEALTH CENTER HAS AN OPEN MEDICAL STAFF AS WELL AS A COMMUNITY BOARD.
PART I, LINE 3C SEE PART V, LINE 13 FOR OTHER CRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE.
Schedule H (Form 990) 2014
Additional Data


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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
Sarah Bush Lincoln Health Center
 
Employer identification number
23-7098532
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) COLES TOGETHER
400 AIRPORT ROAD
MATTOON,IL61938 		37-1243664 501(C)(6) 27,500       SEE PART IV
(2) ILLINOIS PERFORMANCE EXCELLENCE
1415 W DIEHL RD
NAPERVILLE,IL60563 		36-3952696 501(C)(3) 17,500       SEE PART IV




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
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
SCHEDULE I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE: COLES TOGETHER IS A NOT-FOR-PROFIT CORPORATION FOUNDED FOR AND TO PROMOTE COLES ECONOMIC DEVELOPMENT FOR NEW AND EXISTING INDUSTRY IN OUR COUNTY, COLES COUNTY, ILLINOIS. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS BENEFIT OUR ORGANIZATION AS WELL AS OTHER ORGANIZATIONS IN OUR COMMUNITY THAT WOULD ULTIMATELY IMPACT THE UTILIZATION AND VIABILITY OF OUR HOSPITAL ORGANIZATION. ILLINOIS PERFORMANCE EXCELLENCE IS A NOT-FOR-PROFIT ORGANIZATION FOUNDED IN 1994 TO ASSIST ORGANIZATIONS IN USING THE BALDRIDGE CRITERIA FOR PERFORMANCE EXCELLENCE TO LEARN AND SHARE WITH OTHER ORGANIZATIONS BEST PRACTICES FOR CHANGE AND PROCESS IMPROVEMENTS. OUR PARTICIPATION AND COMMITMENT TO THIS PROCESS ENABLES US TO IMPROVE PROCESSES AND PERFORMANCE.
Schedule I (Form 990) 2014


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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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
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
Yes
 
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
Yes
 
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
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 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
1DR GARY MIKELPHYSICIAN OFFICER (i)
(ii)		 263,782
...............................
0 		60,457
...............................
0 		41,284
...............................
0 		8,750
...............................
0 		5,043
...............................
0 		379,316
...............................
0 		0
...............................
0
2DR SHERYL ARTMANNDIRECTOR (i)
(ii)		 356,490
...............................
0 		1,744
...............................
0 		45,952
...............................
0 		8,750
...............................
0 		6,044
...............................
0 		418,980
...............................
0 		0
...............................
0
3DR KIRAN JOAGDIRECTOR (i)
(ii)		 346,307
...............................
0 		121,902
...............................
0 		45,755
...............................
0 		8,667
...............................
0 		5,993
...............................
0 		528,624
...............................
0 		0
...............................
0
4DR JOHN LAUERDIRECTOR (i)
(ii)		 296,732
...............................
0 		92,479
...............................
0 		40,507
...............................
0 		8,750
...............................
0 		3,934
...............................
0 		442,402
...............................
0 		0
...............................
0
5MR CRAIG SHEAGRENFORMER VP FINANCE (i)
(ii)		 231,990
...............................
0 		98,095
...............................
0 		26,805
...............................
0 		7,167
...............................
0 		12,531
...............................
0 		376,588
...............................
0 		0
...............................
0
6DR JOSHUA W GARRETTDIRECTOR (i)
(ii)		 567,999
...............................
0 		705,352
...............................
0 		11,547
...............................
0 		0
...............................
0 		3,426
...............................
0 		1,288,324
...............................
0 		0
...............................
0
7AARON C EUBANKS MDPHYSICIAN (i)
(ii)		 877,585
...............................
0 		725,884
...............................
0 		101,328
...............................
0 		8,750
...............................
0 		6,291
...............................
0 		1,719,838
...............................
0 		0
...............................
0
8LOUIS B MENDELLA MDPHYSICIAN (i)
(ii)		 877,586
...............................
0 		582,373
...............................
0 		104,290
...............................
0 		8,750
...............................
0 		7,891
...............................
0 		1,580,890
...............................
0 		0
...............................
0
9MATTHEW D JONES MDPHYSICIAN (i)
(ii)		 567,456
...............................
0 		660,151
...............................
0 		11,456
...............................
0 		0
...............................
0 		2,782
...............................
0 		1,241,845
...............................
0 		0
...............................
0
10CHARLY T NGUYEN MDPHYSICIAN (i)
(ii)		 850,585
...............................
0 		159,272
...............................
0 		105,334
...............................
0 		8,750
...............................
0 		8,354
...............................
0 		1,132,295
...............................
0 		0
...............................
0
11CURTIS R GREEN MDPHYSICIAN (i)
(ii)		 671,288
...............................
0 		333,212
...............................
0 		79,533
...............................
0 		8,750
...............................
0 		6,681
...............................
0 		1,099,464
...............................
0 		0
...............................
0
12MR TIMOTHY A OLSPRESIDENT & CEO (i)
(ii)		 425,737
...............................
0 		205,524
...............................
0 		13,406
...............................
0 		8,750
...............................
0 		6,511
...............................
0 		659,928
...............................
0 		0
...............................
0
13MR DENNIS J PLUARDVP FINANCE & OPERATIONS (i)
(ii)		 252,208
...............................
0 		104,402
...............................
0 		31,376
...............................
0 		8,750
...............................
0 		20,232
...............................
0 		416,968
...............................
0 		0
...............................
0
14MR JERRY J ESKERVP PRACTICE MANAGEMENT (i)
(ii)		 239,816
...............................
0 		90,101
...............................
0 		29,466
...............................
0 		8,750
...............................
0 		13,436
...............................
0 		381,569
...............................
0 		0
...............................
0
15MS MARY LOU WILDVP PATIENT CARE (i)
(ii)		 233,317
...............................
0 		86,636
...............................
0 		29,624
...............................
0 		8,750
...............................
0 		8,816
...............................
0 		367,143
...............................
0 		0
...............................
0
16DR JAMES HILDEBRANDTVP MEDICAL AFFAIRS (i)
(ii)		 334,809
...............................
0 		123,553
...............................
0 		43,446
...............................
0 		8,750
...............................
0 		4,359
...............................
0 		514,917
...............................
0 		0
...............................
0
17MR ERIC G BENSONVP HUMAN RESOURCES (i)
(ii)		 187,374
...............................
0 		74,494
...............................
0 		24,799
...............................
0 		7,511
...............................
0 		19,473
...............................
0 		313,651
...............................
0 		0
...............................
0
18MS KIMBERLY A UPHOFFVP DEVELOPMENT & FOUNDATION (i)
(ii)		 161,335
...............................
0 		67,156
...............................
0 		19,014
...............................
0 		6,721
...............................
0 		20,877
...............................
0 		275,103
...............................
0 		0
...............................
0
19MS MARGARETT A RATLIFFVP INFORMATION SYSTEMS (i)
(ii)		 195,879
...............................
0 		76,671
...............................
0 		3,793
...............................
0 		8,089
...............................
0 		13,760
...............................
0 		298,192
...............................
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
SCHEDULE J, PART I, LINE 7 COMPENSATION INFORMATION: ADDITIONAL COMPENSATION TO OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DEPENDENT ON SPECIFIC ORGANIZATIONAL AND INDIVIDUAL GOALS. THESE GOALS INCLUDE FINANCIAL, QUALITY, CUSTOMER SERVICE, AND OTHER GOALS RELATED TO THE ORGANIZATION'S STRATEGIC PLAN.
SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES AND COMPANION TRAVEL: COUNTRY CLUB DUES ARE REPORTED AS TAXABLE COMPENSATION FOR OUR PRESIDENT AND CEO, MR. TIMOTHY A OLS. TRAVEL FOR COMPANIONS IS PROVIDED PER THE EMPLOYMENT AGREEMENT WITH THE PRESIDENT & CEO, TIM OLS. ANY PERSONAL ITEMS, EXTRA DAYS, AND MEALS FOR BOTH ARE PAID FOR USING HIS PERSONAL CREDIT CARD.
SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SARAH BUSH LINCOLN HEALTH CENTER CURRENTLY MAINTAINS A NONQUALIFIED, UNFUNDED, DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, ON BEHALF OF CERTAIN DESIGNATED MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE PLAN IS INTENDED TO BE AN UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, AS DESCRIBED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE FOLLOWING PERSONS LISTED IN FORM 990, PART VII ARE PARTICIPANTS IN THE PLAN: GARY MIKEL, MD KIRAN JOAG, MD SHERYL ARTMANN, MD JOHN LAUER, MD AARON EUBANKS, MD LOUIS MENDELLA, MD CHARLEY NGUYEN, MD TIMOTHY A OLS DENNIS J PLUARD CRAIG SHEAGREN ERIC BENSON JERRY ESKER MARY LOU WILD KIMBERLY UPHOFF JAMES HILDEBRANDT MARGARETT RATLIFF THE FOLLOWING RECEIVED DISTRIBUTIONS FROM THE PLAN DURING THE TAX YEAR: DENNIS PLUARD $10,175 AARON EUBANKS, MD $79,456
Schedule J (Form 990) 2014

Additional Data


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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
Sarah Bush Lincoln Health Center
 
Employer identification number
23-7098532
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 FINANCE AUTHORITY
  		86-1091967   03-18-2011 45,000,000 SEE PART VI   X X     X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 10,210,000      
2 Amount of bonds legally defeased . . . . . . . . . . . 0      
3 Total proceeds of issue . . . . . . . . . . . . . . 45,000,000      
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0      
5 Capitalized interest from proceeds . . . . . . . . . . . 0      
6 Proceeds in refunding escrows . . . . . . . . . . . . 0      
7 Issuance costs from proceeds . . . . . . . . . . . . 517,777      
8 Credit enhancement from proceeds . . . . . . . . . . . 0      
9 Working capital expenditures from proceeds . . . . . . . . . 0      
10 Capital expenditures from proceeds . . . . . . . . . . . 26,444,431      
11 Other spent proceeds . . . . . . . . . . . . . . 18,037,792      
12 Other unspent proceeds . . . . . . . . . . . . . . 0      
13 Year of substantial completion . . . . . . . . . . . . 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X              
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . . .   X            
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 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        
6 Total of lines 4 and 5 . . . . . . . . . . . . .        
7 Does the bond issue meet the private security or payment test? . . . . .   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X            
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . . X              
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .                
b Exception to rebate? . . . . . . . .                
c No rebate due? . . . . . . . .                
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X              
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . . 0
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X            
b Name of provider . . . . . . . . . 0
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X              
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART I, LINE A, COLUMN F DESCRIPTION OF PURPOSE: REFINANCE OLD BONDS AND CONSTRUCTION OF MASTER FACILITY PLAN
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
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) RHONDA WILSON SISTER OF SCOTT WILSON 16,795 R WILSON EMPLOYED BY HLTH CTR   No
(2) LAURIE E MOONEY WIFE OF TIM MOONEY 126,272 L MOONEY EMPLOYED BY HLTH CTR   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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
Return Reference Explanation
FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS: AS A NOT-FOR-PROFIT PROVIDER OF HEALTHCARE, SARAH BUSH LINCOLN HEALTH CENTER LEADERSHIP AND STAFF HAPPILY SHOULDER THE SOCIAL RESPONSIBILITY TO PROVIDE CARE AND RESOURCES TO MEMBERS OF THE COMMUNITY WHO ARE IN NEED-- REGARDLESS OF THEIR PERSONAL CIRCUMSTANCES. THE PUBLIC TRUSTS US TO CONSERVE OUR RESOURCES AND USE THEM WISELY, WHILE IT LOOKS TO US FOR LEADERSHIP, PARTNERSHIP AND COLLABORATION ON A VARIETY OF PROJECTS. TO THAT END, WE PROVIDE HIGH QUALITY HEALTHCARE TO PEOPLE REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL TO THE OPERATION AND STABILITY OF SBLHC, WE RECOGNIZE THAT NOT EVERYONE IS ABLE TO AFFORD ESSENTIAL MEDICAL SERVICES. SINCE IT IS OUR MISSION TO PROVIDE HEALTHCARE AND EDUCATION TO ALL MEMBERS OF THE COMMUNITY, WE PROVIDE: -BOTH FREE AND SUBSIDIZED CARE, -CARE TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW-COST REIMBURSEMENT AND, -HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY AT LARGE DURING THE FISCAL YEAR THAT ENDED JUNE 30, 2015, WE SERVED 7,378 INPATIENTS AND PROVIDED 500,628 OUTPATIENT SERVICES. WE SPONSORED NUMEROUS WELLNESS AND COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR OLDER RESIDENTS AND THE MEDICALLY UNDERSERVED, AND A WIDE VARIETY OF COMMUNITY SUPPORT ACTIVITIES. THIS INFORMATION OUTLINES THE MANY PROGRAMS AND SERVICES PROVIDED BY SBLHC DURING FISCAL YEAR 2015, MOST OF WHICH ARE ON-GOING. WE MAKE THIS INFORMATION AVAILABLE TO YOU SO YOU HAVE A BETTER UNDERSTANDING OF OUR MISSION, INCLUDING THE WAYS IN WHICH OUR RESOURCES ARE USED WITHIN THE COMMUNITY. WE ARE FIRMLY COMMITTED TO PROVIDING EXCEPTIONAL CARE AND CREATING HEALTHY COMMUNITIES, AND WE TRUST YOU'LL SEE THAT OUR ACTIONS MATCH OUR WORDS. SUMMARY WE HAVE CATEGORIZED OUR COMMUNITY SOCIAL RESPONSIBILITY STATEMENT TO CORRESPOND WITH OUR STRATEGIC GOALS. THE FOLLOWING IS A SNAPSHOT OF OUR ACTIVITIES FOR FISCAL YEAR 2015. EACH PROGRAM IS FURTHER DESCRIBED THROUGHOUT THIS BOOKLET. IMPROVE PATIENT EXPERIENCE AND LOYALTY $8,263 o ADVANTAGE 50 IMPROVE CLINICAL AND OPERATIONAL QUALITY $846,521 o COMMUNITY HEALTH SCREENS o SARAH BUSH LINCOLN DENTAL SERVICES o EAST CENTRAL ILLINOIS BREAST & CERVICAL CANCER PROGRAM o HEALTH EDUCATION o HEART TO HEART COMMUNITY SCREENING PROGRAM o METS PHASE III AT EIU o NOURISHMENT o REGIONAL BEHAVIORAL HEALTH NETWORK o SARAH BUSH LINCOLN WEBSITE o STEP IN THE RIGHT DIRECTION & LIVING WITH DIABETES o SUPPORT GROUPS ENHANCE HUMAN CAPITAL $19,576 o HEALTH OCCUPATIONS CREATE HEALTHY COMMUNITIES $513,518 o COMMUNITY AID o I SING THE BODY ELECTRIC o MOBILE MAMMOGRAPHY o ORGANIZATIONAL SUPPORT o ROTARY HIGH SCHOOL ATHLETIC HEART SCAN o YOUTH EDUCATION o HEALTHY KIDS o SPORTS PHYSICALS MAINTAIN FINANCIAL VIABILITY $13,855,266 o FINANCIAL ASSISTANCE o GOVERNMENTAL INSURANCE PROGRAMS IMPROVE PATIENT EXPERIENCE AND LOYALTY ADVANTAGE 50 THIS FREE MEMBERSHIP GROUP IS OPEN TO ANYONE 50 YEARS OLD OR BETTER. IT PROVIDES HEALTH INFORMATION AND SOCIAL OUTINGS, AS WELL AS A VARIETY OF DISCOUNTS. THE NON-REIMBURSED COST TO SBLHC IS $8,263. IMPROVE CLINICAL AND OPERATIONAL QUALITY COMMUNITY HEALTH SCREENS PREVENTIVE HEALTH SCREENS ARE AVAILABLE FOR FREE AND AT REDUCED COSTS BOTH AT THE HEALTH CENTER AND AT OUTREACH LOCATIONS. TESTS SCREEN FOR VARIOUS CANCERS AND MEASURE CHOLESTEROL LEVELS, PULMONARY FUNCTION, BONE DENSITY, BLOOD PRESSURE AND BODY FAT. BLOOD SUGAR ANALYSIS AND VISION/GLAUCOMA SCREENINGS ARE ALSO PROVIDED, AS ARE WORKSHOPS FOCUSED ON LIFESTYLE MODIFICATION. THE NET NON-REIMBURSED COST OF THESE SERVICES AFTER DISCOUNTED FEES AND GRANT FUNDING WAS APPROXIMATELY $73,178. SARAH BUSH LINCOLN DENTAL SERVICES SARAH BUSH LINCOLN DENTAL SERVICES IS A COLLABORATIVE COMMUNITY EFFORT THAT PROVIDES DENTAL CARE AT NO COST TO FAMILIES WHO QUALIFY. THE STAFF CONSISTS OF DENTISTS, DENTAL HYGIENISTS, DENTAL ASSISTANTS, SUPPORT STAFF AND VOLUNTEER DENTISTS. THE PROGRAM SERVES A NINE-COUNTY SERVICE AREA INCLUDING CLARK, COLES, CUMBERLAND, DOUGLAS, EDGAR, EFFINGHAM, JASPER, MOULTRIE AND SHELBY. ALMOST HALF OF THE STUDENT POPULATION IN OUR PARTNERING SCHOOLS QUALIFY FOR DENTAL SERVICES. THROUGH THE SBL DENTAL SERVICES, PREVENTATIVE AND RESTORATIVE DENTAL CARE IS PROVIDED TO CHILDREN WITHOUT MEANS TO IMPROVE THEIR HEALTH AND SELF-ESTEEM THROUGH A COLLABORATIVE EFFORT BETWEEN SARAH BUSH LINCOLN HEALTH SYSTEM, LAKELAND COLLEGE DENTAL HYGIENE PROGRAM, SEVEN VOLUNTEER DENTISTS AND SIX LOCAL HEALTH DEPARTMENTS. SEVENTY SCHOOLS PARTICIAPATE IN A 9-COUNTY REGION. THE NET NON-REIMBURSED COST OF THESE SERVICES AFTER DISCOUNTED FEES AND GRANT FUNDING WAS APPROXIMATELY $299,095. EAST CENTRAL ILLINOIS BREAST AND CERVICAL CANCER PROGRAM THE EAST CENTRAL ILLINOIS BREAST AND CERVICAL CANCER PROGRAM (ECIBCCP) PROVIDES MAMMOGRAMS AND CERVICAL CANCER SCREENS TO WOMEN. SBLHC PROMOTES THE PROGRAM AND WORKS WITH WOMEN IN NEED IN A NINE-COUNTY AREA BY SCHEDULING THEIR APPOINTMENTS. IN FY 2015 ECIBCCP PROVIDED SERVICES TO 365 WOMEN. THE NON-REIMBURSED COST WAS APPROXIMATELY $170,279. HEALTH EDUCATION HEALTH-RELATED EDUCATIONAL PROGRAMS ARE OFFERED IN MANY SETTINGS THROUGHOUT THE COMMUNITY ON SUCH TOPICS AS NUTRITION, DIABETES, DEPRESSION, EATING DISORDERS, SLEEP DISORDERS, OSTEOPOROSIS, HYPERTENSION, EXERCISE, CARDIAC HEALTH, CANCER, BEREAVEMENT, LIVING WILLS AND PRE- AND POST-NATAL CARE OF MOTHERS AND INFANTS. HEALTH STYLES, THE HEALTH CENTER'S QUARTERLY OUTREACH MAGAZINE, PROVIDES HEALTH INFORMATION AND IS DISTRIBUTED TO 68,000 HOUSEHOLDS IN AN EIGHT-COUNTY AREA AT A COST OF $64,500. HEART TO HEART COMMUNITY SCREENING PROGRAM HEART TO HEART IS A COMMUNITY CARDIAC SCREENING PROGRAM THAT PROVIDES AFFORDABLE HEART DISEASE SCREENING AND EDUCATION. IT INCLUDES BASELINE EKG, BLOOD PRESSURE, CORONARY CT CALCIUM SCORING, LIPID PROFILE, RENAL FUNCTION TESTING, ETC. FOR A $95 CHARGE THAT DOES NOT COVER COSTS FOR TESTING, ADMINISTRATION OF THE PROGRAM AND PROGRAM PROMOTION. THE NET NON-REIMBURSED COST OF THIS SERVICE TO SBLHS IS $19,152. METS PHASE III AT EIU EXERCISE AND CARDIOVASCULAR EDUCATION ARE COMBINED TO HELP PEOPLE WITH CARDIAC EVENTS REHABILITATE. THE NON-REIMBURSED COST TO SBLHS IS $20,660. REGIONAL BEHAVIORAL HEALTH NETWORK SARAH BUSH LINCOLN, THE COLES COUNTY MENTAL HEALTH CENTER (NOW LIFE LINKS) AND THE HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES JOINED FORCES TO CREATE THE REGIONAL BEHAVIORAL HEALTH NETWORK, AN ORGANIZATION THAT STREAMLINES ACCESS TO MENTAL HEALTHCARE FOR PEOPLE IN CRISIS. TOGETHER, THE THREE ORGANIZATIONS ESTIMATE THEY RESPOND TO ABOUT 3,000 CRISES INQUIRES FOR BEHAVIORAL HEALTH SERVICES ANNUALLY. THE COLLABORATIVE EFFORT IS PARTIALLY FUNDED BY GRANTS. THE HEALTH CENTER'S DIRECT AND IN-KIND NON-REIMBURSED COST WAS $74,000. SARAH BUSH LINCOLN WEBSITE THE HEALTH CENTER'S WEBSITE, WWW.SARAHBUSH.ORG, PROVIDES AREA RESIDENTS WITH ACCESS TO ACCURATE MEDICAL INFORMATION ABOUT ILLNESSES, TESTS AND TREATMENTS, AND IT OFFERS THEM A PLACE TO STORE THEIR OWN HEALTH INFORMATION. THE COST OF MAINTAINING THE SITE WAS $74,540. STEP IN THE RIGHT DIRECTION AND LIVING WITH DIABETES THIS SIX-MONTH LIFESTYLE MODIFICATION PROGRAM IS FREE TO AREA RESIDENTS WHO ARE AT RISK FOR DIABETES. PARTICIPANTS EXERCISE TWICE WEEKLY IN A CLASS SETTING, WHILE LEARNING ABOUT THEIR HEALTH AND WAYS TO IMPROVE IT. IT IS DESIGNED TO ASSIST PARTICIPANTS WITH WEIGHT LOSS, ESTABLISH REGULAR AND APPROPRIATE EXERCISE AND DIET CHANGES. THE PROGRAM HAS SERVED MORE THAN 50 COMMUNITY MEMBERS WITH BLOOD GLUCOSE LEVELS OF 100 TO 125. THE NON-REIMBURSED COST WAS $45,717. SUPPORT GROUPS SUPPORT GROUPS ASSIST THOSE AFFECTED BY CANCER, OSTOMY, STROKE, ADD, ADHD, POOR PULMONARY FUNCTION, LOSS OF A CHILD THROUGH MISCARRIAGE AND STILLBIRTH, NUTRITION AND CERTAIN CARDIAC EVENTS. THE NON-REIMBURSED COST OF PROVIDING EDUCATION AND RESOURCES WAS APPROXIMATELY $5,400. ENHANCE HUMAN CAPITAL HEALTH OCCUPATIONS THE HEALTH OCCUPATIONS PROGRAM PROVIDES AREA HIGH SCHOOL STUDENTS WITH THE OPPORTUNITY TO LEARN MORE ABOUT HEALTHCARE. THE COLLABORATIVE PROGRAM RUNS THROUGHOUT THE SCHOOL YEAR, PROVIDES JOB SHADOWING FOR STUDENTS AND FREQUENT INTERACTION WITH PRACTICING PROFESSIONALS. STUDENTS GRADUATE WITH A CERTIFIED NURSE ASSISTANT CERTIFICATE. FORTY-FIVE STUDENTS WERE INVOLVED IN THE PROGRAM DURING FY15. THE NON-REIMBURSED COST OF PROVIDING CLASSROOM SPACE FOR TRAINING WAS $19,576. CREATE HEALTHY COMMUNITIES COMMUNITY AID SBLHC ASSISTED MISSIONS IN VARIOUS AREAS AND LOCAL PROJECTS WITH HEALTHCARE NEEDS BY DONATING MEDICAL SUPPLIES AND EQUIPMENT. THE COST WAS APPROXIMATELY $118,859. ORGANIZATIONAL SUPPORT (CASH AND IN-KIND GIFTS) BEING A GOOD NEIGHBOR MEANS SUPPORTING THE EFFORTS OF LOCAL AND REGIONAL ORGANIZATIONS WITH SIMILAR MISSIONS. THE HEALTH SYSTEM GAVE DIRECT FINANCIAL SUPPORT, STAFF TIME, THE USE OF HEALTH CENTER FACILITIES, AND OTHER RESOURCES IN EXCESS OF $248,216 TO COMMUNITY ORGANIZATIONS AND/OR PROJECTS, INCLUDING BUT NOT LIMITED TO: COLES COUNTY DIAL-A-RIDE, A
FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: SCOTT WILSON, WILLIAM PERRY, DR. GARY MIKEL, AND TINA STOVALL HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER AS A RESULT OF ALL SERVING AS BOARD MEMBERS OF SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES, A FOR-PROFIT AFFILIATE OF THE ORGANIZATION. ALL MEMBERS OF THE HEALTH CENTER BOARD HAVE DUAL MEMBERSHIP WITH THE HEALTH SYSTEM BOARD. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS SARAH BUSH LINCOLN HEALTH SYSTEM.
PART VI, SECTION A, LINE 7A ELECTION OF GOVERNING BODY: BOARD MEMBERS WILL AID IN THE SELECTION FOR THE NOMINATION OF NEW BOARD MEMBERS WHEN VACANCIES OCCUR OR WHEN TERMS WILL EXPIRE, BUT THE FINAL APPROVAL OF THE CANDIDATES IS MADE BY THE SOLE MEMBER OF THE CORPORATION, SARAH BUSH LINCOLN HEALTH SYSTEM.
PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY: THE SARAH BUSH LINCOLN HEALTH SYSTEM BOARD, THE SOLE MEMBER OF THE HEALTH CENTER BOARD, RETAINS CERTAIN RESERVED POWERS INCLUDING; AMENDING ARTICLES OF INCORPORATION OR BYLAWS, APPROVING THE ANNUAL OPERATING BUDGET AND LONG RANGE STRATEGIC PLAN, APPROVAL OF ANY TRANSACTIONS REQUIRING A CERTIFICATE OF NEED, APPROVAL OF THE BORROWING OF FUNDS AND INCURRING DEBT, APPROVAL OF MERGERS, CONSOLIDATIONS, SALE, OF ALL OR SUBSTANTIALLY ALL ASSETS, SELECTING AUDITORS, CREATING OR ACQUIRING SUBSIDIARY OR AFFILIATE CORPORATIONS, DISSOLVING THE CORPORATION, APPOINTING, EVALUATING AND REMOVAL OF PRESIDENT/CEO, AND ELECTING BOARD MEMBERS.
FORM 990 PART VI, SECTION B, LINE 11A FORM 990 REVIEW: THE SENIOR ACCOUNTING STAFF REVIEWS ALL ELEMENTS OF THE 990 BASED ON PRIOR KNOWLEDGE AND INTERVIEWS WITH OTHER INDIVIDUALS IN THE ORGANIZATION. IN ADDITION, BOARD MEMBERS SUBMIT DETAILED QUESTIONNAIRES WITH REGARDS TO THEIR RELATIONSHIPS WITH THE ORGANIZATION. THE FINAL FORM 990 IS MADE AVAILABLE TO THEM ONLINE VIA A WEB PORTAL FOR REVIEW AND QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12A-C CONFLICT OF INTEREST POLICY: MEMBERS OF THE BOARD OF DIRECTORS ANNUALLY COMPLETE A CERTIFICATION STATEMENT WHICH IDENTIFIES POSSIBLE CONFLICTS OF INTEREST RELATED TO THEIR PROFESSIONAL AND PERSONAL LIVES. DURING DELIBERATIONS AND DECISIONS ON WHICH THERE APPEARS TO BE A CONFLICT OF INTEREST, THE BOARD MEMBER IS EXCUSED FROM THE DISCUSSION AND DELIBERATION, SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON OR BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM IN RESPECT TO THE TRANSACTION OR CONTRACT.
FORM 990, PART VI, SECTION B, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION: COMPENSATION IS DETERMINED FOR THE PRESIDENT & CEO, VP MEDICAL AFFAIRS, VP FINANCE & OPERATIONS, VP PRACTICE MANAGEMENT, VP PATIENT CARE SERVICES, VP INFORMATION SERVICES, VP HUMAN RESOURCES, AND THE VP DEVELOPMENT & FOUNDATION BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE SBL BOARD. AN INDEPENDENT CONSULTANT, HAY GROUP, INC., REVIEWED CURRENT COMPENSATION FOR EACH POSITION AND COMPARED IT TO SIMILAR POSITIONS IN LIKE ORGANIZATIONS. THE COMMITTEE APPROVED COMPENSATION CONSISTENT WITH THE BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THIS PROCESS IS DONE ANNUALLY, BETWEEN JUNE AND AUGUST, FOR ALL THE LISTED POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19 PUBLIC DISCLOSURE: CURRENTLY, SARAH BUSH LINCOLN HEALTH CENTER POSTS THEIR COMMUNITY BENEFITS STATEMENT ON OUR PUBLIC WEB-SITE. NO OTHER GOVERNING DOCUMENTS ARE ROUTINELY MADE AVAILABLE.
FORM 990, PART XII A FEDERAL AWARD WAS GRANTED AND AN A-133 AUDIT REQUIRED. THE A-133 AUDIT WAS PERFORMED IN CONJUNCTION WITH THE HOSPITAL'S ROUTINE AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
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
Sarah Bush Lincoln Health Center
 
Employer identification number

23-7098532
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) SARAH BUSH LINCOLN HEALTH SYSTEM
1000 HEALTH CENTER DRIVE

MATTOON,IL61938
37-1136714 		PARENT CO IL 501(C)(3) 11-I NA
 
 
No
(2) SARAH BUSH LINCOLN HEALTH CTR FOUNDATION
1000 HEALTH CENTER DRIVE

MATTOON,IL61938
37-1136713 		FUNDRAISING IL 501(C)(3) 11-I SBLHS
 
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) SARAH BUSH LINCOLN HEALTH MGMT SERVICES

1000 HEALTH CENTER DRIVE
MATTOON,IL61938
37-1136614 		RETAIL DME/RX IL SBLHS
  		C CORP 0 0   Yes  
(2) SARAH BUSH LINCOLN CAPTIVE INSURANCE LTD

 
 
INSURANCE CJ SBLHS
  		C CORP 0 0   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
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
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
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
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) SARAH BUSH LINCOLN HEALTH CENTER FOUNDATION

 C 10,354 BOOK VALUE
(2) SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES

 A 232,702 CONTRACTED RATE
(3) SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES

 L 2,593,312 BOOK VALUE



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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