TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Rex Budde President/CEO	40.0 ................. 15.0	X	X	807,442	230,562
(2) Marlene Simpson Secretary	2.0 ................. 1.0	X	X	350	0
(3) Eugene Basanta Chair	2.0 ................. 2.0	X	X	350	0
(4) DR Terrence Glennon Vice Chair	2.0 ................. 2.0	X	X	978	0
(5) Steve Sabens Trustee	2.0 ................. 2.0	X		400	0
(6) Kathleen Fralish Trustee	2.0 ................. 2.0	X		400	0
(7) Harold Bardo Trustee	2.0 ................. 2.0	X		400	0
(8) George O'Neill Trustee	2.0 ................. 2.0	X		350	0
(9) Morton Levine Trustee	2.0 ................. 2.0	X		450	0
(10) Debra McMorrow Trustee	2.0 ................. 1.0	X		350	0
(11) Mike Absher Trustee Resigned May 2015	2.0 ................. 1.0	X		100	0
(12) Bob Mees Trustee	2.0 ................. 1.0	X		450	0
(13) Mike Hudson Trustee Partial Year as of Sept. 2015	2.0 ................. 1.0	X		50	0
(14) Parviz Sanjabi MD Trustee Partial Year as of May 2015	2.0 ................. 1.0	X		250	0
(15) Mike Kasser VP/CFO/Treasurer	40.0 ................. 15.0		X	528,125	139,669
(16) William Sherwood VP/ General Counsel	40.0 ................. 15.0		X	546,830	167,534
(17) Julie Firman VP/CNO	50.0 ................. 0		X	332,114	83,634

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) Philip Schaefer VP/ Amb & Phys Services	30.0 .......................50.0	X			471,777	147,047
(19) Pam Henderson VP/ HR	40.0 .......................0	X			329,916	73,958
(20) John B Millstead VP/ Administrator	55.0 .......................0	X			536,372	166,963
(21) William Thorne VP/ Community Benefits	40.0 .......................0	X			280,082	95,462
(22) Terrence Farrell VP/ Administrator	60.0 .......................0	X			438,258	131,085
(23) John Brothers VP/Administrator Partial Year until May 2015	50.0 .......................0	X			383,319	9,824
(24) Shelly Pierce VP/Quality	30.0 .......................25.0	X			272,319	55,338
(25) Marci L Moore-Connelley MD VP/CMO	40.0 .......................15.0	X			398,209	54,699
(26) Gerald Mourey VP/Info Systems Partial Year as of Jul. 2015	40.0 .......................11.0	X			150,897	7,639
(27) Thomas Hentrich Pharmacist	40.0 .......................0		X		194,109	37,980
(28) Daniel Skiles Exec Director PHO	40.0 .......................0		X		207,382	40,411
(29) Robert Self System Pharmacy Director	40.0 .......................0		X		240,601	43,265
(30) Claudia Crews Staff Pharmacist	40.0 .......................0		X		180,261	48,915
(31) Charles Brooks Staff Nurse	40.0 .......................0		X		183,512	32,469
(32) David Holland Former VP	0.0 .......................0.0			X	317,222	20,148

(A) Name and business address	(B) Description of services	(C) Compensation
HURON CONSULTING GROUP 4795 PAYSPHERE CIR CHICAGO,IL60674	REVENUE CONSULTING	12,706,270
BRIGHAM ANESTHESIA SOUTH LLC 35 ALBANY RD STE C CARBONDALE,IL62903	MEDICAL AND HEALTHCARE PAYMENTS	4,297,407
AOS LLC 1859 BOWKES AVE FENTON,MO63026	IT SERVICES	4,173,941
MEDICAL STAFFING NETWORK PO BOX 203000 DALLAS,TX72445	MEDICAL AND HEALTHCARE PAYMENTS	1,698,794
CLAIMASSIST PO BOX 464 NEEDHAM,MA02494	PATIENT FINANCIAL CONSULTING	1,045,885
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 44

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

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

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

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

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

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

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

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

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

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

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2015

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Name of organization SOUTHERN ILLINOIS HOSPITAL SERVICES

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Page 3

Name of organization SOUTHERN ILLINOIS HOSPITAL SERVICES		Employer identification number 37-0618939

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Page 4


Name of organization SOUTHERN ILLINOIS HOSPITAL SERVICES			Employer identification number 37-0618939
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

Yes

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

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

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

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

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

Yes

81,689

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

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

Yes

63,221

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

144,910

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1g DIRECT CONTACT WITH LEGISLATORS	THE ORGANIZAITON HAS HIRED A PROFESSIONAL SERVICES FIRM TO CONDUCT LOBBYING ON BEHALF OF THE ORGANIZATION.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	A portion of dues paid to the Illinois Hospital Association is used for lobbying by that Association in the amount of $63,221.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	A portion of dues paid to the Illinois Hospital Association is used for lobbying by that Association in the amount of $63,221.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land ...	0	13,572,798		13,572,798
b	Buildings	0	138,528,549	67,019,689	71,508,860
c	Leasehold improvements		4,264,788	3,415,212	849,576
d	Equipment ...		292,075,647	180,177,585	111,898,062
e	Other ...		53,112,486	7,375,985	45,736,501
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					243,565,797

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) Due from affiliates				48,842,434
(2) Student/Tuition Loans Receivable				787,476
(3) Other Current Assets				764,081
(4) Unamortized Bond Costs, Net				3,198,017
(5) Executive Benefit Plan				2,846,890
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				56,438,898

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Estimated third-party payor settlements	12,761,522
Interest rate swap contract	18,365,845
Medical Professional Liability	2,028,241
Accrued Bond Interest	568,757
Asbestos Liability	330,603
Long Term Executive Retirement Plan	316,941
Miscellaneous	314,732
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	34,686,641
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

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

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

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

The organization is included in consolidated financial statements. Below is the FIN 48 (ASC 740) footnote from those financial statements: The Corporation is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. The Corporation realized certain income which the Internal Revenue Service considers to be unrelated business income subject to income tax. For the years ended March 31, 2016 and 2015, no tax was due related to these operations. When tax returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would be ultimately sustained. Examples of tax positions common to health systems include matters such as the tax exempt entity taking a tax position that an organization is tax exempt without observing corresponding proof of tax exemption from federal and state taxing authorities and there is material net income generated by the entity or egregious compensation paid to insiders that could result in revocation of exempt status (outside the scope of intermediate sanctions excise tax penalties). The tax position is to consider that these compensatory arrangements do not jeopardize tax exemption. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions taken are not offset or aggregated with other positions. Tax positions that meet the "more-likely-than-not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely of being realized upon settlement with the applicable taxing authority. There were no uncertain tax benefits identified and recorded at March 31, 2016 and 2015. The Corporation does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Corporation would recognize interest and/or penalties related to income tax matters in miscellaneous expenses. There was no interest and/or penalties related to income tax matters identified and recorded at March 31, 2016 and 2015. Tax returns filed by the Corporation are subject to examination by the Internal Revenue Service (IRS) up to three years from the extended due date of each return. Tax returns filed by the Corporation are no longer subject to examination for the years ended March 31, 2012 and prior.

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

See separate instructions. Right pointing arrow large image

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

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

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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)	(f) Total expenditures for and investments in region
	Central America and the Caribbean	0	0	Investments	11,385,000
















3a	Sub-total .....	0	0		11,385,000
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		11,385,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015

Schedule F (Form 990) 2015

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2015

Schedule F (Form 990) 2015Page 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) 2015

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2015

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 (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .			4,177,355	0	4,177,355	0.92 %
b	Medicaid (from Worksheet 3, column a) . . . . .			101,058,554	64,128,442	36,930,112	8.10 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	105,235,909	64,128,442	41,107,467	9.02 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			538,872		538,872	0.12 %
f	Health professions education (from Worksheet 5) . . .			3,158,023	597,819	2,560,204	0.56 %
g	Subsidized health services (from Worksheet 6) . . . .			3,528,070	1,621,662	1,906,408	0.42 %
h	Research (from Worksheet 7) .			253,724	115,473	138,251	0.03 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			414,491		414,491	0.09 %
j	Total. Other Benefits . .	0	0	7,893,180	2,334,954	5,558,226	1.22 %
k	Total. Add lines 7d and 7j .	0	0	113,129,089	66,463,396	46,665,693	10.24 %

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

Schedule H (Form 990) 2015

Page

Part II

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

		(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					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building			140,372		140,372	0.03 %
7	Community health improvement advocacy			319,732		319,732	0.07 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	460,104	0	460,104	0.10 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

6,351,588

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

1,396,635

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

Section B. Medicare

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

135,540,594

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

142,649,987

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

-7,109,393

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1PHYSCIAN'S SURGERY CENTER	SURGERY CENTER	59.46 %	0 %	40.54 %
2SOUTHERN ILLINOIS ORTHOPEDICS CENTER	MEDICINE	34 %	0 %	66 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?3 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)							Other (Describe)	Facility reporting group
1	MEMORIAL HOSPITAL OF CARBONDALE 405 WEST JACKSON STREET CARBONDALE,IL62901 www.sih.net 0000513	X	X	X		X		A
2	HERRIN HOSPITAL 201 SOUTH 14TH STREET HERRIN,IL62948 www.sih.net 0000935	X	X			X	ACUTE REHAB	A
3	ST JOSEPH MEMORIAL HOSPITAL 2 SOUTH HOSPITAL DRIVE MURPHYSBORO,IL62966 www.sih.net 0004614	X	X		X	X		A

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): WWW.SIH.NET/ABOUT/COMMUNITY-BENEFITS/

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

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

Yes

If "Yes" (list url): WWW.SIH.NET/ABOUT/COMMUNITY-BENEFITS/

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0% and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

www.sih.net/patients-visitors/healthcare-assistance-program/

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

www.sih.net/patients-visitors/healthcare-assistance-program/

A plain language summary of the FAP was widely available on a website (list url):
www.sih.net/patients-visitors/healthcare-assistance-program/

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

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

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

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

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

Other (describe in Section C)

Billing and Collections

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - A. The broad interests of the community we serve were incorporated by including input from residents, patient groups, health care practitioners, local health departments, social services providers, and other community organizations and partners. Participants contributed to this assessment by: -Identifying and prioritizing needs; -Highlighting current successful and ongoing activities; -Identifying gaps where attention is needed; -Fostering collaboration, pursuing opportunities for innovation and sustainability; -Developing plans to address significant community health issues. The process was guided by a steering committee composed of an internal team of SIH representatives and an external team of community stakeholders knowledgeable about health, needs assessment, and the local community. The process included a primary survey of our community's health priorities, meetings with healthcare providers and a 34 member SIH CHNA Advisory team. The CHNA Advisory team members included SIH staff, local public health department staff, and health and social service providers. This team reviewed the data, provided input and shared their perceptions of overall impact, magnitude of the problem, severity, and ability and interest of the community to address the issues. Active participation in local Health Community Coalitions also provided insight into the needs and priorities of our community members.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - A. MEMORIAL HOSPITAL OF CARBONDALE, CARBONDALE, IL HERRIN HOSPITAL, HERRIN, IL ST JOSEPH MEMORIAL HOSPITAL, MURPHYSBORO, IL
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - A. Three implementation plan teams were developed in order to bring experts together with expertise and interest in each of the chosen areas. Key issues and needs were identified and intervention strategies were developed. The Community Health Needs Assessment and Implementation Plan was reviewed and adopted by the SIH Board of Trustees on March 24, 2016. The priority areas through this needs assessment will be used to focus Community Benefits Department planning for the next three years (April 1 2016 - March 31, 2019). Some issues were identified but not prioritized to directly address at this time due to such factors as other groups and organizations, including SIH, already working to address them.
Schedule H, Part V, Section B, Line 22 Facility A, 1	Facility A, 1 - A. SOUTHERN ILLINOIS HEALTHCARE IS USING THE LOOK-BACK METHOD OF DETERMINING THE AMOUNTS GENERALLY BILLED ("AGB"), AS DESCRIBED IN TREASURY REGULATION 1.501(R)-5(B)(3). THE ORGANIZATION LIMITS THE AMOUNT CHARGED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO ANYONE WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE TO AGB.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?26
Name and address		Type of Facility (describe)
1	Cancer Institute 1400 Pin Oak Drive Carterville,IL62918	Cancer treatment
2	Prairie Building 409 West Oak Carbondale,IL62901	Cardiac Diagnostic
3	RIC & SIH Rehabilitation Services PO Box 3988 Carbondale,IL62901	Rehabilitation Services
4	St Jo Lab & Imaging - St Jo 2601 West Main St Carbondale,IL62901	Lab & Imaging Services
5	Physician Surgery Center 2601 West Main Carbondale,IL62901	Surgery Center
6	LPC-WF Imaging & Lab 502 St Louis Street West Frankfort,IL62896	Radiology
7	Sleep Center 8305 Express Drive Marion,IL62959	Sleep Studies
8	Breast Center 1237 East Main St Carbondale,IL62901	Mammography
9	Rehab Unlimited 305 West Jackson Carbondale,IL62901	Physical Therapy
10	Primary Care Group 117 East Clark Street Harrisburg,IL62946	Lab, Imaging, Wound Care, Physical Therapy
11	Miners Memorial Health Center 2553 Ken Gray Blvd West Frankfort,IL62896	Family Practice, Radiology, Lab and Specialty Clinics
12	Reference Lab 500 Lincoln Drive Herrin,IL62948	Lab Services
13	Logan Park Radiology & Lab 405 Rushing Drive Herrin,IL62948	Radiology, Lab
14	Rehab Unlimited 515 East Vienna St Anna,IL62906	Physical Therapy
15	Rehab Unlimited - Logan Park 3308 Logan Drive Herrin,IL62948	Physical Therapy
16	RUN - Marion 1403 Joe Abbott Way Marion,IL62959	Physical Therapy
17	Rehab Unlimited 6 East Shawnee Drive Murphysboro,IL62966	Physical Therapy
18	Wound Care 315 South 13th St Herrin,IL62948	Wound Care
19	Franklin Medical Arts 203 Bailey Lane Benton,IL62812	Lab, Imaging
20	RUN - LPC WF 502 W St Louis St West Frankfort,IL62896	Physical Therapy
21	Women's Center 3117 Williamson Co Parkway Marion,IL62959	Mammography
22	RIC Physician Practices 3224 South Park Avenue Herrin,IL62948	Rehabilitation Services
23	Workcare Occupational Health 500 Lincoln Drive Herrin,IL62948	Workcare, Occupational Therapy
24	Herrin Medical Arts 220 South Park Ave Herrin,IL62948	Outpt cardiovascular center/CHF Clinic
25	RUN - McLeansboro 119 South Jackson McLeansboro,IL62859	Physical Therapy
26	Wound Care 411 West Poplar Harrisburg,IL62946	Wound Care

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
Schedule H, Part I, Line 7g Subsidized Health Services	A FAMILY PRACTICE CENTER IS INCLUDED IN SUBSIDIZED HEALTH SERVICES. THE COST OF PROVIDING THIS CENTER WAS $1,243,625.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARIES ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET NUMBER 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET NUMBER 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET NUMBER 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE WAS UTILIZED FOR CALCULATING PORTIONS OF THE SUBSIDIZED HEALTH SERVICES. THE ORGANIZATION'S COST ACCOUNTING SOFTWARE ENCOMPASSES ALL PATIENT TYPES, SERVICES, AND PAYORS. THE COST ASSOCIATED WITH A SERVICE ARE REVIEWED AND UPDATED ANNUALLY TO PROVED THE MOST ACCURATE COST POSSIBLE. BOTH DIRECT AND INDIRECT COSTS ARE CONSIDERED WHEN ENTERED INTO THE SYSTEM. ACTUAL COST OF HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH EDUCATION, RESEARCH PROGRAMS, SOME SUBSIDIZED HEALTH SERVICES AND DONATIONS ARE STATED AT ACTUAL COST. THE COSTS OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE.
Schedule H, Part II Community Building Activities	Through Community Building activities, Southern Illinois Hospital Services addresses the causes of health problems through programs that advocate for Community Health Improvements. These programs include: Healthy Communities - This initiative is directed at improving community health through timely assessment of needs and facilitating the planning, implementation, and evaluation of community-based programs and services. SIH is active in two Healthy Communities Coalitions in local counties. These coalitions are comprised of health providers, social service agencies, citizens and other interested community groups interested in improving the health of their respective communities. Coordinated School Health - This program is directed at reducing the growth of childhood obesity and improving the overall health and well-being of children and adolescents. The "Illinois CATCH on to Health Consortium (ICHC)" is a collaborative initiative between the SIU School of Medicine Center for Rural Health and Social Services Development, local health departments and community organizations in southern Illinois. Together SIH impacted over 80 schools and 20,000 kids in the lower 15 counties of Illinois. SIH partners with local schools to form School Wellness Committees, complete the CDC's School Health Index, and implement Coordinated School Health Programs and policies to improve health and reduce overweight and obesity among southern Illinois students. During FY16, SIH staff worked with 29 schools, impacting 8,573 children, in the 7 county service area. SIH also impacted over 2,800 students/ families through Family Fun Nights, school sponsored 5K's, math and science nights, Family Vacation Nights, school safety days, and much more. SIH staff also conducted training for 42 school food service workers and 25 physical education teachers. SIH staff assisted school personnel with assessment, program planning, implementation, and evaluation with the CDC's "Whole School, Who Community, Whole Child (WSCC) Expanded Model for Coordinated School Health. ICHC members also worked collaboratively with schools in the SIH coverage area to promote and assist in the implementation of coordinated school health programming by providing training and technical support, and by training staff on the CATCH (Coordinated Approach to Child Health) program and supplying CATCH curriculum and materials. CATCH (Coordinated Approach To Child Health) is a coordinated school health program designed to promote physical activity, healthy food choices, and prevent tobacco use in elementary to middle school aged children. Patient Support Initiative - Southern Illinois Hospital Services provides a Patient Support Initiative (PSI) with the goal of providing patients with adequate care and compensating physicians at reasonable rates for patients that do not have resources available to pay their health care bills. SIHS compensates physicians for the care of patients that enter the healthcare system via the emergency departments at SIHS facilities and are assigned to physicians based upon the on-call rotation coverage. PSI is designed for physician/patient contact that occurs in a hospital based setting when there was no previous relationship between the patient and the physician or the physician's practice. PSI pays compensation for professional fees only, relating directly to the episode of care begun in the Emergency Department, not to exceed 30 days. Indigent Care Funding - Southern Illinois Hospital Services provides funding to purchase prescriptions, medical supplies and transportation to patients deemed financially indigent on a case-by case basis.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	In evaluating the collectability of accounts receivable, the Corporation analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for provision for bad debts. For receivables associated with services provided to patients who have third-party insurance coverage, the Corporation analyzes contractually due amounts and provides a provision for bad debts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Corporation records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The Corporation regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the provision for bad debt.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The cost to charge ratio is calculated utilizing Worksheet 2 included in the Internal Revenue Service's Form 990 Schedule H instructions. This cost to charge ratio is applied to the charges that are written off per the above methodology. To estimate the amount of care that was written off as bad debt expense that would have been eligible for charity under our policy the following steps were taken: - The number of encounters by county at each of our 3 facilities was obtained from our registration system. The percentage of patients from each county varies by facility due to the location of the facility. - The amount of bad debt expense by county at each hospital was estimated by applying the percentages obtained above to the amount of total charges written off at each facility. - The poverty rate of each county was then applied to these allocated charges to estimate the amount of charges that would have been eligible under our charity policy based on poverty level guidelines. - The cost to charge ratio as calculated utilizing Worksheet 2 from the Schedule H instructions was then used to determine the cost of these charges.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Taken from the Consolidated Audit Report Page 18: Provision for Bad Debt - Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectibility of accounts receivable, the Corporation analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party insurance coverage, the Corporation analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Corporation records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The Corporation regularly performs hindsight procedures to evaluate historical write-off and collection experience throughout the year to assist in determining the reasonableness of its process for estimating the allowance for doubtful accounts. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The expenses from the audited financial statements are adjusted per Medicare regulations. Overheads are allocated based on the step-down method by using Medicare approved statistics. Medicare costs are determined by multiplying the days or charges times the per diem amount or the cost to charge ratio applicable to the department. Home office expenses are allocated to the facilities based on the Home office cost report. Statistics used on the Home office cost report are approved by the Medicare intermediary. One hundred percent of the shortfall of Medicare allowable costs over Medicare revenue is considered to be a community benefit. By Continuing to treat patients eligible for Medicare, hospitals alleviate the federal government's burden for directly providing medical services. The IRS has acknowledged that lessening the government burden associated with providing Medicare benefits is a charitable purpose.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	If SIH determines the individual is eligible for financial assistance, SIH will: -Provide the individual with a billing statement that indicates the amount the individual owes for the care as an individual eligible for financial assistance ("HAP-eligible") (assuming the individual is eligible for assistance other than free care) and how that amount was determined and states, or describes how the individual can get information regarding, the amounts generally billed for the care -Refund to the individual any amount he or she has paid for the care (whether to the hospital facility or any other party to whom the hospital facility has referred or sold the individual's debt for the care) that exceeds the amount he or she is determined to be personally responsible for paying as a HAP-eligible individual, unless such amount is less than $5 (or such other amount published in the Internal Revenue Bulletin). -Take all reasonable available measures to reverse any extraordinary collection actions ("ECAs") (with the exception of a sale of debt) taken against the individual to obtain payment for the care. After determining financial assistance eligibility, SIH takes the following actions at least 30 days before first initiating one or more of the above ECAs to obtain payment for care: - Provide the individual with a written notice that indicates financial assistance is available for eligible individuals, identifies the ECA(s) that SIH (or other authorized party) intends to initiate to obtain payment for the care, and states a deadline after which such ECA(s) may be initiated that is no earlier than 30 days after the date that the written notice is provided. -Provide the individual with a plain language summary of the HAP with the written notice described above. -Make a reasonable effort to orally notify the individual about SIH's HAP and about how the individual may obtain assistance with the HAP application process.
Schedule H, Part V, Section B, Line 16a FAP website	A - MEMORIAL HOSPITAL OF CARBONDALE: Line 16a URL: www.sih.net/patients-visitors/healthcare-assistance-program/;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - MEMORIAL HOSPITAL OF CARBONDALE: Line 16b URL: www.sih.net/patients-visitors/healthcare-assistance-program/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - MEMORIAL HOSPITAL OF CARBONDALE: Line 16c URL: www.sih.net/patients-visitors/healthcare-assistance-program/;
Schedule H, Part VI, Line 2 Needs assessment	A complete copy of the organization's most recently conducted community health needs assessment and implementation strategy can be found at: http://www.sih.net/about/community-benefits/. The community benefits department at SIHS regularly assesses the needs within the community and provides programs in order to meet the needs in surrounding areas.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	SIH takes the following steps to notify patients about the availability of the healthcare assistance policy ("HAP"): -Financial Assistance notices are placed in all departments registering patients. -SIH will post signage in English and Spanish regarding the availability of financial assistance. -SIH's website posts notice of financial assistance through the Healthcare Assistance Program and applications in English and Spanish. -Information regarding HAP is available in all Patient Intake offices and in other public locations within the hospital, (upon request without charge). -Registrars inform all patients of the Healthcare Assistance Program, and offers a plain language summary.
Schedule H, Part VI, Line 4 Community information	The primary service area of Southern Illinois Healthcare is a seven-county region in Southern Illinois that includes Perry, Jackson, Franklin, Williamson, Union, Johnson, and Saline counties. The combined population of this area is approximately 245,000. Median household incomes in the area are substantially less than the statewide average. All seven counties have more residents living in poverty than the state average. The population of this area as a whole is largely homogeneous with greater than 95% of the population being white. Jackson County is the most diverse of the counties with 78.5% of the population being white, 14.7% African American and the remainder Hispanic and Asian/Pacific Islander. Eight non-SIH hospitals exist within the 7-county primary market area. The Marion VA Medical Center in Marion (Williamson County) is a 55-bed bed acute care facility owned and operated by the US Department of Veterans Affairs. Heartland Regional Medical Center, also located in Marion, is a 92-bed acute care hospital owned by Community Health Systems (CHS). Harrisburg Medical Center in Harrisburg (Saline County) is licensed for 45 acute care beds plus 31 acute mental illness beds. The remaining facilities are 25-bed Critical Access Hospitals: Ferrell Hospital in Eldorado (Saline County); Franklin Hospital in Benton (Franklin County); Marshall Browning Hospital in Du Quoin (Perry County); Pinckneyville Community Hospital in Pinckneyville (Perry County); and CHS-owned Union County Hospital District in Anna (Union County). Harrisburg Medical Center and Marshall Browning Hospital have affiliation agreements with Southern Illinois Healthcare. Each of the seven counties within the primary market area has been federally designated as a Health Professional Shortage Area, and at least a portion of each county has been federally designated as a Medically Underserved Area or having a Medically Underserved Population.
Schedule H, Part VI, Line 5 Promotion of community health	Southern Illinois Hospital Services (SIHS) is dedicated to promoting the health and well being of all of the people in the communities we serve. Our mission is guided by our values: compassion, collaboration, quality, stewardship, integrity, accountability and respect. Over 3,300 employees, along with physicians and volunteers, are working together to achieve our missions and ensure that the health care needs of those we serve are met by treating patients in SIHS facilities, by offering services in rural clinics, by collaborating with some of America's best hospitals and by improving the quality of life in our communities with our charitable community benefits programs. SIHS provides quality health services to people throughout Southern Illinois regardless of race, creed, sex, national origin, handicap, age or ability to pay. SIHS operates 3 community hospitals with a combined total of 279 beds. Each hospital operates a full time emergency room. No one is denied care or treatment within the hospitals or emergency rooms. Medical staff privileges are available to all qualified physicians in the area, consistent with the services provided at each facility. The Board of Trustees of SIHS is comprised of 13 members. These members are comprised of local community leaders, physicians and our CEO. The majority of the Board is comprised of persons who are neither employees nor independent contractors of the organization or family members thereof. SIHS invests excess funds from operations into the expansion and replacement of existing facilities and equipment, repayment of debt and improvement in patient care. Southern Illinois Hospital Services has also extended its services beyond hospital walls and into the neighborhoods where people live and work. Annually operating funds are allocated specifically to bring health-related programs to the areas in which they are most needed. Our goal is to respond to identified community health needs, increase access to care, lead and serve as a example to others in service to the community and improve the overall health status of those in the communities served by SIH facilities. Currently, the Community Benefits Department of SIHS collaborates with Southern Illinois schools to address childhood obesity. Included in this initiative are the Coordinated School Health program, CATCH (Coordinated Approach to Child Health) program and School Based Fitness Assessment and Training for Physical Education Teachers. A Health Ministry initiative, aiding the region's faith communities through the training and support of parish nurses, is an ongoing effort of the department. Over 140 parish nurses have been trained and are being supported in the health promotion work of their respective faith communities to date. Over 34,000 contacts were made during the current year. Also the department is active in the creation and facilitation of Healthy Community Coalitions. These groups include health providers, social service agencies, concerned citizens and other community groups interested in improving the health of their respective communities. The groups seek to meet locally identified community health needs and through the implementation of programs that address the demonstrated unmet health needs of the residents of the communities served. These coalitions make a significant impact on the lives of those within the communities served by SIHS. Currently, staff is engaged in numerous community health promotion, education, and prevention initiatives. An increase in access to primary health, behavioral health, and oral health care services has been affected through the SIHS support of existing and developing community-based interventions. Increased numbers of collaborative partnerships that support increased individual and community capacity to achieve a healthy community vision are ongoing. In order to accomplish the organization's mission as well as the overall goals previously outlined, the Community Benefits Department of Southern Illinois Healthcare implements a number of directed initiatives. Following is a description of these initiatives, the specific goals and objectives to be achieved for FY16, and an outline of the means by which department staff will work to plan, implement, and evaluate these programs. The Coordinated School Health program is working to reduce the growth of childhood obesity and improve the overall health and well-being of children and adolescents. The goal is to increase the number of schools involved in the SIH programs and to increase active PE time. The Health Ministry program collaborates with southern Illinois faith communities to improve the health and wellness of people in the communities they serve. Emphasizing wholeness of body, mind and spirit, faith communities with a health ministry offer health promotion and education activities; advocacy and referral; and caring spiritual support. The goal is to raise awareness of the Parish nursing specialty and establish new health ministries. The focus of the SIH Health Communities Program is to improve the community health through timely assessment of needs and facilitating the planning, implementation, and evaluation of community based programs and services. The goal is to increase collaborative capacity of local agencies and to develop a regional chronic disease/diabetes self management program. SIH provides funding to sponsor activities and events in the community to promote and encourage healthy and active lifestyles. Sponsored efforts help build a sustainable community-linked infrastructure and a health enhancing environment. On an on-going basis, Community Benefit Department staff participates in and facilitates a variety of boards, coalitions, networks, commissions, committees, partnerships and panels. Spending time in the community enable staff to bring back first-hand knowledge of community needs, existing resources, and identify opportunities for clinical and community linkages.
Schedule H, Part VI, Line 6 Affiliated health care system	Southern Illinois Hospital Services (SIHS) is part of a larger system that provides health services to the population of Southern Illinois. SIHS provides care through its three hospitals and one community health center. Southern Illinois Medical Services (SIMS) provides care through physician practices. These practices are comprised of the Center for Medical Arts, Logan Primary Care, Physician Care Group, individual physician practices, hospital physicians and emergency room physicians. SIHS and SIMS work together in providing care and treatment of the medically sick, injured or afflicted. Both provide quality health services to people throughout Southern Illinois regardless of race, creed, sex, national origin, handicap, age or ability to pay.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number
37-0618939

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

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

(1) LAND OF LINCOLN LEGAL ASST FOUNDATION 509 S UNIVERSITY AVE 3RD FLOOR CARBONDALE,IL62901	37-0958448	501(C)(3)	85,000	General Program Funding
(2) THE H GROUP 902 WEST MAIN ST WEST FRANKFORT,IL62896	37-0916475	501(C)(3)	16,500	General Proram Funding
(3) SOUTHERN ILLINOIS UNIVERSITY 1235 DOUGLAS DRIVE CARBONDALE,IL62901	37-6005961	GOVERNMENT ENTITY	31,350	General Program Funding
(4) AMERICAN CANCER SOCIETY 3870 PAYSHERE CIRCLE CHICAGO,IL60674	13-1788491	501(c)(3)	10,000	General Program Funding
(5) ILLINOIS POISON CENTER 222 S RIVERSIDE PLAZA SUITE 1900 CHICAGO,IL60606	37-2167008	501(C)(3)	23,132	General Program Funding
(6) HERRIN CHAMBER OF COMMERCE 3 SOUTH PARK AVE SUITE A HERRIN,IL62948	37-0618499	501(C)(6)	14,752	General Program Funding
(7) WOMENT FOR HEALTH & FITNESS 700 LOGAN COLLEGE ROAD CARTERVILLE,IL62918	37-1331447	501(C)(3)	12,500	General Program Funding
(8) JACKSON COUNTY HEALTH DEPARTMENT 415 HEALTH DEPT ROAD MURPHYSBORO,IL62956	37-6001092	Government Entity	10,000	General Program Funding
(9) SIU Foundation PO Box 19666 Springfield,IL62794	37-6024575	501(C)(3)	5,400	General Program Funding
(10) Southern Seven Health Department 260 Lick Creek Road Anna,IL62906	37-1069423	Government Entity	10,000	General Program Funding
(11) Egyptian Health Department 1412 US 45 South Eldorado,IL62930	37-6006931	Government Entity	10,000	General Program Funding
(12) Perry County Health Department PO Box 49 907 West Main St PInckneyville,IL62274	37-6001795	Government Entity	10,000	General Program Funding
(13) FranklinWilliamson Health Department 2312 West Main Marion,IL62959	37-6021157	Government Entity	10,000	General Program Funding
(14) Randolph County Health Department 2515 State Street Chester,IL62233	37-6001873	Government Entity	10,000	General Program Funding
(15) American Heart Association 7272 Greenville Avenue Dallas,TX75231	13-5613797	501(C)(3)	30,000	General Program Funding
(16) Our Lady of Mt Carmel School 316 West Monroe St Herrin,IL62948	37-0711803	501(C)(3)	7,199	General Program Funding
(17) Shawnee Health Services PO Box 577 109 California St Carterville,IL62918	37-0966854	501(C)(3)	50,000	General Program Funding
(18) Carbondale Park District 1115 West Sycamore St Carbondale,IL62903	37-6001080	Government Entity	13,811	General Program Funding

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

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

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

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

Part IV

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

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	All grants made are unrestricted and can be used in any way the donee organization sees fit to further its exempt purpose.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

Any related organization?

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

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

The organization?

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Rex Budde President/CEO	(i) (ii)	544,254 ------------- 0	37,838 ------------- 0	225,350 ------------- 0	204,975 ------------- 0	25,587 ------------- 0	1,038,004 ------------- 0	192,880 ------------- 0
2David Holland Former VP	(i) (ii)	0 ------------- 0	0 ------------- 0	317,222 ------------- 0	0 ------------- 0	20,148 ------------- 0	337,370 ------------- 0	60,199 ------------- 0
3Mike Kasser VP/CFO/Treasurer	(i) (ii)	351,262 ------------- 0	25,076 ------------- 0	151,787 ------------- 0	98,772 ------------- 0	40,897 ------------- 0	667,794 ------------- 0	120,108 ------------- 0
4William Sherwood VP/ General Counsel	(i) (ii)	267,510 ------------- 0	19,410 ------------- 0	259,910 ------------- 0	121,787 ------------- 0	45,747 ------------- 0	714,364 ------------- 0	228,861 ------------- 0
5Julie Firman VP/CNO	(i) (ii)	222,920 ------------- 0	16,636 ------------- 0	92,558 ------------- 0	62,920 ------------- 0	20,714 ------------- 0	415,748 ------------- 0	64,179 ------------- 0
6Philip Schaefer VP/ Amb & Phys Services	(i) (ii)	316,570 ------------- 0	22,791 ------------- 0	132,416 ------------- 0	106,656 ------------- 0	40,391 ------------- 0	618,824 ------------- 0	105,099 ------------- 0
7Pam Henderson VP/ HR	(i) (ii)	224,015 ------------- 0	16,002 ------------- 0	89,899 ------------- 0	65,942 ------------- 0	8,016 ------------- 0	403,874 ------------- 0	59,595 ------------- 0
8John B Millstead VP/ Administrator	(i) (ii)	369,126 ------------- 0	26,277 ------------- 0	140,969 ------------- 0	121,256 ------------- 0	45,707 ------------- 0	703,335 ------------- 0	111,384 ------------- 0
9William Thorne VP/ Community Benefits	(i) (ii)	189,507 ------------- 0	13,934 ------------- 0	76,641 ------------- 0	52,764 ------------- 0	42,698 ------------- 0	375,544 ------------- 0	38,647 ------------- 0
10Terrence Farrell VP/ Administrator	(i) (ii)	302,993 ------------- 0	22,020 ------------- 0	113,245 ------------- 0	94,667 ------------- 0	36,418 ------------- 0	569,343 ------------- 0	76,935 ------------- 0
11John Brothers VP/Administrator Partial Year until May 2015	(i) (ii)	52,530 ------------- 0	15,595 ------------- 0	315,194 ------------- 0	3,052 ------------- 0	6,772 ------------- 0	393,143 ------------- 0	208,640 ------------- 0
12Shelly Pierce VP/Quality	(i) (ii)	214,043 ------------- 0	15,394 ------------- 0	42,882 ------------- 0	39,094 ------------- 0	16,244 ------------- 0	327,657 ------------- 0	14,562 ------------- 0
13Marci L Moore-Connelley MD VP/CMO	(i) (ii)	346,792 ------------- 0	23,793 ------------- 0	27,624 ------------- 0	42,543 ------------- 0	12,156 ------------- 0	452,908 ------------- 0	0 ------------- 0
14Gerald Mourey VP/Info Systems Partial Year as of Jul. 2015	(i) (ii)	123,320 ------------- 0	0 ------------- 0	27,577 ------------- 0	2,280 ------------- 0	5,359 ------------- 0	158,536 ------------- 0	0 ------------- 0
15Thomas Hentrich Pharmacist	(i) (ii)	179,111 ------------- 0	0 ------------- 0	14,998 ------------- 0	6,694 ------------- 0	31,286 ------------- 0	232,089 ------------- 0	0 ------------- 0
16Daniel Skiles Exec Director PHO	(i) (ii)	197,427 ------------- 0	0 ------------- 0	9,955 ------------- 0	8,196 ------------- 0	32,215 ------------- 0	247,793 ------------- 0	0 ------------- 0
17Robert Self System Pharmacy Director	(i) (ii)	223,201 ------------- 0	0 ------------- 0	17,400 ------------- 0	8,131 ------------- 0	35,134 ------------- 0	283,866 ------------- 0	0 ------------- 0
18Claudia Crews Staff Pharmacist	(i) (ii)	158,935 ------------- 0	0 ------------- 0	21,326 ------------- 0	6,797 ------------- 0	42,118 ------------- 0	229,176 ------------- 0	0 ------------- 0
19Charles Brooks Staff Nurse	(i) (ii)	173,989 ------------- 0	0 ------------- 0	9,523 ------------- 0	1,259 ------------- 0	31,210 ------------- 0	215,981 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

Schedule J, Part I, Line 4a Severance or change-of-control payment

Dave Holland, VP/Info Systems, received severance payments of $236,799

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

The organization made the following supplemental nonqualified retirement plan payments/contributions: Rex Budde - $192,880 payment, $194,375 deferred compensation Pam Henderson - $59,594 payment, $56,556 deferred compensation Dave Holland - $60,199 payment, no deferred compensation Mike Kasser - $120,108 payment, $88,172 deferred compensation Bart Millstead - $111,384 payment, $110,656 deferred compensation Phil Schaefer - $105,099 payment; $96,056 deferred compensation Bill Sherwood - $228,861 payment, $111,187 deferred compensation Julie Firman - $64,179 payment, $55,219 deferred compensation William Thorne - $38,647 payment. $44,483 deferred compensation Terence Farrell - $76,935 payment, $85,858 deferred compensation Shelly Pierce - $14,562 payment, $31,151 deferred compensation John Brothers - $255,738 payment, no deferred compensation Marci Moore-Connelley - No payment, $32,984 deferred compensation Gerald Mourey - No payment, $2,280 deferred compensation

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number
37-0618939

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	ILLINOIS FINANCE AUTHORITY	86-1091967	45200FS42	02-18-2010	68,985,878	See Supplemental Information		X		X		X
B	ILLINOIS FINANCE AUTHORITY	86-1091967		10-27-2011	14,420,000	See Supplemental Information		X		X		X
C	ILLINOIS FINANCE AUTHORITY	86-1091967		07-01-2014	127,215,000	See Supplemental Information		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	200,000		10,005,000		3,130,000
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	68,985,878		14,420,000		127,215,000
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	0		0		0
6 Proceeds in refunding escrows ...............	0		0		0
7 Issuance costs from proceeds ...............	0		282,518		979,638
8 Credit enhancement from proceeds .............	0		0		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	0		0		108,379,362
11 Other spent proceeds .............	68,985,878		14,137,482		0
12 Other unspent proceeds .............	0		0		17,856,000
13 Year of substantial completion .............	2010		2011		2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part IV

Arbitrage

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

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........
c Term of GIC .........					0 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X

Part VI

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

Return Reference

Explanation

Schedule K, Part I, Column (f) Explanation of bond issue

2014 bond issue - The bond issue contains two bonds issued at the same time. It includes revenue bonds in the amount of $75,580,000 and revenue refunding bonds in the amount of $51,635,000. These bonds were reported on one Form 8038. 2011 bond issue - The bond issue financed capital expenditures and refunded the 2008 variable rate demand revenue bonds which had a deemed reissuance in 2011. 2010 bond issue - The bond issue refunded the 1998 bond issue.

Schedule K (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

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

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

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

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

Part II

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

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) Terence Farrell	Officer	Sale of Personal Residence		X	75,483	75,483		No	Yes		Yes
(2) Liam Farrell	Son of Terence Farrell	Tuition Assistance		X	11,500	1,851		No	Yes		Yes








Total ............... $						77,334

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) LIAM FARRELL	SON OF VP/ADMINISTRATOR TERENCE FARRELL	68,855	EMPLOYEE COMPENSATION		No
(2) DAVID FISCHER	SON-IN-LAW OF VP/CFO MIKE KASSER	63,336	EMPLOYEE COMPENSATION		No
(3) ANGELA MOTT	DAUGHTER OF VP/INFO SYSTEMS DAVID HOLLAND	14,996	EMPLOYEE COMPENSATION		No
(4) COLIN FARRELL	SON OF VP/ADMINISTRATOR TERENCE FARRELL	19,192	EMPLOYEE COMPENSATION		No
(5) AMANDA FARRELL	DAUGHTER-IN-LAW OF VP/ADMINISTRATOR TERENCE FARRELL	23,659	EMPLOYEE COMPENSATION		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) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Return Reference	Explanation
Form 990, Part III, Line 1 ORGANIZATION'S MISSION	(CONTINUED FROM PART III) OVER 3,300 EMPLOYEES, ALONG WITH PHYSICIANS AND VOLUNTEERS, ARE WORKING TOGETHER TO ACHIEVE OUR MISSION AND ENSURE THAT THE HEALTH CARE NEEDS OF THOSE WE SERVE ARE MET BY TREATING PATIENTS IN SIHS FACILITIES, BY OFFERING SERVICES IN RURAL CLINICS, BY COLLABORATING WITH SOME OF AMERICA'S BEST HOSPITALS AND BY IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITIES WITH OUR CHARITABLE COMMUNITY BENEFITS PROGRAMS. OUR SERVICES ARE PROVIDED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.
Form 990, Part III, Line 4a HOSPITAL SERVICES	(CONTINUED FROM PART III) THE FACILITIES THAT MAKE UP SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) INCLUDE: MEMORIAL HOSPITAL OF CARBONDALE: OPENED IN 1950, MEMORIAL HOSPITAL OF CARBONDALE, WITH 140 LICENSED BEDS, IS THE FLAGSHIP HOSPITAL FOR SIH AND A REGIONAL REFERRAL CENTER FOR THE 16 COUNTY SOUTHERN ILLINOIS REGION. PHYSICIANS IN NEARLY 40 DIFFERENT SPECIALTIES PRACTICE HERE, BRINGING EXPERTISE AND NEW PROCEDURES, BUT SUCCESSFULLY TAILORING THEM TO THE PARTICULAR NEEDS OF A RURAL SETTING. IT IS HOME TO THE FIRST OPEN HEART SURGERY PROGRAM IN THE IMMEDIATE SOUTHERN ILLINOIS AREA AND IS THE CORE HOSPITAL FOR SIH'S COMPREHENSIVE, REGIONAL HEART PROGRAM, PRAIRIE HEART INSTITUTE. THE REGION'S ONLY PRIMARY STROKE CENTER IS LOCATED WITHIN THIS HOSPITAL. THE HOSPITAL IS ALSO HOME TO A COMMISSION ON CANCER ACCREDITED COMPREHENSIVE CANCER TREATMENT CENTER, THE ONLY LEVEL II PLUS NEO-NATAL INTENSIVE CARE UNIT, AND THE ONLY PEDIATRIC UNIT IN THE IMMEDIATE SOUTHERN ILLINOIS AREA. THE HOSPITAL IS AFFILIATED WITH SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL THROUGH ITS FAMILY PRACTICE RESIDENCY PROGRAM. HERRIN HOSPITAL: OPENED IN 1913, HERRIN HOSPITAL WAS THE FIRST HOSPITAL OWNED AND OPERATED BY THE ORGANIZATION. HERRIN HOSPITAL CURRENTLY OPERATES 85 LICENSED BEDS. IT IS ALSO HOME TO THE 29 BED ACUTE REHABILITATION CENTER, AN AFFILIATE PROGRAM WITH THE REHABILITATION INSTITUTE OF CHICAGO, RECOGNIZED AS THE TOP REHABILITATION HOSPITAL IN AMERICA. A RECENT RENOVATION UPGRADED PATIENT ACCOMMODATIONS TO INCLUDE PRIVATE ROOMS AND IMPROVED ACCESS TO OUTPATIENT SERVICES BY RELOCATING THOSE SERVICES TO THE MAIN FLOOR. THE AREA'S ONLY BARIATRIC SURGICAL PROGRAM FOR WEIGHT LOSS IS HOUSED AT THIS HOSPITAL AS WELL AS BEING THE REGION'S FIRST ACCREDITED CHEST PAIN CENTER. ST. JOSEPH MEMORIAL HOSPITAL: ST JOSEPH MEMORIAL HOSPITAL IS LOCATED IN MURPHYSBORO, ILLINOIS AND IS A FULL-SERVICE, CRITICAL ACCESS HOSPITAL WITH 25 LICENSED BEDS. ST. JOSEPH OPENED ON OCTOBER 1, 1960 AND WAS ACQUIRED BY SOUTHERN ILLINOIS HOSPITAL SERVICES ON JANUARY 5, 1995 FROM THE SISTERS OF THE ASC HEALTH SYSTEM. ST JOSEPH'S CATHOLIC IDENTITY HAS BEEN RETAINED BY SIHS SINCE THE PURCHASE AND THE STAFF TAKES PRIDE IN THE HOSPITAL'S SPIRITUAL ROOTS. ST. JOSEPH HAS EVOLVED OVER TIME TO BECOME A REGIONAL PROVIDER OF SPECIALIZED OUTPATIENT SERVICES. THESE SPECIALIZED SERVICES INCLUDE A SLEEP DISORDERS CENTER ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE, THE AREA'S ONLY COORDINATED INFUSION THERAPY PROGRAM, A WOULD CARE CENTER WITH HYPERBARIC THERAPY, AND AN OUTPATIENT GERIATRIC COUNSELING PROGRAM. MINERS MEMORIAL HEALTH CENTER: WEST FRANKFORT, ILLINOIS IS HOME TO MINERS MEMORIAL HEALTH CENTER. THE HEALTH CENTER HOUSES A PHYSICIAN SPECIALTY CLINIC THAT OFFERS VISITING SPECIALISTS INCLUDING UROLOGY, PODIATRY AND CARDIOLOGY. IT IS ALSO HOME TO WEST FRANKFORT FAMILY MEDICINE, WITH FAMILY MEDICINE AND OBSTETRIC PHYSICIANS FROM SIU SCHOOL OF MEDICINE, AND OFFERS MAMMOGRAPHY, X-RAY, ULTRASOUND, BONE DENSITOMETRY, AND LABORATORY SERVICES. SERVICES PROVIDED: DURING THIS REPORTING PERIOD, OUR HOSPITALS RECORDED 67,123 ADULT AND CHILD PATIENT DAYS AND 3,059 NEWBORN PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 351,894 WITH 72,791 OF THESE REGISTRATIONS BEING EMERGENCY ROOM VISITS. APPROXIMATELY 66.3% OF THESE DAYS AND REGISTRATIONS PROVIDED CARE THAT WAS CLASSIFIED AS EITHER UNCOMPENSATED CHARITY CARE OR UNCOMPENSATED GOVERNMENT HEALTH CARE. AN ADDITIONAL 1.5% OF THE CARE PROVIDED IN THESE DAYS AND REGISTRATIONS WERE WRITTEN OFF AS BAD DEBT. ROUTINE INPATIENT CARE AND OUTPATIENT PROCEDURES ARE PROVIDED AT ALL THREE OF OUR FACILITIES. EACH FACILITY ALSO HAS ITS OWN UNIQUE PROGRAMS AND PATIENT CARE UNITS. OUR TWO LARGER FACILITIES, CARBONDALE MEMORIAL HOSPITAL AND HERRIN HOSPITAL BOTH HOUSE INTENSIVE CARE UNITS. THESE TWO LARGER FACILITIES EACH HAVE SPECIALTY UNITS WITHIN THEIR RESPECTIVE FACILITIES. CARBONDALE MEMORIAL HOSPITAL PROVIDES OBSTETRICAL, PEDIATRICS, AND A NEONATAL NURSERY. HERRIN HOSPITAL PROVIDES THE ACUTE REHABILITATION CENTER. SURGICAL SERVICES ARE OFFERED AT ALL FACILITIES, WITH CARBONDALE MEMORIAL HOSPITAL PROVIDING OPEN-HEART AND CARDIAC SERVICES. ST. JOSEPH MEMORIAL HOSPITAL ALSO OPERATES SWING BEDS. ST. JOSEPH ALSO OFFERS UNIQUE OUTPATIENT SERVICES TO THE AREA. THE SLEEP DISORDERS CENTER OFFERS TWO LOCATIONS AND THE SENIOR RENEWAL PROGRAM OFFERS OUTPATIENT BEHAVIORAL HEALTH TREATMENT. SIHS HAS ALSO PROVIDED SUBSIDIZED HEALTH CARE SERVICES. SUBSIDIZED HEALTH SERVICES INCLUDE, BUT ARE NOT LIMITED TO PHYSICIAN REFERRAL CENTERS, FAMILY PRACTICE CENTERS, SENIOR MEMBERSHIP, ETC. THESE HEALTH CARE SERVICES ARE PROVIDED IN RESPONSE TO COMMUNITY NEEDS. THESE HEALTH SERVICES MUST BE SUBSIDIZED FROM OTHER REVENUE SOURCES IN ORDER TO BE PROVIDED. SIHS PROVIDES MEDICAL EDUCATION THROUGH AN AFFILIATION WITH THE SOUTHERN ILLINOIS UNIVERSITY'S MEDICAL SCHOOL FAMILY PRACTICE RESIDENCY PROGRAM.
Form 990, Part III, Line 4b COMMUNITY BENEFITS	(CONTINUED FROM PART III) THE OVERARCHING GOAL OF SOUTHERN ILLINOIS HEALTHCARE'S COMMUNITY BENEFITS DEPARTMENT IS TO RESPOND TO IDENTIFIED COMMUNITY HEALTH NEEDS, INCREASE ACCESS TO CARE, LEAD AND SERVE AS AN EXAMPLE TO OTHERS IN SERVICE TO THE COMMUNITY, AND IMPROVE THE OVERALL HEALTH STATUS OF THOSE IN THE COMMUNITIES SERVED BY SIH FACILITIES. SOUTHERN ILLINOIS HEALTHCARE'S OVERALL APPROACH TO COMMUNITY BENEFITS IS TO TARGET THE INTERSECTIONS OF DOCUMENTED UNMET COMMUNITY HEALTH NEEDS AND THE ORGANIZATION'S MISSION, VALUES AND KEY STRENGTHS. COMMUNITY BENEFIT ACTIVITIES EMPHASIZE PRIMARY HEALTH CARE SERVICES, HIGH IMPACT HEALTH SCREENING AND PROMOTION, CHRONIC DISEASE PREVENTION AND MANAGEMENT, AND INCREASE ACCESS TO CARE ESPECIALLY FOR VULNERABLE AND UNDERSERVED PEOPLE. IN ORDER TO ACCOMPLISH THE ORGANIZATION'S MISSION, THE COMMUNITY BENEFITS DEPARTMENT OF SIHS IMPLEMENTS A NUMBER OF DIRECTED INITIATIVES. PROGRAMS DURING THE REPORTING YEAR INCLUDE: HEALTH MINISTRY -- THE HEALTH MINISTRY PROGRAM COLLABORATES WITH SOUTHERN ILLINOIS FAITH COMMUNITIES TO IMPROVE THE HEALTH AND WELLNESS OF PEOPLE IN THE COMMUNITIES THEY SERVE. EMPHASIZING WHOLENESS OF BODY, MIND AND SPIRIT, FAITH COMMUNITIES WITH A HEALTH MINISTRY OFFER HEALTH PROMOTION AND EDUCATION ACTIVITIES; ADVOCACY AND REFERRAL; AND CARING SPIRITUAL SUPPORT. HEALTHY COMMUNITIES -- THE FOCUS OF THE WORK IN THE AREA OF HEALTHY COMMUNITIES IS TO INCREASE THE CAPACITY OF LOCAL AGENCIES TO WORK COLLABORATIVELY TO ADDRESS THE UNMET HEALTH NEEDS WITH THE COMMUNITIES SERVED BY SIHS. STAFF WILL WORK TO IMPROVE COMMUNITY HEALTH THROUGH THE ASSESSMENT OF COMMUNITY NEEDS AND THE PLANNING, IMPLEMENTATION, AND EVALUATION OF COMMUNITY BASED HEALTH PROMOTIONS, EDUCATION, PREVENTION PROGRAMS, AND SERVICES. AN INCREASED FOCUS OF THESE ACTIVITIES WILL BE DIRECTED TO INITIATIVES ADDRESSING CARDIOVASCULAR DISEASE AND CANCER, AND THE DEVELOPMENT OF STRATEGIES, PROGRAMMING, AND INTERVENTIONS TO REDUCE SUBSTANCE ABUSE, AND THE CONTINUATION OF EFFORTS TO EXPAND ACCESS TO CARE FOR THE UNINSURED AND THE UNDER-SERVED. HEALTHY COMMUNITY COALITIONS -- THE FORMAL GATHERING OF HEALTH PROVIDERS, SOCIAL SERVICE AGENCIES, CONCERNED CITIZENS, AND OTHER COMMUNITY GROUPS INTERESTED IN IMPROVING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. SIHS IS ACTIVE IN THREE SUCH COALITIONS, REPRESENTING FOUR COUNTIES - JACKSON, PERRY, FRANKLIN AND WILLIAMSON COUNTIES. EMERGENCY ORAL HEALTH CARE - COLLABORATION WITH LOCAL DENTAL PROVIDERS TO PROVIDE PREVENTIVE ORAL HEALTH CARE FOR MEDICAID PATIENTS; HOPEFULLY REPLACING EMERGENCY ROOM VISITS FOR TOOTH RELATED COMPLAINTS. MEDICAL LEGAL PARTNERSHIP SI -- AN INNOVATIVE PROGRAM THAT PROVIDES LEGAL ASSISTANCE TO LOW-INCOME AND UNDERINSURED ADULTS SEEKING MEDICAL CARE. THE ONGOING MEDICAL-LEGAL COLLABORATION BETWEEN LAND OF LINCOLN LEGAL SERVICES AND SIH IS ADDRESSING MANY OF THE SOCIAL ISSUES FACED BY PATIENTS CONTRIBUTING TO THEIR HEALTH CARE NEEDS. LEGAL ASSISTANCE IN PROVIDED IN THE AREAS OF PUBLIC BENEFITS, DISABILITY, FAMILY, HOUSING AND CONSUMER ISSUES. START! WALKING - SIH IS A REGIONAL SPONSOR OF THE AMERICAN HEART ASSOCIATION'S START! WALKING GUIDE TO LOCAL PATHS AND PARKS. CURRENTLY APPROXIMATELY 50 PATHS ARE DESIGNATED AS START! WALKING PATHS. WE CHOOSE HEALTH SOUTHERNMOST ILLINOIS - A MULTI-YEAR INITIATIVE TO ENCOURAGE AND SUPPORT PLACE-BASED POLICIES, SYSTEMS AND ENVIRONMENTAL CHANGES AIMED AT IMPROVING AND SUSTAINING HEALTH. SIH IS ENGAGED WITH LOCAL HEALTH DEPARTMENTS AND COMMUNITY PARTNERS IN THE LOWER 16 COUNTIES IN ILLINOIS TO PROMOTE HEALTHY EATING AND ACTIVE LIVING IN SCHOOLS AND WORKSITES REDUCE EXPOSURE TO SECONDHAND SMOKE IN MULTI-UNIT HOUSING COMPLEXES AND OUTDOOR PLACES, INCREASE ACCESS TO HEALTHIER FOODS AND PROMOTE BREASTFEEDING, IMPROVE OUR LOCAL BUILT ENVIRONMENT TO INCREASE OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND TO IMPROVE THE SOCIAL AND EMOTIONAL HEALTH OF STUDENTS.
Form 990, Part III, Line 4c SCHOOL BASED HEALTH SERVICES	(CONTINUED FROM PART III) THE FOLLOWING IS A SUMMARY OF THE PROGRAMS DURING THIS REPORTING YEAR: THE ILLINOIS CATCH ON TO HEALTH CONSORTIUM IS A COLLABORATIVE INITIATIVE BETWEEN THE SIU SCHOOL OF MEDICINE CENTER FOR RURAL HEALTH AND SOCIAL SERVICES DEVELOPMENT, SOUTHERN ILLINOIS HEALTHCARE, LOCAL HEALTH DEPARTMENTS AND COMMUNITY ORGANIZATION IN SOUTHERN ILLINOIS. TOGETHER OVER 80 SCHOOLS AND 20,000 STUDENTS IN THE LOWER 15 COUNTIES OF ILLINOIS HAVE BEEN IMPACTED BY THIS PROGRAM. THIS CONSORTIUM ALSO WORKED WITH SCHOOLS TO PROMOTE AND ASSIST IN THE IMPLEMENTATION OF COORDINATED SCHOOL HEALTH PROGRAMMING BY PROVIDING TRAINING AND TECHNICAL SUPPORT. CATCH (COORDINATED APPROACH TO CHILD HEALTH) -- CATCH IS A PROGRAM DESIGNED TO PROMOTE PHYSICAL ACTIVITY, HEALTHY FOOD CHOICES, AND PREVENT TOBACCO USE IN ELEMENTARY SCHOOL AGED CHILDREN. CATCH EMPLOYS A COORDINATED APPROACH TO CHILD HEALTH PROMOTION BY TARGETING MULTIPLE ASPECTS OF THE SCHOOL ENVIRONMENT AND INVOLVING CLASSROOM TEACHERS, SCHOOL FOOD SERVICE STAFF, PHYSICAL EDUCATION (PE) TEACHERS, STUDENTS' FAMILIES, AND THE BROADER SCHOOL COMMUNITY IN A RANGE OF HEALTH PROMOTING ACTIVITIES FOR ALL CHILDREN IN GRADES PREK-8, SIMILAR TO THE CDC'S COORDINATED SCHOOL HEALTH PROGRAM MODEL. THE FOUR CORE COMPONENTS OF CATCH INCLUDE: (1) THE EAT SMART SCHOOL NUTRITION PROGRAM, (2) A CLASSROOM PHYSICAL ACTIVITY AND HEALTHY EATING CURRICULA, (3) THE CATCH PHYSICAL EDUCATION PROGRAM, AND (4) A FAMILY EDUCATION AND INVOLVEMENT PROGRAM. THE COORDINATION OF HEALTH MESSAGES AND ACTIVITIES BETWEEN THESE FOUR COMPONENT AREAS IS CRITICAL TO POSITIVELY IMPACTING CHILDREN'S KNOWLEDGE, SKILLS, AND BEHAVIOR. SIH AND PROGRAM PARTNERS ARE IMPLEMENTING COMPONENTS OF THE CATCH PROGRAM IN 80 ELEMENTARY SCHOOL DISTRICTS IN THE 15 COUNTIES IN THE SOUTHERN ILLINOIS REGION. THIS PROGRAM IMPACTS OVER 20,000 STUDENTS AND THEIR FAMILIES. ANOTHER INITIATIVE IS PROMOTING LIFELONG FITNESS BY SUPPORTING QUALITY PHYSICAL EDUCATION IN SOUTHERN ILLINOIS SCHOOLS AND ASSISTING CHILDREN TO MEET THE SURGEON GENERAL'S RECOMMENDATION FOR 60 MINUTES OF DAILY PHYSICAL ACTIVITY. THIS NEED IS BASED UPON CURRENT LOCATOC RESEARCH AND NATIONAL PHYSICIAN EDUCATION STANDARDS. PROGRAM COMPONENTS ASSIST SCHOOLS IN DEVELOPING A QUALITY PHYSICAL EDUCATION PROGRAM THAT HELPS STUDENTS SET AND WORK TOWARD GOALS, PRACTICE SELF ASSESSMENT AND LEARN THE BENEFITS OF LIFELONG PHYSICAL ACTIVITY.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	GOVERNANCE COMMITTEE The Board has a Governance Committee consisting of 5 Trustees. The purpose of the Governance Committee is to assure the Board of Trustees that the respective programs are functional to fulfill the responsibilities of the Board of Trustees: * Develop and maintain effective compensation and benefit policies and practices; review and recommend in advance all executive compensation arrangements; provide for the evaluation of the performance of the CEO and other System Officers; review and recommend annual performance objectives for System Officers; provide for conduct of a periodic self-evaluation of the Board of Trustees. * Assure that the programs which address new Board member orientation, continuing education, mentoring, and facilitate understanding of current trends in healthcare and medical terminology, are functional. * Identify competent, highly qualified individuals to serve as members of the Board of Trustees; recommend individuals to serve in leadership positions on the Board; and facilitate and interview potential Board members. * Act for the Board of Trustees in all matters as specifically authorized by resolution of the Board or when the Board of Trustees is not in session.
Form 990, Part VI, Line 6 Classes of members or stockholders	The organization's sole member is Southern Illinois Hospital Enterprises, Inc., a related tax-exempt organization. The member has the right to elect members to the board of trustees and approve some decisions of the board.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The organization's sole member, Southern Illinois Healthcare Enterprises, has the exclusive right to elect Trustees to the organization's Board of Trustees.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The organization's sole member, Southern Illinois Healthcare Enterprises (Corporate Member), has reserved powers found in the Organizations bylaws. Except for transfers identified in the budget of the Organization approved by the Corporate Member, the Organization may not transfer assets to entities other than the Corporate Member or entities that the Corporate Member controls (the "Corporate Member Affiliates"), without the approval of the Corporate Member. The Corporate Member has the right to require the Organization to transfer assets to the extent necessary to accomplish the Corporate Member's goals and objectives. The Corporate Member also has the right to require the organization to provide for the payment of all indebtedness of the Corporate Member or a Corporate Member Affiliate. The Organization cannot be required to violate its charitable purposes, the terms of any restricted gifts, or the covenants of its debt instruments in complying with any asset transfers directed by the Corporate Member. In addition, the following matters must be submitted to and receive the approval of the Corporate Member: 1. Capital expenditures in excess of $500,000; 2. The buying, selling, leasing, mortgaging or disposing of real property belonging to the Corporation or any of its subsidiaries; 3. The establishment or discontinuance of any major services; including services requiring Certificates of Need; 4. Long-Range Strategic Plans; 5. Master Facilities and Site Plans; 6. The creation or dissolution of any corporation, the sole member or majority stockholder of which is the Corporation; 7. Joint venture or affiliation agreements; 8. The incurrence of indebtedness in excess of $500,000; 9. Such other matters as may be required by law or by the Organization's Articles of Incorporation, or by its bylaws to be submitted to the Corporate Member; 10. Delegation of the functions, powers, duties and responsibilities of any officer of the Corporation, and; 11. Any other matter which may be specified from time to time by the Corporate Member. In addition, The Corporate Member retains the right to approve all changes to the organization's bylaws.
Form 990, Part VI, Line 11b Review of form 990 by governing body	A draft of the Form 990 and supplemental schedules was distributed to the CEO, CFO and certain Vice-Presidents of the corporation for their review and comments. A draft copy was presented to the Finance Committee by the CFO and the organization's tax advisors for review and comments. After the review and comment period, all suggestions and comments were considered and the Form 990 was updated as appropriate. The finalized Form 990 and supplemental schedules was then presented to the Board of Trustees and a copy of the return was made available to every member of the governing body before it was filed with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	Annually, the General Counsel sends out a Conflict of Interest Questionnaire to each Trustee, Director, Officer, Manager and key employee to complete and return. The General Counsel then reviews these Questionnaires to determine what conflicts, real or perceived, exist. During every board meeting, the General Counsel reminds the Trustees that the Board has a conflict of interest policy, that the General Counsel has reviewed the agenda for any conflicts, but that the Trustees are obligated to give notice if a conflict has been over-looked or if a discussion or action comes before the Board which may involve or create a conflict of interest for someone. If a Trustee has a conflict of interest, the Trustee or the General Counsel discloses the conflict. The Trustee with the conflict is allowed to remain in the meeting to answer any question the Trustee may need to answer and then the conflicted Trustee is excused from the meeting. The remaining Trustees then discuss the matter further and action is taken on the matter. Finally, the conflicted Trustee is then invited back into the meeting. Interested persons may also be asked, in rare situations, to resign their position on the Board.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The Board of Trustees sets the executive compensation policy and is responsible for approval of the compensation. The Governance Committee is designated by the Board to act as the Compensation Committee for matters concerning executive compensation. Each member of the Committee, while considering executive compensation issues, must be an independent director, free from any conflict of interest. The Committee seeks out and contracts the services of an outside, independent executive compensation consultant to advise the Committee in matters of market values of comparable executive positions. The Committee annually reviews all comparability data and prepares a recommendation as to the compensation package of the President/CEO for the full Board. Only the full Board has the authority to approve the compensation of the President/CEO. The decisions and deliberations are documented in the governance committee minutes. This process was last undertaken in June 2015.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	The Board of Trustees sets the executive compensation policy and is responsible for approval of the compensation. The Governance Committee is designated by the Board to act as the Compensation Committee for matters concerning executive compensation. Each member of the Committee, while considering executive compensation issues, must be an independent director, free from any conflict of interest. The Committee seeks out and contracts the services of an outside, independent executive compensation consultant to advise the Committee in matters of market values of comparable executive positions. The Committee annually reviews all comparability data and prepares a recommendation as to the compensation package of all officers for the full Board. Only the Committee will have the authority to approve the compensation of the senior management team and will report it's actions to the Board. The decisions and deliberations are documented in the governance committee minutes. This process was last undertaken in June 2015.
Form 990, Part VI, Line 19 Required documents available to the public	The organization makes its conflict of interest policy available to the public on its website and upon request. Governing documents and financial statements are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104; these documents are not available to the public at this time.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Miscellaneous - Total Revenue: 1274900, Related or Exempt Function Revenue: 1274900, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part IX, Line 11g Other Fees	Consulting Fees - Total Expense: 14592200, Program Service Expense: 477744, Management and General Expenses: 14114456, Fundraising Expenses: 0; Credit & Collection Fees - Total Expense: 784813, Program Service Expense: 25594, Management and General Expenses: 759219, Fundraising Expenses: 0; Clinical Service Fees - Total Expense: 6548766, Program Service Expense: 6547913, Management and General Expenses: 853, Fundraising Expenses: 0; Engineering Fees - Total Expense: 200250, Program Service Expense: 188106, Management and General Expenses: 12144, Fundraising Expenses: 0; Architect Fees - Total Expense: 182187, Program Service Expense: 175480, Management and General Expenses: 6707, Fundraising Expenses: 0; Recruitment Fees - Total Expense: 453702, Program Service Expense: 56907, Management and General Expenses: 396795, Fundraising Expenses: 0; Other Professional Fees - Total Expense: 3996528, Program Service Expense: 3271219, Management and General Expenses: 725309, Fundraising Expenses: 0; Agency Staffing - Total Expense: 946754, Program Service Expense: 813731, Management and General Expenses: 133023, Fundraising Expenses: 0; Physician Services - Total Expense: 31557798, Program Service Expense: 31427687, Management and General Expenses: 130111, Fundraising Expenses: 0; Purchased Services - Total Expense: 18182051, Program Service Expense: 12230138, Management and General Expenses: 5951913, Fundraising Expenses: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	EQUITY TRANSFERS - -1822029; CHANGE IN FAIR VALUE OF INTERESET RATE SWAP - -739317; GAIN/LOSS ON DERIVATIVE - -950807;
Form 990, Part XII, Line 3a REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133	AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2015 SOUTHERN ILLINOIS HEALTHCARE SERVICES AND AFFILIATES RECEIVED AN AUDIT FOR THE 2014 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SOUTHERN ILLINOIS HOSPITAL SERVICES

Employer identification number

37-0618939

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) QUALITY HEALTH PARTNERS LLC 1239 E MAIN ST CARBONDALE,IL62901 45-4435852	ADMINISTRATIVE SERVICES	IL	480,010	186,319	SOUTHERN ILLINOIS HOSPITAL SERVICES

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES INC PO BOX 3988 CARBONDALE,IL62902 37-1136788	LEASING OF MEDICAL SPACE	IL	501(c)(3	Type II	NA		No
(2)SOUTHERN ILLINOIS MEDICAL SERVICES NFP 1239 EAST MAIN STREET CARBONDALE,IL62901 20-5521741	MEDICAL SERVICES	IL	501(c)(3	3	SOUTHERN ILLINOIS HOSPITAL SERVICES	Yes
(3)SIH FOUNDATION NFP 1239 EAST MAIN STREET CARBONDALE,IL62901 27-1933790	FUNDRAISING	IL	501(c)(3	Type I	SOUTHERN ILLINOIS HOSPITAL SERVICES	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) RIC AND SIHS REHABILITATION SERVICES LLC PO BOX 3988 CARBONDALE,IL62902 36-4566925	MEDICAL SERVICES	IL	SIHS	Related	7,012,612	999		No	0		No	99.9 %
(2) PHYSICIANS' SURGERY CENTER LLC 2601 WEST MAIN STREET CARBONDALE,IL62901 26-0425547	MEDICAL SERVICES	IL	SIHS	Related	161,029	1,421,548		No	0		No	59.459 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) SIH CAYMAN SPC GROUP LTD PO BOX 1051 Cayman Islands,CAYMAN ISLANDSKY11102 CJ 98-0611605	FINANCING	CJ	SIHS	C Corporation	5,070,453	39,109,223	100 %	Yes
(2) HEALTH SERVICES OF SOUTHERN ILLINOIS INC PO BOX 3988 CARBONDALE,IL62902 37-1115061	FITNESS CENTER	IL	NA	C Corporation			0 %		No
(3) HIDK PROPERTIES LAND TRUST 1239 EAST MAIN STREET CARBONDALE,IL62901 46-6693066	RENTAL PROPERTIES	IL	SIHS	Trust	0	0	100 %	Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

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

Yes

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

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) SOUTHERN ILLINOIS MEDICAL SERVICES	J	724,255	FMV
(2) SOUTHERN ILLINOIS MEDICAL SERVICES	A	544,356	FMV
(3) SOUTHERN ILLINOIS MEDICAL SERVICES	R	1,822,029	FMV
(4) SIH FOUNDATION	C	909,802	FMV

Schedule R (Form 990) 2015

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

1	Briefly describe the organization’s mission or most significant activities: Southern Illinois Hospital Services' (SIHS) mission statement is "We are dedicated to improving the health and well-being of all of the people in the communities we serve."
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	3,507
6	Total number of volunteers (estimate if necessary) .............	6	216
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,970,472	1,809,839
9	Program service revenue (Part VIII, line 2g) .........	442,698,599	482,963,048
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	31,838,028	-1,134,732
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,369,016	4,236,051
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	484,876,115	487,874,206
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	474,620	409,841
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)	186,057,556	193,342,368
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 148,935
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	234,088,793	262,011,543
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	420,620,969	455,763,752
19	Revenue less expenses. Subtract line 18 from line 12.......	64,255,146	32,110,454
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	741,249,071	788,949,760
21	Total liabilities (Part X, line 26).............	249,476,334	272,976,668
22	Net assets or fund balances. Subtract line 21 from line 20.....	491,772,737	515,973,092

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 373,434,696 including grants of $ 0 ) (Revenue $ 485,376,501 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THROUGH DAILY OPERATIONS, SIHS' HOSPITALS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE, UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE, SUBSIDIZED HEALTH SERVICES AND MEDICAL EDUCATION. THE PRIMARY SERVICE AREA OF SIHS IS A VERY RURAL SEVEN-COUNTY REGION WITH A COMBINED POPULATION OF APPROXIMATELY 245,000. THE RESIDENTS OF THESE COUNTIES' MEDIAN HOUSEHOLD INCOMES ARE BELOW THE STATE AVERAGE, PLUS THE POVERTY RATE IS HIGHER THAN THE STATE AVERAGE. (CONTINUED IN SCHEDULE O)

4b	(Code: ) (Expenses $ 1,538,721 including grants of $ 409,841 ) (Revenue $ 0 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. THE COMMUNITY BENEFITS DEPARTMENT OF SIHS WAS INSTITUTED IN 1994 WITH AN OPERATING BUDGET SPECIFICALLY ALLOCATED TO BRING HEALTH-RELATED PROGRAMS TO THE AREAS IN WHICH THEY WERE MOST NEEDED. COMMUNITY BENEFITS HAS UNDERTAKEN A WIDE VARIETY OF SUCCESSFUL PROGRAMS SINCE ITS INCEPTION. (CONTINUED IN SCHEDULE O)

4c	(Code: ) (Expenses $ 108,729 including grants of $ 0 ) (Revenue $ 0 )
	SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS) PROVIDES PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE CHILDREN AND ADOLESCENTS ATTENDING SOUTHERN ILLINOIS SCHOOLS. (CONTINUED IN SCHEDULE O)

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses375,082,146

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,803,625	0	1,586,602

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	909,802
e	Government grants (contributions)		1e	823,303

f	All other contributions, gifts, grants, and similar amounts not included above		1f	76,734

g	Noncash contributions included in lines 1a-1f:$ 0
h Total.Add lines 1a-1f.......		1,809,839

			Business Code
2a	Patient Revenue	622110	481,189,447	481,189,447	0	0
b	Partnership Income	900099	1,085,209	1,085,209	0	0
c	Leasehold revenue from related organizations	531120	688,392	688,392	0	0
d			0	0	0	0
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			482,963,048

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			10,602,189	0	0	10,602,189
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		561,380
b	Less: rental expenses		533,311
c	Rental income or (loss)	0	28,069
d	Net rental income or (loss)......			28,069	0	0	28,069
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	872,430	481,119,163
b	Less: cost or other basis and sales expenses	709,343	493,019,171
c	Gain or (loss)	163,087	-11,900,008
d	Net gain or (loss).....			-11,736,921	0	0	-11,736,921
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Cafeteria/Vending/Hospital Auxiliary		900099	2,369,650	575,121	0	1,794,529
b	Medical Records/X-Ray		621300	200,307	200,307	0	0
c	Internet Physician Revenue		621300	363,125	363,125	0	0
d	All other revenue ....			1,274,900	1,274,900	0	0
e	Total. Add lines 11a–11d ......			4,207,982
12	Total revenue. See Instructions......			487,874,206	485,376,501	0	687,866

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	409,841	409,841
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	7,180,744	1,196,313	5,984,431	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	198,202	198,202	0	0
7	Other salaries and wages	142,092,790	116,952,234	25,029,957	110,599
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,368,009	3,162,983	203,143	1,883
9	Other employee benefits .......	29,776,054	27,697,034	2,060,198	18,822
10	Payroll taxes ...........	10,726,569	8,557,593	2,160,792	8,184
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	1,848,667	21,411	1,827,256	0
c	Accounting ...........	198,525	0	198,525	0
d	Lobbying ...........	81,689	0	81,689	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	618,602	0	618,602	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	77,445,049	55,214,519	22,230,530	0
12	Advertising and promotion ....	997,512	7,847	989,665	0
13	Office expenses .......	9,493,644	7,729,784	1,754,413	9,447
14	Information technology ......	11,944,185	8,555,620	3,388,565	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	7,320,151	5,890,394	1,429,757	0
17	Travel ............	761,979	469,635	292,344	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	1,000,264	500,995	499,269	0
20	Interest ...........	6,527,128	6,487,586	39,542	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	30,316,631	20,048,496	10,268,135	0
23	Insurance ...	6,253,112	5,734,177	518,935	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	88,659,251	88,659,251	0	0
b	Provider Tax	9,519,587	9,519,587	0	0
c	Equipment Rental	7,113,159	6,580,239	532,920	0
d	Hospital Auxiliary	638,798	638,798	0	0
e	All other expenses	1,273,610	849,607	424,003	0
25	Total functional expenses. Add lines 1 through 24e	455,763,752	375,082,146	80,532,671	148,935
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,200	1	8,158
2	Savings and temporary cash investments .........			9,133,193	2	12,657,715
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			91,220,690	4	96,882,463
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	75,483
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	1,851
7	Notes and loans receivable, net ....			895,042	7	165,453
8	Inventories for sale or use ........			10,964,223	8	11,806,439
9	Prepaid expenses and deferred charges ......			5,159,044	9	5,940,270
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	501,554,268
b	Less: accumulated depreciation	10b	257,988,471	209,980,725	10c	243,565,797
11	Investments—publicly traded securities .			355,366,981	11	347,054,035
12	Investments—other securities. See Part IV, line 11 .....			13,187,824	12	13,087,906
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			1,278,035	14	1,265,292
15	Other assets. See Part IV, line 11 ...........			44,056,114	15	56,438,898
16	Total assets. Add lines 1 through 15 (must equal line 34)...			741,249,071	16	788,949,760

17	Accounts payable and accrued expenses .....	53,518,940	17	59,316,027
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	162,216,000	20	178,974,000
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	33,741,394	25	34,686,641
26	Total liabilities. Add lines 17 through 25..	249,476,334	26	272,976,668

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	491,357,603	27	515,506,109
28	Temporarily restricted net assets ...........	415,134	28	466,983
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....	0	30	0
31	Paid-in or capital surplus, or land, building or equipment fund ...	0	31	0
32	Retained earnings, endowment, accumulated income, or other funds	0	32	0
33	Total net assets or fund balances ...........	491,772,737	33	515,973,092
34	Total liabilities and net assets/fund balances ........	741,249,071	34	788,949,760

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately 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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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 separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No