Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 10-01-2019 , and ending 09-30-2020
BCheck if applicable:
CName of organization
MEMORIAL HEALTH SYSTEM
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
701 NORTH FIRST STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
SPRINGFIELD, IL627810001
D Employer identification number

37-1110690
E Telephone number

G Gross receipts $ 1,767,912,198
F Name and address of principal officer:
EDGAR J CURTIS
701 NORTH FIRST STREET
SPRINGFIELD,IL627810001
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHOOSEMEMORIAL.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5670
K Form of organization:  
L Year of formation: 1981
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 8,323
6 Total number of volunteers (estimate if necessary) ............. 6 14
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 309,320
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 75,790,676 83,011,917
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 642,548 21,962,375
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,369,907 2,674,333
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 77,803,131 107,648,625
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 552,481 33,173
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) 39,035,968 45,032,284
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 42,478,364 44,770,014
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 82,066,813 89,835,471
19 Revenue less expenses. Subtract line 18 from line 12....... -4,263,682 17,813,154
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 491,172,846 515,238,317
21 Total liabilities (Part X, line 26)............. 366,390,141 386,412,477
22 Net assets or fund balances. Subtract line 21 from line 20..... 124,782,705 128,825,840
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 32,798,258 including grants of $   ) (Revenue $ 2,219,912 )
INFORMATION TECHNOLOGYMEMORIAL HEALTH SYSTEM (MHS) CONTINUES TO IMPLEMENT LEADING EDGE TECHNOLOGY SOLUTIONS TO AUGMENT PATIENT SAFETY, QUALITY AND CLINICAL EFFECTIVENESS AND TO IMPROVE MHS'S BUSINESS PROCESSES. MHS'S STAFF OF EXPERIENCED INFORMATION TECHNOLOGY PROFESSIONALS IS ON THE CUTTING EDGE OF MEDICAL AND BUSINESS TECHNOLOGY. THEY SUPPORT A VAST ARRAY OF PATIENT CARE TECHNOLOGY AND BUSINESS APPLICATIONS. DURING FY2020, INFORMATION TECHNOLOGY IMPLEMENTED NUMEROUS SOLUTIONS TO SUPPORT THE HEALTH SYSTEM AND COMMUNITY DURING THE COVID-19 PANDEMIC, INCLUDING HOSPITAL INCIDENT COMMAND SYSTEM, TELEHEALTH TECHNOLOGY, ONLINE SCHEDULING, REMOTE WORK TECHNOLOGY, MICROSOFT TEAMS DEPLOYMENT, RESPIRATORY CARE TESTING AND MASS VACCINATION CLINICS. OTHER SIGNIFICANT INFORMATION TECHNOLOGY PROJECTS IN FY2020 INCLUDED MIGRATING MHS BUSINESS APPLICATIONS TO MHS'S NEWEST AFFILIATE IN DECATUR, ILLINOIS; EXPANSION OF MHS'S CERNER ELECTRONIC HEALTH RECORD (EHR) TO PASSAVANT AREA HOSPITAL IN JACKSONVILLE AND DECATUR MEMORIAL HOSPITAL; EXPANSION OF MHS PACS IMAGING AND DICTATION SYSTEMS TO ALL AFFILIATES; IMPLEMENTED THE ALLSCRIPTS AMBULATORY EHR AND HOSTING THAT SOLUTION FOR THE SPRINGFIELD CLINIC, SIU HEALTH AND MEMORIAL PHYSICIAN SERVICES; MIGRATING ORTHOPEDIC CENTERS OF ILLINOIS TO THE AMBULATORY EHR MANAGED SERVICE ORGANIZATION; UPGRADED MHS HOSPITAL EHR TO THE LATEST PACKAGES FOR MEANINGFUL USE, PROMOTING INTEROPERABILITY AND ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES; EXPANDED UPON MHS'S USE OF CLOUD TECHNOLOGY TO REDUCE COSTS AND OPTIMIZE FTE ALLOCATION; AND INCREASED MHS'S STORAGE AND NETWORK BANDWIDTH TO MHS AFFILIATE SITES TO PROVIDE BETTER RESPONSE TIME AND ACCOMMODATE FUTURE GROWTH.
4b (Code:   ) (Expenses $ 10,667,083 including grants of $   ) (Revenue $ 6,492,701 )
BUILDING AND FACILITY EXPANSION AND IMPROVEMENTSIN SUPPORT OF MHS'S MISSION, SAFE, FUNCTIONAL FACILITIES ARE THE FOUNDATION OF THE HEALTHCARE SERVICES WE PROVIDE. CLINICAL PROJECTS THAT BEGAN IN FY2020:-BAYLIS 3RD FLOOR RENOVATION - REDUCED SIZE OF HAND THERAPY SPACE AND BACKFILLED AREA WITH EXAM ROOMS FOR SIU. UPDATED FINISHES AND FIXTURES ON ENTIRE FLOOR TO MATCH THE 4TH & 5TH FLOORS.-BAYLIS 5TH FLOOR RENOVATION - RECONFIGURATION OF EXAM, STORAGE, AND RESTROOMS TO CREATE UROLOGY EXAM ROOMS WITH A NEW FLUOROSCOPY / X-RAY MACHINE FOR SIU.-7C ICU RENOVATION - RENOVATIONS MADE TO INCLUDE ICU AND BURN UNIT ROOMS. PROJECT SCOPE INCLUDED TWO NEW ISOLATION ROOMS, LOCKDOWN ROOM, AND TUB ROOM FOR BURN UNIT. INCLUDED INTERIOR UPGRADES TO MODERN FINISHES FOR PATIENT ROOMS AND SOME SUPPORTING AREAS INCLUDING THE WAITING AREA, CORRIDORS AND ELEVATOR LOBBIES.-DESIGNATED COVID PATIENT ROOMS - CONVERTED 125 PATIENT ROOMS ON MULTIPLE FLOORS TO COVID ROOMS. THIS INCLUDED MAKING ROOMS NEGATIVE AIRFLOW, AS WELL AS INSTALLING OBSERVATION WINDOWS IN DOORS TO LIMIT COLLEAGUE EXPOSURE TO COVID.OTHER PROJECTS COMPLETED FOR THE MEDICAL CENTER INCLUDE:-340 WEST MILLER RENOVATION - RENOVATED BUILDING TO SERVE AS ADMINISTRATIVE OFFICE SPACE. -OR (OPERATING ROOM) BID PACKAGE 3 - ORS 11-16 FINISH UPGRADES, NEW LIGHTS & BOOMS, AND CLEANSWEEP WITH INTEGRATION SYSTEM.-OR CORRIDOR FINISHES - UPGRADES TO OR CORRIDOR INCLUDING PAINTING, WALL PROTECTION, CEILINGS AND LIGHTS.-ORS 21-24 SOLID SURFACES - UPGRADED ORS 21-24 TO SAME STANDARDS AS ALL OTHER ORS.-303 BIDWELL RENOVATIONS - UPGRADES MADE TO AN UNOCCUPIED BUILDING TO SUPPORT SIU AND MEMORIAL BEHAVIORAL HEALTH.-PHARMACY BACKFILL - CONSISTED OF RENOVATING THE EXISTING H-BUILDING IN ORDER TO COMPLY WITH THE UPS 800 REQUIREMENTS FOR HAZARDOUS STORAGE ALONG WITH OFFICE SPACE AND PHARMACEUTICAL STORAGE.-2G RENOVATION - RENOVATIONS MADE TO SUPPORT 22 NEW PRIVATE PATIENT ROOMS HOSTING MMC PLASTIC SURGERY PROGRAM AND BARIATRICS PROGRAM.-PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION (PAH) MEDICAL OFFICE BUILDING EXPANSION - ADDITIONAL 36,000-SQUARE-FOOT, TWO?STORY ADDITION TO THE EXISTING MEDICAL OFFICE BUILDING. FOR PATIENTS IN THE PAH SERVICE AREA, IT IS DESIRED TO PROVIDE ACCESS TO EXPANDED CLINIC SERVICES INCLUDING FAMILY PRACTICE/PRIMARY CARE, OPHTHALMOLOGY, NEPHROLOGY, ENDOCRINOLOGY, MED ONCOLOGY, INFUSION, PHARMACY COMPOUNDING ROOM, EXPANDED LABORATORY, AND AN ADDITIONAL X-RAY ROOM.-PAH'S STAIR H REPLACEMENT -THE EXISTING STAIR H WAS CITED IN A CMS LIFE SAFETY SURVEY AS HAVING DEFICIENCIES, AS A RESULT WE REPLACE THE STAIR IN ITS ENTIRETY. -PAH'S STAIR L REPLACEMENT - THIS STAIR WAS CITED IN A CMS LIFE SAFETY SURVEY AS HAVING LIFE SAFETY ISSUES, AS A RESULT WE REPLACED THIS STAIR IN ITS ENTIRETY.-TAYLORVILLE MEMORIAL HOSPITAL - PHASE II CONSTRUCTION - DEMOLITION OF EXISTING POWER PLANT, TOWER, AND KITCHEN. NEW CONSTRUCTION OF POWER PLANT, KITCHEN AND CONFERENCE ROOMS.
4c (Code:   ) (Expenses $ 5,822,747 including grants of $   ) (Revenue $ 71,493,709 )
SENIOR LEADERSHIPGUIDED BY THE VALUES OF MEMORIAL HEALTH SYSTEM, SENIOR LEADERSHIP IS RESPONSIBLE FOR STRATEGIC PLANNING, PRIORITIZING AMONG COMPETING ISSUES AND ENGAGING IN DIALOGUE AND DECISION-MAKING THAT WILL ENABLE MEMORIAL HEALTH SYSTEM TO ACHIEVE ITS MISSION (TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE), ITS VISION (TO BE THE HEALTH SYSTEM PEOPLE CHOOSE OVER ALL OTHERS) AND ITS STRATEGIC GOALS (GREAT COLLEAGUES, GREAT PARTNERS, GREAT ACCESS, GREAT EXPERIENCE, AND GREAT RESULTS).IN FY2019, MHS SENIOR LEADERSHIP REFRESHED AND UPDATED MHS'S STRATEGIC PLAN, 5 YEAR GOALS AND MEASURES OF SUCCESS TO REFLECT EMERGING PRIORITIES RELATED TO HEALTH REFORM, QUALITY IMPROVEMENT, POPULATION HEALTH, CARE COORDINATION AND THE RESULTS OF OUR COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS UPDATED STRATEGIC PLAN SERVED MEMORIAL HEALTH SYSTEM WELL THROUGHOUT THE COVID-19 PANDEMIC AND WAS A CATALYST FOR MANAGING AND RESPONDING TO THE PANDEMIC IN A COORDINATED, SYSTEMIZED FASHION. LEADERSHIP WAS ABLE TO RESPOND EFFICIENTLY AND EFFECTIVELY IN A DYNAMIC, EVER- CHANGING ENVIRONMENT AS THE COVID-19 PANDEMIC EVOLVED. WHILE MANY PRIORITIES AND INITIATIVES HAD TO BE PUT ON PAUSE DUE TO THE COVID-19 PANDEMIC, MEMORIAL HEALTH SYSTEM MADE GREAT PROGRESS IN INTEGRATING A NEW AFFILIATE HOSPITAL, DECATUR MEMORIAL HOSPITAL, IN FY2020. IN ADDITION, THE LEADERSHIP TEAM EXECUTED THE HEALTH SYSTEM STRATEGIC AND FISCAL YEAR ACTION PLANS (AS ADJUSTED DUE TO THE COVID-19 PANDEMIC) AND REPORTED RESULTS TO ITS BOARD. FY2020 WAS CHARACTERIZED BY MEETING THE DEMANDS OF THE COVID-19 PANDEMIC, INCLUDING PREPARING FOR A SURGE OF PATIENTS FORECASTED TO OVERWHELM ILLINOIS HOSPITALS CRITICAL CARE CAPACITY BY APRIL, 2020. UTILIZING METHODS DRAWN FROM ITS SUCCESSFUL LEAN SIX SIGMA PROGRAM AND ALLOCATED VIA A HOSPITAL INCIDENT COMMAND STRUCTURE, MEMORIAL HEALTH SYSTEM DEVELOPED A PHASED REGIONAL ACTION PLAN KNOWN AS THE ACUTE RESPIRATORY CARE (ARCH) MODEL. ARCH ALLOCATED PATIENT REFERRALS, RESOURCES, AND PROTOCOL THROUGH SIX PHASES OF PANDEMIC INTENSITY ACROSS THE SYSTEM'S FIVE REGIONAL HOSPITAL CAMPUSES AS WELL AS ITS AMBULATORY CARE SITES. IN THIS WAY, PATIENT SURGE (WHICH DID MATERIALIZE BY NOVEMBER-DECEMBER TO PLACE 180 COVID-19-POSITIVE INPATIENTS AT ONCE IN OUR HOSPITALS) WAS "LOAD BALANCED" SO THAT CONSTRAINED RESOURCES (MANPOWER, MATERIAL, MACHINE) WERE CONSERVED AS REGIONAL CAPABILITIES WERE ENHANCED AND BEST-PRACTICE LEARNING SHARED. THE ARCH MODEL, REVISED SEVEN TIMES DURING THE PAST 14 MONTHS, ALLOWED MHS TO APPROPRIATELY CARE FOR APPROXIMATELY 22% OF COVID-19 INPATIENTS IN OUR FOUR OTHER HOSPITALS BEYOND OUR TERTIARY ACADEMIC HOSPITAL IN SPRINGFIELD TO ALLOW OTHER CRITICALLY ILL PATIENTS WITH STROKE, TRAUMA, AND CANCER TO BE SERVED IN UNIQUE SPECIALTY PROGRAMS THERE. SUCH METHODS, REPLICATED ACROSS OUR FIVE CENTRAL ILLINOIS HOSPITALS, DROVE A REDUCTION OF MORTALITY IN THE SICKEST COVID-19 PATIENTS EVEN AS THEIR NUMBER PEAKED AT THE HEIGHT OF THE PANDEMIC.
(Code:   ) (Expenses $ 4,428,987 including grants of $ 33,173 ) (Revenue $ 2,805,595 )
OTHER REVENUE INCLUDES PARTNERSHIP INCOME AND MISCELLANEOUS INCOME FOR MHS AND MEMORIAL HEALTH PARTNERS (MHP). MHP IS A DISREGARDED ENTITY OWNED 100% BY MHS. FOR FY2020, MHS RECORDED A LOSS IN LINCOLN LAND HEALTH INFORMATION EXCHANGE, LLC (LLHIE). A GAIN WAS RECORDED IN BJC COLLABORATIVE. MHS ALSO HAD CARE COORDINATION PAYMENTS FOR MHP AND A CHARGEBACK FOR STAFF TIME TO LLHIE IN WHICH MHS IS A 27.27% OWNER.
4d Other program services (Describe in Schedule O.)
(Expenses $ 4,428,987 including grants of $ 33,173 ) (Revenue $ 2,805,595 )
4e Total program service expensesMediumBullet53,717,075
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
39
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
8,323
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKATHRYN KEIM SENIOR VP & CFO701 NORTH FIRST STREET   SPRINGFIELD,IL627810001 (217) 788-3830
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DOUGLAS RAHN DBA......................................................................
FORMER KEY EMPLOYEE
 0.00
.................
0.00 		          X 1,263,270 0 0
(2) EDGAR CURTIS EX-OFFICIO......................................................................
PRESIDENT & CEO
 25.00
.................
25.00 		X   X       1,647,768 0 49,361
(3) CHARLES CALLAHAN PHD......................................................................
PRESIDENT - MHS HOSPITAL GROUP
 0.00
.................
50.00 		      X     0 829,533 221,430
(4) DAVID GRAHAM MD......................................................................
SVP & CHIEF QUALITY&INNOVATN OFFCR
 25.00
.................
25.00 		      X     678,915 0 189,207
(5) ANNA EVANS JD......................................................................
SVP & GENERAL COUNSEL
 25.00
.................
25.00 		      X     572,544 0 161,107
(6) ROBERT KAY......................................................................
FORMER OFFICER
 0.00
.................
0.00 		          X 687,024 0 43,009
(7) RAJESH GOVINDAIAH MD......................................................................
SVP & CHIEF MEDICAL OFFICER
 25.00
.................
25.00 		      X     632,072 0 93,900
(8) KATHRYN KEIM......................................................................
SVP & CFO
 25.00
.................
25.00 		    X       616,905 0 106,609
(9) KEVIN ENGLAND......................................................................
SVP & CHIEF ADMINISTRATIVE OFFICER
 25.00
.................
25.00 		      X     488,390 0 210,594
(10) AIMEE DAILY PHD......................................................................
SVP & CHIEF TRANSFORMATION OFFICER
 25.00
.................
25.00 		      X     0 530,817 85,734
(11) ROBERT SCOTT......................................................................
SVP & CHIEF HR OFFICER
 25.00
.................
25.00 		      X     509,009 0 85,609
(12) MARSHA PRATER PHD......................................................................
SVP & CHIEF NURSING OFFICER
 25.00
.................
25.00 		      X     0 520,426 36,367
(13) JAMESON ROSZHART......................................................................
PRESIDENT - MHS AMBULATORY GROUP
 25.00
.................
25.00 		      X     460,078 0 90,502
(14) J TRAVIS DOWELL......................................................................
PRESIDENT & CEO MPS
 0.00
.................
50.00 		        X   409,177 0 97,906
(15) DOLAN DALPOAS......................................................................
PRESIDENT & CEO ALMH
 0.00
.................
50.00 		        X   419,729 0 58,683
(16) KIMBERLY BOURNE......................................................................
PRESIDENT & CEO TMH
 0.00
.................
50.00 		        X   355,681 0 82,286
(17) W SCOTT BOSTON MD......................................................................
PRESIDENT & CEO PAH
 0.00
.................
50.00 		        X   301,443 0 47,456
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JERRY MILLER........................................................................
VP, INFORMATION SERVICES
 50.00
.......................0.00 		        X   267,496 0 56,615
(19) JOSEPH HURWITZ........................................................................
BOARD MEMBER
 0.70
.......................0.70 		X           0 0 0
(20) NINA HARRIS........................................................................
BOARD MEMBER
 0.70
.......................0.70 		X           0 0 0
(21) WILLIAM PUTMAN MD........................................................................
BOARD MEMBER(THRUDEC19)
 0.70
.......................0.00 		X           0 0 0
(22) MICHAEL NEUMEISTER MD........................................................................
BOARD MEMBER(THRUDEC19)
 0.70
.......................0.00 		X           0 0 0
(23) REGINALD BENTON........................................................................
BOARD MEMBER
 0.70
.......................1.40 		X           0 0 0
(24) GINNY FANNING........................................................................
BOARD MEMBER(THRUSEP20)
 0.70
.......................1.40 		X           0 0 0
(25) JERRY KRUSE MD MSPH........................................................................
BOARD MEMBER
 0.70
.......................0.00 		X           0 0 0
(26) SUSAN KOCH EDD........................................................................
BOARD MEMBER(THRUJUNE20)
 0.70
.......................0.70 		X           0 0 0
(27) JOHN BLACKBURN........................................................................
BOARD MEMBER
 0.70
.......................0.70 		X           0 0 0
(28) RANDALL GERMERAAD........................................................................
BOARD MEMBER
 0.70
.......................0.70 		X           0 0 0
(29) LARRY ALTENBAUMER........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.00 		X           0 0 0
(30) AIMEE FYKE........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.00 		X           0 0 0
(31) JONATHAN LOCKE MD........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.00 		X           0 0 0
(32) DAVID GRIFFEN MD PHD........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.70 		X           0 0 0
(33) CHERYL MARTIN........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.00 		X           0 0 0
(34) RICHARD LEVI........................................................................
BOARD MEMBER(FROMJAN20)
 0.70
.......................0.70 		X           0 0 0
(35) MICHAEL AIELLO........................................................................
BRDMEM(THRUDEC19);2NDVCHR
 1.40
.......................1.40 		X   X       0 0 0
(36) TODD WISE........................................................................
2NDVCHR(THRUDEC19);1STVCHRTREAS
 1.40
.......................1.40 		X   X       0 0 0
(37) DEAN ROBERT JR........................................................................
1STVCHAIR(THRUDEC19);CHAIR
 1.40
.......................1.40 		X   X       0 0 0
(38) DALE BECKER........................................................................
TREASURER(THRUDEC19)
 1.40
.......................1.40 		X   X       0 0 0
(39) DIANE RUTLEDGE PHD........................................................................
CHAIR(THRUDEC19);BOARD MEMBER
 1.40
.......................1.40 		X   X       0 0 0
(40) GEOFFREY ISRINGHAUSEN........................................................................
SECRETARY
 1.40
.......................1.40 		X   X       0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,309,501 1,880,776 1,716,375
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet87
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SIRIUS COMPUTER SOLUTIONS

10100 REUNION PL 500
SAN ANTONIO,TX78216 		IT SERVICES 4,935,297
HAROLD O'SHEA BUILDERS INC

3401 CONSITUTION DR
SPRINGFIELD,IL62711 		COMMERCIAL CONSTRUCTION 4,873,346
BURWOOD GROUP INC

125 S WACKER DR SUITE 2950
CHICAGO,IL60606 		IT SERVICES 2,584,095
JUMP COMPANY

1120 S 6TH STREET STE 502
ST LOUIS,MO63104 		ADVERTISING 1,686,673
CUMBERLAND CONSULTING

2550 MERIDIAN BLVD STE 200
FRANKLIN,TN37067 		IT CONSULTING 1,424,656
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet40
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a MANAGEMENT FEES 900099 71,493,709 71,243,093 250,616  
b PROGRAM RELATED RENT 900099 6,492,701 6,492,701    
c MHP REVENUE 900099 2,824,525 2,824,525    
d IT REIMBURSED EXPENSES 900099 2,219,912 2,219,912    
e RELATED PARTNERSHIP RE 900099 -30,930 -30,930    
f All other program service revenue. 12,000 12,000    
g Total. Add lines 2a–2f .....MediumBullet 83,011,917
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 507,751     507,751
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   15,593,514 6a
b Less: rental expenses   14,613,164 6b
c Rental income or (loss)   980,350 6c
d Net rental income or (loss).......MediumBullet 980,350   13,674 966,676
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   1,667,105,033 7a
b Less: cost or other basis and sales expenses 1,342 1,645,649,067 7b
c Gain or (loss) -1,342 21,455,966 7c
d Net gain or (loss).........MediumBullet 21,454,624     21,454,624
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a BILLING SERVICE 561000 1,692,926   43,973 1,648,953
b TRANSFER FEES 900009 1,057   1,057  
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,693,983
12 Total revenue. See instructions.....MediumBullet 107,648,625 82,761,301 309,320 24,578,004
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 33,173 33,173
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 5,822,747 5,822,747    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 246,464 246,464    
7 Other salaries and wages........ 30,417,698 15,240,891 15,176,807  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,996,287 1,000,246 996,041  
9 Other employee benefits ....... 4,204,862 2,032,552 2,172,310  
10 Payroll taxes ........... 2,344,226 1,104,307 1,239,919  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,151,094   1,151,094  
c Accounting ........... 587,251   587,251  
d Lobbying ........... 95,000   95,000  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 84,102   84,102  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 4,661,396 749,049 3,912,347  
12 Advertising and promotion .... 2,606,862 188,056 2,418,806  
13 Office expenses ....... 4,420,439 1,409,601 3,010,838  
14 Information technology ...... 14,611,522 11,272,360 3,339,162  
15 Royalties ..        
16 Occupancy ........... 2,931,937 2,636,311 295,626  
17 Travel ............ 136,557 51,942 84,615  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 15,810 2,350 13,460  
20 Interest ........... 1,023,605 1,023,605    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 11,220,774 10,324,054 896,720  
23 Insurance ... 394,013   394,013  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MINOR PROJECT COSTS 481,042 481,042    
b ACQUISITION FEES 129,642   129,642  
c RECRUITMENT 109,854 10,765 99,089  
d REPAIRS AND MAINTENANCE 85,232 84,261 971  
e All other expenses 23,882 3,299 20,583  
25 Total functional expenses. Add lines 1 through 24e 89,835,471 53,717,075 36,118,396 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1 0
2 Savings and temporary cash investments ......... 15,858,601 2 6,167,369
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 6,906,667 4 10,666,661
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7 2,296,794
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 8,644,852 9 7,299,651
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 386,113,326
b Less: accumulated depreciation 10b 187,914,020 195,516,131 10c 198,199,306
11 Investments—publicly traded securities . 9,987,329 11 72,619,518
12 Investments—other securities. See Part IV, line 11 ..... 778,991 12 613,977
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 253,480,275 15 217,375,041
16 Total assets. Add lines 1 through 15 (must equal line 33)... 491,172,846 16 515,238,317
Liabilities 17 Accounts payable and accrued expenses ..... 18,354,013 17 28,380,675
18 Grants payable ...   18  
19 Deferred revenue ......... 1,339,163 19 707,701
20 Tax-exempt bond liabilities ......... 261,820,998 20 203,459,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 47,155,291 23 61,420,185
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 37,720,676 25 92,444,916
26 Total liabilities. Add lines 17 through 25.. 366,390,141 26 386,412,477
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 124,782,705 27 128,825,840
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 124,782,705 32 128,825,840
33 Total liabilities and net assets/fund balances ........ 491,172,846 33 515,238,317
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
107,648,625
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
89,835,471
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
17,813,154
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
124,782,705
5
Net unrealized gains (losses) on investments ...............
5
-20,747,740
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,977,721
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
128,825,840
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................13
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) MEMORIAL MEDICAL CENTER
  		370661220 3   No 47,396,536 0
(B) PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
  		370661230 3   No 2,649,319 0
(C) ABRAHAM LINCOLN MEMORIAL HOSPITAL
  		370723793 3   No 1,525,074 0
(D) TAYLORVILLE MEMORIAL HOSPITAL
  		370661250 3   No 1,338,826 0
(E) DECATUR MEMORIAL HOSPITAL
  		370661199 3   No 0 0
(F) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
  		370646367 7   No 739,561 0
(G) SPRINGFIELD RESIDENTIAL SERVICES
  		371298589 7   No 0 0
(H) ABRAHAM LINCOLN HEALTHCARE FOUNDATION
  		363492268 7   No 0 0
(I) MEMORIAL MEDICAL CENTER FOUNDATION
  		371110301 7   No 0 0
(J) MEMORIAL HOME SERVICES
  		370714225 7   No 705,854 0
(K) DECATUR MEMORIAL HEALTH FOUNDATION
  		454256254 7   No 0 0
(L) MEMORIAL PHYSICIAN SERVICES
  		371181194 10   No 3,746,573 0
(M) MEMORIAL HEALTH VENTURES
  		363492266 10   No 5,360 0
Total
13
 58,107,103 0
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
No
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
No
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
No
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.
6
 
No
7
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) .
7
 
No
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
No
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
No
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
No
c
Did a disqualified person (as defined in line 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.
9c
 
No
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
 
No
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
No
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?
1
Yes
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
Yes
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
Yes
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
Yes
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
Yes
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
SECTION A, LINE 1 MEMORIAL HEALTH SYSTEM'S (37-1110690) SUPPORTED ORGANIZATIONS ARE NOT LISTED BY NAME IN MEMORIAL HEALTH SYSTEM'S GOVERNING DOCUMENTS. HOWEVER, MEMORIAL HEALTH SYSTEM IS LISTED IN THE SUPPORTED ORGANIZATIONS' GOVERNING DOCUMENTS AS THE SOLE CORPORATE MEMBER (PARENT) OF THE SUPPORTED ORGANIZATION (MEMORIAL MEDICAL CENTER, THE PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION, THE ABRAHAM LINCOLN MEMORIAL HOSPITAL, TAYLORVILLE MEMORIAL HOSPITAL, DECATUR MEMORIAL HOSPITAL, MENTAL HEALTH CENTERS OF ILLINOIS, ABRAHAM LINCOLN HEALTHCARE FOUNDATION, MEMORIAL HOME SERVICES, MEMORIAL PHYSICIAN SERVICES, MEMORIAL HEALTH VENTURES) OR IS THE SOLE CORPORATE MEMBER (PARENT) OF THE SOLE CORPORATE MEMBER (SUBSIDIARY) LISTED IN THE SUPPORTED ORGANIZATION'S GOVERNING DOCUMENTS (SPRINGFIELD RESIDENTIAL SERVICES, MEMORIAL MEDICAL CENTER FOUNDATION, DECATUR MEMORIAL HEALTH FOUNDATION). ALL SUPPORTED ORGANIZATIONS ARE CONSIDERED RELATED ORGANIZATIONS OF THE FILING ORGANIZATION AND ARE DISCLOSED ON SCHEDULE R, PART II. MEMORIAL HEALTH SYSTEM HAS SUPPORTED THESE RELATED ORGANIZATIONS SINCE EACH ORGANIZATION BECAME A RELATED ORGANIZATION IN FURTHERANCE OF MEMORIAL HEALTH SYSTEM'S TAX-EXEMPT MISSION, THUS DEMONSTRATING THE EXISTENCE OF A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN THE SUPPORTING ORGANIZATION AND ITS SUPPORTED ORGANIZATIONS. ALL SUPPORTED ORGANIZATIONS OF MEMORIAL HEALTH SYSTEM ARE DESIGNATED BY THE CLASS AND/OR PURPOSE, WHICH AS STATED IN MEMORIAL HEALTH SYSTEM'S GOVERNING DOCUMENTS IS DESCRIBED AS FOLLOWS: "TO ESTABLISH, ACQUIRE, SUPPORT, ERECT, MAINTAIN, OWN AND EQUIP HEALTH CARE PROVIDERS AND INSTITUTIONS, INCLUDING, WITHOUT LIMITING THE FOREGOING, HOSPITALS, NURSING HOMES, SKILLED NURSING FACILITIES, INTERMEDIATE CARE FACILITIES AND AMBULATORY CARE CENTERS; TO CONDUCT, SPONSOR, SUPPORT, PROMOTE, DEVELOP, OWN AND OPERATE CHARITABLE, EDUCATIONAL, SCIENTIFIC AND SCHOLASTIC PROGRAMS AND ACTIVITIES AND OTHER ACTIVITIES AND PROGRAMS ANCILLARY TO AND IN SUPPORT OF THE FOREGOING; TO FOSTER, PROMOTE, SUPPORT, DEVELOP, ENCOURAGE, MAINTAIN, RECEIVE AND ACCEPT FUNDS, GIFTS AND CONTRIBUTIONS FOR AND ON BEHALF OF SUCH ACTIVITIES; AND TO ESTABLISH, CONDUCT, SPONSOR, ACQUIRE, OWN, MAINTAIN AND OPERATE SUCH OTHER ENTITIES AND ACTIVITIES WHICH IN THE OPINION OF THE BOARD OF DIRECTORS AND AT ITS DISCRETION, WILL SUPPORT THE FOREGOING, EXCLUSIVELY FOR THE BENEFIT OF AN TO CARRY OUT SOME OR ALL OF THE PURPOSES OF ORGANIZATIONS DESCRIBED IN EITHER SECTION 509(A)(1) OR 509(A)(2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR ANY SUBSEQUENT LAW OF THE UNITED STATES. IN NO INSTANCES, HOWEVER, WILL THE CORPORATION ENGAGE IN THE PRACTICE OF MEDICINE."
SECTION A, LINE 5A (I) DECATUR MEMORIAL HOSPITAL (DMH)(EIN: 37-0661199) & DECATUR MEMORIAL HEALTH FOUNDATION (DMHF)(EIN: 37-1169605) (II) DMH & DMHF ACQUIRED ON 10/1/2019 AND ADDED AS A SUPPORTED ORGANIZATIONS (III) AUTHORITY AS REQUIRED BY MEMORIAL HEALTH SYSTEM'S GOVERNING DOCUMENTS (IV) ACQUISITION OF SUPPORTED ORGANIZATIONS THROUGH BOARD APPROVAL AND AMENDMENT TO GOVERNING DOCUMENTS
SECTION D, LINE 3 MHS EXISTS TO SUPPORT THE SUPPORTED ORGANIZATIONS AS AN ADMINISTRATIVE PARENT ORGANIZATION. EACH SUPPORTED ORGANIZATION POOLS ITS INVESTMENTS UNDER MHS INVESTMENT POLICY AND GOVERNANCE. THE ASSETS AND INCOME OF MHS ARE USED TO SUPPORT THE OPERATION AND ADMINISTRATION TO SUPPORT ALL SUPPORTED ORGANIZATIONS.
SECTION E, LINE 3A MHS IS THE PARENT AND SOLE CORPORATE MEMBER OF EACH OF ITS SUPPORTED ORGANIZATIONS. MHS CONTAINS 104 INDIVIDUAL MEMBER WHO ELECT THE BOARD OF DIRECTORS FOR EACH OF ITS SUPPORTED ORGANIZATIONS.
SECTION E, LINE 3B MEMORIAL HEALTH SYSTEM IS THE PARENT AND SOLE CORPORATE MEMBER OF EACH OF ITS SUPPORTED ORGANIZATIONS. IN ITS CAPACITY AS THE SOLE CORPORATE MEMBER, MEMORIAL HEALTH SYSTEM PROVIDES OVERALL DIRECTION, MANAGEMENT AND CONTROL OVER ITS SUPPORTED ORGANIZATIONS. MEMORIAL HEALTH SYSTEM ALSO HAS CERTAIN RESERVED POWERS. FOR EXAMPLE, ALL CAPITAL AND OPERATING BUDGETS MUST BE APPROVED BY MEMORIAL HEALTH SYSTEM.
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


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

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

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
MEMORIAL HEALTH SYSTEM
 
Employer identification number

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

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
95,000
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
95,000
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: MEMORIAL HEALTH SYSTEM ENGAGES LOBBYISTS TO ASSIST IT IN SECURING FEDERAL GRANTS AND MONITORING STATE REGULATIONS IN SUPPORT OF FURTHERING THE MEMORIAL HEALTH SYSTEM MISSION, WHICH IS "TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE". THIS INCLUDES ASSISTING MEMORIAL HEALTH SYSTEM IN DEVELOPING PRESENTATIONS TO THE ILLINOIS CONGRESSIONAL DELEGATION, REQUESTING APPROPRIATIONS FOR PRIORITY PROJECTS INVOLVING LOCAL PATIENT SAFETY, QUALITY IMPROVEMENT AND IMPROVED LOCAL ACCESS TO MEDICAL CARE. THE LOBBYISTS ALSO ASSIST MEMORIAL IN COMMUNICATING THE IMPORTANCE OF ADEQUATE MEDICAID FUNDING IN SUPPORT OF THE SUBSTANTIAL SERVICES MEMORIAL'S AFFILIATES PROVIDE TO THOSE IN POVERTY AND IN MONITORING LEGISLATIVE AND REGULATORY DEVELOPMENTS THAT WOULD AFFECT MEMORIAL HEALTH SYSTEM'S ABILITY TO CONTINUE DELIVERING ITS SUBSTANTIAL COMMUNITY BENEFIT.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 ..... 2,824,078 20,417,977 23,242,055
b Buildings .... 159,716,899 86,230,186 114,405,280 131,541,805
c Leasehold improvements        
d Equipment .... 4,560,037 84,457,334 71,108,452 17,908,919
e Other ..... 937,195 26,969,620 2,400,288 25,506,527
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 198,199,306
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)LIFE INSURANCE - VARIOUS AGREEMENTS 2,534,091
(2)INTERCOMPANY DEBT FROM RELATED ENTITIES 190,947,237
(3)DEFERRED TAX ASSET & VALUATION 51,861
(4)RIGHT OF USE ASSET 7,471,393
(5)PREPAID PENSION 10,325,010
(6)NONCURRENT INSURANCE RECOVERIES 6,045,449
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 217,375,041
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  
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 92,444,916
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) 2019

Schedule D (Form 990) 2019
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
PART X, LINE 2: EACH OF MEMORIAL HEALTH SYSTEM'S SUBSIDIARIES, EXCLUDING THOSE DESCRIBED IN THE FOLLOWING PARAGRAPH, IS A SEPARATELY INCORPORATED NOT-FOR-PROFIT CORPORATION AS DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE AND IS TAX-EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY DO, HOWEVER, OPERATE CERTAIN PROGRAMS THAT MAY RESULT IN UNRELATED BUSINESS INCOME. UPON REVIEW AS REQUIRED BY ASC 740, INCOME TAXES, NO TAX PROVISION WAS RECORDED FOR THE YEARS ENDED SEPTEMBER 30, 2020 OR 2019. MEMORIAL HEALTH SYSTEM IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2017. MHS QALICB, LLC (QALICB), MCDEKK, LLC (MCDEKK), AND MEMORIAL HEALTH PARTNERS (MHP) ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES AND ARE EXEMPT FROM INCOME TAX. MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS (MHSCI) IS A TAXABLE FOR-PROFIT CORPORATION, AND PASSAVANT PHYSICIAN ASSOCIATION (PPA) IS A TAXABLE NOT-FOR-PROFIT CORPORATION. BOTH ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES.
Schedule D (Form 990) 2019


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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
noncash assistance		 (h) Purpose of grant
or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
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) 2019

Schedule I (Form 990) 2019
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
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) EDUCATION GRANT 3 20,870      
(2) EDUCATION TUITION REIMBURSEMENT 6 12,303      
(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
PART I, LINE 2: MHS PROVIDES GRANTS PRIMARILY TO LOCALLY MANAGED 501(C)(3) ORGANIZATIONS THAT SUPPORT OR SHARE THE MISSION OF MHS. REQUESTS TO SUPPORT INITIATIVES IN LINE WITH MHS'S COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES RECEIVE SPECIAL CONSIDERATION. SENIOR LEADERSHIP MUST APPROVE ALL GRANTS. MHS EMPLOYEES ARE VOLUNTEER BOARD MEMBERS OR PARTICIPATE AS VOLUNTEERS FOR SOME OF THE ORGANIZATIONS THAT MHS ASSISTS. WHEN AN ORGANIZATION IS GIVEN A DONATION, IT EITHER AGREES TO RESTRICT THE DONATION TO THE PURPOSE FOR WHICH IT WAS REQUESTED OR IT RECEIVES A LETTER DIRECTING THAT DONATION MAY BE USED ONLY FOR THE APPROVED GRANT'S PURPOSE. ADDITIONALLY, EMPLOYEES FREQUENTLY ATTEND MANY OF THE SPONSORED EVENTS OR MHS RECEIVES ACKNOWLEDGEMENT FROM THE ORGANIZATION ABOUT THE PROGRAM THAT WAS SUPPORTED BY THE GRANT. MEMORIAL HEALTH SYSTEM'S EDUCATIONAL GRANT PROGRAM PROVIDES THE OPPORTUNITY FOR COLLEAGUES TO PURSUE ADDITIONAL EDUCATION IN EXCHANGE FOR A WORK COMMITMENT ONCE THE EDUCATION IS COMPLETED. EDUCATION GRANTS ARE AVAILABLE TO THOSE PURSUING HEALTH CARE CAREERS THAT ARE DEEMED CRITICAL TO THE ORGANIZATION'S PRESENT OR PROJECTED STAFFING NEEDS. GRANT APPLICATIONS FOR ALL OTHER CAREERS WILL BE REVIEWED ON A CASE-BY-CASE BASIS WITH A FINAL DETERMINATION TO BE MADE BY THE MHS WORKFORCE STRATEGIES ADVISORY COUNCIL. FUNDING FOR THE EDUCATION OF MEMORIAL HEALTH SYSTEM'S COLLEAGUES IS BASED UPON THE NEEDS OF THE ORGANIZATION AS WELL AS THE COLLEAGUE'S EDUCATIONAL GOALS. COLLEAGUES WILL BE AWARDED TUITION REIMBURSEMENT BASED ON THE COLLEAGUE'S PRESENT JOB SKILL NEEDS OR TO PREPARE THE COLLEAGUE FOR FUTURE ADVANCEMENT WITHIN MEMORIAL HEALTH SYSTEM. THE TUITION REIMBURSEMENT PROCESS REQUIRES COLLEAGUES TO RECEIVE PRIOR APPROVAL FROM THEIR MANAGERS FOR THE COURSEWORK.
Schedule I (Form 990) 2019



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1DOUGLAS RAHN DBA
FORMER KEY EMPLOYEE 		(i)

(ii)		 0
-------------
0 		0
-------------
0 		1,263,270
-------------
0 		0
-------------
0 		0
-------------
0 		1,263,270
-------------
0 		1,047,921
-------------
0
2EDGAR CURTIS EX-OFFICIO
PRESIDENT & CEO 		(i)

(ii)		 952,518
-------------
0 		431,182
-------------
0 		264,068
-------------
0 		27,650
-------------
0 		21,711
-------------
0 		1,697,129
-------------
0 		0
-------------
0
3CHARLES CALLAHAN PHD
PRESIDENT - MHS HOSPITAL GROUP 		(i)

(ii)		 0
-------------
514,252 		0
-------------
194,411 		0
-------------
120,870 		0
-------------
188,840 		0
-------------
32,590 		0
-------------
1,050,963 		0
-------------
43,418
4DAVID GRAHAM MD
SVP & CHIEF QUALITY&INNOVATN OFFCR 		(i)

(ii)		 446,208
-------------
0 		162,444
-------------
0 		70,263
-------------
0 		170,378
-------------
0 		18,829
-------------
0 		868,122
-------------
0 		51,095
-------------
0
5ANNA EVANS JD
SVP & GENERAL COUNSEL 		(i)

(ii)		 384,820
-------------
0 		141,913
-------------
0 		45,811
-------------
0 		128,754
-------------
0 		32,353
-------------
0 		733,651
-------------
0 		31,394
-------------
0
6ROBERT KAY
FORMER OFFICER 		(i)

(ii)		 399,870
-------------
0 		184,283
-------------
0 		102,871
-------------
0 		24,900
-------------
0 		18,109
-------------
0 		730,033
-------------
0 		0
-------------
0
7RAJESH GOVINDAIAH MD
SVP & CHIEF MEDICAL OFFICER 		(i)

(ii)		 477,234
-------------
0 		119,972
-------------
0 		34,866
-------------
0 		87,299
-------------
0 		6,601
-------------
0 		725,972
-------------
0 		0
-------------
0
8KATHRYN KEIM
SVP & CFO 		(i)

(ii)		 443,391
-------------
0 		162,807
-------------
0 		10,707
-------------
0 		74,674
-------------
0 		31,935
-------------
0 		723,514
-------------
0 		0
-------------
0
9KEVIN ENGLAND
SVP & CHIEF ADMINISTRATIVE OFFICER 		(i)

(ii)		 313,249
-------------
0 		152,475
-------------
0 		22,666
-------------
0 		176,300
-------------
0 		34,294
-------------
0 		698,984
-------------
0 		0
-------------
0
10AIMEE DAILY PHD
SVP & CHIEF TRANSFORMATION OFFICER 		(i)

(ii)		 0
-------------
337,310 		0
-------------
134,536 		0
-------------
58,971 		0
-------------
65,319 		0
-------------
20,415 		0
-------------
616,551 		0
-------------
24,887
11ROBERT SCOTT
SVP & CHIEF HR OFFICER 		(i)

(ii)		 331,450
-------------
0 		120,614
-------------
0 		56,945
-------------
0 		58,468
-------------
0 		27,141
-------------
0 		594,618
-------------
0 		22,519
-------------
0
12MARSHA PRATER PHD
SVP & CHIEF NURSING OFFICER 		(i)

(ii)		 0
-------------
334,354 		0
-------------
121,199 		0
-------------
64,873 		0
-------------
25,710 		0
-------------
10,657 		0
-------------
556,793 		0
-------------
0
13JAMESON ROSZHART
PRESIDENT - MHS AMBULATORY GROUP 		(i)

(ii)		 320,570
-------------
0 		129,155
-------------
0 		10,353
-------------
0 		60,107
-------------
0 		30,395
-------------
0 		550,580
-------------
0 		0
-------------
0
14J TRAVIS DOWELL
PRESIDENT & CEO MPS 		(i)

(ii)		 247,557
-------------
0 		65,512
-------------
0 		96,108
-------------
0 		56,009
-------------
0 		41,897
-------------
0 		507,083
-------------
0 		22,354
-------------
0
15DOLAN DALPOAS
PRESIDENT & CEO ALMH 		(i)

(ii)		 289,946
-------------
0 		74,302
-------------
0 		55,481
-------------
0 		58,264
-------------
0 		419
-------------
0 		478,412
-------------
0 		22,995
-------------
0
16KIMBERLY BOURNE
PRESIDENT & CEO TMH 		(i)

(ii)		 263,657
-------------
0 		68,747
-------------
0 		23,277
-------------
0 		55,333
-------------
0 		26,953
-------------
0 		437,967
-------------
0 		1,706
-------------
0
17W SCOTT BOSTON MD
PRESIDENT & CEO PAH 		(i)

(ii)		 196,817
-------------
0 		96,098
-------------
0 		8,528
-------------
0 		31,150
-------------
0 		16,306
-------------
0 		348,899
-------------
0 		0
-------------
0
18JERRY MILLER
VP, INFORMATION SERVICES 		(i)

(ii)		 199,993
-------------
0 		57,658
-------------
0 		9,845
-------------
0 		30,316
-------------
0 		26,299
-------------
0 		324,111
-------------
0 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A CHARTER TRAVEL IS OCCASIONALLY PROVIDED FOR EXECUTIVES/KEY EMPLOYEES ATTENDING OFF-SITE BUSINESS RELATED MEETINGS, SO AS TO MINIMIZE TRAVEL TIME AND ENABLE THEM TO WORK EFFICIENTLY AND SECURELY ON CONFIDENTIAL ORGANIZATION BUSINESS MATTERS. CHARTER TRAVEL IS NOT TAXABLE INCOME TO THE INDIVIDUAL BECAUSE IT IS STRICTLY RELATED TO BUSINESS TRAVEL.
PART I, LINE 3 THE REPORTED COMPENSATION AND BENEFITS RECEIVED BY EDGAR CURTIS, PRESIDENT AND CEO OF MEMORIAL HEALTH SYSTEM, FOR CALENDAR YEAR 2019 (BEFORE THE COVID-19 PANDEMIC), WAS COMPRISED OF THE FOLLOWING COMPONENTS: BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER COMPENSATION, RETIREMENT/DEFERRED COMPENSATION AND OTHER NONTAXABLE BENEFITS. BASE COMPENSATION FOR MR. CURTIS WAS DETERMINED BASED ON THE METHODS DESCRIBED IN PART I, LINE 3 CONDUCTED BY INDEPENDENT COMPENSATION CONSULTANTS. BASE COMPENSATION LEVELS WERE SET BY THE LEADERSHIP COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE MHS BOARD CONSISTING ENTIRELY OF MHS BOARD MEMBERS WHO ARE INDEPENDENT AND WHO ARE FREE OF ANY CONFLICTS OF INTEREST. BASE COMPENSATION IS SET AT OR AROUND THE MIDDLE OF THE MARKET BASE SALARY DATA FOR HEALTHCARE ORGANIZATIONS SIMILAR TO MHS, AS MEASURED AND PRESENTED TO THE COMMITTEE BY THE INDEPENDENT COMPENSATION CONSULTANT. INCENTIVE COMPENSATION WAS CONTINGENT ON THE ACHIEVEMENT OF SPECIFIC, RIGOROUS PERFORMANCE MEASURES ACROSS ALL OF MHS, AND THOSE PERFORMANCE MEASURES WERE REVIEWED AND APPROVED IN ADVANCE BY THE LEADERSHIP COMPENSATION COMMITTEE. RETIREMENT BENEFITS IN COLUMN (B)(III) IS COMPRISED PRIMARILY OF THE DISTRIBUTION OF VESTED AMOUNTS OF $216,334 THAT WERE PREVIOUSLY DEPOSITED IN A DEFERRED COMPENSATION PLAN, BUT ARE NOW DISTRIBUTED DIRECTLY BECAUSE MR. CURTIS IS FULLY VESTED.
PART I, LINE 4B CERTAIN LISTED INDIVIDUALS PARTICIPATE IN NONQUALIFIED DEFERRED COMPENSATION PLANS MAINTAINED BY MEMORIAL HEALTH SYSTEM (MHS). MHS CREDITS ANNUAL CONTRIBUTION AMOUNTS TO THESE PLANS, AND THESE AMOUNTS SERVE TO PROVIDE SUPPLEMENTAL RETIREMENT INCOME TO THESE INDIVIDUALS. ALL CREDITED AMOUNTS ARE REVIEWED AND APPROVED BY A COMMITTEE OF THE MHS BOARD AS PART OF REASONABLE TOTAL COMPENSATION. ALL AMOUNTS CREDITED ARE UNVESTED WHILE THE EXECUTIVE IS REQUIRED TO PROVIDE SUBSTANTIAL FUTURE SERVICES, AND THEN ARE TAXED IN FULL WHEN THE SERVICE PERIOD IS COMPLETED AND THE AMOUNTS BECOME VESTED. ALL AMOUNTS CREDITED TO THESE EXECUTIVES UNDER THESE PLANS ARE INCLUDED IN COLUMN (C) AS UNVESTED, NONTAXABLE DEFERRED COMPENSATION WHEN FIRST CREDITED, AND THEN ARE AGAIN INCLUDED IN COLUMN (B)(III) WHEN THE AMOUNTS BECOME VESTED AND ARE SUBJECT TO TAX. THE AMOUNTS INCLUDED IN COLUMN (F) FOR CERTAIN INDIVIDUALS REPRESENT AMOUNTS THAT WERE REPORTED ON PRIOR FORM 990S FOR PRIOR YEARS, AND SHOULD BE SUBTRACTED FROM THE TOTAL COMPENSATION IN COLUMN (E) TO RESULT IN A MORE ACCURATE TOTAL COMPENSATION FOR CALENDAR YEAR 2019. THE FOLLOWING CURRENT OR FORMER OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES RECEIVED DEFERRED COMPENSATION PAYOUTS IN THE CALENDAR YEAR FROM MHS OR A RELATED ORGANIZATION, MEMORIAL MEDICAL CENTER: KIMBERLY BOURNE $2,230, CHARLES CALLAHAN, PH.D. $49,491, EDGAR CURTIS $216,334, AIMEE DAILY, PH.D. $28,299, DOLAN DALPOAS $29,972, J. TRAVIS DOWELL $24,769, ANNA EVANS, J.D. $39,220, DAVID GRAHAM, M.D. $58,332, ROBERT KAY $54,234, MARSHA PRATER, PH.D. $47,491, DOUGLAS RAHN, D.B.A. $1,263,270, AND ROBERT SCOTT $26,432. TO BECOME ENTITLED TO THE BENEFITS PROVIDED, EACH COVERED EMPLOYEE MUST MEET SUBSTANTIAL REQUIREMENTS RELATING TO FURTHER EMPLOYMENT. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EMPLOYEE IS NOT ENTITLED TO THESE AMOUNTS. IF THE EMPLOYEE WERE TO HAVE TERMINATED EMPLOYMENT VOLUNTARILY IN THE YEAR TO WHICH THIS RETURN APPLIES AND NOT MET THESE SUBSTANTIAL REQUIREMENTS, THESE SUPPLEMENTAL RETIREMENT BENEFITS WOULD HAVE BEEN FORFEITED. THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ACCORDINGLY, ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE. THE LEADERSHIP COMPENSATION COMMITTEE OF THE MHS BOARD APPROVES ALL RETIREMENT BENEFITS, TOGETHER WITH ALL OTHER FORMS OF COMPENSATION AND BENEFITS FOR THESE AND OTHER SYSTEM LEADERS, IN A MANNER INTENDED TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER FEDERAL INCOME TAX LAW.
Schedule J (Form 990) 2019

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number
37-1110690
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A ILLINOIS FINANCE AUTHORITY
  		86-1091967 45203HYQ9 01-30-2014 60,465,495 SEE PART VI X     X   X
B ILLINOIS FINANCE AUTHORITY
  		86-1091967 45204EU22 02-05-2019 148,436,538 SEE PART VI   X   X   X
C ILLINOIS FINANCE AUTHORITY
  		86-1091967   09-11-2020 55,510,000 SEE PART VI   X   X   X
D ILLINOIS FINANCE AUTHORITY
  		86-1091967   11-30-2015 22,778,000 SEE PART VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 55,945,000 3,700,000   5,189,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 60,465,495 148,436,538 55,510,000 22,778,000
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............     54,930,000  
7 Issuance costs from proceeds ...............     580,000 270,707
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 60,465,495 42,654,388    
11 Other spent proceeds .............   105,782,150   22,432,282
12 Other unspent proceeds .............       75,011
13 Year of substantial completion ............. 2015 2019 2020 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........ 		  X X   X   X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........ 		  X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X X     X X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part Ⅲ
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X X     X X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?     X       X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X X     X X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?     X       X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet   0.060 %   2.240 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet   1.000 %   0 %
6 Total of lines 4 and 5 .............   1.060 %   2.240 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X   X  
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X X   X   X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X     X   X   X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 01/30/2019
PART I, COLUMN (F) CONTINUATIONS THE PURPOSE OF THE 2014A ISSUE WAS (A) TO REPAY TAXABLE DEBT IN THE AMOUNT OF $25,057,493 USED FOR PAYMENT OF THE COST OF ACQUIRING, CONSTRUCTING, RENOVATING, REMODELING AND EQUIPPING HEALTH FACILITIES AT MEMORIAL MEDICAL CENTER, AND (B) FOR PAYING ADDITIONAL COSTS OF THOSE PROJECTS NOT PREVIOUSLY FINANCED WITH THE TAXABLE DEBT. THE 2014A SERIES WAS PARTIALLY REFUNDED BY THE TAXABLE 2020A ISSUE. AS OF SEPTEMBER 30, 2020, $4,055,000 OF THE 2014A SERIES REMAINED OUTSTANDING. THE PURPOSE OF THE 2015 ISSUE WAS TO CURRENT REFUND $22,432,282 OF THE CITY OF JACKSONVILLE ILLINOIS ADJUSTABLE RATE DEMAND INDUSTRIAL REVENUE IMPROVEMENT BONDS, SERIES 2006B. THE PROCEEDS WERE ALSO USED TO PAY ISSUANCE EXPENSES OF THE BOND ISSUANCE. THE PURPOSE OF THE 2019 ISSUE WAS TO REFINANCE THE 2009 SERIES AND UPGRADE THE SPRINGFIELD CAMPUS'S EMERGENCY POWER SYSTEM; UPGRADE MEMORIAL HEALTH SYSTEMS REVENUE CYCLE SOFTWARE; RENOVATE AND EQUIP MEMORIAL MEDICAL CENTER'S OR, ICU AND SEVERAL OTHER AREAS IN MEMORIAL MEDICAL CENTER, AND ROUTINE CAPITAL EXPENDITURES. THE PURPOSE OF THE TAX-EXEMPT 2020 ISSUE WAS TO FULLY REFINANCE THE 2014B SERIES ($55,510,000) AND PAY ASSOCIATED ISSUANCE COSTS.
PART II, LINE 3 TOTAL PROCEEDS ISSUED AMOUNT IN COLUMNS A & B DOESN'T TIE TO PART I COLUMN (E) DUE TO INVESTMENT EARNINGS INCLUDED IN PART II, LINE 3.
PART II, LINE 11 COLUMN B: $105,782,150 OF THE 2019 ISSUE WAS USED TO REFINANCE THE 2009 SERIES. COLUMN D: $22,432,282 OF THE 2015 ISSUE WAS USED TO REFUND THE 2006B SERIES.
PART III, LINE 3B & 3D MEMORIAL HEALTH SYSTEM'S INTERNAL COUNSEL, AS WELL AS EXTERNAL BOND COUNSEL, ROUTINELY REVIEWS MANAGEMENT AND SERVICE CONTRACTS AND RESEARCH AGREEMENTS RELATING TO FINANCED PROPERTY.
PART IV, LINE 1 THE ARBITRAGE REBATE FILING IS ONLY REQUIRED EVERY 5 YEARS, AND NO REBATABLE ARBITRAGE HAS BEEN EARNED FOR ISSUES AT SUCH 5 YEAR ANNIVERSARIES.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) HENRY HURWITZ SEE PART V 246,464 SEE PART V   No
(2) TROXELL
  		SEE PART V 216,972 SEE PART V   No
(3) LEVI RAY AND SHOUP
  		SEE PART V 207,970 SEE PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
(A) NAME OF PERSON: HENRY HURWITZ (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: EMPLOYEE; SON OF JOSEPH HURWITZ, MHS BOARD MEMBER(C) AMOUNT OF TRANSACTIONS: $246,464(D) DESCRIPTION OF TRANSACTION: MEMORIAL HEALTH SYSTEM PAID COMPENSATION AND BENEFITS OF $246,464 TO HENRY HURWITZ RELATED TO EMPLOYMENT SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2020. HENRY HURWITZ IS THE SON OF JOSEPH HURWITZ, MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS. THE COMPENSATION PAID WAS NEGOTIATED AT ARM'S LENGTH AND REPRESENTS FAIR MARKET VALUE FOR THE SERVICES PROVIDED.(E) SHARING OF ORGANIZATION REVENUES: NO
(A) NAME OF PERSON: TROXELL (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER IS THE PRESIDENT OF TROXELL(C) AMOUNT OF TRANSACTIONS: $216,972(D) DESCRIPTION OF TRANSACTION: MEMORIAL HEALTH SYSTEM PAID FEES TO TROXELL FOR SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2020. MICHAEL AIELLO IS A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS AND IS PRESIDENT OF TROXELL. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. (E) SHARING OF ORGANIZATION REVENUES: NO
(A) NAME OF PERSON: LEVI, RAY AND SHOUP (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER IS PRESIDENT OF LEVI, RAY AND SHOUP(C) AMOUNT OF TRANSACTIONS: $207,970(D) DESCRIPTION OF TRANSACTION: MEMORIAL HEALTH SYSTEM PAID FEES TO LEVI, RAY AND SHOUP FOR SERVICES FOR THE YEAR ENDED SEPTEMBER 30, 2020. RICHARD LEVI IS A MEMBER OF MEMORIAL HEALTH SYSTEM'S BOARD OF DIRECTORS AND IS PRESIDENT OF LEVI, RAY AND SHOUP. ALL FEES ARE NEGOTIATED AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED.(E) SHARING OF ORGANIZATION REVENUES: NO
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

37-1110690
Return Reference Explanation
FORM 990, PART III, LINE 4C CONT. THIS SYSTEM ALSO GUIDED THE DEVELOPMENT OF MULTIPLE COVID-19 TESTING PROCEDURES AND EVENTUALLY MASS-VACCINATION CLINICS ACROSS CENTRAL ILLINOIS AS THE BEST MEANS TO MOVE FROM A STATE OF PANDEMIC TO MANAGEABLE ENDEMIC. DURING FY2020, MEMORIAL HEALTH SYSTEM'S FIVE HOSPITALS COMPLETED THE SECOND YEAR OF THEIR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION STRATEGIES TO ADDRESS PRIORITIES IDENTIFIED IN EACH HOSPITAL'S 2018 NEEDS ASSESSMENTS. PRIORITIES IDENTIFIED ARE: MEMORIAL MEDICAL CENTER/SANGAMON COUNTY: ACCESS TO CARE, MENTAL HEALTH, SUBSTANCE ABUSE AND MOTHER/INFANT HEALTH; PASSAVANT AREA HOSPITAL/MORGAN COUNTY: ACCESS TO CARE, MENTAL HEALTH; TAYLORVILLE MEMORIAL HOSPITAL/CHRISTIAN COUNTY: MENTAL HEALTH AND SUBSTANCE ABUSE; AND ABRAHAM LINCOLN MEMORIAL HOSPITAL/LOGAN COUNTY: OBESITY, MENTAL HEALTH, SUBSTANCE ABUSE AND CANCER. DECATUR MEMORIAL HOSPITAL/MACON COUNTY: ACCESS TO CARE, SUBSTANCE USE, AND MENTAL HEALTH. THE SELECTED IMPLEMENTATION STRATEGIES SEEK TO BUILD COLLABORATIONS BETWEEN COUNTY HEALTH DEPARTMENTS, OTHER LOCAL HOSPITALS AND DIRECT-SERVICE ORGANIZATIONS TO MEET THE NEEDS OF OUR COMMUNITIES. SENIOR LEADERSHIP AT EACH HOSPITAL, AND FOR THE HEALTH SYSTEM, INCLUDING THE MHS BOARD'S COMMUNITY BENEFIT COMMITTEE, HELP OVERSEE THE COMMUNITY BENEFIT PROGRAMS. TO FURTHER IMPROVE MEMORIAL HEALTH SYSTEM'S ABILITY TO PROVIDE PATIENT-CENTERED CARE, AN AMBULATORY ORGANIZATIONAL STRUCTURE WAS DEVELOPED IN FY2019 TO ENSURE STRATEGIC ALIGNMENT FOR PROVIDING CARE OUTSIDE OF AN ACUTE CARE SETTING. THIS STRUCTURE PUSHES COORDINATION OF CARE BETWEEN OUR MENTAL HEALTH, HOME SERVICES, HOSPICE, PRIMARY CARE, DURABLE MEDICAL EQUIPMENT, EXPRESSCARE CLINICS, MEMORIAL WEIGHT LOSS AND WELLNESS AND POPULATION HEALTH AFFILIATES. THE STRATEGIC FRAMEWORK ALLOWED MEMORIAL HEALTH SYSTEM TO BE A COMMUNITY LEADER IN RESPONDING TO THE COVID-19 PANDEMIC INCLUDING INITIATIVES SUCH AS DRIVE-UP LABS, RESPIRATORY CLINICS, TESTING CLINICS, AND THE EXPANSION OF TELEHEALTH PLATFORMS TO ALLOW INDIVIDUALS TO ACCESS CARE REMOTELY. OTHER KEY SUCCESSES THIS YEAR DIRECTLY RELATED TO STRONG LEADERSHIP INCLUDE RETENTION OF THE MHS BOND RATING FROM MOODY'S INVESTOR SERVICES OF A1 WITH A STABLE OUTLOOK AND AA- WITH STABLE OUTLOOK FROM S&P. AS A RESULT OF THE COVID-19 PANDEMIC, MHS DID NOT COMPLETE AN EMPLOYEE ENGAGEMENT SURVEY IN FY2020; HOWEVER, A SURVEY WILL BE CONDUCTED IN FY2021. OVERALL PATIENT EXPERIENCE WAS IMPACTED BY THE COVID-19 PANDEMIC AS WELL, WITH IMPACTS ON VISITOR AND PATIENT ACCESS, OPERATIONAL RESTRICTIONS, STAFF REALLOCATIONS AND SOME SERVICE SUSPENSIONS. NONETHELESS, EFFORTS TO MITIGATE ISSUES TO ENHANCE THE OVERALL CUSTOMER EXPERIENCE WERE IMPLEMENTED TO IMPROVE THIS IMPORTANT AREA. IN FY2020, A TOTAL OF 7 OF OUR 30 PATIENT SATISFACTION SURVEYS ACROSS THE HEALTH SYSTEM SCORED AT OR ABOVE THE 75TH PERCENTILE OF THEIR RESPECTIVE NATIONAL PEER GROUPS.
FORM 990, PART IV, LINE 24A ONE SCHEDULE K WAS COMPLETED AT THE PARENT (MEMORIAL HEALTH SYSTEM) LEVEL ONLY. MEMORIAL HEALTH SYSTEM IS SHOWING THE ENTIRE LIABILITY ON THE BALANCE SHEET WITH AN INTERCOMPANY DEBT FROM RELATED ENTITIES, AS CAN BE SEEN ON SCHEDULE D.
FORM 990, PART V, LINE 2A THE NUMBER OF EMPLOYEES REPORTED ON THE W-3 IS FOR ALL MEMORIAL HEALTH SYSTEM AFFILIATES. MEMORIAL HEALTH SYSTEM IS A COMMON PAY AGENT FOR ALL THE AFFILIATES AND REPORTS ALL EMPLOYEES UNDER ITS EIN.
FORM 990, PART VI, SECTION A, LINE 2 MIKE AIELLO, ED CURTIS AND NINA HARRIS HAVE A BUSINESS RELATIONSHIP. TODD WISE AND DIANE RUTLEDGE HAVE A BUSINESS RELATIONSHIP. ED CURTIS AND JERRY KRUSE HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION CONTAINS 104 INDIVIDUAL MEMBERS WHO ELECT THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A THE INDIVIDUAL MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT THE CORPORATION'S BOARD OF DIRECTORS, AS WELL AS THE POWER AND AUTHORITY TO REMOVE MEMBER ELECTED DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE MHS FORM 990 AND ALL ATTACHMENTS IS PROVIDED TO ALL OF THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS AND A BOARD COMMITTEE PRIOR TO FILING. ALL QUESTIONS AND COMMENTS ARISING FROM THESE REVIEWS ARE ADDRESSED PRIOR TO SUBMISSION OF THE RETURN TO THE APPROPRIATE TAXING AUTHORITIES.
FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE CORPORATION ARE REQUIRED TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A SPECIFIC DISCLOSURE STATEMENT WHICH IS ATTACHED TO THE POLICY. MEMORIAL HEALTH SYSTEM MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY IDENTIFYING ANY POTENTIAL CONFLICTS AT THE TIME EACH MEETING AGENDA IS PREPARED. ANY OFFICER OR DIRECTOR WHO HAS A CONFLICT IS NOTIFIED OF SUCH CONFLICT, AS WELL AS THEIR OBLIGATION TO ABSTAIN FROM THE DISCUSSION AND VOTE ON ANY CONFLICTED ISSUES(S). SUCH ABSTENTION(S), IF REQUIRED, ARE DOCUMENTED IN THE MINUTES OF EACH MEETING. BOARD MEMBERS ARE ALSO REQUIRED TO UPDATE THEIR CONFLICT OF INTEREST DISCLOSURE STATEMENTS PROMPTLY IN THE EVENT OF ANY CHANGE IN PERSONAL OR BUSINESS ACTIVITIES THAT WOULD REQUIRE SUCH DISCLOSURE.
FORM 990, PART VI, SECTION B, LINE 15 THE MEMORIAL HEALTH SYSTEM BOARD OF DIRECTORS HAS APPOINTED A LEADERSHIP COMPENSATION COMMITTEE MADE UP OF PAST AND PRESENT INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, AND HAS DELEGATED TO IT THE RESPONSIBILITY OF ADMINISTERING, OVERSEEING AND APPROVING ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE LEADERSHIP, INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER AND OTHER SENIOR VICE PRESIDENTS, WHO ARE KEY EMPLOYEES. THE BOARD HAS ADOPTED A LEADERSHIP COMPENSATION PHILOSOPHY STATEMENT DESCRIBING THE ROLE AND RESPONSIBILITIES OF THE COMMITTEE. THIS PHILOSOPHY EXPRESSLY STATES THE COMMITTEE'S INTENT, ON BEHALF OF THE CORPORATION, TO TAKE ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES. THE COMMITTEE ANALYZES EVERY ELEMENT OF COMPENSATION (INCLUDING CURRENT, INCENTIVE AND DEFERRED COMPENSATION) AND BENEFITS (INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS). THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION FOR EACH EXECUTIVE. IN CONNECTION WITH THE MOST RECENT REVIEW AND APPROVAL PROCESS, THE COMMITTEE RECEIVED PROFESSIONAL ADVICE FROM AN INDEPENDENT CONSULTANT AND OUTSIDE LEGAL COUNSEL. THE COMMITTEE CONSISTS ENTIRELY OF PAST AND PRESENT DISINTEREST MEMBERS OF THE BOARD OR DISINTERESTED COMMITTEE MEMBERS WHO UNDER STATE CORPORATE LAW MAY SERVE ON SUCH A COMMITTEE. THE COMMITTEE WORKS WITH ITS COMPENSATION CONSULTANT TO PREPARE AND REVIEW IN ADVANCE COMPREHENSIVE DATA SHOWING THE COMPENSATION PROVIDED BY SIMILARLY SITUATE ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. THE COMMITTEE ALSO PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES.
FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF MEMORIAL HEALTH SYSTEM, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D).
FORM 990, PART VII COMPENSATION REPORTED FOR CERTAIN INDIVIDUALS ARE BASED ON THE EMPLOYER WHO ISSUED PAYMENT. HOURS ARE REPORTED TO REFLECT AVERAGE HOURS IN THEIR OPERATIONAL ROLE.
FORM 990, PART XI, LINE 9: NONOPERATING RECONCILING ITEMS -2,633,161. CHANGE IN UNRESTRICTED NET ASSETS 9,413,760. INCOME STATEMENT BOOK/TAX DIFF 197,122.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
MEMORIAL HEALTH SYSTEM
 
Employer identification number

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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) MEMORIAL HEALTH PARTNERS LLC
701 NORTH 1ST STREET
SPRINGFIELD,IL62781
46-3947269 		TO COORDINATE PATIENT CARE ACTIVITIES ACROSS THE HEALTHCARE CONTINUUM IL 2,824,525 5,576,653 MEMORIAL HEALTH SYSTEM
 
(2) MHS QALICB LLC
701 NORTH 1ST STREET
SPRINGFIELD,IL62781
47-5644450 		TO FACILITATE NEW MARKETS TAX CREDITS TRANSACTIONS RELATED TO SIU IL 2,046,500 16,446,722 MEMORIAL HEALTH SYSTEM
 
(3) MCDEKK LLC
701 NORTH 1ST STREET
SPRINGFIELD,IL62781
82-2701739 		TO FACILITATE FACTORING OF RECEIVABLES IL 0 10,000 MEMORIAL HEALTH SYSTEM
 






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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


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

 		(f)
Direct controlling
entity

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

SPRINGFIELD,IL627810001
37-0661220 		HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH SYSTEM
 
Yes
 
(2)PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
1600 WEST WALNUT STREET

JACKSONVILLE,IL62650
37-0661230 		HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH SYSTEM
 
Yes
 
(3)ABRAHAM LINCOLN MEMORIAL HOSPITAL
200 STAHLHUT DR

LINCOLN,IL62656
37-0723793 		HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH SYSTEM
 
Yes
 
(4)TAYLORVILLE MEMORIAL HOSPITAL
201 EAST PLEASANT

TAYLORVILLE,IL62568
37-0661250 		HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH SYSTEM
 
Yes
 
(5)DECATUR MEMORIAL HOSPITAL
2300 N EDWARD

DECATUR,IL62526
37-0661199 		HOSPITAL SERVICES IL 501(C)(3) LINE 3 MEMORIAL HEALTH SYSTEM
 
Yes
 
(6)ABRAHAM LINCOLN HEALTHCARE FOUNDATION
200 STAHLHUT DR

LINCOLN,IL62656
36-3492268 		GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) LINE 7 MEMORIAL HEALTH SYSTEM
 
Yes
 
(7)MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
710 NORTH EIGHTH STREET

SPRINGFIELD,IL62702
37-0646367 		TRAINING, PSYCHIATRIC, AND RESIDENT SERVICES FOR MENTALLY ILL AND DISABLED IL 501(C)(3) LINE 7 MEMORIAL HEALTH SYSTEM
 
Yes
 
(8)SPRINGFIELD RESIDENTIAL SERVICES
710 NORTH EIGHTH STREET

SPRINGFIELD,IL62702
37-1298589 		RESIDENTIAL HUD HOUSING PROJECT FOR MENTALLY ILL IL 501(C)(3) LINE 7 MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
 
 
No
(9)MEMORIAL HOME SERVICES
720 NORTH BOND

SPRINGFIELD,IL627024915
37-0714225 		HOME HEALTH AND HOSPICE IL 501(C)(3) LINE 7 MEMORIAL HEALTH SYSTEM
 
Yes
 
(10)MEMORIAL MEDICAL CENTER FOUNDATION
701 N FIRST STREET

SPRINGFIELD,IL62781
37-1110301 		GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) LINE 7 MEMORIAL MEDICAL CENTER
 
 
No
(11)TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION INC
201 EAST PLEASANT

TAYLORVILLE,IL62568
37-1337485 		GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALS IL 501(C)(3) LINE 7 TAYLORVILLE MEMORIAL HOSPITAL
 
 
No
(12)PASSAVANT AREA HOSPITAL FOUNDATION
1600 WEST WALNUT STREET

JACKSONVILLE,IL62650
46-1037396 		SUPPORTING THE HOSPITAL IL 501(C)(3) LINE 7 PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
 
 
No
(13)MEMORIAL PHYSICIAN SERVICES
701 NORTH FIRST ST

SPRINGFIELD,IL627810001
37-1181194 		HEALTH CLINICS IL 501(C)(3) LINE 10 MEMORIAL HEALTH SYSTEM
 
Yes
 
(14)MEMORIAL HEALTH VENTURES
701 NORTH FIRST ST

SPRINGFIELD,IL627810001
36-3492266 		HEALTHCARE ACTIVITIES IL 501(C)(3) LINE 10 MEMORIAL HEALTH SYSTEM
 
Yes
 
(15)JACKSONVILLE CRNA'S INC
1600 WEST WALNUT STREET

JACKSONVILLE,IL62650
27-3083265 		CRNA SERVICES IL 501(C)(3) LINE 10 PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
 
 
No
(16)DECATUR MEMORIAL HEALTH FOUNDATION
2300 N EDWARD

DECATUR,IL62526
45-4256254 		GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPS IL 501(C)(3) LINE 12A, I DECATUR MEMORIAL HOSPITAL
 
 
No
(17)HEARTLAND RISK MANAGEMENT
2300 N EDWARD

DECATUR,IL62526
45-4256254 		SUPPORTING THE HOSPITAL AZ 501(C)(3) LINE 12A, I DECATUR MEMORIAL HOSPITAL
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No












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

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

1600 WEST WALNUT
JACKSONVILLE,IL62650
26-1200566 		PHYSICIAN SERVICES IL N/A
 C       Yes  










Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) DECATUR MEMORIAL HOSPITAL

 A 66,307 FMV
(2) MEMORIAL MEDICAL CENTER

 A 3,225,186 FMV
(3) MEMORIAL PHYSICIAN SERVICES

 A 3,184,803 FMV
(4) MEMORIAL PHYSICIAN SERVICES

 B 28,961,308 FMV
(5) PASSAVANT MEMORIAL AREA HOSPTIAL ASSOCIATION

 B 9,806,270 FMV
(6) DECATUR MEMORIAL HOSPITAL

 B 21,596,916 FMV
(7) MEMORIAL HOME SERVICES

 B 138,982 FMV
(8) TAYLORVILLE MEMORIAL HOSPTIAL

 B 162,265 FMV
(9) MEMORIAL MEDICAL CENTER

 C 205,407,003 FMV
(10) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 C 1,761,642 FMV
(11) MEMORIAL MEDICAL CENTER

 K 182,496 FMV
(12) MEMORIAL MEDICAL CENTER

 L 54,474,023 FMV
(13) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 L 1,525,074 FMV
(14) TAYLORVILLE MEMORIAL HOSPTIAL

 L 1,338,826 FMV
(15) MEMORIAL PHYSICIAN SERVICES

 L 5,000,309 FMV
(16) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 L 760,967 FMV
(17) MEMORIAL HOME SERVICES

 L 455,238 FMV
(18) MEMORIAL MEDICAL CENTER

 M 2,164,271 FMV
(19) PASSAVANT MEMORIAL AREA HOSPTIAL ASSOCIATION

 L 2,616,132 FMV
(20) MEMORIAL PHYSICIAN SERVICES

 N 2,227,540 FMV
(21) MEMORIAL MEDICAL CENTER

 N 735,753 FMV
(22) MEMORIAL MEDICAL CENTER

 O 104,085,644 FMV
(23) MEMORIAL PHYSICIAN SERVICES

 O 19,657,806 FMV
(24) MEMORIAL HOME SERVICES

 O 2,205,841 FMV
(25) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 O 10,998,901 FMV
(26) ABRAHAM LINCOLN HEALTHCARE FOUNDATION

 O 57,463 FMV
(27) DECATUR MEMORIAL HOSPITAL

 O 1,358,159 FMV
(28) TAYLORVILLE MEMORIAL HOSPTIAL

 O 8,392,562 FMV
(29) PASSAVANT MEMORIAL AREA HOSPTIAL ASSOCIATION

 O 16,452,195 FMV
(30) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 O 3,295,090 FMV
(31) MEMORIAL MEDICAL CENTER

 P 436,688,594 FMV
(32) MEMORIAL PHYSICIAN SERVICES

 P 3,228,059 FMV
(33) MEMORIAL HOME SERVICES

 P 2,039,387 FMV
(34) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 P 3,758,045 FMV
(35) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 P 2,844,461 FMV
(36) TAYLORVILLE MEMORIAL HOSPTIAL

 P 2,245,255 FMV
(37) PASSAVANT MEMORIAL AREA HOSPTIAL ASSOCIATION

 P 13,176,336 FMV
(38) MEMORIAL MEDICAL CENTER FOUNDATION

 P 1,757,575 FMV
(39) DECATUR MEMORIAL HOSPITAL

 P 324,470 FMV
(40) MEMORIAL MEDICAL CENTER

 Q 294,254,794 FMV
(41) MEMORIAL HOME SERVICES

 Q 1,866,717 FMV
(42) MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS

 Q 1,607,014 FMV
(43) MEMORIAL PHYSICIAN SERVICES

 Q 9,991,614 FMV
(44) ABRAHAM LINCOLN MEMORIAL HOSPITAL

 Q 1,188,689 FMV
(45) TAYLORVILLE MEMORIAL HOSPTIAL

 Q 24,608,649 FMV
(46) PASSAVANT MEMORIAL AREA HOSPTIAL ASSOCIATION

 Q 15,954,372 FMV
(47) MEMORIAL MEDICAL CENTER FOUNDATION

 Q 1,986,049 FMV
(48) ABRAHAM LINCOLN HEALTHCARE FOUNDATION

 Q 57,531 FMV
(49) DECATUR MEMORIAL HOSPITAL

 Q 968,338 FMV
(50) SPRINGFIELD RESIDENTIAL SERVICES

 Q 55,724 FMV
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
PART V, LINE 2 MEMORIAL HEALTH SYSTEM COLLECTED RENTAL INCOME FROM AFFILIATES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. THE VALUES LISTED IN SCHEDULE R, PART V, LINE 2 WERE DETERMINED USING FAIR MARKET VALUE.
Schedule R (Form 990) 2019

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