Form990


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)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2022 , and ending 06-30-2023
BCheck if applicable:
CName of organization
MARION GENERAL HOSPITAL INC
 
% MARION GENERAL HOSPITAL INC
Doing business as
MARION HEALTH
 
Number and street (or P.O. box if mail is not delivered to street address)
441 N WABASH AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MARION, IN469522690
D Employer identification number

35-0868130
E Telephone number

G Gross receipts $ 258,233,944
F Name and address of principal officer:
STEPHANIE HILTON-SIEBERT
441 N WABASH AVENUE
MARION,IN469522690
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MARIONHEALTH.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 MediumBullet  
K Form of organization:  
L Year of formation: 1910
M State of legal domicile: IN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDES COST-EFFECTIVE HOSPITAL & HEALTH SERVICES TO GRANT AND SURROUNDING COUNTIES. THE SERVICES PROVIDED BY THE HOSPITAL ARE AIMED TO IMPROVE THE WELL-BEING OF THE COMMUNITY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 4
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 1,382
6 Total number of volunteers (estimate if necessary) ............. 6 50
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a -140,245
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 10,904
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 7,985,746 870,796
9 Program service revenue (Part VIII, line 2g) ......... 203,811,620 193,551,066
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 28,249,422 26,663,178
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) -2,124,214 -2,032,496
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 237,922,574 219,052,544
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 205,485 170,079
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) 76,109,192 75,906,491
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).... 126,707,028 139,940,764
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 203,021,705 216,017,334
19 Revenue less expenses. Subtract line 18 from line 12....... 34,900,869 3,035,210
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 541,803,002 521,528,683
21 Total liabilities (Part X, line 26)............. 190,267,050 168,752,104
22 Net assets or fund balances. Subtract line 21 from line 20..... 351,535,952 352,776,579
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 (2021)
Form 990 (2021)
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: MARION GENERAL HOSPITAL EXISTS TO TRANSFORM THE HEALTH OF OUR COMMUNITY THROUGH PATIENT-CENTERED, HIGH QUALITY, AFFORDABLE CARE. BEST PRACTICES BY LEADING A COLLABORATIVE APPROACH INVOLVING PHYSICIANS, STAFF, BUSINESS LEADERS AND OUR COMMUNITY.
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 $ 54,507,482 including grants of $   ) (Revenue $ 33,630,009 )
INPATIENT SERVICES - MARION GENERAL HOSPITAL (MGH) OPERATES A 106-ACUTE CARE BED FACILITY, ALONG WITH AN 18-BED ACUTE REHABILITATION UNIT. INPATIENT SERVICES PROVIDED INCLUDE: MEDICAL/SURGICAL, TELEMETRY, CRITICAL, PEDIATRIC, OBSTETRIC, NEWBORN AND ACUTE REHABILITATION CARE. ADDITIONAL SERVICES PROVIDED TO INPATIENTS INCLUDE SURGERY, LABORATORY, RESPIRATORY THERAPY, PHYSICAL MEDICINE, CARDIOVASCULAR SERVICES AND RADIOLOGY. MARION GENERAL HOSPITAL DISCHARGED 3,688 INPATIENT ADULT AND PEDIATRIC PATIENTS, AND PROVIDED 13,847 INPATIENT ADULT AND PEDIATRIC PATIENT CARE DAYS DURING THE YEAR ENDED JUNE 30, 2023. DURING THE SAME TIME PERIOD, MGH ALSO DISCHARGED 181 AND PROVIDED 1,781 PATIENT CARE DAYS FOR PATIENTS IN THE ACUTE REHAB UNIT. THERE WERE 411 DELIVERIES PERFORMED.
4b (Code:   ) (Expenses $ 19,342,298 including grants of $   ) (Revenue $ 26,415,838 )
EMERGENCY ROOM SERVICES (OUTPATIENT) - MARION GENERAL HOSPITAL OPERATES ONE OF THE BUSIEST 24-HOUR EMERGENCY ROOMS IN THE STATE. THERE WERE 33,182 OUTPATIENT VISITS DURING THE YEAR ENDED JUNE 30, 2023. THERE WERE ALSO AN ADDITIONAL 3,263 EMERGENCY ROOM PATIENTS THAT WERE ULTIMATELY ADMITTED AS AN INPATIENT TO THE HOSPITAL, FOR A TOTAL OF 36,445 VISITS.
4c (Code:   ) (Expenses $ 12,308,257 including grants of $   ) (Revenue $ 23,619,531 )
RADIOLOGY SERVICES (OUTPATIENT) - MARION GENERAL HOSPITAL (MGH) HAS TWO STATE-OF-THE-ART FACILITIES THAT FEATURE THE LATEST IN TECHNOLOGY. THE RADIOLOGY DEPARTMENT FEATURES TWO 3D MAMMOGRAPHY UNITS AND ALSO OFFERS PATIENTS A 128 SLICE CT SCANNER WITH CARDIAC IMAGING CAPABILITIES. MGH HAS TWO MRI UNITS; AN 1.5 MAGNET OFFERING ONBOARD THEATER SYSTEM FOR THOSE PATIENTS WITH CLAUSTRPHOIC CONCERNS, A 3.0T MAGNET WITH THE HIGHEST RESOLUTION AVAILABLE COMMERCIALLY. MGH HAS A SPECT/CT AND A PET/CT SCANNER, FUSING NUCLEAR MEDICINE AND CT TECHNOLOGY. OTHER SERVICES OFFERED INCLUDE NUCLEAR MEDICINE, ULTRASOUND AND X-RAY. MARION GENERAL HOSPITAL PROVIDED 89,324 OUTPATIENT RADIOLOGY PROCEDURES DURING THE YEAR ENDED JUNE 30, 2023.
(Code:   ) (Expenses $ 106,812,695 including grants of $ 170,079 ) (Revenue $ 109,885,688 )
SEE SCHEDULE O DISCLOSURE FOR: PROGRAM
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
SERVICE ACCOMPLISHMENTS
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
PART III, LINE 4D
4d Other program services (Describe in Schedule O.)
(Expenses $ 106,812,695 including grants of $ 170,079 ) (Revenue $ 109,885,688 )
4e Total program service expensesMediumBullet192,970,732
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
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
List of Attached Documents:
// Content
.........
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
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
List of Attached Documents:
// Content
.........................
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
List of Attached Documents:
// Content
....
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment
List of Attached Documents:
// Content
......
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
List of Attached Documents:
// Content
...................
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
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
Yes
 
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
List of Attached Documents:
// Content
12b
 
No
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....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
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
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
...........
26
Yes
 
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
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the 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
List of Attached Documents:
// Content
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
List of Attached Documents:
// Content
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on 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
81
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
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
1,382
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
12
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
4
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
 
No
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
 
No
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
 
No
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 on 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 on 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 on 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
IN
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 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:
MediumBulletMARION GENERAL HOSPITAL INC441 N WABASH AVENUE   MARION,IN469522690 (765) 660-7000
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) STEPHANIE HILTON-SIEBERT......................................................................
PRESIDENT/CEO
50.0
.................
0.0
X   X       1,458,228 0 36,199
(2) EDMOND BENDALY MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   846,524 0 9,150
(3) CHARLES COSSELL DO......................................................................
PHYSICIAN
40.0
.................
0.0
        X   741,766 0 22,602
(4) STEPHEN KELLER MD......................................................................
PHYSICIAN/BOARD MEMBER
40.0
.................
0.0
X           696,571 0 37,103
(5) KAREN JACOBS DO......................................................................
PHYSICIAN
40.0
.................
0.0
        X   660,729 0 34,554
(6) KAVITA RAJ DO......................................................................
PHYSICIAN
40.0
.................
0.0
        X   620,091 0 52,803
(7) SHANKARAN SRIKANTH MD......................................................................
PHYSICIAN/BOARD MEMBER
40.0
.................
0.0
        X   591,083 0 50,774
(8) JAMES ORRELL MD......................................................................
PHYSICIAN/CHIEF OF MED. STAFF
40.0
.................
0.0
X           429,665 0 53,054
(9) ANTHONY ROBERTS......................................................................
CFO
50.0
.................
0.0
    X       395,402 0 40,881
(10) SIRAJABID KHATIB MD......................................................................
PHYSICIAN/BOARD MEMBER
40.0
.................
0.0
X           376,648 0 22,840
(11) CYNTHIA FUTRELL......................................................................
CNO
50.0
.................
0.0
    X       308,808 0 41,017
(12) NABIN AGRAWAL MD......................................................................
PHYSICIAN/BOARD MEMBER
40.0
.................
0.0
X           283,163 0 50,398
(13) M NABI SHARIF MD......................................................................
PHYSICIAN/BOARD MEMBER
40.0
.................
0.0
X           162,300 0 0
(14) DON TRICARICO JR......................................................................
CAO (LEFT 01/19)
1.0
.................
0.0
          X 136,500 0 0
(15) ELIZABETH GUTIERREZ......................................................................
BOARD TREASURER
2.0
.................
0.0
X   X       0 0 0
(16) KEVIN CATES......................................................................
BOARD SECRETARY
1.0
.................
0.0
X   X       0 0 0
(17) LEZLIE WINTER......................................................................
BOARD MEMBER
2.0
.................
0.0
X           0 0 0
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) MICHAEL HOTZ........................................................................
BOARD MEMBER
2.0
.......................0.0
X           0 0 0
(19) STEVEN BERRY........................................................................
VICE CHAIR
2.0
.......................0.0
X   X       0 0 0
(20) TIMOTHY DAILEY........................................................................
CHAIR
2.0
.......................0.0
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 7,707,478 0 451,375
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 MediumBullet188
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
CROTHALL HEALTHCARE,
955 CHESTERBROOK BLVD
WAYNE,PA19087
OUTSIDE MGMT SERVICE 6,381,000
AYA HEALTHCARE INC,
5930 CORNERSTONE CT WEST 300
SAN DIEGO,CA92121
NURSING COVERAGE 7,063,228
HAGERMAN INC,
510 W WASHINGTON BLVD
FORT WAYNE,IN46802
GENERAL CONTRACTING 20,221,234
SHAMBAUGH SON LP,
PO BOX 1287
FORT WAYNE,IN46801
GENERAL CONTRACTING 10,289,414
JJ ELECTRIC OF INDIANA INC,
3180 W STATE ROAD 18
KOKOMO,IN46903
GENERAL CONTRACTING 8,260,072
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet58
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 855,187
f All other contributions, gifts, grants, and similar amounts not included above1f 15,609
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 870,796
 Program Service RevenueAmt Business Code
2a PATIENT REVENUE 622110 192,041,929 192,041,929    
b MED DIRECTOR SERVICES 622110 401,065 401,065    
c VHA DIVIDEND 622110 248,650 248,650    
d MEDICAL RECORDS 622110 66,532 66,532    
e ALL OTHER 622110 792,890 792,890    
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 193,551,066
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 9,762,844   -190,610 9,953,454
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   714,196 6a
b Less: rental expenses   2,802,147 6b
c Rental income or (loss) 0 -2,087,951 6c
d Net rental income or (loss).......MediumBullet -2,087,951     -2,087,951
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 100,552 53,179,035 7a
b Less: cost or other basis and sales expenses 2,080 36,377,173 7b
c Gain or (loss) 98,472 16,801,862 7c
d Net gain or (loss).........MediumBullet 16,900,334     16,900,334
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 5,090
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 5,090   5,090
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a BILLING SERVICES 541900 50,365   50,365  
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 50,365
12 Total revenue. See instructions.....MediumBullet 219,052,544 193,551,066 -140,245 24,770,927
Form 990 (2021)
Form 990 (2021)
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 .... 170,079 170,079
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 2,417,035 451,598 1,965,437  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 0      
7 Other salaries and wages........ 54,185,569 48,592,130 5,593,439  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,582,608 1,358,635 223,973  
9 Other employee benefits ....... 12,642,157 10,853,023 1,789,134  
10 Payroll taxes ........... 5,079,122 4,360,318 718,804  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 650,212   650,212  
c Accounting ........... 133,650   133,650  
d Lobbying ........... 33,740   33,740  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 14,872,020 11,897,616 2,974,404  
12 Advertising and promotion .... 456,811 365,449 91,362  
13 Office expenses ....... 10,182,951 8,146,361 2,036,590  
14 Information technology ...... 4,563,226 3,650,581 912,645  
15 Royalties .. 0      
16 Occupancy ........... 4,024,266 3,219,413 804,853  
17 Travel ............ 315,591 252,473 63,118  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 98,074 78,459 19,615  
20 Interest ........... 2,589,721 2,460,235 129,486  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 9,131,126 7,304,901 1,826,225  
23 Insurance ... 1,587,847 1,168,736 419,111  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES/DRUGS 28,560,476 28,560,476    
b PROVISION FOR BAD DEBTS 8,573,835 8,573,835    
c PHYSICIAN SERVICES 31,116,995 31,116,995    
d PURCHASED SERVICES 11,193,451 8,954,761 2,238,690  
e All other expenses 11,856,772 11,434,658 422,114  
25 Total functional expenses. Add lines 1 through 24e 216,017,334 192,970,732 23,046,602 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 (2021)
Form 990 (2021)
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 ........ 4,200 1 4,075
2 Savings and temporary cash investments ......... 97,368,838 2 38,264,295
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 26,163,201 4 22,547,624
5 Loans and other receivables from 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 .......
76,107 5 118,806
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) ...
0 6 0
7 Notes and loans receivable, net ........... 1,644,365 7 1,582,713
8 Inventories for sale or use ............ 2,189,250 8 2,097,130
9 Prepaid expenses and deferred charges ...... 3,476,154 9 3,923,142
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 330,731,875
b Less: accumulated depreciation 10b 174,581,828 111,369,639 10c 156,150,047
11 Investments—publicly traded securities . 192,819,978 11 185,046,500
12 Investments—other securities. See Part IV, line 11 ..... 95,711,697 12 99,760,251
13 Investments—program-related. See Part IV, line 11 .. 0 13 1,695,171
14 Intangible assets ............... 2,290,238 14 1,892,578
15 Other assets. See Part IV, line 11 ........... 8,689,335 15 8,446,351
16 Total assets. Add lines 1 through 15 (must equal line 33)... 541,803,002 16 521,528,683
Liabilities 17 Accounts payable and accrued expenses ..... 26,613,945 17 19,568,556
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 136,740,737 20 133,515,136
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
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 .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 26,912,368 25 15,668,412
26 Total liabilities. Add lines 17 through 25.. 190,267,050 26 168,752,104
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 .......... 351,535,952 27 352,776,579
28 Net assets with donor restrictions ........... 0 28 0
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 ........... 351,535,952 32 352,776,579
33 Total liabilities and net assets/fund balances ........ 541,803,002 33 521,528,683
Form 990 (2021)
Form 990 (2021)
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
219,052,544
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
216,017,334
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
3,035,210
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
351,535,952
5
Net unrealized gains (losses) on investments ...............
5
-2,315,123
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
520,540
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
352,776,579
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 on
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 (2021)
Form 990 (2021)
Additional Data


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

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
2022
Open to Public
Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
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 ...............................  
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
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 5 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
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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
First 5 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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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
 
 
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on 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
 
 
c
Did a disqualified person (as defined on 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
 
 
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
 
 
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) 2022

Schedule A (Form 990) 2022
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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 0.015 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 0.035 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) 2022

Schedule A (Form 990) 2022
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, 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 2022. 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 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990) (2022)
Schedule B (Form 990) (2022) Page 2
Name of organization
MARION GENERAL HOSPITAL INC
 
Employer identification number
35-0868130
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 4
Name of organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2022)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

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
2021
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
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
33,740
j
Total. Add lines 1c through 1i ....................................................................................................
33,740
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 1g MARION GENERAL HOSPITAL OCCASIONALLY SENDS LETTERS TO OR DIRECTLY CONTACTS LEGISLATORS. PART II-B, LINE 1i MARION GENERAL HOSPITAL PAID MEMBERSHIP DUES TO SEVERAL ORGANIZATIONS FOR WHICH A VARYING PERCENTAGE WAS ATTRIBUTED TO LOBBYING EXPENSES. THESE ORGANIZATIONS INCLUDE THE INDIANA HOSPITAL ASSOC., AMERICAN HOSPITAL ASSOC., AMERICAN ACADEMY OF FAMILY PHYSICIANS, AMERICAN COLLEGE OF PHYSICIANS, AMERICAN MEDICAL ASSOC., AMERICAN OSTEOPATHIC ASSOCIATION, ONCOLOGY NURSING SOCIETY, AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS, INDIANA STATE MEDICAL ASSOCIATION, AMONG VARIOUS OTHERS.
Schedule C (Form 990) 2021


Additional Data


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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
2021
Open to Public Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
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) 2021

Schedule D (Form 990) 2021
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 .....   12,819,425 12,819,425
b Buildings ....   155,179,210 105,376,966 49,802,244
c Leasehold improvements   1,004,506 723,442 281,064
d Equipment ....   79,266,068 65,247,811 14,018,257
e Other .....   82,462,666 3,233,609 79,229,057
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 156,150,047
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
(A) PRIVATE EQUITY FUNDS
59,169,301 F

(B) FIXED INCOME SECURITIES
40,590,950 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 99,760,251
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' 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 0
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 15,668,412
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) 2021

Schedule D (Form 990) 2021
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 ....... 1 211,376,725
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -2,315,123
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 3,213,139
e Add lines 2a through 2d ..................... 2e 898,016
3 Subtract line 2e from line 1.................. 3 210,478,709
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 8,573,835
c Add lines 4a and 4b.................... 4c 8,573,835
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 219,052,544
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 ........... 1 210,245,646
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 2,802,147
e Add lines 2a through 2d.................... 2e 2,802,147
3 Subtract line 2e from line 1................... 3 207,443,499
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 8,573,835
c Add lines 4a and 4b..................... 4c 8,573,835
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 216,017,334
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
ASC 740 FOOTNOTE THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS SUCH, THE HOSPITAL IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THE HOSPITAL IS REQUIRED TO FILE FEDERAL FORM 990-RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, WHICH IS AN INFORMATIONAL RETURN ONLY. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH JUNE 30, 2022. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS).
RECONCILIATION SCHEDULE D, PART XI, LINE 2D RENTAL EXPENSE $ 2,802,147 GAIN ON JV $ 410,992 TOTAL: $ 3,213,139 SCHEDULE D, PART XII, LINE 2D RENTAL EXPENSE $ 2,802,147 SCHEDULE D, PART XI & XII, LINE 4B BAD DEBT EXPENSE $ 8,573,835
Schedule D (Form 990) 2021


Additional Data


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Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
  4,606 3,510,295   3,510,295 1.690 %
b Medicaid (from Worksheet 3, column a) . . . . .     62,457,396 36,554,334 25,903,062 12.490 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   4,606 65,967,691 36,554,334 29,413,357 14.180 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   52,353 946,640   946,640 0.460 %
f Health professions education (from Worksheet 5) . . .   701 1,528,562   1,528,562 0.740 %
g Subsidized health services (from Worksheet 6) . . . .   995 310,813   310,813 0.150 %
h Research (from Worksheet 7) .   14 512   512  
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .   4,754 255,766   255,766 0.120 %
j Total. Other Benefits . .   58,817 3,042,293   3,042,293 1.470 %
k Total. Add lines 7d and 7j .   63,423 69,009,984 36,554,334 32,455,650 15.650 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     6,227   6,227  
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development   968 979,581   979,581 0.560 %
9 Other            
10 Total   1,268 985,808   985,808 0.560 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
3,482,692
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
348,269
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
27,347,318
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
31,909,956
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,562,638
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1PROGRESSIVE CANCER
 
ONCOLOGY CENTER 53.43 % 7.3 % 12.02 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MARION GENERAL HOSPITAL
441 N WABASH AVENUE
MARION,IN46952
WWW.MARIONHEALTH.COM
X X         X   OFF-CAMPUS RADIOLOGY ONCOLOGY, SLEEP LAB PHYSICAL MED, LAB  
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MARION GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE DISCLOSURE
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MARION GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.MARIONHEALTH.COM
b
WWW.MARIONHEALTH.COM
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
MARION GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MARION GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, LINE 5 THE LINK FOR THE CHNA WAS PROVIDED TO SEVERAL EMAIL GROUPS INCLUDING: AREA K-12 SCHOOLS, GRANT BLACKFORD MENTAL HEALTH, FAMILY SERVICE SOCIETY, INC., BRIDGES TO HEALTH, COMMUNITY MEDICAL SERVICES, THE COMMUNITY OPIOID RESONSE ENDEAVOR CONSORTIUM (INCLUDING BEHAVIORAL HEALTH PROVIDERS, TRANSITIONAL HOUSES, AND SOCIAL AGENCIES), THE BREATHE EASY TOBACCO TASK FORCE MEMBERS, AND VARIOUS COMMUNITY ADVISORY GROUPS. THE INDIANA RURAL HEALTH ASSOCIATION UTILIZED INFORMATION ACROSS THE COMMUNITY TO COMPLETE THE EXECUTIVE SUMMARY AND FINAL REPORT.
SCHEDULE H, PART V, SECTION B, LINE 6B INDIANA RURAL HEALTH ASSOCIATION
SCHEDULE H, PART V, SECTION B, LINE 7B MH POSTS THE FINAL REPORTS ON A COMMUNITY BASED WEBSITE, AND PROVIDES A LINK TO THE CHNA REPORTS ON THE MH SITE. https://www.marionhealth.com/about/for-the-community/ OR DIRECTLY TO https://www.marionhealth.com/documents/Marion-Health-2021-Community-Health -Needs-Assessment.pdf MH HOSTS SEVERAL COMMUNITY MEETINGS AND ATTENDS AREA GATHERINGS TO PRESENT THE COMMUNITY HEALTH PROFILE FINDINGS. ALL OF THE COMMUNITY PARTNERS RECEIVE ACCESS TO THE FINAL REPORT.
SCHEDULE H, PART V, SECTION B, LINE 10A HTTPS://WWW.MARIONHEALTH.COM/DOCUMENTS/MARION-HEALTH-IMPLEMENTION-PLAN-202 3-2026.PDF
SCHEDULE H, PART V, SECTION B, LINE 11 THE MOST RECENT CHNA INDICATED AN OVERWHELMING NEED FOR MENTAL HEALTH AND SUBSTANCE USE/MISUSE DISORDER SERVICES AND PROGRAMS. MARION HEALTH OBTAINED FUNDS FROM THE OPIOID SETTLEMENT TO BUILD STRONGER MENTAL HEALTH CARE FOR OUR PRIMARY CARE OFFICES AND THE INPATIENT UNITS. GRANT AWARD MONIES WILL BE USED TO HIRE A SECOND LICENSED CLINICAL PSYCHOLOGIST AND TWO LICENSED THERAPISTS. THIS WILL PROVIDE THE OPPORTUNITY TO DO MENTAL HEALTH SCREENINGS, DEVELOP A DIAGNOSTIC PLAN, AND PROVIDE A WARM HAND-OFF PRIOR TO THE INDIVIDUAL OBTAINING SERVICES THROUGH THE LOCAL MENTAL HEALTH PROVIDERS FOR ON-GOING SUPPORT, THERAPY, AND INTERVENTIONS. POVERTY CONCERNS, SOCIAL DETERMINANTS OF HEALTH, AND THE UNINSURED AND UNDERINSURED SURFACED AS SIGNIFICANT NEEDS IN CHNA. MARION HEALTH HAS A ROBUST PATIENT ASSISTANCE PROGRAM AS WELL AS A MAJOR PARTNER WITH THE FREE CLINIC. CHRONIC ILLNESS CONTINUES TO BE AN AREA OF CONCERN FOR ALL THE COUNTY'S HEALTH PROVIDERS. MARION HEALTH DEVELOPED A CHRONIC DISEASE W-UP WITH PATIENTS UPON DISCHARGE FROM THE HOSPITAL TO ENSURE CONTINUUM OF CARE AND ASSURE DISCHARGE PLANS APPROPRIATE AND TIMELY FOR REGAINING HEALTH. TWO COMMUNITY HEALTH WORKERS HAVE BEEN ADDED TO THE CARDIOVASCULAR TEAM TO INCREASE SUPPORT, EDUCATION, AND MANAGEMENT FOR PATIENTS WITH HEART FAILURE OR OTHER CARDIOVASCULAR ILLNESSES. REMOTE PATIENT MONITORING IS ALSO AVAILABLE FOR APPROPRIATE PATIENTS INCLUDING HIGH RISK MATERNITY PATIENTS. TOBACCO/NICOTINE USE REMAINS A MAJOR RISK FACTOR FOR OUR YOUTH AND ADULT POPULATIONS. A FULL-TIME TOBACCO COORDINATOR IS WORKING WITH PRIMARY PREVENTION IN OUR HIGH SCHOOLS AS WELL AS MULTIPLE COMMUNITY EVENTS TO INCREASE AWARENESS OF THE NEGATIVE IMPACT OF VAPING AND COMBUSTIBLE PRODUCT USE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?24
Name and address Type of Facility (describe)
1 MGH SURGERY CENTER
330 N WABASH AVENUE STE 200
MARION,IN46952
OUTPATIENT SURGERY CENTER
2 MGH PEDIATRIC CENTER
330 N WABASH AVENUE STE 320
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
3 UROLOGY CENTER OF MGH
330 N WABASH AVENUE STE 350
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
4 MARION SURGEONS
330 N WABASH AVENUE STE 370
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
5 SPECIALTY PHYSICIANS
330 N WABASH AVENUE STE 400
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
6 LUNG CENTER OF MGH
330 N WABASH AVENUE STE 450
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
7 FAMILY MEDICINE CENTER-MARION
330 N WABASH AVENUE STE 430
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
8 MGH SLEEP LAB
1387 N BALDWIN AVENUE
MARION,IN46952
SLEEP LAB
9 MGH DIAGNOSTICS-NORTHWOOD
1379 N BALDWIN AVENUE
MARION,IN46952
LAB
10 FAMILY MEDICINE CENTER-NORTHWOOD
1399 N BALDWIN AVENUE
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
11 MGH PHYSICAL MEDICINE
1393 N BALDWIN AVENUE
MARION,IN46952
PHYSICAL, OCCUPATIONAL AND speech therapy
12 MARION FAMILY PRACTICE
1391 N BALDWIN AVENUE
MARION,IN46952
PHYSICIAN PRACTICE OFFICE
13 MGH DIAGNOSTICS-SOUTH
1408 W BELLA DRIVE
MARION,IN46953
LAB, RADIOLOGY
14 FAMILY MEDICINE CENTER-SOUTH
1406 W BELLA DRIVE
MARION,IN46953
PHYSICIAN PRACTICE OFFICE
15 OBSTETRICS AND GYNECOLOGY
1419 W BELLA DRIVE
MARION,IN46953
PHYSICIAN PRACTICE OFFICE
16 MGH MEDICAL ONCOLOGY
831 N THEATRE DRIVE
MARION,IN46952
MEDICAL ONCOLOGY, PHYSICIAN office
17 MGH WORK SOLUTIONS
119 S WASHINGTON STREET
MARION,IN46952
OCCUPATIONAL MEDICINE
18 FAMILY MEDICINE CENTER-CONVERSE
308 N JEFFERSON STREET
CONVERSE,IN46919
PHYSICIAN PRACTICE OFFICE
19 FAMILY MEDICINE CENTER-SWAYZEE
2651 S 800 W
SWAYZEE,IN46986
PHYSICIAN PRACTICE OFFICE
20 FAMILY MEDICINE CENTER-GAS CITY
4781 KAY BEE DRIVE
GAS CITY,IN46933
PHYSICIAN PRACTICE OFFICE
21 MGH DIAGNOSTICS-GAS CITY
4781 KAY BEE DRIVE
GAS CITY,IN46933
LAB
22 FAIRMOUNT MEDICAL ASSOCIATES
157 W 8TH STREET
FAIRMOUNT,IN46928
PHYSICIAN PRACTICE OFFICE
23 MGH DIAGNOSTICS-FAIRMOUNT
157 W 8TH STREET
FAIRMOUNT,IN46928
LAB
24 MGH EXPRESS
1130 N BALDWIN AVENUE
MARION,IN46952
URGENT CARE
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART II MARION GENERAL HOSPITAL, DBA MARION HEALTH (MH), IS COMMITTED TO RESPONDING TO THE FEDERAL DESIGNATIONS THAT GRANT COUNTY IS A MEDICAL PROFESSION SHORTAGE AREA (MPSA) AND MEDICALLY UNDERSERVED AREA (MUSA). ACTIVE RECRUITING AND LOAN FORGIVENESS (AS INCENTIVES) FOR PROVIDER HIRING IS CRITICAL TO SERVE OUR HEALTHCARECOMMUNITIES. A NEWLY ADQUIRED HRSA LOAN FORGIVENESS AND SCHOLARSHIP PROGRAM FOR PHYSICIANS AND NURSE PRACTITIONERS WILL BE A GREAT ASSET TO ENHANCE RECRUITING TO OUR RURAL COMMUNITY. MH IS THE ONLY NON-GOVERNMENTAL HOSPITAL IN OUR COUNTY. THE NEED FOR RECRUITING AND RETAINING PROVIDERS PRESENTS SIGNIFICANT CHALLENGES FOR A SMALL RURAL AREA. NEW EFFORTS ARE UNDERWAY TO PROVIDER TELEHEALTH WITH EXAM TECHNOLOGY FOR PATIENTS AND PROVIDERS TO ACCESS SPECIALTIES THAT ARE NOT LOCALLY AVAILABLE IN OUR COMMUNITY. MARION HEALTH ANTICIPATES OPENING A NEW STATE OF THE ART, INNOVATION CAMPUS TO EXPAND SERVICES TO AN AREA OF IDENTIFIED NEED AND SHORTAGE. REPRESENTATIVES FROM MH SERVE ON THE INDIANA WESLEYAN UNIVERSITY (IWU) SCHOOL OF NURSING COMMUNITY ADVISORY BOARD AND THE COMMUNITY ADVISOTRY BOARD FOR OCCUPATIONAL THERAPY. MH REPRESENTATIVES HAVE BEEN INSTRUMENTAL IN WORKING WITH IWU TO CREATE GRADUATE EDUCATION PROGRAMS THAT MEET COMMUNITY PROVIDER NEEDS. MH FACILITATES A LARGE COMMUNITY TASK FORCE FOR SERVICE PROVIDERS WHOSE CLIENTS ARE IMPACTED BY SUBSTANCE ABUSE DISORDERS. MH ALSO FACILIATES A CORE (COMMUNITY OPIOID RESPONSE ENDEAVOR) CONSORTIUM UNDER MH LEADERSHIP HAS FACILITATED FREE COMMUNITY BASED NARCAN BOXES TO ADDRESS THE HIGH NUMBERS OF OVERDOSES. MH IS THE LARGEST SUPPORTER OF OUR COUNTY'S FREE HEALTH AND DENTAL CLINIC, BRIDGES TO HEALTH. MH HAS BEEN WORKING DILIGENTLY WITH AN FQHC AND IU SCHOOL OF DENTISTRY TO BRING A LOW COST, SLIDING FEE DENTAL CLINIC TO OUR COUNTY. THE OPENING DATE FOR THIS WAS SEPTEMBER 2023. THE HOSPITAL IS ONE OF THE LARGEST DONORS FOR IN-KIND AND MONETARY GIFTS TO LOCAL NONT-FOR-PROFIT ORGANIZATIONS THAT ASSIST IN THE MISSIONS TO IMPROVE THE HEALTH IN GRANT COUNTY. IN THE SUMMER OF 2024, MARION HEALTH IS BEGINNING THE INAUGURAL YEAR OF A FAMILY PRACTICE RESIDENCY PROGRAM, WHERE HOPES ARE TO HOST SIX INDIVIDUALS PER YEAR FOR THE THREE YEAR ACADEMIC REQUIREMENT.
SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT AT COST IS ESTIMATED BY MULTIPLYING TOTAL PROVISION FOR BAD DEBT FOR THE YEAR BY THE AVERAGE COST-TO-CHARGE RATIO AS DERIVED FROM THE FILED MEDICARE COST REPORT.
SCHEDULE H, PART III, SECTION A, LINE 3 THE AMOUNT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICIES IS ESTIMATED BASED UPON PAST EXPERIENCE.
SCHEDULE H, PART III, SECTION A, LINE 4 SEE PAGE 13 OF THE ATTACHED FINANCIAL STATEMENTS, UNDER THE HEADING NET PATIENT SERVICE REVENUE, RELATED RECEIVABLES AND ESTIMATED SETTLEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8 MH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE INCLUDED WHEN ATTEMPTING TO REFLECT THE FINANCIAL BENEFIT THAT THE ORGANIZATION PROVIDES TO ITS COMMUNITY. TO THAT END, MH SHOWS THIS AMOUNT SEPARATELY ON ITS ANNUAL COMMUNITY BENEFIT REPORT. SERVICES ARE PROVIDED TO MEDICARE PATIENTS BY MH WHILE, AT THE SAME TIME, WE FULLY EXPECT TO RECEIVE LESS IN REIMBURSEMENT THAN IT COSTS TO PROVIDE THESE SERVICES. WE ARE BENEFITING THE COMMUNITY BY BEING A CONVENIENT AND REPUTABLE SOURCE WITHIN THE COMMUNITY TO RECEIVE SUCH SERVICES. THE MEDICARE ALLOWABLE COSTS OF CARE IS TAKEN DIRECTLY FROM THE FILED MEDICARE COST REPORT.
SCHEDULE H, PART III, SECTION C, LINE 9B MARION HEALTH'S COLLECTION POLICY DISTINGUISHES BETWEEN 'FINANCIAL ASSISTANCE' - PATIENTS UNABLE TO PAY, AND 'BAD DEBT' - PATIENTS UNWILLING TO PAY. MH SENDS A STATEMENT ON DAY 1 WITH AN EXPECTED DUE DATE OF THIRTY (30) DAYS FROM THE DATE OF THE STATEMENT. THIRTY (30) DAYS LATER A SECOND STATEMENT IS SENT FOLLOWED BY A LATE PAYMENT CALL. AT SIXTY (60) DAYS ANOTHER STATEMENT IS SENT FOLLOWED BY ANOTHER CALL. BY MONTH FOUR (4) IF NO RESPONSE AN ECA NOTIFICATION IS MAILED TO PATIENT NOTIFYING THEM THAT THE ACCOUNT MAY BE TURNED TO COLLECTION. CALLS ARE DOCUMENTED IN THE AR SYSTEM FOR FURTHER FOLLOW-UP ACTION. PAYMENT IN FULL IS ALWAYS THE PREFERRED METHOD OF RESOLUTION FOR A SELF-PAY BALANCE. IF THIS IS NOT POSSIBLE, THE PATIENT SERVICES REPRESENTATIVE OR FINANCIAL COUNSELOR PROVIDES INFORMATION TO THE PATIENT AND/OR OTHER RESPONSIBLE PARTY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IN A WAY THAT IS EASY TO UNDERSTAND. THE PATIENT SERVICE REPRESENTATIVE OR FINANCIAL COUNSELOR RESPONDS PROMPTLY TO QUESTIONS ABOUT THE PATIENT'S BILLS AND REQUESTS FOR ASSISTANCE. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE ARE NOT REPORTED TO A COLLECTION AGENCY AS LONG AS REQUESTED DOCUMENTATION IS PROVIDED TIMELY.
SCHEDULE H, PART VI, LINE 2 MARION GENERAL HOSPITAL DBA MARION HEALTH (MH) FACILITATES A COUNTY -WIDE COMMUNITY HEALTH PROFILE (NEEDS ASSESSMENT) EVERY THREE YEARS. THE SURVEY PROCESS INVOLVES PRIMARY AND SECONDARY DATA. THE SURVEY TOOL USED FOR THE MOST RECENT SURVEY WAS DONE IN PARTNERSHIP WITH INDIANA RURAL HEALTH ASSOCIATION, AND THE QUESTIONS WERE DERIVED FROM FOCUS GROUPS DESIGNATED TO INCLUDE ALL SECTORS OF THE COMMUNITY. THE SURVEY WAS SHARED THROUGHOUT THE COUNTY IN ELECTRONIC FORMAT. FOCUS GROUPS AND COMMUNITY-BASED MEETINGS WERE HELD ON SPECIFIC, IDENTIFIED NEEDS WITHIN THE THREE-YEAR TIME FRAME ADDING ADDITIONAL INFORMATION TO INFORM OUR COUNTY ON EMERGING HEALTH NEEDS AND ISSUES. ADDITIONAL INFORMATION AND DATA FROM VARIOUS ORGANIZATIONS WERE REVIEWED INCLUDING THE GRANT COUNTY HEALTH DEPARTMENT, INDIANA DEPARTMENT OF HEALTH, CDC, COUNTY HEALTH RANKINGS AND ROADMAPS, INDIANA CANCER REGISTRY, INDIANA YOUTH INSTITUTE, AND AREA NEEDS ASSESSMENTS FROM LOCAL ORGANIZATIONS. DATA FROM THE COMMUNITY HEALTH PROFILE (CHNA) AND MARION HEALTH STAFF REGULARLY ASSIST AND INFORM THE NEEDS ASSESSMENTS AND GRANT APPLICATIONS FOR AREA AGENCIES. ONGOING FOCUSED ASSESSMENTS IMPACT PLANNING AND PROGRAM DEVELOPMENT.
SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AS A NOT-FOR-PROFIT HOSPITAL, MH HAS SIGNAGE AT ALL REGISTRATION POINTS INTO THE FACILITY AND THE HOSPITAL'S BUSINESS OFFICE ADVISING THEM OF THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM (FAP). WE HAVE A BROCHURE TITLE 'UNDERSTANDING HOSPITAL BILLS AND INSURANCE' THAT DIRECTS THEM TO CALL US IF THEY DO NOT HAVE INSURANCE OR HAVE THE ABILITY TO PAY THEIR BILL. ALL BEDDED PATIENTS RECEIVE THIS BROCHURE UPON ADMISSION. WE ALSO HAVE A PATIENT NOTICE OF FINANCIAL ASSISTANCE POLICY STATEMENT AVAILABLE AT ALL REGISTRATION LOCATIONS AND THE BUSINESS OFFICE. OUR BILLING STATEMENTS ADVISE OUR PATIENTS THAT WE OFFER FINANCIAL ASSISTANCE AND DIRECTS THEM TO CONTACT US IN THE BUSINESS OFFICE TO GET ADDITIONAL INFORMATION AND AN APPLICATION ON OUR WEBSITE. ONCE A PATIENT IS APPROVED FOR ASSISTANCE, THEY ARE QUALIFIED FOR A PERIOD OF ONE YEAR FROM APPROVAL OF THE APPLICATION. MH ALSO ASSISTS PATIENTS WITH THE COMPLETION OF THE FAP APPLICATION, AS WELL AS, EVALUATION OF THEIR ELIGIBILITY FOR STATE AND FEDERAL GOVERNMENT BENEFIT PROGRAMS.
SCHEDULE H, PART VI, LINE 4 MARION HEALTH IS THE ONLY NON-GOVERNMENT ACUTE CARE HOSPITAL IN RURAL GRANT COUNTY, OUR PRIMARY GEOGRAPHIC LOCATION. GRANT COUNTY DEMOGRAPHICS ARE AS FOLLOWS: WHITE 88.1%, BLACK/AFRICAN AMERICAN 7.7%, MULTI-RACIAL 2.8%, ASIAN 0.9%. LATINO/HISPANIC 4.9%. MEDIAN INCOME IS $50,009, POPULATION IS 66,263, 8.3% ARE WITHOUT HEALTH INSURANCE AND 18.8% OF PERSONS IN POVERTY (WWW.CENSUS.GOV UPDATED ON JULY 1, 2022). THE COMMUNITY HEALTH PROFILE (CHNA EVERY 3 YEARS) IS DESIGNED TO GATHER INFORMATION FROM ALL TOWNSHIPS AND PEOPLE GROUPS. GRANT COUNTY IS IN NORTH CENTRAL INDIANA. THE COUNTY IS DESIGNATED RURAL BY THE U.S. HEALTH RESOURCES & SERVICES ADMINISTRATION AND IS THE THIRTIETH LARGEST COUNTY IN INDIANA AT APPROXIMATELY 414.07 SQUARE MILES IN AREA AND 0.82 SQUARE MILES IN WATER. INTERSTATE 69 RUNS ALONG THE ENTIRE EASTERN BOUNDARY OF THE COUNTY, AND THE MISSISSINEWA RIVER RUNS FROM THE SOUTHEAST TO NORTHWEST THROUGH THE CENTER OF THE COUNTY.
SCHEDULE H, PART VI, LINE 5 MARION HEALTH MAKES A CONCENTRATED EFFORT TO PROVIDE PRIMARY CARE LOCATIONS IN MOST AREAS OF THE COUNTY. THE PRACTITIONER REFERRAL LINE, MARION HEALTH ACCESS, ASSISTS PATIENTS TO SCHEDULE IMMEDIATE PRIMARY CARE APPOINTMENTS. MUCH TIME, EFFORT, AND MONEY ARE USED TO RECRUIT THE NEEDED PHYSICIANS AND TEAM MEMBERS FOR OUR RURAL AREA. STAFF MEMBERS AND LEADERS SERVE ON COUNTLESS BOARDS ACROSS THE COUNTY TO EXTEND THE MISSION, TRANSFORMING THE HEALTH OF OUR COMMUNITY. MARION HEALTH COMMUNITY OUTREACH STAFF OFFERS LUNCH AND LEARNS FOR AREA PROVIDER OFFICES, NOT-FOR-PROFIT ORGANIZATIONS, SCHOOL NURSES, AREA SOCIAL WORKERS, AND MULTIPLE UNIVERSITY STUDENT GROUPS. MARION HEALTH HAS HELPED FACILITATE THE EARLY STATE OF A PROGRAM TITLES HANDLE WITH CARE TO CONNECT LAW ENFORCEMENT AND FIRST RESPONDERS TO SCHOOLS TO PREVENT RE-TRAUMATIZATION OF STUDENTS WHOSE FAMILY HAS BEEN INVOLVED IN AN EVENT. MARION HEALTH HAS A LOAN FORGIVENESS PROGRAM FOR STUDENTS CHOOSING NURSING AND OTHER ALLIED HEALTH FIELDS TO ASSIST WITH RECRUITMENT AND RETENTION OF STAFF. THE PARISH NURSE PROGRAM STAFF PROVIDES PREPARATION, EDUCATION, AND SUPPORT FOR THE FAITH COMMUNITY NURSES (120 NURSES) AND FACILITATES THE BASIC PARISH NURSE EDUCATION PROGRAM EACH YEAR. BRIDGES TO HEALTH, A FREE HEALTH CLINIC, IS PRIMARILY SUPPORTED BY DONATIONS FROM MARION HEALTH PROVIDING FEE DIAGNOSTIC CARE TO BRIDGES PATIENTS WHO ARE UNDER 250% OF FEDERAL POVERTY LEVEL GUIDELINES. APPROXIMATELY 17 COLLEGES AND UNIVERSITIES ARE HOSTED FOR A ROBUST PROGRAM FOR STUDENT ROTATIONS AND PRACTICUMS IN MULTIPLE AREAS OF HEALTH CARE, PROVIDING 46,000 STUDENT ROTATION HOURS. MARION HEALTH HAS PARTNERED WITH SEVERAL STATE AND LOCAL ORGANIZATIONS TO HOUSE AND PROVIDE A CHECK OUT SYSTEM FOR A MOBILE KITCHEN TO PROMOTE HEALTHY COOKING, FOOD PREP AND PLANNING HEALTHY MEALS. MARION HEALTH SERVES AS A RESOURCE FOR NEEDS ASSESSMENTS, EDUCATION, AND GRANT OPPORTUNITIES.
SCHEDULE H, PART VI, LINE 7 INDIANA
Schedule H (Form 990) 2022
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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
2022
Open to Public
Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number
35-0868130
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) BRIDGES TO HEALTH INC
119 S WASHINGTON STREET
MARION,IN46952
20-5405181 501(C)(3) 108,250   FMV   DONATION
(2) CANCER SERVICES OF GRANT COUNTY
305 S NORTON AVENUE
MARION,IN46952
35-1058216 501(C)(3) 15,260   FMV   DONATION
(3) UNITED WAY OF GRANT COUNTY
PO BOX 61
MARION,IN46952
35-0995975 501(C)(3) 39,463   FMV   DONATION
(4) GREATER GRANT COUNTY
217 S ADAMS
MARION,IN46952
35-1850390 501(C)(3) 7,106   FMV   DONATION
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
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) 2022

Schedule I (Form 990) 2022
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)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 THE MARION HEALTH COMMUNITY SUPPORT POLICY/PROCEDURE PROVIDES GUIDANCE IN RESPONSE TO COMMUNITY ORGANIZATION REQUESTS FOR SUPPORT. AS ONE OF THE LARGER EMPLOYERS IN GRANT COUNTY, MARION HEALTH DEEMS IT BENEFICIAL AND NECESSARY TO BE A GOOD CORPORATE CITIZEN, AND WILL CONSIDER SUPPORT OF COMMUNITY ENDEAVORS AND PROJECTS THAT WILL IMPROVE THE LIVES AND LIVELIHOOD OF THE COMMUNITY IT SERVES.
Schedule I (Form 990) 2022



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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
2022
Open to Public Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
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
 
 
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
 
 
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
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
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) 2022

Schedule J (Form 990) 2022
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, 1099-MISC compensation, and/or 1099-NEC (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
1ANTHONY ROBERTS
CFO
(i)

(ii)
293,442
-------------
0
101,960
-------------
0
0
-------------
0
9,150
-------------
0
31,731
-------------
0
436,283
-------------
0
 
-------------
 
2CYNTHIA FUTRELL
CNO
(i)

(ii)
227,642
-------------
0
80,770
-------------
0
396
-------------
0
9,150
-------------
0
31,867
-------------
0
349,825
-------------
0
 
-------------
 
3DON TRICARICO JR
CAO (LEFT 01/19)
(i)

(ii)
0
-------------
0
0
-------------
0
136,500
-------------
0
0
-------------
0
0
-------------
0
136,500
-------------
0
 
-------------
 
4JAMES ORRELL MD
PHYSICIAN/CHIEF OF MED. STAFF
(i)

(ii)
283,224
-------------
0
104,373
-------------
0
42,068
-------------
0
9,150
-------------
0
43,904
-------------
0
482,719
-------------
0
 
-------------
 
5M NABI SHARIF MD
PHYSICIAN/BOARD MEMBER
(i)

(ii)
162,300
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
162,300
-------------
0
 
-------------
 
6NABIN AGRAWAL MD
PHYSICIAN/BOARD MEMBER
(i)

(ii)
202,082
-------------
0
47,536
-------------
0
33,545
-------------
0
7,877
-------------
0
42,521
-------------
0
333,561
-------------
0
 
-------------
 
7SHANKARAN SRIKANTH MD
PHYSICIAN/BOARD MEMBER
(i)

(ii)
507,619
-------------
0
58,961
-------------
0
24,503
-------------
0
9,150
-------------
0
41,624
-------------
0
641,857
-------------
0
 
-------------
 
8SIRAJABID KHATIB MD
PHYSICIAN/BOARD MEMBER
(i)

(ii)
319,073
-------------
0
28,472
-------------
0
29,103
-------------
0
9,150
-------------
0
13,690
-------------
0
399,488
-------------
0
 
-------------
 
9STEPHANIE HILTON-SIEBERT
PRESIDENT/CEO
(i)

(ii)
891,114
-------------
0
411,575
-------------
0
155,539
-------------
0
9,150
-------------
0
27,049
-------------
0
1,494,427
-------------
0
 
-------------
 
10STEPHEN KELLER MD
PHYSICIAN/BOARD MEMBER
(i)

(ii)
628,527
-------------
0
21,125
-------------
0
46,919
-------------
0
9,150
-------------
0
27,953
-------------
0
733,674
-------------
0
 
-------------
 
11CHARLES COSSELL DO
PHYSICIAN
(i)

(ii)
711,310
-------------
0
0
-------------
0
30,456
-------------
0
9,150
-------------
0
13,452
-------------
0
764,368
-------------
0
 
-------------
 
12EDMOND BENDALY MD
PHYSICIAN
(i)

(ii)
506,263
-------------
0
320,261
-------------
0
20,000
-------------
0
9,150
-------------
0
0
-------------
0
855,674
-------------
0
 
-------------
 
13KAREN JACOBS DO
PHYSICIAN
(i)

(ii)
628,486
-------------
0
9,848
-------------
0
22,395
-------------
0
9,150
-------------
0
25,404
-------------
0
695,283
-------------
0
 
-------------
 
14KAVITA RAJ DO
PHYSICIAN
(i)

(ii)
284,831
-------------
0
301,359
-------------
0
33,901
-------------
0
9,150
-------------
0
43,653
-------------
0
672,894
-------------
0
 
-------------
 
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 4a DON TRICARICO RECEIVED SEVERANCE PAY OF $136,500 DURING FY23.
Schedule J (Form 990) 2022

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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 , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number
35-0868130
Part
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 INDIANA FINANCE AUTHORITY
 
35-1602316   07-07-2015 33,000,000 NEW MONEY AND CURRENT REFUNDING   X   X   X
B INDIANA FINANCE AUTHORITY
 
35-1602316 45471ATE2 11-13-2020 74,933,215 NEW MONEY AND REFUNDING 2012A BOND   X   X   X
C INDIANA FINANCE AUTHORITY
 
35-1602316 45471ATW2 04-29-2021 31,066,642 CURRENT REFUNDING   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 9,950,000 0 550,000  
2 Amount of bonds legally defeased .............. 0 0 0  
3 Total proceeds of issue .................. 33,197,594 76,098,383 31,066,642  
4 Gross proceeds in reserve funds ............. 0 0 0  
5 Capitalized interest from proceeds ............. 0 0 0  
6 Proceeds in refunding escrows ............... 0 0 0  
7 Issuance costs from proceeds ............... 333,500 801,959 337,913  
8 Credit enhancement from proceeds ............. 0 0 0  
9 Working capital expenditures from proceeds ............. 0 0 0  
10 Capital expenditures from proceeds ............. 15,549,096 56,129,540 0  
11 Other spent proceeds ............. 17,315,000 0 30,728,729  
12 Other unspent proceeds ............. 0 19,166,884 0  
13 Year of substantial completion ............. 2019 2021
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 2020, a current refunding issue)? ........
X     X X      
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
  X   X   X    
16 Has the final allocation of proceeds been made? .......... X     X X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X      
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X X   X      
b Exception to rebate? ........   X   X   X    
c No rebate due? ......... X     X   X    
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X    
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period? X     X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X      
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
PART II LINE 3 07/01/2019 INVESTMENT EARNING AS SET FORTH BELOW. TOTAL INVESTMENT EARNINGS FOR EACH ISSUE: 2021 BONDS - $0 2020 BONDS - $1,165,168 2015 BONDS - $197,594
PART III LINE 7 BECAUSE THE PRIVATE USE PERCENTAGE FOR EACH BOND ISSUE IS MONITORED TO ENSURE THAT THE PRIVATE USE LIMIT IS NOT EXCEEDED, THE AMOUNT OF PRIVATE PAYMENTS HAS NOT BEEN CALCULATED.
PART IV LINE 2C THE 2021 BONDS WERE ISSUED TO CURRENTLY REFUND THE 2012A BONDS WHICH WERE ISSUED FOR PURPOSES OF (1) FINANCING THE ACQUISITION, CONSTRUCTION, EQUIPPING OR IMPROVEMENT OF CERTAIN CAPITAL ASSETS AND (II) REFUNDING THE ISSUER'S HOSPITAL REVENUE BONDS, SERIES 2002 (MARION GENERAL HOSPITAL PROJECT). THE 2015 BONDS WERE ISSUED FOR THE PURPOSES OF (I) FINANCING THE ACQUISITION, CONSTRUCTION, EQUIPPING OR IMPROVEMENT OF CERTAIN CAPITAL ASSETS AND (II) REFUNDING THE ISSUER'S VARIABLE RATE DEMAND REVENUE BONDS SERIES 2008A (MARION GENERAL HOSPITAL PROJECT). THE REBATE COMPUTATION FOR THE 2015 BONDS WERE PERFORMED ON 07/01/2019. THE 2020 BONDS WERE ISSUED TO FINANCE CERTAIN NEW MONEY PROJECTS OF MARION HEALTH.
Schedule K (Form 990) 2021

Additional Data


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Schedule L
(Form 990)
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
2021
Open to Public Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
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
(1) SIRAJABID KHATIB MD EMPLOYED RECRUITMENT   X 20,000 11,667   No Yes   Yes  
(2) JAMES ORRELL MD EMPLOYED RECRUITMENT   X 25,000 10,000   No Yes   Yes  
(3) KAREN JACOBS DO EMPLOYED RECRUITMENT   X 20,000 5,000   No Yes   Yes  
(4) SHANKARAN SRIKANTH MD EMPLOYED RECRUITMENT   X 25,000 12,500   No Yes   Yes  
(5) STEPHEN KELLER MD EMPLOYED RECRUITMENT   X 125,000 11,250   No Yes   Yes  
(6) CHARLES COSSELL DO EMPLOYED RECRUITMENT   X 125,000 68,389   No Yes   Yes  
Total ...............Small Bullet $ 118,806
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) 2021
Schedule L (Form 990) 2021
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) IMG INSURANCE SEE COMMENT 652,247 SEE COMMENT   No
(2) GCA TITLE SEE COMMENT 109,639 SEE COMMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
PART IV The son of Tim Dailey, MGH board member, owns >35% of IMG Insurance, a company which conducts business with MGH. MICHAEL HOTZ, MGH BOARD MEMBER, OWNS >35% OF GCA TITLE, A COMPANY WHICH CONDUCTS BUSINESS WITH MGH.
Schedule L (Form 990) 2021


Additional Data


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Software Version:  




SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Return Reference Explanation
FORM 990, PART VI, LINE 1A THERE ARE NORMALLY 15 MEMBERS OF THE BOARD, 13 OF WHICH ARE VOTING. THERE WAS ONE VACANCY AS OF JUNE 30, 2023, SO THERE WERE 14 MEMBERS OF WHICH 12 WERE VOTING MEMBERS.
FORM 990, PART VI, SECTION A, LINE 1B STEPHANIE HILTON-SIEBERT, DR. STEPHEN KELLER, DR. SIRAJABID KHATIB, DR. NABIN AGRAWAL, DR. JAMES ORRELL, AND DR. JEREMY WILSON ARE COMPENSATED AS EMPLOYEES OF THE ORGANIZATION. DR. M. NABI SHARIF IS COMPENSATED AS AN INDEPENDENT CONTRACTOR. AS A RESULT, ALL THE ABOVE INDIVIDUALS ARE CONSIDERED NON-INDEPENDENT BOARD MEMBERS. IN ADDITION, DR. KHATIB, DR. SRIKANTH, DR. ORRELL, TIM DAILEY, MICHAEL HOTZ, AND DR. STEPHEN KELLER ARE ALSO CONSIDERED NON-INDEPENDENT DUE TO THE TRANSACTIONS LISTED ON SCH. L.
FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION INCORPORATES NUMEROUS PARTIES INTO THE PRODUCTION AND REVIEW OF THE FORM 990 AND ASSOCIATED SCHEDULES. FINANCE DEPARTMENT STAFF AND MANAGEMENT COMPLETE THE FORM 990 SCHEDULES. THE FORMS AND SCHEDULES ARE REVIEWED IN DETAIL BY THE FINANCE MANAGER, CHIEF FINANCIAL OFFICER AND PRESIDENT/CEO. THE ORGANIZATION ENGAGES FORVIS LLP TO REVIEW THE COMPLETED FORM 990 AND ASSOCIATED SCHEDULES. PRIOR TO FILING THE RETURN, THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE 990, AND THE BOARD OF DIRECTORS ALSO RECEIVES A COPY.
FORM 990, PART VI, SECTION B, LINE 12C EVERY YEAR EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD OF DIRECTORS DELEGATED POWERS ARE REQUIRED TO SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, AGREES TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, A DETERMINATION IS MADE BY THE REMIANING BOARD OF DIRECTORS OR COMMITTEE MEMBERS IN ATTENDANCE AND WHO ARE ELIGIBLE TO VOTE. IF A CONFLICT DOES INDEED EXIST, THE PERSON IS REQUIRED TO LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE OF, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15A TO SUPPORT THE MISSION, VISION, AND VALUES OF MARION GENERAL HOSPITAL, INC. (MGH) AND THE CHARITABLE PURPOSE FOR WHICH IT EXISTS, THE EXECUTIVE TOTAL COMPENSATION PROGRAM IS DESIGNED AND ADMINISTERED TO ENSURE THAT MGH CAN ATTRACT, RETAIN AND MOTIVATE HIGHLY-TALENTED EXECUTIVES. EXECUTIVES ARE PLACED WITH APPROPRIATE SALARY RANGES BASED ON THE EXECUTIVE'S KNOWLEDGE, COMPETENCIES AND EXPERIENCE, PERFORMANCE, IMPORTANCE OF RETAINING THE EXECUTIVE, INTERNAL EQUITY CONSIDERATIONS AND FINANCIAL RESOURCES AVAILABLE. THE ORGANIZATION USES THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS TO REVIEW COMPENSATION PACKAGES, AND ALSO ENGAGES INDEPENDENT COMPENSATION CONSULTANTS TO PREPARE SURVEYS OR STUDIES TO ENSURE THAT THE EXECUTIVE TOTAL COMPENSATION IS REASONABLE AND COMPETITIVE. THIS PROCESS IS UNDERTAKEN ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 15B THE LAST FORMAL REVIEW OF OTHER OFFICERS AND KEY ADMINISTRATIVE DIRECTORS WAS IN 2022, PREPARED BY MERCER.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE KEPT ON SITE, AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR THE MARION GENERAL HOSPITAL, INC. BONDS.
FORM 990, PART XI, LINE 9 PENSION RELATED CHANGES $ 2,298,970 NET PERIODIC PENSION COST $-2,189,422 GAIN ON JV $ 410,992 TOTAL $ 520,540
PROGRAM SERVICES ACCOMPLISHMENTS Part III, Line 4d Marion General Hospital is a not-for-profit, 106-bed, acute care, rural, sole community hospital located in Grant county, Indiana. MGH provides healthcare services throughout Grant County (includes Marion, Fairmount, Upland, Gas City and Swayzee) and in Miami County (Converse), Indiana. Administrators and staff of Marion General Hospital believe everyone should have access to healthcare and continue to address ongoing financial challenges to meet the healthcare needs of our community. Clients and families receive impartial access to treatment, available healthcare accommodations and medically indicated services regardless of race, creed, sex, national origin, or source of payment for care. In addition to the inpatient services, radiology services and room services previously described, Marion General Hospital also provides ambulance, anticoagulation clinic, medical oncology, cardiovascular, cardiac cath lab, CHF clinic, cardiac REHAB, laboratory, observation, neurodiagnostic, surgery, physical, speech and occupational therapy, and wound clinic services. Marion General Hospital continues to provide hospitalist services 24/7, as well as interventional cardiology services performed by St. Vincent Medical Group providers right here at Marion General Hospital.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


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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
2021
Open to Public Inspection
Name of the organization
MARION GENERAL HOSPITAL INC
 
Employer identification number

35-0868130
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)MGH FOUNDATION INC
441 N WABASH AVENUE

MARION,IN46952
81-1872365
SUPPORT IN 501(C)(3) 12A MGH
 
Yes
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
(1) PROGRESSIVE CANCER CARE LLC

831 N THEATRE DRIVE
MARION,IN46952
32-0061469
ONCOLOGY CENTER IN NA
 
RELATED 385,461 1,664,741   No     No 51.026 %












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












Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
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
Yes
 
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
 
No
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
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) PROGRESSIVE CANCER CARE LLC

F 302,037 FMV
(2) PROGRESSIVE CANCER CARE LLC

K 227,005 FMV
(3) PROGRESSIVE CANCER CARE LLC

P 154,634 FMV



Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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