TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) SHAWN MCCOY...................................................................... PRESIDENT / CEO OF DEACONESS	30.00 ................. 25.00	X	X	1,551,117	9,600	317,182
(2) SHARON REED WALKER...................................................................... CHAIRMAN	5.00 ................. 5.00	X		0	6,200	0
(3) NAROTHAMA R AEDDULA MD...................................................................... DIRECTOR	5.00 ................. 50.00	X		0	970,108	30,981
(4) SCOTT CORDTS MD...................................................................... DIRECTOR	50.00 ................. 5.00	X		340,697	5,800	59,764
(5) JAMIE L DAVIDSON MD...................................................................... DIRECTOR	50.00 ................. 0.00	X		401,852	0	26,612
(6) JEFF JUSTICE...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0	0
(7) LARRY KILINSKI MD...................................................................... DIRECTOR	5.00 ................. 5.00	X		66,656	4,800	0
(8) GLEN MUEHLBAUER...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0	0
(9) DAVE PAPARIELLA...................................................................... DIRECTOR	5.00 ................. 5.00	X		0	7,000	0
(10) DAVID RYON MD...................................................................... DIRECTOR	50.00 ................. 0.00	X		553,388	1,800	60,454
(11) DANIELA VIDAL...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0	0
(12) ANN WHITE PHD...................................................................... DIRECTOR	5.00 ................. 0.00	X		0	0	0
(13) CHERYL WATHEN...................................................................... TREASURER / CHIEF FINANCIAL OFFICER	30.00 ................. 35.00		X	810,574	9,600	201,621
(14) JAMES PORTER MD...................................................................... PRESIDENT OF DEACONESS HEALTH SYSTEM	50.00 ................. 18.00		X	1,078,642	4,600	209,328
(15) LYNN LINGAFELTER...................................................................... PRESIDENT	50.00 ................. 11.00		X	878,665	4,000	182,889
(16) MELINDA D LEBOFSKY...................................................................... VICE PRESIDENT	50.00 ................. 0.00		X	513,007	0	74,884
(17) JOANN WOOD MD...................................................................... CHIEF MEDICAL OFFICER	50.00 ................. 10.00		X	575,994	0	125,409

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) MARC FLORENCE........................................................................ VICE PRESIDENT	50.00 .......................13.00	X			590,416	0	135,997
(19) BRADLEY SCHEU MD........................................................................ VICE PRESIDENT	5.00 .......................57.00	X			0	500,579	129,103
(20) JENNIFER CHIUSANO........................................................................ CHIEF NURSING EXECUTIVE	50.00 .......................0.00	X			418,573	0	87,781
(21) RAGHAV GUPTA MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00		X		1,344,264	0	49,151
(22) VENKATESH MADADI MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00		X		1,125,829	0	63,701
(23) ANDREI TRIPAC MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00		X		1,320,065	0	51,572
(24) PAUL MICK MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00		X		1,069,002	0	37,914
(25) MARK H MURRAY MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00		X		1,055,589	0	46,513
(26) LINDA WHITE........................................................................ FORMER CEO EMERITA, FOUNDATION	0.00 .......................71.00			X	0	212,056	15,832
(27) MAQBOOL AHMED MD........................................................................ FORMER DIRECTOR	0.00 .......................55.00			X	0	670,305	0
(28) MIA HINDI........................................................................ FORMER DIRECTOR	5.00 .......................55.00			X	0	1,192,223	56,769
(29) JOSEPH KLINK MD........................................................................ DIRECTOR	0.00 .......................50.00			X	0	1,070,636	39,442

(A) Name and business address	(B) Description of services	(C) Compensation
EVANSVILLE SURGERY CENTER PO BOX 2185 EVANSVILLE,IN47728	SURGICAL SERVICES	29,049,344
PROGRESSIVEHEALTH OF INDIANA 150 N ROSENBERGER AVE EVANSVILLE,IN47712	PHYSICAL THERAPY	20,271,835
TRI STATE RADIATION ONCOLOGY 700 N BURKHARDT AVE EVANSVILLE,IN47715	RADIATION & ONCOLOGY SERVICES	19,348,119
TOTAL MSP LLC 221 W COLLEGE AVE FLOOR 2 APPLETON,WI54911	STAFFING	14,877,640
ORTHOALIGN LLC 4011 GATEWAY BLVD NEWBURGH,IN47630	MEDICAL SERVICES	13,920,727
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 91

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

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.)

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

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

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

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

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

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 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)		(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)		(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

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

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

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

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

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

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

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

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)		(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)		(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.)..

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

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

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

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

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

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

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).

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

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

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

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

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

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

10a

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

10b

Schedule A (Form 990) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

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

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.

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

By reason of the relationship described in 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.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2022

Page 6

Part V

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

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

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

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

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

Schedule A (Form 990) 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:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution: An organization that 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 DEACONESS HOSPITAL INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization DEACONESS HOSPITAL INC		Employer identification number 35-0593390

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 DEACONESS HOSPITAL INC			Employer identification number 35-0593390
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

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 Bullet

Go 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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

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 Bullet

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes

54,707

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

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

Yes

42,574

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

97,281

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	LOBBYING EXPENDITURES CONSISTED OF A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL ORGANIZATIONS IN WHICH DEACONESS HOSPITAL AND ITS EMPLOYEES ARE MEMBERS. THE LOBBYING PORTION OF THE DUES IS NOTED ON THE MEMBERSHIP APPLICATION OR BILLING STATEMENT.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	7,787,991	9,633,606	8,745,525	8,037,280	7,914,040
b	Contributions ...	10,551	1,075	1,100	1,075	1,075
c	Net investment earnings, gains, and losses	1,430,429	-1,370,697	1,041,502	867,885	195,423
d	Grants or scholarships ...	-1,000
e	Other expenditures for facilities and programs ...	276,743	475,993	154,521	160,715	73,258
f	Administrative expenses ....
g	End of year balance ......	8,953,228	7,787,991	9,633,606	8,745,525	8,037,280

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

Board designated or quasi-endowment SchDMd Bullet

12.000 %

Permanent endowment SchDMd Bullet

88.000 %

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	4,544,159	23,608,102		28,152,261
b	Buildings ....	58,657,062	888,612,434	459,231,904	488,037,592
c	Leasehold improvements
d	Equipment ....		330,733,423	265,128,562	65,604,861
e	Other .....		47,495,147	4,144,080	43,351,067
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					625,145,781

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) OTHER SECURITIES	168,680,216	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	168,680,216

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.)

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)RELATED ORGANIZATION RECEIVABLES				123,148,939
(2)OTHER ASSETS				16,413,832
(3)RIGHT OF USE ASSET				26,478,896
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				166,041,667

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
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	471,288,302
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

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART V, LINE 4:	THE DEACONESS HOSPITAL FOUNDATION UTILIZES ENDOWMENT FUNDS TO SUPPORT AND BENEFIT THE MISSION OF DEACONESS HOSPITAL. SPECIFICALLY, ENDOWMENT FUNDS ARE USED TO HELP SUPPORT ACTIVITIES OR PROJECTS THAT HELP TO PROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE.
PART X, LINE 2:	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM 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 SYSTEM AND HAS CONCLUDED THAT AS OF SEPTEMBER 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 CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.
PART VII AND IX:	SECTIONS ARE NOT REQUIRED AS THE TOTALS FOR EACH LINE ARE LESS THAN 5% OF THE TOTAL ASSETS LISTED ON FORM 990, PART X, LINE 16.
PART XI AND XII:	SECTIONS ARE NOT REQUIRED AS THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. THE CONSOLIDATED FINANCIAL STATEMENT IS AUDITED BY AN INDEPENDENT ACCOUNTING FIRM AND IS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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
DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2022

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 DH PARTY OF YR (event type)	(b) Event #2 DH CLASSIC (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	819,916	209,580	1,029,496
2	Less: Contributions . . . .	698,572	192,765	891,337
3	Gross income (line 1 minus line 2) . . . . . .	121,344	16,815	138,159

4	Cash prizes . . . . .
5	Noncash prizes . . . .		45,245	45,245
6	Rent/facility costs . . . .	82,016	33,720	115,736
7	Food and beverages . . .
8	Entertainment . . . .	26,501	2,048	28,549
9	Other direct expenses . . .	57,096	3,514	60,610
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			250,140
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			-111,981

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2022

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	14,101,233		14,101,233	1.200 %
b	Medicaid (from Worksheet 3, column a) . . . . .	230,612,138	182,707,772	47,904,366	4.090 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	244,713,371	182,707,772	62,005,599	5.290 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,145,614		1,145,614	0.100 %
f	Health professions education (from Worksheet 5) . . .	8,603,222	2,601,601	6,001,621	0.510 %
g	Subsidized health services (from Worksheet 6) . . . .	320,958	21,279	299,679	0.030 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,087,783	53,655	2,034,128	0.170 %
j	Total. Other Benefits . .	12,157,577	2,676,535	9,481,042	0.810 %
k	Total. Add lines 7d and 7j .	256,870,948	185,384,307	71,486,641	6.100 %

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	1,250	1,250	0 %
2	Economic development	34,046	34,046	0 %
3	Community support	22,716	22,716	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	59,089	59,089	0.010 %
9	Other
10	Total	117,101	117,101	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

12,518,806

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. ......

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

Section B. Medicare

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

243,154,708

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

216,734,767

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

26,419,941

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

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?3Name, 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)						Facility reporting group
1	DEACONESS HOSPITAL INC 600 MARY STREET EVANSVILLE,IN47747 WWW.DEACONESS.COM 23-005074-1	X	X	X	X	A
2	DEACONESS GATEWAY HOSPITAL 4011 GATEWAY BLVD NEWBURGH,IN47630 WWW.DEACONESS.COM 23-005074-1	X	X	X	X	A
3	DEACONESS CROSS POINTE 7200 E INDIANA STREET EVANSVILLE,IN47715 WWW.DEACONESS.COM 23-005074-1	X				A

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)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): HTTP://WWW.DEACONESS.COM/CHNA

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

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

Yes

If "Yes" (list url): HTTP://WWW.DEACONESS.COM/CHNA

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 350.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

SEE PART V

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

SEE PART V

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: DEACONESS HOSPITAL, INC, - FACILITY 2: DEACONESS GATEWAY HOSPITAL, - FACILITY 3: DEACONESS CROSS POINTE
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 5:	THREE APPROACHES WERE USED TO COLLECT PRIMARY AND SECONDARY DATA. DIEHL CONSULTING GROUP (DCG) WAS CONTRACTED TO PROVIDE SUPPORT FOR THESE METHODS. THIS INCLUDED COMPILING EXISTING SECONDARY DATA, ADMINISTERING PROVIDER/STAKEHOLDER SURVEYS, AND CONDUCTING FOCUS GROUPS. DCG ANALYZED AND SUMMARIZED DATA FROM THESE METHODS AND ASSISTED IN THE PRIORITIZATION AND FINAL REPORTING PROCESS.METHODS ARE SUMMARIZED BELOW AND FURTHER DETAILED IN EACH OF THE RESPECTIVE RESULTS SECTIONS OF THIS REPORT AND APPENDIX A. TO SUPPORT PRIORITIZATION, A SYNTHESIS OF KEY FINDINGS FROM DATA COLLECTION PROCESSES WAS PRESENTED AND SUMMARY DOCUMENTS PRODUCED TO GUIDE DISCUSSION.SECONDARY DATA SOURCES WERE REVIEWED TO BETTER UNDERSTAND THE HEALTH NEEDS AND SOCIAL, ECONOMIC, AND DEMOGRAPHIC CHARACTERISTICS OF THOSE LIVING IN THE SERVICE AREA. SOURCES INCLUDED (A) THE 2021 VERSION OF COUNTY HEALTH RANKINGS & ROADMAPS, (B) THE INDIANA STATE DEPARTMENT OF HEALTH, (C) THE U.S. CENSUS, (D) THE WELBORN BAPTIST FOUNDATION 2021 GREATER EVANSVILLE HEALTH SURVEY, AND (E) OTHER LOCAL DATA SOURCES PROVIDED BY COMMUNITY PARTNERS. PROVIDER/STAKEHOLDER SURVEYS WERE ADMINISTERED TO GATHER INSIGHTS INTO THE HEALTH ISSUES IMPACTING THE COMMUNITY. PARTICIPANTS WERE PROVIDED A LIST OF TWENTY (20) HEALTH ISSUES AND SOCIAL DETERMINANTS OF HEALTH, AS WELL AS AN OPPORTUNITY TO WRITE-IN OTHER ISSUES NOT INCLUDED ON THE LIST. PARTICIPANTS SELECTED FIVE (5) ISSUES THEY CONSIDERED TO BE HIGHEST PRIORITY NEEDS IN THE COUNTY. RESPONDENTS THEN RANKED THE FIVE (5) ISSUES BASED ON PRIORITY. FOR EACH ISSUE IDENTIFIED, RESPONDENTS WERE THEN ASKED TO PROVIDE FEEDBACK ON THE PERCEIVED TREND OF THE ISSUE SINCE 2018, THE ADEQUACY OF RESOURCES DEVOTED TO ADDRESSING THE ISSUE, AND ANY PERCEIVED BARRIERS TO ADDRESSING THE ISSUE.PROVIDER/STAKEHOLDER FOCUS GROUPS WERE CONDUCTED VIRTUALLY WITH 75 PARTICIPANTS ACROSS 14 GROUPS REPRESENTING MEDICAL/HEALTHCARE ORGANIZATIONS AND ORGANIZATIONS WITH UNIQUE PERSPECTIVES ON PUBLIC SERVICE, NONPROFIT SERVICES, CHILD/YOUTH DEVELOPMENT, HEALTH EQUITY, AND BUSINESS/ECONOMIC DEVELOPMENT. FOCUS GROUPS EXPANDED ON INFORMATION COLLECTED THROUGH THE SURVEYS BY PROVIDING ADDITIONAL INSIGHT ON THE HIGHEST RANKED PRIORITY NEEDS IDENTIFIED THROUGH THE SURVEYS.LISTINGS OF THOSE COMMUNITY PARTNERS ARE INCLUDED IN THE APPENDICES SECTION OF THE CHNA REPORT (APPENDIX B) AND ALSO LISTED IN THE PRIORITIZATION PROCESS SECTION AS APPLICABLE (SECTION 6).
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 6A:	BOTH HEALTH SYSTEMS IN VANDERBURGH AND WARRICK COUNTY WORKED TOGETHER TO ADMINISTER THE SAME CHNA SURVEY TO RESIDENTS IN BOTH COUNTIES. PARTICIPATING HEALTH SYSTEMS (IN ADDITION TO DEACONESS HEALTH SYSTEM) INCLUDED ASCENSION/ST. VINCENT.
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 6B:	2022 CHNA CONDUCTED COLLABORATIVELY BY DEACONESS HEALTH SYSTEM, ASCENSION ST. VINCENT EVANSVILLE HOSPITAL, ECHO COMMUNITY HEALTHCARE, VANDERBURGH COUNTY HEALTH DEPARTMENT, UNITED WAY OF SOUTHWESTERN INDIANA, AND THE WELBORN BAPTIST FOUNDATION.
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 11:	VANDERBURGH COUNTY:FROM THE FIVE ENDORSED ISSUES IDENTIFIED FOR PRIORITIZATION, THE GROUP SELECTED BEHAVIORAL HEALTH, MATERNAL CHILD HEALTH, AND EXERCISE, WEIGHT & NUTRITION AS OUR PRIMARY POINTS OF FOCUS FOR THE NEXT CHNA PERIOD. COVID-19 RESPONSE IS SOMETHING THAT WE WILL CONTINUE TO ADDRESS AND ACCESS TO CARE WILL BE REVIEWED IN CONTEXT OF THESE SELECTED ISSUES.THE BROAD CATEGORIES OF BEHAVIORAL HEALTH, MATERNAL CHILD HEALTH, AND EXERCISE, WEIGHT & NUTRITION WERE SUBSEQUENTLY NARROWED DOWN TO THE FOLLOWING, MORE SPECIFIC, STRATEGIES. SUBJECT EXPERTS AND GROUPS CURRENTLY CONDUCTING WORK IN THESE FIELDS WILL CONTINUE TO MEET TO IDENTIFY METRICS AND OUTCOME MEASURES AS WELL AS ASSIGN TASKS FOR THE THREE-YEAR CHNA PERIOD.BEHAVIORAL HEALTH1. REVIEW AND REVISE REGIONAL MENTAL HEALTH SERVICES MAP (CREATED IN 2017) TO IDENTIFY SERVICES, GAPS, BARRIERS, ETC. IN ORDER TO ADDRESS ACCESS TO CARE ISSUES.2. IDENTIFY EXISTING COMMITTEES AND GROUPS AND RELAUNCH/REVITALIZE EFFORTS TO SPEARHEAD INITIATIVES THAT IMPACT BEHAVIORAL HEALTH.A. SUCH AS SUPPORTING THE REINSTATEMENT OF THE VCHD'S RECIDIVISM REDUCTION PROGRAM.MATERNAL CHILD HEALTH1. WORK WITH THE COMMUNITY ACTION TEAM (CAT) AS IT IMPLEMENTS RECOMMENDATIONS IN OUR COMMUNITY AS IDENTIFIED BY THE FETAL INFANT MORTALITY REVIEW TEAM DATA AND FINDINGS.2. IDENTIFY AND SUPPORT PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH ON MATERNAL AND CHILD OUTCOMES.EXERCISE, WEIGHT & NUTRITION1. USE PROGRAMS AND PROJECTS SUCH AS A MOBILE MARKET, FARMER'S/POP-UP MARKETS, AND COMMUNITY GARDENS TO INCREASE THE AVAILABILITY OF FRESH PRODUCE AND OTHER HEALTHY FOOD OPTIONS IN "HEALTHY FOOD PRIORITY AREAS."2. SUPPORT AND EXPAND COMMUNITY ACTIVE LIVING PROGRAMS, SUCH AS STORY TRAILS, COMPLETE STREETS, WARRICK TRAILS, AND ADDITIONAL UPGRADE IN SCHOOL ACTIVITIES.3. MAP OUT PROGRAMS AND SERVICES TO PROVIDE EDUCATION ON AVAILABILITY OF HEALTHY FOOD ASSISTANCE, DIABETES PROGRAMS, ACTIVE LIVING PROGRAMS, ETC.WARRICK COUNTY: FROM THE FOUR ENDORSED ISSUES IDENTIFIED FOR PRIORITIZATION, THE GROUP SELECTED BEHAVIORAL HEALTH, ACCESS TO CARE, AND OBESITY & HEALTHY FOOD ACCESS AS OUR PRIMARY POINTS OF FOCUS FOR THE NEXT CHNA PERIOD. COVID-19 RESPONSE IS SOMETHING THAT WE WILL CONTINUE TO ADDRESS. HEALTHY FOOD ACCESS WAS WRAPPED INTO THE BROADER HEADING OF "EXERCISE, WEIGHT & NUTRITION."THE BROAD CATEGORIES OF BEHAVIORAL HEALTH, ACCESS TO CARE, AND EXERCISE, WEIGHT & NUTRITION WERE SUBSEQUENTLY NARROWED DOWN TO THE FOLLOWING, MORE SPECIFIC, STRATEGIES. SUBJECT EXPERTS AND GROUPS CURRENTLY CONDUCTING WORK IN THESE FIELDS WILL CONTINUE TO MEET TO IDENTIFY METRICS AND OUTCOME MEASURES AS WELL AS ASSIGN TASKS FOR THE THREE-YEAR CHNA PERIOD.BEHAVIORAL HEALTH1. REVIEW AND REVISE REGIONAL MENTAL HEALTH SERVICES MAP (CREATED IN 2017) TO IDENTIFY SERVICES, GAPS, BARRIERS, ETC. IN ORDER TO ADDRESS ACCESS TO CARE ISSUES.2. IDENTIFY EXISTING COMMITTEES AND GROUPS AND RELAUNCH/REVITALIZE EFFORTS TO SPEARHEAD INITIATIVES THAT IMPACT BEHAVIORAL HEALTH.A. SUCH AS SUPPORTING THE REINSTATEMENT OF THE VCHD'S RECIDIVISM REDUCTION PROGRAM.ACCESS TO CARE1. WORK CONDUCT A TRANSPORTATION STUDY FOR THE GREATER EVANSVILLE REGION, WITH SPECIFIC FOCUS ON VANDERBURGH AND WARRICK COUNTIES, FOR MEDICALLY RELATED APPOINTMENTS AND ACTIVITIES.2. FOCUS ON THE UNIQUE NEEDS OF RESIDENTS OF RURAL WARRICK COUNTY BY IDENTIFYING OPPORTUNITIES TO BRING SERVICES AND PROGRAMS TO THEM.EXERCISE, WEIGHT & NUTRITION1. USE PROGRAMS AND PROJECTS SUCH AS A MOBILE MARKET, FARMER'S/POP-UP MARKETS, AND COMMUNITY GARDENS TO INCREASE THE AVAILABILITY OF FRESH PRODUCE AND OTHER HEALTHY FOOD OPTIONS IN "HEALTHY FOOD PRIORITY AREAS."2. SUPPORT AND EXPAND COMMUNITY ACTIVE LIVING PROGRAMS, SUCH AS STORY TRAILS, COMPLETE STREETS, WARRICK TRAILS, AND ADDITIONAL UPGRADE IN SCHOOL ACTIVITIES.3. MAP OUT PROGRAMS AND SERVICES TO PROVIDE EDUCATION ON AVAILABILITY OF HEALTHY FOOD ASSISTANCE, DIABETES PROGRAMS, ACTIVE LIVING PROGRAMS, ETC.
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 15E:	WELL FUND IS AVAILABLE TO DEACONESS HEALTH SYSTEM PATIENTS TO ASSIST WITH APPLYING FOR MEDICAID OR EXCHANGE PRODUCTS.
GROUP A-FACILITY 1 -- DEACONESS HOSPITAL, INC. PART V, SECTION B, LINE 16J:	OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: DEACONESS HOSPITAL SEEKS OUT THE PATIENTS THAT ARE SELF-PAY AND INTERVIEWS THESE PATIENTS WHILE THEY ARE IN THE FACILITY. THE FINANCIAL ASSISTANCE POLICY IS PROMOTED TO PATIENTS. DEACONESS HOSPITAL SEEKS OUT THOSE PATIENTS THAT WOULD QUALIFY FOR THE FINANCIAL ASSISTANCE POLICY. COLLECTABILITY SCORING IS ALSO COMPLETED AND ALLOWANCES ARE MADE BASED UPON THESE SCORES.
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 5:	DESCRIPTION OF COMMUNITY INPUT IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 6A:	OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 6B:	OTHER ORGANIZATIONS CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 11:	HOW THE SIGNIFICANT NEEDS ARE BEING ADDRESSED IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 15E:	OTHER METHOD USED FOR APPLYING FOR FINANCIAL ASSISTANCE IS THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 2 -- DEACONESS GATEWAY HOSPITAL PART V, SECTION B, LINE 16J:	OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 5:	DESCRIPTION OF COMMUNITY INPUT IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 6A:	OTHER HOSPITAL FACILITIES CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 6B:	OTHER ORGANIZATIONS CHNA WAS CONDUCTED WITH IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 11:	HOW THE SIGNIFICANT NEEDS ARE BEING ADDRESSED IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 15E:	OTHER METHOD USED FOR APPLYING FOR FINANCIAL ASSISTANCE IS THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
GROUP A-FACILITY 3 -- DEACONESS CROSS POINTE PART V, SECTION B, LINE 16J:	OTHER METHOD USED TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IS REPORTED THE SAME AS DEACONESS HOSPITAL, INC. (HOSPITAL FACILITY #1).
PART V, SECTION B, LINE 16A, FAP WEBSITE:	THE FINANCIAL ASSISTANCE POLICY (FAP) FOR ALL THREE HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE:	THE FINANCIAL ASSISTANCE POLICY (FAP) APPLICATION FOR ALL THREE HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16B, FAP PLAIN LANGUAGE SUMMARY WEBSITE:	THE FINANCIAL ASSISTANCE POLICY (FAP) PLAIN LANGUAGE SUMMARY FOR ALL THREE HOSPITAL FACILITIES IS MADE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE:HTTPS://WWW.DEACONESS.COM/PAY-MY-BILL/FINANCIAL-ASSISTANCE

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?35
Name and address		Type of Facility (describe)
1	1 - CARDIAC REHAB 4015 GATEWAY BLVD SUITE 2122 NEWBURGH,IN47630	OUTPATIENT SERVICES
2	2 - DEACONESS CLINIC GATEWAY REG LAB 4233 GATEWAY BLVD SUITE 201 NEWBURGH,IN47630	DIAGNOSTIC CENTER
3	3 - DEACONESS COMPREHENSIVE PAIN CTR & MED 4600 W LLOYD EXPRESSWAY SUITE A EVANSVILLE,IN47712	OUTPATIENT SERVICES
4	4 - DEACONESS COMPREHENSIVE PAIN CTR-GATEWAY 4099 GATEWAY BLVD NEWBURGH,IN47630	OUTPATIENT SERVICES
5	5 - DEACONESS CROSS POINTE 445 CROSS POINTE BLVD EVANSVILLE,IN47715	OUTPATIENT PHYSICIAN CLINIC
6	6 - DEACONESS FAMILY MEDICINE RESIDENCY 415 W COLUMBIA ST SUITE 110 EVANSVILLE,IN47710	OUTPATIENT PHYSICIAN CLINIC
7	7 - DEACONESS GATEWAY GASTROENTEROLOGY 4133 GATEWAY BLVD SUITE 290 NEWBURGH,IN47630	OUTPATIENT SERVICES
8	8 - DEACONESS HOSPITAL ANTICOAGMED THERAPY 350 W COLUMBIA ST SUITE 210 EVANSVILLE,IN47747	OUTPATIENT SERVICES
9	9 - DEACONESS HOSPITAL BREAST CENTER 520 MARY STREET SUITE 140 EVANSVILLE,IN47710	DIAGNOSTIC CENTER
10	10 - DEACONESS HOSPITAL CANCER SERVICES 4055 GATEWAY BLVD NEWBURGH,IN47630	OUTPATIENT SERVICES
11	11 - DEACONESS HOSPITAL ENDOSCOPYSPECIALTY 4219 GATEWAY BLVD SUITE 1005 NEWBURGH,IN47630	OUTPATIENT SERVICES
12	12 - DEACONESS HOSPITAL INFUSION CTRPHARMACY 4111 GATEWAY BLVD NEWBURGH,IN47630	OUTPATIENT SERVICES
13	13 - DEACONESS HOSPITAL LAB & EKGDIABETES ED 520 MARY STREET SUITE 330 EVANSVILLE,IN47710	DIAGNOSTIC CENTER
14	14 - DEACONESS HOSPITAL LAB & RADIOLOGY 4209 GATEWAY BLVD NEWBURGH,IN47630	DIAGNOSTIC CENTER
15	15 - DEACONESS HOSPITAL LABRADIOLOGY 4219 GATEWAY BLVD SUITE 1004 NEWBURGH,IN47630	DIAGNOSTIC CENTER
16	16 - DEACONESS HOSPITAL PAIN CTRMED THERAPY 4015 GATEWAY BLVD SUITE 2120 NEWBURGH,IN47630	OUTPATIENT SERVICES
17	17 - DEACONESS HOSPITAL PHYS MED-OA 10455 ORTHOPAEDIC DRIVE NEWBURGH,IN47630	OUTPATIENT SERVICES
18	18 - DEACONESS HOSPITAL PHYSICAL MEDICINE 4600 W LLOYD EXPRESSWAY SUITE B EVANSVILLE,IN47715	OUTPATIENT SERVICES
19	19 - DEACONESS HOSPITAL PHYSICAL MEDICINE 520 MARY STREET SUITE 280 EVANSVILLE,IN47747	OUTPATIENT SERVICES
20	20 - DEACONESS HOSPITAL RADIOLOGY EXPRESS 4087 GATEWAY BLVD NEWBURGH,IN47630	DIAGNOSTIC CENTER
21	21 - DEACONESS HOSPITAL SPECIALTY 4219 GATEWAY BLVD SUITE 2003 NEWBURGH,IN47630	OUTPATIENT SERVICES
22	22 - DEACONESS HOSPITAL SPECIALTY CLINIC 120 SE 4TH STREET SUITE 3200 EVANSVILLE,IN47708	DIAGNOSTIC CENTER
23	23 - DEACONESS HOSPITAL WEIGHT LOSS SOLUTIONS 4219 GATEWAY BLVD SUITE 2001 NEWBURGH,IN47630	OUTPATIENT SERVICES
24	24 - DEACONESS LAB & RADIOLOGY 120 SE 4TH STREET SUITE 1100 EVANSVILLE,IN47708	DIAGNOSTIC CENTER
25	25 - DEACONESS PRIMARY CARE FOR SENIORS 1750 OAK HILL ROAD EVANSVILLE,IN47710	OUTPATIENT PHYSICIAN CLINIC
26	26 - DEACONESS PRIMARY CARE FOR SENIORS 4498 FIRST AVENUE EVANSVILLE,IN47710	OUTPATIENT PHYSICIAN CLINIC
27	27 - DEACONESS RADIOLOGY LAB & RADIOLOGY 8600 NORTH KENTUCKY AVENUE EVANSVILLE,IN47725	DIAGNOSTIC CENTER
28	28 - DEACONESS REGIONAL LABORATORY 4133 GATEWAY BLVD SUITE 110 NEWBURGH,IN47630	DIAGNOSTIC CENTER
29	29 - DEACONESS REGIONAL LABORATORY 4494 N FIRST AVENUE EVANSVILLE,IN47710	DIAGNOSTIC CENTER
30	30 - DEACONESS SLEEP CENTER 350 W COLUMBIA STREET SUITE 100 EVANSVILLE,IN47710	OUTPATIENT SERVICES
31	31 - DEACONESS SLEEP CENTER-EAST 7307 E COLUMBIA ST EVANSVILLE,IN47715	DIAGNOSTIC CENTER
32	32 - DEACONESS SLEEP LAB 350 W COLUMBIA STREET SUITE LL-10 EVANSVILLE,IN47710	DIAGNOSTIC CENTER
33	33 - DEACONESS WEIGHT LOSS SOLUTIONS 310 W IOWA STREET EVANSVILLE,IN47710	OUTPATIENT PHYSICIAN CLINIC
34	34 - DEACONESS WOUND CARE CENTER 350 W COLUMBIA STREET SUITE 350 EVANSVILLE,IN47710	OUTPATIENT SERVICES
35	35 - MT VERNON MEDICAL CENTER LAB & RADIOLOGY 1900 W FOURTH STREET MT VERNON,IN47620	DIAGNOSTIC CENTER

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
PART I, LINE 6A:	DEACONESS HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS MADE AVAILABLE ON THE DEACONESS WEBSITE AT HTTP://WWW.DEACONESS.COM/CHNA
PART I, LINE 7:	A COST TO CHARGE RATIO WAS USED FOR MOST OF THE CALCULATIONS FOR THE TABLE. IRS INSTRUCTION'S WORKSHEET 2 WAS USED FOR THIS CALCULATION. WE DID NOT USE THE COST TO CHARGE RATIO FOR LINE 7G AS IT WAS NOT RELEVANT TO THESE SERVICES. THE ACTUAL COST FROM OUR COSTING SYSTEM WAS USED WHEN AVAILABLE. THE COST TO CHARGE RATIO FOR EACH SERVICE TYPE WAS USED TO ESTIMATE COST WHEN NOT AVAILABLE FROM OUR INTERNAL COSTING SYSTEM.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES ATTRIBUTED TO PHYSICIAN CLINICS HAVE A COST OF $5,330.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING PERCENTAGE IN THIS COLUMN IS $0.00.
PART II, COMMUNITY BUILDING ACTIVITIES:	DEACONESS PROVIDES SUPPORT TO NUMEROUS ORGANIZATIONS THAT FOCUS ON EDUCATION, COMMUNITY IMPROVEMENTS, AND LEADERSHIP DEVELOPMENT. DEACONESS BELIEVES THAT IN SUPPORTING THESE LOCAL SCHOOLS AND ORGANIZATIONS WE ARE PROVIDING ASSISTANCE IN BETTERING OUR COMMUNITY AND OUR PATIENTS.DEACONESS DID PROVIDE SUPPORT TO OUR LOCAL CHAMBER OF COMMERCE TO HOST NUMEROUS LUNCHEONS AND AWARD CEREMONIES THAT PROMOTES LEADERSHIP DEVELOPMENT AND THE IMPORTANCE OF COMMUNITY AND GOVERNMENT INVOLVEMENT. DEACONESS ALSO PROVIDED SUPPORT TO IMPORTANT COMMUNITY ORGANIZATIONS SUCH AS LOCAL SCHOOLS, WISE CHOICE FALL FESTIVAL COMMUNITY FORUM, AND OUR ZOO TO SHOW OUR SUPPORT OF THEIR MISSIONS.
PART III, LINE 2:	THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE SIGNIFICANT AND DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY, DETERMINED ON A PORTFOLIO BASIS, ARE RECORDED AS BAD DEBT EXPENSE. CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS.
PART III, LINE 3:	DEACONESS HOSPITAL DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT.
PART III, LINE 4:	THE FOOTNOTE DESCRIBING BAD DEBT EXPENSES IS INCLUDED IN THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE "CHARITY CARE, COMMUNITY BENEFIT AND ASSISTANCE TO THE UNINSURED" STARTING ON PAGE 13 AND "PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE" STARTING ON PAGE 11.
PART III, LINE 8:	THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE ACTUAL BASED UPON THE 2023 MEDICARE COST REPORT.
PART III, LINE 9B:	DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY WILL BE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON.
PART VI, LINE 2:	NEEDS ASSESSMENT PROCESS: DEACONESS UTILIZES A VARIETY OF SOURCES TO GATHER DATA ON LOCAL HEALTH CARE NEEDS. WE USE DATA FROM THE UNITED WAY OF SOUTHWESTERN INDIANA'S COMPREHENSIVE NEEDS ASSESSMENT, WELBORN BAPTIST FOUNDATION'S GREATER EVANSVILLE HEALTH SURVEY, COUNTY HEALTH RANKINGS WEBSITE, INDIANA STATE DEPARTMENT OF HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU. ADDITIONAL INFORMATION COMES FROM OUR OWN ELECTRONIC MEDICAL RECORD SYSTEM AND THROUGH OUR INTERACTION WITH LOCAL SERVICE PROVIDERS AND OTHER NON-PROFIT ORGANIZATIONS. THAT INCLUDES "PROMISE ZONE" INITIATIVES THAT KEEP US AWARE OF CHANGING NEEDS IN OUR MOST DISENFRANCHISED POPULATION.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DEACONESS HOSPITAL UTILIZES FINANCIAL COUNSELORS TO EDUCATE, INFORM AND ASSIST PATIENTS AND FAMILIES IN UNDERSTANDING THEIR FINANCIAL OBLIGATION, ABILITY TO QUALIFY FOR FINANCIAL ASSISTANCE THROUGH DEACONESS HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PAYMENT OPTIONS. SPECIFICALLY, FINANCIAL COUNSELORS STAFF THE EMERGENCY DEPARTMENT, REGISTRATION AREAS, CASHIER AREA, AS WELL AS, FLOAT AMONG INPATIENT AREAS TO ENSURE EACH AND EVERY PATIENT REQUIRING ASSISTANCE IS REACHED. IN ADDITION TO THE PERSONAL AND INDIVIDUALIZED COUNSELING PROVIDED BY THE FINANCIAL COUNSELORS, VARIOUS FORMS OF MEDIA ARE DISTRIBUTED THROUGHOUT DEACONESS HOSPITAL EXPLAINING THE FINANCIAL ASSISTANCE PROCESS. ADDITIONALLY, POLICIES FOR FINANCIAL ASSISTANCE ARE POSTED WIDELY THROUGHOUT DEACONESS HOSPITAL AND ON THE INTERNET AT WWW.DEACONESS.COM. HTTPS://WWW.DEACONESS.COM/FOR-YOU/PATIENTS-AND-VISITORS/PATIENTS/FINANCIAL-ASSISTANCE. IN ADDITION TO THE VARIOUS PLACES THAT THE PROGRAM IS PUBLISHED, IT IS ALSO REFERENCED ON OUR PATIENT STATEMENT AND PHONE MESSAGE WHEN THE PATIENT CALL THE BILLING PHONE NUMBER.
PART VI, LINE 4:	DEACONESS DEFINES ITS COMMUNITY AS ALL PEOPLE LIVING IN VANDERBURGH AND WARRICK COUNTIES IN INDIANA ANY TIME DURING THE YEAR.VANDERBURGH COUNTYVANDERBURGH COUNTY IS MORE DIVERSE THAN MUCH OF INDIANA IN TERMS OF RACIAL AND ETHNIC CHARACTERISTICS, EVENLY SPLIT WITH REGARD TO GENDER, WITH THE MAJORITY OF INDIVIDUALS LIVING IN AREAS CONSIDERED URBAN. VANDERBURGH COUNTY'S POPULATION OF 180,136 PERSONS IS SIMILAR TO THE STATEWIDE POPULATION, WITH ABOUT 80.6% OF THE POPULATION BEING WHITE, 9.8% BLACK/AFRICAN AMERICAN, 1.4% ASIAN, AND THE REMAINDER BEING OF OTHER OR 2 OR MORE RACES. HOWEVER, VANDERBURGH COUNTY REPORTS A 3.5% HISPANIC POPULATION COMPARED TO 8.2% FOR THE STATE. VANDERBURGH COUNTY IS ALSO ONE OF THE MORE URBAN AREAS WITH A 9.2% RURAL RATING COMPARED TO THE INDIANA AVERAGE OF 27.6%. ACCORDING TO THE 2021 COUNTY HEALTH RANKINGS, VANDERBURGH COUNTY RANKS 82 OUT OF 92 INDIANA COUNTIES FOR HEALTH OUTCOMES AND 47 OUT OF 92 INDIANA COUNTIES FOR HEALTH FACTORS. INSTANCES OF VIOLENT CRIME, INJURY DEATHS, SEXUALLY TRANSMITTED INFECTIONS, AND CHILDREN LIVING IN POVERTY ARE HIGHER IN VANDERBURGH COUNTY THAN THE INDIANA AVERAGE. THIS INFORMATION MATCHES OUR CHNA DATA.WARRICK COUNTY - CONVERSELY, WARRICK COUNTY RANKS 9 OUT OF 92 INDIANA COUNTIES FOR HEALTH OUTCOMES AND 6 OUT OF 92 INDIANA COUNTIES FOR HEALTH FACTORS ON THE 2021 COUNTY HEALTH RANKINGS. INCIDENTS OF VIOLENT CRIME, INJURY DEATHS, SEXUALLY TRANSMITTED INFECTIONS, AND CHILDREN LIVING IN POVERTY ARE SIGNIFICANTLY LOWER THAN THE STATE AVERAGE. WARRICK COUNTY HAS LESS DIVERSITY THAN VANDERBURGH COUNTY AND THE STATE OF INDIANA. MORE THAN 90% OF PEOPLE THERE IDENTIFY AS WHITE COMPARED TO 77% FOR INDIANA. ONLY 1.7% OF THE POPULATION IS LISTED AS BLACK/AFRICAN AMERICAN AND 2.2% AS HISPANIC. THAT'S COMPARED TO STATE AVERAGES OF 9.6% AND 8.2% RESPECTIVELY. WARRICK COUNTY IS ALSO MORE RURAL THAN THE AVERAGE INDIANA COUNTY (29.3% RURAL IN WARRICK COUNTY COMPARED TO 27.6% STATE AVERAGE).
PART VI, LINE 5:	WITH COVID-19 NO LONGER BEING THE PRIMARY ISSUE IMPACTING HEALTH AND HOSPITAL CARE, WE WERE ABLE TO RETURN TO PROMOTING SERVICES AND INFORMATION THAT HELPED US ADDRESS THE GREATEST HEALTH NEEDS OF THE COMMUNITY AS DEFINED BY OUR MOST RECENT CHNA, AS WELL AS ENCOURAGE PEOPLE TO GET THE PREVENTIVE SCREENINGS THEY NEED AND MAY HAVE PUT OFF DUE TO PANDEMIC CONCERNS.WITH FEWER COVID RESTRICTIONS, WE WERE ABLE TO HOST AND ATTEND PUBLIC EVENTS, SUCH AS OUR ANNUAL ORAL, HEAD AND NECK CANCER SCREENINGS; COLON CANCER SCREENINGS, HAND-ONLY CPR TRAINING, ETC. ADDITIONALLY, WE CREATED AND DISTRIBUTED WRITTEN AND VISUAL CONTENT THAT ADDRESSED SPECIFIC ISSUES AND HEALTH CONCERNS FOR OUR COMMUNITY.E-NEWSLETTER ARTICLES:NO NEWSLETTER DUE TO VENDOR ISSUE/CHANGESSOCIAL MEDIA POSTS:OCTOBER 1-7, 2022 DAILY POSTS REGARDING HEALTHY FOOD OPTIONS AT THE ANNUAL FALL FESTIVALMULTIPLE POSTS IN OCTOBER REGARDING MAMMOGRAMS OCTOBER 6, 2022 BREAST CANCER AWARENESS MONTH VIDEO: HENDERSON MAMMOGRAM BLITZ WITH DR. AMBER KOON OCTOBER 10, 2022 MENTAL HEALTH AWARENESS DAY VIDEO: WARNING SIGNS OF TEEN DEPRESSION WITH DR. GARRETT KOONOCTOBER 11, 2022 REMINDER TO BEGIN SCHEDULING FLU SHOT AT A DEACONESS FLU SHOT CLINICOCTOBER 13, 2022 IMPROVING ACCESS: DEACONESS CLINIC URGENT CARE WEST NOW OPENOCTOBER 15, 2022 BREAST CANCER AWARENESS MONTH VIDEO: THE IMPORTANCE OF PRIORITIZING BREAST HEALTH WITH JENNIFER SMALLOCTOBER 19, 2022 BREAST CANCER AWARENESS MONTH: BRA DAY BREAST CANCER RECONSTRUCTION WITH DR. KATE KOTTWITZOCTOBER 20, 2022 VIDEO: HOW FLU SHOTS CAN SAVE LIVES WITH DR. CHASE MORANOCTOBER 21, 2022 BREAST CANCER AWARENESS MONTH VIDEO: THE DANGERS OF SKIPPING A MAMMOGRAM WITH JENNIFER SMALLOCTOBER 22, 2022 RSV-WHEN TO CALL YOUR PEDIATRICIANOCTOBER 23, 2022 BONE & JOINT HEALTH VIDEO: HOW DEXA SCAN MEASURES BONE LOSS WITH CHERYL LINNEMANOCTOBER 24, 2022 BEHAVIORAL HEALTH VIDEO: TIPS FOR CHILDREN WHO ARE BEING BULLIED OR ARE BULLYING OTHERS WITH SCOTT BRANAMOCTOBER 25, 2022 DRIVE THRU FLU SHOT AND COVID BOOSTER CLINICOCTOBER 26, 2022 VIDEO: HOW TO DISTINGUISH RSV FROM THE COMMON COLD/FLU WITH DR. JONATHAN PHILLIPSOCTOBER 27, 2022 VIDEO: THE IMPORTANCE OF KIDS GETTING FLU SHOTS WTH DR. GARRETT KOONOCTOBER 29, 2022 VIDEO: SIGNS & SYMPTOMS OF STROKE WITH ANGIE BLACKOCTOBER 30, 2022 BEHAVIORAL HEALTH VIDEO: WARNING SIGNS OF DOMESTIC VIOLENCE AND WHERE TO GET HELP WITH ELISSA JONESOCTOBER 31, 2022 VIDEO: HALLOWEEN SAFETY WITH DR. JONATHAN PHILLIPSNOVEMBER 2, 2022 FLU SHOT CLINICNOVEMBER 3, 2022 IMPROVING ACCESS VIDEO: DEACONESS VIDEO VISITS WITH DR. AMANDA BOHLEBERNOVEMBER 7, 2022 BLOG POST: DIABETES 101 BY ANNA SMITHNOVEMBER 14, 2022 VIDEO: HOW TO MANAGE DIABETES WITH DANIELLE HUDAKNOVEMBER 17, 2022 SMOKING FACTSNOVEMBER 23, 2022 VIDEO: HEALTHY, DIABETES-FRIENDLY THANKSGIVING TIPS WITH MOLLIE FRANCISNOVEMBER 30, 2022 VIDEO: KEEPING SKIN HEALTHY DURING THE WINTER WITH DR. DYLAN GREENEYDECEMBER 1, 2022 WHERE TO GO FOR FLUDECEMBER 2, 2022 FLU SHOT REMINDERDECEMBER 6, 2022 FLU SHOT REMINDERDECEMBER 7, 2022 FLU SHOT REMINDERDECEMBER 9, 2022 - FLU SHOT REMINDERDECEMBER 19, 2022 VIDEO: ER OR URGENT CARE WITH DR. GINA HUHNKEDECEMBER 21, 2022 VIDEO: WINTER HEALTH TIPS WITH DR. GINA HUHNKEDECEMBER 28, 2022 MENTAL HEALTH VIDEO: COPING WITH THE WINTER BLUES WITH SCOTT BRANAMDECEMBER 30, 2022 VIDEO: NEW YEAR'S EVE SAFETY WITH DR. TODD BURRYJANUARY 8, 2023 EXERCISE & NUTRITION VIDEO: LIFESTYLE CHANGES WITH BROOKE MCCARTNEYJANUARY 10, 2023 DEACONESS BEHAVIORAL HEALTHJANUARY 13, 2023 PEDIATRIC WEIGHT MANAGEMENT PROGRAMJANUARY 17, 2023 VIDEO: CARDIAC ARREST AND AORTIC ANEURYSM WITH DR. LEE WAGMEISTERJANUARY 19, 2023 MENTAL HEALTH VIDEO: GOOD GRIEF PATROL AND HELPING CHILDREN COPE WITH GRIEFJANUARY 24, 2023 VIDEO: CERVICAL CANCER AND PREVENTION WITH DR. SARAH O'NANCOMMUNITY EVENTSOCTOBER 1-7, 2022 HEALTHY EATING MESSAGES WITH WISE CHOICE AT THEFALL FESTIVAL.MARCH 1, 2023 CARDIOVASCULAR SYMPOSIUMMARCH 4, 2023 HANDS-ONLY CPR TRAININGMARCH 18, 2023 DRIVE-THRU COLON CANCER SCREENINGAPRIL 1, 2023 WALKING FOR HEALTH: ORAL CANCER AWARENESS MONTH W/ DR. WARD HARBINSCREENING MAMMOGRAMS VIA MOBILE BREAST CENTERAPRIL 7, 2023 WALKING FOR HEALTH: SEXUAL ASSAULT PREVENTION & WELLNESS WITH DR. PEARL QUARTEYAPRIL 14, 2023 WALKING FOR HEALTH: NATIONAL MINORITY HEALTH MONTH WITH DR. WARD HARBINAPRIL 20, 2023 ORAL, HEAD AND NECK CANCER SCREENINGAPRIL 20, 2023 CAR SEAT CHECKS AND EDUCATION AT IVY TECH HEALTH & WELLNESS FAIRAPRIL 27, 2023 WOUND & STROKE TEAM AT HOMELESS CONNECT AT ONB EVENTS PLAZAMAY 8, 2023 WALKING FOR HEALTH: WOMEN'S HEALTH WITH DR. JARED CERNYMAY 10, 2023 FREE SKIN CANCER SCREENINGSMAY 27, 2023 WALKING FOR HEALTH: OSTEOPOROSIS2022 MOBILE SCREENING MAMMOGRAMSOCTOBER--320NOVEMBER--228DECEMBER--241FY23 MOBILE SCREENING MAMMOGRAMS JANUARY--162FEBRUARY--204 MARCH--250APRIL--176MAY--256 JUNE-192 JULY--225 AUGUST--231 SEPTEMBER--196PATIENT CARE - MEDICATION ASSISTANCE AND FAMILY MEDICINE RESIDENCY CLINICDEACONESS PROVIDES FREE AND REDUCED CARE WITHIN OUR HOSPITAL BUILDINGS. THROUGH OUR MEDICATION ASSISTANCE PROGRAM (MAP) AND OUR FAMILY PRACTICE RESIDENCY CLINIC, PATIENTS CAN ACCESS THE HIGH QUALITY HEALTH CARE THEY NEED IN CONVENIENT LOCATIONS AND AT A PRICE THEY CAN AFFORD. IN FY 22-23, OUR RESIDENTS TREATED MORE THAN 15,562 PATIENTS AT A COST TO THE HOSPITAL OF $2,282,688. SIMILARLY, THE MAP SERVICED 2,920 INDIVIDUALS FOR 4,905 UNIQUE MEDICATIONS/PRESCRIPTIONS PROVIDED AT A TOTAL DOLLAR VALUE OF MORE THAN $87,730,541 IN FREE DRUGS TO PATIENTS. AN ADDITIONAL $272,342 IN COPAY/FOUNDATION ASSISTANCE WAS ALSO PROVIDED.BEHAVIORAL HEALTH AND SUICIDE PREVENTION--STAFF FROM DEACONESS CROSS POINTE EDUCATED OVER 6,762 PEOPLE IN THE SURROUNDING COMMUNITY ABOUT BEHAVIORAL HEALTH, RELATED RESOURCES, AND SUICIDE PREVENTION.LOCAL SPONSORSHIPS - IN FY22-23, DEACONESS SPONSORED PROGRAMS AND ACTIVITIES FOR MORE THAN 170,000 PEOPLE, CONTRIBUTING $1.2 MILLION IN SUPPORT OF CLUBS, GROUPS, SOCIAL SERVICE ORGANIZATIONS, AND OTHERS STRIVING TO MAKE OUR COMMUNITY A BETTER PLACE.HANDS ONLY CPR TRAINING 2/16/23 FREE COMMUNITY TRAINED OVER 300 PEOPLE IN HOW TO USE HANDS ONLY CPR.
PART VI, LINE 6:	N/A

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
DEACONESS HOSPITAL INC

Employer identification number
35-0593390

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AMERICAN RED CROSS 29 S STOCKWELL RD EVANSVILLE,IN47714	53-0196605	501(C)(3)	10,000	GENERAL SUPPORT & MIDWEST TORNADOS
(2) AURORA INC 1001 MARY STREET EVANSVILLE,IN47710	35-1759576	501(C)(3)	16,900	HOMELESS OUTREACH
(3) BAPTIST HEALTH DEACONESS MADISONVILLE INC 900 HOSPITAL DRIVE MADISONVILLE,KY42431	61-0654587	501(C)(3)	150,000	UNIVERSITY OF LOUISVILLE OFF CAMPUS MED SCHOOL PROGRAM
(4) BOYS & GIRLS CLUB OF EVANSVILLE IN PO BOX 6311 EVANSVILLE,IN47719	35-1007558	501 (C) (3)	13,100	GENERAL SUPPORT & HEALTHY HABITS PROGRAM
(5) CHEMO BUDDIES 3700 BELLEMEADE AVE EVANSVILLE,IN47714	45-3043243	501(C)(3)	47,284	GENERAL SUPPORT & SHUTTLE BUS SPONSORSHIP
(6) ECHO COMMUNITY HEALTH CARE 315 MULBERRY STREET EVANSVILLE,IN47713	35-1791786	501(C)(3)	20,000	PEDIATRIC/OB PLEDGE FOR PRIMARY HEALTH CARE
(7) EVANSVILLE EMERGENCY FOOD PANTRY CONSORTIUM INC PO BOX 2536 EVANSVILLE,IN47728	37-1697515	501(C)(3)	20,000	FOOD FOR FOOD PANTRIES
(8) EVANSVILLE REGIONAL BUSINESS COMMITTEE INC 211 NW RIVERSIDE DR EVANSVILLE,IN47708	03-0408032	501(C)(6)	15,000	GENERAL SUPPORT
(9) EVANSVILLE REGIONAL ECONOMIC PARTNERSHIP 318 MAIN STREET SUITE 400 EVANSVILLE,IN47708	35-0298180	501(C)(6)	25,000	GENERAL SUPPORT
(10) EVANSVILLE-VANDERBURGH COUNTY CONVENTION & VISITORS COMMISSION SPORTS COMP 4300 HECKEL ROAD EVANSVILLE,IN47725	47-2582515	501 (C) (3)	26,250	SUPPORT HEALTH TRAIL
(11) GOLF GIVES BACK INC ONE MAIN STREET SUITE 100 EVANSVILLE,IN47708	81-4223347	501(C)(3)	7,000	GENERAL SUPPORT
(12) GRANTED INC 4445 COMMERCE STREET EVANSVILLE,IN47710	31-1154659	501(C)(3)	33,333	GRANTED HOUSE OF HOPE CAPITAL CAMPAIGN
(13) IMPACT EVANSVILLE INC 1201 S BEDFORD AVE EVANSVILLE,IN47713	86-3629886	501(C)(3)	25,000	GENERAL SUPPORT & BEDFORD COLLAB PROJECT
(14) INDIANA FIRE CHIEF'S ASSOCIATION PO BOX 305 CAMBY,IN46113	35-6035820	501(C)(6)	10,000	GENERAL SUPPORT
(15) ISAIAH 117 HOUSE 1705 STATE LINE RD PO BOX 842 ELIZABETHTON,TN37643	82-0631497	501(C)(3)	10,000	GENERAL SUPPORT
(16) IVY TECH FOUNDATION 3501 N 1ST AVENUE EVANSVILLE,IN47710	23-7073977	501(C)(3)	50,000	GENERAL SUPPORT & GRANT DONATION
(17) JUNIOR ACHIEVEMENT OF SW INDIANA 431 E DIAMOND AVENUE EVANSVILLE,IN47711	35-6048156	501 (C) (3)	11,940	INSPIRING OUR YOUTH & GENERAL SUPPORT
(18) LEADERSHIP EVERYONE PO BOX 2449 EVANSVILLE,IN47722	31-0883858	501(C)(3)	10,000	GENERAL SUPPORT & REGIONAL VOICE
(19) PERRY COUNTY COMMUNITY FOUNDATION PO BOX 13 TELL CITY,IN47586	35-1830262	501(C)(3)	8,000	GENERAL SUPPORT & SGT. H. GLENN MEMORIAL FUND
(20) RILEY CHILDREN'S FOUNDATION PO BOX 3356 INDIANAPOLIS,IN46206	35-0868147	501(C)(3)	25,000	GENERAL SUPPORT & RACING TO RESPOND DOCUMENTARY
(21) RONALD MCDONALD HOUSE CHARITIES OF THE OHIO VALLEY 3540 WASHINGTON AVENUE EVANSVILLE,IN47714	35-1748468	501(C)(3)	12,500	GENERAL SUPPORT
(22) SOUTHERN INDIANA GRADUATE MEDICAL EDUCATION CONSORTIUM INC 515 WALNUT STREET SUITE 4134 EVANSVILLE,IN47708	47-2044966	501 (C) (3)	100,000	GENERAL SUPPORT
(23) THE POTTER'S WHEEL INC 333 JEFFERSON AVENUE EVANSVILLE,IN47713	74-3105998	501(C)(3)	25,000	GENERAL SUPPORT
(24) TRAIL HEADS-SOUTHWEST INDIANA 3855 DEER RUN CT BOONVILLE,IN47601	47-3452266	501(C)(3)	14,000	PARKS & TRAILS PROJECT
(25) TRI-STATE FOOD BANK 2504 LYNCH ROAD EVANSVILLE,IN47711	35-1539870	501 (C) (3)	100,000	GENERAL SUPPORT
(26) TULIP TREE HEALTH SERVICES 123 N MCCREARY FORT BRANCH,IN47648	35-2055749	501 (C) (3)	10,000	GENERAL SUPPORT
(27) UNITED CARING SHELTERS 324 NW SIXTH STREET EVANSVILLE,IN47708	35-1892153	501(C)(3)	32,500	HOMELESS MEDICAL RESPITE & GENERAL SUPPORT
(28) YOUTH FIRST 111 SE THIRD STREET STE 405 EVANSVILLE,IN47708	35-2050168	501(C)(3)	16,860	GENERAL SUPPORT
(29) YWCA 118 VINE STREET EVANSVILLE,IN47708	35-0869075	501 (C) (3)	11,820	GENERAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 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
PART I, LINE 2:	DEACONESS HOSPITAL CONFIRMS ALL RECIPIENTS OF FUNDS ARE ORGANIZATIONS WHOSE GOALS COINCIDE WITH DEACONESS' MISSION OF PROVIDING QUALITY HEALTH CARE WITH A COMPASSIONATE AND CARING SPIRIT. THE ORGANIZATIONS PROVIDE NEEDED SERVICES TO OUR COMMUNITY TO IMPROVE HEALTH AND WELLNESS FOR THE CITIZENS IN THE SURROUNDING AREA.

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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .....

Yes

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? ....

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1SHAWN MCCOY PRESIDENT / CEO OF DEACONESS	(i) (ii)	1,004,638 ------------- 0	322,989 ------------- 0	223,490 ------------- 9,600	273,802 ------------- 0	43,380 ------------- 0	1,868,299 ------------- 9,600	216,756 ------------- 0
2RAGHAV GUPTA MD ANESTHESIOLOGIST	(i) (ii)	1,224,151 ------------- 0	62,820 ------------- 0	57,293 ------------- 0	16,580 ------------- 0	32,571 ------------- 0	1,393,415 ------------- 0	0 ------------- 0
3ANDREI TRIPAC MD ANESTHESIOLOGIST	(i) (ii)	1,248,772 ------------- 0	14,000 ------------- 0	57,293 ------------- 0	16,580 ------------- 0	34,992 ------------- 0	1,371,637 ------------- 0	0 ------------- 0
4JAMES PORTER MD PRESIDENT OF DEACONESS HEALTH SYSTEM	(i) (ii)	632,974 ------------- 0	174,754 ------------- 0	270,914 ------------- 4,600	172,267 ------------- 0	37,061 ------------- 0	1,287,970 ------------- 4,600	267,465 ------------- 0
5MIA HINDI FORMER DIRECTOR	(i) (ii)	0 ------------- 982,969	0 ------------- 161,680	0 ------------- 47,574	0 ------------- 21,210	0 ------------- 35,559	0 ------------- 1,248,992	0 ------------- 0
6VENKATESH MADADI MD ANESTHESIOLOGIST	(i) (ii)	1,082,716 ------------- 0	0 ------------- 0	43,113 ------------- 0	33,057 ------------- 0	30,644 ------------- 0	1,189,530 ------------- 0	0 ------------- 0
7JOSEPH KLINK MD DIRECTOR	(i) (ii)	0 ------------- 899,372	0 ------------- 163,013	0 ------------- 8,251	0 ------------- 13,890	0 ------------- 25,552	0 ------------- 1,110,078	0 ------------- 0
8PAUL MICK MD ANESTHESIOLOGIST	(i) (ii)	954,491 ------------- 0	0 ------------- 0	114,511 ------------- 0	16,580 ------------- 0	21,334 ------------- 0	1,106,916 ------------- 0	0 ------------- 0
9MARK H MURRAY MD ANESTHESIOLOGIST	(i) (ii)	1,012,712 ------------- 0	0 ------------- 0	42,877 ------------- 0	16,580 ------------- 0	29,933 ------------- 0	1,102,102 ------------- 0	0 ------------- 0
10LYNN LINGAFELTER PRESIDENT	(i) (ii)	608,584 ------------- 0	168,260 ------------- 0	101,821 ------------- 4,000	151,033 ------------- 0	31,856 ------------- 0	1,061,554 ------------- 4,000	97,784 ------------- 0
11CHERYL WATHEN TREASURER / CHIEF FINANCIAL OFFICER	(i) (ii)	577,576 ------------- 0	134,675 ------------- 0	98,323 ------------- 9,600	159,494 ------------- 0	42,127 ------------- 0	1,012,195 ------------- 9,600	92,511 ------------- 0
12NAROTHAMA R AEDDULA MD DIRECTOR	(i) (ii)	0 ------------- 789,364	0 ------------- 126,890	0 ------------- 53,854	0 ------------- 30,981	0 ------------- 0	0 ------------- 1,001,089	0 ------------- 0
13MARC FLORENCE VICE PRESIDENT	(i) (ii)	418,131 ------------- 0	95,606 ------------- 0	76,679 ------------- 0	98,824 ------------- 0	37,173 ------------- 0	726,413 ------------- 0	72,580 ------------- 0
14JOANN WOOD MD CHIEF MEDICAL OFFICER	(i) (ii)	462,273 ------------- 0	106,786 ------------- 0	6,935 ------------- 0	106,362 ------------- 0	19,047 ------------- 0	701,403 ------------- 0	2,691 ------------- 0
15MAQBOOL AHMED MD FORMER DIRECTOR	(i) (ii)	0 ------------- 358,692	0 ------------- 141,493	0 ------------- 170,120	0 ------------- 0	0 ------------- 0	0 ------------- 670,305	0 ------------- 0
16BRADLEY SCHEU MD VICE PRESIDENT	(i) (ii)	0 ------------- 395,518	0 ------------- 102,385	0 ------------- 2,676	0 ------------- 92,726	0 ------------- 36,377	0 ------------- 629,682	0 ------------- 0
17DAVID RYON MD DIRECTOR	(i) (ii)	469,103 ------------- 0	40,680 ------------- 0	43,605 ------------- 1,800	30,720 ------------- 0	29,734 ------------- 0	613,842 ------------- 1,800	0 ------------- 0
18MELINDA D LEBOFSKY VICE PRESIDENT	(i) (ii)	315,517 ------------- 0	195,768 ------------- 0	1,722 ------------- 0	47,338 ------------- 0	27,546 ------------- 0	587,891 ------------- 0	0 ------------- 0
19JENNIFER CHIUSANO CHIEF NURSING EXECUTIVE	(i) (ii)	337,149 ------------- 0	77,880 ------------- 0	3,544 ------------- 0	69,080 ------------- 0	18,701 ------------- 0	506,354 ------------- 0	0 ------------- 0
20JAMIE L DAVIDSON MD DIRECTOR	(i) (ii)	382,602 ------------- 0	6,240 ------------- 0	13,010 ------------- 0	25,840 ------------- 0	772 ------------- 0	428,464 ------------- 0	0 ------------- 0
21SCOTT CORDTS MD DIRECTOR	(i) (ii)	258,287 ------------- 0	53,167 ------------- 0	29,243 ------------- 5,800	30,470 ------------- 0	29,294 ------------- 0	400,461 ------------- 5,800	0 ------------- 0
22LINDA WHITE FORMER CEO EMERITA, FOUNDATION	(i) (ii)	0 ------------- 177,170	0 ------------- 27,529	0 ------------- 7,357	0 ------------- 5,002	0 ------------- 10,830	0 ------------- 227,888	0 ------------- 0

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
PART I, LINE 1A	SOCIAL CLUB DUES ARE PAID FOR LINDA WHITE AND SHAWN MCCOY FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEES.
PART I, LINE 4B	NONQUALIFIED PAYMENTS: NAROTHAMA AEDDULA $20,500 JAMIE DAVISON $20,500 SHAWN MCCOY $20,500 DAVID RYON $20,500 CHERYL WATHEN $20,500 JAMES PORTER $20,500 JENNIFER CHIUSANO $20,500 JOANN WOOD $20,500 LYNN LINGAFELTER $20,500 MARC FLORENCE $20,500 BRADLEY SCHEU $20,500 MELINDA LEBOFSKY $5,000 RAGHAV GUPTA $20,500 ANDREI TRIPAC $20,500 VENKATESH MADADI $20,500 PAUL MICK $20,500 MARK MURRAY $20,500 LINDA WHITE $20,500 MIA HINDI $20,500 MAQBOOL AHMED $20,500 JOSEPH KLINK $20,500 PART 1, 4B: SHAWN MCCOY: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $247,426.22 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $216,756.32 CHERYL WATHEN: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $119,207.04 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $92,510.50 JAMES PORTER: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $138,747.43 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $267,465.17 LYNN LINGAFELTER: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $126,485.28 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $97,783.51 JOANN WOOD SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $89,782.42 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $2,691.33 MARC FLORENCE: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $77,613.72 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $72,579.88 JENNIFER CHIUSANO: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $52,500.40 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $0.00 BRADLEY SCHEU: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $71,515.95 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $0.00 MELINDA LEBOFSKY: SUPPLEMENTAL ACCUMLATION ACCOUNT CONTRIBUTIONS OF $47,338.40 SUPPLEMENTAL ACCUMLATION ACCOUNT PAYOUT OF $0.00
PART I, LINE 6	COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANIZATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS HOSPITAL'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED.

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

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

Attach to Form 990.
SchKMediumBullet

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
DEACONESS HOSPITAL INC

Employer identification number
35-0593390

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY-2021B	35-1602316	45506EDH3	10-28-2021	36,810,000	REFUND 2013C ISSUED 7/23/13		X		X		X
B	INDIANA FINANCE AUTHORITY-2016A	35-1602316	45506DXT7	10-05-2016	109,999,091	NEW MONEY PROJECTS	X			X		X
C	INDIANA FINANCE AUTHORITY-2015A	35-1602316	45506DUL7	07-09-2015	49,772,341	03/6/2009 REFUNDING	X			X		X
D	INDIANA FINANCE AUTHORITY-2013B	35-1602316	000000000	03-05-2013	21,440,000	5/27/04 REFUNDING		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,790,000		405,000		2,015,000		11,920,000
2 Amount of bonds legally defeased ..............			54,760,000		38,890,000
3 Total proceeds of issue ..................	36,810,000		111,373,335		49,772,341		21,440,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			4,660,332
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	135,400		935,528		601,847		125,000
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............			2,885,418
10 Capital expenditures from proceeds .............			102,892,057
11 Other spent proceeds .............	36,674,600				49,170,494		21,315,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2021		2018		2015		2013
	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	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			X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
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 ....
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X			X		X	X
c No rebate due? .........		X	X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X		X	X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

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	X
b Name of provider ..........							FIFTH THIRD
c Term of hedge .........							1500.0000000000 %
d Was the hedge superintegrated? ......								X
e Was the hedge terminated? ........								X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
PART II, COLUMN B, LINE 3:	THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE THE INVESTMENT EARNINGS ON THE PROJECT FUND IN THE AMOUNT OF $1,374,244
PART II, COLUMN D, LINE 11:	THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW.
SCHEDULE K, PART IV, COLUMN B, LINE 2C:	A REBATE CALCULATION WAS COMPLETED, WITH NO REBATE DUE.
PART IV, COLUMN C, LINE 2C:	A REBATE CALCULATION WAS COMPLETED, WITH NO REBATE DUE, ON APRIL 17, 2017.
PART I, LINE A, COLUMN F:	THE PURPOSE OF THE ISSUE IS TO REFUND THE SERIES 2004A ISSUED: 5/27/2004 AND REFUND SERIES 2009A ISSUED: 3/26/2009.
PART II, COLUMN A, LINE 11:	THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW.
PART II, COLUMN C, LINE 11:	THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW.

Schedule K (Form 990) 2021

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

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

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

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

Part II

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

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) ABBY PAPARIELLA	SEE PART V	90,608	COMP.		No
(2) JESSICA COX	SEE PART V	366,125	COMP.		No
(3) JOAN MCCOY	SEE PART V	61,450	COMP.		No
(4) SHERRI MCCOY	SEE PART V	23,767	COMP.		No
(5) SOUTH WESTERN COMMUNICATIONS	SEE PART V	302,098	TELECOMMUNICATION SERVICES		No
(6) LARRY KILINSKI	SEE PART V	26,320	ANESTHESIA SERVICES		No
(7) KRISTEN WATHEN	SEE PART V	7,147	COMP.		No
(8) ANNA MCCOY	SEE PART V	8,589	COMP.		No

Part V

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

Return Reference

Explanation

SCH L, PART IV, ABBREVIATION:

COMP. = REPORTABLE COMPENSATION

SCH L, PART V, RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:

INTERESTED PERSON: ABBY PAPARIELLARELATIONSHIP: DAUGHTER OF DAVE PAPARIELLAINTERESTED PERSON: SOUTH WESTERN COMMUNICATIONSRELATIONSHIP: BOARD MEMBER KEVIN KOCH IS THE CHAIRMAN OF SOUTH WESTERN COMMUNICATIONS. SOUTH WESTERN COMMUNICATIONS PROVIDES TELECOMMUNICATION SERVICES.INTERESTED PERSON: JESSICA COXRELATIONSHIP: DAUGHTER TO LYNN LINGAFELTERINTERESTED PERSON: JOAN MCCOYRELATIONSHIP: WIFE OF SHAWN MCCOYINTERESTED PERSON: OLD NATIONAL BANKRELATIONSHIP: BOARD MEMBER JAMES RYAN IS THE CEO OF OLD NATIONAL BANK. OLD NATIONAL BANK PROVIDES INVESTMENT MANAGEMENT SERVICES.INTERESTED PERSON: SHERRI MCCOYRELATIONSHIP: SISTER OF SHAWN MCCOYINTERESTED PERSON: KRISTEN WATHENRELATIONSHIP: DAUGHTER TO CHERYL WATHENINTERESTED PERSON: ANNA MCCOYRELATIONSHIP: DAUGHTER TO SHAWN MCCOYINTERESTED PERSON: LARRY KILINSKIRELATIONSHIP: LARRY KILINSKI, BOARD MEMBER OF THE HOSPITAL, PROVIDES ANESTHESIA SERVICES TO THE HOSPITAL.

Schedule L (Form 990) 2021

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..	X	4	12,576	FMV
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( OTHER )	X	40	43,632	FMV
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, COLUMN (B):	THE AMOUNT IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.

Schedule M (Form 990) (2022)

Additional Data

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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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

Return Reference	Explanation
FORM 990, PART III, LINE 1, ORGANIZATION'S MISSION:	DEACONESS HOSPITAL PROVIDES QUALITY HEALTHCARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE. AT DEACONESS HOSPITAL, OUR VALUES ARE BASED ON OUR COMMITMENT TO QUALITY. WE DEFINE QUALITY AS THE CONTINUOUS IMPROVEMENT OF SERVICES TO MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF THE CUSTOMERS WE SERVE. OUR VALUES ARE QUALITY IN EVERYTHING WE DO, RESPECT FOR ALL PEOPLE, EFFICIENCY AND EFFECTIVENESS IN THE USE OF RESOURCES, INNOVATION TOWARD CONTINUOUS SYSTEMS IMPROVEMENT, PARTNERSHIP WITH THOSE WE SERVE AND WITH SUPPLIERS, EDUCATION FOR CONTINUOUS GROWTH AND KNOWLEDGE AND PRIDE IN WORKMANSHIP. TO ACCOMPLISH ITS MISSION, DEACONESS HOSPITAL IS COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THE PEOPLE OF THE TRI-STATE BY DEMONSTRATING EXCELLENCE IN HEALTHCARE SERVICES, PROVIDING ACCESS TO HEALTHCARE, PROVIDING CHARITY CARE TO THOSE IN NEED, PROMOTING HEALTHY LIFESTYLES, OFFERING SPIRITUAL AND PSYCHOLOGICAL SUPPORT, SUPPORTING HEALTH RELATED EDUCATION, AND ADVANCING HEALTH KNOWLEDGE THROUGH RESEARCH.
FORM 990, PART III, LINE 4A	PROGRAM SERVICES ACCOMPLISHMENT 1: PATIENT SERVICE REVENUE. DEACONESS HOSPITAL IS A MAJOR REFERRAL CENTER FOR A 26 COUNTY TRI-STATE AREA IN SOUTHWESTERN INDIANA, WESTERN KENTUCKY AND SOUTHEASTERN ILLINOIS. THE HOSPITAL AND ITS FACILITIES ARE LOCATED ON FOUR CAMPUSES WHICH INCLUDE THE MAIN 28-ACRE CAMPUS ON THE NEAR NORTH SIDE OF EVANSVILLE IN VANDERBURGH COUNTY; THE 63-ACRE GATEWAY CAMPUS LOCATED IN WARRICK COUNTY ON THE EASTERN BORDER OF VANDERBURGH COUNTY; AND TWO OTHER EASTSIDE EVANSVILLE LOCATIONS FOR PSYCHIATRIC BEHAVIORAL SERVICES AND REHABILITATION SERVICES. THE HOSPITAL OPERATES A MIDTOWN CAMPUS WITH A TOTAL OF 259 BEDS CONSISTING OF 37 INTENSIVE CARE BEDS, 16 CARDIAC INTENSIVE CARE BEDS, 41 CARDIAC BEDS, 19 STEPDOWN BEDS, 44 ORTHOPAEDIC/ NEUROLOGICAL BEDS, 41 MEDICAL/SURGICAL BEDS, 39 MEDICAL RENAL BEDS, AND 22 BEDS DEDICATED TO PATIENTS IN OBSERVATION. IN ADDITION, THE HOSPITAL PROVIDES A FULL-ARRAY OF COMPREHENSIVE OUTPATIENT AND AMBULATORY SERVICES ON ITS MIDTOWN CAMPUS AND OTHER SPECIFIC SERVICES AT MULTIPLE SITES WITHIN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE HOSPITAL OPERATES THE 254 BED DEACONESS GATEWAY HOSPITAL WHICH WAS OPENED IN JANUARY 2006, ON THE GATEWAY CAMPUS CONSISTING OF 18 ADULT INTENSIVE CARE BEDS, 12 PEDIATRIC AND PEDIATRIC INTENSIVE CARE BEDS, 32 NEUROSURGICAL BEDS, 32 ORTHOPAEDIC BEDS, 32 NEURO INTENSIVE CARE BEDS, 32 SURGICAL ONCOLOGY BEDS, 32 GENERAL MED/ TELEMETRY BEDS, 32 CARDIAC BEDS, AND 32 BEDS DEDICATED TO PATIENTS IN OBSERVATION. THE ORTHOPEDIC NEUROSCIENCE HOSPITAL OPENED ON THE GATEWAY CAMPUS IN MAY OF 2018. THE HOSPITAL OWNS AND OPERATES DEACONESS CROSS POINTE, A FREE-STANDING, 60 BED INPATIENT PSYCHIATRIC HOSPITAL LOCATED APPROXIMATELY 7 MILES EAST OF THE MIDTOWN CAMPUS IN EVANSVILLE.
FORM 990, PART III, LINE 4B	PROGRAM SERVICES ACCOMPLISHMENT 2: CHARITY CARE/ SUBSIDIZED CARE. DEACONESS HOSPITAL MAKES A DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT. IN DETERMINING AN INDIVIDUAL OR FAMILY'S ABILITY TO PAY, DEACONESS HOSPITAL EVALUATES WHETHER OR NOT THE RESPONSIBLE PARTY HAS SUFFICIENT RESOURCES AVAILABLE FOR PAYMENT. IF AN INDIVIDUAL IS DETERMINED TO NOT HAVE SUFFICIENT RESOURCES TO PAY, THEY ARE CONSIDERED ELIGIBLE FOR CHARITY CARE AND WILL NOT BE PROCESSED THROUGH EITHER INTERNAL OR EXTERNAL COLLECTIONS. ACCOUNTS OF CHARITY CARE PATIENTS WHO ARE UNABLE TO PAY DO NOT RESULT IN BAD DEBT AND ARE NOT COLLECTED UPON. DEACONESS HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT OF REIMBURSEMENT IS BELOW COST, DEACONESS HOSPITAL ABSORBS THESE COSTS IN MEETING ITS MISSION TO THE COMMUNITY. IN SUPPORT OF ITS MISSION, DEACONESS HOSPITAL PROVIDED $13.3 MILLION OF CHARITY CARE AND $46.6 MILLION OF SUBSIDIZED SERVICES TO THE MEDICAID PROGRAM, AND $130.8 MILLION OF SUBSIDIZED SERVICES TO THE MEDICARE PROGRAM.
FORM 990, PART III, LINE 4C	PROGRAM SERVICES ACCOMPLISHMENT 3: GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION & COMMUNITY BENEFITS. DEACONESS HOSPITAL PLAYS AN ACTIVE ROLE IN MEDICAL EDUCATION, OPERATING A THREE YEAR FAMILY MEDICINE RESIDENCY PROGRAM AND A POST-GRADUATE PHARMACY RESIDENCY PROGRAM. DEACONESS HOSPITAL ALSO PROVIDES CONTINUING MEDICAL EDUCATION PROGRAMS FOR ATTENDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, OTHER ALLIED HEALTH PROGRAMS, COMMUNITY HEALTH PROGRAMS AND A CHAPLAIN RESIDENCY PROGRAM. IN ADDITION TO EDUCATIONAL SERVICES, DEACONESS HOSPITAL PROVIDED $10.1 MILLION IN COMMUNITY BENEFIT ACTIVITIES (ALL ON A COST BASIS), SERVING A MINIMUM OF 1,175,995 PEOPLE WITHIN THE TRI-STATE AREA.
FORM 990, PART VI, SECTION A, LINE 6	CLASS OF MEMBERS OR STOCKHOLDERS: DEACONESS HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF DEACONESS HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7A	ELECTION OF GOVERNING BODY: THE BOARD OF DIRECTORS MAY ELECT ONE OR MORE NON-MEDICAL STAFF MEMBERS OF THE GOVERNING BODY THROUGH AN APPROVED ELECTION AND APPROVAL PROCESS. THE ELECTION AND APPROVAL PROCESS FOR NON-MEDICAL STAFF MEMBERS BEGINS WITH A RECOMMENDATION BY THE GOVERNANCE COMMITTEE FOR MEMBERSHIP TO THE BOARD OF DIRECTORS. THAT RECOMMENDATION IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. DEPENDING ON THE DECISION REACHED BY THE BOARD OF DIRECTORS, MEMBERSHIP MAY OR MAY NOT BE GRANTED TO THAT INDIVIDUAL. MEDICAL STAFF EXECUTIVE COUNCIL LEADERSHIP ARE APPOINTED TO BOARD OF DIRECTOR MEMBERSHIP THROUGH THEIR POSITION AS ELECTED MEDICAL STAFF LEADERS. THROUGH THE ELECTION PROCESS OF THE MEDICAL STAFF EXECUTIVE COUNCIL, THEIR APPOINTMENT IS CONFIRMED AND APPROVED.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS: THE PROCESS THAT DEACONESS HOSPITAL UTILIZES TO PRESENT THE FORM 990 TO ITS GOVERNING BODY PRIOR TO FILING IS TO PRESENT THE FORM 990 TO THE CFO AND CEO OF THE ORGANIZATION FOR REVIEW. AFTER THIS REVIEW IS PERFORMED AND ALL QUESTIONS ARE ANSWERED, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS OF DEACONESS HEALTH SYSTEM AT THE BOARD MEETING PRIOR TO THE FILING DATE OF THE FORM 990. ANY ADDITIONAL QUESTIONS ARE ANSWERED AND THE FINAL FILING IS THEN COMPLETED.
FORM 990, PART VI, SECTION B, LINE 12C	COMPLIANCE WITH CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST REVIEW AND COMPLIANCE ACTIVITIES ARE CONDUCTED THROUGHOUT THE YEAR UNDER THE DIRECTION OF DEACONESS HOSPITAL'S CORPORATE COMPLIANCE OFFICER. UPON APPOINTMENT AND, ANNUALLY, THEREAFTER, OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES, ALSO KNOWN AS INTERESTED PERSONS, ARE REQUIRED TO COMPLETE "THE CONFLICTS OF INTEREST QUESTIONNAIRE AND/OR "THE DISCLOSURE QUESTIONNAIRE". THESE DOCUMENTS SERVE TO ENSURE INTERESTED PERSONS OR COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS HAVE AN APPROPRIATE AND TIMELY MANNER IN WHICH TO DISCLOSE ANY POTENTIAL CONFLICTS. CONFLICTS ARE CONSIDERED WITH RESPECT TO OUTSIDE INTEREST, INVESTMENTS, OUTSIDE ACTIVITIES, AND BUSINESS INTERESTS AMONG THE INTERESTED PERSONS AS WELL AS THEIR FAMILY MEMBERS. ON A PERIODIC BASIS, REVIEWS OCCUR TO ENSURE DEACONESS HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSE. SUBJECTS THAT ARE REVIEWED ON A PERIODIC BASIS INCLUDE COMPENSATION, PHYSICIAN RELATIONSHIPS, PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR TOP OFFICIALS AND OTHER OFFICERS: DEACONESS HOSPITAL UTILIZES A COMPENSATION COMMITTEE TO APPROVE EXECUTIVE, DIRECTOR AND PHYSICIAN COMPENSATION AS WELL AS EXECUTIVE AND PHYSICIAN BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS AND MUST MEET THE INDEPENDENCE REQUIREMENTS OF THE SEC. THE COMMITTEE HAS THE POWER AND AUTHORITY TO: 1. ANNUALLY REVIEW AND APPROVE AND RECOMMEND TO THE BOARD OF DIRECTORS FOR ITS FINAL APPROVAL FOR THE CEO AND EACH OTHER EXECUTIVE OFFICER OF THE SYSTEM ALL ELEMENTS OF EXECUTIVE COMPENSATION. 2. MONITOR BROADLY THE STRUCTURE, PHILOSOPHY OR COMPETITIVENESS OF THE SYSTEM'S GENERAL HIRING OR COMPENSATION PRACTICES. 3. OVERSEE THE ESTABLISHMENT AND ADMINISTRATION OF THE COMPANY'S BROAD-BASED BENEFIT PLANS AND PROGRAMS 4. REVIEW OR APPROVE SIGNIFICANT AMENDMENTS OR CHANGES TO THE PLANS AND PROGRAMS. 5. RETAIN AND TERMINATE ANY COMPENSATION CONSULTANT TO BE USED TO ASSIST IN THE EVALUATION OF DIRECTOR, CEO OR EXECUTIVE OFFICE COMPENSATION 6. SOLE AUTHORITY TO APPROVE THE CONSULTANT'S FEES AND OTHER RETENTION TERMS. 7. OBTAIN ADVICE AND ASSISTANCE FROM INTERNAL OR EXTERNAL LEGAL, ACCOUNTING OR OTHER ADVISORS. 8. APPROVE ALL PHYSICIAN AND PHYSICIAN RELATED CONTRACTS. 9. MAKE REGULAR REPORTS TO THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: DEACONESS HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE SECRETARY OF STATE'S WEBSITE. DEACONESS HOSPITAL IS PART OF A CONSOLIDATED FINANCIAL STATEMENT WHICH IS AVAILABLE WITH THE PUBLIC DISCLOSURE COPY OF THE IRS FORM 990. ALSO, AS REQUIRED BY LAW, THE HOSPITAL SUBMITS ITS CONSOLIDATED FINANCIAL STATEMENTS TO THE INDIANA DEPARTMENT OF HEALTH WHICH ARE PUBLISHED ON ITS WEBSITE. GOVERNING DOCUMENTS, ASIDE FROM THE ARTICLES OF INCORPORATION, AND THE CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART IX, LINE 11G	PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 134,359,485. MANAGEMENT AND GENERAL EXPENSES 10,253,892. FUNDRAISING EXPENSES 22,352. TOTAL EXPENSES 144,635,729. PROFESSIONAL FEES- PHYSICIANS: PROGRAM SERVICE EXPENSES 16,563,512. MANAGEMENT AND GENERAL EXPENSES 4,435. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,567,947.
FORM 990, PART XI, LINE 9:	CHANGE IN PENSION LIABILITY 14,864,393. FOUNDATION MONIES GRANTED FROM RESTRICTION -3,099,872. AFFILIATE TRANSFER -58,072,654. CHANGE IN INVESTMENT IN SWAP 53,736,643. CHANGE IN BENEFICIAL INTEREST 83,624.
FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT:	THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

DEACONESS HOSPITAL INC

Employer identification number

35-0593390

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)	(e) End-of-year assets	(f) Direct controlling entity
(1) REGIONAL EMERGENCY DEPARTMENT 600 MARY ST EVANSVILLE,IN47710 46-3509500	HEALTHCARE	IN	0	DEACONESS HOSPITAL
(2) READY DEVELOPMENT OF INDIANA 600 MARY ST EVANSVILLE,IN47747 47-2040018	REAL ESTATE	IN	4,884,855	DEACONESS HOSPITAL
(3) BASELINE INVESTORS LLC 600 MARY ST EVANSVILLE,IN47710	REAL ESTATE	IN	0	DEACONESS HOSPITAL
(4) 533 COLUMBIA LLC 600 MARY ST EVANSVILLE,IN47710	REAL ESTATE	IN	0	DEACONESS HOSPITAL
(5) INVESTORS PROPERTY DEVELOPMENT LLC 600 MARY ST EVANSVILLE,IN47710	REAL ESTATE	IN	0	DEACONESS HOSPITAL
(6) 7307 E COLUMBIA LLC 600 MARY ST EVANSVILLE,IN47710	REAL ESTATE	IN	0	DEACONESS HOSPITAL

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)DEACONESS HEALTH SYSTEM 600 MARY STREET EVANSVILLE,IN47747 35-1532889	HEALTHCARE	IN	501(C)(3)	LINE 12A, I	N/A		No
(2)DEACONESS CLINIC INC 421 CHESNUT STREET EVANSVILLE,IN47713 26-3083364	HEALTHCARE	IN	501(C)(3)	LINE 3	DEACONESS HEALTH SYSTEM		No
(3)DEACONESS VNA PLUS LLC 610 E WALNUT ST EVANSVILLE,IN47713 46-5223267	HEALTHCARE	IN	501(C)(3)	LINE 10	DEACONESS HEALTH SYSTEM		No
(4)DEACONESS SPECIALTY PHYSICIANS INC 600 MARY STREET EVANSVILLE,IN47747 82-4503095	HEALTHCARE	IN	501(C)(3)	LINE 3	DEACONESS HEALTH SYSTEM		No
(5)DEACONESS HEALTH KENTUCKY INC 600 MARY STREET EVANSVILLE,IN47747 83-0966826	HEALTHCARE	IN	501(C)(3)	LINE 10	DEACONESS HEALTH SYSTEM		No
(6)METHODIST HEALTH INC PO BOX 48 HENDERSON,KY42419 61-0461753	HEALTHCARE	KY	501(C)(3)	LINE 3	DEACONESS HEALTH KENTUCKY		No
(7)DEACONESS GIBSON HOSPITAL 1808 SHERMAN DR PRINCETON,IN47670 35-0877575	HEALTHCARE	IN	501(C)(3)	LINE 3	DEACONESS HEALTH SYSTEM		No
(8)UNION COUNTY METHODIST HOSPITAL FOUNDATION 4604 US HWY 60 WEST MORGANFIELD,KY42437 61-1230297	SUPPORT METHODIST HEALTH	KY	501(C)(3)	LINE 10	DEACONESS HEALTH KENTUCKY		No
(9)GIBSON GENERAL HEALTH FOUNDATION INC 1808 SHERMAN DRIVE PRINCETON,IN47670 35-0950175	SUPPORT GIBSON HOSPITAL	IN	501(C)(3)	LINE 12A, I	DEACONESS GIBSON HOSPITAL		No
(10)DEACONESS UNION COUNTY HOSPITAL 4604 US HWY 60 WEST MORGANFIELD,KY42437 86-2614124	HEALTHCARE	KY	501(C)(3)	LINE 3	DEACONESS HEALTH KENTUCKY		No
(11)DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA LLC 4199 GATEWAY BLVD NEWBURGH,IN47630 35-2062016	HEALTHCARE	IN	501(C)(3)	LINE 3	DEACONESS HEALTH SYSTEM		No
(12)DEACONESS ILLINOIS SPECIALTY CLINIC 600 MARY STREET EVANSVILLE,IN47747 92-0904755	HEALTHCARE	IN	501(C)(3)	LINE 10	DEACONESS HEALTH SYSTEM		No
(13)DEACONESS ILLINOIS CLINIC 600 MARY STREET EVANSVILLE,IN47747 92-0574205	HEALTHCARE	IN	501(C)(3)	LINE 10	DEACONESS HEALTH SYSTEM		No

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

Cat. No. 50135Y

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) DEACONESS HEALTH PLANS LLC 7100 EAGLE CREST BLVD EVANSVILLE,IN47715 38-3492529	PREFERRED PROVIDER NETWORK	IN	DEACONESS HOSPITAL	RELATED	1,238,535	2,833,758		No			No	97.610 %
(2) ENCOMPASS HEALTH DEACONESS REHABILIATION 9001 LIBERTY PARKWAY BIRMINGHAM,AL35242 72-1375246	OUTPATIENT	AL	DEACONESS HOSPITAL	RELATED	4,049,415	12,199,783		No			No	27.500 %
(3) MAINSPRING MANAGERS LLC 4011 GATEWAY BLVD NEWBURGH,IN47630 46-4601001	NEUROLOGY SERVICES	IN	DEACONESS HOSPITAL	RELATED	1,446,514	1,248,301		No		Yes		53.620 %
(4) ORTHOALIGN LLC 4011 GATEWAY BLVD NEWBURGH,IN47630 81-2816013	HEALTHCARE	IN	DEACONESS HOSPITAL	RELATED	1,985,007	1,221,209		No			No	51.000 %
(5) PROGRESSIVE HEALTH OF IN LLC 150 N ROSENBERGER EVANSVILLE,IN47712 20-8480988	OUTPATIENT	IN	DEACONESS HOSPITAL	RELATED	4,668,806	2,533,509		No			No	51.000 %
(6) TRI - STATE HEALTHCARE CONSULTING LLC 4199 GATEWAY BLVD NEWBURGH,IN47630 92-2120911	HEALTHCARE	IN	DEACONESS HOSPITAL	RELATED	5,241	5,241		No			No	51.000 %
(7) TRI-STATE RADIATION ONCOLOGY PO BOX 819067 TAX DEPT DALLAS,TX75381 26-3706834	OUTPATIENT	DE	DEACONESS HOSPITAL	RELATED	7,800,440	10,816,455		No			No	51.000 %
(8) VASCMED LLC 600 MARY STREET EVANSVILLE,IN47747 47-2578168	VASCULAR SERVICES	IN	DEACONESS HOSPITAL	RELATED	667,358	611,875		No			No	51.000 %
(9) BURKHARDT CANCER CENTER 4972 LINCOLN AVENUE STE 100 EVANSVILLE,IN47715 30-0256432	HEALTHCARE	IN	N/A					No			No
(10) BOSTON IVF FERTILITY SERVICES AT THE WOMEN'S HOSPITAL 4199 GATEWAY BLVD NEWBURGH,IN47630 45-5549778	HEALTHCARE	IN	N/A					No			No
(11) INNOVATIVE HEALTHCARE COLLABORATIVE OF INDIANA LLC 600 MARY STREET EVANSVILLE,IN47747 83-3592473	HEALTHCARE	IN	N/A					No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) TRI-STATE MEDICAL MANAGEMENT INC 600 MARY STREET EVANSVILLE,IN47747 35-1875888	PHYSICIAN MANAGEMENT	IN	DEACONESS HOSPITAL	C					No

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

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 .....................

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) DEACONESS HEALTH PLANS LLC	P	168,109	COST
(2) MAINSPRING	P	3,056,927	COST
(3) VASCMED	P	183,287	COST
(4) ORTHOALIGN	P	582,310	COST
(5) HEALTHCARE RESOURCE SOLUTIONS	P	9,180,210	COST
(6) MAINSPRING	Q	8,120,780	COST
(7) VASCMED	Q	3,672,190	COST
(8) ORTHOALIGN	Q	14,039,106	COST

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE QUALITY HEALTH CARE SERVICES WITH A COMPASSIONATE AND CARING SPIRIT CONTINUE TO SCH O TO PERSONS, FAMILIES AND COMMUNITIES OF THE TRI-STATE.
2	Check this box
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	6
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	7,311
6	Total number of volunteers (estimate if necessary) .............	6	76
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	41,932,468
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	23,853

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	20,026,347	3,870,968
9	Program service revenue (Part VIII, line 2g) .........	1,078,935,922	1,107,127,457
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,603,816	9,080,056
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	128,627,758	187,360,194
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,240,193,843	1,307,438,675
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	862,927	1,047,036
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)	503,887,232	505,444,365
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 503,478
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	625,506,976	664,481,116
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,130,257,135	1,170,972,517
19	Revenue less expenses. Subtract line 18 from line 12.......	109,936,708	136,466,158
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,165,494,851	2,366,520,353
21	Total liabilities (Part X, line 26).............	697,949,041	700,362,780
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,467,545,810	1,666,157,573

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 182,047,096 including grants of $ ) (Revenue $ 492,997,080 )
	PATIENT SERVICE REVENUE. SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 824,061,073 including grants of $ ) (Revenue $ 610,028,657 )
	CHARITY CARE/SUBSIDIZED CARE. SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 14,165,254 including grants of $ ) (Revenue $ 4,101,720 )
	GRADUATE MEDICAL EDUCATION, MEDICAL EDUCATION AND COMMUNITY BENEFIT. SEE SCHEDULE O.

	(Code: ) (Expenses $ 1,047,036 including grants of $ 1,047,036 ) (Revenue $ 67,083,990 )


4d	Other program services (Describe in Schedule O.)
	(Expenses $ 1,047,036 including grants of $ 1,047,036 ) (Revenue $ 67,083,990 )
4e	Total program service expenses1,021,320,459

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	13,694,330	4,669,307	2,002,899

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	891,337
d	Related organizations		1d	717,907
e	Government grants (contributions)		1e	1,050,972

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,210,752

g	Noncash contributions included in lines 1a - 1f:$		1g	56,208

h Total. Add lines 1a-1f.......		3,870,968

		Business Code
2a	NET PATIENT REVENUE	900099	1,107,127,457	1,107,127,457
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,107,127,457

3 Investment income (including dividends, interest, and othersimilar amounts) ......			16,005,436			16,005,436
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		21,695,535	6a
b	Less: rental expenses		10,107,565	6b
c	Rental income or (loss)		11,587,970	6c
d	Net rental income or (loss).......			11,587,970			11,587,970
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,960	418,166,415	7a
b	Less: cost or other basis and sales expenses	90,829	425,003,926	7b
c	Gain or (loss)	-87,869	-6,837,511	7c
d	Net gain or (loss).........			-6,925,380			-6,925,380
8a	Gross income from fundraising events (not including $ 891,337of contributions reported on line 1c). See Part IV, line 18 ....
			8a	138,159
b	Less: direct expenses ...		8b	250,140
c	Net income or (loss) from fundraising events..			-111,981			-111,981
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER HOSPITAL SERVICE		900099	96,318,305	29,450,558		66,867,747
b	LABORATORY SALES		621500	38,667,510		38,667,510
c	INVESTMENT IN JOINT VE		900099	37,633,432	37,633,432
d	All other revenue ....			3,264,958		3,264,958
e	Total. Add lines 11a–11d ......			175,884,205
12	Total revenue. See instructions.....			1,307,438,675	1,174,211,447	41,932,468	87,423,792

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,047,036	1,047,036
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	7,987,799		7,987,799
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	391,015,892	351,435,843	39,288,074	291,975
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,930,830	1,506,651	424,179
9	Other employee benefits .......	77,980,565	62,704,229	15,276,336
10	Payroll taxes ...........	26,529,279	23,384,260	3,145,019
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,175,468		3,175,468
c	Accounting ...........	52,145		52,145
d	Lobbying ...........	97,281		97,281
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,407,777		1,407,777
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	161,203,676	150,922,997	10,258,327	22,352
12	Advertising and promotion ....	179,607	15,716	163,891
13	Office expenses .......	10,391,192	8,628,194	1,728,729	34,269
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	15,977,307	9,413,094	6,564,213
17	Travel ............	6,413			6,413
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	224,610	143,618	80,992
20	Interest ...........	14,724,084	8,114,450	6,609,634
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	55,053,651	35,388,414	19,665,189	48
23	Insurance ...	4,614,219	3,601,641	1,012,578
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/SURGICAL SUPPLI	242,929,282	242,929,282
b	MEDICAID ASSESSMENT FEE	52,048,100	52,048,100
c	EQUIP RENTAL/MAINTENANC	51,131,800	35,144,397	15,987,403
d	DUES & SUBSCRIPTIONS	1,384,562	26,923	1,312,446	45,193
e	All other expenses	49,879,942	34,865,614	14,911,100	103,228
25	Total functional expenses. Add lines 1 through 24e	1,170,972,517	1,021,320,459	149,148,580	503,478
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			225,019,611	2	176,664,213
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			153,949,305	4	195,741,495
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 .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			1,798,788	7	3,104,354
8	Inventories for sale or use ............			10,072,497	8	11,375,719
9	Prepaid expenses and deferred charges ......			15,538,735	9	15,791,586
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,353,650,327
b	Less: accumulated depreciation	10b	728,504,546	534,953,362	10c	625,145,781
11	Investments—publicly traded securities .			975,609,207	11	955,756,769
12	Investments—other securities. See Part IV, line 11 .....			59,985,410	12	168,680,216
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			48,218,553	14	48,218,553
15	Other assets. See Part IV, line 11 ...........			140,349,383	15	166,041,667
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,165,494,851	16	2,366,520,353

17	Accounts payable and accrued expenses .....	111,486,885	17	125,142,686
18	Grants payable ...		18
19	Deferred revenue .........	9,451	19	1,981,319
20	Tax-exempt bond liabilities .........	108,234,746	20	101,950,473
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	478,217,959	25	471,288,302
26	Total liabilities. Add lines 17 through 25..	697,949,041	26	700,362,780

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,458,032,820	27	1,656,851,867
28	Net assets with donor restrictions ...........	9,512,990	28	9,305,706
	Organizations that do not follow FASB ASC 958, check here 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 ...........	1,467,545,810	32	1,666,157,573
33	Total liabilities and net assets/fund balances ........	2,165,494,851	33	2,366,520,353