Mendota Community Hospital

“COMPENSATION FOR THE ORGANIZATION'S OTHER OFFICERS IS PAID BY OSF HEALTHCARE SYSTEM, A RELATED TAX EXEMPT ORGANIZATION. THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS THAT OWNS OR IS ASSOCIATED WITH THE HEALTHCARE SYSTEM WHO have taken a vow of poverty. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. SOME KEY EMPLOYEES LISTED IN PART VII ARE PRACTICING PHYSICIANS WHO ARE LISTED AS KEY EMPLOYEES AS A RESULT OF THE COMPENSATION THEY RECEIVE AND NOT DUE TO ANY EXECUTIVE OR MANAGEMENT POSITION WHICH THEY HOLD. such physicians generally are not participants in the executive compensation plan, and their compensation, including base salary, benefits, and any applicable bonus or incentive compensation, is established in accordance with nationally recognized physician compensation surveys and is set forth in written employment agreements (which are approved by the Board of Directors or its Executive Committee) and/or the Physician and Advanced Practice Provider Compensation Plan Document (which is approved by the Human Resources Committee). BECAUSE THE ORGANIZATION'S OTHER OFFICERS ARE NOT PAID BY THE FILING ORGANIZATION, THE FORM 990 INSTRUCTIONS REQUIRE THIS TO BE ANSWERED "NO."”

“Osf healthcare system is the sole corporate member of mendota community hospital.”

“Osf healthcare system as a sole corporate member of mendota community hospital has the power to elect members of the board.”

“Reserved powers: the following powers are reserved for the member: a) to establish, approve, or modify the philosophy, vision, values, and mission according to which the corporation operates. (b) to amend the corporation's articles of incorporation and bylaws. (c) to appoint and remove, with or without cause, the directors of the corporation. (d) to merge or consolidate the corporation with other entities or to dissolve the corporation. (e) to acquire an interest in an existing entity or to establish a new entity. (f) to lease, sell, encumber or otherwise alienate any real property or interest in real property of the corporation. (g) to approve any transfer, lease, sale or encumbrance of personal property of the corporation except in the ordinary course of business. (h) to approve any borrowing or debt financing on behalf of the corporation. (i) to appoint, discipline, terminate and remove the corporation's operating division president. (j) to appoint and remove the corporation's chairperson, vice chairperson(s), chief executive officer, president, secretary, and treasurer, and the assistant secretary and assistant treasurer, if any. (k) to approve or amend strategic plans, management objectives, and capital and operating budgets of the corporation. (l) to approve any purchase or other aquisition by the corporation that is not included in its capital budget and exceeds one million dollars ($1,000,000) per item. (m) to name or rename any hospital or medical center owned and operated by the corporation. (n) to require a certified audit of finances of the corporation and to appoint the certified public accountant to perform the audit. (o) to approve the engagement of and to dismiss any outside legal counsel to represent the corporation on a regular basis or in connection with any matter deemed by the member, in good faith, to have significance for the corporation as a whole. (p) to give preliminary approval prior to the development of, and to give final approval prior to the execution of, all documents to which the corporation is or will be a party and which relate to the creation, formation, organization, or termination of any other legal entity (whether a corporation, limited liability company, partnership, or any other entity) in which the corporation will have any ownership interest, membership interest, power to elect or appoint board members or officers, or any other formal participation arrangement, whether acting alone or in conjunction with any other person or entity. (q) to take any and all actions deemed necessary, in the sole judgement of the member board to protect and preserve the tax-exempt status and public charity status of the corporation or the member and any tax-exempt affiliate of the corporation or the member (including federal and state income tax exemptions, property tax exemptions, and sales tax exemptions); provided the member board has given a written request to the board to take action or refrain from taking action, which would have sufficiently protected and preserved such tax-exempt and public charity status, and the board has failed to promptly take such action or refrain from taking such action.”

“Brian silverstein, m.d. 1000 elm ridge drive glencoe, il 60022”

“The proposed final version of the form 990 is provided via an online portal to all officers and members of the board of directors for their review prior to filing. Any appropriate changes requested by the officers and directors are then incorporated into the final form 990 and all schedules before filing.”

“Disclosures by officers, directors and trustees, as well as key employees and employees charged with purchasing, procurement and contraction decision-making are made through an electronic reporting system on an annual basis. Disclosures are received and reviewed by the corporate compliance division on an annual basis. If a potential conflict of interest is identified, then the disclosing employee is notified of the potential conflict and may be asked for additional information. The corporate compliance division determines whether a plan to manage a possible or actual conflict of interest is needed, discusses the mangement plan with the employee and monitors the employee's compliance with the plan. Plans to manage conflicts are tracked through the electronic disclosure system.”

“The board of directors has established a board committee known as the human resources committee whose members are all professed members of the religious congregation known as the sisters of the third order of saint francis that owns or is associated with the healthcare system who have taken a vow of poverty. Hence, they do not personally benefit from decisions of the committee. The committee determines which officers, key employees and other employees are eligible to participate in the executive compensation plan. Based on performance reviews by the supervisors of such persons and compensation survey data and recommendations from a nationally known independent compensation consultant, the committee approves any executive compensation plan applicable to key employees and established the base salary and benefits for plan participants. Prior to payment of any bonus or incentive compensation, the total compensation for each key employee, including base salary, benefits, and proposed bonus or incentive compensation, is again reviewed by a nationally recognized compensation consultant to ensure that no excess benefit amount is paid or furnished. The compensation review is done annually.”

“The organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.”

“Other Revenue - Total Revenue: 17820, Related or Exempt Function Revenue: 17820, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”

“The tax law requires that each legal entity within the osf healthcare system complete a separate tax return which appropriately reflects the activities and financial position of the particular organization. This reporting, however, is not reflective of the osf healthcare system as a whole. Please see the attached audited financial statements of osf healthcare system and subsidiaries for a complete overview of the system.”

“Inter-company Transfers - -530998; Net Assets Released From Restrictions - 227090; Equity Transfers - 1606516;”