2007 - Memorial Hospital of South Bend

ANSWERING THE CALL AND THE CALLING2007 ANNUAL REPORT

Dear Memorial Friends and Family,As another year slips by faster than we can allbelieve, those of us in health care see anotheryear of families needing life saving care.This year’s annual report pays tribute to theteam who answers the call, providing lifesavingservice to our most critical patients– the physicians, nurses and staff at theMemorial Leighton Trauma Center, who areSaving Lives every day.Our journey to provide advanced traumacare throughout the region has included therecruitment and support of board-certifiedemergency physicians, specialty and subspecialistphysicians and nurses, an airmedical transport team, EMS services, a teamof surgeons, rehabilitation specialists, andsupport staff, ready to respond to save lives.In 2007, the American College of Surgeonsrewarded these efforts with re-verificationof our Level II Trauma status, recognizingour dedication to providing optimal care forinjured patients.This level of care is only possible whenprofessionals called to this line of workpartner together across specialties for agreater good. This exceptional level ofteamwork allows the entire Memorial team toanswer the call for medical care throughoutour region.I am honored to extend my thanks toeveryone whose passion and commitmentto the greater good help make Memorial amodel for others to follow and a great sourceof pride for our community.Philip A. NewboldPresident & CEO2 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

Philip A. Newbold—Celebrating 20 YearsPhilip A. Newbold celebrated 20 years as Presidentand Chief Operating Officer of Memorial HealthSystem in 2007. As an internationally renownedspeaker, innovator and businessman, Newbold hasguided this organization through an amazing journey,establishing Memorial as a model for others to follow,and re-imagining ways to create health.He infused his first years at Memorial with theTotal Quality Management strategy of processimprovement, creating a culture of world-classquality and customer service.As one of the first hospitals in the country to establish atithing policy, Newbold’s foray into the world of HealthyCommunities helped focus Memorial’s priorities intobuilding the health of our community. More than justmedical health, tithing 10 percent of annual bottom linenet revenues brought new meaning to “Quality of Life.”Newbold also ushered in the era of innovation,establishing a free exchange of ideas and a culture ofcreativity; encouraging ideas that differentiate Memorialfrom the pack and give patients that WOW! experience.As with other areas of his life, Newbold has taken hispassion for innovation to the next level, becoming aninnovation guru. He is sought out as a motivationaland inspirational speaker, breathing innovation intothe lives of organizations across the country.As a strong community leader, Newbold also serves onnumerous local and national boards bringing his uniquevision of health and wellness to the broader community.Dear Friends and Colleagues,In 2007 we celebrated both new beginnings andcontinued partnerships. It was a year filled withrapid change and continued growth to helpmake life better for those we serve.Like most hospitals, our medical staff faced andovercame many challenges in 2007. Throughoutthese opportunities for growth, I observeda spirit of unity and an unfailing physiciancommitment to improve quality of care. And,our focus on the needs of patients remainedexactly where it ought to be—at the center ofall decision making.We welcomed 107 new members to theMemorial Medical Staff last year, and we lookforward to their contributions as we moveforward to another successful year.Sincerely,Gerard I. Duprat, M.D.Medical Staff President

SARAH TALKINGTON…We need to transfer a patient toMemorial’s Trauma Center. A 19-year-oldfemale was a passenger in the rear seat,involved in an MVC. She is unconsciousand posturing. Head CT shows a nondepressedskull fracture, a head bleedand swelling. She’s a 7 on the GlasgowComa Scale and is intubated…It was truly every parent’s worst nightmare. At2 a.m. on April 1, 2007, Al and Mary Talkington heardfrantic knocks at their front door. Fearing the worstthey scrambled to the door to learn their 19-year-olddaughter Sarah had been in a car accident. In a panic,the Talkingtons rushed to their local hospitalin Michigan City to find Sarah lyingunconscious, being attended to by doctorsand nurses in the Emergency Room.Just minutes before, Sarah and two ofher friends had been hit by a drunkdriver. In the back seat, Sarah tookthe brunt of the crash, and wasthrown to the front, sufferingsevere head injuries.Rev. Titus Matemavi, Chaplain4 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

Memorial’s MedFlight ® helicopter was requestedto transport Sarah to South Bend. “They told us thatshe had to be airlifted to Memorial immediately,”remembers Sarah’s mom Mary. “I’ll never forget Aland I standing there watching the helicopter take offwith her inside.”The Talkingtons stopped at home to pick up somesupplies, including a hair tie for Sarah’s famouslylong locks, and headed to South Bend. The family wasmet by the Trauma Team, including neurosurgeonThomas R. Keucher, M.D., who evaluated Sarah andtook Mary and Al into the hallway to fillthem in on what was happening.“He was just great. We couldn’t haveasked for anybody better,” says Mary.“He told us ‘I’m just going totell you how it is. I’m not goingto sugar coat it.’ And he didn’t,which we really appreciated.”Memorial’s Trauma Teamcontinued to stabilizeSarah while thechaplain and othersupport stafftried to keep herfamily calm.Sarah spent two weeks in the Intensive CareUnit (ICU) where the staff monitored theswelling in her brain. While in the ICU, theTalkingtons formed a relationship with staff R.N.Joshua Pennington, who helped the family getthrough the tough times. From the ICU, Sarahtransferred to the Intermediate Care Unit andcontinued her recovery for the next month.“I honestly don’t remember too much aboutmy time at Memorial,” says Sarah, “but I doremember what mattered most to me. My parentscoming to stay with me for the entire day. My dadgiving me sips of his Mountain Dew. My momwould occasionally do it, but not as much as him.”She also remembers her physical therapist comingin to get her out of bed for exercises. “A nurses aidewould also come in every morning to get me up, andthat’s something I wish I couldn’t remember!”“One of my nurses, Amy, was the best. I also reallyliked Josh in the ICU,” says Sarah. “Amy wouldalways remind me when I get out of here, I will getback to my normal life, in time. She even took me ona ride around the hospital and even outside, it was avery warm day that day! I think the both of us had agood time.”(from left) Sarah’s mom Mary, Sarah, and dad Al TalkingtonMary chokes up when she remembers her daughterbeing helped into a wheelchair for the first time afterthe accident. It was a special gift. On Mother’s Day.“You know I still have that hair tie on my wrist,” saysMary. “I put a new one on my wrist each month shewas away from home. I’ve got four of them on therenow. And I haven’t taken them off yet.”“Sarah has progressed from a wheelchair to a walkerto a cane. She’s done so well,” says Mary. “We are allso very proud of her.”“A college friend first suggested I go into medicine, and neurosurgery was the most exciting specialty for me.It is cases such as Sarah’s that continue to make it a very rewarding career.” — Thomas Keucher, M.D.

ANN THOMAS…We’ve got a 57-year-old female with a GSWto the abdomen. Ambulance requested…“God must have something else for me to do. I shouldhave been dead.”Reflecting on a day that nearly ended her life, Memorialemployee Ann Thomas will tell you that something elsewas at work when she encountered a gunman outside herhome last year.After attending church services and an anniversary partyfor her pastor and his wife, Ann said a brief good-bye toher friends and went home to get ready for a churchevent later that evening.“When I came home I saw there was a lawn chair lyingout in the front lawn, and I thought ‘something’s notright here,’” remembers Ann. “Then I noticed that theback door was wide open and I know I didn’t leave itopen like that,” she adds.“When I looked inside the house, it was just ransacked.I mean just destroyed,” says Ann. “I was stepping backdown the steps to get out of there and call the police.”After that, her recollections become more emotional.She remembers a very sudden feeling of extreme6 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

heat in her side and back. When she looked downshe saw blood and thought, “Oh my God, I’ve beenshot!” Still on her feet and able to think clearly, sheran back into her house and called an ambulance.She had been shot four times in the chest andabdomen, one just inches from her heart.Rushed to the Memorial Leighton Trauma Center,Ann received immediate evaluation and treatmentfrom a team of doctors, nurses, therapists, andothers who treat the most critical patients. The rapidresponse of the Trauma Team resulted in getting Annto the operating room withinminutes, which ultimatelysaved her life. The surgerywas a success and Ann wastransferred to the SurgicalCare Center to begin herjourney toward recovery.“The care Ireceived was justexcellent,” saysAnn. “MemorialHospital has thebest trauma team,and I’m not justsaying that becauseI work there! Dr. Scott Thomas is one of the besttrauma surgeons there is, I was lucky to have him.”Her amazing recovery is matched only by heramazing spirit and gratefulness to be alive. Herfriends and family from home, work and churchaided in her recovery.“Everybody who came to see me said, ‘I can’t believeyou look so good!’” Her doctors and nurses were alsoamazed. “As the doctors came in to visit me, they toldme they couldn’t believe how good I looked after allI’d been through.”Not only did she look much better, she was beginningto feel much better as well. And after just one weekin the hospital, she was discharged to the care of herfamily and friends at home. Now back to work inMemorial Hospital’s Childbirth Unit, Ann says she’sglad to be back with her friends and colleagues, helpingothers, just as she received help, not too long ago.“It’s been mind blowing just to think about it,” addsAnn. When talking about that fateful day, she realizesjust how fortunate she is. “I know who kept me, it wasthe grace of God. I am a walking miracle.”(from left) Dietitians Holly Platz, R.D.,and Melissa Spencer, R.D.“Trauma care is about the team. Our goal is to provide injured patients with the highest quality of care available today.Our team has consistently demonstrated its ability to meet those standards.” — Scott Thomas, M.D.

JEREMY MCDANIEL…We need an ambulance to 100 Center.16-year-old male with significant headtrauma, high-speed fall from car…“He was a kid just being a kid,” says Jeremy’s momLaDonna McDaniel. When looking back on the accidentthat nearly took her son’s life, she attributes his recoveryto a lot of prayers and the amazing work of Memorial’sTrauma Team.Jeremy and a friend were at a park sitting on the trunkof a car when another friend decided to take it for a joyride. At 40 mph, the two boys fell off, leaving Jeremywith significant closed head injuries. His friend walkedaway with minor injuries.When the EMS team arrived,they evaluated Jeremy who wasunresponsive with slow breathing.He was transported to the MemorialLeighton Trauma Center wherea multidisciplinary staff fromacross the hospital came togetherto help save a young life.Social Worker Nancie Stutzman-Neese, LCSW8 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

“They warned me that I may have to be preparedto make a decision. That he may not make itthrough the night,” remembers LaDonna.“That was unbelievably scary.”For more than a week, Jeremy’s family was by hisside as he lay in a coma in Memorial’s IntensiveCare Unit. Spending the night at the RonaldMcDonald Family Room, the group never strayedfar. Doctors found that Jeremy had a number ofcontusions on his brain, telling the family thatif his brain had moved any more than it had, heprobably wouldn’t have made it. “He’s a miracle,that’s for sure,” says LaDonna.“All the nurses and doctors were great,” addsLaDonna. “There was one nurse in particularwhose son also went to Mishawaka High. Shereally took to Jeremy, and he responded verywell to her, which I was glad to see. I felt it reallyhelped him get through this.”After his time at Memorial, Jeremy’s recoverycontinued for four more weeks at a rehabilitationfacility. He continued his rehabilitation atMemorial’s Outpatient Brain Injury Program,mastering basic functions like strength andbalance, reaction time and swallowing.“He doesn’t remember anythingabout the accident, but I go overit in my mind all the time,” saysLaDonna. “How did he land? Whatwas he thinking when he was in theair? I kept wondering what it musthave been like for him. I was makingmyself crazy!”LaDonna says she got through theordeal thanks to the prayers offamily and friends. She’s also gratefulto the staff she encountered from dayone, who kept her informed of herson’s condition as it developed andsupported her family through their darkest moments.“I’ll tell you exactly when I began to realize thateverything was going to be o.k.,” says LaDonna. “I washaving trouble with my phone calling back and forthto family. The minute he took the phone out of myhand, fixed it, and gave it back to me was when I justknew everything was going to be all right. I knew Ihad my Jeremy back.”“He’s my baby, and I’m so grateful he’s still here.”“Challenges I faced as a child growing up in the health care system of the 1950s made me keenly aware of the deficits in thatsystem. These experiences, both positive and negative, became the influence that guided my decision to pursue medicine andprovide patient and family focused health care.” — Michael Long, M.D.

BETTY KRIEG…We’ve got an MVC on 331 South.67-year-old female with multiple trauma.We need an ambulance…“I don’t remember seeing her cross the center line,but all at once she was right in front of me,” remembersBetty Krieg, when recounting her narrow escape from afrightening car accident last March.Driving down 331 South, Betty’s car was hit head on bya woman who had crossed into her lane. After spinningaround a few times, Betty’s car came to a stop facing thewrong way down the wrong side of the street.“The first thing I remember was thinkingthe car was on fire and that I needed to getout. I learned later it was a burn from theairbag,” says Betty.“I also remember turning off the car,unlocking it and asking a man who hadstopped to help me to get the seat beltoff because it was hurting my stomach.”Respiratory Therapist Dan Travis, RRT10 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

“Then, when the ambulance came, the mankept saying ‘talk to me, talk to me, talk to me.’I remember he told me we were going to thetrauma center and to hold on because it was goingto be a bumpy ride,” says Betty. “Then I don’tremember much of anything else. I was kind of inand out of it, as you can imagine.”When Betty arrived, the Memorial LeightonTrauma Center Team identified a laundry list oftraumatic injuries. She had suffered: a compoundfracture of the wrist, a knee cap that was brokenin four places, a crushed heel, a broken sternum,seven fractured ribs, an open book pelvic fracturein three places, a collapsed lung and more than20 broken bones. Her injuries also included aperforated small intestine, which required theremoval of an 8-foot section.“I didn’t even realize how bad of a condition I wasin,” adds Betty. “What I do know now, is what awonderful job the trauma team did on me. I can’tsay enough about the doctors and nurses in thetrauma unit. They really did save my life.”Betty required a total of nine surgeries over a numberof weeks to address her injuries. In fact, OrthopedicTrauma Surgeon Bryan Boyer, M.D. postponed hisvacation to make sure he would bethere to repair the open book pelvicfracture she had suffered. A gestureBetty has never forgotten.“I had very good experiences atMemorial. The nurses were verygood to me on the floor and thedoctors were always friendly,” saysBetty. “They were also very nice to myhusband and sons as far as talking tothem and letting them know whatwas going on. I was blessed to havesuch a great care team.”Even though her condition was serious,the doctors told her they were confident she wouldwalk again, but they couldn’t tell her just how well, or ifher gait would ever be back to ‘normal.’ With extensivetherapy, she’s now back to walking around her homewith no problem, only using a cane when braving thewinter weather of Michiana.“Drs. Boyer, Balint, Kim, Noveroske, Fromm, Clark,Guentert, Koscielski, they all helped save my life,” saysBetty. “I remember them all coming into the room to seeme. They kept telling me that it was a miracle that I wasstill alive. I guess I was stronger than I thought I was.”Betty and her husband William“Ever since I was a child I have always had this altruistic passion for wanting to help people. Becoming an orthopedictrauma surgeon has provided me with the opportunity and privilege to aid injured people in need and possibly make adifference in their lives.” — Bryan Boyer, M.D.

New Levels of Medical CareMemorial MEDFLIGHT ®2007 Program SummaryAn Advanced Diagnostic Tool—The Invisible Becomes VisibleA new level of care is now available to Memorial patients with the 2007 purchase ofa LightSpeed Volume Computed Tomography (VCT), an innovative technology that’stransforming the diagnosis of cardiovascular disease andenhancing the care we can offer to trauma, stroke, pediatricand other patients.Memorial is the only hospital in the region offering thistechnology with Snapshot tm Pulse Low-Dose Software,producing high-quality images with a significant reduction inradiation dosage to the patient.The LightSpeed VCT can capture images of a beating heartin five heartbeats, an organ in a second, and perform wholebody trauma scans in 10 seconds, more than twice as fast asconventional multi-slice CT scanners. And it does so withoutsacrificing clarity—its sub-millimeter resolution offersspectacular views of arteries and veins.One 0.35-second rotation of the scanner produces 64 images. For cardiologists, thismeans new diagnostic power, including CT angiography and rapid tests for help indiagnosing chest-pain patients.The ability to quickly scan trauma patients also enhances the care we give through ourLevel II Memorial Leighton Trauma Center. This speed has also improved our abilityto provide timely and accurate information to our physicians on stroke patients.Memorial Receives Chest Pain Center AccreditationIn 2007, Memorial Hospital renewed a three-year accreditation with PCI(percutaneous cardiac intervention) from the AccreditationReview Committee of the Society of Chest Pain Centers(SCPC), a renewal of the accreditation first received in 2004.SCPC is a patient-centered, non-profit internationalprofessional organization focused on improving care forpatients with acute coronary syndromes and other related issues.Da Vinci ® Robotic SurgeryThe da Vinci Surgical System combinescomputer and robotic technologies to createa new category of surgical treatment, roboticassistedlaparoscopic, thoracoscopic orendoscopic surgery. This system makes itpossible to treat a broader range of conditionsusing a minimally invasive approach.The da Vinci Surgical System enablesgynecologic surgeons to perform minimallyinvasive surgeries for women who otherwisewould have open abdominal procedures. Forprostate patients, recent studies also suggestthat it may reduce the risk of impotence andurinary incontinence.This precision partnership between experiencedphysicians and robotic technology is Memorial’slatest fulfillment of its promise to bring thelatest technological advances to the community.Total Calls ................................................441Inter-Facility Calls ..................................284Scene Calls .............................................157Completed Transports ...........................217Inter-Facility Transports .......................165Scene Transports ....................................52Requesting Hospitals ..............................32Requesting EMS-Related Agencies .....20Destination Hospitals ..............................21Helicopter EMS Safety andReview Sessions ....................................52Responders Attending .......................1,01912 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

Expert care to help youRest, Heal & Live Well.Life-Saving Solutions for Life-Threatening Weight GainThe Memorial Weight Loss & Bariatric Surgery Center enjoyed anothersuccessful year in 2007. The Center’s staff have performed more than 130surgeries and have seen more than 400 non-surgical weight loss patientssince its inception. The center’s team is comprised of surgeons, nurses,an exercise physiologist and behaviorist, and dietitians that specialize indiabetes, hyperlipedemia, metabolic syndrome and childhood obesity.Medical Conditions ResolvedHypertension 83%Diabetes 92%Joint Pain 92%Sleep Apnea 88%Fatigue 100%GERD 95%Incontinence 100%Memorial bariatric patient, Sue SeallRecord Growth at Memorial Home CareMemorial Home Care (MHC) continuedits strong support of the health system andthe community with another record yearof revenue and number of patients served.Census figures show that MHC servedthe needs of more than 10,000 patientsper month in 2007. MHC was able toachieve record growth through additionallines of business, including the expansionof pharmacy services via a new strategicalliance with Mar-Main Pharmacy.MHC’s continued growth led to theconstruction of their new 50,000-square-foot facility that opened inspring 2007. The new facility servesas the foundation building for homecare staffing, intermittent care services,equipment and supplies, oxygen therapy,home infusion services, a health productsretail store, and all administrative andfinancial support services.In addition, MHC was a recipient ofthe 2007 OCS Vision Award, whichhonors home care, hospice and privateduty organizations for strategic and/or innovative use of OCS products infurthering agency performance.As the only Joint Commissionaccredited, full-service home carecompany in the area, MHC reaches outto the community every day through itspeople and products. MHC also servesthe community through innovativeinitiatives such as the annual WheelchairTune-Up Day, quarterly AWAKE supportgroups for those with sleep disorders,annual flu shot clinics and numeroushealth fairs.Making RoomEight additional emergency room (ER)beds were added in March of 2007 tohelp alleviate wait times for patients. Thenew space, which incorporates real estatefrom the old emergency room area, hasits own nurses’ station and is connectedto the main ER for the convenience ofdoctors, nurses and ER staff.Marcy Parisi, R.N., BSN,emergency care center nurse

Occupational Health KeepsMichiana on the JobThe Memorial Center for OccupationalHealth offers a full range of occupationalhealth services to more than 2,500 clientcompanies, including:· Treatment for on-the-job injuries· Ergonomic assessments· Follow-up care for Workers’Compensation cases· Executive physicals· Injury prevention· Industrial rehabilitation· Work-site assessment for Americanswith Disabilities Act standards· Drug screenings· Corporate wellness programs· Safety and accident prevention seminarsMemorial Medial Group’s ClinicalResearch Institute Continues to GrowMemorial’s highly successful and growing ClinicalResearch Institute (CRI) continues to make great stridesin the advancement of medicine.“We’re no longer the new kids on the block,” says MichaelGordon, Executive Director of Memorial Medical Group.“We’ve established ourselves as a nationally recognized,reliable, high quality research department.”Just three years since its inception, the CRI has developed anational reputation, with pharmaceutical and research companiescourting Memorial’s physicians—instead of the other way around.2007 Clinical Research Institute StatisticsResearch Study Contracts Secured.............................................21Contracted Dollars......................................................$1.6 millionDoctors as Principle Investigators...............................................11Doctors as Sub Investigators......................................................23Eric Wohlrab, M.D., MPH, M.S., FACOEMMemorial Medical Group Welcomes New PhysiciansMemorial Medical Group recorded 382,005 patient visits and welcomed 12 new physicians in 2007. (pictured from left)Sandra Cho, DPMPortage Road Medical GroupKaren Davis, M.D.Navarre PediatricsKate Dutkiewicz, M.D.Pediatric HospitalistThomas Felger, M.D.Med-Point at Schwartz-WiekampMedical GroupNatalie Frentz, M.D.Schwartz-Wiekamp Medical GroupFaiz Khan, M.D.LaPorte Medical GroupMichelle Klawiter-Benton, M.D.Portage Road Medical GroupDale Patterson, M.D.E. Blair Warner Family Medicine CenterJennifer Pennington, D.O.Schwartz-Wiekamp Medical GroupJulie Platt, M.D.Memorial Maternal Fetal MedicineModupe Popoola, M.D.Med-Point at Main Street Medical GroupSara Syeda, M.D.Med-Point at Schwartz-WiekampMedical Group

New Levels of Medical CareExpansion to Portage RoadIn 2007, Memorial Medical Groupopened its newest practice on PortageRoad in South Bend. Physicians atthe Portage Road Medical Group offera wide range of services, including:geriatrics, gynecology, occupationalhealth, internal medicine, pediatrics,family medicine and dermatology.MEDPOINT express ®Expands to MartinsContinuing to Redefine the Best of Health Care in the RegionThe largest expansion in Memorial’s 112-year history is well underway.Ground has been broken, foundations poured and walls erected on thenew surgical suite replacement project, which will increase capacity to13 pre-surgery rooms, 13 operating rooms, 12 recovery rooms, and sixswing rooms for either pre-surgery or recovery. The project also includesrenovation of the Outpatient Surgery Center. This 137,066 square-footexpansionwill result in up to 45 new clinical jobs and 300 constructionrelatedjobs over three years, with completion slated for summer of 2009.Memorial President and CEO Philip A. Newbold says “This extensiveproject will allow us to accommodate a 53 percent increase in surgicalcases to keep up with the demand for specialized care.”Life is busy. Those who have theadded burden of a minor illnesscan now stop at MEDPOINTexpress, which have expandedfrom Wal-Mart ® stores to includeclinics inside local Martin’sSuper Markets. At MEDPOINTexpress, patients can see a nursepractitioner for minor healthconditions. No appointments arenecessary and visits usually takeabout 15 minutes.This extensiveproject will allowus to accommodatea 53 percent increasein surgical cases…– Philip A. NewboldMemorial Spine and Neuroscience CenterThe Memorial Spine andNeuroscience Center(MSNC), a partnershipbetween MemorialHealth System and NorthCentral Neurosurgery,opened for business in2007. Attention to patientcare is found in every aspectof the new facility, locatedon the fourth floor ofNavarre Medical Plaza. TheCenter’s staff works withminimally invasive andmicrosurgical options,and offers innovativeapproaches toanesthesia delivery.The space iscomfortable, modernand, most importantly,it’s a healing restorative place forpatients. “The overall goal is forpatients to be able to resume theirnormal lives as soon as safelypossible,” says Dan Cooke, M.D.,MSNC medical director andanesthesiologist.Physicians Serving Patientsat Memorial’s Spine andNeuroscience Center:David Cockerill, M.D.Dan Cooke, M.D.John Eash, M.D.Harriett Hamer, M.D.Thomas Keucher, M.D.Walter Langheinrich, M.D.Rosa Navarro, M.D.Steve Schroeder, M.D.Stephen Smith, M.D.Robert Yount, M.D.

PROGRESS THROUGH PARTNERSHIPSCommunity Health Enhancement (CHE)Brain Health Programs. CHE is encouraged by the positive response fromtwo new research-based programs, Is It All In Your Head? and Brain Gymnastics.Each class provides information on memory and aging as well as tools to enhancememory and brain health.Olivia Fusillo, M.D.16 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORTCommunity Plunges. What the Future Holds…Parenting. Nearly 60 participantsgathered to hear about current-day parenting issues. The group then visited HopeMinistries’ Family Life Center to hear from organizations offering assistance toyoung parents. The second Plunge explored the topic of Predatory Lending. Severalpeople offered their personal stories as a testament to this growing problem.St. Joseph County Women, Infants, and Children (WIC). WIC providesnutritional services for pregnant women, new mothers, infants and youngchildren. WIC clinics are located on Ireland Rd. and Lafayette Blvd. This was the16 th year of Memorial’s sponsorship of the St. Joseph County WIC Program.Community Health AllianceCommunity Health Alliance (CHA),a physician hospital organization (PHO)jointly owned by Michiana MedicalAssociates and Memorial Health System,continues to grow. CHA’s membershiphas reached more than 106,000 throughits coverage to insurers and theircustomers throughout 56 counties inIndiana, Michigan and Illinois. Memberscan select from more than 16,489physician locations, 109 hospitals anda number of other health care providersin the CHA network. CHA is recognizedas the 15 th largest managed careorganization in the state.New In-House LaboratoryIn 2007 Memorial brought routine laboratorytesting in-house with the forming of ahospital-based laboratory. For clinicalpathology and specialty lab testing, Memorialmaintained a relationship with the South BendMedical Foundation.Indiana Blood CenterMemorial has joined the network of morethan 60 hospitals in Indiana who rely onIndiana Blood Center for blood and bloodcomponents. The relationship ensuresMemorial will meet its patients’ needfor some 800 units of blood and bloodcomponents each month as well as provideaccess to 24-hour physician counsel withtransfusion specialists, advanced bloodcompatibility testing, Indiana’s bonemarrow registry and technical educationfor lab and medical staff.Indiana Blood Center is a nonprofitcommunity blood center that relies onvolunteer donors to fulfill its mission toprovide a safe, constant and stable bloodsupply in Indiana. With 14 donationsites and an extensive mobile collectionoperation throughout the state, IndianaBlood Center has extended its reach intoSouth Bend with a blood donation programat Memorial, and blood drives throughoutSt. Joseph and surrounding counties,allowing the community to support thelife-saving collaboration between Memorialand Indiana Blood Center.

New Health Care Choicesin Northwest IndianaWith patient healing and comfort at thecenter of all we do, Memorial’s visionis to create new health care choices forNorthwest Indiana. By combining bestpractices from across the country with localcommunity needs, we intend to createexceptional experiences and achieve highquality medical outcomes in a welcoming,safe environment.To achieve this vision, Memorial HealthSystem closed on the purchase of 53acres near the intersection of Route 49and Burlington BeachRoad in Valparaiso, IN.Memorial leaders areworking with physiciangroups, payors, andbusiness and communityleaders throughoutNorthwest Indiana to gatherinput regarding the project includingthe range of clinical services to be offeredalong with physicians’ needs in the area.The new facility, targeted for completionin 2010, will be owned and operated byMemorial Health System.New medical services under review forthe health park include: Cardiology,Emergency Care, Pediatrics, Surgery,Home Health Care, Obstetrics,Oncology, Orthopedics and PhysicalTherapy. For more information, visitwww.newcarechoices.org.Health Works! ExpansionIn 2007, North Mississippi MedicalCenter became the first organizationto begin the process of replicatingHealthWorks! Kids’ Museum in theirown community. The new facility inTupelo, Mississippi, slated to open atthe end of 2008, shares Memorial’scommitment to the health of all children.“As our partnership has grown, it’slead to new relationships in areas thatextend far beyond Health Works!,” saysHealthWorks! Infection Agent RebeccaZakowski, R.N., “areas that mutuallystrengthen both organizations.”Strengthening Alliances in 2007NEXXT Solutions. In 2007, Memorialpartnered with NEXXT Solutions, acompany that has provided the NFL withinjury documentation and tracking softwarefor the past 20 years. In the past 10 yearsthey have branched out to include the NBA,NHL and MLB.A recent initiative was to expand theirsoftware to make it compatible with twoother athletic populations; the collegeathlete and the high school athlete. Theyapproached the NCAA to secure the formerpopulation and approached the MemorialSports Medicine Institute to work withtheir software developer to adapt thissoftware for use in high school trainingrooms. Currently, this software tracks anddocuments injuries at Riley, Washington,New Prairie and LaVille high schools.“So far, this innovative project is savingtime for athletic trainers, improvingdocumentation, expediting communicationwith physicians and, most importantly,improving safety for athletes,” says Mark E.Lavallee, M.D., CSCS, FACSM, director ofthe Memorial Sports Medicine Institute.Behavioral ScienceTechnology, Inc.In 2007, Memorial beganits partnership with Behavioral ScienceTechnology, Inc. (BST), an internationalworkplace safety company that hasemployed its safety methodology in morethan 2,000 projects with organizationsaround the world, including NASA in theaftermath of the Columbia disaster.Developed to enhance results of Memorial’sprimary WIG of safety, this relationshipwith BST helps solidify Memorial’scommitment to putting safety first–always.This partnership will:• Improve the quality of patient care• Tap into the personal mission of healthcare providers• Create a culture that enhances trust andencourages staff to report and learn fromtheir errors• Establish and fortify patient and teammember safety as a prioritySo far, this innovative project is saving time for athletic trainers, improving documentation,expediting communication with physicians and, most importantly, improving safety for athletes.– Mark E. Lavallee, M.D., CSCS, FACSM

IWILDLY IMPORTANT GOALS (WIGS)Defining “What’s Wildly Important”in 2007Memorial’s Executive Planning Groupwhittled down a lengthy list of ambitiousaspirations for 2007 to just four WildlyImportant Goals (WIGs)—goals that if wedidn’t achieve, nothing else would matter.To Provide Quality and Safetyin All That We DoGreat strides were made in theperformance of 20 publicly-reportedCenters for Medicare & Medicaid Services(CMS) quality indicators. Thoughroom for improvement still exists in thepneumococcal vaccination rate, Memorialenjoyed high levels of performance inacute MI and congestive heart failure rates.Memorial also achieved a 51 percentreduction in patient identification errors,exceeding the goal of 25 percent. PatientID band and specimen labeling errorswere reduced by 51 percent from 2006and 67 percent from 2005.Memorial also finalized a relationshipwith Behavioral Science Technology (BST)to help establish and sustain a world-classculture of safety throughout the healthsystem. Quality Compass also piloted aninfectious disease tracking tool to betterrecognize patients with “super bug”18 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORTinfections. In addition, Memorial helpedthe community standardize wristbandcolors to reduce identification errors ontransferred patients.II Though significant organizationalTo Provide Excellent Service in aGreat Place to Work and Practicechallenges may have impacted employeesatisfaction levels, Memorial stillexceeded its goal, continuing an upwardtrend over the last few years. Overallscores of 76.5 in 2007 are up from 67percent in 2006.Although the overall goal was not met,Memorial did see a significant increasein inpatient admissions from a targetedgroup of physicians. Memorial alsoenjoyed an 89 percent CommunityHealth Alliance payor satisfaction rating,adding 958 new providers for a 6percent net growth in 2007.Through the dedication of a crossdisciplinaryteam producing steadyimprovement throughout the year,Memorial Home Care IntermittentServices exceeded their overall clientsatisfaction goal, achieving a 92.2.Memorial Medical Group primary careand specialist patient satisfaction scoresboth exceeded their goals with a score of94.3 and 95.3 respectively.Though not meeting their goal,the Emergency Care Center madetremendous progress in 2007,enjoying two quarters of recordbreakingresults. The first yearof Ambulatory Surgery rankingsalso brought successful results,especially in the second quarter.This achievement was especiallystriking in light of significantdisruption to the patientexperience due to construction.Significant gains were made inMemorial’s Inpatient Satisfactionpercentile goal of 90 percent. Currentlyin the top 20 percent of all hospitalsnation-wide, Memorial continues tostrive to hit the top 10 percent.IIIby Achieving $1 Million in ProfitTo Lead Change ThroughInnovation and Strategic GrowthImprovement from WOW! ProjectsA variety of Wow! Projects fromthroughout Memorial Health Systemcontributed to the achievement of $1.3million in cost savings as measured byMemorial’s Idea Propulsion Lab. Further,Memorial’s strategy for fueling projectswith an eye on expense stewardshipproduced an ROI or “Return onImmagination” of 1.8x. WOW!Projects continue to return significantvalue to the organization andposition Memorial as an innovationleader within the health care industry.IVA number of challenges presentedTo Achieve Strong and SustainedFinancial Performancethemselves in 2007, including a slightdrop in inpatient utilization and anincrease in the uninsured. The drop inutilization, as measured in inpatientdays per 1000 enrollees, occurredwith the Commercial and Medicaidpopulations. Certain labor and nonlaborcost control initiatives wereimplemented in an effort to matchcorresponding changes in revenues.Despite these changes, overall NetRevenue grew 5.5% while OperatingIncome finished $1.4 million behind2006 results.

HEALTH FOUNDATION REPORT TO THE COMMUNITYThis report provides an accounting of the Memorial Health Foundation’s funds invested in the past year to improve the Quality of Lifeof those who live in our community. We enthusiastically express our admiration and appreciation of all who support this work.CommunityAfrican American Women In Touch Awareness Initiative 49,216HealthWorks! – Operational Support 302,636HealthWorks! – Program Support 9,509HealthWorks! – School Scholarships 20,946Junior Volunteer Program at Memorial Hospital 14,312Judd and Mary Morris Leighton Lecture Series 22,598Multiple Investments in Creating Healthy Communities 65,096“Reach Out and Read” – Physicians and Young Families 7,252Reach Out Club – “Off The Wall” at HealthWorks! 41,680Sunburst – A Community Fitness Celebration 40,500Total $573,745Service“CarePages” – Patient Family Support Internet Software 37,000Family Healing Services 3,046Interfaith Chapel – General Support 11,628Memorial Children’s Hospital – Patient & Family Support 43,232Ronald McDonald Family Room at Memorial Children’s Hospital 17,826Total $112,732QualityE. Blair Warner Family Medicine Residency Program 2,000Frontiers of Medicine – Continuing Medical Education 12,476Leighton Emergency Trauma Center 3,250Memorial Children’s Hospital – Auxiliary Support 76,947Memorial Children’s Hospital – Developmental Pediatrics 128,866Memorial Children’s Hospital – General 8,731Memorial Children’s Hospital – NICU Research 240,085Memorial Children’s Hospital – Steinmetz Fund Childlife Services 42,633Memorial Regional Breast Care Center 25,332Memorial Staff Training and Education 5,216Northern Indiana Cancer Research Consortium 9,870Oncology Genetics Clinic 35,000Reach Out Club – Memorial Staff Education 20,311Rehabilitation Services 7,693Total $618,410PeopleFriends of Nursing – “The Spirit of Nursing” 20,000Memorial Team Staff Wellness –“People Achieving Total Health” (PATH) 20,360Scholarships – Epworth School of Nursing 15,213Scholarships – Friends of Nursing 2,785Scholarships – Jane McFall 17,560Scholarships – Memorial Hospital Auxiliary 50,171Scholarships – Helen Gregory Newland 4,883Scholarships – William & Kathryn Shields 14,671Scholarships – Arthur & Helen Shireman 3,269Scholarships – Ruth & Chris Steeneck 14,727Total $163,639GrowthLeighton Heart & Vascular Center 800,098Total 800,098Total Distributions 2007 $2,268,624If you would like more information on any of these gifts or want to learnmore about Memorial Health Foundation, please call us at 574-647-6613,or visit www.qualityoflife.org/foundation.

FINANCIAL REPORTMemorial Health System ended 2007 in a strongand stable financial position. We maintained ourstrong AA- bond rating with both Standard &Poors and Fitch.Net Revenue ended the year 2007 at slightlymore than $428 million representing a 5.5%growth over 2006. Operating income ended atnearly $14.9 million representing a drop of $1.4million over 2006. Investment income finished atnearly $17 million and was $6 million lower than2006 results. However, the Health System’s cashposition finished at a record level of nearly $243million, excluding funds already set aside for theSurgery construction project.Capital investment into the Health Systemcontinues to remain high. Net additions toproperty, plant and equipment were $57.7million. Much of this year’s capital spend relatesto the new Surgery construction project. Otherlarge capital investments in 2007 included:building of a new Lab, an eight room expansionto the Emergency Department, replacementof the Hospital’s CT scanners to the latesttechnology, significant information technologyenhancements and a variety of new capitalequipment and upgrades.$500$375$250$1250$60,000$45,000$30,000$15,000$2642001$41,526$2882002$3272003$3502004$3802005REVENUE(in millions)$4052006$39,773$37,900$38,766 $39,730$37,648$4282007$57,680$20,000$15,000$10,000$5,0000$6,2932001$3,000$2,250$1,500$750$7,5922002$10,5752003$17,532$16,284$14,061$14,888200420052006OPERATING INCOME(in thousands)$2,520$2,688$2,659$2,376$1,4732007$1,474Memorial’s exceptional financial performancecombined with our continued commitment tothe community through our tithing initiativespositions us well to fund our future and tocontinue to improve the quality of health care inour community.0200120022003200420052006CAPITAL INVESTMENT(in millions)2007020022003200420052006TITHING INVESTMENT(in thousands)200720 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

SUMMARY OF FINANCIAL CONDITION AND RESULTSAs of December 31, 2007 and 2006 (in thousands of dollars)Consolidated Balance Sheet2007 2006AssetsCurrent AssetsCash and cash equivalents $ 41,362 $ 23,482Account receivable, net of allowances 70,298 70,921Other current assets 35,946 46,527Total Current Assets 147,606 140,930Consolidated Statement of Operations2007 2006Unrestricted Revenue and Other SupportNet patient service revenue $ 411,581 $ 389,462Other revenue 15,852 15,820Net assets released from restrictionsused for operations 1,148 933428,581 406,215Asset Limited as to UseInternally designated 201,467 186,836Externally designated under debtagreements and insurance trust 61,039 1,066262,506 187,902Other AssetsProperty and equipment, net 316,666 284,663Endowment investments 15,110 15,110Other 21,986 20,379353,762 320,152Total Assets $ 763,874 $ 648,984Liabilities and Net AssetsCurrent LiabilitiesAccounts payable and accrued expenses $ 44,284 $ 39,351Other current liabilities 3,660 3,735Total Current Liabilities 47,944 43,086Noncurrent LiabilitiesLong-term debt, less current maturities 232,864 156,046Other long-term liabilities 11,349 21,971Interest rate and basis swaps, net 7,022 2,474251,235 180,491Total Liabilities 299,179 223,577Net AssetsUnrestricted net assets 440,818 401,334Temporarily restricted net assets 8,767 8,963Permanently restricted net assets 15,110 15,110464,695 425,407Total Liabilities and Net Assets $ 763,874 $ 648,984ExpensesSalaries and wages 161,938 153,639Employee benefits 42,073 42,666Supplies and other 101,784 92,851Professional fees and purchased services 46,733 42,293Depreciation and amortization 25,679 24,124Interest 7,244 6,836Provision for bad debts 28,242 24,702413,693 387,111Income from Operations before asset 14,888 19,104retirement obligationAsset retirement obligation - (2,820)Income from Operations 14,888 16,284Nonoperating IncomeInvestment income, net 16,943 23,059Unrealized (losses) gains on swaptransactions, net (6,016) 13,489Loss on early extinquishment of debt 0 (4,589)Net Income 25,815 48,243Key Statistics – Memorial Hospital of South Bend, Inc.2007 2006Adult & Pediatric Patient Days 72,463 74,321Adult & Pediatric Admissions 17,539 17,968Average Length Of Stay 4.13 4.14Emergency Room Visits 49,230 48,236Surgeries 13,686 14,184

ACHIEVING EXCELLENCEPerformance ExcellenceAn exciting commitment to Performance Excellence overtook the worldof Memorial in 2007, infusing new thinking and fresh outlooks intoday-to-day operations.The Six Sigma and Lean methodology of process improvement havemade an enormous impact on the kind of care Memorial can give toit’s patients and families, while improving the quality of work life forphysicians and employees.Memorial’s partnership with General Electric (GE), acompany widely known as one of the best managedcompanies in the world, has brought Lean, Six Sigma, theChange Acceleration Process and Work-Out TM to Memorial’swell established culture of forward thinking innovation.This brave new world began when 21 Memorial employees undertookthe daunting task of completing GE’s Lean Six Sigma Black Belt andGreen Belt Development Program. At the end of the six-month trainingprogram, five Black Belts and 16 Green Belts emerged, ready to takeon the roadblocks and destroy the barriers that keep change andimprovement from happening.Consumer Choice AwardFor the sixth year running,local consumers have namedMemorial Hospital as SouthBend’s preferred hospital foroverall quality and image,according to a poll conductedby National Research Corporation (NRC). The 2007/08 NRCHealthcare Market Guide study surveyed more than 200,000households representing 450,000 consumers in the United States.FierceHealthcare AwardFierceHealthcare named Memorial Hospitalof South Bend the Most Innovative AcuteCare Hospital in the nation for 2007.The team cited Memorial’s unique R&Dcenter, and it’s courage to establish“innovation” as one of its core values.The award also recognizes Memorial’spartnerships with organizations outsidehealth care, such as 3M ® , Dupont ® ,Motorola ® and Land’s End ® . Memorial’sability to meet it’s goal of generating $1million in revenue on innovation projectsalso caught their eye, calling it “a model forothers to follow.”See How We’ve GrownPatients Entered into Trauma Registry:2004 – 8782005 – 8892006 – 9832007 – 1044A 19% increase from 2004 (when wewere verified as a Level II Trauma Center)to 2007.Trauma Referrals into MemorialHospital of South Bend:2004 – 1502005 – 1652006 – 2102007 – 250An increase of 67% from 2004 to 2007.Trauma Patients Transferred out ofMemorial Hospital of South Bend:2004 – 302005 – 412006 – 332007 – 26A decrease of 13% from2004 to 2007.Jim Bell, R.N. andGisela Kaniewski, R.N.,trauma nurses22 | MEMORIAL HEALTH SYSTEM 2007 ANNUAL REPORT

LEVEL II TRAUMA CARE AT MEMORIALIn 2007, the American College of Surgeons’ (ACS)Committee on Trauma re-verified Memorial Hospital ofSouth Bend as a Level II Trauma Center, just one of fourLevel II facilities in the state. Level II Trauma Centers likeMemorial serve as a lead facility for the region, as theclosest Level I facility is in Indianapolis. “We take thisrole seriously providing education and follow-up to areaproviders and hospitals who rely on our expertise,” saysRobert A. Yount, M.D., neurosurgeon.“We commend Memorial Hospital of South Bend for itsdemonstrated commitment to provide superior traumacare,” said Frank L. Mitchell III, M.D., MHA, FACS,Chairman of the Verification Review Committee.“Comprehensive care from admission to dischargeand beyond is what the Memorial Leighton TraumaCenter is all about,” said Scott Thomas, M.D., FACS,medical director of Memorial’s Trauma Services.“It truly is a network of units and specialists comingtogether to provide optimal, timely care to the mostcritically injured patients. Everyone takes greatpride in the role they play in bringing about positiveoutcomes. Recognition of our team approach is thereason for the growth of our Trauma Center.”The Level II verification is based ondemonstration of a well-organized systemof care that covers the spectrum fromprevention education to pre-hospitalemergency care, acute care, effectivediagnosis, treatment and rehabilitation.The system requires a multi-disciplinary hospitalteam of board-certified physician specialists, nurses,clinicians and support staff, all equipped with themost effective diagnostic and treatment resources.“As a Level II Trauma Center, there’s a sequence ofevents that automatically occurs with each traumapatient. It gives us a more structured approach whena patient comes in,” said Keith Sherry, M.D., FACEP,Memorial Hospital EMS medical director. “Instead ofreinventing the process for each new case, we alreadyhave a system in place.”“Minutes count,” says Dr. Thomas. “Saving Lives is areality in the trauma program, not just a slogan.”Prevention is Always the Best MedicineThere’s more to a great trauma program thantreating those needing critical care. To be a truesteward of health in the community, the best traumateams place a strong emphasis on preventingtrauma in the first place. For years, Memorial hasbeen recognized as much for its work in injuryprevention as for its clinical services.Memorial Trauma Services and HealthWorks! Kids’Museum have worked together to bring multipleinjury prevention programs to area youth. During2007, more than 38,000 youth and adults havelearned how to stay safe.These programs include: American Trauma Society’s“Trauma Roo,” “Trauma Nurses Talk Tough,” “ThinkFirst” and “Crazy Cranium” camp specificallyoffered at HealthWorks! Along with HealthWorks!Kids’ Museum, Trauma Services participatesin multiple community safety fairs offeringdemonstrations on seat belt safety, Poison Control,and other health and safety issues.Memorial Hospital is the lead agency for SafeKids of St. Joseph County, part of a worldwideorganization that focuses on preventing injuriesfor youth ages 0 – 14.The Memorial Trauma Team will continue toreach out to provide innovative programmingfor youth and adults in our community.Robert A. Yount, M.D., neurosurgeonKeith H. Sherry, M.D., EMS medical director

LEADERSHIP 2007-2008Memorial Health System Presidentand Chief Executive OfficerPhilip A. NewboldMemorial Health System Senior VicePresident and Chief Operating OfficerMichael J. O’NeilMemorial Hospital Executive VicePresident and Chief Operating OfficerKreg R. GruberMedical StaffGerard I. Duprat, M.D., PresidentThomas L. Hauch, M.D., Vice PresidentEtta K. Nevel M.D., Secretary/TreasurerMemorial Health SystemBoard of DirectorsRev. Richard V. Warner, CSC, ChairmanJohn P. Hiler, Vice ChairmanVivian G. Sallie, SecretaryLarry D. Harding, TreasurerRafat H. Ansari, M.D.Gary B. Fromm, M.D.Terry L. GerberVincent C. Henderson, M.D.Nancy L. IcklerPhilip A. NewboldUna Mae Reck, Ed.D.Todd F. SchurzHerbert L. WilsonMemorial Hospital Board of TrusteesBipin N. Doshi, ChairmanWellington D. Jones, Vice ChairmanFaye L. Magneson, M.D., SecretaryThomas R. Cassady, Jr., TreasurerSandra R. Brown, M.D.Thomas G. BurishLeslie V. DashiellGayle RosencrantzGerard I. Duprat, M.D.Thomas L. Hauch, M.D.Jesse Hsieh, M.D.Maurice R. Hurwich, M.D.Craig A. KapsonMargaret B. KingM. Rose MeissnerCharles B. MillerEtta K. Nevel, M.D.James T. Schwartz, Sr.Maria B. SlagerPerry Watson, IIIRobert A. Yount, M.D.Memorial Health FoundationBoard of DirectorsNancy L. Ickler, ChairmanJames F. Keenan, Jr., Vice ChairmanPamela J. Newman, SecretaryNajeeb A. Khan, TreasurerRev. R Mark BeesonBarbara Shields-ByrumGeorge B. Friend, M.D.Nancy D. GerberMary Jo HalbritterLeland R. Kaiser, Ph.D.John C. KerrTerri T. KosikMary E. LowePatricia H. LuckGladys Muhammad-WardCarmi MurphyLouis M. NanniPhilip A. NewboldOlubunmi A. Okanlami, M.D.John T. PhairJan R. ReinekeGayle RosencrantzJulia J. SchwartzSilvia SchweizerKurt SimonPeter VeldmanJane J. WarnerMemorial Home CareBoard of DirectorsDean L. Strycker, M.D., ChairmanChristopher J. Murphy, III, Vice ChairmanMichael J. O’Neil, SecretaryPhilip A. Newbold, Treasurer & PresidentBruce R. BancroftTerry L. GerberCharles F. Hagenow, M.D.Hollis E. Hughes, Jr.Fred S. KahnRichard J. PfeilJohn M. PycikRichard J. RiceMaritza RoblesDavid R. SageDennis J. SchwartzA. Dean Speicher, Ed.D.Janet E. ThompsonTrustee Emeritus MembersWilliam A. CarletonJudd C. Leighton (deceased)Mary Lou M. Leighton (deceased)Bruce C. Hammerschmidt (deceased)JoAnn R. MeehanDean L. Strycker, M.D.E. Blair Warner (deceased)William Steinmetz, Sr. (deceased)615 North Michigan StreetSouth Bend, IN 46601www.qualityoflife.org