JANE ADDAMS COMMUNITY MENTAL HEALTH CENTER: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
JANE ADDAMS COMMUNITY MENTAL HEALTH CENTER (EIN 36-2879689)
Tax period
2024-01-01 to 2024-12-31
Filed
2026-06-29
IRS object ID
202611809349301126
Schema version
2024v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2026-06-29T13:52:38-05:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362879689EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JANE ADDAMS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJANEBusinessNameControlTxt
Phone8155996209PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 WEST STEPHENSON STREETAddressLine1Txt
CityFREEPORTCityNm
State AbbreviationILStateAbbreviationCd
ZIP61032ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL C CLARKPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone8155996361PhoneNum
Signature2026-06-29SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1FHN FAMILY COUNSELINGBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerMARK S GRIDLEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 W STEPHENSON STAddressLine1Txt
CityFREEPORTCityNm
State AbbreviationILStateAbbreviationCd
ZIP61032ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$658,835GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FHN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1976FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTO PROVIDE AND PROMOTE SOCIAL, PSYCHOLOGICAL, AND PSYCHIATRIC SERVICES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$616,106PYContributionsGrantsAmt
CY Contributions Grants$80,486CYContributionsGrantsAmt
PY Program Service Revenue$1,997,252PYProgramServiceRevenueAmt
CY Program Service Revenue$578,241CYProgramServiceRevenueAmt
PY Investment Income$106PYInvestmentIncomeAmt
CY Investment Income$108CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,613,464PYTotalRevenueAmt
CY Total Revenue$658,835CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,232,662PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$791,581CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$864,590PYOtherExpensesAmt
CY Other Expenses$607,380CYOtherExpensesAmt
PY Total Expenses$3,097,252PYTotalExpensesAmt
CY Total Expenses$1,398,961CYTotalExpensesAmt
PY Revenues Less Expenses-$483,788PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$740,126CYRevenuesLessExpensesAmt
Total Assets BOY$809,133TotalAssetsBOYAmt
Total Assets EOY$34,359TotalAssetsEOYAmt
Total Liabilities BOY$1,527,358TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,492,710TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$718,225NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,458,351NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE THE HEALTH OF OUR COMMUNITIES, WORKING TOGETHER WITH THOSE WE SERVE. JAI COORDINATES AND INTERGRATES BEHAVIORAL HEALTH SERVICES AND PROVIDES IMPARTIAL ACCESS TO BEHAVIORAL HEALTH SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR SOURCE OF PAYMENT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$304,810ExpenseAmt
Revenue$283,833RevenueAmt
DescADULT OUTPATIENT SERVICES PROVIDES ASSESSMENT AND COUNSELING FOR INDIVIDUALS, COUPLES, FAMILIES, AND GROUPS. TYPICAL ISSUES WORKED WITH ENCOMPASS GRIEF, DEPRESSION, ANXIETY, MARITAL AND FAMILY CONFLICT, DIVORCE MEDIATION, AND EDUCATION CLASSES. THE OBJECTIVE OF THIS SERVICE IS TO ADDRESS AND CHALLENGE DYSFUNCTIONAL PATTERNS OF COPING WITH STRESSORS AND REALIGN STRENGTHS TOWARD ACHIEVING INDIVIDUAL GOALS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$577,533ExpenseAmt
Revenue$346,371RevenueAmt
DescFHN FAMILY COUSELING CENTER'S CASE MANAGEMENT SERVICES HELP PLAN, COORDINATE AND ADVOCATE FOR CLIENTS WHO NEED MULTIPLE SERVICES AND REQUIRE ASSISTANCE IN GAINING ACCESS TO AND IN USING MEDICAL, MENTAL HEALTH, SOCIAL, VOCATIONAL, EDUCATIONAL,HOUSING, PUBLIC INCOME AND OTHER COMMUNITY SERVICES TO ASSIST THE CLIENT IN THE COMMUNITY.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$117,842ExpenseAmt
Revenue$28,173RevenueAmt
DescOUTPATIENT CRISIS SERVICES ARE PROVIDED 24/7/365 TO CHILDREN, ADOLESCENTS, ADULTS AND INCLUDE ASSESSMENTS, LINKAGE AND REFERRAL & REPLACEMENT SERVICES FOR THOSE REQUIRING EMERGENCY INTERVENTION. THE OBJECTIVE OF THIS SERVICE IS TO AMELIORATE THE EMERGENCY NATURE OF THE MENTAL HEALTH ISSUE AND ENHANCE STABILITY IN THE LIVES OF THOSE SERVED.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$93,749ExpenseAmt
Revenue$458RevenueAmt
DescTHE SUBSTANCE USE PREVENTION TEAM WORKS WITH MIDDLE SCHOOL AND HIGH SCHOOL YOUTH TO MAKE DECISIONS THAT DO NOT TURN TO DRUG AND ALCOHOL USE THROUGH EDUCATIONAL CURRICULUMS. THE TEAM SUPPORTS THE SCHOOLS IN STEPHENSON AND JO DAVIESS COUNTIES IN COMPLETING THE ILLINOIS YOUTH SURVEY EVERY TWO YEARS. THEY COORDINATE AND PROVIDE CUMMUNICATION CAMPAIGNS WITHIN BOTH COUNTIES TO EDUCATE ON MAKING GOOD CHOICES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$93,749TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$458TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$1,093,934TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL CLARK CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8155996209PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 WEST STEPHENSON STAddressLine1Txt
CityFREEPORTCityNm
State AbbreviationILStateAbbreviationCd
ZIP61032ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
HEATHER MCPHERSON
CHAIR0.50Yes (X)$0$0$0
RICH CHANG
VICE CHAIR0.50Yes (X)$0$0$0
STEVE KNEUBUEHL
TREASURER0.50Yes (X)$0$0$0
BRUCE BALDWIN
SECRETARY0.50Yes (X)$0$0$0
MARK WRIGHT
BOARD MEMBER0.50Yes (X)$0$0$0
GARY QUINN
BOARD MEMBER0.50Yes (X)$0$0$0
SHOKRY TAWFIK MD
BOARD MEMBER0.50Yes (X)$0$0$0
GLENDA KOELLER
BOARD MEMBER0.50Yes (X)$0$0$0
DAN SCHMITT
BOARD MEMBER0.50Yes (X)$0$0$0
AMY BAKER
BOARD MEMBER0.50Yes (X)$0$0$0
KIMBERLY BEGGIN
BOARD MEMBER0.50Yes (X)$0$0$0
MARK S GRIDLEY
PRESIDENT/CEO4.00$5,866$580,748$202,20836.00Yes (X)
MICHAEL C CLARK
EXECUTIVE VP/CFO4.00$3,469$344,418$76,87436.00Yes (X)
LEONARD CARTER
CHIEF HUMAN RESOURCE OFFICER4.00$2,326$230,261$49,38436.00Yes (X)
CLARENCE PARKS
CHIEF MEDICAL OFFICER4.00$0$430,116$35,06436.00Yes (X)
TIMOTHY JESSEN MD
CHAIR PHYSICIAN COUNCIL4.00$0$303,002$52,84836.00Yes (X)
BETH KALNINS MD
PRESIDENT MEDICAL STAFF4.00$0$304,382$34,11936.00Yes (X)
REBECCA PEDERSEN MD
CHIEF QUALITY OFFICER4.00$0$433,707$57,85636.00Yes (X)
ROBERT GELLER MD
HEAD OF INFECTIOUS DISEASE4.00$0$239,264$43,86836.00Yes (X)
KATHRYN J MARTINEZ
CHIEF NURSING OFFICER4.00$0$261,916$201,51036.00Yes (X)
CLAYTON CUNNINGHAM
EXECUTIVE DIRECTOR40.00$162,341$0$47,582Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$174,002TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,127,814TotReportableCompRltdOrgAmt
Total Other Compensation$801,313TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonDR JAMES DALYPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line13133 BROOK HARBOUR DRAddressLine1Txt
CityROCKFORDCityNm
State AbbreviationILStateAbbreviationCd
ZIP61114ZIPCd
FieldValueIRS element (for citing)
ServicesPHYSICIANServicesDesc
Compensation$320,213CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$80,486GovernmentGrantsAmt
Total Contributions$80,486TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REVENUE621400$553,049$553,049
MISCELLANEOUS621400$25,192$25,192
FieldValueIRS element (for citing)
Total Program Service Revenue$578,241TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$108TotalRevenueColumnAmt
Exclusion$108ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$658,835TotalRevenueColumnAmt
Related Or Exempt Func Income$578,241RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$108ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$14,946TotalAmt
Management And General$14,946ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$552,802TotalAmt
Program Services$436,595ProgramServicesAmt
Management And General$116,207ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$14,067TotalAmt
Program Services$11,886ProgramServicesAmt
Management And General$2,181ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$162,191TotalAmt
Program Services$121,042ProgramServicesAmt
Management And General$41,149ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$47,575TotalAmt
Program Services$36,963ProgramServicesAmt
Management And General$10,612ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$583TotalAmt
Management And General$583ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$141,224TotalAmt
Program Services$89,323ProgramServicesAmt
Management And General$51,901ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,452TotalAmt
Program Services$2,452ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,307TotalAmt
Program Services$3,188ProgramServicesAmt
Management And General$1,119ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$12,299TotalAmt
Program Services$12,299ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CORPORATE ALLOCATION$243,603$243,603
MEDICAL SPECIALIST FEES$122,713$122,713
CONTRACTED SERVICES$51,413$7,817$43,596
DUES$8,042$8,042

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$20,744TotalAmt
Program Services$6,053ProgramServicesAmt
Management And General$14,691ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,398,961TotalAmt
Program Services$1,093,934ProgramServicesAmt
Management And General$305,027ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$235,202BOYAmt
EOY$15,821EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$572,075BOYAmt
EOY$18,538EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,856BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$809,133BOYAmt
EOY$34,359EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$23,055BOYAmt
EOY$9EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$307,621BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,196,682BOYAmt
EOY$1,492,701EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,527,358BOYAmt
EOY$1,492,710EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$718,225BOYAmt
EOY-$1,458,351EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$718,225BOYAmt
EOY-$1,458,351EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$809,133BOYAmt
EOY$34,359EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$740,126ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,362,297CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$641,760CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$807,228CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$616,106CurrentTaxYearMinus1YearAmt
Current Tax Year$80,486CurrentTaxYearAmt
Total$3,507,877TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,362,297CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$641,760CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$807,228CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$616,106CurrentTaxYearMinus1YearAmt
Current Tax Year$80,486CurrentTaxYearAmt
Total$3,507,877TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,507,877PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$562CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,124CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,739CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$106CurrentTaxYearMinus1YearAmt
Current Tax Year$108CurrentTaxYearAmt
Total$5,639TotalAmt
FieldValueIRS element (for citing)
Total Support$3,513,516TotalSupportAmt
Public Support CY1700.99840PublicSupportCY170Pct
Public Support PY1700.99860PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO FMH$785,543
DUE TO FRHCF$407,188
DUE TO JAHS$299,970
FieldValueIRS element (for citing)
Total Liability$1,492,701TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARK S GRIDLEY
PRESIDENT/CEO$5,331$527,783$0$0$535$52,965$1,514$149,913$508$50,273$7,888$780,934$0$0
MICHAEL C CLARK
EXECUTIVE VP/CFO$2,665$264,798$0$0$804$79,620$301$29,792$468$46,313$4,238$420,523$0$0
LEONARD CARTER
CHIEF HUMAN RESOURCE OFFICER$2,126$210,461$0$0$200$19,800$0$0$494$48,890$2,820$279,151$0$0
CLARENCE PARKS
CHIEF MEDICAL OFFICER$0$391,666$0$0$0$38,450$0$32,252$0$2,812$0$465,180$0$0
TIMOTHY JESSEN MD
CHAIR PHYSICIAN COUNCIL$0$259,841$0$12,661$0$30,500$0$30,881$0$21,967$0$355,850$0$0
BETH KALNINS MD
PRESIDENT MEDICAL STAFF$0$304,137$0$245$0$0$0$0$0$34,119$0$338,501$0$0
REBECCA PEDERSEN MD
CHIEF QUALITY OFFICER$0$394,157$0$9,050$0$30,500$0$9,659$0$48,197$0$491,563$0$0
ROBERT GELLER MD
HEAD OF INFECTIOUS DISEASE$0$167,336$0$42,277$0$29,651$0$7,413$0$36,455$0$283,132$0$0
KATHRYN J MARTINEZ
CHIEF NURSING OFFICER$0$242,480$0$0$0$19,436$0$158,340$0$43,170$0$463,426$0$0
CLAYTON CUNNINGHAM
EXECUTIVE DIRECTOR$152,642$0$0$0$9,699$0$4,850$0$42,732$0$209,923$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD REVIEWS ALL TRANSACTIONS THAT AFFECT THE FILING OF THE ORGANIZATION'S FORM 990 AND EQUIVALENT STATE RETURNS. THE FORM 990 WAS REVIEWED AND SIGNED BY THE CHIEF FINANCIAL OFFICER.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A DEDICATED CORPORATE COMPLIANCE OFFICER. ALL MEMBERS OF THE BOARD, OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE EACH YEAR A CONFLICT OF INTEREST QUESTIONNAIRE. THESE DOCUMENTS ARE REVIEWED BY THE CCO TO DETERMINE IF ANY INDIVIDUAL HAS A CONFLICT OF INTEREST THAT NEEDS TO BE ADDRESSED.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS THE CEO, TOP MANAGAMENT AND EXECUTIVE DIRECTORS COMPENSATION. THE COMMITTEE RELIES ON INTERNAL AND EXTERNAL INFORMATION TO DETERMINE THE APPROPRIATE COMPENSATION AND EMPLOYS AN INDEPENDENT THIRD PARTY TO CONDUCT THE ANNUAL EXECUTIVE COMPENSATION ANALYSIS. THIS ANALYSIS IS USED TO DETERMINE IF THE BOARD'S WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY HAS BEEN MET. THE EXECUTIVE COMPENSATION COMMITTEE RECEIVES A REASONABLENESS LETTER FROM THE THIRD PARTY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE THESE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 24EREPAIRS: PROGRAM SERVICE EXPENSES 1,355. MANAGEMENT AND GENERAL EXPENSES 5,428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,783. SUPPLIES: PROGRAM SERVICE EXPENSES 2,486. MANAGEMENT AND GENERAL EXPENSES 3,528. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,014. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,485. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,485. CREDIT CARD FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,250. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,250. TELEPHONE: PROGRAM SERVICE EXPENSES 990. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 990. FOOD: PROGRAM SERVICE EXPENSES 656. MANAGEMENT AND GENERAL EXPENSES 247. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 903. TRASH: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 690. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 690. COLLECTION FEES: PROGRAM SERVICE EXPENSES 566. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 566. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 63. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63.
PART XII LINES 2CNO CHANGES HAVE BEEN MADE TO THE PROCESS OF THE SELECTION OF THE INDEPENDENT AUDITORS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
FREEPORT REGIONAL HEALTH CARE FOUNDATION
1045 WEST STEPHENSON STREETFREEPORTIL61032363290904HEALTH CAREIL501(C)(3)LINE 12N/A0
FREEPORT MEMORIAL HOSPITAL
1045 WEST STEPHENSON STREETFREEPORTIL61032362181997HEALTH CAREIL501(C)(3)LINE 30FREEPORT REGIONAL HEALTH CARE FOUNDATION
JANE ADDAMS HEALTHCARE SERVICES INC
1045 WEST STEPHENSON STREETFREEPORTIL61032363677357HEALTH CAREIL501(C)(3)LINE 120FREEPORT REGIONAL HEALTH CARE FOUNDATION

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL ENTERPRISES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11045 WEST STEPHENSON STAddressLine1Txt
CityFREEPORTCityNm
State AbbreviationILStateAbbreviationCd
ZIP61032ZIPCd
FieldValueIRS element (for citing)
EIN363353871EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1FREEPORT REGIONAL HEALTH CARE FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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