2024-08-09T16:56:59-05:00 2023-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 370684691 Memorial Hospital Association MEMO 2173573131 PO Box 160 Carthage IL 62321 Teresa Smith CFO 2173573131 2024-08-09 1 1 Kim Hunwardsen CPA P00484560 6122536500 2024-08-09 2023 2024-08-08 14:25:15Z Ada Bair PO Box 160 Carthage IL 62321 51841297 0 X www.mhtlc.org X 1947 IL Memorial Hospital provides clinical care, diagnostic, treatment, and wellness services 15 14 413 25 0 0 2381302 2121827 43717775 47943394 185879 419212 60203 -12872 46345159 50471561 275600 562333 0 0 24425306 27180067 0 0 214558 19321566 20356740 44022472 48099140 2322687 2372421 47754183 50796946 22088046 22404212 25666137 28392734 X Memorial Hospital is committed to improving health by providing education and wellness programs and innovative services at all the stages of life. 1 0 40211983 562333 47943394 Memorial Hospital is dedicated to maintaining and improving the health of all people in the Hancock County area. Governed by a Board of Directors, we serve as a vital safety net, serving our communities with access to quality healthcare services. Memorial Hospital provides many types of community benefit care. Community benefit care includes charity care, community health fairs, lectures, and free health screenings, demonstrating our commitment to improving the overall health of the residents of the Hancock County area.In 2023 the Hospital had 2,377 patient days with 532 admissions and 530 discharges. (Continued on Schedule O)There were 6,105 emergency room visits, 1,344 provider-based physician clinic visits, 7,803 independent physician visits and 44,118 rural health physician clinic visits.We are always committed to providing compassionate care to every member of our community regardless of their ability to pay.To fulfill its mission of community service, the Organization provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Revenue from services to these patients and residents is recorded in the accounting system at the established rates, but the Organization does not pursue collection of the amounts. The resulting adjustments are recorded as adjustments to patient and resident service revenue, depending on the timing of the charity determination.The Illinois legislature passed a bill titled the "Hospital Uninsured Patient Discount Act." Effective April 1, 2009, this Act requires hospitals to provide certain mandated discounts from charges to the uninsured in Illinois. Charges are to be discounted at 135% of cost. Furthermore, a hospital may not collect more than 25% of an uninsured family's gross income in any one year.The Organization provides health care services to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Organization does not pursue collection of these amounts, they are not reported as patient and resident service revenue. The estimated cost of providing these services was $393,000 for the year ended December 31, 2023, calculated by multiplying the ratio of cost to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients and residents.In addition, the Organization provides services to other medically indigent patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Organization also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. 40211983 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 64 0 1 413 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 IL X Kim Byers 2173576571 PO Box 160 Carthage IL 62321 Dan Asbury President 3.00 1.00 X X 0 0 0 LuAnn Haas Vice President 3.00 1.00 X X 0 0 0 Dennis Rankin Secretary/Treasurer 3.00 1.00 X X 0 0 0 Robert Barlow Director 3.00 1.00 X 0 0 0 Charles Gilbert Director 3.00 1.00 X 0 0 0 Doug Groth DVM Director 3.00 1.00 X 0 0 0 Larry McClintock Director 3.00 1.00 X 0 0 0 Tanya Mero MD Director (Until Sept 23) 3.00 1.00 X 0 0 0 Katie Pearson Director 3.00 1.00 X 0 0 0 Angela Pollock Director (Until Sept 23) 3.00 1.00 X 0 0 0 Terry Pope Director 3.00 1.00 X 0 0 0 Victoria Kalivoda-Popela DO Director 40.00 1.00 X 489905 0 14731 Debbie Simon Director 3.00 1.00 X 0 0 0 Brenda Young Director 3.00 1.00 X 0 0 0 Joe Zumwalt Director (Until Sept 23) 3.00 1.00 X 0 0 0 Dr Jean Alexandre Director (as of Sept 23) 3.00 1.00 X 0 0 0 Noah Dearwester Director (as of Sept 23) 3.00 1.00 X 0 0 0 Jami Hocker Director (as of Sept 23) 3.00 1.00 X 0 0 0 Ada Bair CEO 40.00 3.00 X 281075 0 18301 Teresa Smith CFO 40.00 3.00 X 198379 0 28451 Peter Perll MD Surgeon 40.00 0.00 X 554301 0 41835 Drake White MD Surgeon 40.00 0.00 X 495066 0 31671 Christopher Jones MD OB/GYN 40.00 0.00 X 410420 0 27654 Gina Bell MD OB/GYN 40.00 0.00 X 408029 0 27654 Nileshwa Senthe MD Pediatrician 40.00 0.00 X 378934 0 34954 3216109 0 225251 38 0 1 0 Nes Illinois Inc 39 Main St Tiburon CA 94920 ER Physician Services 2363027 Sullivan Construction 305 W Depot St Colchester IL 62326 Construction Company 988258 Quincy Medical Group 1017 Hampshire St Quincy IL 62301 Temporary Staffing Personnel 718978 Psychiatric Medical Care LLC PO Box 734606 Dallas TX 753734606 Geriatric Behavioral Health 543197 Aya Healthcare Inc 5930 Cornerstone CT W Ste 300 San Diego CA 92121 Temporary Staffing Personnel 504255 16 2017119 104708 2121827 Patient & resident service revenu 621110 46823738 46823738 Pharmacy revenue 900099 622318 622318 Equity in Advance Phys Therapy 900099 -6661 -6661 503999 503999 47943394 335859 335859 63107 75979 -12872 -12872 -12872 1377110 1258779 34978 118331 -34978 83353 83353 50471561 47943394 0 406340 X 562333 562333 1041247 509010 532237 114963 114963 21128042 18290757 2666898 170387 243142 213029 30113 3223789 2918540 305249 1428884 1264388 164496 113883 113883 76460 76460 9724 9724 8479152 6839408 1632535 7209 288175 73524 199047 15604 1226330 937520 274944 13866 718780 680265 38515 165647 93076 68324 4247 132596 103042 26799 2755 625963 422037 203926 2385008 1608020 776988 488926 279879 209047 Medical supplies 3930532 3930532 Provider Tax 805846 805846 Repairs and maintenance 466701 465623 1078 Dues, Fees, Subscriptio 393786 78007 315779 49231 12460 36281 490 48099140 40211983 7672599 214558 13664237 14574022 7627279 7196541 12645 593841 510994 503258 707430 44834592 27847064 15978553 16987528 6960872 7035079 104183 66300 166371 278126 2142944 3440926 47754183 50796946 3134262 3243305 8980 17850 14091227 13302963 4053577 3371350 800000 2468744 22088046 22404212 X 25005904 27626181 660233 766553 25666137 28392734 47754183 50796946 X 2372421 293888 60288 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9724 9724 0 Part II-B, Line 1: Memorial Hospital is a member of the Illinois Health & Hospital Association (IHA) and 37% of their dues are used for lobbying expenses which totaled $9,724 in 2023. 4136202 387925 191674 4332453 4958105 -509244 312659 4136202 4590361 692053 324309 4958105 4257525 291901 -40935 4590361 3951916 592682 287073 4257525 0.99460 0.00540 0.00000 0 0 514957 514957 29620298 17691983 11928315 23098 23098 0 12984146 9219164 3764982 1692093 912819 779274 16987528 Other Receivables 967978 Interest in net assets of Memorial Hospital Foundation 691349 Right-of-use asset - Operating 152286 Employee retention tax credit 1629313 3440926 Estimated Health Claims 650000 Estimated Third-Party Payor Settlements 1408000 Construction Payable 254260 Notes and advances from affiliates 2912 Operating lease liabilities 153572 2468744 X 50279095 293888 -562333 -268445 50547540 -75979 -75979 50471561 47612786 75979 75979 47536807 562333 562333 48099140 Part V, Line 4: An endowment fund with the income to be used for the benefit of Memorial Hospital Association. Permanently restricted funds are required to be retained permanently, either by explicit donor stipulation or by UPMIFA. Board designated funds are to be used for facility and equipment upgrades. Part X, Line 2: The Hospital believes they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Transfer between affiliates -562,333. Part XI, Line 4b - Other Adjustments: Rent expenses included in revenue for Form 990 -75,979. Part XII, Line 2d - Other Adjustments: Rent expenses included in revenue for Form 990 75,979. Part XII, Line 4b - Other Adjustments: Transfer between affiliates 562,333. 1 1 X 1 X 1 X 0 1 1 0 1 1 393000 393000 0.00820 9729403 8623499 1105904 0.02300 10122403 8623499 1498904 0.03120 19771767 11474273 8297494 0.17250 19771767 11474273 8297494 0.17250 29894170 20097772 9796398 0.20370 1 2465531 303260 9847567 9872665 -25098 X 1 1 1 1 Memorial Hospital Association 1454 North County Road 2050 Carthage IL 62321 www.mhtlc.org 0005611 X X X X 6 Rural Health Clinics Memorial Hospital Association 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X See Part V X 1 21 1 https://www.mhtlc.org/about-us/community-reports/ 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X 1 X https://www.mhtlc.org/patients-visitors/financial-assistance/ X https://www.mhtlc.org/patients-visitors/financial-assistance/ X https://www.mhtlc.org/patients-visitors/financial-assistance/ X X X X X 1 X 0 X X X X 1 X 0 1 Memorial Hospital Association Part V, Section B, Line 5: Data collection came from multiple sources for analysis. Some of the sources identified were the IPLAN data system, CDC, Behavioral Risk Factor Surveys, local mental health agency, local hospital as well as Comp Data which is an Illinois repository for hospital discharge data and demographics. As the process progressed, data from local law enforcement as well as a Hancock County Economic Development Survey was included in the analysis by this group. Memorial Hospital Association Part V, Section B, Line 6b: Hancock County Health Department Memorial Hospital Association Part V, Section B, Line 11: The Community Health Needs Assessment (CHNA) was completed in 2021 and 3 needs were identified to prioritize and focus on over the next 3 years. Poor Physical Health Maintenance - Goals for poor physical health maintenance1. To improve weight management and quality of life for Hancock County residents through encouragement of regular physical activity.2. To reduce food insecurity and poor nutrition in Hancock County through educational campaigns and increased awareness of current resources.3. To improve the self-management of chronic diseases for Hancock County Residents. 2. Mental Health - Goals for mental health1. To improve general mental wellness through community education on effective stress management and resiliency.2. Increase access to mental health and substance abuse services for adult and child residents of Hancock County.3. Cancer - Goals for cancer1. To reduce the burden of cancer on Hancock County residents through early detection and supportive services.2. To reduce the burden of cancer by creating awareness of cancer risk factors in Hancock County through wellness campaigns and cancer risk education. Current year actions:- Analyzed, goal setting, and approval of survey completed in 2020. Rolled out new goals and action plan.- Goals set in the areas of Cancer screening improvement, better physical health, and mental health (specifically stress management/post COVID)- Performed several health screening events throughout the county. Free A1-C testing, blood pressure checks and skin cancer checks were performed. We also added a lipid analyzer in 2023 for our health screenings.- Worked with our local Mental Health Services and more counselors were added into the school systems to help our children with mental health issues.- Hospital Dietitian visited schools within the county for healthy food options education for our children.- Hospital represented at the local Farmer's Market monthly. Provides information regarding healthy choices.- Social Media posts completed monthly for all areas of the CHNA goals - Hospital wide fund raising for Hancock County Fights Cancer- We have been able to raise our Mammography screening by 5% from our last CHNA. We are also offering Low Dose CT Lung Cancer screenings. - Hospital formed and now participates in a community-based group to improve health to individuals who live in Hancock County. KEY- Keep Encouraging Yourself- to good health. The Key group provided signage for milage for walking trails, hosted swim events at all pools in the county and attended health fairs and hosted 2 glow walks around the county. Memorial Hospital Association Part V, Section B, Line 13h: PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines, but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor. Memorial Hospital Association Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. Part V, Section B, Line 7a: Website for Hospital's CHNA:https://www.mhtlc.org/about-us/community-reports/ 3 1 - Advance Physical Therapy 1452 N County Road 2050 E Carthage IL 62321 Physical therapy rehabilitation 2 - Memorial Medical Clinic Hamilton 1471 Keokuk Street Hamilton IL 62341 Physician clinic 3 - Memorial Medical Clinic Locust Street 610 Locust Street Carthage IL 62321 Dermatology Part I, Line 3c: PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor. Part I, Line 6a: The community benefit report information is shared in Memorial Hospital's annual report and available on their website www.mhtlc.org. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost to charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Line 7g: A physician clinic included as a subsidized service on the 990. Direct and indirect costs were $3,757,244. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: The estimated amount of the Organization's bad debt expense is calculated based on the percentage of residents with income below the poverty level. In 2023 the percentage was 12.3%. Part III, Line 4: The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 15-16 of the attached financial statements. Part III, Line 8: Memorial Hospital Association is a critical access hospital showing a Medicare shortfall. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. These amounts do not include fee schedule amounts. If costs related to amounts reimbursed on a fee schedule were included there would have been a greater Medicare Shortage. Total revenue received from Medicare based on a fee schedule 1,021,311Medicare estimated costs of care relating to payments (445,129)Net Shortage (1,021,311) Part III, Line 9b: Memorial Hospital does not pursue collection activities for patients that qualify for charity care or patients that have set up payment arrangements for their accounts. Memorial Hospital does not charge interest on patients with payment arrangements. Also, collection activities are not pursued for patients that are in the process of applying for charity care and patients waiting for approval or denial from public aid. Any personal portion due after financial assistance is established would follow normal collection procedures. Part VI, Line 2: Memorial Hospital, based on its mission, wants to ensure that the health care needs of the community it serves are met. The Hospital has medical clinics located throughout Hancock County to improve access to health care services to our patients. The Board also has four committees; Finance, Planning, Quality and Community Health, and Marketing Committees that have community representation to ensure that input is obtained from the community when considering the health care needs of those we serve. Community input on desired services is obtained through patient satisfaction surveys that are initiated by the inpatient unit, emergency department, and medical clinics that provide a line of communication to identify additional health care services that community desires. The third Community Health Needs Assessment is completed and posted to our website at www.mhtlc.com. Part VI, Line 3: Memorial Hospital strives to provide a rewarding and healing process to our patients, plus an affordable, comfortable process to meet their financial obligations. Memorial Hospital informs their patients individually upon admission about the eligibility for assistance under federal, state or local government programs, and provides the patient with information regarding the Organization's charity care policy.Our Collection and Financial Assistance Policies and applications are on our website. We also provide financial counseling to any patient. We post our Charity Care Policy and information regarding federal, state, and local programs at all our registration areas. Brochures are distributed regarding financial assistance with all admission packages.Billing statements have financial assistance support telephone numbers at the bottom of each statement. Our third party billing service provides counseling to our patients regarding available financial assistance if there is a need. Part VI, Line 4: Memorial Hospital Association is an 18-bed critical access hospital located in Carthage, IL. Carthage is a city in Hancock County, Illinois. It is located in western Illinois along the Mississippi River. The nearest city with a population > 50,000 is Peoria, IL. Its primary service area from its most recently completed community health needs assessment is defined as Hancock County, with Colchester, Lomax, Keokuk, Tennessee and Blandinsville as the secondary service area. The 2023 population is approximately 28,947.The 2023 median household income is approximately $61,026, significantly lower than the state of Illinois. The unemployment rate was 3.3% which is lower than the rate for the state of Illinois of 4.7%.The most common industries are manufacturing, agriculture, construction, and health care. The nearest hospital is McDonough District Hospital in Macomb, IL about 28 miles east of Carthage, IL. Part VI, Line 5: Memorial Hospital is dedicated to improving health by providing education and wellness programs and innovative services at all the stages of life for residents of Hancock County. The Hospital is governed by a 15-member, volunteer Board of Directors that represent key areas within Hancock County as well as the medical staff. As a critical access hospital, Memorial Hospital is an 18-bed facility that provides general medical, surgical services along with obstetrics and an array of outpatient services for the community. Specialty clinics are also provided locally in the areas of behavioral health, cardiology, dermatology, oncology, neurology, ophthalmology, podiatry, orthopedic, pulmonology, urology, ENT, rheumatology, and sleep apnea so that our patients don't have to travel far to receive needed health care services. These specialty physicians are members of the Hospital's medical staff along with other providers that desire to serve members of our service area. The Hospital extends medical staff privileges to all qualified physicians in the community. Memorial Hospital provides up-to-date, diagnostic equipment and services with a capital budget also presented and approved on an annual basis to ensure that needed equipment is obtained to meet the expectations of our patients. Memorial Hospital operates an emergency room available to all regardless of ability to pay.The Hospital also participates in several health care events throughout the year providing free services as well as a listing of services that are offered through the Hospital, clinics, and specialty clinics. This includes, but is not limited to, health fairs, blood pressure screenings, and diabetic education. Memorial Hospital sponsors the bloodmobile and provides language assistance services. 1 Hancock County Senior and Childcare Services Association PO Box 160 Carthage IL 62321 370902248 501(c)(3) 562333 0 Daycare operations 1 0 Part I, Line 2: The Board of Directors determines and votes on specific expenditures. The amount given to Hancock County Senior Services, related organization, was to provide funds for their daycare operations and other operating expenses. The daycare is intergenerational as Hancock County Senior and Childcare Services Association has the children interact with the elderly. X X X 0 0 0 0 0 0 0 0 0 Peter Perll MD Surgeon 537113 0 16000 0 1188 0 0 0 41895 0 596196 0 0 0 Drake White MD Surgeon 493878 0 0 0 1188 0 0 0 31731 0 526797 0 0 0 Victoria Kalivoda-Popela DO Director 487619 0 0 0 2286 0 0 0 14791 0 504696 0 0 0 Christopher Jones MD OB/GYN 409646 0 0 0 774 0 0 0 27714 0 438134 0 0 0 Gina Bell MD OB/GYN 406755 0 500 0 774 0 0 0 27714 0 435743 0 0 0 Nileshwa Senthe MD Pediatrician 377746 0 0 0 1188 0 0 0 35014 0 413948 0 0 0 Ada Bair CEO 254332 0 25507 0 1236 0 0 0 18361 0 299436 0 0 0 Teresa Smith CFO 187605 0 10000 0 774 0 0 0 28511 0 226890 0 0 0 A Western Illinois Economic Development Authority 352256539 958362BL8 2016-07-21 18659314 Refund Revenue Bond Series 2016 issued 9/16/2008 0 0 0 A 5264314 18659314 344284 18315030 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Western Illinois Economic Development Authority Date the Rebate Computation was Performed: 07/16/2021 Shelley Smith Family member to Teresa Smith, Officer 51170 Employee compensation 0 Katlyn Pollock Family member to Angela Pollock, Director 63793 Employee compensation 0 Form 990, Part III, line 2 The Memorial Hospital Association added the Memorial Institute of Health and Healing in April 2023. Along with conventional medicine Memorial Institute of Health and Healing provides holistic care by combining the benefts of functional medicine, integrative medicine, and an opportunity to use food as medicine. Form 990, Part VI, Section A, line 1a The Executive Committee consists of the President, Vice President, Secretary-Treasurer, additional members as the Board appoints, the Chief Executive Officer and any other leadership team members deemed appropriate by the officers of the Board. The Chief Executive Officer and any Leadership Team members do not have the right to vote upon any action being taken. The Executive Committee meets only in the event that the Board is unable to take necessary action, has an agenda for each meeting, keeps minutes of its meetings, and mails a copy of the minutes of each meeting to each member of the Board of Directors within twenty-four (24) hours of the adjournment of the meeting. The primary purpose of the Executive Committee is to carry out critical tasks for effective Board functioning, including, but not limited to, Chief Executive Officer Management performance, management company performance, if applicable, and providing assistance to the Board in situations requiring action when it is impossible or impractical to convene a full Board meeting. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the Finance Committee and then by the Board of Directors before it is filed. The final return is reviewed and signed by the CFO. Form 990, Part VI, Section B, line 12c Officers, Board members, and key employees are required to sign a conflict of interest statement upon hiring or becoming a Board member. The disclosure is updated at the annual meeting. Any possible conflict of interest is disclosed to the other Board members and made a matter of record through an annual procedure and also when the interest becomes a matter of Board action. Disclosures are reviewed by the Board of Directors and any Member for whom conflicts have been identified leaves and abstains from voting. Appropriate documentation of the handling of the conflict is kept to protect the interested party and Memorial Hospital Association. Additionally, the Compliance Officer meets with the Compliance Committee of the board. Any issues identified are logged and followed up by the Compliance Officer. Form 990, Part VI, Section B, line 15a Salary surveys are reviewed annually to ensure all positions individually are within the market rate. The Executive Committee determines the salary for the CEO. Each Board member does an independent performance review of the CEO, which is compiled and used by the Executive Committee. The Executive Committee uses the Illinois Hospital Association salary survey as a guide for compensation using the high, middle, and low ranges for similar size organizations. Measures such as revenue, performance of the CEO, and budgetary constraints are all factors that are considered when reviewing the CEO's salary. The salary for the CFO is determined by the CEO using the CAH Compensation Survey sponsored by Integrated Healthcare Strategies as a guide for similar organizations. The most recent review of salary occurred in 2019. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. The financial statements are also required to be attached to the Form 990. Form 990, Part IX, line 11g Purchased services: Program service expenses 6,425,558. Management and general expenses 1,423,834. Fundraising expenses 0. Total expenses 7,849,392. Professional fees: Program service expenses 413,850. Management and general expenses 208,701. Fundraising expenses 0. Total expenses 622,551. Other fees: Program service expenses 0. Management and general expenses 0. Fundraising expenses 7,209. Total expenses 7,209. Form 990, Part XI, line 9: Change in interest in net assets of Memorial Hospital Foundation Other Changes in net assets-990 60,288. Hancock County Senior and Childcare Services Association PO Box 160 Carthage IL 62321 370902248 Caring for the elderly IL 501(c)(3) Line 10 Memorial Hospital Association 1 Advance Physical Therapy of Hancock County 620 Wabash Street Carthage IL 62321 113655886 Physical therapy rehabilitation IL Memorial Hospital Association Related -5698 14871 0 1 0.50000 Hancock County SLF LLP 403 S Adams Carthage IL 62321 204445121 Assisted living facility IL N/A 0 0 HGV Foundation Inc 400 S Adams St Carthage IL 62321 450609346 Supporting living IL N/A C 0 0 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 Hancock County Senior and Childcare Services Association P 167231 General Ledger Hancock County Senior and Childcare Services Association B 562333 General Ledger