2024-11-14T16:50:32-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 475 REGENCY PARK SUITE 175 OFALLON IL 62269 990 2023-01-01 370662561 ANDERSON HOSPITAL ANDE 6183916400 6800 STATE ROUTE 162 MARYVILLE IL 62062 PATRICK J GARVEY CPA CFO 6183916421 2024-11-13 1 0 JEFF PARKER P00970069 6182331200 2024-11-13 2023 2024-10-15 13:58:12Z KEITH PAGE 6800 STATE ROUTE 162 MARYVILLE IL 62062 231858211 0 X WWW.ANDERSONHOSPITAL.ORG X 1977 IL OUR COMMUNITY TURNS TO ANDERSON FIRST FOR ALL HEALTHCARE NEEDS. 16 15 1448 149 0 0 2041907 2984116 176751078 195337730 4122704 7419327 1894055 3201560 184809744 208942733 102460 39276 0 0 76070001 82070125 0 0 0 102531544 105639288 178704005 187748689 6105739 21194044 249772057 251641575 87508011 76001528 162264046 175640047 TO EXCEED EXPECTATIONS IN PROVIDING PERSONAL, CONVENIENT, QUALITY HEALTHCARE. 0 0 149514278 39276 195408885 NURSING AND ANCILLARY SERVICES FOR 22,554 INPATIENT DAYS, 119,011 OUTPATIENT VISITS, 9,930 OUTPATIENT SURGERIES AND 35,584 EMERGENCY VISITS. 149514278 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 12 0 1448 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 IL X PATRICK GARVEY CPA 6183916421 6800 STATE ROUTE 162 MARYVILLE IL 62062 MARK SHASHEK CHAIR 0.50 4.50 X X 0 0 0 JOSEPH SMITH VICE CHAIR 0.25 0.50 X X 0 0 0 ROBERT CIUFERI TREASURER 0.25 0.00 X X 0 0 0 KAY WERNER ASSISTANT SECRETARY 0.25 0.00 X X 0 0 0 LAURA BERNAIX PHD BOARD MEMBER 0.25 0.25 X 0 0 0 GARY CERETTO BOARD MEMBER 0.25 0.00 X 0 0 0 GREGORY COFFEY BOARD MEMBER 0.25 0.25 X 0 0 0 MAX EAKIN BOARD MEMBER 0.25 4.00 X 0 0 0 FRANK FLANIGAN BOARD MEMBER 0.25 0.50 X 0 0 0 JOSEPH HAGERTY BOARD MEMBER 0.25 0.50 X 0 0 0 MARK MAYNARD BOARD MEMBER 0.25 0.00 X 0 0 0 JEFFREY PARRES MD BOARD MEMBER 0.25 0.00 X 0 0 0 LENDELL PHELPS JR BOARD MEMBER 0.25 4.00 X 0 0 0 NANCY THOMAS BOARD MEMBER 0.25 0.00 X 0 0 0 VIRGINIA TRUCANO BOARD MEMBER 0.25 6.00 X 0 0 0 PATRICK ZIMMERMAN MD BOARD MEMBER 0.25 0.00 X 0 274390 0 KEITH PAGE PRESIDENT/CEO 27.00 16.75 X 0 560441 110100 MICHAEL MARSHALL COO 27.00 16.75 X 0 327905 52419 PATRICK GARVEY CFO 27.00 13.00 X 0 103223 5991 JOHN MAGUIRE CHARGE RN 40.00 0.00 X 187395 0 21149 SCOTT KATICH DIRECTOR OF PHARMACY 40.00 0.00 X 160042 0 27382 DANIEL ROJEK NURSING DIRECTOR 40.00 0.00 X 159483 0 17699 ROULA AUBUSCHON SPECIALTY CARE RN 40.00 0.00 X 157754 0 18371 CALLIE TRETTENERO STAFF RN 40.00 0.00 X 152781 0 4433 817455 1265959 257544 110 0 1 0 AYA HEALTHCARE INC 1200 E CAMPBELL RD SUITE 108 RICHARDSON TX 75081 MEDICAL STAFFING 5517045 MIDWEST EMERGENCY DEPARTMENT 320 EAST US HIGHWAY 50 OFALLON IL 622692704 EMERGENCY PHYSICIANS 2589947 SODEXO INC & AFFILITES PO BOX 360170 PITTSBURGH PA 152516170 DIETARY SERVICES 1943187 THE KORTE COMPANY PO BOX 146 HIGHLAND IL 622490146 CONSTRUCTION SERVICES 1460514 AVADYNE HEALTH 734 W MAIN ST GREENSBURG IN 47240 COLLECTION SERVICES 859155 38 150000 2834116 2984116 NET PATIENT REVENUE 621110 195337730 195337730 195337730 2805690 2805690 1151656 0 1151656 1151656 1151656 27529115 22879870 35608 4649245 -35608 4613637 4613637 JV INCOME 621110 1283725 1283725 OTHER 621110 565094 565094 MEDICAL RECORDS FEES 561000 94678 94678 106407 71155 35252 2049904 208942733 195408885 0 10549732 X 39276 39276 1110379 1110379 67350036 57921031 9429005 1192804 1092552 100252 7420187 6504115 916072 4996719 4297178 699541 957589 957589 340660 340660 27041464 16495293 10546171 249962 217467 32495 41819045 32618855 9200190 4427721 3852117 575604 6700381 4020229 2680152 103262 82610 20652 845630 845630 7744990 7744990 1557111 1557111 BAD DEBT 13250836 13250836 EQUIPMENT 249541 217101 32440 DUES AND SUBSCRIPTIONS 211763 184234 27529 OTHER EXPENSES 73414 73414 65919 57350 8569 187748689 149514278 38234411 0 875286 4330790 7255093 3180459 19665429 22703393 3509305 3582989 2185170 2258438 175086676 96614574 80841774 78472102 102768685 96265945 26426291 32806768 2470552 1736033 3774472 6304658 249772057 251641575 17274210 16945175 31488159 27080347 38745642 31976006 87508011 76001528 X 162264046 175640047 162264046 175640047 249772057 251641575 X 21194044 5989627 4329687 -18137357 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 29505 0 0 0 29505 0 PART II-B, LINE 1: THE AMOUNT REPRESENTS THE PORTION OF DUES PAID TO PROFESSIONAL ORGANIZATIONS THAT IS ALLOCATED TO THE LOBBYING ACTIVITIES OF THOSE ORGANIZATIONS. 1273864 1273864 115165873 57339253 57826620 2452444 2047585 404859 55511539 37227736 18283803 682956 682956 78472102 INVESTMENT- SUBSIDIARY 23155783 F INESTMENT- SURGERY CENTER 4090000 F INVESTMENT- CANCER CENTER 605324 F INVESTMENT- REHAB 4955661 F 32806768 LEASE LIABILITY 1743946 DUE TO THIRD PARTY 10458499 OTHER LIABILITIES 19773561 31976006 SCHEDULE D, PART V, LINE 4: THE FUNDS ARE DESIGNATED FOR CAPITAL IMPROVEMENTS, TO PROVIDE SELF-INSUANCE COVERAGE, TO MEET BOND REQUIREMENTS, AND TO PROVIDE FUNDS FOR HEALTH CARE PROGRAMS. HOWEVER, NONE OF THE FUNDS MEET THE DEFINITION OF AN ENDOWMENT FUND UNDER SFAS 117, THEREFORE, PART V HAS NOT BEEN COMPLETED. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 924161 924161 0.00530 36866288 33302979 3563309 0.02040 37790449 33302979 4487470 0.02570 98481 98481 0.00060 2680072 2680072 0.01540 33952846 29669098 4283748 0.02450 133778 133778 0.00080 36865177 29669098 7196079 0.04130 74655626 62972077 11683549 0.06700 1 13692741 8215645 69902606 92789624 -22887018 X 1 1 1 1 ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 WWW.ANDERSONHOSPITAL.ORG 0004119 X X X ANDERSON HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 1 21 1 HTTPS://ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 600.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.ANDERSONHOSPITAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.ANDERSONHOSPITAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X HTTPS://WWW.ANDERSONHOSPITAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 ANDERSON HOSPITAL PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT CHNA, ANDERSON HOSPITAL ELICITED INPUT FROM THE COMMUNITY MEMBERS THROUGH A VARIETY OF METHODS. WE PARTNERED WITH THE MADISON COUNTY HEALTH DEPARTMENT TO HOLD FOCUS GROUPS, CONDUCT A COMMUNITY HEALTH SURVEY, AND ORGANIZE MEETINGS TO SET TOP HEALTH PRIORITIES. THE STAKEHOLDER FOCUS GROUPS ALLOWED US TO OBTAIN PERTINENT INFORMATION FROM OUR COMMUNITY LEADERS AND STAFF MEMBERS TO ESTABLISH KEY HEALTH CONCERNS. EIGHT TOTAL FOCUS GROUPS WERE HELD THROUGHOUT THE COMMUNITY IN MADISON COUNTY, WITH ONE BEING HELD AT ANDERSON HOSPITAL. THE ATTENDEES OF THE STAKEHOLDER FOCUS GROUPS WERE INDIVIDUALS WHO ARE INVOLVED WITH THE HEALTH OF THE COMMUNITY THROUGH THEIR PROFESSION OR PERSONAL INTEREST IN HEALTH AND WELLNESS. EXAMPLES INCLUDED HEALTH EDUCATORS AND ADMINISTRATORS FROM HOSPITALS AND ASSISTED LIVING FACILITIES IN THE AREA, FACULTY FROM LOCAL UNIVERSITIES AND COLLEGES, PHARMACISTS, HEALTH EDUCATORS FROM THE MADISON COUNTY HEALTH DEPARTMENT, COLLEAGUES THAT WORK WITH SPECIFIC POPULATIONS AND PERSONS WITH DISABILITIES, AND STAFF FROM ORGANIZATIONS THAT FOCUS ON THE HEALTH AND WELLBEING OF THE COMMUNITY. THE FOCUS GROUP QUESTIONS TARGETED WHAT IS IMPORTANT TO THE HEALTH OF OURCOMMUNITY, WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT ARE THE CAUSES OF THESE PROBLEMS, WHAT ARE THE STRENGTHS OF THE SERVICES IN THE COMMUNITY, AND WHAT ARE THE GREATEST OBSTACLES. PARTICIPANTS WERE ASKED FOR FURTHER INVOLVEMENT IN PROMOTING COMPLETION OF THE COMMUNITY HEALTH SURVEY.THE COMMUNITY HEALTH SURVEY WAS DISSEMINATED ELECTRONICALLY THROUGH EMAIL AND THROUGH PAPER SURVEYS THAT WERE PLACED AROUND THE COMMUNITY AND AT ANDERSON HOSPITAL. THE SURVEY YIELDED 389 RESPONSES FROM OUR PRIMARY SERVICE AREA. QUESTIONS FOCUSED ON WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT KEEPS PEOPLE FROM BEING HEALTHY, WHY PEOPLE DO NOT GET NEEDED HEALTH CARE, AND RATE HEALTH ISSUES ON A SCALE OF MOST URGENT TO NOT A PROBLEM. FROM THE SURVEY RESULTS, TEN TOP HEALTH CONCERNS WERE IDENTIFIED.ANDERSON HOSPITAL PARTICIPATED IN THE MADISON COUNTY HEALTH DEPARTMENT MEETINGS TO IDENTIFY THEIR TOP CONCERNS TO GAIN INSIGHT, THEN MET WITH OUR INTERNAL TEAM TO DETERMINE WHAT THE TOP CONCERNS WERE FOR OUR SPECIFIC SERVICE AREA. ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNINGCOMMITTEE MET AND MEMBERS INDIVIDUALLY CHOSE THEIR TOP CONCERNS, AND THEN DISCUSSED EACH TOPIC AS A COMMITTEE TO ULTIMATELY DETERMINE OUR TOP 4 PRIORITY TOPICS. THE TOPICS INCLUDED CANCER, POVERTY, OBESITY, AND SUBSTANCE ABUSE. ANDERSON HOSPITAL PART V, SECTION B, LINE 11: ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE FACILITATES AND MAINTAINS AN ANNUAL DASHBOARD FOCUSED ON THE TOP HEALTH PRIORITIES FOR 2022-2025 THAT WERE IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED IN 2021. ANDERSON CHOSE A TOTAL OF FOUR INTERNAL AND EXTERNAL HEALTH PRIORITIES BASED ON TOP HEALTH CONCERNS IN OUR SERVICE AREA. EACH HEALTH PRIORITY HAS A LIST OF OBJECTIVES THAT WERE THE PRIMARY FOCUS OVER THE LAST THREE YEARS. ANDERSON WORKED CLOSELY WITH OUR COMMUNITY PARTNERS TO MEET THESE OBJECTIVES.ALTHOUGH THERE WERE MANY HEALTH CONCERNS IN OUR COMMUNITY THAT NEEDED TO BE ADDRESSED, WE PRIORITIZED ON THE TOP FOUR WITH THE BEST INTEREST OF IMPROVING THESE CONCERNS OVER THE THREE YEAR TIME PERIOD. THE HEALTH EDUCATION PLANNING COMMITTEE MEETS AT LEAST QUARTERLY TO UPDATE THEDASHBOARD WITH THE OBJECTIVES THAT HAVE BEEN MET, AS WELL AS DOCUMENT IF A PARTICULAR OBJECTIVE COULD NOT BE MET AND WHY. ADDITIONALLY, WE RECORD AND MAINTAIN ALL COMMUNITY BENEFIT DATA FOR ANDERSON HOSPITAL IN THE CBISA DATABASE.WITH THIS INFORMATION, WE CAN IDENTIFY HOW WE HAVE MET OUR GOALS AND OBJECTIVES, AND FOCUS ON AREAS OF GROWTH IN THE FUTURE. 13 1 - MARYVILLE IMAGING 2023 VADALABENE DR MARYVILLE IL 62062 IMAGING SERVICES 2 - ANDERSON SLEEP CENTER 2809 NORTH CENTER MARYVILLE IL 62062 SLEEP STUDY 3 - COLLINSVILLE EXPRESS CARE 1103 BELT LINE RD COLLINSVILLE IL 62234 ER- OTHER 4 - GLEN CARBON EXPRESS CARE 17 GINGER CREEK GLEN CARBON IL 62034 ER- OTHER 5 - HIGHLAND EXPRESS CARE 2504 COMMERCE LN HIGHLAND IL 62249 ER- OTHER 6 - WELLNESS CENTER 2133 VADALABENE DR MARYVILLE IL 62062 REHAB SERVICES 7 - ANDERSON HOME HEALTH 6800 STATE ROUTE 162 MARYVILLE IL 62062 HOME HEALTH SERVICES 8 - BETHALTO EXPRESS CARE 159 E MCARTHUR BATHALTO IL 62010 ER- OTHER 9 - ANDERSON CANCER CENTER 2227 VADALABENE MARYVILLE IL 62062 CANCER TREATMENT 10 - ANDERSON PEDIATRIC CENTER 6820 STATE ROUTE 162 MARYVILLE IL 62062 PEDITRIC SERVICES 11 - ONCOLOGY TREATMENT CENTER 6836 STATE ROUTE 162 MARYVILLE IL 62062 CANCER TREATMENT 12 - ANDERSON REHAB SERVICES 1212 BROADWAY HIGHLAND IL 62249 REHAB SERVICES 13 - TROY EXPRESS CARE 108 WEST HIGHWAY 40 TROY IL 62294 ER- OTHER PART I, LINE 3C: IN ADDITION TO FPG, THE ORGANIZATION USES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 13,250,836. PART II, COMMUNITY BUILDING ACTIVITIES: ANDERSON HOSPITAL WILL PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE AND STRIVES TO INCREASE ACCESS TO CARE FOR ALL MEMBERS OF THE COMMUNITY. ANDERSON HOSPITAL IS AN EMS RESOURCE HOSPITAL PROVIDING TRAINING AND EDUCATION TO LOCAL EMS PERSONNEL. PART III, LINE 2: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 4: SEE PAGE 11, 17 AND 18 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE SHORTFALLS SHOULD BE RECORDED AS COMMUNITY BENEFIT AS RATES ARE SET BY THE GOVERNMENT AT LEVELS SIGNIFICANTLY BELOW COSTS. 30% OR MORE OF ANDERSON'S TOTAL BUSINESS IS PATIENTS IN OUR COMMUNITY WITH MEDICARE COVERAGE. PART III, LINE 9B: ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF ANDERSON HOSPITAL, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. ANDERSON HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIR AND CONSISTENTLY APPLIED WITHIN EACH ENTITY. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE PROVIDED THAT ASSISTANCE AND THEIR ACCOUNTS ARE WRITTEN OFF AND NO FURTHER COLLECTION ACTIVITY OCCURS ON THE PORTION OF THE BILL THAT QUALIFIES FOR CHARITY. PART VI, LINE 2: THE COMMUNITY BENEFIT PLAN IDENTIFIES COMMUNITY HEALTH NEEDS AND GAPS THROUGH COMMUNITY, EMPLOYEE, AND VOLUNTEER SURVEYS, PERIOD MEETINGS WITH THE LOCAL MAYOR, AND COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNS THOSE WITH THE HOSPITAL'S INITIATIVES. THE PLAN IS DEVELOPED BY THE HEALTH EDUCATION PLANNING COMMITTEE IN COLLABORATION WITH THE MADISON COUNTY PARTNERSHIP FOR COMMUNITY HEALTH AND COMMUNITY LEADERS. PART VI, LINE 3: FINANCIAL COUNSELORS ASSIST PATIENTS WITH THEIR HEALTH INSURANCE OR FINANCIAL ASSISTANCE NEEDS. DURING THE BILLING CYCLE, PATIENT FINANCIAL SERVICES WORKS WITH PATIENTS WHO NEED ASSISTANCE OR PAYMENT PLANS. FINANCIAL ASSISTANCE INFORMATION IS POSTED ON THE ANDERSON HOSPITAL WEBSITE. PART VI, LINE 4: ANDERSON HOSPITAL SERVES PATIENTS IN MADISON COUNTY, AND THE ILLINOIS CITIES OF TROY, MARYVILLE, EDWARDSVILLE, GLEN CARBON, GRANITE CITY, AND HIGHLAND. THE COMMUNITY IS MOSTLY A WHITE COLLAR COMMUNITY WITH LITTLE INDUSTRY. PART VI, LINE 5: TO CONTINUE MCPCH INVOLVEMENT WITH COMMITTEE REPRESENTATION FROM ANDERSON HOSPITAL, INCLUDING: MOTOR VEHICLE COMMITTEE, ADDICTIVE BEHAVIOR COMMITTEE, SEXUAL RISK BEHAVIORS COMMITTEE, CANCER COMMITTEE, CARDIOVASCULAR COMMITTEE, AND MCPCH COMMITTEE MEMBERS TO REPORT AT HEPC. TO CONTINUE TO INCREASE AWARENESS OF DISASTER PREPAREDNESS IN THE COMMUNITY BY: AUGMENTING MCPCH COMMUNITY DISASTER PLANS AND PRESENTING TO LOCAL BUSINESSES. TO EDUCATE AND DISSEMINATE INFORMATION TO THE COMMUNITY REGARDING INFECTION CONTROL, TARGETING MRSA, INFLUENZA A, H1N1, AND PREVENTATIVE PRACTICES AND EDUCATION OF THESE TO LOCAL SCHOOLS. TO MAINTAIN PARTNERSHIP WITH LOCAL BUSINESSES AND PUBLIC SERVICES TO MEET THEIR EMPLOYEES' SPECIFIC HEALTHCARE NEEDS. TO EXPAND HEALTH AND WELLNESS EXPOSURE AT ANDERSON HOSPITAL. TO INCREASE COMMUNITY AWARENESS RELATED TO CONGESTIVE HEART FAILURE. IN COLLABORATION WITH COMMUNITY LEADERS, ANDERSON'S COMMUNITY INCLUDES SEMI-ANNUAL MEETINGS WITH THE LOCAL MAYORS TO DISCUSS THE STRATEGIC PLAN OF THE HOSPITAL, PROVIDE UPDATES ON PLANNED CAPITAL SPENDING, DISCUSS NEW SERVICES, AND TO RECEIVE FEEDBACK FROM THE COMMUNITY REGARDING CURRENT SERVICES OR THE NEEDS FOR ADDITIONAL SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES IL 1 POWER OF THE GIRAFFE CHARITY 316 HICKORY DR BETHALTO IL 62010 465490742 501(C)(3) 8970 0 GENERAL GRANT 1 PART I, LINE 2: THE ORGANIZATION ONLY MAKES GRANTS TO PRE-SELECTED CHARITABLE AND GOVERNMENTAL ORGANIZATIONS. 0 1 0 0 0 0 0 0 0 KEITH PAGE PRESIDENT/CEO 0 552284 0 0 0 8157 0 89703 0 20397 0 670541 0 0 MICHAEL MARSHALL COO 0 322019 0 0 0 5886 0 23000 0 29419 0 380324 0 0 PATRICK ZIMMERMAN MD BOARD MEMBER 0 268859 0 0 0 5531 0 0 0 0 0 274390 0 0 JOHN MAGUIRE CHARGE RN 187395 0 0 0 0 0 5805 0 15344 0 208544 0 0 0 SCOTT KATICH DIRECTOR OF PHARMACY 160042 0 0 0 0 0 4992 0 22390 0 187424 0 0 0 DANIEL ROJEK NURSING DIRECTOR 159483 0 0 0 0 0 840 0 16859 0 177182 0 0 0 ROULA AUBUSCHON SPECIALTY CARE RN 157754 0 0 0 0 0 9835 0 8536 0 176125 0 0 0 CALLIE TRETTENERO STAFF RN 152781 0 0 0 0 0 4433 0 0 0 157214 0 0 0 PART I, LINE 4B NAME: KEITH PAGE, DESCRIPTION: 2023 ANNUAL CONTRIBUTION, CURRENT YEAR AMOUNT: $9,515. PLAN DESCRIPTION: SECTION 457(F) PLAN OF RELATED ORGANIZATION NAME: MICHAEL MARSHALL, DESCRIPTION: 2023 ANNUAL CONTRIBUTION, CURRENT YEAR AMOUNT: $12,975. PLAN DESCRIPTION: SECTION 457(F) PLAN OF RELATED ORGANIZATION SCHEDULE J, PART I, LINE 3: THE PRESIDENT, COO, AND CFO ARE COMPENSATED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USED THE FOLLOWING FACTORS TO ESTABLISH COMPENSATION: 1. COMPENSATION COMMITTEE 2. COMPENSATION SURVEY OR STUDY 3. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE A SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY 371234684 2016-05-17 18258036 SEE PART VI 0 0 0 B VILLAGE OF MARYVILLE ILLINOIS 370922463 2016-06-01 7541971 SEE PART VI 0 0 0 C VILLAGE OF MARYVILLE ILLINOIS 370922463 2016-06-16 8480753 SEE PART VI 0 0 0 D VILLAGE OF MARYVILLE ILLINOIS 370922463 2016-07-01 5175473 SEE PART VI 0 0 0 A 8554773 18258036 300989 17957047 2008 1 1 1 1 B 5112430 7541971 120657 7421314 1999 1 0 1 1 C 4463886 8480753 94614 8386139 2011 1 0 1 1 D 2564196 5175473 59501 5115972 2011 1 0 1 1 A 0 1 1 1 0 0.00500 0.00000 0.00500 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 PART I, LINE A, COLUMN (F): ADVANCE REFUND 2006 BONDS (ORIGINALLY ISSUED ON 12/15/2006) AND CURRENT REFUND 2011B BONDS (ORIGINALLY ISSUED ON 12/29/2011). PART I, LINE B, COLUMN (F): CURRENT REFUND 2011A BONDS (ORIGINALLY ISSUED ON 12/29/2011). PART I, LINE C, COLUMN (F): CURRENT REFUND 2011 BONDS (ORIGINALLY ISSUED ON 8/4/2011). PART I, LINE D, COLUMN (F): CURRENT REFUND 2012 BONDS (ORIGINALLY ISSUED ON 2/17/2012). PART II, COLUMN A, LINE 3: BOND PROCEEDS WERE USED TO REFUND PRIOR BOND ISSUES. AS A RESULT, THERE IS NO "PROJECT PERIOD AND EARNINGS IN THE COSTS OF ISSUANCE ACCOUNT AND ESCROW FUND HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. PART II, COLUMN A, LINE 11: THIS AMOUNT REPRESENTS $7,278,188.99 OF BOND PROCEEDS USED TO CURRENT REFUND THE 2011B BONDS, $10,676,029.73 USED TO ADVANCE REFUND THE 2006 BONDS, AND $2,828.14 USED TO PAY INTEREST ON THE BONDS. PART II, COLUMN B, LINE 3: BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIOD AND EARNINGS IN THE COSTS OF ISSUANCE ACCOUNT HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. PART II, COLUMN B, LINE 11: THIS AMOUNT REPRESENTS $7,419,803.04 OF BOND PROCEEDS USED TO CURRENT REFUND THE 2011A BONDS AND $1,511.44 USED TO PAY INTEREST ON THE BONDS. PART II, COLUMN C, LINE 3: BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIOD AND EARNINGS IN THE COSTS OF ISSUANCE ACCOUTN HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. PART II, COLUMN C, LINE 11: THIS AMOUNT REPRESENTS $8,384,439.87 OF BOND PROCEEDS USED TO CURRENT REFUND THE 2011 BONDS AND $1,699.56 USED TO PAY INTEREST ON THE BONDS. PART II, COLUMN D, LINE 11: THIS AMOUNT REPRESENTS $5,115,115.96 OF BOND PROCEEDS USED TO CURRENT REFUND THE 2012 BONDS AND $856.29 USED TO PAY INTEREST ON THE BONDS. PART III, COLUMN A: PART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003. PART IV, COLUMN A, LINE 2C: ARBITRAGE ANALYSIS COMPLETED AS OF 2/15/2017. PART IV, COLUMN A, LINE 6: BOND PROCEEDS WERE DEPOSITED AND INVESTED IN A YIELD RESTRICTED ESCROW FUND UNTIL THE REDEMPTION OF THE 2006 BONDS. PART I, LINE A, COLUMN (F), ENTITY 2: ACQUIRE, CONSTRUCT, FURNISH AND EQUIP HOSPITAL FACILITIES. PART II, COLUMN A, LINE 3, ENTITY 2: TOTAL PROCEEDS OF THE ISSUE DOES NOT EQUAL ISSUE PRICE REPORTED IN PART I AS A RESULT OF INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD. PART II, COLUMN A, LINE 13, ENTITY 2: ALL BOND PROCEEDS WERE SPENT AS OF THE FISCAL YEAR END; HOWEVER, NOT ALL PROJECTS WERE COMPLETED AS OF THE FISCAL YEAR END. PART IV, COLUMN A, LINE 2C, ENTITY 2: ARBITRAGE ANALYSIS COMPLETED AS OF 12/1/2019. PART III, COLUMN B: PART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003. PART III, COLUMN A, LINE 4: AMOUNT REPRESENTS THE MAXIMUM AMOUNT OF BOND PROCEEDS USED IN A PRIVATE BUSINESS USE. A SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY 371234684 2019-05-30 15229849 SEE PART VI 0 0 0 A 6493036 15255430 217399 15038031 2019 0 0 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 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS ANDERSON HEALTHCARE, A TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE RIGHT TO APPOINT THE VOTING MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE ORGANIZATION HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: - REVISIONS TO THE MISSION STATEMENT AND AMENDMENTS TO GOVERNING DOCUMENTS; - APPOINTMENT AND REMOVAL OF MEMBERS OF THE GOVERNING BODY AND THE PRESIDENT/CEO - APPROVAL OF UNBUDGETED EXPENDITURES IN EXCESS OF AN ESTABLISHED THRESHOLD; - APPROVAL OF THE DISPOSAL OF ASSETS AND INCURRENCE OF DEBT IN EXCESS OF AN ESTABLISHED THRESHOLD; - APPROVAL OF AFFILIATIONS WITH OTHER HEALTHCARE ORGANIZATIONS; - APPROVAL OF ESTABLISHMENT, ACQUISITION, OR AFFILIATIONS OF SUBSIDIARIES AND JOINT VENTURES; - TRUSTEE OF OFFICER INDEMNIFICATION; - USE OF FICTITIOUS NAMES FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND CONTROLLER. INFORMATION FOR THE RETURN IS GATHERED BY THE HOSPITAL'S FINANCE DEPARTMENT AND GIVEN TO AN INDEPENDENT AUDITOR FOR FILING PREPARATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE COMPLIANCE OFFICER REVIEWS AND MONITORS THE POLICY ANNUALLY. PERSONS COVERED UNDER THE POLICY INCLUDE TRUSTEES/DIRECTORS/MANAGERS, OFFICERS AND COMMITTEE MEMBERS OF THE ANDERSON ENTITIES; DEPARTMENT DIRECTORS, ADMINISTRATIVE DIRECTORS, ASSISTANT DIRECTORS, MEMBERS OF SENIOR MANAGEMENT AND MEDICAL STAFF LEADERS OF ANDERSON, MEDICAL STAFF MEMBERS AND NON-MANAGEMENT STAFF. CONFLICTS ARE REVIEWED, IDENTIFIED AND MAINTAINED BY THE COMPLIANCE OFFICER. EXPLANATION OF ANY RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND AT EVERY ANNUAL MEETING OF THE ANDERSON ENTITY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; AND C. WHEN THE COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED AT A BOARD OR COMMITTEE MEETING. FOR MANAGERS AND MEDICAL STAFF LEADERS: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF AN ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO THE COMPLIANCE OFFICER AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; AND B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; C. WHEN A COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED ON BEHALF OF ANDERSON AND THE COVERED INDIVIDUAL IS IN A POSITION TO INFLUENCE THE OUTCOME OF THE CONSIDERATION. DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST MADE AT THE MEETING AT WHICH THE TRANSACTION OR ARRANGEMENT IS BEING CONSIDERED SHALL BE MADE TO ALL INDIVIDUALS PRESENT AT THE MEETING. FOR OTHER MEDICAL STAFF MEMBERS: DISCLOSURE OCCURS AT APPOINTMENT AND REAPPOINTMENT UNLESS THEY ARE BOARD MEMBERS THESE PHYSICIANS FOLLOW THE BOARD OR TRUSTEE REQUIREMENTS. EMPLOYEES NOT IN MANAGEMENT POSITIONS: AT TIE OF HIRE AND AT EACH ANNUAL EMPLOYEE EVALUATION. FORM 990, PART VI, SECTION B, LINE 15A THE CEO SALARY AND BONUS STRUCTURE IS DETERMINED ON AN ANNUAL BASIS BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES, AND APPROVED BY THE FULL BOARD BASED ON AN EVALUATION DONE BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 9,504,487. MANAGEMENT AND GENERAL EXPENSES 6,076,640. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,581,127. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 254,184. MANAGEMENT AND GENERAL EXPENSES 162,511. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 416,695. OTHER PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 1,012,167. MANAGEMENT AND GENERAL EXPENSES 647,123. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,659,290. : PROGRAM SERVICE EXPENSES 5,724,455. MANAGEMENT AND GENERAL EXPENSES 3,659,897. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,384,352. FORM 990, PART XI, LINE 9: TRANSFER BETWEEN AFFILIATES -18,137,357. AUXILIARY OF ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 376080063 SUPPORT ORGANIZATION IL 501(C)(3) LINE 12D, III-O N/A 0 COMMUNITY HOSPITAL OF STAUNTON 400 N CALDWELL STREET STAUNTON IL 62088 370624255 HOSPITAL IL 501(C)(3) LINE 3 ANDERSON HEALTHCARE 0 ANDERSON HOSPITAL FOUNDATION 6800 STATE ROUTE 162 MARYVILLE IL 62062 274548522 SUPPORT ORGANIZATION IL 501(C)(3) LINE 7 ANDERSON HOSPITAL 1 ANDERSON HEALTHCARE 6800 STATE ROUTE 162 MARYVILLE IL 62062 843965822 HEALTH CARE IL 501(C)(3) LINE 11 N/A 0 FRIENDS OF COMMUNITY MEMORIAL HOSPITAL 400 N CALDWELL STREET STAUNTON IL 62088 363913722 FUNDRAISING IL 501(C)(3) LINE 10 COMMUNITY HOSPITAL OF STAUNTON 0 ANDERSON SURGERY CENTER LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 834200085 SURGERY IL ANDERSON HOSPITAL RELATED -1209374 2417159 0 1 0.82740 ANDERSON REHABILITATION INSTITUTE LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 832844780 REHAB IL ANDERSON HOSPITAL RELATED 1283724 16136494 0 1 0.60000 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 ANDERSON SURGERY CENTER LLC R 1418962 CASH COMMUNITY HOSPITAL OF STAUNTON L 1427004 COST ANDERSON HOSPITAL FOUNDATION C 150000 CASH