2023-08-11T19:31:27+00:00 2022-09-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2021-10-01 362167785 Mendota Community Hospital MEND 3096552850 124 SW Adams St Peoria IL 61602 MICHAEL M ALLEN CFO 3096552850 2023-08-11 true Michael M Allen 999009999 Jennifer Burke P01342224 3128997000 2021 2023-04-26 12:10:37Z OSF Saint Paul Medical Center Michael M Allen 124 SW Adams St Peoria IL 61602 38641995 false X www.osfhealthcare.org X 1944 IL IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. 11 8 157 11 0 0 1313058 1557349 36130541 36548492 5114 6937 250484 498244 37699197 38611022 0 0 14837686 15217232 0 0 17982076 16279562 32819762 31496794 4879435 7114228 32137344 32792778 19296078 13724107 12841266 19068671 IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. false false 24388982 36977923 MENDOTA COMMUNITY HOSPITAL is licensed to operate 25 patient beds. The hospital provided $1,887,326 in financial assistance to the community during FISCAL YEAR 2022. The Hospital's services provided during fiscal year 2022 are as follows: Patient days of 2,556, Outpatient visits of 35,699, Patient visits to the emergency room of 6,058. 24388982 true true false true false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 5 0 true 157 true false false false false false false false false false false false false X 11 8 false false false false true true true true true true false true true true true true true true true false IL X Michael M Allen 3096552850 124 SW Adams St PEORIA IL 61602 Robert C Sehring Vice Chairperson Chief Executive Officer 1.0 43.0 X X 0 2650545 42606 Sister Agnes Joseph Williams OSF Assistant Secretary 1.0 43.0 X X 0 0 0 Sister Diane Marie McGrew OSF President and Treasurer 1.0 43.0 X X 0 0 0 Sister Judith Ann Duvall OSF Chairperson 1.0 43.0 X X 0 0 0 Sister Theresa Ann Brazeau OSF Secretary 1.0 43.0 X X 0 0 0 Brian J Silverstein MD Board Member 1.0 42.0 X 0 45000 0 Gerald J McShane MD Board Member 1.0 42.0 X 0 183578 29878 Sister M Angelica Neumann FSGM Board Member 1.0 42.0 X 0 0 0 Sister M Beata Ziegler FSGM Board Member 1.0 42.0 X 0 0 0 Sister M Mikela Meidl FSGM Board Member 1.0 43.0 X 0 0 0 Sister Rose Therese Mann OSF Board Member 1.0 43.0 X 0 0 0 August J Querciagrossa Chief Executive Officer Western Region 1.0 41.0 X 0 562037 40856 Bradley V Solberg President, OSF HealthCare Saint James- John W. Albrecht MC 1.0 41.0 X 0 473668 44167 Carol A Friesen Chief Executive Officer Eastern Region 1.0 41.0 X 0 772415 50315 Chad E Boore Chief Executive Officer Eastern Region (Through Aug 2022) 1.0 41.0 X 0 713662 47689 David M Hall SVP Info Systems/Chief Information Officer 1.0 41.0 X 0 614445 46225 Dawn C Trompeter President, OSF Healthcare St. Elizabeth MC/ St. Paul MC 40.0 2.0 X 399396 0 38232 Jacqueline D Kernan President, OSF HealthCare St Clare Medical Center & St Luke MC 1.0 41.0 X 0 349542 35713 James J Mormann Chief Information Officer 1.0 41.0 X 0 989677 48832 Jared C Rogers President, OSF HealthCare Heart of Mary Medical Center 1.0 41.0 X 0 547842 37511 Jason R Rodeghero President, OSF Home Care and Rehab Services 1.0 41.0 X 0 351552 40237 Jeffry M Tillery President, OSF Medical Group 1.0 41.0 X 0 942742 40704 Jerry W Rumph President, OSF HealthCare Saint Anthony's Health Center 1.0 41.0 X 0 337803 16128 John R Evancho SVP Chief Compliance Officer 1.0 41.0 X 0 433915 42434 Kathleen M Kinsella President, OSF HealthCare Little Company of Mary Medical Center 1.0 41.0 X 0 510038 28658 Kelly A Jefferson President, OSF HealthCare St. Francis Hospital & Medical Group 1.0 41.0 X 0 226816 34247 Leon A Yeh MD VP Chief Medical Officer Emergency Serv 1.0 41.0 X 0 720064 25269 Lisa DeKezel President, OSF HealthCare Holy Family MC and St. Mary MC 1.0 41.0 X 0 377167 29413 Lori L Wiegand Chief Nursing Officer 1.0 41.0 X 0 673410 24691 Lynn A Fulton President, OSF HealthCare St. Joseph Medical Center 1.0 41.0 X 0 486071 40570 Michael A Cruz MD Chief Operating Officer 1.0 41.0 X 0 1119188 48596 Michael A Wells President CHOI 1.0 41.0 X 0 340691 30146 Michael M Allen Chief Financial Officer 1.0 42.0 X 0 1112574 42879 Michelle D Conger Chief Strategy Officer, OSF Healthcare/ CEO OnCall Digital Health 1.0 41.0 X 0 906223 35892 Ned Hill President, OSF HealthCare Sacred Heart Medical Center 1.0 41.0 X 0 156173 15096 Paula A Carynski President, OSF HealthCare Saint Anthony Medical Center 1.0 41.0 X 0 595645 41762 Ralph Velazquez MD System Chief Medical Officer 1.0 41.0 X 0 853298 43644 Robert G Anderson Chief Executive Officer Central Region 1.0 41.0 X 0 729059 34907 Robert L Brandfass SVP Chief Legal Officer 1.0 41.0 X 0 862096 36626 Roxanna Crosser Chief Executive Officer Western Region 1.0 41.0 X 0 680825 29894 Shelley A Nguyen Chief Human Resources Officer 1.0 41.0 X 0 268708 24519 Stephen E Hippler MD Chief Clinical Officer 1.0 41.0 X 0 1065555 50320 Thomas G Hammerton President OSF Healthcare Foundation Chief Development Officer 1.0 42.0 X 0 604139 42145 Denise M Bickett Registered Nurse Hospital 40.0 0 X 100418 0 30661 Jodie L Borchelt Director Surgical/Inpatient Services, Medical/Surgical Acute 40.0 0 X 119053 0 33728 Katherine R Riva-Foster MD Physician 40.0 0 X 248557 0 28238 Kenneth K Potts MD Physician 40.0 0 X 253004 0 31393 Stacy A Piller Advanced Practice Nurse 40.0 0 X 119851 0 30001 1240279 22256163 1414822 6 false true false Emergency Physician Staffing Solutions 1504 Timber Trail Washington IL 61571 Emergency Services Physicians 2170918 1 0 0 0 182118 1099031 276200 0 1557349 PATIENT REVENUE 622110 35729666 35729666 CONTRACTED PHARMACY 622110 737915 737915 MEDICAL DIRECTORSHIPS 624200 80911 80911 0 0 0 0 36548492 6937 6937 19872 19872 0 19872 19872 0 0 33657 30973 2684 2684 CAFETERIA 624200 46257 46257 AFFILIATE SERVICES 621300 378998 378998 50433 50433 0 0 475688 38611022 36977923 0 75750 442649 354119 88530 11617951 9670627 1947324 419033 296967 122066 2032426 1565503 466923 705173 547610 157563 12017 12017 2487461 2417785 69676 0 898 898 4307431 3985919 321512 408557 49766 358791 48750 34317 14433 29031 20656 8375 5118807 3259867 1858940 666892 312547 354345 53938 16125 37813 CONTRACTS AND REPAIRS 1632152 365909 1266243 BAD DEBTS 396385 396385 PROVIDER TAX 877030 877030 COLLECTION AGENCIES 4425 4425 235788 216952 18836 0 31496794 24388982 7107812 0 900 615 129235 235627 0 4261925 4276840 0 0 0 0 0 728976 854165 2056 93202 34960584 20499295 13994803 14461289 165007 222320 0 0 0 12854442 12648720 32137344 32792778 4658203 2114301 0 0 0 0 0 0 0 0 14637875 11609806 19296078 13724107 X 10804694 17237822 2036572 1830849 0 0 0 12841266 19068671 32137344 32792778 X 7114228 -50742 -836081 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 12017 12017 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION'S LOBBYING ACTIVITIES INCLUDE PAYING MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION, WHO PARTICIPATE IN LOBBYING ACTIVITIES ON BEHALF OF HEALTHCARE ORGANIZATIONS. 1034874 -172177 30984 831713 854817 225552 45495 1034874 805217 49600 854817 801256 3961 805217 731914 69342 801256 0.0 0.5996 0.4004 false true true 1927000 1927000 16249923 7508497 8741426 2056749 1356803 699946 14636255 11633995 3002260 90657 0 90657 14461289 GOODWILL 10817871 RESTRICTED FOUNDATION ASSETS 1830849 12648720 ASSET RETIREMENT OBLIGATION 24538 ADVANCES DUE CORP-TERM OTHER NOTES - LOANS PAYABLE MEDICARE ADVANCE PAYMENTS DEFERRED INCOME - BLUE CROSS DEFERRED INCOME - OTHER Federal Pandemic Funds Due to OSF 11092755 Due to PCI 492513 11609806 X Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT IS HELD BY OSF HEALTHCARE FOUNDATION, A RELATED 501(c)(3) ENTITY. PROCEEDS OF THE ENDOWMENT, AS DICTATED BY THE DONORS, ARE USED AS BEST DETERMINED BY THE FOUNDATION COUNCIL. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote OSF is a not-for-profit corporation as described by Section 501(c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Under ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - An Interpretation of FASB Statement No. 109, OSF and PCI must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. As of September 30, 2022 or 2021, OSF and PCI do not have any uncertain tax positions. true true X true X 250 true X true true true false true true 613381 613381 0.0195 4721492 4588772 132720 0.0042 0 0.0 0 0 5334873 4588772 746101 0.0237 136002 14695 121307 0.0039 102668 102668 0.0033 3040349 2297783 742566 0.0236 0 0.0 6298 6298 0.0002 0 0 3285317 2312478 972839 0.0309 0 0 8620190 6901250 1718940 0.0546 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 290097 0 12982115 11190323 1791792 X true true 1 1 MENDOTA COMMUNITY HOSPITAL 1401 E 12TH STREET MENDOTA IL 61342 HTTPS://WWW.OSFHEALTHCARE.ORG/SAINT-PAUL/ IL0005819 X X X X MENDOTA COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 21 true true false true X https://www.osfhealthcare.org/about/community-health/ X true 22 false true false true X 250.0 400.0 X X X X X true true X X X X true X https://www.osfhealthcare.org/billing/financial-assistance/ X https://www.osfhealthcare.org/billing/financial-assistance/ X https://www.osfhealthcare.org/billing/financial-assistance/ X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs were prioritized as significant health needs of the community and identified through the CHNA. See CHNA for further information. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. FOR THE 2022 CHNA, MENDOTA COMMUNITY HOSPITAL d/b/a SAINT PAUL MEDICAL CENTER SOLICITED AND TOOK INTO ACCOUNT INPUT FROM THE FOLLOWING SOURCES: 1) CURRENT PUBLIC HEALTH ADMINISTRATOR AT THE LASALLE COUNTY HEALTH DEPT. and CURRENT HEALTH EDUCATOR AND PUBLIC INFORMATION FROM THE LASALLE COUNTY HEALTH DEPT. 2) PRIMARY DATA WAS COLLECTED FROM THE AT-RISK AND ECONOMICALLY DISADVANTAGED POPULATION BY COLLECTING A STRATIFIED SAMPLE OF SURVEYS DISTRIBUTED IN ENGLISH AND SPANISH AT ALL HOMELESS SHELTERS, FOOD PANTRIES AND SOUP KITCHENS. 3) THE PRIOR AND NEW 2022 CHNA WAS MADE WIDELY AVAILABLE TO THE COMMUNITY AND FEEDBACK RECEIVED FROM COMMUNITY SERVICE ORGANIZATIONS WAS TAKEN INTO ACCOUNT. 4) ADDITIONAL SOURCES OF INPUT WAS RECEIVED FROM A COLLABORATIVE TEAM CREATED TO CONDUCT THE CHNA, WHICH INCLUDED CONSUMER ADVOCATES, REPRESENTATIVES FROM NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, ACADEMIC EXPERTS AND HEALTH EDUCATORS, LOCAL GOVERNMENT OFFICIALS, ADMINISTRATORS FROM LOCAL SCHOOL DISTRICTS, HEALTH CARE PROVIDERS AND COMMUNITY HEALTH CENTERS, EXECUTIVE DIRECTOR OF IL VALLEY PADS HOMELESS SHELTER PROGRAM, PROGRAM COORDINATOR FOR THE YOUTH SERVICE BUREAU OF IL VALLEY SERVING THE LATINO POPULATION ENROLLED IN PUBLIC BENEFITS, EXECUTIVE DIRECTOR OF UNITED WAY, AND EXECUTIVE DIRECTOR OF MENDOTA AREA SENIOR SERVICES. MEMBERS OF THE COLLABORATIVE TEAM BY NAME, AFFILIATIONS, TITLE AND EXPERTISE ARE LISTED IN APPENDIX 1 TO THE 2022 CHNA. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER - MENDOTA, IL. THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2022 FOR LASALLE COUNTY WAS A COLLABORATIVE UNDERTAKING BY OTTAWA REGIONAL HOSPITAL AND HEALTHCARE CENTER DBA OSF SAINT ELIZABETH MEDICAL CENTER AND MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER. THE CHNA HIGHLIGHTS THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN LASALLE COUNTY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R)(3). THE FINAL CHNA FOR THE HOSPITAL WAS APPROVED AND ADOPTED BY THE SYSTEM'S BOARD OF DIRECTORS ON JULY 29, 2019. THIS CHNA IS EFFECTIVE FOR FISCAL YEARS 2020, 2021 AND 2022. THE LASALLE COUNTY CHNA WAS DONE AS A COLLABORATIVE UNDERTAKING BY OSF SAINT ELIZABETH AND OSF SAINT PAUL MEDICAL CENTERS TO HIGHLIGHT THE HEALTH NEEDS AND WELL BEING OF RESIDENTS IN LASALLE COUNTY. THE COLLABORATIVE TEAM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AS A PRIORITY: HEALTHY BEHAVIORS AND BEHAVIORAL HEALTH. IN RESPONSE TO THESE PRIORITY HEALTH NEEDS, THE HOSPITALS DEVELOPED AN IMPLEMENTATION STRATEGY DESCRIBING THE ACTIONS THE HOSPITALS INTEND TO TAKE TO ADDRESS BOTH PRIORITY HEALTH NEEDS, THE RESOURCES THE HOSPITALS PLAN TO COMMIT TO ADDRESS THE HEALTH NEEDS, AND ANY PLANNED COLLABORATIONS WITH OTHER ORGANIZATIONS TO ADDRESS THE HEALTH NEEDS. THE HOSPITALS REVIEW THEIR IMPLEMENTATION STRATEGY AT LEAST ANNUALLY AND MAKE REVISIONS AS NEEDED TO MAXIMIZE THE IMPACT ON IDENTIFIED PRIORITY HEALTH NEEDS. A SUMMARY OF HOW THE HOSPITALS HAVE ADDRESSED THE PRIORITY HEALTH NEEDS IS PROVIDED BELOW. HEALTHY BEHAVIORS DEFINED AS - ACTIVE LIVING, HEALTHY EATING AND OBESITY GOALS. ACTIVE LIVING - A HEALTHY LIFESTYLE, COMPRISED OF REGULAR PHYSICAL ACTIVITY, HAS BEEN SHOWN TO INCREASE PHYSICAL, MENTAL, AND EMOTIONAL WELL-BEING. GOAL 1: INCREASE ACTIVE LIVING IN LASALLE COUNTY OVER THE NEXT THREE YEARS AS EVIDENCED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY. OUTCOME METRIC: INCREASE ACTIVE LIVING IN LASALLE COUNTY BY INCREASING THE NUMBER OF RESPONDENTS EXERCISING (HEALTHY ACTIVITY) 1 - 5 TIMES PER WEEK FROM 60% TO 62% AND DECREASING THOSE REPORTING THEY DO NOT EXERCISE AT ALL FROM 28% TO 25%. TACTICS AND PROGRESS FOR FY 2022 (1) Promoted the University of Illinois walking guide for Ottawa, Streator, and Mendota virtually in Live Well Streator's 20 in 21 social media campaign, daily on the OSF Center for Health Streator's waiting room digital screens, on April 13 at Illinois Valley Community College Student Wellness Fair, April 29 at Streator YMCA Healthy Kids Day, and May 7 at Mendota YMCA Healthy Kids Day. In addition, Live Well Streator partnered with the Streator Chamber for a Poker Walk on October 1 (2) INCREASE OFFERING OF THE HEALTHY KIDS U PROGRAM: PROGRESS FY 2022 HKU to launch in May 2022. Due to low enrollment class cancelled. Participated in April 29 Streator YMCA's Healthy Kids Day, May 7 Mendota YMCA's Healthy Kids Day, July 2 Streator 4th of July Celebration's Kids Korner and July 14-15 LaSalle County 4-H Fair. Co-sponsored and participated in the University of Illinois Extension's Illinois Junior Chef program in Streator June 20-24. (3) IMPLEMENT JOURNEY TO HEALTH - REDESIGNED PROGRAM. PROGRESS FY 2022 - Reset Program - locally 350 people participate LaSalle County. 90% complete all 6 weeks. July 12 - Summer Out Loud - 3 week summer family program. Fall Session - 9 participants HEALTHY EATING - A HEALTHY LIFESTYLE, COMPRISED OF A PROPER DIET, HAS BEEN SHOWN TO INCREASE PHYSICAL, MENTAL, AND EMOTIONAL WELL-BEING. OBESITY - A HEALTH OUTCOME, WHICH IS DIRECTLY RELATED TO HEALTHY BEHAVIORS. GOAL 2: INCREASE COMMUNITY CONSUMPTION OF FRUITS/VEGETABLES TO MORE THAN 2 SERVINGS PER DAY. OUTCOME METRIC 2: INCREASE THE RATE FROM 44% TO 48% OF THE COMMUNITY THAT REPORTED THAT THEY CONSUME MORE THAN 2 SERVINGS OF FRUITS/VEGETABLES PER DAY ON THE 2022 CHNA SURVEY. BASELINE: PER THE 2019 CHNA, 44% OF THE COMMUNITY REPORTED THAT THEY CONSUME MORE THAN 2 SERVICES OF FRUITS/VEGETABLES PER DAY. TACTICS AND PROGRESS FOR FY 2022 (1) PROMOTE AWARENESS OF COMMUNITY GARDENS AT OSF HEALTHCARE, OTTAWA COMMUNITY GARDENS, SHS EDIBLE GARDEN, NORTHLAWN JR. HIGH SCHOOL GARDEN AND THE DISTRIBUTION LOCATIONS TO ADDRESS LOCAL FOOD DISPARITIES AND ACCESS TO HEALTHY FOODS. PROGRESS FY2022 Micropantry installed at Reading Township Hall, Streator. Ottawa - 12 beds and herbs planted. Mendota - 26 beds. Streator - 3 garden bed areas, south lot garden divided into 4 sections, transportation center 12 raised beds. The Ottawa Community Garden harvested 640 pounds and donated the produce to A Servant's Heart. Streator donated 713.75 pounds to the Streatorland Food Pantry, Grace Community Church Food Pantry, New Beginnings Baptist Church Food Pantry and the Streator Salvation Army Food Pantry. The Mendota garden donated 1,175 pounds to the OSF Saint Paul Cafe, Mission Partners, and the Mendota Area Christian Food Pantry. Total of 2,528.75 pounds of produce this season. PROGRESS FY2022 - HKU to launch in May 2022. Due to low enrollment class cancelled. Participated in April 29 Streator YMCA's Healthy Kids Day, May 7 Mendota YMCA's Healthy Kids Day, July 2 Streator 4th of July Celebration's Kids Korner and July 14-15 LaSalle County 4-H Fair. Co-sponsored and participated in the University of Illinois Extension's Illinois Junior Chef program in Streator June 20-24. (2) Develop and Promote Live Well Streator Health Eating Restaurant Menu Guide PROGRESS FY2022: 1 restaurant, due to COVID, supplier and staffing challenges. Content on Live Well Streator Facebook page highlighted 12 restaurants with healthy options, 4 posts with 100-calorie swap outs and 20 fruit/vegetable features. (3) Conduct the Illinois Jr. Chef's Cooking School in three communities PROGRESS FY2022: 30 students participated in Streator June 20-24. (4) Promote healthier school lunchroom environments PROGRESS FY2022: Due to COVID restrictions with limited access for visitors at schools, community implementation was identified including Illinois Junior Chef at Northlawn Junior High School in Streator, Safety Town at Central Elementary School in Ottawa, Illinois Valley Community College Student Wellness Fair. (5) King Care-A-Van client nutrition education and food demonstrations within OSF Service area through mobile King Care-A-Van service PROGRESS FY2022: Nutrition education - Habitat Restore Peru, Streator Salvation Army, Ottawa Homeless Shelter/IV PADS MENTAL HEALTH - THE CHNA SURVEY ASKED RESPONDENTS TO INDICATE PREVALENCE OF SPECIFIC MENTAL-HEALTH ISSUES, NAMELY DEPARESSION AND STRESS/ANXIETY. OF RESPONDENTS, 41% INDICATED THEY FELT DEPRESSED IN THE LAST 30 DAYS AND 39% INDICATED THEY FELT ANXIOUS OR STRESSED. GOAL1: INCREASE THE OVERALL COMMUNITY UNDERSTANDING OF MENTAL HEALTH NEEDS AND ACCESS TO MENTAL HEALTH SERVICES. OUTCOME METRIC 1: DECREASE SELF-REPORTS OF DEPRESSION AND ANXIETY TO SEE A REDUCTION OF INDIVIDUALS REPORTING DEPRESSION AND ANXIETY WITHIN THE LAST 30 DAYS FROM 35% TO 32% BY 2022. (PER CHNA SURVEY, 2019) TACTICS FOR PROGRESS IN 2022 (1) North Central trained 12 participants at Park Presbyterian Church/Streator March 12th and 14 staff from Peru & Ottawa homeless shelters (IV PADS) July 19th (2) EMBED BILINGUAL BEHAVIORAL HEALTH PROVIDER AT OSF MULTI-SPECIALTY GROUP MENDOTA, BILINGUAL PROGRAMMING'S AND COMMUNICATIONS. PROGRESS FY2022: Implementation delayed due to staff turnover. Currently using Globo for translation services. (3) ENGAGE FAITH COMMUNITY NURSE TO WORK WITH SCHOOL NURSES REGARDING STUDENTS NOT HAVING MEDICATIONS NEEDED PROGRESS FY2022 - DELAYED DUE TO STAFF TURNOVER. (4) PROVIDE FREE ACCESS TO DIGITAL BEHAVIORAL HEALTH SOLUTION - SILVERCLOUD PROGRESS FY2022 - 64 UTILIZING APP. (5) PROVIDE FREE BEHAVIORAL HEALTH NAVIGATION SERVICE PROGRESS FY2022 - 231 USING SERVICE. GOAL 2: USE SOCIAL DETERMINATES OF HEALTH (SDOH) TO IDENTIFY PATIENTS AT INCREASED RISK OF POOR MENTAL HEALTH AND CONNECT THEM TO COMMUNITY ORGANIZATIONS IN ORDER TO IMPROVE MENTAL HEALTH OUTCOMES. OUTCOME MEASURE 2: DECREASE THE PERCENTAGE OF RESPONDENTS STATING THEY HAVE POOR OVERALL MENTAL HEALTH BY 1%. BASELINE: PER THE 2019 CHNA SURVEY, 8% OF RESPONDENTS STATED THEY HAVE POOR OVERALL MENTAL HEALTH. NOT HAVING BASIC HUMAN NEEDS IS LIKELY LINKED TO POOR MENTAL HEALTH. IF A SURVEY RESPONDENT DOES NOT HAVE HOUSING, FOOD, TRANSPORTATION (ETC.), THEIR OVERALL STATE OF MENTAL HEALTH WOULD LIKELY BE RATED LOWER. TACTICS FOR PROGRESS IN 2022 (1) IMPLEMENT SCREENING OF PATIENTS FOR SDOH. SCREEN AND CONNECT. NUMBER OF PATIENTS SCREENED. PROGRESS FY2022 - 8,047 (2) TRACK NUMBER OF PATIENTS REFERRED TO COMMUNITY BASED ORGANIZATIONS (CBO) PROGRESS FY2022 - 273 (3) TRACK NUMBER OF MISSION PARTNERS EDUCATED FOR CONTINUED ROLL-OUT - PROGRESS FY2022 - completed (4) TRACK NUMBER OF PATIENT REFERRALS TO OSF CARE MANAGEMENT AND SOCIAL WORKERS PROGRESS FY2022 - 22 Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE WHEN CHARGES EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT BILLED IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES THIS ADJUSTMENT IS THE MOST GENERAL ASSISTANCE. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. PRESUMPTIVE FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDES FOR A DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO A PATIENT WITH NO INSURANCE BENEFITS, WHEN THE PATIENT ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA: HOMELESSNESS; DECEASED WITH NO ESTATE; MENTAL INCAPACITATION WITH NO ONE TO ACT ON THE PATIENT'S BEHALF; AND CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. THE FINANCIAL ASSISTANCE POLICY IS AVAIABLE BY WEBSITE, FAX, POSTAL ADDRESS AND PATIENTS ARE DIRECTED TO STAFF IN THE PATIENT FINANCIAL SERVICES AND ADMITTING AREAS AT OSF HOSPITALS FOR ASSISTANCE IN OBTAINING ANSWERS TO QUESTIONS REGARDING THE POLICY. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - MENDOTA COMMUNITY HOSPITAL. A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS, INFORMATION ABOUT FINANCIAL ASSISTANCE AND THE APPLICATION PROCESS IS INCLUDED ON OR WITH THE OSF PATIENT BILLING STATEMENT, AND OSF PROVIDES COPIES OF THE PLAIN LANGUAGE SUMMARY AND THE FAP APPLICATION FORM TO REFERRING STAFF PHYSICIANS. 0 Schedule H, Part I, Line 3c Criteria for Free or Discounted Care CATASTROPHIC CHARITY ASSISTANCE REGARDLESS OF INCOME OR ASSET LEVELS FOR MEDICALLY NECESSARY SERVICES WHICH EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT DUE IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES CATASTROPHIC CHARITY IS MORE GENEROUS. PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; - DECEASED WITH NO ESTATE; - MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR - CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. ALL PATIENTS RECEIVE THE GREATEST REQUESTED DISCOUNT AVAILABLE UNDER ANY OF THE OSF PROGRAMS. NO ASSET TESTS ARE USED. EXCEPT AS OTHERWISE NOTED, THESE POLICIES APPLY BOTH TO UNINSURED PATIENTS AND TO INSURED PATIENTS WITH RESPECT TO THE PATIENT RESPONSIBILITY AMOUNT. Schedule H, Part I Coronavirus Pandemic On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient activity and related revenues for most services were significantly impacted starting in mid-March 2020, as various policies were implemented by federal, state, and local governments in response to the COVID-19 pandemic. In March 2020, the CARES Act was signed into law, providing temporary and limited relief to hospitals during the COVID-19 outbreak. Under the CARES Act, appropriations were made for hospitals to cover expenses and lost revenue associated with the treatment of COVID-19 patients, the Medicare Accelerated and Advanced payment program was expanded, employee retention tax credits to employers affected by COVID-19 were provided, the 2% reduction in Medicare payments from sequestration through December 2021 has been eliminated, add-on payments for inpatient hospitals treating COVID-19 patients were created, and a reduction in Medicaid funding for Medicare disproportionate share hospitals was delayed. Schedule H, Part I, Line 7g Subsidized Health Services NET COSTS (TOTAL EXPENSE LESS REVENUE) OF PHYSICIAN CLINICS ARE INCLUDED AS SUBSIDIZED HEALTH SERVICES ON PART 1, LINE 7G. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Medicare cost to charge ratio Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount IN GENERAL, AND IN ACCORDANCE WITH MEDICARE REGULATIONS, PATIENT ACCOUNT BALANCES ARE WRITTEN OFF TO BAD DEBT EXPENSE AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY OR LAW FIRM. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, OSF ANALYZES PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. 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, OSF ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE PATIENTS ARE SCREENED AGAINST THE OSF FINANCIAL ASSISTANCE POLICY AND UNINSURED DISCOUNT POLICY. FOR ANY REMAINING PATIENT RESPONSIBILITY BALANCE, OSF RECORDS A PROVISION FOR BAD DEBTS 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) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BAD DEBT EXPENSE OF 396,385 ON FORM 990, PART IX, LINE 24B IS BASED UPON ACCRUAL ACCOUNTING REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THIS AMOUNT CONSEQUENTLY DIFFERS FROM THE BAD DEBT EXPENSE OF 290,097 ON SCHEDULE H, PART III, LINE 2 WHICH REQUIRES THE ORGANIZATION TO REPORT AGGREGATE BAD DEBT AT COST. BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS THEREFORE CALCULATED BY MULTIPLYING GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE TIMES THE MEDICARE COST-TO-CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT. Schedule H, Part III, Line 3 Bad Debt Expense Methodology DISCOUNTS, INCLUDING ANY APPLICABLE THIRD PARTY PAYER CONTRACTUAL ALLOWANCES AND ANY FINANCIAL ASSISTANCE DISCOUNTS (VALUED AT GROSS CHARGES), ARE APPLIED TO PATIENT ACCOUNT GROSS CHARGES TO DETERMINE THE ACCOUNT BALANCE BEFORE PATIENT PAYMENTS. THE AGGREGATE AMOUNT OF ALL PATIENT PAYMENTS IS THEN APPLIED TO THE ACCOUNT BALANCE. WHEN DETERMINATION IS MADE THAT NO FURTHER AMOUNTS CAN BE COLLECTED IN ACCORDANCE WITH THE CORPORATION'S BAD DEBT POLICY, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; -DECEASED WITH NO ESTATE; -MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR -CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. THEREFORE, THE CORPORATION DOES NOT BELIEVE THAT BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 INCLUDES ANY AMOUNTS THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY UNDER THE CORPORATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote PLEASE SEE PAGE 22 OF NOTES TO CONSOLIDATED FINANCIAL STATEMENTS Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs OSF IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY USING THE MEDICARE COST TO CHARGE RATIO. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. SHOULD THERE BE A SHORTFALL, IT WOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UN-REIMBURSED COSTS FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE CORPORATION HAS A self-pay BILLING COLLECTION POLICY WHICH APPLIES FOR ALL PATIENTS. THE POLICY INCLUDES: -REQUIRED INFORMATION PROVIDED IN BILLS TO PATIENTS (INCLUDING A REQUIREMENT THAT INFORMATION BE PROVIDED ON HOW THE PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE). -PROCESS FOR PATIENTS TO INQUIRE ABOUT OR DISPUTE A BILL, INCLUDING TOLL-FREE TELEPHONE NUMBER, ADDRESS, CONTACT NAME AND E-MAIL ADDRESS. -REQUIREMENTS FOR TIMELY RESPONSE TO PATIENT INQUIRIES. -CONDITIONS WHICH MUST BE SATISFIED BEFORE PATIENT MAY BE SENT TO A COLLECTION AGENCY OR ATTORNEY. -LEGAL ACTION FOR NON-PAYMENT OF A PATIENT BILL MAY NOT BE INITIATED UNTIL AN AUTHORIZED HOSPITAL OFFICIAL HAS DETERMINED THAT ALL CONDITIONS IN THE CORPORATION'S POLICY (INCLUDING ALL THE FOREGOING POLICY PROVISIONS) HAVE BEEN SATISFIED FOR INITIATING LEGAL ACTION. -LEGAL ACTION MAY NOT BE PURSUED AGAINST UNINSURED PATIENTS WHO HAVE CLEARLY DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS - EVEN IF SUCH PATIENTS DO NOT APPLY FOR FINANCIAL ASSISTANCE. -THE CORPORATION SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS, SUCH AS SUBMITTING REPORTS TO CREDIT AGENCIES BEFORE REASONABLE ATTEMPTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE HAVE BEEN COMPLETED. -IF A PATIENT RECEIVES AN APPLICATION FOR FINANCIAL ASSISTANCE BUT FAILS TO RETURN IT, OSF WILL TRY TO USE SECONDARY SOURCES TO DETERMINE THE PATIENT'S ELIGIBILITY FOR NON COMPLIANT CHARITY BEFORE PURSUING LEGAL ACTION FOR NONPAYMENT. IF A COMPLETE APPLICATION IS RECEIVED DURING THE APPLICATION PERIOD, OSF WILL SUSPEND EXTRAORDINARY COLLECTION ACTIONS AND MAKE A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE. IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, OSF WILL ISSUE APPROPRIATE REFUNDS AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN, AS MORE FULLY DESCRIBED IN THE OSF FAIR BILLING - COLLECTION POLICY. Schedule H, Part V, Section B, Line 16a FAP website - MENDOTA COMMUNITY HOSPITAL: Line 16a URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - MENDOTA COMMUNITY HOSPITAL: Line 16b URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - MENDOTA COMMUNITY HOSPITAL: Line 16c URL: https://www.osfhealthcare.org/billing/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS PREVIOUSLY STATED. THE CHNA IS UPDATED EVERY 3 YEARS AND CORRESPONDING IMPLEMENTATION STRATEGY IS REFRESHED YEARLY. NOT ONLY DOES THE PLAN GET REFRESHED YEARLY, BUT EACH ACTION ITEM HAS A RESPONSIBLE PARTY INVOLVED TO GET THE WORK ASSOCIATED WITH THE NEED ACCOMPLISHED. THE 2021 TAX YEAR REPRESENTS THE FINAL YEAR OF THE NEEDS ASSESSMENT ADOPTED AS PART OF THE 2019 CHNA. THE NEW CHNA WAS APPROVED AND ADOPTED BY THE OSF BOARD OF DIRECTORS ON JULY 29, 2019 AND THE CORRESPONDING IMPLEMENTATION STRATEGY WAS APPROVED JANUARY 27, 2020. THE ASSOCIATED PLAN GOALS AND ACCOMPLISHMENTS ARE LISTED IN THIS YEARS FILING. LEADERSHIP WITHIN OSF SIT ON VARIOUS COMMUNITY ADVISORY BOARDS TO STAY CONNECTED TO THE OTHER AGENCIES WITHIN THE COMMUNITY. THIS WORK ALIGNS WITH OUR MISSION STATEMENT TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE CORPORATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, IN ENGLISH AND IN ANY OTHER LANGUAGE SPOKEN BY POPULATIONS WITH LIMITED ENGLISH PROFICIENCY THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY OF THE HOSPITAL, IN THE FOLLOWING WAYS: -SIGNS ARE POSTED IN PATIENT REGISTRATION AREAS (INCLUDING EMERGENCY DEPARTMENT REGISTRATION) INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, THE AVAILABILITY OF FINANCIAL ASSISTANCE COUNSELORS, AND HOW TO OBTAIN A COPY OF THE OSF FINANCIAL ASSISTANCE POLICY AND APPLICATION. -A PLAIN LANGUAGE SUMMARY OF THE OSF FINANCIAL ASSISTANCE POLICY IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS AND INCLUDED IN THE BILLING STATEMENT MAILED PRIOR TO INITIATING EXTRAORDINARY COLLECTION ACTIONS. IN ADDITION, THE PLAIN LANGUAGE SUMMARY AND APPLICATION ARE PROVIDED TO REFERRING STAFF PHYSICIANS. -OSF MAKES REASONABLE EFFORTS TO ORALLY NOTIFY PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN ASSISTANCE IN APPLYING. -A NOTICE OF AVAILABILITY OF THE CORPORATION'S FINANCIAL ASSISTANCE AND UNINSURED PATIENT DISCOUNT POLICIES IS PROMINENTLY AVAILABLE ON THE CORPORATION'S WEBSITE. THE APPLICATION FORM WITH INSTRUCTIONS AND THE PLAIN LANGUAGE SUMMARY IS AVAILABLE FOR DOWNLOAD. -A NOTE REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE (TOGETHER WITH CONTACT PHONE NUMBERS) APPEARS ON EVERY PATIENT BILLING STATEMENT AS WELL AS THE WEBSITE WHERE COPIES OF THE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY MAY BE OBTAINED. -FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND BY PHONE TO ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND IN DETERMINING ELIGIBILITY AND APPLYING FOR GOVERNMENT PROGRAM BENEFITS, INCLUDING MEDICAID. -THE CORPORATION'S FINANCIAL ASSISTANCE POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC. Schedule H, Part VI, Line 4 Community information MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER IS LOCATED IN LASALLE COUNTY. THE OSF SAINT PAUL MEDICAL CENTER SERVICE COMMUNITY IS LOCATED PRIMARILY IN LASALLE COUNTY BUT EXTENDS INTO PORTIONS OF LEE, BUREAU, AND DEKALB COUNTIES. THE RACE AND ETHNICITY MAKEUP OF THE SERVICE AREA INDICATES THAT MORE THAN 12.6% OF THE POPULATION IS OF HISPANIC ORIGIN. OTHER RACE AND ETHNICITY NUMBERS ARE TYPICAL OF RURAL ILLINOIS. THERE ARE NO LARGE CHANGES IN THE PROFILE OVER THE PAST FIVE YEARS. THE POVERTY RATE FOR LASALLE COUNTY WAS 13.6 PERCENT IN 2017. THE POPULATION USED FOR THE CALCULATION WAS 110,067 YIELDING 14,969 RESIDENTS LIVING IN POVERTY IN THE LASALLE COUNTY AREA. DATA FROM THE LAST CENSUS INDICATE THE POPULATION OF LASALLE COUNTY HAS SLIGHTLY DECREASED (2.1%) BETWEEN 2013 AND 2017. THE POPULATION IN LASALLE COUNTY HAS DECREASED FROM 112,424 IN 2013 TO 110,067 IN 2017. Schedule H, Part VI, Line 5 Promotion of community health MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER SPONSORING ORGANIZATION IS A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS. IN ACCORDANCE WITH CANON LAW OF THE ROMAN CATHOLIC CHURCH AND FEDERAL TAX LAW APPLICABLE TO SUPPORTING ORGANIZATIONS, A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION ARE PROFESSED MEMBERS OF THE SPONSORING RELIGIOUS CONGREGATION. THEY HAVE A COMMUNITY ADVISORY BOARD CONSISTING OF MEMBERS OF THE COMMUNITY WHO ARE NOT DIRECTORS, OFFICERS, OR CONTRACTORS OF MENDOTA. EXCEPT FOR HOSPITAL DEPARTMENTS WHICH HAVE BEEN CLOSED, OR IN WHICH CLINICAL PRIVILEGES HAVE BEEN RESTRICTED, FOR CLINICAL OR QUALITY OF CARE REASONS BY ACTIONS OF THE HOSPITAL'S MEDICAL STAFF AND THE BOARD OF DIRECTORS, MENDOTA EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE MENDOTA SURPLUS FUNDS WERE USED DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2021 FOR IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. MENDOTA HOSPITAL MEETS THE REQUIREMENTS OF REVENUE RULING 69-545 BY: -OPERATING AN EMERGENCY DEPARTMENT WHICH IS STAFFED 24 HOURS PER DAY BY QUALIFIED PHYSICIANS AND OTHER MEDICAL PERSONNEL AND WHICH IS OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY. -HAVING MEDICAL STAFFS WHICH ARE OPEN TO ALL QUALIFIED PHYSICIANS, MID-LEVEL PROVIDERS, PODIATRISTS, AND DENTISTS IN THE COMMUNITY (EXCEPT WHERE RESTRICTED IN RARE CASES FOR CLINICAL QUALITY REASONS BY ACTION OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS). -ACCEPTING MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAM PATIENTS. -ACCEPTING ALL PATIENTS, INCLUDING UNINSURED PATIENTS, WITHOUT REGARD TO THEIR ABILITY TO PAY. -USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. MENDOTA HOSPITAL PARTNERS WITH OTHER LOCAL SERVICE AGENCIES TO ENSURE ACCESS FOR RURAL HEALTHCARE INCLUDING OFFERING SPACE TO OTHER AGENCIES TO CO-LOCATE UNDER ONE ROOF. OSF ON CALL OFFERS A 24/7 ONLINE ACCESS TO MEDICAL CARE VIA SMARTPHONE, TABLET OR COMPUTER. THE HOSPITAL FORMED A TRANSIT PARTNERSHIP UNDER THE CITY OF OTTAWA AND NORTH CENTRAL AREA TRANSIT (NCAT). Schedule H, Part VI, Line 6 Affiliated health care system The Corporation is part of an affiliated health care system (the "OSF System"), which is an integrated health system that operates acute care hospitals, home health care services, two colleges of nursing, a medical training simulation center, and other health care facilities in Illinois and Michigan. The OSF System includes many other entities which are controlled, directly or indirectly by the Sisters of the Third Order of St. Francis (the "Congregation"). All affiliated entities apply and follow the financial assistance policies of the Corporation and are operated in furtherance of the mission to provide comprehensive, durable medical equipment, integrated quality care to the communities served by the Corporation. The OSF System's corporate office in Peoria, Illinois (the "Corporate Office"), provides corporate management services as well as direction, consultation and assistance to the administration of the OSF System's health care facilities and subsidiary corporations. The primary affiliated corporations of the OSF System are the following: The Congregation, which works exclusively in the health care apostolate, holds the assets of the religious congregation and directs all other corporations in the affiliated health care system through board representation and the exercise of reserved powers. OSF Multi-Specialty Group was incorporated in 2011. Virtually all physicians and advance practice providers providing professional services through the OSF System's acute care hospital facilities and ambulatory practice settings (with a few limited exceptions) provide services pursuant to employment agreements or professional service agreements with the Multi-Specialty Group. OSF Medical Group is a d/b/a of Multi-Specialty Group. Pointcore, Inc., formerly known as OSF Saint Francis, Inc., was originally incorporated in 1986 and is engaged in the following lines of business: retail pharmacies, retail shops, a mobile medical system, emergency medical transportation, home therapeutics, real estate, equipment technology services, telecommunications, electronic health records, telehealth services, and consulting services. Pointcore, Inc. also participates in various health related joint ventures. OSF Healthcare Foundation was incorporated in 1989 to conduct fundraising and other activities for the benefit of OSF Healthcare System and in support of the mission of the Congregation. Ottawa Regional Hospital & Healthcare Center, formerly known as Community Hospital of Ottawa was incorporated in 1964. OSF Healthcare System became the sole member of Ottawa Regional Hospital & Healthcare Center in 2012, and the hospital was renamed as d/b/a/ OSF Saint Elizabeth Medical Center. Mendota Community Hospital, formerly known as Mendota Hospital Foundation, was incorporated in 1944. OSF Healthcare System became the sole member of Mendota Community Hospital in 2015, and the hospital was renamed as d/b/a/ OSF Saint Paul Medical Center Schedule H, Part VI, Line 7 State filing of community benefit report IL X X X X false false false false false false false false false Robert C Sehring Vice Chairperson Chief Executive Officer 0 1553315 0 983702 0 113528 0 14250 0 28356 0 2693151 0 0 Gerald J McShane MD Board Member 0 183578 0 0 0 0 0 8026 0 21852 0 213456 0 0 Michael M Allen Chief Financial Officer 0 706904 0 373634 0 32036 0 14250 0 28629 0 1155453 0 0 Robert G Anderson Chief Executive Officer Central Region 0 491993 0 213559 0 23507 0 14250 0 20657 0 763966 0 0 Chad E Boore Chief Executive Officer Eastern Region (Through Aug 2022) 0 475127 0 217483 0 21052 0 14250 0 33439 0 761351 0 0 Robert L Brandfass SVP Chief Legal Officer 0 583708 0 254163 0 24225 0 14250 0 22376 0 898722 0 0 Paula A Carynski President, OSF HealthCare Saint Anthony Medical Center 0 394889 0 176412 0 24344 0 14250 0 27512 0 637407 0 0 Michelle D Conger Chief Strategy Officer, OSF Healthcare/ CEO OnCall Digital Health 0 610475 0 274252 0 21496 0 10599 0 25293 0 942115 0 0 Roxanna Crosser Chief Executive Officer Western Region 0 443307 0 201819 0 35699 0 4828 0 25066 0 710719 0 0 Michael A Cruz MD Chief Operating Officer 0 747881 0 337760 0 33547 0 14250 0 34346 0 1167784 0 0 Lisa DeKezel President, OSF HealthCare Holy Family MC and St. Mary MC 0 258274 0 105642 0 13251 0 3849 0 25564 0 406580 0 0 John R Evancho SVP Chief Compliance Officer 0 303026 0 129348 0 1541 0 14500 0 27934 0 476349 0 0 Carol A Friesen Chief Executive Officer Eastern Region 0 516780 0 234927 0 20708 0 14250 0 36065 0 822730 0 0 Lynn A Fulton President, OSF HealthCare St. Joseph Medical Center 0 340332 0 144725 0 1014 0 14500 0 26070 0 526641 0 0 David M Hall SVP Info Systems/Chief Information Officer 0 422743 0 178464 0 13238 0 14250 0 31975 0 660670 0 0 Thomas G Hammerton President OSF Healthcare Foundation Chief Development Officer 0 377680 0 176711 0 49748 0 14250 0 27895 0 646284 0 0 Ned Hill President, OSF HealthCare Sacred Heart Medical Center 0 116015 0 20000 0 20158 0 5676 0 9420 0 171269 0 0 Stephen E Hippler MD Chief Clinical Officer 0 716326 0 323758 0 25471 0 14250 0 36070 0 1115875 0 0 Kelly A Jefferson President, OSF HealthCare St. Francis Hospital & Medical Group 0 170763 0 52420 0 3633 0 9038 0 25209 0 261063 0 0 Jacqueline D Kernan President, OSF HealthCare St Clare Medical Center & St Luke MC 0 232104 0 101978 0 15460 0 14500 0 21213 0 385255 0 0 Kathleen M Kinsella President, OSF HealthCare Little Company of Mary Medical Center 0 348458 0 139333 0 22247 0 14500 0 14158 0 538696 0 0 James J Mormann Chief Information Officer 0 648289 0 295900 0 45488 0 14250 0 34582 0 1038509 0 0 Shelley A Nguyen Chief Human Resources Officer 0 206461 0 62193 0 54 0 6698 0 17821 0 293227 0 0 August J Querciagrossa Chief Executive Officer Western Region 0 372725 0 167775 0 21537 0 8939 0 31917 0 602893 0 0 Jason R Rodeghero President, OSF Home Care and Rehab Services 0 242434 0 103427 0 5691 0 14500 0 25737 0 391789 0 0 Jared C Rogers President, OSF HealthCare Heart of Mary Medical Center 0 373142 0 169411 0 5289 0 14500 0 23011 0 585353 0 0 Jerry W Rumph President, OSF HealthCare Saint Anthony's Health Center 0 243028 0 80548 0 14227 0 14500 0 1628 0 353931 0 0 Bradley V Solberg President, OSF HealthCare Saint James- John W. Albrecht MC 0 332551 0 133728 0 7389 0 14500 0 29667 0 517835 0 0 Jeffry M Tillery President, OSF Medical Group 0 632733 0 285300 0 24709 0 14250 0 26454 0 983446 0 0 Dawn C Trompeter President, OSF Healthcare St. Elizabeth MC/ St. Paul MC 259648 0 118294 0 21454 0 13265 0 24967 0 437628 0 0 0 Ralph Velazquez MD System Chief Medical Officer 0 561365 0 255943 0 35990 0 14250 0 29394 0 896942 0 0 Michael A Wells President CHOI 0 241929 0 98072 0 690 0 10385 0 19761 0 370837 0 0 Lori L Wiegand Chief Nursing Officer 0 446455 0 203868 0 23087 0 14278 0 10413 0 698101 0 0 Leon A Yeh MD VP Chief Medical Officer Emergency Serv 0 532381 0 168135 0 19548 0 14250 0 11019 0 745333 0 0 Jodie L Borchelt Director Surgical/Inpatient Services, Medical/Surgical Acute 107971 0 11028 0 54 0 6390 0 27338 0 152781 0 0 0 Kenneth K Potts MD Physician 252968 0 0 0 36 0 7678 0 23715 0 284397 0 0 0 Katherine R Riva-Foster MD Physician 216542 0 27696 0 4319 0 6577 0 21661 0 276795 0 0 0 Schedule J, Part I, Line 3 SCH J, PART I, LINE 3 THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF A RELIGIOUS CONGREGATION THAT OWNS OR IS ASSOCIATED WITH THE HEALTHCARE SYSTEM WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS, COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED. Form 990, Part I, Line 1 PART I THE TAX LAW REQUIRES THAT EACH LEGAL ENTITY WITHIN THE OSF HEALTHCARE SYSTEM COMPLETE A SEPARATE TAX RETURN WHICH APPROPRIATELY REFLECTS THE ACTIVITIES AND FINANCIAL POSITION OF THE PARTICULAR ORGANIZATION. THIS REPORTING, HOWEVER, IS NOT REFLECTIVE OF THE OSF HEALTHCARE SYSTEM AS A WHOLE. PLEASE SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS OF OSF HEALTHCARE SYSTEM AND SUBSIDIARIES FOR A COMPLETE OVERVIEW OF THE SYSTEM. Form 990, Part VI, Line 6 Classes of members or stockholders OSF HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body OSF HEALTHCARE SYSTEM AS A SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL HAS THE POWER TO ELECT MEMBERS OF THE BOARD. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESERVED POWERS: THE FOLLOWING POWERS ARE RESERVED FOR THE MEMBER: A) TO ESTABLISH, APPROVE, OR MODIFY THE PHILOSOPHY, VISION, VALUES, AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. (B) TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (C) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION. (D) TO MERGE OR CONSOLIDATE THE CORPORATION WITH OTHER ENTITIES OR TO DISSOLVE THE CORPORATION. (E) TO ACQUIRE AN INTEREST IN AN EXISTING ENTITY OR TO ESTABLISH A NEW ENTITY. (F) TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE ANY REAL PROPERTY OR INTEREST IN REAL PROPERTY OF THE CORPORATION. (G) TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. (H) TO APPROVE ANY BORROWING OR DEBT FINANCING ON BEHALF OF THE CORPORATION. (I) TO APPOINT, DISCIPLINE, TERMINATE AND REMOVE THE CORPORATION'S OPERATING DIVISION PRESIDENT. (J) TO APPOINT AND REMOVE THE CORPORATION'S CHAIRPERSON, VICE CHAIRPERSON(S), CHIEF EXECUTIVE OFFICER, PRESIDENT, SECRETARY, AND TREASURER, AND THE ASSISTANT SECRETARY AND ASSISTANT TREASURER, IF ANY. (K) TO APPROVE OR AMEND STRATEGIC PLANS, MANAGEMENT OBJECTIVES, AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. (L) TO APPROVE ANY PURCHASE OR OTHER AQUISITION BY THE CORPORATION THAT IS NOT INCLUDED IN ITS CAPITAL BUDGET AND EXCEEDS ONE MILLION DOLLARS ($1,000,000) PER ITEM. (M) TO NAME OR RENAME ANY HOSPITAL OR MEDICAL CENTER OWNED AND OPERATED BY THE CORPORATION. (N) TO REQUIRE A CERTIFIED AUDIT OF FINANCES OF THE CORPORATION AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. (O) TO APPROVE THE ENGAGEMENT OF AND TO DISMISS ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS OR IN CONNECTION WITH ANY MATTER DEEMED BY THE MEMBER, IN GOOD FAITH, TO HAVE SIGNIFICANCE FOR THE CORPORATION AS A WHOLE. (P) TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WILL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY. (Q) TO TAKE ANY AND ALL ACTIONS DEEMED NECESSARY, IN THE SOLE JUDGEMENT OF THE MEMBER BOARD TO PROTECT AND PRESERVE THE TAX-EXEMPT STATUS AND PUBLIC CHARITY STATUS OF THE CORPORATION OR THE MEMBER AND ANY TAX-EXEMPT AFFILIATE OF THE CORPORATION OR THE MEMBER (INCLUDING FEDERAL AND STATE INCOME TAX EXEMPTIONS, PROPERTY TAX EXEMPTIONS, AND SALES TAX EXEMPTIONS); PROVIDED THE MEMBER BOARD HAS GIVEN A WRITTEN REQUEST TO THE BOARD TO TAKE ACTION OR REFRAIN FROM TAKING ACTION, WHICH WOULD HAVE SUFFICIENTLY PROTECTED AND PRESERVED SUCH TAX-EXEMPT AND PUBLIC CHARITY STATUS, AND THE BOARD HAS FAILED TO PROMPTLY TAKE SUCH ACTION OR REFRAIN FROM TAKING SUCH ACTION. Form 990, Part VI, Line 9 Interested person not at organization's address BRIAN SILVERSTEIN, M.D. 1000 ELM RIDGE DRIVE GLENCOE, IL 60022 Form 990, Part VI, Line 11b Review of form 990 by governing body THE PROPOSED FINAL VERSION OF THE 990 IS PROVIDED VIA AN ONLINE PORTAL TO ALL OFFICERS AND MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES BEFORE FILING. Form 990, Part VI, Line 12c Conflict of interest policy DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTION DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM ON AN ANNUAL BASIS. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION ON AN ANNUAL BASIS. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS THAT OWNS OR IS ASSOCIATED WITH THE HEALTHCARE SYSTEM WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITEE. THE COMMITEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATION FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVEIWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS THAT OWNS OR IS ASSOCIATED WITH THE HEALTHCARE SYSTEM WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHED THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REVENUE - Total Revenue: 50433, Related or Exempt Function Revenue: 50433, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Inter-company Transfers - -39872; Net assets Released from Restrictions - -205721; Equity Transfers - -590488; Form 990 Coronavirus Pandemic and CARES Act Funding On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Patient activity and related revenues for most services were significantly impacted starting in mid-March 2020, as various policies were implemented by federal, state, and local governments in response to the COVID-19 pandemic. In March 2020, the CARES Act was signed into law, providing temporary and limited relief to hospitals during the COVID-19 outbreak. Under the CARES Act, appropriations were made for hospitals to cover expenses and lost revenue associated with the treatment of COVID-19 patients, the Medicare Accelerated and Advanced payment program was expanded, employee retention tax credits to employers affected by COVID-19 were provided, the 2% reduction in Medicare payments from sequestration through December 2021 has been eliminated, add-on payments for inpatient hospitals treating COVID-19 patients were created, and a reduction in Medicaid funding for Medicare disproportionate share hospitals was delayed. SISTERS OF THE THIRD ORDER OF ST FRANCIS 124 SW Adams St PEORIA IL 61602 371259286 PARENT/SU ORG IL 501(c)(3) 1 NA false OSF HEALTHCARE FOUNDATION 124 SW Adams St PEORIA IL 61602 371259284 SUPPORT ORG IL 501(c)(3) Type II SIS 3RD OSF false OTTAWA REGIONAL HOSP & HEALTHCARE CTR 124 SW ADAMS ST Peoria IL 61602 362604009 HOSPITAL IL 501(c)(3) 3 OSF false OTTAWA REGIONAL HOSPITAL FOUNDATION 124 SW ADAMS ST Peoria IL 61602 364007569 SUPPORT ORG IL 501(c)(3) Type I ORHHC false OSF MULTI-SPECIALTY GROUP 124 SW Adams St PEORIA IL 61602 383852646 HLTHCARE SVCS IL 501(c)(3) Type I OSF false OSF HEALTHCARE SYSTEM 124 SW Adams St PEORIA IL 61602 370813229 HOSPITAL IL 501(c)(3) 3 SIS 3RD OSF false OTTAWA REGIONAL HOSPITAL AUXILIARY 124 SW ADAMS ST Peoria IL 61602 363854788 SUPPORT ORG IL 501(c)(3) Type I OSF false CENTER FOR HEALTH AMBULATORY 8800 RTE 91 N PEORIA IL 61615 205557171 SURGICAL CENTER IL OSF Related 0 0 false false 0 EASTLAND MEDICAL PLAZA 1505 EASTLAND DRIVE Bloomington IL 61701 371400643 SURGICAL CENTER IL OSF Related 0 0 false false 0 FORT JESSE IMAGING CENTER LLC 2200 FT JESSE ROAD NORMAL IL 61761 460515604 MEDICAL IMAGING IL OSF Related 0 0 false false 0 SAINT CLARE'S VILLA 915 EAST 5TH STREET ALTON IL 62002 371397289 LOW INC HOUSING IL OSF Related 0 0 false false 0 FOX RIVER CANCER CENTER 1211 STARFISH DRIVE OTTAWA IL 61350 870805865 ONCOLOGY IL ORHHC Related 0 0 false false 0 GREATER PEORIA SPECIALTY HOSPITAL LLC 680 S 4TH STREET LOUISVILLE KY 40202 261579585 LONG TERM ACUTE CARE HOSPITAL DE OSF Related 0 0 false false 0 POINTCORE INC 124 SW Adams St PEORIA IL 61602 363484677 HLTHCARE SVCS IL OSF C Corporation false ILLINOIS PATHOLOGST SERVICES LLC 5666 EAST STATE STREET ROCKFORD IL 61108 800439081 PATHOLOGY SVCS IL OSF C Corporation false SOUTHWEST HEALTH SYSTEMS INC 2800 WEST 95TH STREET EVERGREEN PARK IL 60805 363425830 HEALTHCARE SERVICES IL OSF C Corporation false OSF AVIATION LLC 124 SW Adams St PEORIA IL 61602 300032408 Medical Transportation IL Pointcore Inc C Corporation false OSF ASSURANCE COMPANY 76 ST PAUL STREET Suite 500 BURLINGTON VT 05401 202015375 Insurance company VT Pointcore Inc C Corporation false false false true false false false false false false true true true true true true true false false false