ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (EIN 55-0809159)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-10-17
- IRS object ID
- 202302909349300040
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-10-17T10:36:05-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550809159 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ILLINOIS CRITICAL ACCESS HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | NETWORK | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ILLI | BusinessNameControlTxt |
| Phone | 8158752999 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1945 VANS WAY | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61356 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICIA SCHOU | PersonNm |
| Person Title | EXECUITVE DIRECTOR | PersonTitleTxt |
| Phone | 8158752999 | PhoneNum |
| Signature | 2023-10-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PATRICIA | PersonFirstNm |
| Person Last | SCHOU | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2023-10-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICIA SCHOU | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1945 VANS WAY | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61356 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,565,632 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ICAHN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF ICAHN IS TO STRENGTHEN CRITICAL ACCESS AND SMALL, RURAL HOSPITALS THROUGH COLLABORATION. BETTER TOGETHER, ICAHN AND ITS 58 MEMBER HOSPITALS MAKE IT THEIR OVERARCHING GOAL TO PRESERVE ACCESS TO RURAL HEALTHCARE WHILE IMPROVING THE VIBRANCY AND VIABILITY OF THE COMMUNITIES SERVED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 30 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $17,447,257 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,447,784 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,816,059 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,076,486 | CYProgramServiceRevenueAmt |
| PY Investment Income | $57,514 | PYInvestmentIncomeAmt |
| CY Investment Income | $41,362 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $21,320,830 | PYTotalRevenueAmt |
| CY Total Revenue | $5,565,632 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $17,829,362 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,719,771 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,764,767 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,815,706 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,545,195 | PYOtherExpensesAmt |
| CY Other Expenses | $1,832,431 | CYOtherExpensesAmt |
| PY Total Expenses | $21,139,324 | PYTotalExpensesAmt |
| CY Total Expenses | $5,367,908 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $181,506 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $197,724 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,536,555 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,228,606 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,784,555 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,212,846 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,752,000 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,015,760 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ICAHN IS A NOT-FOR-PROFIT 501(C)(3) CORPORATION ESTABLISHED IN 2003 FOR THE PURPOSES OF SHARING RESOURCES, EDUCATION, PROMOTING EFFICIENCY AND BEST PRACTICE AND IMPROVING HEALTH CARE SERVICES FOR MEMBER CRITICAL ACCESS HOSPITALS AND THEIR RURAL COMMUNITIES. ICAHN, WITH 58 MEMBER HOSPITALS, IS AN INDEPENDENT NETWORK GOVERNED BY A NINE-MEMBER BOARD OF DIRECTORS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,603,740 | ExpenseAmt |
| Grant | $1,719,771 | GrantAmt |
| Revenue | $2,363,892 | RevenueAmt |
| Desc | ICAHN PROVIDES TECHNICAL ASSISTANCE TO SMALL RURAL HOSPITALS:1) TO HELP THEM WITH ADMINISTRATIVE PROCESSES FOR CRITICAL ACCESS HOSPITALS2) TO SHARE RESOURCES WITH MEMBERS3) TO IMPLEMENT PROGRAMS TO IMPROVE QUALITY AND EFFICIENCIES OF MEDICAL SERVICES PROVIDED BY RURAL HEALTH CARE FACILITIES.4) TO PROVIDE CODING SUPPORT WHEN HOSPITALS NEED COVERAGE FOR UNANTICIPATED CERTIFIED CODE ABSENCES, VACANCIES, OR BACKLOG SERVES APPROXIMATELY 58 HOSPITALS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $351,383 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $454,356 | RevenueAmt |
| Desc | ICAHN PROVIDES INFORMATION TECHNOLOGY ASSISTANCE TO SMALL RURAL HOSPITALS ACROSS THE STATE, SERVING APPROXIMATELY 58 HOSPITALS. SERVICES ARE AVAILABLE TO ALL 58 HOSPITALS IF THEY CHOOSE TO UTILIZE THEM. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $197,533 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $103,780 | RevenueAmt |
| Desc | IN SURVEY SOLUTIONS, ICAHN OFFERS A COMPREHENSIVE SURVEY APPROACH FOR SMALL AND RURAL HOSPITALS AND PRACTICES AT A COST-EFFECTIVE RATE, WHILE PROVIDING A STREAMLINED DATA REPORTING STRUCTURE FOR CMS AND OTHER AGENCIES FOR FURTHER NATIONAL BENCHMARKING STATISTICS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $145,173 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $154,458 | RevenueAmt |
| Desc | ICAHN PROVIDES QUALITY EDUCATIONAL OPPORTUNITIES TO MEMBER HOSPITALS FOCUSING ON RURAL HEALTH ISSUES AND STRATEGIES FOR SUCCESS THROUGH ONSITE MEETINGS, VIDEOCONFERENCING, AND WEB-BASED TRAINING. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $145,173 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $154,458 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $4,297,829 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 30 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA SCHOU | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8158752999 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1945 VANS WAY | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61356 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| PATRICIA SCHOU | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $273,132 | $0 | $25,031 | ||
| CURTIS ZIMMERMAN | |||||||
| DIRECTOR-BUSINESS SERVICES | 40.00 | $127,825 | $0 | $27,865 | Yes (X) | ||
| RYAN MORGAN | |||||||
| CHIEF INFO SECURITY OFFICER | 40.00 | $118,414 | $0 | $15,586 | Yes (X) | ||
| RYAN SIERMAN | |||||||
| IT CONSULTANT/CIO | 40.00 | $118,411 | $0 | $7,089 | Yes (X) | ||
| DIANE GARLAND | |||||||
| DIRECTOR OF FINANCE (THRU 06/22) | 40.00 | Yes (X) | $55,009 | $0 | $3,889 | ||
| WENDY HODGE | |||||||
| DIRECTOR OF FINANCE | 40.00 | Yes (X) | $27,806 | $0 | $1,779 | ||
| ALISA COLEMAN | |||||||
| PAST PRESIDENT (THRU 12/22) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PAUL SKOWRON | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TED ROGALSKI | |||||||
| PRESIDENT ELECT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KARISSA TURNER | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| REX BROWN | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JIM JOHNSON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| PAM PFISTER | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DON ROBBINS | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $720,597 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $81,239 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GREG DAVIS MD LTD | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 PARK AVENUE EAST | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61356 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL CONSULTING | ServicesDesc |
| Compensation | $150,000 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $486,200 | MembershipDuesAmt |
| Government Grants | $1,961,584 | GovernmentGrantsAmt |
| Total Contributions | $2,447,784 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| IL RURAL COMMUNITY CARE | 900099 | $1,083,526 | $1,083,526 |
| IT SERVICES | 541519 | $454,356 | $454,356 |
| MANAGED CARE | 541610 | $250,304 | $250,304 |
| SPONSOR/PARTNER REVENUE | 900099 | $231,959 | $231,959 |
| PROFESSIONAL EDUCATION | 611710 | $154,458 | $154,458 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $901,883 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $901,883 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,076,486 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,529 | TotalRevenueColumnAmt |
| Exclusion | $11,529 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,180 | SecuritiesAmt |
| Other | $13,653 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,180 | SecuritiesAmt |
| Other | $13,653 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,833 | TotalRevenueColumnAmt |
| Exclusion | $29,833 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,565,632 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,076,486 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $41,362 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,719,771 | TotalAmt |
| Program Services | $1,719,771 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $386,646 | TotalAmt |
| Program Services | $270,652 | ProgramServicesAmt |
| Management And General | $115,994 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,436 | TotalAmt |
| Program Services | $796,204 | ProgramServicesAmt |
| Management And General | $341,232 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,559 | TotalAmt |
| Program Services | $28,391 | ProgramServicesAmt |
| Management And General | $12,168 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,651 | TotalAmt |
| Program Services | $85,156 | ProgramServicesAmt |
| Management And General | $36,495 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,414 | TotalAmt |
| Program Services | $90,591 | ProgramServicesAmt |
| Management And General | $38,823 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,064 | TotalAmt |
| Program Services | $159,622 | ProgramServicesAmt |
| Management And General | $37,442 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,876 | TotalAmt |
| Management And General | $29,876 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,249 | TotalAmt |
| Management And General | $17,249 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $799,834 | TotalAmt |
| Program Services | $647,866 | ProgramServicesAmt |
| Management And General | $151,968 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $380,753 | TotalAmt |
| Program Services | $228,452 | ProgramServicesAmt |
| Management And General | $152,301 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,133 | TotalAmt |
| Program Services | $102,297 | ProgramServicesAmt |
| Management And General | $43,836 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,221 | TotalAmt |
| Program Services | $35,973 | ProgramServicesAmt |
| Management And General | $7,248 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,858 | TotalAmt |
| Program Services | $86,315 | ProgramServicesAmt |
| Management And General | $57,543 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,741 | TotalAmt |
| Program Services | $13,119 | ProgramServicesAmt |
| Management And General | $5,622 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,702 | TotalAmt |
| Program Services | $33,420 | ProgramServicesAmt |
| Management And General | $22,282 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,367,908 | TotalAmt |
| Program Services | $4,297,829 | ProgramServicesAmt |
| Management And General | $1,070,079 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,735,593 | BOYAmt |
| EOY | $2,118,899 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,160 | BOYAmt |
| EOY | $1,753,496 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $186,004 | BOYAmt |
| EOY | $28,526 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,151 | BOYAmt |
| EOY | $478,139 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,000 | BOYAmt |
| EOY | $85,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,500,664 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $396,127 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,144,645 | BOYAmt |
| EOY | $1,104,537 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $818,002 | BOYAmt |
| EOY | $644,019 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $15,225 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,536,555 | BOYAmt |
| EOY | $6,228,606 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,351,378 | BOYAmt |
| EOY | $216,687 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $885,883 | BOYAmt |
| EOY | $1,459,563 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $547,294 | BOYAmt |
| EOY | $521,371 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $15,225 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,784,555 | BOYAmt |
| EOY | $2,212,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,723,474 | BOYAmt |
| EOY | $3,986,131 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,526 | BOYAmt |
| EOY | $29,629 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,752,000 | BOYAmt |
| EOY | $4,015,760 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,536,555 | BOYAmt |
| EOY | $6,228,606 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $197,724 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$183,964 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $250,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,971,791 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,471,371 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,498,500 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,447,257 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,447,784 | CurrentTaxYearAmt |
| Total | $32,836,703 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,310,679 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,582,631 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,475,555 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,816,059 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,076,486 | CurrentTaxYearAmt |
| Total | $17,261,410 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,282,470 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,054,002 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,974,055 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,263,316 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,524,270 | CurrentTaxYearAmt |
| Total | $50,098,113 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $50,098,113 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,656 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,279 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $56,142 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $57,514 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,529 | CurrentTaxYearAmt |
| Total | $192,120 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,656 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,279 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $56,142 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $57,514 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,529 | CurrentTaxYearAmt |
| Total | $192,120 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $4,490 | CurrentTaxYearMinus3YearsAmt |
| Total | $4,490 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,315,126 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,092,771 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,030,197 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,320,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,535,799 | CurrentTaxYearAmt |
| Total | $50,294,723 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99610 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99590 | PublicSupportPY509Pct |
| Investment Income CY | 0.00380 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00400 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,501 | OtherCostOrOtherBasisAmt |
| Book Value | $25,501 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,099,024 | OtherCostOrOtherBasisAmt |
| Depreciation | $160,427 | DepreciationAmt |
| Book Value | $938,597 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $360,545 | OtherCostOrOtherBasisAmt |
| Depreciation | $235,700 | DepreciationAmt |
| Book Value | $124,845 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,594 | OtherCostOrOtherBasisAmt |
| Book Value | $15,594 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,104,537 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE OBLIGATION | Desc |
| Amt | $15,225 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,225 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $5,381,668 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$183,964 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$183,964 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,565,632 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $5,565,632 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,367,908 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,367,908 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,367,908 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (46 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| CARLE HOOPESTON REGIONAL HEALTH CENTER | ||||||||
| 701 E ORANGE ST | HOOPESTON | IL | 60942 | 261503640 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| CARLINVILLE AREA HOSPITAL | ||||||||
| 20733 N BROAD STREET | CARLINVILLE | IL | 62626 | 370645239 | 501(C)(3) | $31,660 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| CLAY COUNTY HOSPITAL | ||||||||
| 911 STACY BURKE DRIVE | FLORA | IL | 62839 | 010686913 | 501(C)(3) | $27,938 | $0 | 22 SHIP, 21 FLEX |
| COMMUNITY HOSPITAL OF STAUNTON | ||||||||
| 400 NORTH CALDWELL STREET | STAUNTON | IL | 62088 | 370624255 | 501(C)(3) | $11,938 | $0 | 22 SHIP |
| CRAWFORD MEMORIAL HOSPITAL | ||||||||
| 1000 NORTH ALLEN STREET | ROBINSON | IL | 62454 | 371241849 | 501(C)(3) | $11,938 | $0 | 22 SHIP |
| CROSSROADS COMMUNITY HOSPITAL | ||||||||
| 8 DOCTORS PARK RD | MT VERNON | IL | 62864 | 581622971 | 501(C)(3) | $11,938 | $0 | 22 SHIP |
| FAIRFIELD MEMORIAL HOSPITAL | ||||||||
| 303 NW 11TH ST | FAIRFIELD | IL | 62837 | 370661202 | 501(C)(3) | $21,500 | $0 | 22 SHIP, 21 FLEX |
| GENESIS MEDICAL CENTER | ||||||||
| 409 NW 9TH AVENUE | ALEDO | IL | 61231 | 454475683 | 501(C)(3) | $32,438 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| GIBSON AREA HOSPITAL & HEALTH SERVICES | ||||||||
| 1120 N MELVIN ST | GIBSON CITY | IL | 60936 | 364311943 | 501(C)(3) | $45,160 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| GRAHAM HOSPITAL | ||||||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | 370673506 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| HAMILTON MEMORIAL HOSPITAL DISTRICT | ||||||||
| 611 S MARSHALL AVE | MCLEANSBORO | IL | 62859 | 473192014 | 501(C)(3) | $280,638 | $0 | 22 SHIP, ARP SHIP, 22 FLEX GRANTS |
| HAMMOND HENRY HOSPITAL | ||||||||
| 600 NORTH COLLEGE AVENUE | GENESEO | IL | 61254 | 366008003 | GOV | $19,438 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| HARDIN COUNTY GENERAL HOSPITAL | ||||||||
| 6 FERRELL ROAD | ROSICLARE | IL | 62982 | 370702309 | 501(C)(3) | $23,660 | $0 | 22 SHIP |
| HILLSBORO AREA HOSPITAL | ||||||||
| 1200 EAST TREMONT ST | HILLSBORO | IL | 62049 | 370661208 | 501(C)(3) | $36,338 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| HOPEDALE MEDICAL CENTER | ||||||||
| 107 TREMONT ST | HOPEDALE | IL | 61747 | 370808925 | 501(C)(3) | $11,722 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| HORIZON HEALTH | ||||||||
| 721 EAST COURT ST | PARIS | IL | 61944 | 370860281 | 501(C)(3) | $27,297 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| HSHS HOLY FAMILY HOSPITAL | ||||||||
| 200 HEALTHCARE DR | GREENVILLE | IL | 62246 | 370792770 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| ILLINI COMMUNITY HOSPITAL | ||||||||
| 640 WEST WASHINGTON ST | PITTSFIELD | IL | 62363 | 371396010 | 501(C)(3) | $11,938 | $0 | 21 SHIP |
| JERSEY COMMUNITY HOSPITAL | ||||||||
| 400 MAPLE SUMMIT | JERSEYVILLE | IL | 62052 | 376013958 | 501(C)(3) | $11,938 | $0 | 21 SHIP |
| KIRBY MEDICAL CENTER | ||||||||
| 1000 MEDICAL CENTER DRIVE | MONTICELLO | IL | 61856 | 370661215 | 501(C)(3) | $14,938 | $0 | 21 SHIP |
| LAWRENCE COUNTY MEMORIAL HOSPITAL | ||||||||
| 2200 WEST STATE ST | LAWRENCEVILLE | IL | 62439 | 800618988 | 501(C)(3) | $264,478 | $0 | 22 SHIP, ARP SHIP, 22 FLEX GRANTS |
| MARSHALL BROWNING HOSPITAL | ||||||||
| 900 N WASHINGTON ST | DUQUOIN | IL | 62832 | 370661218 | 501(C)(3) | $19,222 | $0 | 22 SHIP |
| MASON DISTRICT HOSPITAL | ||||||||
| 615 N PROMENADE ST | HAVANA | IL | 62644 | 376017857 | GOV | $11,938 | $0 | 21 SHIP |
| MASSAC MEMORIAL HOSPITAL | ||||||||
| 28 CHICK ST | METROPOLIS | IL | 62960 | 370857853 | GOV | $5,875 | $0 | 21-22 FLEX |
| MEMORIAL HOSPITAL - CARTHAGE | ||||||||
| 1454 N COUNTY ROAD 2050 | CARTHAGE | IL | 62321 | 370662570 | 501(C)(3) | $48,500 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| MEMORIAL HOSPITAL - CHESTER | ||||||||
| 1900 STATE STREET | CHESTER | IL | 62233 | 376020801 | 501(C)(3) | $5,552 | $0 | 21-22 FLEX |
| MERCY HARVARD HOSPITAL | ||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 311551871 | 501(C)(3) | $30,222 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| MIDWEST MEDICAL CENTER | ||||||||
| 1 MEDICAL CENTER DRIVE | GALENA | IL | 61036 | 204560540 | 501(C)(3) | $16,938 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| MORRISON COMMUNITY HOSPITAL | ||||||||
| 303 N JACKSON ST | MORRISON | IL | 61270 | 366008167 | GOV | $28,938 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL | ||||||||
| 1302 NORTH MAIN STREET | SANDWICH | IL | 60548 | 364244337 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| OSF ST CLARE MEDICAL CENTER | ||||||||
| 530 PARK AVENUE EAST | PRINCETON | IL | 61356 | 366006057 | 501(C)(3) | $8,000 | $0 | 22 FLEX GRANTS |
| OSF ST LUKE MEDICAL CENTER | ||||||||
| 1051 WEST SOUTH ST | KEWANEE | IL | 61443 | 362167767 | 501(C)(3) | $8,000 | $0 | 22 FLEX GRANTS |
| OSF ST PAUL MEDICAL CENTER | ||||||||
| 1401 EAST 12TH STREET | MENDOTA | IL | 61342 | 362167785 | 501(C)(3) | $7,500 | $0 | 22 FLEX GRANTS |
| PANA COMMUNITY HOSPITAL | ||||||||
| 101 EAST NINTH ST | PANA | IL | 62557 | 376062326 | 501(C)(3) | $15,490 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| PINCKNEYVILLE COMMUNITY HOSPITAL | ||||||||
| 101 NORTH WALNUT STREET | PINCKNEYVILLE | IL | 62274 | 376006955 | GOV | $27,438 | $0 | 21 SHIP, 22 SHIP, 22 FLEX GRANTS |
| RED BUD REGIONAL HOSPITAL | ||||||||
| 325 SPRING ST | RED BUD | IL | 62278 | 364443919 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| RICHLAND MEMORIAL HOSPITAL | ||||||||
| 800 EAST LOCUST | OLNEY | IL | 62450 | 371363001 | 501(C)(3) | $11,722 | $0 | 22 SHIP |
| ROCHELLE COMMUNITY HOSPITAL | ||||||||
| 900 NORTH SECOND ST | ROCHELLE | IL | 61068 | 362548549 | 501(C)(3) | $7,500 | $0 | 22 FLEX GRANTS |
| SALEM TOWNSHIP HOSPITAL | ||||||||
| 1201 RICKER DRIVE | SALEM | IL | 62881 | 370925318 | GOV | $17,238 | $0 | 22 FLEX GRANTS, 22 SHIP |
| SARAH D CULBERTSON MEMORIAL HOSPITAL | ||||||||
| 238 SOUTH CONGRESS AVE | RUSHVILLE | IL | 62681 | 376006672 | GOV | $32,938 | $0 | 22 FLEX GRANTS, 22 SHIP |
| SPARTA COMMUNITY HOSPITAL DISTRICT | ||||||||
| 818 EAST BROADWAY | SPARTA | IL | 62286 | 376014817 | GOV | $25,438 | $0 | 22 FLEX GRANTS, 22 SHIP |
| ST JOSEPH'S HOSPITAL | ||||||||
| 12866 TROXLER AVE | HIGHLAND | IL | 62249 | 370663568 | 501(C)(3) | $7,500 | $0 | 22 FLEX GRANTS |
| THOMAS H BOYD MEMORIAL HOSPITAL | ||||||||
| 800 SCHOOL ST | CARROLTON | IL | 62016 | 370673461 | 501(C)(3) | $10,500 | $0 | 22 FLEX GRANTS |
| WABASH GENERAL HOSPITAL | ||||||||
| 1418 COLLEGE DR | MT CARMEL | IL | 62863 | 376013625 | GOV | $15,500 | $0 | 22 FLEX GRANTS |
| WARNER HOSPITAL & HEALTH SERVICES | ||||||||
| 422 WEST WHITE ST | CLINTON | IL | 61727 | 371380376 | 501(C)(3) | $28,438 | $0 | 22 FLEX GRANTS, 22 SHIP |
| WASHINGTON COUNTY HOSPITAL | ||||||||
| 705 S GRAND | NASHVILLE | IL | 62263 | 376020408 | GOV | $29,938 | $0 | 22 FLEX GRANTS, 22 SHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 47 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ONCE IT IS DETERMINED THAT AN INDIVIDUAL OR ORGANIZATION WILL BE RECEIVING A GRANT AWARD, THEY ARE ISSUED A TRACKING NUMBER AND ENTERED INTO THE GRANT MONITORING DATABASE. THE DATABASE INCLUDES CONTACT INFORMATION FOR THE RECIPIENT, AS WELL AS PAYMENT TERMS, DATE, CHECK NUMBER, AND PAYMENT AMOUNT. AT THE END OF THE GRANT TERM OUTLINED IN THE GRANT AGREEMENT PROVIDED TO THE RECIPIENT A FINAL REPORT IS COMPLETED BY THE RECIPIENT AND SENT BACK TO ICAHN THROUGH THE MAIL OR ELECTRONICALLY WITH A SIGNATURE. ICAHN THEN REVIEWS THE REPORT AND COMPARES IT TO THE AGREEMENT TO ENSURE GRANT FUNDS WERE SPENT AS OUTLINED ON OCCASION. IF A RECIPIENT'S PROJECT IS NEEDED TO CHANGE DUE TO UNFORESEEN CIRCUMSTANCES, THE GRANTEE IS INSTRUCTED TO REQUEST WRITTEN PERMISSION FROM ICAHN AUTHORIZING THE CHANGE. A COPY OF THIS CORRESPONDENCE IS PLACED IN THE RECIPIENT'S GRANT FILE DOCUMENTING THE CHANGE TO THE GRANT PROJECT WHEN THE GRANT REPORT IS RECEIVED BY ICAHN. IT CAN THEN BE NOTED THAT THERE WAS AN AUTHORIZED CHANGE TO THE GRANT PROJECT. IN ADDITION TO THESE TRACKING PROCESSES, THE OPERATIONS COORDINATOR PERFORMS ONSITE VISITS TO GRANT RECIPIENTS OVER THE COURSE OF THE YEAR. DURING THESE VISITS, DOCUMENTATION SUCH AS INVOICES, RECEIPTS, AND FINANCIAL STATEMENTS ARE REVIEWED WITH COPIES OBTAINED, TO ENSURE GRANT FUNDS HAVE BEEN SPENT ON OUTLINED PROJECTS. THE OPERATIONS COORDINATOR PERFORMS ABOUT 12 ONSITE GRANT REVIEW VISITS PER YEAR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICIA SCHOU | ||||||||||||||
| EXECUTIVE DIRECTOR | $251,900 | $0 | $20,000 | $0 | $1,232 | $0 | $8,157 | $0 | $16,874 | $0 | $298,163 | $0 | $0 | $0 |
| CURTIS ZIMMERMAN | ||||||||||||||
| DIRECTOR-BUSINESS SERVICES | $112,798 | $0 | $13,874 | $0 | $1,153 | $0 | $4,131 | $0 | $23,734 | $0 | $155,690 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 5 | FormAndLineReferenceDesc |
| Explanation | THE SENIOR DIRECTOR OF BUSINESS SERVICES IS PAID AN INCENTIVE ON A PERCENTAGE OF THE INSURANCE REVENUES PAID TO ICAHN DURING THE YEAR. ADDITIONAL INCENTIVES ARE PAID ON NEW BUSINESS PARTNER SPONSORSHIPS ADDED DURING THE YEAR, AND ON NEW ACCOUNTS ADDED UNDER CERTAIN BUSINESS SERVICE LINES, INCLUDING CVO SERVICES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. AS OF 2022 THE MEMBERSHIP DUES FOR THE YEAR ARE $8,600. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO THE FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONNAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECUTIVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY TWO TO THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTOR'S SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | MANAGED CARE: PROGRAM SERVICE EXPENSES 314,873. MANAGEMENT AND GENERAL EXPENSES 73,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 388,732. OTHER FEES: PROGRAM SERVICE EXPENSES 328,940. MANAGEMENT AND GENERAL EXPENSES 77,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 406,098. EDUCATION: PROGRAM SERVICE EXPENSES 4,053. MANAGEMENT AND GENERAL EXPENSES 951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,004. |
| FORM 990, PART XI, LINE 9: | TRANSFER FROM MEMBERS 250,000. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS RURAL COMMUNITY CARE ORGANIZATION LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1945 VANS WAY | AddressLine1Txt |
| City | PRINCETON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61356 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 465654316 | EIN |
| Primary Activities | DEVELOP SYSTEMS OF CLINICAL INTEGRATION & EFFICIENCIES FOR MEMBER HOSPITALS | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Total Income | $930,912 | TotalIncomeAmt |
| End Of Year Assets | $1,432,636 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK | BusinessNameLine1Txt |