2023-10-04T09:33:41-05:00 2022-12-31 990 2022-01-01 362181997 FREEPORT MEMORIAL HOSPITAL FREE 8155996209 1045 W STEPHENSON ST FREEPORT IL 61032 MICHAEL C CLARK CHIEF FINANCIAL OFFICER 8155996361 2023-10-04 0 MICHAEL CLARK 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK S GRIDLEY CEO 1045 W STEPHENSON ST FREEPORT IL 61032 168885534 0 X WWW.FHN.ORG X 1964 IL OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES, WORKING TOGETHER WITH THOSE WE SERVE. 11 10 1129 0 37411 31278 210921 894084 168398949 167336050 1230706 655400 0 0 169840576 168885534 0 0 0 0 50258270 54718409 0 0 0 88722373 97632467 138980643 152350876 30859933 16534658 127271445 106715723 36970099 29909259 90301346 76806464 X SEE SCHEDULE O 0 0 79252553 132619010 FREEPORT MEMORIAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS IN FIVE NORTHWESTERN ILLINOIS COUNTIES. THE HOSPITAL ENSURES CONTINIUED ACCESS TO CARE BY SERVING PATIENTS IN MEDICALLY UNDERSERVED AREAS. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW-INCOME PATIENTS. 65867266 35326842 OTHER UNCOMPENSATED CARE: THE HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELLY 72% OF ITS' PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT THE REIMBURSEMENT RATES OF THESE PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COST OF SERVICE FOR MEDICARE PATIENTS WAS APPROXIMATELY $20,992,672 AND MEDICAID PATIENTS WAS APPROXIMATELY $9,547,752 FOR THE YEAR ENDING 12/31/2022. 3103323 648870 CHARITY CARE: THE HOSPITAL PROVIDED CHARITY CARE BENEFITS FOR PATIENTS WHOSE INCOME WAS UP TO 300% OF THE FEDERALLY DETERMINED PROVERTY LEVEL. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO APPROXIMATELY $3,103,323 IN 2022. ESTIMATED COSTS OF PROVIDING THESE SERVICES AMOUNTED TO APPROXIMATELY $648,870 IN 2022. OTHER COMMUNITY BENEFITS: THE HOSPITAL OPERATES AND SUPPORTS A NUMBER OF COMMUNITY BENEFIT PROGRAMS THAT INCLUDE BUT ARE NOT LIMITED TO COMMUNITY HEALTH EDUCATION, HEALTH CARE SUPPORT SERVICES AND HEALTH PROFESSIONAL EDUCATION. 148223142 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 57 0 1 1129 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X MICHAEL CLARK CFO 8155996209 1045 W STEPEHNSON ST FREEPORT IL 61032 NEAL RICHARDSON CHAIRMAN 0.50 X 0 0 0 HEATHER MCPHERSON VICE CHAIRMAN 0.50 X 0 0 0 MARK WRIGHT TREASURER 0.50 X 0 0 0 RICHARD CHANG SECRETARY 0.50 X 0 0 0 STEVEN KNEUBUEHL PAST CHAIRMAN 0.50 X 0 0 0 AMY BAKER BOARD MEMBER 0.50 X 0 0 0 BRUCE BALDWIN BOARD MEMBER 0.50 X 0 0 0 GARY QUINN BOARD MEMBER 0.50 X 0 0 0 GLENDA KOELLER BOARD MEMBER 0.50 X 0 0 0 DAN SCHMITT BOARD MEMBER 0.50 X 0 0 0 SHOKRY TAWFIK MD BOARD MEMBER 0.50 X 0 0 170 MARK S GRIDLEY PRESIDENT/CEO 25.00 15.00 X 457856 280621 67771 MICHAEL C CLARK EXECUTIVE VP/CFO 25.00 15.00 X 260346 159567 64149 LEONARD CARTER CHIEF HUMAN RESOURCES OFFI 25.00 15.00 X 179260 109869 40624 BETH KALNINS MD MEDICAL STAFF 40.00 X 318276 0 29290 REBECCA PEDERSON MD CHIEF QUALITY OFFICER 1.00 40.00 X 0 432650 39477 ROBERT GELLER MD HEAD OF INFECTIOUS DISEASES 1.00 40.00 X 0 284882 31715 TIMOTHY JESSEN MD CHAIR PHYSICIANS COUNCEL 0.50 X 0 253178 50270 CLARENCE PARKS MD PRESIDENT MEDICAL STAFF 40.00 X 562609 0 2351 KATHRYN J MARTINEZ VP OF PATIENT SERVICE 40.00 X 338247 0 36850 ARSHAD SHAIKH MD PHYSICIAN 40.00 X 786410 0 35418 KEITH MARTIN MD PHYSICIAN 40.00 X 470288 0 2772 MAAJID EKKISWALA PHYSICIAN 40.00 X 334543 0 38604 IRENA MARKOVIC MD PHYSICIAN 40.00 X 430953 0 32606 KARENMARIE MEYER MD PHYSICIAN 40.00 X 313889 0 19392 4452677 1520767 491459 70 0 1 0 FREEPORT EMERGENCY SPECIALISTS 1200 HARGER RD STE 408 OAK BROOK IL 60523 MEDICAL SERVICE 5102021 CAMOLOT RADIOLOGY 3849 N PERRYVBILLE RD ROCKFORD IL 61108 RADIOLOGY PHYSICIANS 3172770 ILLINOIS PROVIDER TRUST 27217 NETWORK PLACE CHICAGO IL 60673 FINANCE 1625872 ROCKFORD ANESTHESIOLOGIST ASSOC 2202 HARLEM RD STE 200 LOVES PARK IL 61111 HEALTHCARE 1616120 POG MANAGEMENT LLC 795 W 7TH STREET DUBUQUE IA 52001 MANAGEMENT 1413160 38 894084 894084 PATIENT REVENUE 621400 157677274 157639863 37411 PROVIDER TAX REVENUE 621400 8982608 8982608 GOVERNMENT PAYMENT 621400 605276 605276 OTHER INCOME 621400 60777 60777 CAFETERIA REVENUE 621400 9684 9684 431 431 167336050 488599 488599 166801 0 166801 166801 166801 168885534 167465440 37411 488599 X 2292063 1287623 1004440 40262357 39132226 1130131 9187698 9187698 2976291 2831952 144339 20035 20035 94597 94597 1243288 1243288 74547 71824 2723 183022 80991 102031 9905 9905 4428417 4320808 107609 760863 760863 DRUGS 14802181 14802174 7 SUPPLIES 13385323 13147848 237475 CORPORATE ALLOCATION 13102677 13102677 MEDICAL SPECIALIST 12792536 12792536 36735076 35460634 1274442 152350876 148223142 4127734 0 64974007 46906301 24902926 21413702 759280 1514903 3085204 3146402 3600575 3453504 102664896 83341058 20557856 19323838 4314953 3938778 5076644 7018295 127271445 106715723 30587514 22366234 6382585 7543025 36970099 29909259 X 87714653 74112259 2586693 2694205 90301346 76806464 127271445 106715723 X 16534658 -1544396 -7405 -28477739 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 28090 28090 0 PART II-B, LINE 1: PORTION OF 2022 ILLINOIS HOSPITAL ASSOCIATION DUES USED FOR LOBBYING - $19,809. PORTION OF 2022 AMERICAN HOSPITAL ASSOCIATION DUES USED FOR LOBBYING - $8,281. 944945 944945 54291314 45207685 9083629 2222791 1824223 398568 43519180 35560326 7958854 1686666 748824 937842 19323838 FHM CLAIMS INSURANCE RECEIVABLE 2712763 SECURITY DEPOSIT 2649771 ROU LEASE 1655761 7018295 ACCRUED MALPRACTICE LIABILITY 794663 ASSET RETIREMENT OBLIGATION 1685777 MALPRACTICE LIABILITY LONG TERM 3384069 OTHER LIABILITIES 6456 LT LEASE LIABILITY 554830 ST LEASE LIABILITY 1117230 7543025 1 1 1 X 1 X 1 1 0 1 1 724936 724936 0.00480 29849545 20301793 9547752 0.06270 30574481 20301793 10272688 0.06750 129423 1007 128416 0.00080 111930 111930 0.00070 260490 260490 0.00170 41323 41323 0.00030 543166 1007 542159 0.00350 31117647 20302800 10814847 0.07100 35242 35242 0.00020 35242 35242 0.00020 1 1947142 15025049 36017721 -20992672 X 1 1 1 1 FREEPORT MEMORIAL HOSPITAL 1045 WEST STEPHENSON STREET FREEPORT IL 61032 X X X FREEPORT MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.FHN.ORG X 1 22 1 WWW.FHN.ORG 0 1 X 125.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X WWW.FHN.ORG X WWW.FHN.ORG X WWW.FHN.ORG X X X X X 1 X X 1 X X X X 1 X 0 0 PART I, LINE 7: SCHEDULE H PART I LINE 7 COLUMN(F): OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) WAS $152,350,876. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $8,336,031 THIS LEFT US WITH A TOTAL EXPENSE OF $144,014,845 FOR PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART I, LN 7 COL(F): SCHEDULE H PART I LINE 7: OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) $152,350,876. THE BAD DEBT EXPENSES INCLUDED IN THIS AMOUNT WAS $8,336,031. THIS LEFT US A TOTAL EXPENSES OF $144,014,845 FOR THE PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART III, LINE 4: LINE #2: THE RATIO OF PATIENT CARE COST TO CHARGES AS DETERMINED ON WORKSHEET 2 IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2.LINE # 3: NO BAD DEBT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING THE MEDICARE COST-TO-CHARGE RATIO FROM OUR FILED 12/31/22 MEDICARE COST REPORT.COMMUNITY BENEFIT: WE BELIEVE THAT ALL OF THE 20.99 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE OF THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORDED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 55% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF MEDICARE BENEFICIARIES.0 PART III, LINE 9B: INDIVIDUALS APPROVED FOR ASSISTED CARE ARE GIVEN A CARD WHICH IS TYPICALLY VALID FOR 6 MONTHS. THEY PRESENT THE CARD WHEN THEY RECEIVE SERVICES. INDIVIDUALS APPROVED FOR ASSISTED CARE WILL BE ASKED TO MAKE A MODEST CO-PAY AT THE TIME OF SERVICE, BASED ON THE FOLLOWING SCHEDULE:HOSPITAL INPATIENT SERVICES: $50HOSPITAL EMERGENCY DEPARTMENT: $35HOSPITAL OUTPATIENT SERVICES: $25OUR COLLECTION POLICIES ARE THE SAME FOR ALL OF OUR PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, AN APPLICATION FOR ASSISTED CARE IS SENT TO THE PATIENT. AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN OFF. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE EXISTING DEBT COLLECTION POLICY. COVERAGE FOR THE ASSISTED CARE PROGRAM IS FOR 6 MONTHS AFTER WHICH TIME PATIENTS CAN REAPPLY IF THEY CONTINUE TO MEET THE GUIDELINES ESTABLISHED. PART VI, LINE 7, REPORTS FILED WITH STATES IL SCHEDULE H PART I LINE 6A: ANNUAL COMMUNITY BENEFIT REPORT - OUR ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR THE FHN NETWORK AS A WHOLE AND IS INCLUDED AS A NON-AUDITED SCHEDULE ON THE AUDITED FINANCIAL STATEMENTS. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 MARK S GRIDLEY PRESIDENT/CEO 323317 198162 0 0 134539 82459 12710 7790 29308 17963 499874 306374 0 0 MICHAEL C CLARK EXECUTIVE VP/CFO 175713 107695 0 0 84633 51872 12710 7790 27063 16586 300119 183943 0 0 LEONARD CARTER CHIEF HUMAN RESOURCES OFFI 127252 77993 0 0 52008 31876 0 0 25187 15437 204447 125306 0 0 BETH KALNINS MD MEDICAL STAFF 277207 0 34378 0 6691 0 0 0 29290 0 347566 0 0 0 REBECCA PEDERSON MD CHIEF QUALITY OFFICER 0 388242 0 43142 0 1266 0 0 0 39477 0 472127 0 0 ROBERT GELLER MD HEAD OF INFECTIOUS DISEASES 0 228697 0 36234 0 19951 0 0 0 31715 0 316597 0 0 TIMOTHY JESSEN MD CHAIR PHYSICIANS COUNCEL 0 204088 0 36426 0 12664 0 17524 0 32746 0 303448 0 0 CLARENCE PARKS MD PRESIDENT MEDICAL STAFF 454366 0 35156 0 73087 0 0 0 2351 0 564960 0 0 0 KATHRYN J MARTINEZ VP OF PATIENT SERVICE 260021 0 0 0 78226 0 0 0 36850 0 375097 0 0 0 ARSHAD SHAIKH MD PHYSICIAN 626776 0 92634 0 67000 0 0 0 35418 0 821828 0 0 0 KEITH MARTIN MD PHYSICIAN 373667 0 36893 0 59728 0 0 0 2772 0 473060 0 0 0 MAAJID EKKISWALA PHYSICIAN 298659 0 35156 0 728 0 0 0 38604 0 373147 0 0 0 IRENA MARKOVIC MD PHYSICIAN 394938 0 35156 0 859 0 0 0 32606 0 463559 0 0 0 KARENMARIE MEYER MD PHYSICIAN 293148 0 0 0 20741 0 0 0 19392 0 333281 0 0 0 PART I, LINE 1A FREEPORT MEMORIAL HOSPITAL REIMBURSED A DIRECTOR/TRUSTEE FOR BUSINESS TRAVEL EXPENSES INCLUDING TRAVEL EXPENSES FOR A SPOUSE. GARY QUINN BOARD OF DIRECTORS 77684 GARY QUINN DAUGHTER-IN-LAW WORKS FOR THE ORGANIZATION. 0 MICHAEL CLARK CHIEF FINANCIAL OFFICER 44273 MICHAEL C. CLARK DAUGHTER WORKS FOR THE ORGANIZATION. 0 BRUCE BALDWIN BOARD OF DIRECTORS 12636 BRUCE BALDWIN SPOUSE IS EMPLOYED BY THE ORGANIZATION. 0 BRUCE BALDWIN BOARD OF DIRECTORS 27690 BRUCE BALDWIN SISTER IS EMPLOYED BY THE ORGANIZATION. 0 KATHRYN MARTINEZ CHIEF OPERATING OFFICER/CHIEF NURSING OFFICER 170409 SPOUSE WORKS FOR THE ORGANIZATION 0 BRUCE BALDWIN BOARD OF DIRECTORS 52887 BRUCE BALDWIN NIECE IS EMPLOYED BY THE ORGANIZATION 0 STEPHEN J HARWEGER CNP PLANNING FINANCE COMMITTEE 70132 SPOUSE EMPLOYED BY ORGANOZATION. 0 STEPHEN J HARWEGER CNP PLANNING FINANCE COMMITTEE 117454 MOTHER-IN-LAW EMPLOYED BY THE ORGANIZATION 0 PART III LINE 1 FHN IS REGIONAL HEALTHCARE SYSTEM COMMITTED TO THE HEALTH AND WELL-BEING OF THE PEOPLE OF NORTHWEST ILLINOIS AND SOUTHERN WISCONSIN. WE HAVE SERVICES FOR ALL AGES, SO EVERY MEMBER OF YOUR FAMILY CAN RECEIVE CARING, PERSONAL, PROFESSIONAL HEALTHCARE. AN AVERAGE OF 1,400 PEOPLE VISIT FHN EACH DAY FOR THEIR HEALTHCARE NEEDS (THAT'S MORE THAN 525,000 PATIENTS PER YEAR). FHN IS THE ONLY HEALTHCARE PROVIDER IN OUR SERVICE AREA THAT OFFERS AFFILIATIONS WITH THREE MAJOR HOSPITALS IN ROCKFORD, ILLINOIS, AS WELL AS WITH THE UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS IN MADISON, WISCONSIN. WE SEE EACH PATIENT INTERACTION AS A SERIOUS RESPONSIBILITY THAT REQUIRES CLINICAL EXPERTISE, ACCESS TO THE LATEST IN MEDICAL TECHNOLOGY AND A LEVEL OF TRUST AND COMMITMENT THAT IS EARNED BY OUR PEOPLE, OUR PRODUCTS AND OUR PROCESS. ABOUT FHN MEMORIAL HOSPITAL: 146 LICENSED BED. 24-HOUR EMERGENCY CARE. EICU UNIT, LINKING OUR EXPERIENCED, CARING STAFF ROUND-THE-CLOCK WITH THE UNIVERSITY OF WISCONSIN E-CARE TEAM OF PROFESSIONAL INTENSIVISTS AND CRITICAL CARE NURSES. SATELLITE EDUCATION CENTER FOR THE ILLINOIS POISON CONTROL CENTER (ONE OF ONLY 12 IN THE STATE OF ILLINOIS). OVER 75 PHYSICIANS ON THE ACTIVE AND ASSOCIATED MEDICAL STAFF - 100% ARE BOARD-CERTIFIED OR BOARD-ELIGIBLE. UP-TO-THE-MINUTE EQUIPMENT AND SERVICES, INCLUDING A CARDIOVASCULAR CENTER. SURGERY CAPABILITIES FOR PROCEDURES RANGING FROM A SIMPLE TONSILLECTOMY TO SOPHISTICATED VASCULAR SURGERY. SPECIALTY SERVICE AREAS SUCH AS SLEEP CENTER, PAIN CLINIC, SPINE CENTER AND FAMILY BIRTHING CENTER. AS PART OF YOUR COMMUNITY, WE WILL PROVIDE PERSONAL, PROFESSIONAL AND CARING HEALTHCARE FOR YOUR ENTIRE FAMILY. WE WILL PROVIDE OR FIND SERVICES YOU NEED TO MAKE YOUR LIFE BETTER. WE WILL FOLLOW THROUGH AND MAKE SURE YOU ARE SATISFIED. WE ARE COMMITTED TO EXCELLENCE AND YOUR WELL-BEING IS THE REASON FOR OUR EXISTENCE. WE ARE PART OF YOUR COMMUNITY. AND WE WANT TO KEEP IT HEALTHY, BOTH ECONOMICALLY AND PHYSICALLY, AT WORK, AT PLAY, ON THE FARM, AT SCHOOL AND AT HOME. IN 2006, WE FORMED A PARTNERSHIP WITH THE STEPHENSON COUNTY HEALTH DEPARTMENT TO PROVIDE HEALTHCARE SERVICES FOR THE UNINSURED, UNDERINSURED AND MEDICALLY INDIGENT AT THE FHN COMMUNITY HEALTHCARE CENTER, LOCATED AT THE FORMER CRUSADER COMMUNITY CLINIC INSIDE THE HEALTH DEPARTMENT BUILDING. AND IN SUPPORT OF THE LOCAL UNITED WAY, EACH YEAR OUR EMPLOYEES MAKE THEIR PERSONAL CONTRIBUTIONS, AVERAGING OVER $40,000, AND ALSO SERVE IN LEADERSHIP POSITIONS FOR MANY COMMUNITY ORGANIZATIONS AND BOARDS. FHN IS A COMMUNITY HEALTHCARE SYSTEM, COMPRISED OF LOCAL EXPERTS, INSPIRED BY GLOBAL INNOVATION AND GROUNDED BY ETHICAL LEADERSHIP. FREEPORT MEMORIAL HOSPITAL COORDINATES AND INTEGRATES MEDICAL CARE SERVICES AND PROVIDES INDIVIDUALS IMPARTIAL ACCESS TO MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR SOURCE OF PAYMENT. THE HOSPITAL PROVIDES MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW INCOME PATIENTS. INSURED AND UNDERINSURED PATIENTS, WHO MEET CERTAIN FEDERAL POVERTY GUIDELINES AND/OR OTHER UNIQUE CIRCUMSTANCES, ARE PROVIDED FREE OR DISCOUNTED CARE AFTER A NOMINAL CO-PAYMENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. DURING 2022, THE CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE HOSPITAL'S CHARITY CARE POLICY WAS $3,103,323 AT A COST OF $684,870. FREEPORT MEMORIAL HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 72% OF ITS PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT, THE REIMBURSEMENT RATES FOR BOTH PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COSTS OF SERVICES FOR MEDICAID PATIENTS WERE APPROXIMATELY $9,547,752 FOR THE YEAR ENDING 12/31/2022. MEDICARE PAYMENTS WERE APPROXIMATELY $20,992,672 LESS THAN THE HOSPITAL'S COST TO PROVIDE CARE DURING THE SAME PERIOD. IN ADDITION, THE COST OF CARE PROVIDED TO PEOPLE WHO DID NOT PAY WAS $1,947,142 IN 2022. FREEPORT MEMORIAL HOSPITAL PROVIDES DISCOUNTS TO UNINSURED PATIENTS WITHOUT REGARD TO THEIR INCOME. THE ESTIMATED COSTS ATTRIBUTABLE TO THE DISCOUNTED PORTION OF THESE SERVICES WERE $260,489 FOR 2022. FREEPORT MEMORIAL HOSPITAL AND ITS RELATED ORGANIZATIONS SUPPORT AND PARTICIPATE IN MANY COMMUNITY SERVICES AND OUTREACH PROGRAMS, INCLUDING SUPPORT FOR COMMUNITY HEALTH EDUCATION PROGRAMS, COMMUNITY-BASED CLINICAL SERVICES, HEALTH PROFESSIONAL EDUCATION, RESEARCH, SPONSORSHIP OF COMMUNITY EVENTS, AND COMMUNITY-BUILDING ACTIVITIES. THE HOSPITAL CONTRIBUTED $586,144 TOWARDS THESE PROGRAMS IN 2022. PROGRAM SERVICE EXPENSES: $148,223,142 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S AUDIT COMMITTEE REVIEWS THE FORM 990 BEFORE THE TAX RETURN IS FILED. QUESTIONS AND EXPLANATIONS ARE ANSWERED BY THE FINANCE DEPARTMENT TO THE COMMITTEE'S SATSIFACTION. THE BOARD REVIEWS ALL TRANSACTIONS THAT AFFECT THE FILING OF THE ORGANIZATION'S FORM 990 AND EQUIVALENT STATE RETURNS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A DEDICATED CORPORATE COMPLIANCE OFFICER. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE. THESE DOCUMENTS ARE REVIEWED BY THE CCO TO DETERMINE IF ANY INDIVIDUAL HAS A CONFLICT OF INTEREST THAT NEEDS TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS THE CEO, TOP MANAGEMENT AND EXECUTIVE DIRECTORS COMPENSATION. THE COMMITTEE RELIES ON INTERNAL AND EXTERNAL INFORMATION TO DETERMINE THE APPROPRIATE COMPENSATION AND EMPLOYS AN INDEPENDENT THIRD PARTY TO CONDUCT THE ANNUAL EXECUTIVE COMPENSATION ANALYSIS. THIS ANALYSIS IS USED TO DETERMINE IF THE BOARD'S WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY HAS BEEN MET. THE EXECUTIVE COMPENSATION COMMITTEE ALSO RECEIVES A REASONABLENESS LETTER FROM THE THIRD PARTY. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 24E CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 11,189,808. MANAGEMENT AND GENERAL EXPENSES 278,866. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,468,674. BAD DEBTS: PROGRAM SERVICE EXPENSES 8,336,031. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,336,031. AGENCY STAFFING: PROGRAM SERVICE EXPENSES 6,811,400. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,811,400. PROVIDER TAX: PROGRAM SERVICE EXPENSES 4,856,239. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,856,239. MAINTENANCE/REPAIRS: PROGRAM SERVICE EXPENSES 3,238,859. MANAGEMENT AND GENERAL EXPENSES 208,266. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,447,125. MISC. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 793,023. MANAGEMENT AND GENERAL EXPENSES -4,580. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 788,443. COLLECTION FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 779,063. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 779,063. FOOD: PROGRAM SERVICE EXPENSES 235,274. MANAGEMENT AND GENERAL EXPENSES 12,827. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 248,101. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY TRANSFERS FROM AFFILIATE -28,585,251. NET ASSETS RELEASED FROM TEMP. RESTRICTION -852,268. CONTRIBUTIONS TEMPORARY RESTRICTED 959,780. PART XII LINE 2C NO CHANGES HAVE BEEN MADE TO THE SELECTION OF THE PROCESS FOR THE INDEPENDENT AUDITOR. FREEPORT REGIONAL HEALTH CARE FOUNDATION 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363290904 HEALTH CARE IL 501(C)(3) LINE 11 N/A 0 FREEPORT REGIONAL HEALTHCARE SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363967303 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 FREEPORT REGIONAL MANAGEMENT SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363994636 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 362879689 HEALTH CARE IL 501(C)(3) LINE 7 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS HEALTHCARE SERVICES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363677357 HEALTH CARE IL 501(C)(3) LINE 11 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 MEMORIAL ENTERPRISES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363353871 HEALTH CARE IL FREEPORT REGIONAL HEALTH CARE FOUNDATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0