2023-11-15T14:43:08+00:00 2022-12-31 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE INDIANAPOLIS IN 462045100 990 2022-01-01 371363001 RICHLAND MEMORIAL HOSPITAL RICH 6183952131 800 EAST LOCUST STREET OLNEY IL 62450 DENNIS HESCH EXEC VP & CFO 6183952131 2023-11-15 true DENNIS HESCH 999009999 Jennifer D Rhoderick P00395735 3176817000 2023-11-12 2022 2023-04-26 12:10:37Z DENNIS HESCH EXEC VP & CFO 611 W PART ST URBANA IL 61801 63787432 false X https://carle.org/LOCATIONS/CARLE-RICHLAND-MEMORIAL-HOSPITAL X 1953 IL TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY. 11 7 507 54 463992 0 2055880 2755502 51779241 59309027 87875 40627 958547 724228 54881543 62829384 226587 74527 0 34209626 40721287 0 0 28250546 31003925 62686759 71799739 -7805216 -8970355 31450471 26663290 16108992 13457935 15341479 13205355 TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY. false false 62550297 74527 59359220 RICHLAND MEMORIAL HOSPITAL, INC., DBA CARLE RICHLAND MEMORIAL HOSPITAL (RMH) IS A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION ESTABLISHED FOR THE PURPOSE OF OPERATING A HOSPITAL AND CONDUCTING PATIENT CARE RELATED ACTIVITIES. RICHLAND IS A 104 BED HOSPITAL PROVIDING A RANGE OF ANCILLARY AND SUPPORT SERVICES. THE HOSPITAL ADMITS APPROXIMATELY 1,200 PATIENTS ANNUALLY, IS FULLY ACCREDITED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP), HAS AN EMERGENT STROKE READY DESIGNATION AND A LEVEL II NURSERY DESIGNATION BY THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH AND IS A CLINICAL HUB SITE FOR SOUTHERN ILLINOIS UNIVERSITY PHYSICIAN ASSISTANT PROGRAM. IN 2022, RMH RECORDED 10,386 PATIENT DAYS. IN ADDITION TO THE HOSPITAL, THE ORGANIZATION HAS THREE RURAL HEALTH CLINICS: - CARLE BRIDGEPORT IS LOCATED AT 100 INDUSTRY ROAD, BRIDGEPORT, IL, AND OFFERS AUDIOLOGY AND HEARING, BEHAVIORAL HEALTH, CARDIOVASCULAR MEDICINE, FAMILY MEDICINE, MIDWIFERY, ORTHOPEDICS, AND OTOLARYNGOLOGY (ENT: EAR, NOSE, AND THROAT) SERVICES MONDAY THROUGH FRIDAY, 8 A.M. TO 5 P.M. - CARLE OLNEY IS LOCATED AT 363 N. WEST STREET, OLNEY, IL, 1.3 MILES FROM THE HOSPITAL, WHICH OFFERS BEHAVIORAL HEALTH, CONVENIENT CARE, AND FAMILY MEDICINE SERVICES 8 A.M. - 8 P.M. SEVEN DAYS PER WEEK. - CARLE WEST SALEM IS LOCATED AT 100 S. MAIN STREET, WEST SALEM, IL, AND OFFERS FAMILY MEDICINE SERVICES MONDAY THROUGH FRIDAY, 8 A.M. TO 5 P.M. IN ADDITION TO THE RURAL HEALTH CLINICS, RICHLAND PROVIDES SERVICES UNDER THE FOLLOWING: - RMH PROFESSIONAL SERVICES LOCATED AT 605 E. MAIN STREET, OLNEY, IL ONE-HALF MILE FROM THE HOSPITAL AND OFFERS GENERAL SURGERY AND PODIATRY SERVICES. - THE APOTHECARY SHOPPE, LOCATED AT 108 S. MAIN STREET, WEST SALEM, IL, OFFERS RETAIL PHARMACY SERVICES MONDAY THROUGH FRIDAY FROM 9 A.M. TO 3 P.M., AND SATURDAYS FROM 9 A.M. TO NOON. RMH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, DISABILITY, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THE MISSION OF RMH IS TO SERVE OUR COMMUNITY WITH RESPECT IN PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE OFFER: - FREE CARE TO QUALIFIED INDIVIDUALS UNDER THE RMH FINANCIAL ASSISTANCE PROGRAM - CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND - HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT AND EDUCATE THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, PROFESSIONAL EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. RMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. THE HOSPITAL ALSO PROVIDES CARE TO PERSONS COVERED BY COMMERCIAL INSURANCE AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECOGNIZES THESE AMOUNTS AS COST INCURRED IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. FINANCIAL ASSISTANCE WAS ALSO PROVIDED THROUGH RMH'S FINANCIAL ASSISTANCE POLICY OFFERED IN 2022. 62550297 true true false true false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true true false false true 50 0 true 507 true true true false false false false false false false false false false false X 11 7 true false false false true true true true true false false true true true true true true true true false IL X X DENNIS P HESCH EXEC VP & CFO 2173833311 611 W PARK ST URBANA IL 61801 GARY HOUCHIN TREASURER OF BOARD 2.0 0.0 X X 0 0 0 JENNIFER CUMMINS-ZUHER CHAIR 3.0 0.0 X X 0 0 0 MATTHEW KOLB JD MHA TRUSTEE; EVP, CHIEF OPERATING OFFICER 1.0 39.0 X X 0 1363262 394190 PATRICIA KESSLER-BOOKHOUT DDS VICE CHAIR 2.0 0.0 X X 0 0 0 BERNARD BRAUER TRUSTEE (BEG 10/1/2022) 1.0 0.0 X 0 0 0 COLE DUKE TRUSTEE 1.0 0.0 X 0 0 0 JASON GLOVER TRUSTEE (THU 9/30/2022) 1.0 0.0 X 0 0 0 LARRY DUNN TRUSTEE 2.0 0.0 X 0 0 0 RAYMOND FISHER MD TRUSTEE 40.0 0.0 X 492079 0 53171 ROB MCCLAIN TRUSTEE (THU 9/30/2022) 1.0 0.0 X 0 0 0 SALLY SALMONS MD TRUSTEE & PHYSICIAN 1.0 39.0 X 0 456156 89543 SHERRY GEIER TRUSTEE 2.0 0.0 X 0 0 0 STEVEN THOMSON TRUSTEE (BEG 10/1/2022) 2.0 0.0 X 0 0 0 TOMMIE FEHRENBACHER TRUSTEE (THU 9/30/2022) 1.0 0.0 X 0 0 0 DENNIS HESCH EVP, CHIEF FINANCE & STRATEGY OFFICER 2.0 38.0 X 0 1286099 414800 JAMES C LEONARD MD EX-OFFICIO, PRESIDENT & CEO 0.2 39.8 X 0 2140109 661809 REGINA THOMAS PRESIDENT, RICHLAND MEMORIAL HOSPITAL 40.0 0.0 X 0 274210 66893 KENNETH ARONSON MD MEDICAL DIRECTOR - DIAGNOSTIC SERVICES 1.0 39.0 X 0 623336 63263 LAUREN SCHMID EVP, CHIEF HUMAN RESOURCES OFFICER 1.0 39.0 X 0 772322 228747 NICHOLAS CROMPTON VP, CONSTRUCTION & FACILITY SERVICES 1.0 40.0 X 0 281961 73600 TANNER MILLER MD CRMH MEDICAL DIRECTOR 40.0 0.0 X 0 498065 49931 BENJAMIN CURTIS CRNA - RMH ANESTHESIOLOGY 40.0 0.0 X 275825 0 49335 CHRISTINA BARE DIRECTOR, RMH PRIMARY CARE & SPECIALTY SERVICES 40.0 0.0 X 163562 0 13512 JOHN ALLEN CRNA - RMH ANESTHESIOLOGY 40.0 0.0 X 298367 0 49414 JOHN WALL CRNA LEAD - RMH ANESTHESIOLOGY 40.0 0.0 X 283968 0 51636 THOMAS FALCONE CRNA - RMH ANESTHESIOLOGY 40.0 0.0 X 280568 0 50832 HARRY BROCKUS FORMER - OFFICER 0.0 0.0 X 0 162492 0 1794369 7858012 2310676 45 true true false RURAL PHYSICIANS GROUP 5575 DTC PARKWAY STE 225 GREENWOOD VILLAGE CO 80111 STAFFING 455410 ALL STAR RECRUITING LOCUMS PO BOX 936725 ATLANTA GA 311936725 STAFFING 271466 SENTRY DATA SYSTEMS INC PO BOX 505353 ST LOUIS MO 631505353 PHARMACY SOFTWARE & MAINTENANCE 262755 QUEST DIAGNOSTICS PO BOX 7755460 CHICAGO IL 606775460 LAB SERVICES 215944 COMMERCIAL ELECTRIC INC 720 SOUTH 17TH STREET PO BOX 1157 MATTOON IL 61938 MAINTENANCE & REPAIRS 205100 11 159045 2571457 25000 11971 2755502 NET PATIENT SERVICE REVENUE 622110 59297962 59297962 RENT FROM RELATED ORGS 523000 10176 10176 ALL OTHER PROGRAM SERVICES REVENUE 900099 889 889 0 0 0 0 59309027 40627 40627 0 0 66 66 0 0 1378534 957982 420552 420552 CAFETERIA SERVICES 722331 186423 186423 LAUNDRY SERVICES 812331 16542 16542 CATERING REVENUE 722320 26898 26898 73813 50193 0 23620 303676 62829384 59359220 463992 250670 74527 74527 120253 120253 33736175 29275025 4461150 1599509 1374349 225160 3141765 2596897 544868 2123585 1796802 326783 25440 25440 2540376 2464518 75858 0 8099 2934 5165 358815 193326 165489 2817078 2137648 679430 1030178 667288 362890 38315 22380 15935 44040 35152 8888 202119 168462 33657 2416407 1656182 760225 138143 114809 23334 OTHER PURCHASED SERVICES 357727 313224 44503 PATIENT CARE SUPPLIES 5803993 5803993 INTERNAL PURCHASED SERVS 12066228 11223278 842950 PROVIDER ASSESSMENT TAX 2403466 2403466 753501 105784 647717 0 71799739 62550297 9249442 0 4100567 1377471 5974379 4231585 0 0 0 0 411380 232045 893708 1724548 239268 212171 64582776 45946580 19634086 18636196 0 0 197083 249274 31450471 26663290 4553156 4204867 2307829 998 0 0 5005634 4634730 4242373 4617340 16108992 13457935 X 15341479 13205355 15341479 13205355 31450471 26663290 X -8970355 6834231 X 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 25440 25440 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY $25,440 - PORTION OF HEALTH CARE ORGANIZATION DUES ATTRIBUTABLE TO LOBBYING 1005119 1005119 33401308 22052284 11349024 29227626 23286445 5941181 948723 607851 340872 18636196 DUE TO BLUE CROSS 1239198 ASSET RETIREMENT OBLIGATION 3378142 4617340 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2022 AND 2021. true true X true X true X true true false true true 1054231 1054231 0.0147 16166091 10724675 5441416 0.0758 0 0.0 0 0 17220322 10724675 6495647 0.0905 7607 7607 0.0001 58831 58831 0.0008 17268314 17268314 0.2405 0 0.0 52287 52287 0.0007 0 0 17387039 0 17387039 0.2422 0 0 34607361 10724675 23882686 0.3326 0 0.0 14240 14240 0.0002 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 14240 0 14240 0.0002 true 744750 372375 21436973 31023184 -9586211 X true true 1 1 RICHLAND MEMORIAL HOSPITAL INC 800 EAST LOCUST OLNEY IL 62450 https://carle.org/locations/carle-richland-memorial-hospital 0004200 X X X RICHLAND MEMORIAL HOSPITAL INC 1 false false true X X X X X X X X X 21 true false false true X https://carle.org/about-us/community-health-needs-assessments X true 21 true https://carle.org/about-us/community-health-needs-assessments false true X 200.0 400.0 true true X X X true X SEE SCHEDULE H PART VI X SEE SCHEDULE H PART VI X SEE SCHEDULE H PART VI X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - RICHLAND MEMORIAL HOSPITAL. Provisions in the Affordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. This assessment process results in a CHNA report which assists the hospital in planning, implementing, and evaluating hospital strategies and community benefit activities. The Community Health Needs Assessment was developed and conducted, in partnership with representatives from the community, by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-profit 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational efficiencies, and improving healthcare services for member critical access and rural hospitals and their communities. ICAHN, with 57 member hospitals, is an independent network governed by a nine-member board of directors, with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. This Community Health Needs Assessment will serve as a guide for planning and implementation of healthcare initiatives that will allow the hospital and its partners to best serve the emerging health needs of Olney and the surrounding area. Three focus groups met through facilitated virtual conferencing on May 20, 2021, to discuss the state of overall health and wellness in the Carle Richland Memorial Hospital service area. They were also tasked with identifying health concerns and needs in the delivery of healthcare and health services in order to improve wellness and reduce chronic illness for all residents. The focus groups included representation of healthcare providers, community leaders, community services providers, schools, faith-based organizations, local elected officials, public health, and others. Several members of the groups provided services to underserved and unserved persons as all or part of their roles. The findings of the focus groups were presented along with secondary data analyzed by the consultant to a third group for identification and prioritization of the significant health needs facing the community through a virtual conference on June 28, 2021. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - RICHLAND MEMORIAL HOSPITAL. 1. MENTAL HEALTH SERVICES FOR CHILDREN, ADOLESCENTS, AND ADULTS, INCLUDING: * YOUTH AND ADULT INPATIENT CARE FOR TREATMENT THROUGH RECOVERY * IMPROVED ACCESS TO COUNSELING FOR YOUTH, INCLUDING SERVICES AT SCHOOLS * INPATIENT BEHAVIORAL HEALTH AND SUBSTANCE USE CRISIS CARE * ADDICTION MEDICINE SERVICES, INCLUDING MEDICATION ASSISTED TREATMENT ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE INCREASING ACCESS TO MEDICATION ASSISTED TREATMENT/RECOVERY RESOURCES * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE INCREASING RELATIONSHIPS WITH INPATIENT BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER PROVIDERS * CARLE RICHLAND MEMORIAL HOSPITAL WILL PROVIDE REASONABLE AND APPROPRIATE SUPPORT TO DEVELOPMENT OF THE CRISIS PROGRAM AT LAWRENCE COUNTY HEALTH DEPARTMENT * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE DEVELOPING TELE-COUNSELING * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE NEW AVENUES TO INCREASE ACCESS TO COUNSELING * CARLE RICHLAND MEMORIAL HOSPITAL WILL CONTINUE AND EXPAND THE MENTAL HEALTH FIRST AID PROGRAM ANTICIPATED IMPACTS OF THESE ACTIONS: CARLE RICHLAND MEMORIAL HOSPITAL ANTICIPATES THAT THE STEPS SET OUT ABOVE WILL CREATE INCREASED ACCESS TO COUNSELING FOR YOUTH AND ADULTS, MEDICATION ASSISTED TREATMENT, AND INPATIENT AND CRISIS CARE FOR BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERS. PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED: * ADMINISTRATIVE TEAM PLANNED COLLABORATION BETWEEN HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: * SIU SCHOOL OF MEDICINE * PUBLIC HEALTH * INPATIENT PROVIDERS * LAW ENFORCEMENT * CARLE BEHAVIORAL HEALTH SERVICES EVALUATION OF PRIOR IMPACT: MENTAL AND BEHAVIORAL HEALTH CONTINUE TO BE AN IDENTIFIED HEALTH NEED FOR CARLE RICHLAND MEMORIAL HOSPITAL AND RICHLAND COUNTY, SIMILAR TO COUNTIES ACROSS ILLINOIS AND THE UNITED STATES. THE NUMBER OF MENTAL HEALTH PROVIDERS IN RICHLAND COUNTY IS ROUGHLY 210:1, ACCORDING TO THE MOST RECENTLY AVAILABLE DATA. THIS IS BETTER THAN BOTH THE ILLINOIS AND NATIONAL AVERAGE. IN THE MOST RECENTLY AVAILABLE SUICIDE DATA, THERE WERE 19 SUICIDES PER 100,000 PEOPLE IN RICHLAND COUNTY, WHICH IS HIGHER THAN BOTH THE STATE AND NATIONAL AVERAGE. IN RESPONSE, CARLE RICHLAND MEMORIAL HOSPITAL TOOK THE FOLLOWING ACTIONS IN 2022: * CARLE RICHLAND MEMORIAL HOSPITAL ADDED A BEHAVIORAL HEALTH ROOM IN OUR EMERGENCY DEPARTMENT SO WE CAN SAFELY KEEP PATIENTS WHO NEED TO BE TRANSFERRED TO A BEHAVIORAL FACILITY OR ARE ON SUICIDE PRECAUTIONS, SUPPORTED BY THE RICHLAND COUNTY BOARD IN RECOGNITION OF NEED, AND THE WORK CARLE RICHLAND MEMORIAL HOSPITAL DOES IN CARING FOR PATIENTS. * CARLE RICHLAND MEMORIAL HOSPITAL CONTINUES TO PUT PRIORITIZATION IN OFFERING MENTAL HEALTH FIRST AID TRAININGS, CLASSES, AND SUPPORT, EXPANDING TO INCREASE WORK WITH THE TEEN POPULATION. A COORDINATOR BEGAN GOING INTO THE SCHOOL IN CRAWFORD COUNTY AND 2022 WAS HER FIRST YEAR GOING INTO RICHLAND COUNTY HIGH SCHOOL TO TEACH TEEN MENTAL HEALTH FIRST AID. THE CLASS HELPS TEENS TO IDENTIFY IF A FRIEND OR CLASSMATE MAY BE HAVING A MENTAL HEALTH CRISIS OR ISSUE AND WHAT THEY CAN DO TO SAFELY GET THEM HELP. IT WAS ALSO INSTRUMENTAL IN IDENTIFYING TEENS WHO WERE IN MENTAL HEALTH DISTRESS. 2. FLEXIBLE TRANSPORTATION FOR LOCAL APPOINTMENTS AND ASSISTANCE WHEN NEEDED FOR PERSONS THAT HAVE LITTLE OR NO TRANSPORTATION AT HOME ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE EXPANDING CARE COORDINATION SERVICES TO INCLUDE TRANSPORTATION ANTICIPATED IMPACTS OF THESE ACTIONS: CARLE RICHLAND MEMORIAL HOSPITAL ANTICIPATES THE EXPANDING OF CARE COORDINATION SERVICES TO INCLUDE TRANSPORTATION WILL IMPROVE COORDINATION OF TRANSPORTATION WITH APPOINTMENTS AND ADDRESS PATIENT NEEDS RELATED TO TRANSPORTATION. PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED: * ADMINISTRATIVE TEAM PLANNED COLLABORATION BETWEEN HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: * RIDES MASS TRANSIT DISTRICT * EMBARRAS RIVER BASIN AREA AGENCY (ERBA) EVALUATION OF PRIOR IMPACT: LIKE MANY RURAL COMMUNITIES, PHYSICAL LANDMASS IS LARGE AND RELIABLE TRANSPORTATION TO ACCESS COMMUNITY SERVICES AND CARE IS NOT ALWAYS EASY TO ATTAIN. AS IS COMMON IN RURAL COMMUNITIES, THERE IS A LARGE AGING POPULATION. IN RICHLAND COUNTY, ADULTS AGED 65+ WITH AN INDEPENDENT LIVING DIFFICULTY (INCLUDING ACCESS TO TRANSPORTATION), IS ROUGHLY 15% HIGHER THAN THE STATE AND NATIONAL AVERAGE. IN RESPONSE TO THIS IDENTIFIED HEALTH NEED, CARLE RICHLAND MEMORIAL HOSPITAL TOOK THE FOLLOWING ACTIONS: * CARLE RICHLAND MEMORIAL HOSPITAL CONTINUES TO WORK TO INCREASE SERVICES FOR THOSE NEEDING TRANSPORTATION ASSISTANCE. INPATIENT CARE COORDINATION STAFF HAVE ACCESS TO HOSPITAL DISCHARGE SERVICE TRANSPORTATION FOR PATIENTS AS NEEDED - WHICH HELPS TAKE PATIENTS FROM BEING DISCHARGED FROM THE HOSPITAL TO THEIR HOME IF THEY ARE NEEDING HELP GETTING INTO THEIR HOME OR ARE GOING HOME WITH MEDICAL EQUIPMENT. WHEN PATIENTS DO NOT NEED ANY SPECIAL CIRCUMSTANCES UPON DISCHARGE, THE CARE COORDINATORS CONTINUE TO SCHEDULE RIDES FOR THEM THROUGH RIDES MASS TRANSIT DISTRICT. THE EMERGENCY DEPARTMENT ALSO UTILIZES BOTH SERVICES AS NEEDED FOR DISCHARGES FROM THE EMERGENCY DEPARTMENT. * CARLE RICHLAND MEMORIAL HOSPITAL CONTINUES TO WORK WITH THE MASS TRANSIT DISTRICT TO ADVOCATE FOR ASSISTANCE AND ROUTES FOR PATIENTS IN OUR RURAL COMMUNITIES - A COMMITMENT TO ONGOING DIALOGUE. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - RICHLAND MEMORIAL HOSPITAL (CONTINUED). 3. IMPROVED OPPORTUNITIES TO ACHIEVE WELLNESS THROUGH: * ACCESS TO HEALTH FOODS AND NUTRITION EDUCATION * ACCESS TO LOW COST OR FREE OPPORTUNITIES FOR RECREATION AND FITNESS ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE DEVELOPMENT OF A COMMUNITY GARDEN PROGRAM * CARLE RICHLAND MEMORIAL HOSPITAL WILL CONTINUE THE DEMONSTRATION GARDEN FOR NUTRITION EDUCATION * CARLE RICHLAND MEMORIAL HOSPITAL WILL PROVIDE FUNDING FOR LIGHTING TO ENHANCE USE OF THE COMMUNITY WALKING PATH IN OLNEY * CARLE RICHLAND MEMORIAL HOSPITAL WILL EXPLORE EXPANDING SERVICES OF CARLE HEALTH'S MOBILE MARKET * CARLE RICHLAND MEMORIAL HOSPITAL WILL PARTNER WITH CARLE HEALTH TO PROVIDE THE COMMUNITY WITH ACCESS TO VIDEO WITH HEALTH AND WELLNESS CONTENT * CARLE RICHLAND MEMORIAL HOSPITAL WILL CONTINUE TO SUPPORT LOCAL YOUTH SPORTS ANTICIPATED IMPACTS OF THESE ACTIONS: CARLE RICHLAND MEMORIAL HOSPITAL ANTICIPATES THAT THE ADDITION OF THE PROGRAMS AND SERVICES TO BE UNDERTAKEN WILL IMPROVE OPPORTUNITIES TO ACHIEVE WELLNESS THROUGH ACCESS TO HEALTHY FOODS AND NUTRITION EDUCATION, AND ACCESS TO LOW COST OR FREE OPPORTUNITIES FOR RECREATION AND FITNESS. PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED: * ADMINISTRATIVE TEAM * ORGANIZATIONAL AND COMMUNITY DEVELOPMENT PLANNED COLLABORATION BETWEEN HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: * VOLUNTEERS * CARLE HEALTH * CITY OF OLNEY * UNIVERSITY OF ILLINOIS EXTENSION * CARLE RICHLAND AUXILLARY EVALUATION OF PRIOR IMPACT: LIKE MANY COMMUNITIES IN THE UNITED STATES, OBESITY AND OBESITY-RELATED ILLNESSES CONTINUE TO BE A CONCERN IN RICHLAND COUNTY. OBESITY IS ASSOCIATED WITH POORER MENTAL HEALTH OUTCOMES, REDUCED QUALITY OF LIFE, AND IS THE LEADING CAUSE OF DEATH IN THE U.S. AND WORLDWIDE, THROUGH CONTRIBUTING TO HEART DISEASE, STROKE, DIABETES, AND SOME TYPES OF CANCER. ACCORDING TO 2022 COUNTY HEALTH RANKINGS, ADULT OBESITY IN RICHLAND COUNTY IS 35%, HIGHER THAN THAT STATE AND NATIONAL AVERAGE. ADDITIONALLY, ACCESS TO EXERCISE OPPORTUNITIES IS SIGNIFICANTLY LOWER THAN THE STAT AND NATIONAL AVERAGES, AT ONLY 63% OF PEOPLE LIVING NEAR A PARK OR RECREATIONAL FACILITY. IN RESPONSE TO THIS IDENTIFIED HEALTH NEED, CARLE RICHLAND MEMORIAL HOSPITAL TOOK THE FOLLOWING ACTIONS: * IN 2022, CARLE RICHLAND MEMORIAL HOSPITAL MADE A $10,000 DONATION TO PROJECT COMMUNITY FOR THE ADDITION OF A SPLASH PAD TO A LOCAL PARK, FREE FOR ALL RESIDENTS AND CHILDREN TO EXERCISE OUTDOORS AND ENJOY. * CARLE RICHLAND MEMORIAL HOSPITAL ALSO PLEDGED IN 2022 A $5,000 DONATION TO THE NEW CONSTRUCTION OF PICKLEBALL COURTS. PICKLEBALL IS A SPORT THAT IS ENJOYED BY INDIVIDUALS FROM AGE 8 THROUGH 80, AND THE NEW COURTS ALSO FEATURE A WHEELCHAIR ACCESSIBLE COURT TO ENCOURAGE RESIDENTS TO GET INVOLVED IN A VERY POPULAR NEW HEALTHY ACTIVITY. * IN 2022, CARLE RICHLAND MEMORIAL HOSPITAL CONTINUED IS SUPPORT OF LOCAL YOUTH SPORTS DONATION OR SPONSORING TEAMS THROUGH HIGH SCHOOL ATHLETICS AS WELL AS LOCAL ORGANIZATIONS, MAKING JOINING SPORTS TEAMS AND ACCESS TO EXERCISE MORE AFFORDABLE FOR FAMILIES IN OUR COMMUNITY. * IN 2022, CARLE RICHLAND MEMORIAL HOSPITAL ESTABLISHED A NEW COMMUNITY GARDEN IN SUPPORT WITH THE LOCAL HIGH SCHOOL, WHOSE STUDENTS HELP BUILD RAISED BEDS FOR OUR USE AND DONATED THEM AND VOLUNTEERS TENDED THE GARDEN THROUGHOUT THE WEEK. THE PRODUCE GROWN WAS GIVE OUT AT OUR LOCAL CLINIC LOCATION. * CARLE RICHLAND MEMORIAL HOSPITAL PLEDGED $50,000 OVER 5 YEARS TO THE WALKING TRAIL AT OLNEY CITY PARK TO PUT IN LIGHTING ALL AROUND THE TRAIL SO THAT COMMUNITY MEMBERS COULD WALK NO MATTER WHAT TIME OF MORNING OR EVENING THEY ARE ABLE. 4. DENTAL CARE FOR UNDERINSURED AND UNINSURED ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: CARLE RICHLAND MEMORIAL HOSPITAL CONTINUES TO RECOGNIZE THE IMPORTANCE OF ACCESS TO DENTAL CARE AND THE IMPACT OF DENTAL CARE ON WELLNESS BUT OBSERVES THAT DENTAL CARE IS NOT A FUNCTION FOR WHICH THE HOSPITAL IS WELL-SUITED. CARLE RICHLAND MEMORIAL HOSPITAL RECOGNIZES THAT THE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) MAY BE BETTER POSITIONED TO ADDRESS THIS ISSUE, AND THE HOSPITAL WILL PROMOTE PARTNERSHIPS BETWEEN DENTISTS, THE FQHC, AND ANY OTHER POTENTIAL PARTNERS AS REASONABLE POSSIBLE. ANTICIPATED IMPACTS OF THESE ACTIONS: ANY IMPACTS FROM ANY DEVELOPMENTS ON THIS ISSUE ARE DEPENDENT ON EXTERNAL PARTNERS AND SOLUTIONS THEY MAY OFFER. PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED: * ADMINISTRATIVE TEAM PLANNED COLLABORATION BETWEEN HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: * FEDERALLY QUALIFIED HEALTH CENTER * DENTISTS * OTHERS THAT MAY BE INTERESTED IN THE EFFORT * PUBLIC HEALTH EVALUATION OF PRIOR IMPACT: ACCORDING TO THE MOST RECENTLY AVAILABLE DATA, RICHLAND COUNTY DOES HAVE A HIGHER PROPORTION OF DENTISTS TO THE POPULATION AT 3,950:1 THAN THE STATE AND NATIONAL AVERAGES, AND THE AVERAGE NUMBER OF ADULTS VISITING A DENTIST IS HIGHER THAN THE STATE AND NATIONAL AVERAGES. CARLE RICHLAND MEMORIAL HOSPITAL CONTINUES TO RECOGNIZE THE IMPORTANCE OF ACCESS TO DENTAL CARE AND THE IMPACT OF DENTAL CARE ON WELLNESS BUT OBSERVES THAT DENTAL CARE IS NOT A FUNCTION FOR WHICH THE HOSPITAL IS WELL-SUITED. CARLE RICHLAND MEMORIAL HOSPITAL RECOGNIZED THAT THE FEDERALLY QUALIFIED HEALTH CENTER (FQHC) MAY BE BETTER POSITIONED TO ADDRESS THIS ISSUE, AND THE HOSPITAL WILL PROMOTE PARTNERSHIPS BETWEEN DENTISTS, THE FQHC, AND ANY OTHER POTENTIAL PARTNERS AS REASONABLY POSSIBLE, AND WORKS TO CONTINUE TO ADVOCATE AND SUPPORT THESE COMMUNITY PARTNERS AS WE ARE ABLE. 5 CARLE OLNEY PRIMARY CARE 363 N WEST ST OLNEY IL 62450 RURAL HEALTH CLINIC CARLE (OLNEY) SURGICAL SERVICES 605 E MAIN ST OLNEY IL 62450 SURGICAL SERVICES CARLE WEST SALEM 100 S MAIN ST WEST SALEM IL 62476 RURAL HEALTH CLINIC CARLE BRIDGEPORT 101 INDUSTRY RD BRIDGEPORT IL 624172242 OUTPATIENT CLINIC Schedule H, Part I, Line 3 FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA PATIENTS MAY REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IN ADDITION TO PATIENTS COMPLETING APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM, WE HAVE ROBUST PRESUMPTIVE ELIGIBILITY PROCESSES IN PLACE. WE HAVE PARTNERED WITH EXPERIAN INFORMATION SOLUTIONS, INC. TO HELP US IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. THESE PATIENTS MAY BE APPROVED WITHOUT EVER COMPLETING AN APPLICATION OR EXPRESSING A NEED FOR FINANCIAL ASSISTANCE. IN ADDITION, WE PRESUME ELIGIBILITY FOR PATIENTS WHO ARE VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTALLY INCAPACITATED, ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR WOMEN, INFANTS, AND CHILDREN NUTRITION PROGRAM (WIC), TOWNSHIP ASSISTANCE, LOW INCOME ENERGY ASSISTANCE PROGRAM (LIHEAP), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM OR COVERED BY ILLINOIS MEDICAID. Schedule H, Part II OTHER COMMUNITY BENEFITS/COMMUNITY BUILDING: CASH AND IN-KIND: A LARGE PORTION OF CARLE'S COMMUNITY-BUILDING ACTIVITIES FOCUSED ON ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS, AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS, AND OTHER PROGRAMS IN RICHLAND COUNTY. IN ADDITION TO THE MORE THAN $22,000 IN CASH DONATIONS, LEADERSHIP PROVIDED IN-KIND SUPPORT OF OVER $29,000 BY SERVING ON NUMEROUS COMMUNITY BOARDS AND COMMITTEES. VOLUNTEER SERVICES: EMPLOYEE: CARLE RICHLAND MEMORIAL HOSPITAL ADMINISTRATORS AND LEADERS PROVIDED MORE THAN 95 HOURS ON BEHALF OF CARLE FOR PARTICIPATION IN COMMUNITY BOARDS, COMMITTEES, AND COMMUNITY FUNCTIONS. MOST OF THESE HOURS WERE SPENT BY SENIOR LEADERSHIP. NON-EMPLOYEE: IN 2022, NON-EMPLOYEE VOLUNTEERS PUT IN MORE THAN 6,950 HOURS AT CARLE RICHLAND MEMORIAL HOSPITAL, RECEIVING NO PAYMENT BUT CONTRIBUTING TO CARLE'S MISSION. AT A MINIMUM WAGE OF $12/HOUR, THIS EQUATES TO MORE THAN $83,000 OF POTENTIAL WAGES THAT CARLE SAVED BY HAVING SUCH A STRONG VOLUNTEER PROGRAM. Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE HTTPS://CARLE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE HTTPS://DEV-CMS.CARLE.ORG/GETMEDIA/ADCADB9A-2903-478C-A4A7-06BCF9DB10BC/358-0123-CFAPAPPLICATION.PDF Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE HTTPS://CARLE.ORG/GETMEDIA/F7608F63-CB1C-4EB5-8F0B-02F00EAFEC74/X0873-0223-CFAP-PLAIN-LANGUAGE-SUMMARY.PDF Schedule H, Part I, Line 7g Subsidized Health Services SUBSIDIZED HEALTH SERVICES ARE NET COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. THESE INCLUDE SERVICES OFFERED DESPITE A FINANCIAL LOSS BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND EITHER OTHER PROVIDERS ARE UNWILLING TO PROVIDE THESE SERVICES OR THE SERVICES WOULD OTHERWISE NOT BE AVAILABLE IN A SUFFICIENT AMOUNT. WE INCLUDED AS UNREIMBURSED COSTS OF SUBSIDIZED HEALTH SERVICES: $115,153 FOR HOSPITAL OUTPATIENT SERVICES, $10,850,338 FOR EMERGENCY ROOM, AND $6,303,823 FOR SUBSIDIZED CONTINUING CARE. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance SEE NARRATIVE FOR SCHEDULE H, PART III, LINE 2 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS, AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. THIS NARRATIVE ALSO PERTAINS TO SCHEDULE H, PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology CARLE RICHLAND MEMORIAL HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 28 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID, AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID, AND OTHER FEDERAL, STATE, OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, AND THOSE LESS FORTUNATE DEMOGRAPHICS THAT HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance CARLE RICHLAND MEMORIAL HOSPITAL APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH THOSE ELIGIBLE FOR FINANCIAL ASSISTANCE AND THOSE THAT ARE NOT ELIGIBLE. THE PROCEDURES ARE AS FOLLOWS: 1. WE WILL SEND TWO STATEMENTS AND TWO COLLECTION LETTERS IN A TWENTY-EIGHT-DAY CYCLE. WE WILL SEND STATEMENTS BASED UPON PATIENT PORTION OF $10 OR GREATER. 2. THE PATIENT'S ACCOUNT WILL AGE THROUGH THE STATEMENT PROCESS BEFORE BEING WRITTEN OFF TO BAD DEBT. - PRIVATE PAY ACCOUNTS WILL RECEIVE A STATEMENT WITHIN NINE DAYS OF THE DISCHARGE DATE. - ACCOUNTS WITH A PATIENT PORTION AFTER INSURANCE WILL BE ELIGIBLE TO RECEIVE A STATEMENT APPROXIMATELY FOURTEEN DAYS AFTER THE INSURANCE PAYMENT HAS BEEN POSTED. - TWENTY-EIGHT DAYS LATER THE PATIENT IS MAILED A THIRD STATEMENT. - TWENTY-EIGHT DAYS LATER THE PATIENT IS MAILED THE FIRST COLLECTION LETTER. - TWENTY-EIGHT DAYS LATER THE PATIENT IS MAILED THE FINAL COLLECTION LETTER. - APPROXIMATELY FIFTEEN DAYS LATER THE PATIENT IS WRITTEN OFF TO BAD DEBT. 3. CARLE RICHLAND MEMORIAL HOSPITAL WILL ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE AFTER THEY RECEIVE THE FIRST STATEMENT ON BALANCES GREATER THAN $1,000. 4. CARLE RICHLAND MEMORIAL HOSPITAL WILL ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE AFTER THE SECOND STATEMENT ON BALANCES LESS THAN $1,000. 5. CARLE RICHLAND MEMORIAL HOSPITAL WILL MAKE A SECOND ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE IF PAYMENT OR CONTACT HAS NOT BEEN MADE, USUALLY AROUND THE SAME TIME THE SECOND COLLECTION LETTER IS SENT. 6. CARLE RICHLAND MEMORIAL HOSPITAL WILL SEND TWO COLLECTION LETTERS TO THE PATIENT. THE PATIENT HAS FIFTEEN DAYS AFTER THE FINAL LETTER TO PAY BEFORE BEING WRITTEN OFF TO BAD DEBT. Schedule H, Part V, Section B, Line 16a FAP website - RICHLAND MEMORIAL HOSPITAL INC.: Line 16a URL: SEE SCHEDULE H PART VI; Schedule H, Part V, Section B, Line 16b FAP Application website - RICHLAND MEMORIAL HOSPITAL INC.: Line 16b URL: SEE SCHEDULE H PART VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - RICHLAND MEMORIAL HOSPITAL INC.: Line 16c URL: SEE SCHEDULE H PART VI; Schedule H, Part VI, Line 2 Needs assessment CARLE PRIMARILY ADDRESSES HEALTHCARE NEEDS IN OUR COMMUNITY BY BEING A PART OF THE AFOREMENTIONED CHNA. HOWEVER, CARLE IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE, MAKING IT A MAINSTAY OF OUR COMMUNITY BENEFIT EFFORTS. WE HAVE A STRONG FINANCIAL ASSISTANCE PROGRAM BASED ON A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS, BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITY'S RESOURCES. WHILE ACCESS TO CARE WAS NOT SELECTED AS A PRIORITY FOR THE 2022 CHNA, IT WILL CONTINUE TO BE A PRIORITY FOR CARLE. AS A TAX-EXEMPT ORGANIZATION, CARLE RICHLAND MEMORIAL HOSPITAL PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. CARLE'S GENEROUS FINANCIAL ASSISTANCE PROGRAM HAS RESULTED IN OUR ABILITY TO REACH MANY PEOPLE OVER THE YEARS. TO ENSURE WE ARE ADDRESSING THE NEEDS OF THE COMMUNITY, THE FINANCE AND QUALITY COMMITTEES OF THE CARLE BOARD OF TRUSTEES REVIEW AND EVALUATE CHARITY CARE FIGURES ANNUALLY. WE DO NOT LIMIT THE AMOUNT OF FINANCIAL ASSISTANCE WE PROVIDE AT THIS TIME. OTHER WAYS TO HELP IMPROVE ACCESS TO CARE: IN ADDITION TO CHARITY CARE, CARLE SUPPORTS A WIDE RANGE OF PROGRAMS AND SERVICES TO INCREASE COMMUNITY CAPACITY, HEALTH CARE WORK FORCE EXPANSION, AND SOCIAL SERVICES THAT PROVIDE COMPLEMENTARY HEALTHCARE-RELATED SERVICES. CARLE RICHLAND MEMORIAL HOSPITAL HAS, AND WILL CONTINUE TO, PURSUE THESE INITIATIVES TO IMPROVE ACCESS TO CARE: 1. OFFER A CHARITY CARE PROGRAM 2. COMMUNICATE THE AVAILABILITY OF THE CHARITY CARE PROGRAM 3. RECRUIT MORE PROVIDERS INTO THE CARLE SYSTEM, THEREBY EXPANDING ACCESS/CAPACITY 4. SUPPORT LOCAL COMMUNITY CLINICS TO ENSURE ADDED LOCAL CAPACITY FOR HEALTH CARE 5. SUPPORT UNITED WAY AND OTHER AREA AGENCIES TO IMPROVE AVAILABILITY OF HEALTH SERVICES 6. DONATE TO EXISTING COMMUNITY HEALTH 7. PARTICIPATE IN POPULATION HEALTH INITIATIVES THAT ACTIVELY MANAGE THE HEALTH OF MEMBERS 8. PROMOTE PRESCRIPTION AFFORDABILITY AS A 340B PROVIDER 9. ENHANCE ACCESS-RELATED INITIATIVES THAT WILL IMPROVE PATIENT ACCESS AND ABILITY TO INTERFACE MORE EFFICIENTLY FOR NEEDED SERVICES - PATIENT CONTACT CENTER, PRESCRIPTION REFILL REQUEST PROCESS, E-VISITS, VIRTUAL VISITS, AND MORE 10. CONTINUE ACCESS TO CARE THROUGH SUBSIDIZED SERVICES, INCLUDING THE LTC SKILLED NURSING, THE EXTENDED CARE WING, THE EMERGENCY DEPARTMENT, CARDIAC REHAB, AND MORE. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance OUR PRACTICE IS TO LOOK AT EACH PATIENT'S FINANCIAL STATUS IN RELATION TO OUR CARLE FINANCIAL ASSISTANCE PROGRAM AND THE CRITERIA OF THE UNINSURED PATIENT DISCOUNT ACT, AND TO PROVIDE THE PATIENT WITH THE DEEPEST DISCOUNT AVAILABLE. BY EXPANDING THE PRESUMPTIVE ELIGIBILITY SCREENING PROCESSES AND DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO HELP. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERE'S ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE, AND WE AUTO-QUALIFY CERTAIN PATIENT POPULATIONS FOR CARLE FINANCIAL ASSISTANCE PROGRAM, SUCH AS THE HOMELESS, WIC, SNAP, MEDICAID, LIHEAP, AND TOWNSHIP ASSISTANCE RECIPIENTS. COMMUNICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE CARLE FOUNDATION HOSPITAL HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THESE INCLUDE: * ADVERTISING CARLE FINANCIAL ASSISTANCE PROGRAM; CONTINUED PRESENCE IN APPROPRIATE COMMUNITY PUBLICATIONS; AND ON-SITE VIA DISPLAYS THROUGHOUT THE HOSPITAL AND CLINICS * SIMPLIFIED APPLICATION FORM, INCLUDING A VERSION IN SPANISH, THAT CONTAINS INFORMATION REGARDING THE CARLE FINANCIAL ASSISTANCE PROGRAM * PUBLICATION OF A PLAIN LANGUAGE SUMMARY AND ALL OTHER FINANCIAL ASSISTANCE-RELATED INFORMATION ON CARLE.ORG/FINANCIALASSISTANCE * INFORMATION ABOUT THE CARLE FINANCIAL ASSISTANCE PROGRAM ON ALL STATEMENTS, COLLECTION LETTERS, AND HOSPITAL ADMISSION PACKETS * CARLE FINANCIAL ASSISTANCE PROGRAM INFORMATION AND APPLICATIONS AT ALL REGISTRATION POINTS, HOSPITAL MAIN LOBBIES, AND CARLE.ORG * MEETINGS WITH LOCAL LEGISLATORS TO HELP THEM ASSIST CONSTITUENTS WITH HEALTHCARE NEEDS, INCLUDING FINANCIAL ASSISTANCE Schedule H, Part VI, Line 4 Community information CARLE RICHLAND MEMORIAL HOSPITAL HAS DEFINED ITS PRIMARY SERVICE AREA AND POPULATIONS AS THE GENERAL POPULATION WITHIN THE GEOGRAPHIC AREA IN AND SURROUNDING RICHLAND COUNTY DEFINED IN DETAIL BELOW. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. CARLE RICHLAND MEMORIAL HOSPITAL'S SERVICE AREA IS COMPRISED OF APPROXIMATELY 3,298.30 SQUARE MILES, WITH A POPULATION OF APPROXIMATELY 108,055 PEOPLE AND A POPULATION DENSITY OF 33 PEOPLE PER SQUARE MILE. THE SERVICE AREA CONSISTS OF THE FOLLOWING RURAL ILLINOIS COUNTIES: RICHLAND, LAWRENCE, EDWARDS, JASPER, CLAY, CRAWFORD, WABASH, AND WAYNE. POPULATION ESTIMATES FOR RICHLAND COUNTY AS OF 2022 IS 15,435, PREDOMINATELY WHITE (96.5%). 14.2% OF INDIVIDUALS LIVE IN POVERTY, WHILE THE PERSONS WITHOUT HEALTH INSURANCE UNDER 65 IS 6.7% OF THE POPULATION. Schedule H, Part VI, Line 5 Promotion of community health CARLE RICHLAND MEMORIAL HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY A COMMUNITY BOARD THAT SERVES ON A VOLUNTEER BASIS. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, CLINICAL SERVICE EXPANSION, AND QUALITY IMPROVEMENT. FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS, WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE. Schedule H, Part VI, Line 6 Affiliated health care system CARLE RICHLAND MEMORIAL HOSPITAL IS A 104 BED, NOT-FOR-PROFIT HEALTHCARE FACILITY LOCATED IN OLNEY, ILLINOIS AND BECAME PART OF THE CARLE HEALTH SYSTEM ON APRIL 1, 2017. AS PART OF THE CARLE HEALTH SYSTEM, IT CURRENTLY SERVES EIGHT SOUTHEASTERN ILLINOIS COUNTIES, WITH A TOTAL POPULATION OF MORE THAN 107,000 INDIVIDUALS. THE INTEGRATION OF CARLE AND CARLE RICHLAND MEMORIAL HOSPITAL ALLOWS FOR EXPANDED ACCESS TO HEALTHCARE IN THE REGION. THOUGH CARLE RICHLAND MEMORIAL HOSPITAL FALLS UNDER THE UMBRELLA OF THE CARLE FOUNDATION, IT MAINTAINS A SEPARATE BOARD OF DIRECTORS AND SENIOR LEADERSHIP. WHILE CARLE RICHLAND MEMORIAL HOSPITAL'S CHNA AND COMMUNITY BENEFIT REPORTING IS SEPARATE FROM THE CARLE FOUNDATION HOSPITAL, IT FOLLOWS THE SAME GUIDELINES AND PRINCIPLES. CARLE RICHLAND MEMORIAL HOSPITAL STAFF IS INVOLVED IN THE CHNA AND IMPLEMENTATION PLAN AND SERVE ON HUMAN SERVICES AGENCY BOARDS AND COMMITTEES TO PROVIDE SUPPORT TO HELP ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. Schedule H, Part VI, Line 7 State filing of community benefit report IL true RICHLAND COUNTY HIGH SCHOOL 1200 EAST LAUREL STREET OLNEY IL 62450 376004449 GOV'T 7440 SPONSORSHIP RICHLAND COUNTY DEVELOPMENT CORPORATION 315 WEST MAIN STREET OLNEY IL 62450 371201502 501(C)(3) 10000 PROGRAM SERVICES CITY OF OLNEY 300 S WHITTLE AVE OLNEY IL 62450 376001911 GOV'T 20000 COMMUNITY IMPROVEMENT PROJECT COMMUNITY INC 1702 COYOTE CROSSING OLNEY IL 62450 301200376 501(C)(3) 10600 PROGRAM SUPPORT 4 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. ANY CHARITABLE ORGANIZATION WISHING TO REQUEST FUNDS IS ASKED TO SUBMIT THEIR REQUEST IN WRITING. EMAILED REQUESTS ARE ACCEPTABLE. THE REQUEST MUST INCLUDE A DESCRIPTION OF THE PURPOSE OF THE CONTRIBUTION AND OTHER RELEVANT INFORMATION SUCH AS REQUESTORS NAME, AMOUNT OF THE REQUEST, ETC. THE REQUESTS ARE REVIEWED, EVALUATED, AND ADMINISTERED BY THE MARKETING AND COMMUNICATIONS (PUBLIC RELATIONS) DEPARTMENT, SEEKING ADDITIONAL INFORMATION FROM THE REQUESTOR, AS NEEDED, AND INPUT FROM ANY APPROPRIATE CARLE ADMINISTRATOR OR DIRECTOR. A SET OF ESTABLISHED GUIDELINES DRIVE THESE DECISIONS WHILE MOST ARE MADE TO IMPROVE HEALTHCARE/ACCESS TO HEALTHCARE OR ARE IN LINE WITH OUR ROLE AS A CORPORATE CITIZEN. ASSESSED NEED IS A COMMON CRITERIA. IN THE CASE OF MOST DONATIONS OF $5,000 OR MORE, SUCH AS TO COLLEGES AND UNIVERSITIES OR COMMUNITY CLINICS, WRITTEN AGREEMENTS ARE IN PLACE AND WE HAVE REGULAR CONTACT WITH THOSE ORGANIZATIONS, OFTENTIMES THROUGH A CARLE CONTACT PERSON TO ASSURE THAT THE DONATIONS ARE BEING USED AS AGREED UPON. THE RECORDS ARE EITHER MAINTAINED IN ADMINISTRATION OR PUBLIC RELATIONS. true true false false false false false true false MATTHEW KOLB JD MHA TRUSTEE; EVP, CHIEF OPERATING OFFICER 0 979097 0 225035 0 159130 0 368388 0 25802 0 1757452 0 155067 SALLY SALMONS MD TRUSTEE & PHYSICIAN 0 396944 0 56199 0 3013 0 69824 0 19719 0 545699 0 8 RAYMOND FISHER MD TRUSTEE 490202 0 0 0 1877 0 45010 0 8161 0 545250 0 0 0 JAMES C LEONARD MD EX-OFFICIO, PRESIDENT & CEO 0 1607032 0 528517 0 4560 0 643876 0 17933 0 2801918 0 497 DENNIS HESCH EVP, CHIEF FINANCE & STRATEGY OFFICER 0 993973 0 288063 0 4063 0 396203 0 18597 0 1700899 0 0 REGINA THOMAS PRESIDENT, RICHLAND MEMORIAL HOSPITAL 0 239629 0 32572 0 2009 0 52840 0 14053 0 341103 0 0 LAUREN SCHMID EVP, CHIEF HUMAN RESOURCES OFFICER 0 550105 0 123287 0 98930 0 204706 0 24041 0 1001069 0 95210 KENNETH ARONSON MD MEDICAL DIRECTOR - DIAGNOSTIC SERVICES 0 509212 0 111911 0 2213 0 45010 0 18253 0 686599 0 0 TANNER MILLER MD CRMH MEDICAL DIRECTOR 0 406508 0 89475 0 2082 0 24510 0 25421 0 547996 0 0 NICHOLAS CROMPTON VP, CONSTRUCTION & FACILITY SERVICES 0 252006 0 27955 0 2000 0 45832 0 27768 0 355561 0 0 JOHN ALLEN CRNA - RMH ANESTHESIOLOGY 284620 0 12259 0 1488 0 23857 0 25557 0 347781 0 0 0 JOHN WALL CRNA LEAD - RMH ANESTHESIOLOGY 269419 0 12753 0 1796 0 24510 0 27126 0 335604 0 0 0 THOMAS FALCONE CRNA - RMH ANESTHESIOLOGY 266821 0 12259 0 1488 0 23443 0 27389 0 331400 0 0 0 BENJAMIN CURTIS CRNA - RMH ANESTHESIOLOGY 262078 0 12259 0 1488 0 23515 0 25820 0 325160 0 0 0 CHRISTINA BARE DIRECTOR, RMH PRIMARY CARE & SPECIALTY SERVICES 146978 0 15662 0 922 0 13512 0 0 0 177074 0 0 0 HARRY BROCKUS FORMER - OFFICER 0 0 0 0 0 162492 0 0 0 0 0 162492 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. Schedule J, Part I, Line 4a Severance or change-of-control payment IN 2022, SEVERANCE PAYMENTS WERE PAID TO HARRY BROCKUS ($162,492). Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE 2022 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THAT ARE LISTED IN THE 990 PART VII INCLUDE MATTHEW KOLB, SALLY SALMONS, MD, DENNIS HESCH, JAMES LEONARD, MD, REGINA THOMAS, LAUREN SCHMID, AND NICHOLAS CROMPTON. IN 2022, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO MATTHEW KOLB ($155,067), SALLY SALMONS, MD ($8), JAMES LEONARD, MD ($497), AND LAUREN SCHMID ($95,210). Schedule J, Part I, Line 7 Non-fixed payments PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. WHITLEY HOUCHIN FAMILY MEMBER OF TRUSTEE 120253 EMPLOYMENT false Schedule L, Part V WHITLEY HOUCHIN IS AN EMPLOYEE OF RICHLAND MEMORIAL HOSPITAL AND HAS A FAMILY RELATIONSHIP WITH GARY HOUCHIN (TREASURER OF BOARD). Form 990, Part VI, Line 2 Family/business relationships amongst interested persons MATTHEW KOLB (OFFICER), SALLY SALMONS, MD (TRUSTEE), AND JAMES LEONARD, MD (OFFICER) - Business relationship, DENNIS HESCH (OFFICER) AND JAMES LEONARD, MD (OFFICER) - Business relationship, DENNIS HESCH (OFFICER), JAMES LEONARD, MD (OFFICER), AND LAUREN SCHMID (KEY EMPLOYEE) - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders RICHLAND MEMORIAL HOSPITAL, INC. HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body RICHLAND MEMORIAL HOSPITAL INC.'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RICHLAND MEMORIAL HOSPITAL, INC. MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF GOVERNING DOCUMENTS; RECOMMENDING THE CEO TO THE BOARD; APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS; APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND BOARD OF TRUSTEES FOR THEIR EXPENSES OR COMPENSATION FOR SERVICES; APPROVING ANY NEW, LONG-TERM OR MASTER INSTITUTIONAL PLANS OR CHANGES TO SUCH PLANS; APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC; APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE; APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED (CON) APPROVAL; APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION; APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS; AND APPROVING NON-BUDGETED EXPENDITURES OR SALE EXCEEDING THE CHIEF EXECUTIVE OFFICER'S (CEO) AUTHORIZED SPENDING AUTHORITY. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE COMPLIANCE DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. Form 990, Part VI, Line 19 Required documents available to the public RICHLAND MEMORIAL HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER REVENUE - Total Revenue: 73813, Related or Exempt Function Revenue: 50193, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 23620; Form 990, Part XI, Line 9 Other changes in net assets or fund balances INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS - 6834231; Form 990, Part XII, Line 2c Change of oversight process or selection process FORM 990 PART XII, QUESTIONS 2A, B, C AND PART IV, QUESTION 12 THE FINANCIAL STATEMENTS FOR RICHLAND MEMORIAL HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR. THE CARLE FOUNDATION 611 W PARK ST URBANA IL 618012595 370673465 Parent/Inv Mgnt IL 501(c)(3) Type III-FI NA false THE CARLE FOUNDATION HOSPITAL 611 W PARK ST URBANA IL 618012595 371119538 Hospital Services IL 501(c)(3) 3 TCF true CARLE DEVELOPMENT FOUNDATION 611 W PARK ST URBANA IL 618012595 371159978 Fundraising IL 501(c)(3) 7 TCF true CARLE RETIREMENT CENTERS INC 611 W PARK ST URBANA IL 618012595 371160033 Retirement Living IL 501(c)(3) 10 TCF true CARLE COMMUNITY HEALTH CORPORATION 611 W PARK ST URBANA IL 618012595 364458371 FNDN mission IL 501(c)(3) Type I TCDF true HOOPESTON COMMUNITY MEMORIAL HOSPITAL 701 E ORANGE ST HOOPESTON IL 609421801 363637465 Hospital Services IL 501(c)(3) 3 TCF true CARLE HEALTH CARE INCORPORATED 611 W PARK ST URBANA IL 618012595 371140016 Various Med Services IL 501(c)(3) 10 TCF true CARLE BROMENN MEDICAL CENTER 611 W PARK ST URBANA IL 618012595 850682363 Hospital Services IL 501(c)(3) 3 TCF true CARLE EUREKA HOSPITAL 611 W PARK ST URBANA IL 618012595 850688306 Hospital Services IL 501(c)(3) 3 TCF true CARLE CANCER INSTITUTE NORMAL LLC 407 E VERNON AVE NORMAL IL 61761 371363717 Cancer Treatment IL 501(c)(3) Type I TCF true CARLE WEST PHYSICIAN GROUP INC 611 W PARK ST URBANA IL 618012595 850703768 Physician Services IL 501(c)(3) 10 CHCI true CRIS HEALTHY AGING 309 N FRANKLIN ST DANVILLE IL 618324509 370948852 Senior Citizen Services IL 501(c)(3) 7 CHCI true CHAMPAIGN SURGICENTER LLC 611 W PARK ST URBANA IL 618012595 201915925 Surgical Center IL NA N/A false false HEALTH SYSTEMS INSURANCE LIMITED Governors Square 2nd Floor Bldg 3 23 Line Tree Bay Ave GRAND CAYMAN CJ KY11102 Insurance CJ NA C Corporation true CARLE RISK MANAGEMENT COMPANY 611 W PARK ST URBANA IL 618012595 371217973 Risk Management IL NA C Corporation true EVALIDATA INC 611 W PARK ST URBANA IL 618012595 462022658 Physician Credentialing IL NA C Corporation true CHA HOLDING INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 471854275 Holding Co. IL NA C Corporation true CARLE HOLDING COMPANY INC 611 W PARK ST URBANA IL 618012595 371188284 Holding Co. IL NA C Corporation true HEALTH ALLIANCE MEDICAL PLANS INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 371260731 Health Coverage IL NA C Corporation true HEALTH ALLIANCE CONNECT INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 464796891 Health Care Coordination IL NA C Corporation true HEALTH ALLIANCE NORTHWEST HOLDING INC 820 N CHELAN AVE WENATCHEE WA 98801 461717578 Holding Co. WA NA C Corporation true HEALTH ALLIANCE NORTHWEST HEALTH PLAN INC 820 N CHELAN AVE WENATCHEE WA 98801 461966323 Health Coverage WA NA C Corporation true HEALTH ALLIANCE-MIDWEST INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 371354502 Health Coverage IL NA C Corporation true CARLE VENTURES INC 611 W PARK ST URBANA IL 618012595 371313150 Health Care Partnerships IL NA C Corporation true CARLE HEALTH PHYSICIAN PARTNERS INC 611 W PARK ST URBANA IL 618012595 850718392 Physician Services IL NA C Corporation true FIRST CAROLINA CARE INSURANCE COMPANY 42 Memorial Drive PINEHURST IL 28374 331160597 Insurance IL NA C Corporation true true false true false false false false false false false true true true false false true true false true CARLE DEVELOPMENT FOUNDATION C 159045 BOOK HEALTH ALLIANCE CONNECT INC L 768562 BOOK HEALTH ALLIANCE MEDICAL PLANS INC L 1637687 BOOK HEALTH SYSTEMS INSURANCE LIMITED M 133684 BOOK THE CARLE FOUNDATION P 11918347 BOOK HOOPESTON COMMUNITY MEMORIAL HOSPITAL S 58663 BOOK THE CARLE FOUNDATION HOSPITAL S 255698 BOOK THE CARLE FOUNDATION S 113283 BOOK CARLE HEALTH CARE INCORPORATED Q 1739374 BOOK