HARRISBURG MEDICAL CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HARRISBURG MEDICAL CENTER INC (EIN 23-7426289)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-16
- IRS object ID
- 202221369349306787
- Schema version
- 2020v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-16T12:11:53-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 REGENCY PARK SUITE 175 | AddressLine1Txt |
| City | OFALLON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62269 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237426289 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARR | BusinessNameControlTxt |
| Phone | 6182537671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DONALD H HUTSON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6182537671 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DONALD | PersonFirstNm |
| Person Last | HUTSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF PARKER | PreparerPersonNm |
| PTIN | P00970069 | PTIN |
| Phone | 6182331200 | PhoneNum |
| Preparation | 2022-05-13 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DONALD H HUTSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,354,472 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HARRISBURGMC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 596 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,101,443 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,797,053 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,857,115 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $51,202,471 | CYProgramServiceRevenueAmt |
| PY Investment Income | $132,164 | PYInvestmentIncomeAmt |
| CY Investment Income | $158,706 | CYInvestmentIncomeAmt |
| PY Other Revenue | $269,727 | PYOtherRevenueAmt |
| CY Other Revenue | $204,718 | CYOtherRevenueAmt |
| PY Total Revenue | $60,360,449 | PYTotalRevenueAmt |
| CY Total Revenue | $64,362,948 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,496,455 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,889,993 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,528,093 | PYOtherExpensesAmt |
| CY Other Expenses | $26,824,795 | CYOtherExpensesAmt |
| PY Total Expenses | $59,024,548 | PYTotalExpensesAmt |
| CY Total Expenses | $57,714,788 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,335,901 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,648,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $60,904,148 | TotalAssetsBOYAmt |
| Total Assets EOY | $53,080,348 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,306,177 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,674,972 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,597,971 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,405,376 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF HARRISBURG MEDICAL CENTER IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,939,676 | ExpenseAmt |
| Revenue | $39,562,530 | RevenueAmt |
| Desc | IN SUPPORT OF ITS MISSION, THE HOSPITAL PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS THAT MEET THE HOSPITAL'SFINANCIAL ASSISTANCE CRITERIA. BECAUSE THE HOSPITAL DOES NOT PURSUECOLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) WERE APPROXIMATELY $2,233,000 FOR 2021. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS WHICH ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,437,631 | ExpenseAmt |
| Revenue | $11,639,941 | RevenueAmt |
| Desc | MULBERRY CENTER AT HARRISBURG IS DESIGNED TO OFFER QUALITY PSYCHIATRIC CARE IN AN ENVIRONMENT WHERE COMPREHENSIVE MEDICAL CARE IS AVAILABLE. THROUGH AN INTERACTIVE EXPERIENCE, PATIENTS LEARN TO BETTER UNDERSTAND THEMSELVES AND BEGIN ACCEPTING RESPONSIBILITY FOR THEIR OWN WELLBEING. THE INPATIENT UNIT IS DIVIDED INTO TWO WINGS. THE FIRST IS A GENERAL ADULT UNIT, HOUSING INDIVIDUALS WITH PSYCHIATRIC DISORDERS WHICH DO NOT INVOLVE DEMENTIA. THE SECOND WING IS A GEROPSYCHIATRIC UNIT WHICH TREATS INDIVIDUALS WHOSE PSYCHIATRIC CONDITION IS COMPLICATED BY DEMENTIA.IN THE GERIATRIC WING, PATIENTS ALSO RECEIVE SERVICES FROM NURSES, SOCIAL WORKERS AND ACTIVITY THERAPISTS UNDER THE DIRECTION OF PSYCHIATRISTS, BUT MORE EMPHASIS IS PLACED ON MANAGING THE COGNITIVE DEFICITS THAT ARE ASSOCIATED WITH DEMENTIA. MULBERRY CENTER AT HARRISBURG HAS EMERGENCY ADMISSIONS 24 HOURS A DAY, SEVEN DAYS A WEEK. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $45,377,307 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 60 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 596 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUNE HAYES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6182537671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DR | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DENNIS MURPHY | ||||||||
| BOARD CHAIR | 4.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID EDMISTER | ||||||||
| VICE-CHAIR (TERM ENDED 4/21) | 4.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL WILLIAMS | ||||||||
| SECRETARY/TREASURER | 4.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LARRY JONES MD | ||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BENNA DAUGHERTY | ||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL TISON | ||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT BUSINARO | ||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BECKY MITCHELL | ||||||||
| BOARD MEMBER (TERM ENDED 12/20) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY PHELPS | ||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ANGELA ROWE | ||||||||
| BOARD MEMBER | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GINA SIRACH | ||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD HUTSON | ||||||||
| PRESIDENT/CEO | 40.00 | 0.50 | Yes (X) | $343,670 | $0 | $20,924 | ||
| LESLIE FERRELL | ||||||||
| VICE-PRESIDENT/CNO | 40.00 | 0.00 | Yes (X) | $180,457 | $0 | $14,345 | ||
| THERESA JUNE HAYES | ||||||||
| VICE-PRESIDENT/CFO | 40.00 | 1.00 | Yes (X) | $197,184 | $0 | $16,667 | ||
| JAMES ALEXANDER | ||||||||
| VICE-PRESIDENT/CMO | 40.00 | 0.00 | Yes (X) | $566,816 | $0 | $15,963 | ||
| KEVIN KOTH | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $614,706 | $0 | $17,220 | Yes (X) | ||
| CLAYTON FORD | ||||||||
| PHYSICIAN | 36.00 | 0.00 | $360,363 | $0 | $20,882 | Yes (X) | ||
| ANAND PATEL | ||||||||
| PHYSICIAN | 36.00 | 0.00 | $501,251 | $0 | $2,488 | Yes (X) | ||
| THOMAS BUTLER | ||||||||
| CRNA | 36.00 | 0.00 | $279,360 | $0 | $13,541 | Yes (X) | ||
| JASON VALLETTE | ||||||||
| CRNA | 36.00 | 0.00 | $264,949 | $0 | $19,632 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,308,756 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $141,662 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SOUTHERN ILLINOIS PSYCHIATRY LLC | |||||
| 112 AIRWAY DR | MARION | IL | 62959 | CONTRACTED PHYSICIANS AND OTHER STAFF | $1,923,067 |
| STATERA HEALTHCARE LLC | |||||
| 2250 N ILLINOIS AVE | CARBONDALE | IL | 62902 | CONTRACTED PHYSICIANS AND OTHER STAFF | $969,377 |
| TRINITY MEDICAL STAFFING LLC | |||||
| 2250 N ILLINOIS AVE | CARBONDALE | IL | 62902 | CONTRACTED PHYSICIANS AND OTHER STAFF | $812,236 |
| LIQUID AGRENTS HEALTHCARE LLC | |||||
| 6900 DALLAS PARKWAY SUITE 450 | PLANO | TX | 75024 | CONTRACTED PHYSICIANS AND OTHER STAFF | $284,620 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | CONTRACTED PHYSICIANS AND OTHER STAFF | $274,739 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $12,652,200 | GovernmentGrantsAmt |
| All Other Contributions | $144,853 | AllOtherContributionsAmt |
| Total Contributions | $12,797,053 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624110 | $51,100,908 | $51,100,908 |
| RENT REVENUE | 624100 | $101,563 | $101,563 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $51,202,471 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130,456 | TotalRevenueColumnAmt |
| Exclusion | $130,456 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,019,774 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $991,524 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,250 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,250 | TotalRevenueColumnAmt |
| Exclusion | $28,250 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| OTHER REVENUE | 624100 | $116,272 | $116,272 |
| CAFETERIA REVENUE | 624110 | $80,864 | $80,864 |
| COIN MACHINES & TV | 624100 | $4,219 | $4,219 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,363 | TotalRevenueColumnAmt |
| Exclusion | $3,363 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $204,718 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,362,948 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $51,202,471 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $363,424 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,374,457 | TotalAmt |
| Management And General | $1,374,457 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,385,552 | TotalAmt |
| Program Services | $19,082,008 | ProgramServicesAmt |
| Management And General | $3,303,544 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $693,884 | TotalAmt |
| Program Services | $557,268 | ProgramServicesAmt |
| Management And General | $136,616 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,743,940 | TotalAmt |
| Program Services | $3,804,757 | ProgramServicesAmt |
| Management And General | $939,183 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,692,160 | TotalAmt |
| Program Services | $1,358,998 | ProgramServicesAmt |
| Management And General | $333,162 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,173 | TotalAmt |
| Management And General | $92,173 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,890 | TotalAmt |
| Management And General | $18,890 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,611,453 | TotalAmt |
| Program Services | $7,799,121 | ProgramServicesAmt |
| Management And General | $2,812,332 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,248 | TotalAmt |
| Management And General | $178,248 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,658,173 | TotalAmt |
| Program Services | $3,213,677 | ProgramServicesAmt |
| Management And General | $1,444,496 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $680,132 | TotalAmt |
| Program Services | $614,418 | ProgramServicesAmt |
| Management And General | $65,714 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,866 | TotalAmt |
| Program Services | $66,153 | ProgramServicesAmt |
| Management And General | $2,713 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,088 | TotalAmt |
| Program Services | $26,271 | ProgramServicesAmt |
| Management And General | $34,817 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $898,299 | TotalAmt |
| Program Services | $780,922 | ProgramServicesAmt |
| Management And General | $117,377 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,896,902 | TotalAmt |
| Program Services | $2,896,902 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $720,169 | TotalAmt |
| Program Services | $625,555 | ProgramServicesAmt |
| Management And General | $94,614 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY SUPPLIES | $2,275,733 | $2,275,733 | |
| BAD DEBT EXPENSE | $1,561,912 | $1,561,912 | |
| MEDICAL SUPPLIES | $1,497,686 | $487,338 | $1,010,348 |
| FOOD & DIETARY | $236,507 | $156,764 | $79,743 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,564 | TotalAmt |
| Program Services | $69,510 | ProgramServicesAmt |
| Management And General | $299,054 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,714,788 | TotalAmt |
| Program Services | $45,377,307 | ProgramServicesAmt |
| Management And General | $12,337,481 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,910 | BOYAmt |
| EOY | $823,645 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,759,752 | BOYAmt |
| EOY | $15,067,728 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,451,145 | BOYAmt |
| EOY | $6,493,164 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,257 | BOYAmt |
| EOY | $65,642 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,842,109 | BOYAmt |
| EOY | $1,609,933 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $626,416 | BOYAmt |
| EOY | $822,394 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $58,369,280 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,861,167 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,296,281 | BOYAmt |
| EOY | $26,508,113 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,491,435 | BOYAmt |
| EOY | $1,684,511 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,843 | BOYAmt |
| EOY | $5,218 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,904,148 | BOYAmt |
| EOY | $53,080,348 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,939,470 | BOYAmt |
| EOY | $8,194,320 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,650,001 | BOYAmt |
| EOY | $497,846 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,376,501 | BOYAmt |
| EOY | $18,034,183 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,140,161 | BOYAmt |
| EOY | $948,623 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,044 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,306,177 | BOYAmt |
| EOY | $27,674,972 | 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 | $18,597,971 | BOYAmt |
| EOY | $25,405,376 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,597,971 | BOYAmt |
| EOY | $25,405,376 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,904,148 | BOYAmt |
| EOY | $53,080,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,648,160 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $159,245 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $18,890 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $18,890 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS MEMBERSHIP DUES TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA), A PERCENTAGE OF THESE DUES IS SPENT ON LOBBYING ACTIVITIES BY THESE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $772,443 | OtherCostOrOtherBasisAmt |
| Book Value | $772,443 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,287,123 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,413,958 | DepreciationAmt |
| Book Value | $20,873,165 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $672,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $510,715 | DepreciationAmt |
| Book Value | $161,374 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,623,187 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,936,494 | DepreciationAmt |
| Book Value | $4,686,693 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,438 | OtherCostOrOtherBasisAmt |
| Book Value | $14,438 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,508,113 | TotalBookValueLandBuildingsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $941,217 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $941,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01680 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,731,855 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,291,859 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,439,996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16810 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,673,072 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,291,859 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,381,213 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,673,072 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,291,859 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,381,213 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18490 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,561,912 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $520,637 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,550,999 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,195,973 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,644,974 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HARRISBURGMC.COM | WebsiteAddressTxt |
| State License | 521 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 5: HOW INPUT FROM THE COMMUNITY WAS TAKEN INTO ACCOUNT IN MOST RECENT CHNA: PRIMARY DATA WAS COLLECTED FROM SURVEYS AND ONE-ON-ONE MEETINGS WITH COMMUNITY MEMBERS WHO REPRESENT THE COMMUNITY. COMMUNITY MEMBERS INCLUDED CEO OF EGYPTIAN HEALTH DEPARTMENT, AN ELDORADO SCHOOL NURSE, A CASE MANAGER AND FORMER GALATIA SCHOOL NURSE, AN HMC FAMILY PRACTICE PHYSICIAN, A HARRISBURG SCHOOL NURSE, AN HMC COMMUNITY OUTREACH REGISTERED NURSE, A REPRESENTATIVE FROM SOUTHERN SEVEN HEALTH DEPARTMENT, WHIPPER JOHNSON - SALINE COUNTY SHERRIFF, AND DALE FOUWLER, ILLINOIS STATE SENATOR. INTERVIEWS WERE HELD WITH THESE COMMUNITY LEADERS, WHO REPRESENT STATE AND LOCAL GOVERNMENT, OUR SCHOOLS, AND LOCAL HEALTH DEPARTMENTS, ABOUT SOUTHEASTERN ILLINOIS' HEALTHCARE NEEDS AND THE HOSPITAL'S STRENGTHS AND WEAKNESSES. WE ASKED COMMUNITY MEMBERS OF OUR MEDICALLY UNDERSERVED AREAS TO PARTICIPATE IN HMC'S CHNA BY ANSWERING A SET OF QUESTIONS USING SURVEY MONKEY TO COLLECT THE DATA. RESPONDENTS ANSWERED SEVERAL QUESTIONS RELATED TO INDIVIDUAL HEALTH AND ACCESS TO CARE, HEALTH SERVICES CHALLENGES, AND RISK FACTORS. WE ALSO ASKED AREA PHYSICIANS ABOUT THEIR THOUGHTS AND CONCERNS ABOUT THE HEALTH OF THE COMMUNITY AND THEIR PATIENTS VIA A SURVEY THAT WAS EMAILED TO THEM. |
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 11: THE HOSPITAL'S MOST RECENTLY CONDUCTED CHNA IDENTIFIED AND PRIORITIZED THE FOLLOWING NEEDS: SUBSTANCE ABUSE, HEART DISEASE, STROKE AND CANCER. THE FOLLOWING ARE EXAMPLES OF HOW THESE PRIORITY AREAS ARE BEING ADDRESSED: 1) SUBSTANCE ABUSE HMC HAD PROVIDED AN OUTREACH NURSE TO DO COMMUNITY EDUCATION IN THE LOCAL SCHOOLS. THAT EDUCATION INCLUDED THE IMPACT OF ADDICTION ON COMMUNITY MEMBERS. THE EDUCATION STOPPED AT THE ONSET OF THE COVID 19 PANDEMIC. 2) HEART DISEASE HMC PARTNERS WITH PRAIRIE CARDIOVASCULAR TO PROVIDE CARDIAC SERVICES IN THE CLINIC SETTING 5 DAYS PER WEEK. HMC ALSO PROVIDES SERVICES SUCH AS CARDIOPULMONARY REHABILITATION, CARDIAC STRESS TESTING AND MONITORING. 3) STROKE HMC HAS PARTNERED WITH SOUTHERN ILLINOIS HEALTHCARE TO ENHANCE STROKE CARE ACROSS THE REGION. HMC UTILIZES TELEHEALTH CAPABILITIES TO PROVIDE FAST ACCESS TO NEUROLOGY CONSULTATION. 4) CANCER HMC IMAGING DEPARTMENT OFFERS LOW DOSE LUNG CANCER SCREENING TO PATIENTS WHO ARE AT RISK. HMC NOW HAS THE ABILITY TO PROVIDE MRI SERVICES ON SITE. |
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 13H: OTHER CRITERIA USED IN THE FAP AS ELIGIBILITY CRITERIA FOR FREE AND DSCOUNTED CARE: IF A PATIENT MEETS THE PRESUMPTIVE ELIGIBILITY CATEGORIES LISTED BELOW, THE PATIENT SHALL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SHALL BE DEEMED TO RECEIVE A 100% ALLOWANCE. PRESUMPTIVE ELIGIBILITY CATEGORIES ARE: 1. HOMELESSNESS-WHICH IS DEFINED AS AN INDIVIDUAL WITHOUT PERMANENT HOUSING WHO MAY LIVE ON THE STREETS, STAY IN A SHELTER, MISSION, SINGLE ROOM OCCUPANCY FACILITIES, ABANDONED BUILDING OR VEHICLE, OR IN ANY OTHER UNSTABLE OR NON-PERMANENT SITUATION; 2. DECEASED WITH NO ESTATE; 3. MENTAL INCAPACITATION WITH NO REPRESENTATIVE; 4. MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE; 5. MEDICAID ELIGIBLE ON DATE OF SERVICE, BUT THE SERVICE IS NON-COVERED (I.E. HOSPITAL INPATIENT CO-PAYS, NONCOVERED DAYS, NON-COVERED CHARGES AND SPENDDOWN AMOUNTS. NOTE: THIS DOES NOT INCLUDE OFFICE CO-PAY AMOUNTS); AND 6. INCARCERATION IN A PENAL INSTITUTION. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | THE FAP WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2020/05/FINANCIAL-ASSISTANCE-POLICY-4.28.2020.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE FAP APPLICATION WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2020/12/FINANCIAL-ASSISTANCE-PACKET-11.24.2020.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16C | THE FAP PLAIN LANGUAGE SUMMARY WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2020/12/FINANCIAL-ASSISTANCE-PACKET-11.24.2020.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 7A | THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2020/02/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 10A | THE ORGANIZATION'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2020/04/2019-CHNA-IMPLEMENTATIN-PLAN.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HMC CLINIC AT HARRISBURG | ||||
| 901 S COMMERCIAL | HARRISBURG | IL | 62946 | PROVIDER BASED RURAL HEALTH CLINIC |
| 2 - ELDORADO PRIMARY CARE | ||||
| 1007 US HIGHWAY 45 | ELDORADO | IL | 62930 | PROVIDER BASED RURAL HEALTH CLINIC |
| 3 - HMC CLINIC AT MARION | ||||
| 3106 OUTER DRIVE | MARION | IL | 62959 | PROVIDER BASED RURAL HEALTH CLINIC |
| 5 - MACH MINE CLINIC | ||||
| 16468 LIBERTY SCHOOL ROAD | MARION | IL | 62959 | PRIMARY CARE CLINIC |
| 6 - VIKING MINE CLINIC | ||||
| 13643 NORTH THOMPSONVILLE ROAD | MACEDONIA | IL | 62860 | PRIMARY CARE CLINIC |
| 7 - HMC SURGICAL SERVICES CLINIC | ||||
| 50 DR WARREN TUTTLE DRIVE | HARRISBURG | IL | 62946 | SURGICAL MEDICINE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO REPRESENTATIVE, MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE, MEDICAID ELIGIBLE ON DATE OF SERVICE BUT SERVICE IS NON-COVERED, AND INCARCERATION IN A PENAL INSTITUTION ARE FACTORS THAT QUALIFY A PATIENT UNDER THE HOSPITAL'S PRESUMPTIVE ELIGIBILITY RULES FOR FINANCIAL ASSISTANCE. THE HOSPITAL DOES NOT USE AN ASSET TEST AS A FACTOR IN DETERMINING ELIGIBILITY. |
| PART I, LINE 7: | THE ORGANIZATION USED A COST-TO-CHARGE RATIO AS CALCULATED UTILIZING DATA FROM INTERNAL ACCOUNTING RECORDS AND USING A METHODOLOGY CONSISTENT WITH SCHEDULE H INSTRUCTIONS TO DETERMINE AMOUNTS ON LINES 7A AND 7B OF PART I SCHEDULE H. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,561,912. |
| PART III, LINE 2: | THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST-TO-CHARGE RATIO, AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AND AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. |
| PART III, LINE 3: | BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS, THE ORGANIZATION ESTIMATES THAT IT IS LIKELY THAT UP TO ONE-THIRD OF ACCOUNTS WRITTEN OFF TO BAD DEBT MAY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE, BUT THE PATIENT CHOSE NOT TO APPLY. THEREFORE, 33.333% OF THE BAD DEBT ADJUSTMENTS ARE INCLUDED ON PART III, LINE 3 AT COST. |
| PART III, LINE 4: | THE ORGANIZATION'S BAD DEBT EXPENSE IS EXPLAINED IN NOTE 1 OF ITS AUDITED FINANCIAL STATEMENTS:--PATIENT ACCOUNTS RECEIVABLE--THE HOSPITAL PROVIDES AN ALLOWANCE FOR BAD DEBTS BASED UPON A REVIEW OF OUTSTANDINGRECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. PATIENTSERVICES ARE PROVIDED ON AN UNSECURED BASIS. PAYMENT IS REQUIRED UPON RECEIPT OF THEINVOICE. THE HOSPITAL BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'SLIABILITY IS DETERMINED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF ASBAD DEBTS BASED ON BILLING AND COLLECTION POLICIES OF THE HOSPITAL. AN ESTIMATED ALLOWANCE OFAPPROXIMATELY $2,805,000 AND $3,984,000 WAS RECORDED AT JUNE 30, 2021 AND 2020,RESPECTIVELY. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS ANAVERAGE OF 98% AND 97% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2021 AND 2020,RESPECTIVELY. DURING THE YEARS ENDING JUNE 30, 2021 AND 2020, THE HOSPITAL WROTE OFFAPPROXIMATELY $2,740,000 AND $2,927,000, RESPECTIVELY. |
| PART III, LINE 8: | UNPAID COST OF MEDICARE REPRESENTS THE COST (DETERMINED USING THE OVERALL COST TO CHARGE RATIO) OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE HOSPITAL'S COLLECTION POLICY AND FINANCIAL ASSISTANCE POLICY (FAP) CONTAIN PROVISIONS FOR COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANT. THESE PRACTICES ALSO APPLY BROADLY TO ALL TYPES OF PATIENTS. HOSPITAL WILL PROVIDE PATIENTS WITH A PLAIN LANGUAGE SUMMARY OF THE FAP. HOSPITAL WILL MAKE A REASONABLE EFFORT TO ORALLY NOTIFY THE INDIVIDUAL ABOUT THE FAP AND ABOUT HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FAP APPLICATION. IF HOSPITAL DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, HOSPITAL WILL A) PROVIDE THE INDIVIDUAL WITH A BILLING STATEMENT THAT INDICATES THE AMOUNT HE OR SHE OWES FOR THE CARE RECEIVED, ASSUMING THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE OTHER THAN FREE CARE AND HOW THAT AMOUNT WAS DETERMINED, B) REFUND TO THE INDIVIDUAL ANY AMOUNT HE OR SHE HAS PAID THAT EXCEEDS THE AMOUNT THE INDIVIDUAL IS DETERMINED TO BE PERSONALLY RESPONSIBLE FOR PAYING, C) TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") TAKEN AGAINST THE INDIVIDUAL. FOR ALL TYPES OF PATIENTS, HOSPITAL TAKES THE FOLLOWING ACTIONS AT LEAST 30 DAYS BEFORE INITIATING ECA TO OBTAIN PAYMENT FOR CARE: A) PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INDICATES FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS, B) IDENTIFIES THE ECA(S) THAT HOSPITAL (OR OTHER AUTHORIZED PARTY) INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE AND C) STATES A DEADLINE AFTER WHICH SUCH ECAS MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED. |
| PART VI, LINE 2: | THE HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY AND HOW THE HOSPITAL MIGHT ADDRESS THOSE NEEDS BY PARTICIPATING IN STRATEGIC AND OPERATIONAL PLANNING SESSIONS THAT INCLUDE THE BOARD OF DIRECTORS, STATE LEGISLATORS, OFFICIALS FROM THE LOCAL COMMUNITY COLLEGE AND LOCAL CLERGY. THE CEO PARTICIPATES IN STRATEGEGIC PLANNIC MEETINGS WITH A NEARBY REGIONAL HOSPITAL SYSTEM. HOSPITAL LEADERSHIP MEETS WITH LEADERSHIP FROM LOCAL HEALTH DEPARTMENTS, AREA HOSPITALS, AREA LONG TERM CARE FACILITIES AND EMERGENCY PLANNERS ON AN ONGOING BASIS. THE CMO MEETS REGULARLY WITH PRIMARY CARE CLINIC AND BEHAVIORAL HEALTH CLINIC LEADERS TO ASCERTAIN NEEDS AND ASSESS MEETING OF THE NEEDS. THE CMO MEETS REGULARLY WITH HOSPITALISTS AND EMERGENCY DEPARTMENT PHYSICIANS AND IMPLEMENTS RECOMMENDED CHANGES TO BETTER SERVE THE POPULATION. HOSPITAL DATA IS REVIEWED TO DETERMINE PATIENTS' NEEDS BY ANALYZING DIAGNOSIS, READMISSION RATES AND THE MEDICARE CASE MIX INDEX. THE HOSPITAL PARTICIPATES IN REGIONAL HAZZARD ASSESSMENTS AND DRILLS. |
| PART VI, LINE 3: | ALL PATIENTS WITHOUT THIRD PARTY COVERAGE, I.E., CONSIDERED "SELF-PAY", RECEIVE A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM (FAP) PLAIN LANGUAGE SUMMARY DURING REGISTRATION THAT DETAILS THE FAP. HOSPITAL PATIENT BILLING STATEMENTS INCLUDE A STATEMENT EXPLAINING HOW A PATIENT MAY APPLY FOR CONDSIDERATION UNDER THE HOSPITAL'S FAP. SIGNAGE IS DISPLAYED IN REGISTRATION, PATIENT CARE, AND BUSINESS OFFICE AREAS THAT ANNOUNCES FINANCIAL HELP WITH BILLS FOR THOSE PATIENTS WHO WUALIFY. FF A PATIENT CONTACTS THE BUSINESS OFFICE REGARDING DIFFICULTY IN MAKE PAYMENTS, HOSPITAL PERSONNEL INFORMS THE PATIENT OF THE FAP. ONE FULL-TIME FINANCIAL COUNSELOR ASSISTS THE HOSPITAL'S PATIENTS IN APPLYING FOR GOVERNMENT FUNDED MEDICAL COVERAGE OR IN APPLYING FOR THE HOSPITAL'S OWN FAP. |
| PART VI, LINE 4: | HARRISBURG MEDICAL CENTER PREDOMINATELY SERVES A FIVE-COUNTY AREA INCLUDING SALINE, GALLATIN, HARDIN, POPE AND WHITE COUNTIES. IN THE FIVE COUNTIES THERE IS A TOTAL POPULATION OF APPROXIMATELY 52,000. THE POPULATION HAS SHOWN A DECLINING TREND FOR AT LEAST THE PAST TWENTY YEARS. APPROXIMETELY 23% OF THE POPULATION IS 65 YEARS OLD OR OLDER. THE POPULATION IS PREDOMINANTLY WHITE. AN AVERAGE OF 86.4% OF THE POPULATION HAVE A HIGH SCHOL DIPLOMA WHILE ONLY 13.8% OF THE POPULATION OVER 25 YEARS OLD HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. THE MEDIAN HOUSEHOLD INCOME IN THE POPULATION SERVED FALLS WELL BELOW THE MEDIAN HOUSEHOLD INCOME FOR THE STATE OF ILLINOIS AND FOR THE UNITED STATES OF AMERICA. THE PERCENTAGE OF INDIVIDUALS IN THIS AREA LIVING IN THE POVERTY LEVEL EXCEEDS THE PERCENTAGE FOR THE STATE OF ILLINOIS AND FOR THE UNITED STATES OF AMERICA. THE LOCAL ECONOMY IS HEAVILY DEPENDENT ON RETAIL TRADE, TRANSPORTATION AND UTILITIES (23.1%), EDUCATIONAL AND HEALTH SERVICES (21.8%), PUBLIC ADMINISTRATION (19.6%), AND OTHER PRIVATE SECTOR INDUSTRIES MAKING UP THE REMAINDER. HARRISBURG MEDICAL CENTER'S ENTIRE SERVICE AREA IS CONSIDERED A FEDERALLY DIESGNATED MEDICALLY UNDERSERVED AREA. |
| PART VI, LINE 5: | PROMOTING THE HEALTH OF THE COMMUNITY: HMC IS PASSIONATE ABOUT THE HEALTH AND WELL-BEING OF THE COMMUNITIES SERVED.HMC PARTICIPATES IN MANY COMMUNITY EVENTS TO PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. COVID-19 SAFETY PRECAUTIONS HAVE PREVENTED THE HOSPITAL FROM HOLDING MOST OF THE COMMUNITY EVENTS NORMALLY HELD, BUT WE HAVE FOUND WAYS TO SUPPORT AND PROVIDE OUTREACH FOR OUR COMMUNITY. HMC PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS EVENTS TO PROMOTE HEALTH SUCH AS HEALTH FAIRS AT THE COMMUNITY COLLEGE, LOCAL PARADES, SALINE COUNTY CHAMBER OF COMMERCE, SALINE COUNTY CHAMBER GOLF TOURNAMENT.HMC ACTIVELY SUPPORTS AND WORKS WITH OTHER HEALTH-RELATED ORGANIZATIONS SUCH AS HOSPICE OF SOUTHERN ILLINOIS AND EGYPTIAN HEALTH DEPARTMENT, AS WELL AS OTHER AREA HOSPITALS, NURSING HOMES, ETC. HMC HOSTS SEMI-ANNUAL BLOOD DRIVES FOR THE AMERICAN RED CROSS AT THE HOSPITAL. DURING THE COVID-19 PANDEMIC, THE HOSPITAL AND CLINICS HAVE SUPPORTED OUR LOCAL SCHOOLS IN SALINE COUNTY BY PROVIDING FACE MASKS, HAND SANITIZER, AND DISINFECTING WIPES FOR STUDENTS THAT ARE UNABLE TO PURCHASE THEIR OWN. THE HOSPITAL AND CLINICS HAVE ALSO CONDUCTED FOOD DRIVES FOR LOCAL FOOD PANTRIES, A BABY SUPPLY DRIVE FOR OUR LOCAL CRISIS PREGNANCY CENTER, AND COAT/GLOVE DRIVES FOR THE LOCAL KIDS. HMC CLINICS ALSO PROVIDED FOOD BASKETS TO LOCAL FAMILIES AT THANKSGIVING AND CHRISTMAS AND ALSO PURCHASED GIFTS FOR THE SCHOOLS UNDER PRIVILEDGED STUDENTS. HMC IS A SPONSOR OF THE THE SALINE COUNTY "CREATING ENTREPRENEURIAL OPPORTUNITIES (CEO) PROGRAM" FOR LOCAL HIGH SCHOOL STUDENTS AND HMC'S CEO AND MARKETING DIRECTOR ARE ACTIVELY INVOLVED AS MENTORS TO THE STUDENTS THROUGOUT THE YEAR. SALINE COUNTY CEO PROGRAM IS A MENTORING PROGRAM THAT PROVIDES EFFECTIVE NETWORKING MODEL FOR STUDENTS. HMC IS ACTIVE WITH THE GOLDEN CIRCLE SENIOR CITZENS ORGANIZATION IN HARRISBURG. HMC'S REGISTERED DIETICIANS REVIEW AND APPROVE THEIR MENU EVERY MONTH AT NO CHARGE. OUR REGISTERED DIETICIANS ALSO PROVIDE NUTRITIONAL CONSULTS AT NO CHARGE IN THE CLINICS.HMC PROVIDES AN ATHLETIC TRAINER AND DRUG SCREENING TESTS AT NO CHARGE TO THE HARRSIBURG HIGH SCHOOL. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KOTH | ||||||||||||||
| PHYSICIAN | $530,129 | $0 | $69,577 | $0 | $15,000 | $0 | $11,000 | $0 | $6,220 | $0 | $631,926 | $0 | $0 | $0 |
| JAMES ALEXANDER | ||||||||||||||
| VICE-PRESIDENT/CMO | $311,456 | $0 | $235,860 | $0 | $19,500 | $0 | $11,000 | $0 | $4,963 | $0 | $582,779 | $0 | $0 | $0 |
| ANAND PATEL | ||||||||||||||
| PHYSICIAN | $461,110 | $0 | $40,141 | $0 | $0 | $0 | $0 | $0 | $2,488 | $0 | $503,739 | $0 | $0 | $0 |
| CLAYTON FORD | ||||||||||||||
| PHYSICIAN | $304,403 | $0 | $55,960 | $0 | $0 | $0 | $11,000 | $0 | $9,882 | $0 | $381,245 | $0 | $0 | $0 |
| DONALD HUTSON | ||||||||||||||
| PRESIDENT/CEO | $336,470 | $0 | $0 | $0 | $7,200 | $0 | $11,000 | $0 | $9,924 | $0 | $364,594 | $0 | $0 | $0 |
| THOMAS BUTLER | ||||||||||||||
| CRNA | $259,860 | $0 | $0 | $0 | $19,500 | $0 | $11,000 | $0 | $2,541 | $0 | $292,901 | $0 | $0 | $0 |
| JASON VALLETTE | ||||||||||||||
| CRNA | $258,949 | $0 | $0 | $0 | $6,000 | $0 | $11,000 | $0 | $8,632 | $0 | $284,581 | $0 | $0 | $0 |
| THERESA JUNE HAYES | ||||||||||||||
| VICE-PRESIDENT/CFO | $190,684 | $0 | $0 | $0 | $6,500 | $0 | $7,668 | $0 | $8,999 | $0 | $213,851 | $0 | $0 | $0 |
| LESLIE FERRELL | ||||||||||||||
| VICE-PRESIDENT/CNO | $180,457 | $0 | $0 | $0 | $0 | $0 | $6,973 | $0 | $7,372 | $0 | $194,802 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | JAMES ALEXANDER, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $19,500 KEVIN KOTH, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $15,000 THOMAS BUTLER, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $19,500 JASON VALLETTE, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $6,000 KEVIN KOTH, NON-QUALIFIED RETIREMENT PLAN DISTRIBUTIONS: $85,248 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 861091967 | BondIssuerEIN |
| CUSIP | 45204ETA6 | CUSIPNum |
| Bond Issued | 2017-03-14 | BondIssuedDt |
| Issue Price | $19,500,000 | IssuePriceAmt |
| Purpose | REFUND MORTGAGE NOTE AND FUND EXPANSION PROJECT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,165,468 | RetiredAmt |
| Total Proceeds | $19,500,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $382,353 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $9,984,348 | CapitalExpendituresAmt |
| Other Spent Proceeds | $9,133,299 | OtherSpentProceedsAmt |
| Substantial Completion | 2018 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| TIFFANY BUSINARO | |||
| EMPLOYEE - WIFE OF BOARD MEMBER MATT BUSINARO | $49,513 | WAGES | 0 |
| SKYLAR EDMISTER | |||
| EMPLOYEE - DAUGHTER OF BOARD MEMBER DAVID EDMISTER | $36,276 | WAGES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WAS AUTHORIZED TO NEGOTIATE A LETTER OF INTENT WITH SOUTHERN ILLINOIS HOSPITAL SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS AGREED UPON AND SIGNED THE LETTER OF INTENT AND AFFILIATION AGREEEMENT DURING THE ORGANIZATION'S TAX YEAR, AND SOUTHERN ILLINOIS HOSPITAL SERVICES BECAME THE SOLE MEMBER OF THE ORGANIZATION ON AUGUST 1, 2021. |
| FORM 990, PART VI, SECTION B, LINE 11B | DRAFT COPIES OF THE RETURN WILL BE DISTRIBUTED TO ALL BOARD MEMBERS WITH ADEQUATE TIME TO REVIEW. SPECIFIC ITEMS AND QUESTIONS WILL BE ADDRESSED FIRST WITH THE FINANCE COMMITTEE DURING A FINANCE COMMITTEE MEETING AND AGAIN WITH THE FULL BOARD AT A MONTHLY BOARD MEETING. REVISIONS WILL BE MADE AS REQUESTED AND FINAL COPY WILL BE APPROVED BY THE FULL BOARD AFTER FINANCE COMMITTEE REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND OFFICERS ARE COVERED UNDER THE HOSPITAL'S CONFLICT OF INTEREST POLICY. INTERESTED PERSONS, FINANCIAL INTEREST, AND INDEPENDENCE OF THE BOARD AND OFFICERS ARE DEFINED WITHIN THE POLICY. AFTER DISCLOSURE OF THE FINANCIAL INTEREST, ALL MATERIAL FACTS WILL BE DISCLOSED AND REVIEWED, INCLUDING DISCUSSION WITH THE INTERESTED PERSON. UPON REQUEST BY A BOARD MEMBER THE MATERIAL FACTS OF A NONFINANCIAL INTEREST WILL BE REVIEWED, INCLUDING DISCUSSION WITH THE INTERESTED PARTY. THEN THE POTENTIALLY CONFLICTED MEMBER SHALL LEAVE THE BOARD OR EXECUTIVE COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR EXECUTIVE COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE POLICY OUTLINES THE PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST. IF THE BOARD OR EXECUTIVE COMMITTEE HAS REASONABLE CAUSE TO BELIEVE A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE BOARD OR EXECUTIVE COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS, WITH ASSISTANCE FROM THE DIRECTOR OF HUMAN RESOURCES, REVIEWS THE ILLINOIS HOSPITAL ASSOCIATION (IHA) EXECUTIVE COMPENSATION SURVEY, ALONG WITH THE TOP DATA PAY AND BENEFIT SURVEY TO DETERMINE THE SALARY OF CEO. THE SURVEYS ARE USED EACH YEAR TO ENSURE THAT ANNUAL INCREASES HOLD THE CEO'S COMPENSATION WITHIN THE SALARY RANGE OF CEOS OF SIMILAR SIZED HOSPITALS. THIS PROCESS OF DELIBERATION AND DECISION WAS MOST RECENTLY COMPLETED IN 2020. THE CHIEF EXECUTIVE OFFICE DETERMINES THE PROPOSED COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER, AND CHIEF EXECUTIVE OFFICER BY REVIEWING THE IHA EXECUTIVE SALARY SURVEY. COMPARISONS ARE MADE BETWEEN HMC AND HOSPITAL OF SIMILAR SIZE, REVENUE AND NUMBER OF EMPLOYEES. THE PROPOSED COMPENSATIONS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE SURVEY IS REVIEWED EACH YEAR TO ENSURE THAT ANNUAL INCREASES HOLD THE COMPENSATION WITHIN THE SALARY RANGE OF OFFICERS OF SIMILAR SIZED HOSPITALS. THIS PROCESS OF DELIBERATION AND DECISION WAS MOST RECENTLY COMPLETED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,506,122. MANAGEMENT AND GENERAL EXPENSES 2,231,198. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,737,320. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 292,999. MANAGEMENT AND GENERAL EXPENSES 581,134. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 874,133. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT AND SELECTION PROCESSES DURING THE YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER CLINIC SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452945162 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 EAST CLARK STREET | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371411984 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE R, PART I | FormAndLineReferenceDesc |
| Explanation | HARRISBURG MEDICAL CENTER CLINIC SERVICES LLC OPERATED A PHYSICIAN CLINIC UNTIL APRIL 1, 2018, AT WHICH POINT ALL CLINIC OPERATIONS WERE TRANSFERRED TO HARRISBURG MEDICAL CENTER. THE LLC WAS TERMINATED AS OF JUNE 30, 2021. | ExplanationTxt |
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