2022-03-07T12:47:14-06:00 2021-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2020-07-01 370661208 HILLSBORO AREA HOSPITAL INC HILL 2175326111 1200 EAST TREMONT STREET HILLSBORO IL 62049 REX BROWN PRESIDENT & CEO 2175326111 2022-01-30 1 REX BROWN 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-01-30 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z REX BROWN 1200 EAST TREMONT STREET HILLSBORO IL 62049 35061637 0 X WWW.HILLSBOROAREAHOSPITAL.ORG X 1906 IL OPERATION OF HOSPITAL (INPATIENT, SWING BED & OUTPATIENT) AND ASSISTED LIVING FACILITIES. 11 11 302 51 0 0 3140649 2948145 27471083 31627496 704480 346169 114974 112785 31431186 35034595 115297 148421 0 0 11752165 12705232 0 0 0 13601425 16651870 25468887 29505523 5962299 5529072 53665107 55765297 15738725 11830788 37926382 43934509 TO POSITIVELY AFFECT THE HEALTH AND WELFARE OF THE COMMUNITIES WE SERVE THROUGH THE OPERATION OF A HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) AND AN ASSISTED LIVING FACILITY. 0 0 24422469 148421 31631611 OPERATION OF A 25-BED CRITICAL ACCESS HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) WITH AN ASSISTED LIVING FACILITY. 749 ACUTE DAYS, 933 SWING BED DAYS, 18,920 OUTPATIENT VISITS AND 9,159 ASSISTED LIVING RESIDENT DAYS PROVIDED IN FY 2021. HILLSBORO AREA HOSPITAL ALSO PROVIDED $328,153 IN CHARITY CARE AND $3,157,128 IN OTHER COMMUNITY BENEFITS, NOT INCLUDING BAD DEBT. 24422469 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 53 0 302 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X TERRI CARROLL 2175324187 1200 EAST TREMONT STREET HILLSBORO IL 62049 ANDREW OTT PODIATRIST 40.00 X 247248 0 21369 ELVIS HARRISON VP OF PATIENT CARE SERVICE 40.00 X 159329 0 27393 ABBY BUGG TEAMWORK REHAB DIRECTOR 40.00 X 122715 0 46918 THERESA RAPP DIRECTOR OF SURGICAL SERVICES 40.00 X 110379 0 3321 TERRI CARROLL VP OF FINANCIAL SERVICES 40.00 X 192185 0 33521 REX BROWN PRESIDENT & CEO 40.00 0.90 X 0 0 0 LINDSAY WAGAHOFF CHAIRMAN 1.00 X X 0 0 0 LISA WHITE VICE CHAIR 1.00 X X 0 0 0 EARL FLACK TREASURER 1.00 X X 0 0 0 JULIE JENKINS SECRETARY 1.00 0.20 X X 0 0 0 MISTY BORROWMAN DIRECTOR 1.00 X 0 0 0 DR DOUG BYERS DIRECTOR 1.00 X 0 0 0 DR BEN CADY DIRECTOR 1.00 X 0 0 0 GREG HOLCOMB DIRECTOR (THRU APRIL) 1.00 X 0 0 0 DAVID HOUGH DIRECTOR 1.00 X 0 0 0 DR NATHAN KIRBY DIRECTOR 1.00 X 0 0 0 JORDAN RUPPERT DIRECTOR 1.00 X 0 0 0 BRAD YOUNG DIRECTOR 1.00 X 0 0 0 831856 0 132522 7 0 1 0 ILLINOIS EMERGENCY PHYSICIANS LLP 200 CORPORATE BLVD LAFAYETTE LA 70508 PHYSICIAN COVERAGE 2318333 REDITUS LABORATORIES 200 ENTERPRISE DR PEKIN IL 61554 COVID TESTING SERVICES 1211700 HEALTHTECH MANAGEMENT SERVICES INC 5110 MARYLAND WAY STE 200 BRENTWOOD TN 37027 MANAGEMENT & CEO SERVICES 641269 ESP PERSONNEL 72-877 DINAH SHORE DR RANCHO MIRAGE CA 92270 NURSING PERSONNEL SERVICES 210206 FAVORITE HEALTHCARE STAFFING PO BOX 26225 OVERLAND PARK KS 66225 NURSING PERSONNEL SERVICES 186115 9 2948145 2948145 PATIENT SERVICE REVENUE 621110 31327691 31327691 299805 299805 31627496 358068 358068 78745 0 78745 78745 78745 15143 27042 -11899 -11899 -11899 CAFETERIA REVENUE 722514 29925 29925 AMBULANCE FEES 900099 4115 4115 34040 35034595 31631611 0 454839 X 148421 148421 225706 225706 9621310 8201100 1420210 242584 205345 37239 1909641 1600510 309131 705991 583287 122704 654462 654462 53539 1358 52181 43200 43200 6923516 6286938 636578 54556 54556 111853 30414 81439 339435 319398 20037 24098 21064 3034 32053 24149 7904 164276 164276 1171848 862302 309546 358943 51967 306976 SUPPLIES 2674723 2635650 39073 BAD DEBT EXPENSE 2274187 2274187 REPAIRS & MAINTENANCE 674502 571556 102946 MEDICAID TAX ASSESSMENT 504313 504313 592366 440547 151819 29505523 24422469 5083054 0 9148054 9784304 17014885 18162955 2510756 2939988 557250 896227 479184 439629 35546395 24221476 11454721 11324919 3544582 4536840 8408712 7133802 546963 546633 53665107 55765297 2660870 3227588 1100851 0 4486305 4152745 7490699 4450455 15738725 11830788 X 36932314 42938211 994068 996298 37926382 43934509 53665107 55765297 X 5529072 979591 -500536 X X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10554 10554 0 PART II-B, LINE 1: HILLSBORO AREA HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS, TO HELP WITH STAFF TRAINING, AND TO ASSIST WITH REIMBURSEMENT. HILLSBORO AREA HOSPITAL ESTIMATED THAT $10,554 OUT OF THE TOTAL DUES PAID TO IHA AND AHA WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS. 426926 3469 430395 421176 5750 426926 418430 2746 421176 414863 3567 418430 412788 2075 414863 0.00000 0.66218 0.33782 0 1 1 355860 355860 19617158 11154945 8462213 15468793 13066531 2402262 104584 104584 11324919 CERTIFICATES OF DEPOSITS 7133802 C 7133802 ASSET RETIREMENT OBLIGATION 77061 AMOUNTS PAYBALE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 4373394 4450455 32757642 0 32757642 2276953 2276953 35034595 27231336 0 27231336 2274187 2274187 29505523 PART V, LINE 4: THE ENDOWMENTS ARE INTENDED TO BE USED TO SUPPORT THE MAINTENANCE AND EQUIPMENT NEEDS OF THE HOSPITAL. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,274,187. INVESTMENT INCOME RECORDED TO RESTRICTED NET ASSET 2,766. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,274,187. 1 1 X 1 X 1 X 1 1 0 1 0 141766 141766 0.00520 5715113 3541294 2173819 0.07980 5856879 3541294 2315585 0.08500 16121 4888 11233 0.00040 4464361 3598209 866152 0.03180 203079 203079 0.00750 4683561 3603097 1080464 0.03970 10540440 7144391 3396049 0.12470 75405 75405 0.00280 12039 12039 0.00040 87444 87444 0.00320 0 982476 491238 10072772 9973041 99731 X 1 1 1 1 HILLSBORO AREA HOSPITAL 1200 EAST TREMONT STREET HILLSBORO IL 62049 WWW.HILLSBOROAREAHOSPITAL.ORG 968 X X X X HILLSBORO AREA HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SEE PART V, SECTION C, LINE 7D X 1 18 1 SEE PART V, SECTION C, LINE 7D 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X X 1 X 0 0 HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN PUBLIC HEALTH (LOCAL, REGIONAL, STATE AND/OR TRIBAL). MEMBERS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY THE HOSPITAL OR INDIVIDUALS OR ORGANIZATIONS REPRESENTING THE INTERESTS OF SUCH POPULATIONS ALSO PROVIDED INPUT. THE MEDICALLY UNDERSERVED ARE MEMBERS OF A POPULATION WHO EXPERIENCE HEALTH DISPARITIES, ARE AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED, AND/OR EXPERIENCING BARRIERS TO HEALTH CARE DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL, OR OTHER BARRIERS. MONTGOMERY COUNTY PUBLIC HEALTH PARTICIPATED IN THE PROCESS. FOCUS GROUP#1 - THE GROUP CONSISTED OF MEDICAL PROFESSIONALS AND PARTNERS, INCLUDING REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED PHYSICIANS, A NURSE PRACTITIONER, A PHARMACIST, AN ANESTHESIOLOGIST, AN OPTOMETRIST, NURSES, AND REPRESENTATIVES OF SENIOR CARE FACILITIES. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL.FOCUS GROUP#2 - THE GROUP CONSISTED OF COMMUNITY LEADERS AND REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED SCHOOL OFFICIALS, THE COUNTY PUBLIC HEALTH ADMINISTRATOR, A REPRESENTATIVE OF THE SHERIFF'S OFFICE, LOCAL COMMUNITY DEVELOPMENT LEADERS, UNIVERSITY OF ILLINOIS EXTENSION, COMMUNITY ORGANIZATION MEMBERS, AND OTHERS. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL.FOCUS GROUP#3 - THE GROUP CONSISTED OF COMMUNITY LEADERS AND REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED LEADERS OF VOLUNTEER ORGANIZATIONS, SENIOR CITIZENS, THE MAYOR OF HILLSBORO, AND OTHERS. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL. HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/PART V, SECTION B, LINE 10A:HTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/ HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 11: 1. MENTAL HEALTH A. EDUCATION FOR PARENTS ABOUT MENTAL HEALTH ISSUES FACING YOUTH.OUR FIRST STEP WAS A SEND HOME AN EXPLANATION OF THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF POPULATION SCIENCE AND POLICY (SIU SOM DPS&P) TWO-SESSION SURVEY THAT OCCURRED IN NOVEMBER 2019. B. ADDRESS TEEN SUICIDEASSESSING THE MIDDLE AND HIGH SCHOOL STUDENTS TO REDUCE TEEN SUICIDE WAS THE TARGET OF THE RESEARCH CONTRACT WITH SIU SOM DPS&P. IN NOVEMBER OF 2019, APPROXIMATELY 750 STUDENTS PARTICIPATED IN A SURVEY THAT WAS DIVIDED INTO TWO 45-MINUTE SESSIONS. A COMMUNITY STEERING COMMITTEE WAS FORMED TO ASSESS THE DATA AS PRESENTED BY THE POPULATION SCIENCE AND POLICY RESEARCHERS. THE STEERING COMMITTEE THEN STUDIED PROGRAMS ACROSS THE NATION THAT HAD PROVEN TO BE SUCCESSFUL IN DEALING WITH YOUTH'S ISSUES, SIMILAR TO THE ISSUES FOUND IN THE SURVEY DATA, SURROUNDING SUICIDE. TWO PROGRAMS WERE SELECTED. - CEO, IBH MEDICAL DIRECTOR, AND BEHAVIORAL HEALTH NURSE COORDINATOR ATTENDING DAVID A. IMLER PROGRAM MONTHLY STEERING COMMITTEE MEETINGS TO AID IN THE DIRECTION OF OUR MONTGOMERY COUNTY'S MENTAL HEALTH STRATEGIES. IN ADDITION, A HOSPITAL BOARD MEMBER AND PHYSICIAN MEMBER O THE HOSPITAL BOARD ARE FULL MEMBERS OF THE STEERING COMMITTEE.C. COMMUNITY AWARENESS EDUCATION ON MENTAL HEALTHIN FEBRUARY, 2020 THE STEERING COMMITTEE WAS ABLE TO RAISE ABOUT $37,000 AT AN EVENT SPONSORED BY THE HILLSBORO AREA HEALTH FOUNDATION. ADDITIONAL FUNDS HAVE BEEN ADDED DURING THE 2020 YEAR AND THERE IS NOW SUFFICIENT FUNDING TO SUPPORT THE TWO PROGRAMS FOR A NUMBER OF YEARS. IN PREPARATION FOR FUND-RAISING THE COMMUNITY AWARENESS WAS ADDRESSED AND WAS SUCCESSFUL AS MEASURED BY SIGNIFICANT FUNDS RAISED. -MONTGOMERY COUNTY BICENTENNIAL CELEBRATION JUNE 2021I. COMMUNITY AWARENESS R/T MENTAL HEALTH BOOTH- EDUCATING PUBLIC ON PROGRAMS IN THE HIGH SCHOOL AND ON WAYS TO COPE WITH ANXIETYD. EDUCATION ON AWARENESS AND UNDERSTANDING OF SELF ESTEEMTHE EDUCATION ON AWARENESS AND UNDERSTANDING OF SELF-ESTEEM STARTED WHEN THE "SOURCES OF STRENGTH" PROGRAM LAUNCHED IN OCTOBER 2020. THE SECOND INITIATIVE THAT OPERATES UNDER THE NAME "BLUES PROGRAM" BEGAN IN LATE JANUARY 2021. CONTRACT NEGOTIATIONS FOR THAT PROGRAM BEGAN IN JUNE 2020 AND ARE EXPECTED TO CONCLUDE EARLY ENOUGH IN JANUARY 2021 TO HAVE THE PROGRAM COMMENCE ON SCHEDULE. -BLUES PROGRAMI. OBTAINED ICAHN MENTAL HEALTH GRANTII. 4 IBH STAFF, TRAINED FACILITATORS FEB 2021III. THE HILLSBORO SCHOOL DISTRICT IDENTIFIED 26 YOUTH AT HIGH RISK BASED UPON THE SURVEY WHICH WAS COMPLETED FALL OF 2020, AND OF THAT 26 WE GRADUATED 20 IN APRIL 2021. WE HAVE SUCCESSFULLY COMPLETED OUR FIRST PROGRAM. -WORKED WITH SIU RESEARCH, THE PARTNERSHIP WITH SIU SCHOOL OF MEDICINE TOOK OUR PROCESS UP A FEW STEPS, OPENING THE DOOR TO CONDUCT FOCUS GROUPS, CIRCULATE SURVEYS AND REACH BROADER SOCIAL STRATA AND AGE GROUPS. -SOURCES OF STRENGTH PROGRAMI. ALL PARTIES AGREED TO ADD SOURCES OF STRENGTH TO THE HILLSBORO MIDDLE SCHOOL FALL 2021II. TRAINING OF HILLSBORO MIDDLE SCHOOL STAFF AND STUDENTS OCTOBER 2021E. ADDRESS MENTAL HEALTH DISORDER "TRIGGERS"THE TWO PROGRAMS ARE DESIGNED TO ADDRESS MENTAL HEALTH TRIGGERS. THEY WILL BE TAUGHT AT THE HIGH SCHOOL LEVEL THROUGH 2021. SOURCES OF STRENGTH WILL BEGIN IN THE MIDDLE SCHOOL IN 2021. THE STEERING COMMITTEE HAS ALSO RAISED SUFFICIENT FUNDS TO EXPAND THE PROGRAM TO THE NOKOMIS SCHOOL DISTRICT, WHICH LIES IN THE HOSPITAL'S SECONDARY SERVICE AREA. THE HOSPITAL ALSO ADDED TWO PROFESSIONALS TO THE INTEGRATED BEHAVIORAL MEDICINE STAFF IN 2020. THE FOUR PERSON DEPARTMENT IS OVERSEEN BY BOTH HOSPITAL NURSING AND OUR CONTRACTED PSYCHIATRIST. PATIENTS ARE BEING SEEN AND TREATED AND AN AREA HEALTH SYSTEM IS IN DISCUSSIONS WITH THE HOSPITAL TO EXPAND INTO ONE OF THEIR SERVICE AREAS TO OUR SOUTH. PURSUIT OF TELE PSYCH SERVICES HAS BEEN ACTIVE BUT UNSUCCESSFUL TO THIS POINT. ATTEMPTS TO CONTRACT FOR THIS SERVICE HAVE FAILED WHEN THE CONTRACTING AGENCY IS UNABLE TO FIND QUALIFIED STAFF WITHIN OUR FISCAL YEAR 2021. -TELEPSYCHIATRYI. CONTRACT SIGNED FEB 2021 WITH ARRAY TELEPSYCHIATRY.II. STARTED SEEING PATIENTS IN AUG. 2021-ADDED NEW IBH SOCIAL WORKER EMPLOYEE IN MAY 2021 -HSHS GREENVILLE (BOND COUNTY) COLLABORATION EXPANSIONI. STARTING TO TAKE PATIENTS MAY 2021 II. CARE MANAGER IN GREENVILLE 3 DAYS A WEEK( TUESDAY, THURSDAY, FRIDAY-SPRINGFIELD CLINIC HILLSBOROI. 328 PATIENT ENCOUNTERS-HHSHS HILLSBORO/TAYLORVILLEII. 1295 PATIENT ENCOUNTERS-HSHS GREENVILLEIII. 76 PATIENT ENCOUNTERSCOVID- 19 RESPONSE:-FRONT LINE STAFF- IBH THERAPIST PROVIDED INDIVIDUAL SUPPORT- AVAILABLE 3 TIME/WEEK -WEEKLY GROUP SUPPORT FOR FRONT LINE LONG TERM CARE STAFF-USED VIDEO/AUDIO CONFERENCING TO NOT DISRUPT TREATMENT DURING COVID -19-WEEKLY MENTAL HEALTH EDUCATIONAL EMAILS 2. FLEXIBLE TRANSPORTATION IN THE AREAA. EXPLORE A PARTNERSHIP WITH MACOUPIN COUNTY PUBLIC HEALTH AND OTHER HOSPITALS TO EXPAND PUBLIC TRANSPORTATIONB. EXPLORE VOUCHER AGREEMENTS WITH LOCAL TAXI SERVICESAVAILABLE TRANSPORTATION CONTINUES TO BE A STRUGGLE IN OUR RURAL COMMUNITY. THERE HAS BEEN BROAD BASED NETWORKING TO FIND SUCCESSFUL TRANSPORTATION MODELS IN OTHER RURAL COMMUNITIES. WE ARE RESEARCHING POSSIBLE PARTNERSHIPS WITH LOCAL CHURCHES TO UTILIZE THEIR VANS; HOWEVER, NO SOLUTION HAS YET BEEN IMPLEMENTED. WE ASSIST WITH SCHEDULING RIDES WITH QUAD COUNTY HEALTH AND CENTRAL ILLINOIS PUBLIC TRANSPORTATION. WHEN THIS IS NOT POSSIBLE AND THE PATIENT CANNOT AFFORD TO PAY, THE HOSPITAL ASSISTS WITH PAYMENT TO THE TAXI SERVICE SERVING THE WESTERN SECTION OF THE COUNTY. 3. EXPAND HOSPITAL INVOLVEMENT WITH YOUTH AND SCHOOLS IN ORDER TO IMPROVE AWARENESS OF HEALTH ISSUES, HEALTHY LIVING AND LIFESTYLES, AND HEALTH CAREERS.A. EXPAND AN IN-HOUSE PILOT EMPLOYEE WELLNESS PROGRAM TO CREATE A BEHAVIORAL HEALTH WELLNESS MODEL FOR BUSINESSES IN THE COMMUNITY TO ADDRESS HEALTHY FOODS, EXERCISE, AND FINANCIAL ADVICE. WORKPLACE WELLNESS CONTINUES AT THE HOSPITAL AS PART OF THE EMPLOYEE HEALTH PLAN TO ENCOURAGE PHYSICAL AND MENTAL HEALTH WITH A POINT SYSTEM TO PROVIDE HEALTH INSURANCE DISCOUNT RATES FOR PARTICIPATION.B. EXPLORE AFTER-SCHOOL AND SUMMER PROGRAMS TO CREATE AWARENESS OF HEALTH PROFESSIONS, WELLNESS, AND OTHER ISSUES FOR YOUTH. JUNE & JULY 2020 DUE TO COVID-19, WE WERE UNABLE TO BRING THE CHILDREN INTO THE HOSPITAL FOR LUNCH. A MEAL KIT WITH HEALTHY MENU OPTIONS WERE DELIVERED TO FAMILIES IN NEED WEEKLY. JUNE & JULY 2021 DUE TO CONTINUED CONCERNS OF COVID-19 TRANSMISSION IN THE COMMUNITY, MEAL KITS WITH HEALTHY MENU OPTIONS WERE AGAIN PROVIDED TO FAMILIES IN NEED EACH WEEK.NOV. 2019 - PASSPORT FOR A HEALTHY LIFE HAH PARTNERS WITH FUSION FITNESS AND AQUATICS AND SPRINGFIELD CLINIC TO PROVIDE A HEALTH FAIR DESIGNED FOR ELEMENTARY SCHOOL AGE CHILDREN. THIS FAIR PROVIDES 20 25 STATIONS TO EDUCATE STUDENTS AND THEIR PARENTS ON HEALTHY LIFESTYLES. HEALTH CAREER EXPLORATION IS A PROGRAM FOR HIGH SCHOOL STUDENTS WHO WANT TO LEARN MORE ABOUT SPECIFIC HEALTH CAREERS AND OBSERVE THE WORKPLACE OF VARIOUS HEALTHCARE PROFESSIONALS. IT IS ALSO AN OPPORTUNITY TO FIND INDIVIDUALS WHO WOULD BE AN ASSET TO THE ORGANIZATION AND COULD BE UTILIZED AS INTERNS.COMMUNITY EDUCATION PRESENTATIONS HAVE BEEN POSTPONED THIS FISCAL YEAR BECAUSE OF COVID-19.4. INCREASE LOCAL ACCESS TO URGENT CARE.THE HOSPITAL RECOGNIZES A CONTINUING NEED FOR SERVICES FOR PERSONS WHO ARE UNDERINSURED AND UNINSURED AND WILL EXPLORE THE CREATION OF A MEDICAID PROVIDER'S OFFICE THAT WILL OFFER WALK-IN SERVICES.HAH HAS BEEN UNABLE TO RECRUIT A PHYSICIAN TO ESTABLISH SUCH A SERVICE. THIS EFFORT WILL CONTINUE.5. ADDRESS CHRONIC ILLNESSES AND CAUSES, INCLUDING OBESITY, DIABETES, HEART DISEASE, CANCER, AND CHRONIC OBSTRUCTIVE PULMONARY DISORDER.A. EXPAND WELLNESS PROGRAMMING TO BUSINESSES AND THE COMMUNITY.B. EXPAND NUTRITION EDUCATION PROGRAMMINGC. CONTINUE PARTICIPATION IN A STUDY OF LOCAL CANCER WITH SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE.D. CONTINUE A RELATIONSHIP WITH A PULMONOLOGIST.LUNG CANCER IN 2019 HAH PARTNERED WITH SIU SCHOOL OF MEDICINE TO CONDUCT A LUNG CANCER RESEARCH SURVEY. THERE WERE 270 SURVEYS COMPLETED AND RESULTS WILL BE USED FOR THE CONTINUED RESEARCH BY SIU SCHOOL OF MEDICINE. THE RESEARCH FOCUSED ON THE HIGH RATE OF LUNG CANCER IN OUR COMMUNITY AND THE DETRIMENTS OF NOT BEING SCREENED OR TREATED. EDUCATIONAL MATERIAL WAS DEVELOPED TO EDUCATE THE COMMUNITY ABOUT THE IMPORTANCE OF LUNG CANCER SCREENING. A BILLBOARD WILL BE INSTALLED TO BRING AWARENESS TO THE COMMUNITY. HAH HAS CONTINUED TO PROMOTE THE LUNG CANCER SCREENING PROGRAM THROUGH FY 2021 AND WILL SO IN FY 2022.HAH HAS CONTINUED THE CONTRACTUAL RELATIONSHIP WITH A PULMONOLOGIST FROM SPRINGFIELD CLINIC. HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 20E: A MINIMUM OF 2 STATEMENTS AND 1 LETTER ARE SENT PRIOR TO SENDING THE ACCOUNT TO COLLECTIONS, EACH NOTING HOW TO CONTACT THE HOSPITAL FOR FINANCIAL ASSISTANCE. PART V, SECTION C, LINES 16A-C: HTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/PATIENT-BILLING/FINANCIAL-ASSISTANCE/ 3 1 - TREMONT RIDGE ASSISTED LIVING 801 E TREMONT STREET HILLSBORO IL 62049 ASSISTED LIVING FACILITY 2 - TEAMWORK REHAB NOKOMIS 207 W STATE STREET NOKOMIS IL 62075 OUTPATIENT PHYSICAL THERAPY 3 - TEAMWORK REHAB LITCHFIELD 120 W SAINT JOHN STREET SUITE 2 LITCHFIELD IL 62056 OUTPATIENT PHYSICAL & OCCUPATIONAL THERAPY PART I, LINE 3C: HILLSBORO AREA HOSPITAL USES THE FEDERAL POVERTY GUIDELINES AS ONE MEANS OF DETERMINING ELIGIBILITY FOR CHARITY CARE. THE FEDERAL POVERTY GUIDELINES ARE UPDATED AND PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. AS A GENERAL RULE, A PATIENT'S INCOME, BASED ON FAMILY SIZE, MUST BE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES TO BE ELIGIBLE FOR THE CHARITY CARE PROGRAM AND AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE UNINSURED/UNDERINSURED CHARITY DISCOUNT. A SLIDING SCALE BASED ON THE PATIENT'S INCOME LEVEL UNDER THE FEDERAL POVERTY GUIDELINES WILL BE USED TO DETERMINE THE PRECISE AMOUNT OF CHARITY CARE FOR WHICH A PATIENT WILL BE ELIGIBLE. SOME PATIENTS' INCOME MAY EXCEED THESE GUIDELINES, BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO ONE TO ACT ON THEIR BEHALF, MEDICAID ELIGIBILITY NOT ON THE DATE OF SERVICE (I.E. SPENDDOWN UNMET) OR NON-COVERED SERVICE, CURRENTLY ENROLLED IN A COMMUNITY PROGRAM REQUIRING POVERTY LEVEL INCOME, INCARCERATION IN A PENAL INSTITUTION WITHOUT OTHER COVERAGE AVAILABLE, SELF-ADMINISTERED DRUGS-MEDICARE/MEDICAID DUAL ELIGIBILITY ONLY, MEDICAID DHS SERVICES ONLY (I.E. MENTAL HEALTH SERVICES ONLY), DRUG AND ALCOHOL REHAB PATIENTS, MEDICAID ELIGIBLE FOR HEALTH WOMEN'S BENEFITS (I.E. COVERAGE FOR PAPS, MAMM, ONLY), AND OUT OF STATE MEDICAID. PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT THE HOSPITAL INCLUDES THE OPERATION OF THE EMERGENCY ROOM. THE EMERGENCY ROOM IS OPERATED 24 HOURS A DAY, 7 DAYS A WEEK, AND IS STAFFED BY A HIGHLY TRAINED GROUP OF NURSING STAFF AND PHYSICIANS WHO DO THEIR BEST TO PROVIDE EXCEPTIONAL CARE TO MEMBERS OF THE COMMUNITY IN NEED OF EMERGENCY CARE. THE EMERGENCY DEPARTMENT HAS A LARGE AMOUNT OF FIXED EXPENSES WHICH ARE NECESSARY TO PROVIDE THE SERVICE ON A 24 HOUR A DAY BASIS, WHICH IS A REQUIREMENT OF OPERATING A CRITICAL ACCESS HOSPITAL. THE HOSPITAL TREATS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY, IN ITS EMERGENCY ROOM AND FOR THESE REASONS IT IS A SUBSIDIZED SERVICE WHICH THE HOSPITAL PROVIDES AND OFFERS TO THE COMMUNITY FOR THOSE IN NEED. 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 $ 2,274,187. PART II, COMMUNITY BUILDING ACTIVITIES: COVID-19 RESPONSE DURING FY 2021 - HILLSBORO AREA HOSPITAL HAS CONTINUED IMPLEMENTING PROCESSES TO ENSURE THE SAFETY AND WELLNESS OF OUR TEAM MEMBERS, PATIENTS, AND THE COMMUNITY. THROUGH THE EMERGENCY DEPARTMENT, THE HOSPITAL MAINTAINS THE ONLY DAILY COVID-19 TESTING SITE IN HILLSBORO. OUR TEAM MEMBERS HAVE UNDERGONE TRAINING TO RESPOND TO THE PANDEMIC AND PROVIDE SERVICES TO PATIENTS WHILE MAINTAINING THEIR OWN SAFETY AND THE SAFETY OF OTHERS IN THE HOSPITAL AND COMMUNITY. HOSPITAL LEADERS HAVE WORKED TIRELESSLY WITH THE MONTGOMERY COUNTY HEALTH DEPARTMENT AND OTHERS IN THE COMMUNITY TO ENSURE THAT PROCEDURES ARE IN PLACE TO RESPOND TO OUTBREAKS AND ALSO INFORM THE PUBLIC OF HEALTH PRECAUTIONS. COALITION WITH PANA AND CARLINVILLE HOSPITALS - THIS ALLIANCE ESTABLISHED THE FRAMEWORK TO ALLOW THESE CRITICAL ACCESS HOSPITALS TO COLLABORATE ON MUTUALLY BENEFICIAL OPPORTUNITIES IN ORDER TO MAINTAIN PROFESSIONAL, COMMUNITY-BASED, HIGH QUALITY HEALTHCARE IN THEIR LOCAL COMMUNITIES. THIS ALLIANCE IS NOT A FORMAL AFFILIATION, MERGER OR ACQUISITION, AND DID NOT CHANGE THE INDEPENDENT STATUS OF EACH HOSPITAL. WHILE THE THREE HOSPITALS SERVE DISTINCT, RURAL, SOUTH-CENTRAL ILLINOIS COMMUNITIES, THEY SHARE SIMILAR MISSIONS, GOALS AND CHALLENGES, AND CURRENTLY COLLABORATE IN A VARIETY OF WAYS. ALL THREE HOSPITAL LEADERS ALONG WITH THEIR BOARDS OF DIRECTORS BELIEVE THAT THE HOSPITALS CAN BE STRONGER TOGETHER THROUGH THIS COLLABORATIVE ALLIANCE. CRITICAL ACCESS HOSPITALS FACE MAJOR REGULATORY, GEOGRAPHIC, SOCIAL AND ECONOMIC CHALLENGES WHICH DEMAND CREATIVE, COLLABORATIVE THINKING TO ENSURE RURAL COMMUNITIES CONTINUE TO HAVE ACCESS TO LOCAL, HIGH-QUALITY HEALTHCARE, INCLUDING NEW TECHNOLOGY AND PHYSICIAN SPECIALISTS, WHILE AT THE SAME TIME INCREASING EFFICIENCIES AND LOWERING COSTS. THIS ALLIANCE BETWEEN CARLINVILLE, HILLSBORO AND PANA WILL BETTER POSITION THE THREE HOSPITALS TO FACE CURRENT AND FUTURE CHALLENGES AND ENABLE THEM TO CONTINUE TO PROVIDE HIGH-QUALITY CARE LOCALLY. PART III, LINE 2: THE COSTING METHODOLOGY USED WAS THE RATIO OF PATIENT CARE COST-TO-CHARGES. PART III, LINE 3: THE HOSPITAL BELIEVES THAT THE COMMUNITY BENEFIT OBTAINED FROM ITS CHARITY CARE IS UNDERSTATED DUE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT DO NOT APPLY OR PROVIDE INCOMPLETE INFORMATION. SOME CARE PROVIDED TO PATIENTS IS NOT CLASSIFIED AS CHARITY CARE DUE TO PATIENTS MISSING DOCUMENTATION THAT PROVES THEY QUALIFY FOR CHARITY CARE. THE HOSPITAL'S BAD DEBT DOES INCLUDE AMOUNTS THAT COULD BE CLASSIFIED AS CHARITY CARE IF THE PATIENTS WOULD APPLY OR PROVIDE THE APPROPRIATE INFORMATION TO COMPLETE THE CHARITY CARE APPLICATION. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: PATIENT ACCOUNTS RECEIVABLE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.THE HOSPITAL DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITS EXPENSE BECAUSE PROVIDING MEDICAL CARE AT A SHORTFALL IMPACTS THE HOSPITAL'S OPERATIONS AND GROWTH. THE CARE IS PROVIDED BECAUSE THERE IS A NEED AND A DESIRE TO PROVIDE MEDICAL CARE IN THIS COMMUNITY.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: COLLECTION ACTIONS ARE STOPPED ON PATIENT BALANCES THAT ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: HILLSBORO AREA HOSPITAL CONDUCTS A NEEDS ASSESSMENT AS ITS STRATEGIC PLANNING AND LONG-RANGE BUDGETING PROCESS. THIS PROCESS INCLUDES OBTAINING AND ANALYZING VARIOUS DATA AND MARKET DEMOGRAPHICS. THE DATA IS THEN SUPPLEMENTED WITH VIEWS AND CONCERNS FROM OUR COMMUNITY BOARD MEMBERS, OTHER COMMUNITY OUTREACH RELATIONSHIPS, AND OTHER COMMUNITY ORGANIZATIONS TO DEVELOP AN IMPLEMENTATION PLAN. PART VI, LINE 3: UNINSURED PATIENTS AND PERSONS WHO SEEK AND / OR OBTAIN SERVICES FROM THE HOSPITAL, ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE VIA SIGNAGE THROUGHOUT THE PATIENT ACCESS AREAS OF THE FACILITY, BROCHURES, ADMISSION PACKETS, DISCLOSURE ON THE PATIENT BILL, IN PERSON AND TELEPHONE ASSISTED CUSTOMER SERVICE, AS WELL AS INFORMATION SUCH AS THE GUIDELINES AND APPLICATION BEING PREDOMINATELY POSTED ON THE HOSPITAL'S WEBSITE. PART VI, LINE 4: HILLSBORO AREA HOSPITAL DEFINED ITS PRIMARY SERVICE AREA AND POPULATIONS AS THE GENERAL POPULATION WITHIN THE GEOGRAPHIC AREA IN AND SURROUNDING THE CITY OF HILLSBORO, DEFINED IN DETAIL BELOW. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. THE SERVICE AREA CONSISTS OF THE FOLLOWING RURAL COMMUNITIES. CITIES: HILLSBORO, NOKOMIS, WITTVILLAGES AND UNINCORPORATED COMMUNITIES: FILLMORE, IRVING, COFFEEN, RAYMOND, BUTLER, DONNELLSONACCORDING TO U.S. CENSUS DATA, THE POPULATION IN THE HILLSBORO AREA HOSPITAL SERVICE AREA FELL FROM 19,425 PEOPLE TO 18,938 PEOPLE BETWEEN THE YEARS 2000 AND 2010, A 2.51% DECREASE. THE HISPANIC POPULATION IN BOND COUNTY INCREASED BY 294 (116.21%), INCREASED IN CHRISTIAN COUNTY BY 126 (36.52%), INCREASED IN FAYETTE COUNTY BY 130 (74.71%), INCREASED IN MACOUPIN COUNTY BY 113 (37.05%), AND INCREASED IN MONTGOMERY COUNTY BY 133 (40.8%). IN BOND COUNTY, ADDITIONAL POPULATION CHANGES WERE AS FOLLOWS: WHITE 0.89%, BLACK -17.3%, AMERICAN INDIAN/ALASKA NATIVE 13.58%, ASIAN 47.83%, AND NATIVE HAWAIIAN/PACIFIC ISLANDER -62.5%. IN CHRISTIAN COUNTY, ADDITIONAL POPULATION CHANGES WERE AS FOLLOWS: WHITE -1.37%, BLACK -34.7%, AMERICAN INDIAN/ALASKA NATIVE -10.53%, ASIAN 26.52%, AND NATIVE HAWAIIAN/PACIFIC ISLANDER -27.27% PART VI, LINE 5: DESIGNATED AS CRITICAL ACCESS HOSPITAL THE HOSPITAL USES ANY LIMITED SURPLUS FUNDS TO FURTHER ITS EXEMPT PURPOSE BY PROVIDING PROGRAMS AND ACCESS AS NOTED IN FORM 990, LINE 1 AND 4A. THE BOARD OF DIRECTORS IS MADE UP OF VOLUNTEER COMMUNITY LEADERS WITHIN ITS PRIMARY SERVICE AREA THAT ARE APPROVED BY THE MEMBER ORGANIZATION. PART VI, LINE 6: THE HOSPITAL IS PART OF A CRITICAL ACCESS NETWORK THAT INCLUDES HILLSBORO AREA HEALTH SYSTEM NFP, ITS SOLE CORPORATE MEMBER, WHICH PROVIDES HEALTH AND SUPPORTIVE SERVICES TO THE COMMUNITIES THEY SERVE. THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ACTIVITIES AND SERVICES THAT MEET UNMET COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, HEALTH FAIRS AND EVENTS, HEALTH SCREENINGS AND ASSESSMENTS, SPACE FOR DAYCARE PROGRAMS OFFERED BY THE LOCAL SCHOOL SYSTEM, SUPPORT FOR VITAL COMMUNITY SERVICES, TRAUMA CARE, AND VARIOUS COMMUNITY EDUCATIONAL SERVICES.HILLSBORO AREA HOSPITAL RECEIVED LEED CERTIFICATION FOR THE BUILDING ADDITION COMPLETED IN JULY 2010. THE ENVIRONMENTAL BENEFITS OF LEED INCLUDE: REDUCTION OF WASTE SENT TO LANDFILLS, CONSERVATION OF ENERGY AND WATER, REDUCTION OF HARMFUL GREENHOUSE GASES, AND A HEALTHIER AND SAFER PLACE FOR EMPLOYEES, PATIENTS, AND THE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE CHAMBER OF COMMERCE AND PARTNERS WITH THE MONTGOMERY COUNTY ECONOMIC DEVELOPMENT CORPORATION TO OBTAIN GRANTS AND EXPAND THE SERVICES NEEDED IN THE COMMUNITY.THE HOSPITAL PROVIDES THE USE OF SPACE AT NO CHARGE TO THE HILLSBORO COMMUNITY SCHOOL DISTRICT FOR A DAYCARE FACILITY AND FUNDS STUDER GROUP CONSULTING FEES FOR THE SCHOOL'S COMMITMENT TO A CULTURE OF EXCELLENCE. THE HOSPITAL ALSO PROVIDES GRAND ADVANTAGE SENIOR EXERCISE CLASSES TO THE SENIORS IN THE AREA AT NO CHARGE AND PROVIDES THE DIAMOND CLUB TO SENIORS FOR ASSISTANCE WITH THE UNDERSTANDING AND ORGANIZATION OF MEDICAL BILLS AND INSURANCE. HOSPITAL EMPLOYEES ALSO SHARE THEIR EXPERTISE THROUGH COMMUNITY SPEAKING AT LOCAL ORGANIZATIONS AND EVENTS. SEVERAL MONETARY DONATIONS ARE MADE BY THE HOSPITAL THROUGHOUT THE YEAR TO OTHER NON-PROFIT ORGANIZATIONS. AN AUTOMATIC BLOOD PRESSURE MACHINE IS LOCATED IN THE HOSPITAL LOBBY WHERE THE COMMUNITY MEMBERS CAN USE IT FREE OF CHARGE, AND THE HOSPITAL PROVIDES A BOOTH AT THE LOCAL COMMUNITY FAIR EACH YEAR WHERE EMPLOYEES TAKE BLOOD PRESSURES AND PROVIDE HEALTH INFORMATION TO THE PUBLIC.THE HOSPITAL UTILIZED A USDA DISTANCE LEARNING & TELEMEDICINE GRANT TO EXPAND CERTIFIED NURSING ASSISTANT INSTRUCTION TO HIGH SCHOOL STUDENTS IN OUR COMMUNITY. IN COMBINATION WITH THE HOSPITAL'S MATCHING FUNDS, VIDEO CONFERENCING EQUIPMENT WAS PURCHASED AND PLACED IN 4 COMMUNITY HIGH SCHOOLS SO THAT THE STUDENTS CAN REMAIN IN THEIR OWN CLASSROOMS INSTEAD OF BEING TRANSPORTED TO THE HOSPITAL'S CAMPUS FOR CNA INSTRUCTION. IN ADDITION, THE HOSPITAL PROVIDES THE USE OF SPACE ON OUR CAMPUS FOR THE CLASSES FREE OF CHARGE, SO THE COMBINATION OF FREE SPACE USAGE AND REDUCED TRANSPORTATION COSTS PROVIDES GREAT BENEFITS FOR THIS STATE-APPROVED PROGRAM. THE HOSPITAL ALSO HAS THE HILLSBORO AREA HOSPITAL JUNIOR BOARD WHICH IS COMPRISED OF STUDENT VOLUNTEERS AGES 9-16. THE JUNIOR BOARD MEMBERS LEARNED HOW THE ORGANIZATION WORK, DEVELOP LEADERSHIP SKILLS, AND PLAN AND EXECUTE COMMUNITY IMPROVEMENT ACTIVITIES WITH THE HELP OF THE HOSPITAL STAFF MEMBERS.THE HOSPITAL ALSO PARTICIPATED IN THE STATE COLORECTAL CANCER SCREENING INITIATIVE, HELPED COORDINATE APPOINTMENTS FOR OTHER CANCER SCREENS IN COORDINATION WITH THE MONTGOMERY COUNTY CANCER ASSOCIATION, DONATED FUNDS TO ASSIST SETUP OF THE HILLTOP COOP WHICH WILL ASSIST START-UP OF SMALL BUSINESSES IN THE COMMUNITY, AND HAS ASSISTED SIU SCHOOL OF MEDICINE WITH RESEARCH PROJECTS IN THE COMMUNITY RELATED TO CHILD DEVELOPMENT, LUNG CANCER SCREENINGS, YOUTH ASSESSMENTS AND MENTAL HEALTH PROGRAMS IN LOCAL SCHOOLS. FURTHERMORE, THE HOSPITAL HAS HISTORICALLY BEEN RECOGNIZED AS HILLSBORO'S BUSINESS OF THE YEAR FOR ITS POSITIVE ECONOMIC AND CIVIC IMPACT AND ITS OVERWHELMING SUPPORT OF THE COMMUNITY. 1 SIU SCHOOL OF MEDICINE DEPT OF POPULATION SCIENCE AND POLICY 201 E MADISON STREET SPRINGFIELD IL 62794 364143823 UNIV 30231 ASSISTANCE WITH COMMUNITY RESEARCH PROJECTS RE. CHILD BRAIN DEVELOPMENT, LUNG CANCER AND YOUTH ASSESSMENT. HILLSBORO COMMUNITY SCHOOL DISTRICT 1311 VANDALIA ROAD HILLSBORO IL 62049 376014445 GOV 41440 ASSISTANCE WITH CONSULTING FEES FOR SCHOOL'S COMMITMENT TO A CULTURE OF EXCELLENCE. THE HILLTOP COOP 106 W SEWARD STREET HILLSBORO IL 62049 844839759 N/A 75000 ASSISTANCE WITH STARTING UP THE COOP FOR CO-WORKING SPACE AND BUSINESS INCUBATOR 2 1 PART I, LINE 2: THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE FOR CERTAIN COMMUNITY PROGRAMS AS APPROVED BY THE BOARD OF DIRECTORS. X 1 1 X X X 0 0 0 0 0 0 0 0 0 ANDREW OTT PODIATRIST 221648 0 25600 0 0 0 7466 0 13903 0 268617 0 0 0 ELVIS HARRISON VP OF PATIENT CARE SERVICE 152719 0 6610 0 0 0 1638 0 25755 0 186722 0 0 0 ABBY BUGG TEAMWORK REHAB DIRECTOR 117293 0 5422 0 0 0 3989 0 42929 0 169633 0 0 0 TERRI CARROLL VP OF FINANCIAL SERVICES 184293 0 7892 0 0 0 5959 0 27562 0 225706 0 0 0 PART I, LINE 1B ALL FULL-TIME EMPLOYEES HAVE THE OPTION TO BE A MEMBER OF THE HILLSBORO AREA HEALTH SERVICES' FUSION WELLNESS FACILITY WHICH THE HOSPITAL PAYS DIRECTLY TO HILLSBORO AREA HEALTH SERVICES AS A BENEFIT TO HOSPITAL EMPLOYEES. A CITY OF HILLSBORO MONTGOMERY COUNTY ILLINOIS 376001658 2008-09-30 7220000 CAPITAL IMPROVEMENT PROJECT 0 0 0 A 3067254 7220000 83500 7030981 105519 2010 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 SCHEDULE K, PART IV, LINE 2C: THE ORGANIZATION QUALIFIED FOR AN EXCEPTION TO REBATE. THE BOND QUALIFIES FOR THE 2-YEAR SPENDING EXCEPTION. FORM 990, PART VI, SECTION A, LINE 3 HEALTHTECH MANAGEMENT SERVICES, INC. DBA HEALTHTECHS3, PROVIDES MANAGEMENT AND CEO SERVICES. REX BROWN, PRESIDENT & CEO OF HILLSBORO AREA HOSPITAL, IS EMPLOYED BY HEALTHTECHS3. THE AMOUNT PAID IN TOTAL TO HEALTHTECHS3 IS INCLUDED IN PART VII, SECTION B. FORM 990, PART VI, SECTION A, LINE 6 HILLSBORO AREA HEALTH SYSTEM NFP, A NOT-FOR-PROFIT CORPORATION IS THE SOLE CORPORATE MEMBER OF HILLSBORO AREA HOSPITAL, INC. THE HOSPITAL ALSO HAS INDIVIDUAL MEMBERS. THERE ARE TWO CLASSES OF INDIVIDUAL MEMBERS. ANNUAL (REGULAR) AND LIFE MEMBERS MAKE UP THE CLASSES OF INDIVIDUAL MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A ONLY THE INDIVIDUAL MEMBERS CAN ELECT MEMBERS TO THE GOVERNING BODY. THE VOTING OF DIRECTORS TO THE BOARD ONLY OCCURS IN OCTOBER. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBER, HILLSBORO AREA HEALTH SYSTEM NFP, APPROVES ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR TO THE BYLAWS OF THE CORPORATION AND APPROVES HOSPITAL BOARD MEMBERS ELECTED. THE ONLY VOTING RIGHT OF THE INDIVIDUAL MEMBERS IS THE RIGHT TO ELECT DIRECTORS. IN ADDITION, HILLSBORO AREA HEALTH SYSTEM NFP MUST APPROVE SUCH ITEMS AS BUDGETS, STRATEGIC PLANS, LARGE UNBUDGETED CAPITAL EXPENDITURES, LAND SALES, ETC. FORM 990, PART VI, SECTION B, LINE 11B THE VP OF FINANCIAL SERVICES REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE 990 TO EACH MEMBER OF THE BOARD FOR REVIEW. THE BOARD THEN VOTES ON THE APPROVAL OF THE 990 AS IT IS OR CONTINGENT UPON CHANGES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, EMPLOYEES COMPLETE AND SIGN A DISCLOSURE STATEMENT AND THE BOARD OF DIRECTORS COMPLETE AND SIGN A CONFLICT OF INTEREST FORM. THE BOARD REVIEWS THE DISCLOSURES AND TAKES APPROPRIATE ACTION TO RESOLVE ANY ISSUES. IF A CONFLICT EXISTS, THE BOARD MEMBER SHALL ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 A PERFORMANCE EVALUATION IS COMPLETED AND DISCUSSED IN EXECUTIVE SESSION BY THE BOARD OF DIRECTORS FOR EXECUTIVE EMPLOYEES. THE PROCESS FOR DETERMINING COMPENSATION INCLUDES REVIEWS OF SALARY RANGES FOR THE POSITIONS PER VARIOUS DATABASES AND/OR MATERIAL AVAILABLE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G EMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,281,601. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,281,601. OTHER PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 440,774. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 440,774. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,564,563. MANAGEMENT AND GENERAL EXPENSES 636,578. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,201,141. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -206. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -330. TRANSFER TO HILLSBORO AREA HEALTH SYSTEM NFP -500,000. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS OF THE ORGANIZATION WORK CLOSELY WITH HILLSBORO AREA HEALTH SYSTEM NFP AND THE OTHER RELATED ENTITIES TO SELECT AND APPOINT THE AUDITOR OF THE FINANCIAL STATEMENTS. HILLSBORO AREA HEALTH SYSTEM NFP 1200 E TREMONT ST HILLSBORO IL 62049 364539688 MANAGEMENT AND OVERSIGHT OF HEALTH CARE SYSTEM IL 501(C)(3) LINE 12C, III-FI 0 HILLSBORO AREA HEALTH FOUNDATION 1200 E TREMONT ST HILLSBORO IL 62049 371247796 PROVIDE SUPPORT FOR HILLSBORO AREA HOSPITAL IL 501(C)(3) LINE 7 HILLSBORO AREA HEALTH SYSTEM NFP 1 HILLSBORO AREA HEALTH SERVICES INC 1210 E TREMONT ST HILLSBORO IL 62049 371240643 ESTABLISH AND OPERATE FACILITIES FOR WELLBEING OF PERSONS IN AREA IL 501(C)(3) LINE 10 HILLSBORO AREA HEALTH SYSTEM NFP 1 0 1 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 1 1