2022-10-05T12:40:26-05:00 2021-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2021-01-01 550809159 THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ILLI 8158752999 1945 VANS WAY PRINCETON IL 61356 PATRICIA SCHOU EXECUITVE DIRECTOR 8158752999 2022-07-20 1 PATRICIA SCHOU 999009999 MICHAEL J PETERSON CPA P01833529 2187224705 2022-07-18 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z PATRICIA SCHOU 1945 VANS WAY PRINCETON IL 61356 21320830 0 X WWW.ICAHN.ORG X 2003 IL THE MISSION OF ICAHN IS TO STRENGTHEN CRITICAL ACCESS AND SMALL, RURAL HOSPITALS THROUGH COLLABORATION. BETTER TOGETHER, ICAHN AND ITS 57 MEMBER HOSPITALS MAKE IT THEIR OVERARCHING GOAL TO PRESERVE ACCESS TO RURAL HEALTHCARE WHILE IMPROVING THE VIBRANCY AND VIABILITY OF THE COMMUNITIES SERVED. 9 9 21 65 0 0 8498500 17447257 4475555 3816059 67143 57514 0 0 13041198 21320830 8621276 17829362 0 0 1773703 1764767 0 0 0 1966358 1545195 12361337 21139324 679861 181506 7655501 6536555 4321441 2784555 3334060 3752000 X ICAHN IS A NOT-FOR-PROFIT 501(C)(3) CORPORATION ESTABLISHED IN 2003 FOR THE PURPOSES OF SHARING RESOURCES, EDUCATION, PROMOTING EFFICIENCY AND BEST PRACTICE AND IMPROVING HEALTH CARE SERVICES FOR MEMBER CRITICAL ACCESS HOSPITALS AND THEIR RURAL COMMUNITIES. ICAHN, WITH 57 MEMBER HOSPITALS, IS AN INDEPENDENT NETWORK GOVERNED BY A NINE-MEMBER BOARD OF DIRECTORS. 0 0 19598043 17729362 3260772 ICAHN PROVIDES TECHNICAL ASSISTANCE TO SMALL RURAL HOSPITALS:1) TO HELP THEM WITH ADMINISTRATIVE PROCESSES FOR CRITICAL ACCESS HOSPITALS2) TO SHARE RESOURCES WITH MEMBERS3) TO IMPLEMENT PROGRAMS TO IMPROVE QUALITY AND EFFICIENCIES OF MEDICAL SERVICES PROVIDED BY RURAL HEALTH CARE FACILITIES.4) TO PROVIDE CODING SUPPORT WHEN HOSPITALS NEED COVERAGE FOR UNANTICIPATED CERTIFIED CODE ABSENCES, VACANCIES, OR BACKLOG SERVES APPROXIMATELY 57 HOSPITALS.5) FACILITATE PASS THROUGH COVID RELIEF FUNDS 311744 0 436529 ICAHN PROVIDES INFORMATION TECHNOLOGY ASSISTANCE TO SMALL RURAL HOSPITALS ACROSS THE STATE, SERVING APPROXIMATELY 57 HOSPITALS. SERVICES ARE AVAILABLE TO ALL 57 HOSPITALS IF THEY CHOOSE TO UTILIZE THEM. 210008 85000 118758 ICAHN PROVIDES QUALITY EDUCATIONAL OPPORTUNITIES TO MEMBER HOSPITALS FOCUSING ON RURAL HEALTH ISSUES AND STRATEGIES FOR SUCCESS THROUGH ONSITE MEETINGS, VIDEOCONFERENCING, AND WEB-BASED TRAINING. 20119795 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 31 0 21 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X PATRICIA SCHOU 8158752999 1945 VANS WAY PRINCETON IL 61356 ALISA COLEMAN PRESIDENT 1.00 X X 0 0 0 PAUL SKOWRON PRESIDENT ELECT 1.00 X X 0 0 0 JOANNE EMGE PAST PRESIDENT 1.00 X X 0 0 0 TED ROGALSKI SECRETARY/TREASURER 1.00 X X 0 0 0 REX BROWN DIRECTOR 1.00 X 0 0 0 JIM JOHNSON DIRECTOR 1.00 X 0 0 0 PAM PFISTER DIRECTOR 1.00 X 0 0 0 DON ROBBINS DIRECTOR 1.00 X 0 0 0 KARISSA TURNER DIRECTOR 1.00 X 0 0 0 PATRICIA SCHOU EXECUTIVE DIRECTOR 40.00 X 263443 0 23784 DIANE GARLAND SR DIRECTOR FINANCE/HR 40.00 X 99336 0 13607 CURTIS ZIMMERMAN SR DIRECTOR OF BUSINESS SERVICES 40.00 X 119915 0 35404 RYAN MORGAN CHIEF INFORMATION SECURITY 40.00 X 123491 0 19189 RYAN SIERMAN IT CONSULTANT/CIO 40.00 X 102453 0 7988 708638 0 99972 4 0 1 0 GREG DAVIS MD LTD 204 PARK AVENUE EAST PRINCETON IL 61356 MEDICAL CONSULTING 150000 1 487350 16959907 17447257 IL RURAL COMMUNITY CARE 900099 1954001 1954001 IT SERVICES 541519 436529 436529 CONSULTING REVENUE 541610 238801 238801 PROFESSIONAL EDUCATION 611710 118758 118758 WORKSHOP/MEETING FEES 611710 34940 34940 1033030 1033030 3816059 57514 57514 21320830 3816059 0 57514 17829362 17829362 400169 280118 120051 1077297 754107 323190 37726 26408 11318 132226 92558 39668 117349 82146 35203 150000 121639 28361 54605 54605 17573 17573 518585 420535 98050 363692 218216 145476 195276 136699 58577 19986 16207 3779 121046 72628 48418 29400 20581 8819 66100 39659 26441 BAD DEBT EXPENSE 8932 8932 21139324 20119795 1019529 0 2348154 3735593 249118 249160 30164 186004 2941345 331151 140896 72000 1485069 340424 1210745 1144645 735079 818002 7655501 6536555 1925187 1351378 1529975 885883 866279 547294 4321441 2784555 X 3304573 3723474 29487 28526 3334060 3752000 7655501 6536555 X 181506 36434 200000 X 0 1 X 1 1 1 X 1915004 1971791 2471371 8170000 17447257 31975423 1915004 1971791 2471371 8170000 17447257 31975423 31975423 16495 32656 34279 56142 57514 197086 32172509 17082557 0.99390 0.99120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25501 25501 1099024 122418 976606 360544 218006 142538 1144645 21348332 36434 -8932 27502 21320830 0 21320830 21130392 0 21130392 8932 8932 21139324 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -8,932. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 8,932. 1 ABRAHAM LINCOLN MEMORIAL HOSPITAL 200 STAHLHUT DRIVE LINCOLN IL 62656 370723793 501(C)(3) 264478 0 FLEX POPULATION HEALTH AND ARP (AMERICAN RESCUE PLAN ) SHIP COVID CARLE EUREKA HOSPITAL 101 S MAJOR ST EUREKA IL 61530 362169147 501(C)(3) 276493 0 FLEX MENTAL HEALTH, 2022 SHIP AND ARP SHIP COVID CARLE HOOPESTON REGIONAL HEALTH CENTER 701 E ORANGE ST HOOPESTON IL 60942 261503640 501(C)(3) 256978 0 ARP SHIP COVID CARLINVILLE AREA HOSPITAL 20733 N BROAD STREET CARLINVILLE IL 62626 370645239 501(C)(3) 256978 0 ARP SHIP COVID CLAY COUNTY HOSPITAL 911 STACY BURKE DRIVE FLORA IL 62839 010686913 501(C)(3) 287200 0 FLEX POPULATION HEALTH, FLEX EMS EDUCATION, FLEX MENTAL HEALTH, 2022 SHIP AND ARP SHIP COVID COMMUNITY HOSPITAL OF STAUNTON 400 NORTH CALDWELL STREET STAUNTON IL 62088 370624255 501(C)(3) 276689 0 FLEX OUTPATIENT SERVICES, 2022 SHIP AND ARP SHIP COVID CRAWFORD MEMORIAL HOSPITAL 1000 NORTH ALLEN STREET ROBINSON IL 62454 371241849 501(C)(3) 279533 0 2021 SHIP, 2022 SHIP AND ARP SHIP COVID CROSSROADS COMMUNITY HOSPITAL 8 DOCTORS PARK RD MT VERNON IL 62864 581622971 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID FAIRFIELD MEMORIAL HOSPITAL 303 NW 11TH ST FAIRFIELD IL 62837 370661202 501(C)(3) 276700 0 FLEX MENTAL HEALTH, 2022 SHIP AND ARP SHIP COVID FAYETTE COUNTY HOSPITAL AND LONG TERM CARE 650 WEST TAYLOR ST VANDALIA IL 62471 371255150 501(C)(3) 39055 0 FLEX EMS EDUCATION, FLEX OPERATIONAL IMPROVEMENT, FLEX FINANCIAL ASSESSMENT, 2021 SHIP AND 2022 SHIP FERRELL HOSPITAL 1201 PINE ST ELDORADO IL 62930 201244058 501(C)(3) 279533 0 2021 SHIP, 2022 SHIP AND ARP SHIP COVID FRANKLIN HOSPITAL 201 BAILEY LANE BENTON IL 62812 376058530 501(C)(3) 282200 0 FLEX OPERATIONAL IMPROVEMENT, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID GENESIS MEDICAL CENTER 409 NW 9TH AVENUE ALEDO IL 61231 454475683 501(C)(3) 24222 0 FLEX OUTPATIENT SERVICES, FLEX POPULATION HEALTH AND 2022 SHIP GIBSON AREA HOSPITAL & HEALTH SERVICES 1120 N MELVIN ST GIBSON CITY IL 60936 364311943 501(C)(3) 267978 0 FLEX OUTPATIENT SERVICES, FLEX EMS EDUCATION, FLEX OPERATIONAL IMPROVEMENT AND ARP SHIP COVID GRAHAM HOSPITAL 210 WEST WALNUT STREET CANTON IL 61520 370673506 501(C)(3) 256978 0 ARP SHIP COVID HSHS GOOD SHEPHERD HOSPITAL 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DR GREENVILLE IL 62246 370792770 501(C)(3) 267811 0 2021 SHIP AND ARP SHIP COVID HAMILTON MEMORIAL HOSPITAL DISTRICT 611 S MARSHALL AVE MCLEANSBORO IL 62859 473192014 501(C)(3) 10833 0 2021 SHIP HAMMOND HENRY HOSPITAL 600 NORTH COLLEGE AVENUE GENESEO IL 61254 366008003 GOV 273700 0 FLEX OUTPATIENT SERVICES, 2022 SHIP AND ARP SHIP COVID HARDIN COUNTY GENERAL HOSPITAL 6 FERRELL ROAD ROSICLARE IL 62982 370702309 501(C)(3) 256978 0 ARP SHIP COVID HARRISBURG MEDICAL CENTER 100 DR WARRNE TUTTLE DRIVE HARRISBURG IL 62946 237426289 501(C)(3) 256978 0 ARP SHIP COVID HILLSBORO AREA HOSPITAL 1200 EAST TREMONT ST HILLSBORO IL 62049 370661208 501(C)(3) 276700 0 FLEX MENTAL HEALTH, 2022 SHIP AND ARP SHIP COVID HOPEDALE MEDICAL CENTER 107 TREMONT ST HOPEDALE IL 61747 370808925 501(C)(3) 262978 0 FLEX OPERATIONAL IMPROVEMENT AND ARP SHIP COVID HORIZON HEALTH 721 EAST COURT ST PARIS IL 61944 370860281 501(C)(3) 284200 0 FLEX OUTPATIENT SERVICES, FLEX EMS EDUCATION, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID ILLINI COMMUNITY HOSPITAL 640 WEST WASHINGTON ST PITTSFIELD IL 62363 371396010 501(C)(3) 282272 0 FLEX EMS EDUCATION, FLEX POPULATION HEALTH , FLEX OPERATIONAL IMPROVEMENT, 2022 SHIP AND ARP SHIP COVID IROQUOIS MEMORIAL HOSPITAL 200 FAIRMAN WATSEKA IL 60970 370673512 501(C)(3) 274677 0 FLEX EMS EDUCATION, 2022 SHIP AND ARP SHIP COVID JERSEY COMMUNITY HOSPITAL 400 MAPLE SUMMIT JERSEYVILLE IL 62052 376013958 501(C)(3) 282533 0 FLEX EMS EDUCATION, 2021 SHIP, 2022 SHIP AND ARP SHIP COVID KIRBY MEDICAL CENTER 1000 MEDICAL CENTER DRIVE MONTICELLO IL 61856 370661215 501(C)(3) 282533 0 FLEX EMS EDUCATION, 2021 SHIP, 2022 SHIP AND ARP SHIP COVID LAWRENCE COUNTY MEMORIAL HOSPITAL 2200 WEST STATE ST LAWRENCEVILLE IL 62439 800618988 501(C)(3) 25222 0 FLEX MENTAL HEALTH, FLEX POPULATION HEALTH AND 2022 SHIP MARSHALL BROWNING HOSPITAL 900 N WASHINGTON ST DUQUOIN IL 62832 370661218 501(C)(3) 286311 0 FLEX POPULATION HEALTH, FLEX OPERATIONAL ASSESSMENT, FLEX FINANCIAL ASSESSMENT, 2021 SHIP AND ARP SHIP COVID MASON DISTRICT HOSPITAL 615 N PROMENADE ST HAVANA IL 62644 376017857 GOV 273700 0 FLEX OUTPATIENT SERVICES, 2022 SHIP AND ARP SHIP COVID MASSAC MEMOIRAL HOSPITAL 28 CHICK ST METROPOLIS IL 62960 370857853 GOV 276200 0 FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID MCDONOUGH DISTRICT HOSPITAL 525 E GRANT ST MACOMB IL 61455 465143822 GOV 256978 0 ARP SHIP COVID MEMORIAL HOSPITAL - CARTHAGE 1454 N COUNTY ROAD 2050 CARTHAGE IL 62321 370662570 501(C)(3) 279700 0 FLEX OPERATIONAL IMPROVEMENT, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID MEMORIAL HOSPITAL - CHESTER 1900 STATE STREET CHESTER IL 62233 376020801 501(C)(3) 276200 0 FLEX POPULATION HEALTH, 2022 SHIP AND ARP SHIP COVID MERCY HARVARD HOSPITAL 901 GRANT STREET HARVARD IL 60033 311551871 501(C)(3) 261978 0 FLEX POPULATION HEALTH AND ARP SHIP COVID MIDWEST MEDICAL CENTER 1 MEDICAL CENTER DRIVE GALENA IL 61036 204560540 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID MORRISON COMMUNITY HOSPITAL 303 N JACKSON ST MORRISON IL 61270 366008167 GOV 277700 0 FLEX EMS EDUCATION, FLEX OPERATIONAL IMPROVEMENT, 2022 SHIP AND ARP SHIP COVID NORTHWESTERN MEDICINE VALLEY WEST HOSPITAL 1302 NORTH MAIN STREET SANDWICH IL 60548 364244337 501(C)(3) 267811 0 2021 SHIP AND ARP SHIP COVID OSF HOLY FAMILY MEDICAL CENTER 1000 W HARLEM AVE MONMOUTH IL 61462 370813229 501(C)(3) 276200 0 FLEX POPULATION HEALTH, 2022 SHIP AND ARP SHIP COVID OSF ST CLARE MEDICAL CENTER 530 PARK AVENUE EAST PRINCETON IL 61356 366006057 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID OSF ST JAMES W ALBRECHT MEDICAL CENTER 2500 W REYNOLD ST PONTIAC IL 61764 370662570 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID OSF ST LUKE MEDICAL CENTER 1051 WEST SOUTH ST KEWANEE IL 61443 362167767 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID OSF ST PAUL MEDICAL CENTER 1401 EAST 12TH STREET MENDOTA IL 61342 362167785 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID PANA COMMUNITY HOSPITAL 101 EAST NINTH ST PANA IL 62557 376062326 501(C)(3) 283700 0 FLEX POPULATION HEALTH, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID PERRY MEMORIAL HOSPITAL 530 PARK AVENUE EAST PRINCETON IL 61356 366006057 501(C)(3) 21833 0 FLEX MENTAL HEALTH, FLEX EMS EDUCATION AND 2021 SHIP PINCKNEYVILLE COMMUNITY HOSPITAL 101 NORTH WALNUT STREET PINCKNEYVILLE IL 62274 376006955 GOV 282200 0 FLEX OPERATIONAL IMPROVEMENT, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID RED BUD REGIONAL HOSPITAL 325 SPRING ST RED BUD IL 62278 364443919 501(C)(3) 264978 0 FLEX EMS EDUCATION, FLEX FINANCAIL ASSESSMENT AND ARP SHIP COVID RICHLAND MEMORIAL HOSPITAL 800 EAST LOCUST OLNEY IL 62450 371363001 501(C)(3) 267811 0 2021 SHIP AND ARP SHIP COVID ROCHELLE COMMUNITY HOSPITAL 900 NORTH SECOND ST ROCHELLE IL 61068 362548549 501(C)(3) 273700 0 FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID SALEM TOWNSHIP HOSPITAL 1201 RICKER DRIVE SALEM IL 62881 370925318 GOV 278150 0 FLEX OUTPATIENT SERVICES, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID SARAH D CULBERTSON MEMORIAL HOSPITAL 238 SOUTH CONGRESS AVE RUSHVILLE IL 62681 376006672 GOV 287033 0 FLEX FINANCIAL ASSESSMENT, 2021 SHIP, 2022 SHIP AND ARP SHIP COVID SPARTA COMMUNITY HOSPITAL DISTRICT 818 EAST BROADWAY SPARTA IL 62286 376014817 GOV 31222 0 FELX POPULATION HEALTH, FLEX OPERATIONAL IMPROVEMENT/ IT IMPROVEMENT, 2022 SHIP SSM HEALTH ST MARY'S HOSPITAL 420 NORTH PLEASANT CENTRALIA IL 62801 370662580 501(C)(3) 256978 0 ARP SHIP COVID ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 501(C)(3) 267811 0 2021 SHIP AND ARP SHIP COVID ST JOSEPH'S HOSPITAL 12866 TROXLER AVE HIGHLAND IL 62249 370663568 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID ST JOSEPH MEMORIAL HOSPITAL 2 SOUTH HOSPITAL DRIVE MURPHYSBORO IL 62966 370618939 501(C)(3) 279533 0 2021 SHIP, 2022 SHIP AND APR SHIP COVID ST MARGARET'S HEALTH - SPRING VALLEY 600 E FIRST STREET SPRING VALLEY IL 61356 362167884 501(C)(3) 256978 0 ARP SHIP COVID ST MARGARET'S HEALTH - PERU 925 WEST STREET PERU IL 61354 362852553 501(C)(3) 256978 0 ARP SHIP COVID TAYLORVILLE MEMORIAL HOSPITAL 201 EAST PLEASANT ST TAYLORVILLE IL 62568 370661250 501(C)(3) 256978 0 ARP SHIP COVID THOMAS H BOYD MEMORIAL HOSPITAL 800 SCHOOL ST CARROLTON IL 62016 370673461 501(C)(3) 279200 0 FLEX EMS EDUCATION, FLEX FINANCIAL ASSESSMENT, 2022 SHIP AND ARP SHIP COVID UNION COUNTY HOSPITAL DISTRICT 517 NORTH MAIN ST ANNA IL 62906 586025393 501(C)(3) 268700 0 2022 SHIP AND ARP SHIP COVID WABASH GENERAL HOSPITAL 1418 COLLEGE DR MT CARMEL IL 62863 376013625 GOV 285199 0 FLEX EMS EDUCATION, FLEX POPULATION HEALTH, FLEX OPERATIONAL IMPROVEMENT, 2022 SHIP AND ARP SHIP COVID WARNER HOSPITAL & HEALTH SERVICES 422 WEST WHITE ST CLINTON IL 61727 371380376 501(C)(3) 294566 0 FLEX POPULATION HEALTH, FLEX FINANCIAL ASSESSMENT, 2021 SHIP, 2022 SHIP AND ARP SHIP COVID WASHINGTON COUNTY HOSPITAL 705 S GRAND NASHVILLE IL 62263 376020408 GOV 291933 0 FLEX OPERATIONAL IMPROVEMENT, FLEX FINANCAIL ASSESSMENT, 2021 SHIP. 2022 SHIP AND ARP SHIP COVID 65 0 PART I, LINE 2: ONCE IT IS DETERMINED THAT AN INDIVIDUAL OR ORGANIZATION WILL BE RECEIVING A GRANT AWARD, THEY ARE ISSUED A TRACKING NUMBER AND ENTERED INTO THE GRANT MONITORING DATABASE. THE DATABASE INCLUDES CONTACT INFORMATION FOR THE RECIPIENT, AS WELL AS PAYMENT TERMS, DATE, CHECK NUMBER, AND PAYMENT AMOUNT. AT THE END OF THE GRANT TERM OUTLINED IN THE GRANT AGREEMENT PROVIDED TO THE RECIPIENT A FINAL REPORT IS COMPLETED BY THE RECIPIENT AND SENT BACK TO ICAHN THROUGH THE MAIL OR ELECTRONICALLY WITH A SIGNATURE. ICAHN THEN REVIEWS THE REPORT AND COMPARES IT TO THE AGREEMENT TO ENSURE GRANT FUNDS WERE SPENT AS OUTLINED ON OCCASION. IF A RECIPIENT'S PROJECT IS NEEDED TO CHANGE DUE TO UNFORESEEN CIRCUMSTANCES, THE GRANTEE IS INSTRUCTED TO REQUEST WRITTEN PERMISSION FROM ICAHN AUTHORIZING THE CHANGE. A COPY OF THIS CORRESPONDENCE IS PLACED IN THE RECIPIENT'S GRANT FILE DOCUMENTING THE CHANGE TO THE GRANT PROJECT WHEN THE GRANT REPORT IS RECEIVED BY ICAHN. IT CAN THEN BE NOTED THAT THERE WAS AN AUTHORIZED CHANGE TO THE GRANT PROJECT. IN ADDITION TO THESE TRACKING PROCESSES, THE OPERATIONS COORDINATOR PERFORMS ONSITE VISITS TO GRANT RECIPIENTS OVER THE COURSE OF THE YEAR. DURING THESE VISITS, DOCUMENTATION SUCH AS INVOICES, RECEIPTS, AND FINANCIAL STATEMENTS ARE REVIEWED WITH COPIES OBTAINED, TO ENSURE GRANT FUNDS HAVE BEEN SPENT ON OUTLINED PROJECTS. THE OPERATIONS COORDINATOR PERFORMS ABOUT 12 ONSITE GRANT REVIEW VISITS PER YEAR. X X X X 0 0 0 1 0 0 0 0 0 PATRICIA SCHOU EXECUTIVE DIRECTOR 221501 0 20000 0 21942 0 7866 0 15918 0 287227 0 0 0 CURTIS ZIMMERMAN SR DIRECTOR OF BUSINESS SERVICES 108331 0 8679 0 2905 0 3859 0 31545 0 155319 0 0 0 PART I, LINE 5 THE SENIOR DIRECTOR OF BUSINESS SERVICES IS PAID AN INCENTIVE ON A PERCENTAGE OF THE INSURANCE REVENUES PAID TO ICAHN DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. AS OF 2021 THE MEMBERSHIP DUES FOR THE YEAR ARE $8,550. FORM 990, PART VI, SECTION A, LINE 7A EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO THE FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONNAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECUTIVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTOR'S SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER FROM MEMBERS 200,000. ILLINOIS RURAL COMMUNITY CARE ORGANIZATION LLC 1945 VANS WAY PRINCETON IL 61356 465654316 DEVELOP SYSTEMS OF CLINICAL INTEGRATION & EFFICIENCIES FOR MEMBER HOSPITALS IL 1879606 2390461 ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK