MIDWEST MEDICAL CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- MIDWEST MEDICAL CENTER (EIN 20-4560540)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-06-28
- IRS object ID
- 202121799349300952
- Schema version
- 2019v5.2
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-06-28T10:12:13-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204560540 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MIDW | BusinessNameControlTxt |
| Phone | 8157771340 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | GALENA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61036 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRACY BAUER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8157771340 | PhoneNum |
| Signature | 2021-06-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2021-05-17 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TRACY BAUER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | GALENA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,749,328 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MIDWESTMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CITY OF GALENA, ILLINOIS AND THE SURROUNDING AREA REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 290 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $114,525 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,628,969 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,414,941 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,933,291 | CYProgramServiceRevenueAmt |
| PY Investment Income | $133,697 | PYInvestmentIncomeAmt |
| CY Investment Income | $168,298 | CYInvestmentIncomeAmt |
| PY Other Revenue | $651,569 | PYOtherRevenueAmt |
| CY Other Revenue | -$37,450 | CYOtherRevenueAmt |
| PY Total Revenue | $26,314,732 | PYTotalRevenueAmt |
| CY Total Revenue | $28,693,108 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,564 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,156 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,276,419 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,895,614 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,421,442 | PYOtherExpensesAmt |
| CY Other Expenses | $13,202,748 | CYOtherExpensesAmt |
| PY Total Expenses | $25,703,425 | PYTotalExpensesAmt |
| CY Total Expenses | $26,106,518 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $611,307 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,586,590 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,962,942 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,226,329 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,243,881 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,920,678 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,280,939 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,694,349 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,378,368 | ExpenseAmt |
| Grant | $8,156 | GrantAmt |
| Revenue | $19,887,799 | RevenueAmt |
| Desc | MIDWEST MEDICAL CENTER OWNS AND OPERATES A 25-BED CRITICAL ACCESS HOSPITAL AND LEADS IN THE DELIVERY OF HEALTHCARE SERVICES TO ITS REGION WITH OVER 260 ASSOCIATES, INCLUDING 35 PHYSICIANS AND TWO MID-LEVEL PRACTITIONERS, WHICH COORDINATE PATIENT CARE AS AN INTEGRATED UNIT. THE HOSPITAL AND ITS ASSOCIATES WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE. THE ACCOMPLISHMENTS WHICH FOLLOW ARE ATTRIBUTABLE TO THE HOSPITAL AND ALL OF ITS DEPARTMENTS AS A WHOLE. THE HOSPITAL IS A NON-PROFIT CORPORATION PROVIDING HEALTHCARE AND RESIDENTIAL SERVICES IN GALENA, ILLINOIS, AND NEIGHBORING COMMUNITIES. ALL OF THESE SERVICES ARE OFFERED UNDER THE MISSION OF THE ORGANIZATION, WHICH STATES THAT "MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE." IN FISCAL YEAR 2020, THE HOSPITAL PROVIDED 572 ACUTE INPATIENT DAYS, 1,724 SWING BED DAYS, 3,588 EMERGENCY ROOM VISITS, 6,127 RADIOLOGY SERVICES, 99,508 LABORATORY TESTS, 32,345 PHYSICAL THERAPY TREATMENTS, AND 454 SURGICAL PROCEDURES AMONG MANY OF THE PATIENT SERVICES PROVIDED DURING THE YEAR.OR SERVICES INCREASED AGAIN IN 2020 WHICH INCREASED PATIENT AND REVENUE GROWTH. OUR CONTRACTED ORTHOPEDIC SURGEON THAT VISITED OUR FACILITY TWICE A MONTH ENDED IN FEBRUARY, BUT MMC WAS ABLE TO CONTRACT WITH ANOTHER ORTHOPEDIC SURGEON TO PROVIDE 80 HOURS OF SERVICE EACH MONTH WHICH STARTED IN JUNE 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,880,931 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,036,168 | RevenueAmt |
| Desc | MIDWEST MEDICAL CENTER RECOGNIZES THAT THE AGING AND DISABLED POPULATION OF PATIENTS ARE OFTEN AN UNDERSERVED DEMOGRAPHIC OF THE POPULATION AND TO MEET THE HEALTHCARE NEEDS OF THESE PATIENTS THE HOSPITAL OPERATES THE GALENA-STAUSS SENIOR CARE COMMUNITY. THIS SENIOR CARE CAMPUS PROVIDES SENIOR CARE SERVICES THROUGH ITS 57-BED LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY AS WELL AS ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS PROVIDED 14,705 DAYS OF SKILLED NURSING AND INTERMEDIATE NURSING HOME CARE DAYS IN ADDITION TO THE ASSISTED LIVING AND ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS OFFERS SKILLED NURSING TO THE RESIDENTS AND PATIENTS IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY, WOUND CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED. THE SENIOR CARE CAMPUS OPERATES IN CONJUNCTION WITH THE MIDWEST MEDICAL CENTER HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN MIDWEST MEDICAL CENTER'S CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW-COST CARE TO THE COMMUNITY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,632,195 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,724,447 | RevenueAmt |
| Desc | MIDWEST MEDICAL CENTER ALSO OPERATES TWO PHYSICIAN CLINICS KNOWN AS MIDWEST HEALTH CLINIC, ONE LOCATED IN GALENA, IL AND ONE LOCATED IN ELIZABETH, IL. THE CARE PROVIDED IN THE MIDWEST HEALTH CLINICS ARE COORDINATED WITH THE CARE OF MIDWEST MEDICAL CENTER'S HOSPITAL IN AN EFFORT TO CONTINUE TO PROVIDE LOW COST AND HIGH QUALITY PATIENT CARE FOR THE RESIDENTS OF GALENA, ILLINOIS, ELIZABETH, IL AND THE SURROUNDING AREAS. THE HEALTH CLINICS OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC TO MIDWEST MEDICAL CENTER'S HOSPITAL AND THE PRACTICE IS MADE UP OF FOUR FAMILY PRACTICE PHYSICIANS, AN INTERNAL MEDICINE PHYSICIAN, AND TWO MID-LEVEL PRACTITIONERS. ADDITIONAL SERVICES ARE ALSO PROVIDED IN THE CLINIC BY OUTREACH DOCTORS THAT PROVIDE SERVICES ON A LIMITED BASIS IN THE AREAS OF ORTHOPEDIC SURGERY, GENERAL SURGERY, PODIATRY, OTOLARYNGOLOGY, OPHTHALMOLOGY, GASTROENTEROLOGY, AND PLASTIC SURGERY. THE CLINIC PROVIDERS ALSO ENGAGE IN MANY ACTIVITIES WHICH PROMOTE THE WELL-BEING OF THE COMMUNITY AND PROVIDE HEALTH EDUCATION TO THE COMMUNITY. AN EXAMPLE OF THESE SERVICES IS DR. WELLS, DR. HARMSTON, DR. MATT GULLONE, DR. RICHARD FARRELL, AND PEG DITTMAR PROVIDE EDUCATIONAL EXPERIENCES AND TRAINING TO MEDICAL STUDENTS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS AT MIDWEST HEALTH CLINIC FOR THOSE STUDENTS INTERESTED IN LEARNING ABOUT RURAL MEDICINE. ANOTHER EXAMPLE IS DR. MATT GULLONE, WHO SPECIALIZES IN SPORTS MEDICINE AND PROVIDES FREE CARE TO LOCAL ATHLETES DURING SPORTING EVENTS. THE CLINIC HAS ALSO BEEN VERY ACTIVE IN PROMOTING ANNUAL WELLNESS VISITS TO MEDICARE PATIENTS AS WELL AS PROVIDING CHRONIC CARE MANAGEMENT. MIDWEST MEDICAL CENTER PARTICIPATES IN THE ILLINOIS RURAL COMMUNITY CARE ORGANIZATION (IRCCO), WHICH IS AN ACCOUNTABLE CARE ORGANIZATION (ACO). IRCCO IS A GROUP OF PHYSICIANS, HOSPITALS, AND CLINICS WHO VOLUNTARILY WORK TOGETHER WITH MEDICARE TO PROVIDE HIGH-QUALITY SERVICES AND COORDINATED CARE TO OUR MEDICARE PATIENTS THROUGH THE MEDICARE SHARED SAVINGS PROGRAM (MSSP). THE IRCCO MISSION IS TO: 1. IMPROVE THE HEALTH OF THE INDIVIDUAL SEEKING CARE AND SERVICES2. IMPROVE THE OVERALL HEALTH OF THE RURAL POPULATION SERVED | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $21,891,494 | 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 | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 290 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KELLI JACKSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8157771340 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | GALENA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD FARRELL MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $336,930 | $0 | $32,759 | |||
| GREG HARMSTON MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $273,778 | $0 | $29,881 | |||
| MICHAEL WELLS MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $193,597 | $0 | $26,512 | |||
| KRISTEN HEIMBUCH CRNA | ||||||||
| CRNA | 40.00 | Yes (X) | $194,190 | $0 | $21,070 | |||
| MATTHEW GULLONE MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $199,251 | $0 | $14,658 | |||
| TRACY BAUER | ||||||||
| CEO | 50.00 | $266,256 | $0 | $29,375 | 0.15 | Yes (X) | ||
| KELLI JACKSON | ||||||||
| CONTROLLER | 50.00 | $40,460 | $0 | $7,212 | Yes (X) | |||
| MARY SHEAHEN RN | ||||||||
| CHAIR | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | Yes (X) | |
| DR BARB SLOAN | ||||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | Yes (X) | |
| DAVID HEY | ||||||||
| TREASURER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | Yes (X) | |
| GARRY THOMPSON | ||||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | Yes (X) | |
| CHRIS ALLENDORF | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| MATTHEW CAROLL | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| DONNA FERRY | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| JOEL HOLLAND | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| HELEN KILGORE | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| JOHN LORENZEN | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| CARTER NEWTON | ||||||||
| BOARD MEMBER | 2.00 | $0 | $0 | $0 | 0.15 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,504,462 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $161,467 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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 |
|---|---|---|---|---|---|
| RALPH LOSEY MD | |||||
| 207 SOUTH PROSPECT | GALENA | IL | 61036 | EMERGENCY ROOM PHYSCIAN, CMO | $319,825 |
| MERCY RADIOLOGISTS OF DUBUQUE | |||||
| PO BOX 3160 | DUBUQUE | IA | 520043160 | RADIOLOGISTS | $293,564 |
| MICHAEL D GREEN MD | |||||
| 1340 W NEWPORT | CHICAGO | IL | 60657 | EMERGENCY ROOM PHYSICIAN | $229,721 |
| CT HORIZONS INC | |||||
| 845 NORTH KINGSBURY ST UNIT 715 | CHICAGO | IL | 60610 | EMERGENCY ROOM PHYSICIAN | $227,198 |
| THOMSAS OH MD | |||||
| 3607 OTHELLO DR | NAPERVILLE | IL | 60564 | EMERGENCY ROOM PHYSICIAN | $215,518 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $12,500 | RelatedOrganizationsAmt |
| Government Grants | $3,590,563 | GovernmentGrantsAmt |
| All Other Contributions | $25,906 | AllOtherContributionsAmt |
| Total Contributions | $3,628,969 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| HOSPITAL PATIENT REVENUE | 621990 | $19,887,799 | $19,887,799 | |
| SENIOR CARE REVENUE | 623000 | $3,036,168 | $3,036,168 | |
| CLINIC REVENUE | 621110 | $1,724,447 | $1,724,447 | |
| CAFETERIA REVENUE | 621990 | $187,608 | $187,608 | |
| FITNESS CENTER REVENUE | 621990 | $97,269 | $97,269 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,933,291 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $181,240 | TotalRevenueColumnAmt |
| Exclusion | $181,240 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $5,828 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,278 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$37,450 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$37,450 | TotalRevenueColumnAmt |
| Exclusion | -$37,450 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $12,942 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$12,942 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,942 | TotalRevenueColumnAmt |
| Exclusion | -$12,942 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,693,108 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,648,414 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $415,725 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,156 | TotalAmt |
| Program Services | $8,156 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,663 | TotalAmt |
| Management And General | $407,663 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,955,395 | TotalAmt |
| Program Services | $8,880,831 | ProgramServicesAmt |
| Management And General | $1,074,564 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,338 | TotalAmt |
| Program Services | $232,722 | ProgramServicesAmt |
| Management And General | $32,616 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,570,329 | TotalAmt |
| Program Services | $1,333,312 | ProgramServicesAmt |
| Management And General | $237,017 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,889 | TotalAmt |
| Program Services | $581,878 | ProgramServicesAmt |
| Management And General | $115,011 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,643 | TotalAmt |
| Management And General | $62,643 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,070 | TotalAmt |
| Management And General | $58,070 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,429,266 | TotalAmt |
| Program Services | $3,913,764 | ProgramServicesAmt |
| Management And General | $515,502 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,045 | TotalAmt |
| Management And General | $98,045 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,345 | TotalAmt |
| Program Services | $47,703 | ProgramServicesAmt |
| Management And General | $4,642 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,981 | TotalAmt |
| Management And General | $307,981 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,919 | TotalAmt |
| Program Services | $450,919 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,250 | TotalAmt |
| Program Services | $33,499 | ProgramServicesAmt |
| Management And General | $7,751 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,350,963 | TotalAmt |
| Program Services | $1,161,182 | ProgramServicesAmt |
| Management And General | $189,781 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,434,579 | TotalAmt |
| Program Services | $2,092,574 | ProgramServicesAmt |
| Management And General | $342,005 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,293 | TotalAmt |
| Management And General | $308,293 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES & OTHER | $1,955,067 | $1,792,792 | $162,275 |
| MEDICAL SUPPLIES | $981,535 | $981,484 | $51 |
| BED ASSESSMENT | $412,954 | $125,014 | $287,940 |
| PROVISION FOR BAD DEBT | $226,907 | $226,907 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,931 | TotalAmt |
| Program Services | $28,757 | ProgramServicesAmt |
| Management And General | $3,174 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,106,518 | TotalAmt |
| Program Services | $21,891,494 | ProgramServicesAmt |
| Management And General | $4,215,024 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,172 | BOYAmt |
| EOY | $26,829 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,372,408 | BOYAmt |
| EOY | $10,193,927 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,899,659 | BOYAmt |
| EOY | $3,993,771 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,340 | BOYAmt |
| EOY | $207,001 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,581 | BOYAmt |
| EOY | $374,165 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,854 | BOYAmt |
| EOY | $150,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,266,475 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,955,670 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,056,785 | BOYAmt |
| EOY | $22,310,805 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,882,582 | BOYAmt |
| EOY | $3,962,367 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,561 | BOYAmt |
| EOY | $6,562 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,962,942 | BOYAmt |
| EOY | $41,226,329 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,106,986 | BOYAmt |
| EOY | $2,066,068 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $309,159 | BOYAmt |
| EOY | $1,158,973 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,904 | BOYAmt |
| EOY | $84,703 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,469,832 | BOYAmt |
| EOY | $36,912,834 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $270,000 | BOYAmt |
| EOY | $2,698,100 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,243,881 | BOYAmt |
| EOY | $42,920,678 | 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 | -$5,825,883 | BOYAmt |
| EOY | -$3,253,438 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,544,944 | BOYAmt |
| EOY | $1,559,089 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,280,939 | BOYAmt |
| EOY | -$1,694,349 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,962,942 | BOYAmt |
| EOY | $41,226,329 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,586,590 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | $22,100 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $22,100 | 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 | MIDWEST REGIONAL MEDICAL CENTER PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE ORGANIZATIONS RECOGNIZE THAT A PORTION OF THE ACTIVITIES CONDUCTED BY BOTH IHA AND ICAHN ARE FUNDED IN CONJUNCTION WITH THE TOTAL ANNUAL DUES PAID. MIDWEST REGIONAL MEDICAL CENTER ESTIMATED THAT $22,100 OR 39% OUT OF THE TOTAL DUES PAID TO IHA AND ICAHN WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $331,333 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $9,809 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $341,142 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $325,642 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,691 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $331,333 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $322,959 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,683 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $325,642 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $329,934 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,965 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $8,940 | GrantsOrScholarshipsAmt |
| End Year Balance | $322,959 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $344,116 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $2,251 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $16,433 | GrantsOrScholarshipsAmt |
| End Year Balance | $329,934 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.59220 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.40780 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $448,597 | OtherCostOrOtherBasisAmt |
| Book Value | $448,597 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,824,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,205,684 | DepreciationAmt |
| Book Value | $18,618,936 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,785,088 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,749,986 | DepreciationAmt |
| Book Value | $3,035,102 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $208,170 | OtherCostOrOtherBasisAmt |
| Book Value | $208,170 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,310,805 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| BOARD DESIGNATED INVESTMENTS FOR CAPITAL IMPROVEMENTS | $2,607,694 | C |
| DONOR RESTRICTED-MEDICAL SCHOLARSHIPS | $1,354,673 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $3,962,367 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAMS | $300,000 |
| SBA - PPP LOAN PAYABLE | $2,398,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,698,100 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS, IN TRUST, SECURITY DEPOSITS FROM THE RESIDENTS OF THE ASSISTED LIVING FACILITY. SECURITY DEPOSITS ARE REFUNDABLE UPON VACANCY. |
| PART V, LINE 4: | THE ENDOWMENTS CONSIST OF TWO DONOR-RESTRICTED FUNDS, WHICH WERE ESTABLISHED TO PROVIDE INVESTMENT INCOME FOR MEDICAL EDUCATION SCHOLARSHIPS. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $224,814 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $224,814 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00860 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,722,659 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,928,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,794,418 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06870 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,947,473 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,928,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,019,232 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07730 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,884,956 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,064,737 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $820,219 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03140 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,141 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,887,097 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,064,737 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $822,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,834,570 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,992,978 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,841,592 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10880 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $159,417 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $79,708 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,948,843 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,029,345 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$80,502 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | MIDWEST MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | GALENA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MIDWESTMEDICALCENTER.ORG | WebsiteAddressTxt |
| State License | 0005488 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PROVIDER BASED RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST 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 SUPPLEMENTAL INFORMATION | 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 SUPPLEMENTAL INFORMATION | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | HTTP://WWW.MIDWESTMEDICALCENTER.ORG/WORDPRESS/INSURANCE-PAYMENT/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.MIDWESTMEDICALCENTER.ORG/WORDPRESS/INSURANCE-PAYMENT/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.MIDWESTMEDICALCENTER.ORG/WORDPRESS/INSURANCE-PAYMENT/ | 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 Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MIDWEST MEDICAL CENTER | PART V, SECTION B, LINE 5: MIDWEST MEDICAL CENTER FORMED THREE FOCUS GROUPS COMPRISED OF AREA HEALTHCARE PROFESSIONALS/PARTNERS, LOCAL OFFICIALS, COMMUNITY LEADERS, AND COMMUNITY OFFICIALS. EACH FOCUS GROUP SESSION RESULTED IN A LIST OF PRIORITIZED HEALTH NEEDS AND ISSUES. |
| MIDWEST MEDICAL CENTER | PART V, SECTION B, LINE 11: THERE WERE MANY TOPICS IDENTIFIED THROUGH THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT BY MIDWEST MEDICAL CENTER. THESE TOPICS WERE PRIORITIZED WITH THE FOCUS GROUPS AND THE FOLLOWING CORE HEALTH RELATED TOPICS WERE DISCUSSED AS BEING THE HIGHEST LEVEL OF CONCERN FOR COMMUNITY MEMBERS AND LEADERS: MENTAL HEALTH SERVICES, EMERGENCY MEDICAL SERVICES, SENIOR RESOURCES, IMPROVED PUBLIC TRANSPORTATION, AFFORDABLE HEALTH INSURANCE, PATIENT EDUCATION, AND ACCESS TO DENTAL CARE IN AN INCREASINGLY CHALLENGING ECONOMY. MIDWEST MEDICAL CENTER REVIEWED THE ACTIVITIES AND DETERMINED THE FOLLOWING TOPICS NEEDED FURTHER REVIEW BY THE ORGANIZATION AND TOOK THE FOLLOWING ACTION STEPS THROUGH ITS IMPLEMENTATION PLAN AS WELL AS ONGOING MISSION AND OPERATIONS OF THE ORGANIZATION. MMC IS COLLABORATING WITH REGROUP TO OFFER TELEPYSCH SERVICES TO CHILDREN AND ADULTS THROUGH ITS SPECIALTY CLINIC IN 2020. MMC WILL CONTINUE TO WORK WITH COUNTY ON EMS ISSUES TO BETTER STAFF THE AMBULANCES. MMC PLANS TO EXPAND THE "WELCOME TO MEDICARE" PROGRAMS FOR SENIORS AS WELL AS EDUCATE PROVIDERS ABOUT LOCAL SERVICES FOR SENIORS. EXPANDING JO DAVIESS TRANSIT IS KEY TO IMPROVING PUBLIC TRANSPORTATION FOR THE LOCAL POPULATION. MMC IS CONTINUING TO LOOK INTO OFFERING LOCAL COVERAGE TO BE OFFERED TO THE COMMUNITY AT AN AFFORDABLE PRICE. MMC IS EXPANDING ITS CHRONIC CARE MANAGEMENT PROGRAM AS WELL AS WELLNESS AND NUTRITION EDUCATION, AND REDUCED FEE LAB AND BLOOD PRESSURE CHECK PROGRAMS. FINALLY, MMC IS READY TO PARTNER OR PARTICIPATE WITH A DENTAL CARE PROVIDER TO PROVIDE SUPPORT TO THE UNDERINSURED OR UNINSURED MEMBERS OF THE COMMUNITY. MMC HAS STARTED A DIABETES PROGRAM IN 2020 WHICH HAS BENEFITED THE PATIENTS IN NUMEROUS WAYS IN TERMS OF COST, CARE COORDINATION, AND ACCESSIBILITY. |
| MIDWEST MEDICAL CENTER | PART V, SECTION B, LINE 16J: THE POLICY IS OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARD TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE. |
| MIDWEST MEDICAL CENTER | PART V, SECTION B, LINE 20E: PATIENTS ARE GIVEN THE OPPORTUNITY TO APPLY FOR CHARITY CARE PRIOR TO ANY COLLECTION PRACTICES NOTED EARLIER UNDER POLICIES OF MIDWEST MEDICAL CENTER. THE POLICY AND APPLICATION ARE OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARD TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE. |
| PART V, SECTION B, LINE 7A: | HTTP://WWW.MIDWESTMEDICALCENTER.ORG/WORDPRESS/WP-CONTENT/UPLOADS/2019/10/MIDWEST-MEDICAL-CENTER-CHNA.PDF |
| PART V, SECTION B, LINE 10: | HTTP://WWW.MIDWESTMEDICALCENTER.ORG/WORDPRESS/WP-CONTENT/UPLOADS/2019/10/MIDWEST-MEDICAL-CENTER-CHNA.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - GALENA-STAUSS SENIOR CARE CAMPUS | ||||
| 215 SUMMIT STREET | GALENA | IL | 61036 | SKILLED NURSING FACILITY, ASSISTED LIVING, AND ADULT DAY CARE |
| 2 - MIDWEST HEALTH CLINIC - ELIZABETH | ||||
| 117 N MAIN STREET | ELIZABETH | IL | 61028 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MIDWEST MEDICAL CENTER PRIMARILY USES FEDERAL POVERTY GUIDELINES TO ESTABLISH CHARITY OR DISCOUNTED CARE TO THOSE IN NEED OF CARE IN THE COMMUNITY, HOWEVER THERE ARE OTHER CONSIDERATIONS GIVEN TO PATIENTS TO AVOID HAVING PATIENTS BE IN FINANCIAL DISTRESS DUE TO CONCERNS OVER THEIR MEDICAL BILLS. BELOW ARE THE GENERAL GUIDELINES AS DEFINED IN MIDWEST MEDICAL CENTER'S CHARITY CARE POLICY WHICH ARE FOLLOWED BY THE ORGANIZATION:PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME AT OR BELOW 125% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD WILL BE ELIGIBLE FOR 100% CHARITY CARE.PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME GREATER THAN 125%, BUT EQUAL TO OR LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD, WILL BE ELIGIBLE FOR PARTIAL FINANCIAL ASSISTANCE.PATIENT ACCOUNT GUARANTORS WITH INSUFFICIENT ASSETS TO PAY THE AMOUNT DUE, AND WHO DO NOT QUALIFY FOR CHARITY CARE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES, WILL BE ELIGIBLE FOR A CATASTROPHIC CHARITY ADJUSTMENT WHEN THE TOTAL AMOUNT DUE TO MIDWEST MEDICAL CENTER EQUALS AT LEAST 20% OF THE DEBTOR'S ADJUSTED GROSS INCOME. CATASTROPHIC CHARITY IS AN EIGHTY PERCENT (80%) ADJUSTMENT OFF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES. |
| PART I, LINE 7: | THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES (EXCLUDING THE PROVISION FOR BAD DEBTS) DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. (THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE HOSPITAL.) |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES AT MIDWEST MEDICAL CENTER INCLUDES THE OPERATION OF SEVERAL DEPARTMENTS. THE INPATIENT UNIT ALSO PROVIDES CARE TO OVERNIGHT OBSERVATION PATIENTS WHICH ARE KEPT FOR OBSERVATION IN FOLLOW UP CARE FROM THE EMERGENCY ROOM AS WELL AS PROVIDING A SIGNIFICANT NUMBER OF SWING BED SERVICES. IT IS THE GOAL OF MIDWEST MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WHILE THERE IS A GROWING ARGUMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. MIDWEST MEDICAL CENTER PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. MIDWEST MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. |
| PART III, LINE 4: | IN EVALUATING THE COLLECTABILITY OF PATIENT AND RESIDENT RECEIVABLES, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS OR RESIDENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS OR RESIDENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS AND RESIDENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, RADIOLOGY PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT MIDWEST MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2020, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES IN A LOCAL SETTING, 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: | UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, MIDWEST MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S BUSINESS OFFICE OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. |
| PART VI, LINE 2: | MIDWEST MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH MIDWEST MEDICAL CENTER'S MISSION IN THE COMMUNITY. MIDWEST MEDICAL CENTER ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND ITS PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. DURING FISCAL YEAR 2019 MIDWEST MEDICAL CENTER COMPLETED A FORMALIZED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | UNINSURED AND UNDER-INSURED PATIENTS ARE ASKED TO MEET WITH THE ORGANIZATION'S REGISTRATION REPRESENTATIVE AT THE TIME SERVICE IS PROVIDED AND WHEN THE PATIENT'S BILL IS GENERATED. A REGISTRATION REPRESENTATIVE WILL EXPLAIN THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PROVIDE THE FINANCIAL ASSISTANCE APPLICATION. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE ILLINOIS PUBLIC AID PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. INFORMATION ABOUT THE AVAILABILITY OF SUCH PROGRAMS IS ALSO AVAILABLE AT MIDWESTMEDICALCENTER.ORG. |
| PART VI, LINE 4: | THE PRIMARY SERVICE AREA FOR MIDWEST MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 30 TO 60 MILE RADIUS OF THE HOSPITAL. |
| PART VI, LINE 5: | MIDWEST MEDICAL CENTER IS AN INDEPENDENT COMMUNITY HOSPITAL GOVERNED BY A 11-MEMBER BOARD OF DIRECTORS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | NOTES RECEIVABLE FOR SCHOLARSHIPS FORGIVEN | GrantTypeTxt |
| Recipient | 4 | RecipientCnt |
| Non Cash Assistance | $8,156 | NonCashAssistanceAmt |
| Valuation Method Used | CURRENT NOTE RECEIVABLE BALANCE | ValuationMethodUsedDesc |
| Non Cash Assistance | FORGIVENESS OF NOTES RECEIVABLE IS GOVERNED BY THE HOSPITAL'S MEDICAL EDUCATION SCHOLARSHIP PROGRAM AND FORGIVENESS IS GRANTED IF INDIVIDUALS FULFILL FUTURE SERVICE REQUIREMENTS WITH MIDWEST MEDICAL CENTER IN HEALTH PROFESSIONAL RELATED FIELDS. THE HOSPITAL TRACKS THIS INFORMATION ANNUALLY AND AWARDS THE FORGIVENESS BASED ON THE COMPLETION OF THE REQUIRED CRITERIA OF THE PROGRAM. | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MIDWEST MEDICAL CENTER TRACKS THE GRANTS PROVIDED THROUGH THE USE OF NOTES RECEIVABLE AS THE SCHOLARSHIP PROGRAMS ARE INTENDED TO SUPPLEMENT AND BE A FORM OF STUDENT LOANS FOR MEMBERS OF THE COMMUNITY PURSUING ADDITIONAL EDUCATION IN HEALTH RELATED FIELDS. PRIOR TO APPROVING A NOTE TO A PERSPECTIVE STUDENT, AN APPLICATION IS REVIEWED FOR APPROVAL BY THE HOSPITAL'S CONTROLLER TO ENSURE THAT ALL BACKGROUND INFORMATION ON THE CANDIDATE WAS PROVIDED. AFTER REVIEW BY THE CONTROLLER, THIS INFORMATION IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. EACH STUDENT MUST SIGN A PROMISSORY NOTE WITH MIDWEST MEDICAL CENTER THAT THEY COMMIT TO COMPLETE THE EDUCATIONAL PROGRAM AND THAT UPON GRADUATION THEY WILL PERFORM SERVICES FOR MIDWEST MEDICAL CENTER (PENDING AN AVAILABLE POSITION IN THE HOSPITAL AT THE TIME) OR THEY WILL REPAY THE NOTE WITH INTEREST. (THE REPAYMENT TERMS ENSURE THAT THE ENDOWED AND DONATED FUNDS ARE AVAILABLE IN FUTURE YEARS TO OTHER MEMBERS OF THE COMMUNITY OR THAT SERVICES ARE RETURNED TO THE COMMUNITY THROUGH SERVICE TO THE MEDICAL CENTER.) SERVICES PERFORMED AT MIDWEST MEDICAL CENTER RESULT IN FORGIVENESS OF NOTE RECEIVABLE AMOUNTS BASED ON HOURS WORKED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD FARRELL MD | ||||||||||||||
| PHYSICIAN | $336,930 | $0 | $0 | $0 | $0 | $0 | $14,007 | $0 | $18,752 | $0 | $369,689 | $0 | $0 | $0 |
| GREG HARMSTON MD | ||||||||||||||
| PHYSICIAN | $273,778 | $0 | $0 | $0 | $0 | $0 | $11,129 | $0 | $18,752 | $0 | $303,659 | $0 | $0 | $0 |
| MICHAEL WELLS MD | ||||||||||||||
| PHYSICIAN | $193,597 | $0 | $0 | $0 | $0 | $0 | $8,177 | $0 | $18,335 | $0 | $220,109 | $0 | $0 | $0 |
| KRISTEN HEIMBUCH CRNA | ||||||||||||||
| CRNA | $194,190 | $0 | $0 | $0 | $0 | $0 | $8,126 | $0 | $12,944 | $0 | $215,260 | $0 | $0 | $0 |
| MATTHEW GULLONE MD | ||||||||||||||
| PHYSICIAN | $199,251 | $0 | $0 | $0 | $0 | $0 | $6,861 | $0 | $7,797 | $0 | $213,909 | $0 | $0 | $0 |
| TRACY BAUER | ||||||||||||||
| CEO | $266,256 | $0 | $0 | $0 | $0 | $0 | $11,040 | $0 | $18,335 | $0 | $295,631 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | A SIGN ON BONUS IN THE AMOUNT OF $25,000 WAS PAID OUT TO RICHARD FARRELL, MD PER HIS EMPLOYMENT CONTRACT. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PAMELA SMITH | |||
| FAMILY MEMBER OF TRACY BAUER, CEO | $50,017 | EMPLOYMENT COMPENSATION | 0 |
| PATRICIA BAUER | |||
| FAMILY MEMBER OF TRACY BAUER, CEO | $20,164 | EMPLOYMENT COMPENSATION | 0 |
| REBECCA ANDERSON | |||
| FAMILY MEMBER OF TRACY BAUER, CEO | $44,112 | EMPLOYMENT COMPENSATION | 0 |
| JASON FRANK | |||
| FAMILY MEMBER OF KELLI JACKSON, CONTROLLER | $13,155 | EMPLOYMENT COMPENSATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF MIDWEST MEDICAL CENTER IS MIDWEST MEDICAL FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF MIDWEST MEDICAL FOUNDATION HAVE THE RIGHT TO APPOINT MEMBERS OF THE BOARD OF DIRECTORS OR REMOVAL OF BOARD MEMBERS OF MIDWEST MEDICAL CENTER. THE MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER WILL ALSO BE BOARD MEMBERS OF MIDWEST MEDICAL FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER PREVIOUSLY ISSUED TAX-EXEMPT BONDS THROUGH THE ILLINOIS FINANCE AUTHORITY TO FINANCE THE CONSTRUCTION OF A REPLACEMENT HOSPITAL. UNDER THE TERMS OF THE BOND AGREEMENTS, THE ORGANIZATION IS LIMITED AS TO ISSUING NEW DEBT, PURCHASING SIGNIFICANT CAPITAL ASSETS, DISPOSING OF SIGNIFICANT ASSETS, AND/OR SETTING UP NEW CORPORATIONS OR SUBSTANTIALLY RESTRUCTURING THE CURRENT ORGANIZATION WITHOUT FIRST OBTAINING APPROVAL OF THE BOND TRUSTEES. IN TAX YEAR 2018 THE ORGANIZATION DID HAVE A CHANGE IN THEIR PARENT AND PAID OFF THE TAX-EXEMPT BONDS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS RECEIVED A COPY OF THE FINAL 990 FOR REVIEW AND APPROVAL THROUGH POSTING TO AN ELECTRONIC SECURE WEBSITE BY MANAGEMENT OF MIDWEST MEDICAL CENTER PRIOR TO ITS SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | SINCE MIDWEST MEDICAL CENTER IS PART OF A SMALL COMMUNITY, CONFLICTS OF INTEREST ARE GENERALLY KNOWN. THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUAL DISCLOSURE STATEMENTS. THESE ARE KEPT ON FILE AT THE HOSPITAL AND ALL MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING MANAGEMENT WHICH ATTEND MEETINGS, ARE TOLD OF THE CONFLICTS. ANY MEMBERS WITH KNOWN CONFLICTS ABSTAIN FROM VOTING ON THESE CONFLICTS DURING MEETINGS AND ENGAGE IN ONLY LIMITED DISCUSSIONS ON THESE TOPICS. THE BOARD AND MANAGEMENT HOLD EACH OTHER ACCOUNTABLE THROUGH OBSERVATION AND ENFORCEMENT OF THE POLICY DURING MEETINGS AND AT ORGANIZATION FUNCTIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS EVALUATIONS FOR THESE INDIVIDUALS, COMPARES DATA TO COMPETITIVE MARKET DATA OBTAINED FROM SALARY SURVEYS, AND CONSULTS WITH OUTSIDE ORGANIZATIONS AS NEEDED IN REVIEWING CONTRACTS. LEGAL AND OUTSIDE VALUATION SERVICES ARE OBTAINED IN ENSURING THE KEY EMPLOYEES, EXECUTIVES, AND PHYSICIANS' SALARIES ARE IN LINE WITH REASONABLE AND PRUDENT BUYER CONCEPTS AS WELL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A: | EXPLANATION OF HOURS WORKED: THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER ALSO SERVES AS THE BOARD OF DIRECTORS FOR THE MIDWEST REGIONAL HEALTH SYSTEM. NO ADDITIONAL HOURS OF SERVICE ARE DEDICATED TO THE BOARD POSITIONS ON THE MIDWEST REGIONAL HEALTH SYSTEM. THE MIDWEST REGIONAL HEALTH SYSTEM WAS ORGANIZED TO SERVE AS A SUPPORTING ORGANIZATION FOR MIDWEST MEDICAL CENTER AND MIDWEST REGIONAL HEALTH FOUNDATION. ADDITIONALLY, SOME OFFICERS AND BOARD MEMBERS ALSO SERVE AS BOARD MEMBERS OF MIDWEST REGIONAL HEALTH FOUNDATION. THE HOURS OF SERVICE PROVIDED TO THIS ORGANIZATION IS REFLECTED ON LINE 2 OF COLUMN B. |
| FORM 990, PART IX, LINE 11G | EMERGENCY SERVICES: PROGRAM SERVICE EXPENSES 1,752,878. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,752,878. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 785,998. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 785,998. CLINIC SERVICES: PROGRAM SERVICE EXPENSES 583,975. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 583,975. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 193,195. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193,195. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 597,718. MANAGEMENT AND GENERAL EXPENSES 515,502. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,113,220. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST MEDICAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | GALENA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204560639 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)3 | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | 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 | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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