FURP.ORG / PUBLIC DATA EXPLORER

HILLSBORO AREA HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HILLSBORO AREA HOSPITAL INC (EIN 37-0661208)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-02-09
IRS object ID
202130409349300003
Schema version
2019v5.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-02-09T06:30:01-06:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11502 LONDON ROAD SUITE 200AddressLine1Txt
CityDULUTHCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55812ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370661208EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHILLBusinessNameControlTxt
Phone2175326111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1Txt
CityHILLSBOROCityNm
State AbbreviationILStateAbbreviationCd
ZIP62049ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonREX BROWNPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone2175326111PhoneNum
Signature2021-01-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL J PETERSON CPAPreparerPersonNm
PTINP01833529PTIN
Phone2187224705PhoneNum
Preparation2021-01-27PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerREX BROWNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1Txt
CityHILLSBOROCityNm
State AbbreviationILStateAbbreviationCd
ZIP62049ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,431,186GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HILLSBOROAREAHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1906FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionOPERATION OF HOSPITAL (INPATIENT, SWING BED & OUTPATIENT) AND ASSISTED LIVING FACILITIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee305TotalEmployeeCnt
Total Volunteers51TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$46,106PYContributionsGrantsAmt
CY Contributions Grants$3,140,649CYContributionsGrantsAmt
PY Program Service Revenue$25,630,247PYProgramServiceRevenueAmt
CY Program Service Revenue$27,471,083CYProgramServiceRevenueAmt
PY Investment Income$687,451PYInvestmentIncomeAmt
CY Investment Income$704,480CYInvestmentIncomeAmt
PY Other Revenue$122,113PYOtherRevenueAmt
CY Other Revenue$114,974CYOtherRevenueAmt
PY Total Revenue$26,485,917PYTotalRevenueAmt
CY Total Revenue$31,431,186CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$115,297CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,064,714PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,752,165CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,872,959PYOtherExpensesAmt
CY Other Expenses$13,601,425CYOtherExpensesAmt
PY Total Expenses$23,937,673PYTotalExpensesAmt
CY Total Expenses$25,468,887CYTotalExpensesAmt
PY Revenues Less Expenses$2,548,244PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,962,299CYRevenuesLessExpensesAmt
Total Assets BOY$41,262,184TotalAssetsBOYAmt
Total Assets EOY$53,665,107TotalAssetsEOYAmt
Total Liabilities BOY$8,351,263TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,738,725TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$32,910,921NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$37,926,382NetAssetsOrFundBalancesEOYAmt
MissionTO POSITIVELY AFFECT THE HEALTH AND WELFARE OF THE COMMUNITIES WE SERVE THROUGH THE OPERATION OF A HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) AND AN ASSISTED LIVING FACILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$20,714,507ExpenseAmt
Grant$115,297GrantAmt
Revenue$27,474,533RevenueAmt
DescOPERATION OF A 25 BED CRITICAL ACCESS HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) WITH AN ASSISTED LIVING FACILITY. 722 ACUTE DAYS, 1,701 SWING BED DAYS, 14,782 OUTPATIENT VISITS AND 12,654 ASSISTED LIVING RESIDENT DAYS PROVIDED IN FY 2020. HILLSBORO AREA HOSPITAL ALSO PROVIDED $658,663 IN CHARITY CARE AND $1,973,608 IN OTHER COMMUNITY BENEFITS, NOT INCLUDING BAD DEBT.Desc
Total Program Service Expenses$20,714,507TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document62IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee305EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTERRI CARROLLPersonNm
Phone2175324187PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1Txt
CityHILLSBOROCityNm
State AbbreviationILStateAbbreviationCd
ZIP62049ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ANDREW OTT
PODIATRIST40.00Yes (X)$241,218$0$20,893
ELVIS HARRISON
VP OF PATIENT CARE SERVICE40.00Yes (X)$163,804$0$26,583
ABBY BUGG
TEAMWORK REHAB DIRECTOR40.00Yes (X)$114,037$0$45,962
ANGELA LEGENDRE
OCCUPATIONAL THERAPIST40.00Yes (X)$100,434$0$4,107
TERRI CARROLL
VP OF FINANCIAL SERVICES40.00$173,869$0$32,4691.00Yes (X)
REX BROWN
PRESIDENT & CEO40.00$0$0$01.30Yes (X)
LINDSAY WAGAHOFF
CHAIRMAN1.00$0$0$0Yes (X)Yes (X)
LISA WHITE
VICE CHAIR1.00$0$0$0Yes (X)Yes (X)
EARL FLACK
TREASURER1.00$0$0$0Yes (X)Yes (X)
PATRICIA CLARK
TREASURER (THRU SEPT)1.00$0$0$0Yes (X)Yes (X)
JULIE JENKINS
SECRETARY1.00$0$0$00.10Yes (X)Yes (X)
MISTY BORROWMAN
DIRECTOR1.00$0$0$0Yes (X)
DR DOUG BYERS
DIRECTOR1.00$0$0$0Yes (X)
DR BEN CADY
DIRECTOR1.00$0$0$0Yes (X)
GREG HOLCOMB
DIRECTOR1.00$0$0$0Yes (X)
DAVID HOUGH
DIRECTOR1.00$0$0$0Yes (X)
BRIAN KNODLE
DIRECTOR (THRU SEPT)1.00$0$0$0Yes (X)
JORDAN RUPPERT
DIRECTOR1.00$0$0$0Yes (X)
BRAD YOUNG
DIRECTOR1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$793,362TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$130,014TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ILLINOIS EMERGENCY PHYSICIANS LLP
200 CORPORATE BLVDLAFAYETTELA70508PHYSICIAN COVERAGE$1,859,950
HEALTHTECH MANAGEMENT SERVICES
5110 MARYLAND WAY STE 200BRENTWOODTN37027MANAGEMENT & CEO SERVICES$612,303
AUREUS RADIOLOGY
PO BOX 3037OMAHANE68103LAB PERSONNEL SERVICES$193,681
PRECISE SPECIALTIES CORP
PO BOX 572HILLSBOROIL62049ULTRASOUND SERVICES$184,945
MEDICAL OUTSOURCING SOLUTIONS
1735 DEKALB AVESYCAMOREIL60178NUCLEAR MEDICINE$180,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Government Grants$3,108,624GovernmentGrantsAmt
All Other Contributions$32,025AllOtherContributionsAmt
Total Contributions$3,140,649TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621110BusinessCd
Total Revenue Column$27,291,720TotalRevenueColumnAmt
Related Or Exempt Func Income$27,291,720RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$179,363TotalRevenueColumnAmt
Related Or Exempt Func Income$179,363RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$27,471,083TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$704,060TotalRevenueColumnAmt
Exclusion$704,060ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$76,054RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$76,054RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,054TotalRevenueColumnAmt
Exclusion$76,054ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$420OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$420OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$420TotalRevenueColumnAmt
Exclusion$420ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA REVENUE722514$35,470$35,470
AMBULANCE FEES900099$3,450$3,450
FieldValueIRS element (for citing)
Other Revenue Total$38,920OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,431,186TotalRevenueColumnAmt
Related Or Exempt Func Income$27,474,533RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$816,004ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$115,297TotalAmt
Program Services$115,297ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$206,338TotalAmt
Management And General$206,338ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,000,047TotalAmt
Program Services$7,719,618ProgramServicesAmt
Management And General$1,280,429ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$228,014TotalAmt
Program Services$188,819ProgramServicesAmt
Management And General$39,195ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,662,951TotalAmt
Program Services$1,367,580ProgramServicesAmt
Management And General$295,371ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$654,815TotalAmt
Program Services$529,861ProgramServicesAmt
Management And General$124,954ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$627,068TotalAmt
Management And General$627,068ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$48,376TotalAmt
Management And General$48,376ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$44,008TotalAmt
Management And General$44,008ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,873,642TotalAmt
Program Services$4,266,467ProgramServicesAmt
Management And General$607,175ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$54,273TotalAmt
Management And General$54,273ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$123,193TotalAmt
Program Services$42,925ProgramServicesAmt
Management And General$80,268ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$368,338TotalAmt
Program Services$349,905ProgramServicesAmt
Management And General$18,433ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$54,981TotalAmt
Program Services$41,789ProgramServicesAmt
Management And General$13,192ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$29,360TotalAmt
Program Services$25,852ProgramServicesAmt
Management And General$3,508ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$176,663TotalAmt
Program Services$176,663ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,057,451TotalAmt
Program Services$778,123ProgramServicesAmt
Management And General$279,328ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$350,814TotalAmt
Program Services$46,538ProgramServicesAmt
Management And General$304,276ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$2,097,756$2,041,495$56,261
BAD DEBT EXPENSE$1,901,110$1,901,110
REPAIRS & MAINTENANCE$698,915$594,022$104,893
MEDICAID TAX ASSESSMENT$444,144$444,144

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$651,333TotalAmt
Program Services$528,443ProgramServicesAmt
Management And General$122,890ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$25,468,887TotalAmt
Program Services$20,714,507ProgramServicesAmt
Management And General$4,754,380ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,254,654BOYAmt
EOY$9,148,054EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$12,192,719BOYAmt
EOY$17,014,885EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,139,308BOYAmt
EOY$2,510,756EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$532,890BOYAmt
EOY$557,250EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$453,684BOYAmt
EOY$479,184EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,686,873LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$23,232,152LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,728,646BOYAmt
EOY$11,454,721EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,000,504BOYAmt
EOY$3,544,582EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,439,503BOYAmt
EOY$8,408,712EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$520,276BOYAmt
EOY$546,963EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$41,262,184BOYAmt
EOY$53,665,107EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,402,979BOYAmt
EOY$2,660,870EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,100,851EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,807,480BOYAmt
EOY$4,486,305EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,835,100EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,140,804BOYAmt
EOY$5,655,599EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,351,263BOYAmt
EOY$15,738,725EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,939,083BOYAmt
EOY$36,932,314EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$971,838BOYAmt
EOY$994,068EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,910,921BOYAmt
EOY$37,926,382EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$41,262,184BOYAmt
EOY$53,665,107EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,962,299ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$37,826NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$984,664OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$10,982OtherActivitiesAmt
Total Lobbying Expenditures$10,982TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationHILLSBORO AREA HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS, TO HELP WITH STAFF TRAINING, AND TO ASSIST WITH REIMBURSEMENT. HILLSBORO AREA HOSPITAL ESTIMATED THAT $10,982 OUT OF THE TOTAL DUES PAID TO IHA AND AHA WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$421,176BeginningYearBalanceAmt
Investment Earnings Or Losses$5,750InvestmentEarningsOrLossesAmt
End Year Balance$426,926EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$418,430BeginningYearBalanceAmt
Investment Earnings Or Losses$2,746InvestmentEarningsOrLossesAmt
End Year Balance$421,176EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$414,863BeginningYearBalanceAmt
Investment Earnings Or Losses$3,567InvestmentEarningsOrLossesAmt
End Year Balance$418,430EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$412,788BeginningYearBalanceAmt
Investment Earnings Or Losses$2,075InvestmentEarningsOrLossesAmt
End Year Balance$414,863EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$410,867BeginningYearBalanceAmt
Investment Earnings Or Losses$1,921InvestmentEarningsOrLossesAmt
End Year Balance$412,788EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.66760PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.33240TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$355,860OtherCostOrOtherBasisAmt
Book Value$355,860BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,411,122OtherCostOrOtherBasisAmt
Depreciation$10,626,364DepreciationAmt
Book Value$8,784,758BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,877,584OtherCostOrOtherBasisAmt
Depreciation$12,605,788DepreciationAmt
Book Value$2,271,796BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,307OtherCostOrOtherBasisAmt
Book Value$42,307BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,454,721TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescCERTIFICATES OF DEPOSITSDesc
Book Value$8,408,712BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$8,408,712TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$72,947
AMOUNTS PAYBALE TO THIRD-PARTY REIMBURSEMENT PROGRAMS$5,582,652
FieldValueIRS element (for citing)
Total Liability$5,655,599TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$29,523,182TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$29,523,182RevenueSubtotalAmt
Other Revenues Not Included$1,908,004OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,908,004RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$31,431,186TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$23,567,777TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$23,567,777ExpensesSubtotalAmt
Other Expenses Not Included$1,901,110OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,901,110ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$25,468,887TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENTS ARE INTENDED TO BE USED TO SUPPORT THE MAINTENANCE AND EQUIPMENT NEEDS OF THE HOSPITAL.
PART XI, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 1,901,110. INVESTMENT INCOME RECORDED TO RESTRICTED NET ASSET 6,894.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBTS 1,901,110.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically Available0ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$295,360TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$295,360NetCommunityBenefitExpnsAmt
Total Expense0.01250TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,505,732TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,542,815DirectOffsettingRevenueAmt
Net Community Benefit Expns$962,917NetCommunityBenefitExpnsAmt
Total Expense0.04090TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,801,092TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,542,815DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,258,277NetCommunityBenefitExpnsAmt
Total Expense0.05340TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,970TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,660NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,238,677TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,312,397DirectOffsettingRevenueAmt
Net Community Benefit Expns$926,280NetCommunityBenefitExpnsAmt
Total Expense0.03930TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$258,628TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$258,628NetCommunityBenefitExpnsAmt
Total Expense0.01100TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,517,275TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,319,707DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,197,568NetCommunityBenefitExpnsAmt
Total Expense0.05080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,318,367TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,862,522DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,455,845NetCommunityBenefitExpnsAmt
Total Expense0.10420TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,532TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,532NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,532TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,532NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$852,503BadDebtExpenseAmt
Bad Debt Expense Attributable$426,252BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,583,053ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,598,437CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$15,384MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1Txt
CityHILLSBOROCityNm
State AbbreviationILStateAbbreviationCd
ZIP62049ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.HILLSBOROHEALTH.ORGWebsiteAddressTxt
State License968StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, PAGE 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/PATIENT-BILLING/FINANCIAL-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/PATIENT-BILLING/FINANCIAL-ASSISTANCE/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/PATIENT-BILLING/FINANCIAL-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
HILLSBORO AREA HOSPITALPART V, SECTION B, LINE 5: THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN PUBLIC HEALTH (LOCAL, REGIONAL, STATE AND/OR TRIBAL). MEMBERS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY THE HOSPITAL OR INDIVIDUALS OR ORGANIZATIONS REPRESENTING THE INTERESTS OF SUCH POPULATIONS ALSO PROVIDED INPUT. THE MEDICALLY UNDERSERVED ARE MEMBERS OF A POPULATION WHO EXPERIENCE HEALTH DISPARITIES, ARE AT RISK OF NOT RECEIVING ADEQUATE MEDICAL CARE AS A RESULT OF BEING UNINSURED OR UNDERINSURED, AND/OR EXPERIENCING BARRIERS TO HEALTH CARE DUE TO GEOGRAPHIC, LANGUAGE, FINANCIAL, OR OTHER BARRIERS. MONTGOMERY COUNTY PUBLIC HEALTH PARTICIPATED IN THE PROCESS. FOCUS GROUP#1 - THE GROUP CONSISTED OF MEDICAL PROFESSIONALS AND PARTNERS, INCLUDING REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED PHYSICIANS, A NURSE PRACTITIONER, A PHARMACIST, AN ANESTHESIOLOGIST, AN OPTOMETRIST, NURSES, AND REPRESENTATIVES OF SENIOR CARE FACILITIES. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL.FOCUS GROUP#2 - THE GROUP CONSISTED OF COMMUNITY LEADERS AND REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED SCHOOL OFFICIALS, THE COUNTY PUBLIC HEALTH ADMINISTRATOR, A REPRESENTATIVE OF THE SHERIFF'S OFFICE, LOCAL COMMUNITY DEVELOPMENT LEADERS, UNIVERSITY OF ILLINOIS EXTENSION, COMMUNITY ORGANIZATION MEMBERS, AND OTHERS. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL.FOCUS GROUP#3 - THE GROUP CONSISTED OF COMMUNITY LEADERS AND REPRESENTATIVES OF GROUPS THAT REPRESENT OR SERVE PERSONS THAT MAY BE UNDERSERVED BY LOCAL MEDICAL SERVICES. THE GROUP INCLUDED LEADERS OF VOLUNTEER ORGANIZATIONS, SENIOR CITIZENS, THE MAYOR OF HILLSBORO, AND OTHERS. THE GROUP MET ON OCTOBER 17, 2018 AT HILLSBORO AREA HOSPITAL.
HILLSBORO AREA HOSPITALPART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/PART V, SECTION B, LINE 10A:HTTP://WWW.HILLSBOROAREAHOSPITAL.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/
HILLSBORO AREA HOSPITALPART V, SECTION B, LINE 11: 1. MENTAL HEALTH A. EDUCATION FOR PARENTS ABOUT MENTAL HEALTH ISSUES FACING YOUTH.OUR FIRST STEP WAS A SEND HOME EXPLANATION OF THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF POPULATION SCIENCE AND POLICY (SIU SOM DPS&P) TWO-SESSION SURVEY THAT OCCURRED IN NOVEMBER 2019. B. ADDRESS TEEN SUICIDEASSESSING THE MIDDLE AND HIGH SCHOOL STUDENTS TO REDUCE TEEN SUICIDE WAS THE TARGET OF THE RESEARCH CONTRACT WITH SIU SOM DPS&P. IN NOVEMBER OF 2019, APPROXIMATELY 750 STUDENTS PARTICIPATED IN A TWO SESSION SURVEY. A COMMUNITY STEERING COMMITTEE WAS FORMED TO ASSESS THE DATA AS PRESENTED BY THE POPULATION SCIENCE AND POLICY RESEARCHERS. THE STEERING COMMITTEE THEN STUDIED PROGRAMS ACROSS THE NATION THAT HAD PROVEN TO BE SUCCESSFUL IN DEALING WITH YOUTH'S ISSUES SURROUNDING SUICIDE. TWO PROGRAMS WERE SELECTED. C. COMMUNITY AWARENESS EDUCATION ON MENTAL HEALTHIN FEBRUARY, 2020 THE STEERING COMMITTEE WAS ABLE TO RAISE ABOUT $37,000 AT AN EVENT SPONSORED BY THE HILLSBORO AREA HEALTH FOUNDATION. ADDITIONAL FUNDS HAVE BEEN ADDED DURING THE 2020 YEAR AND THERE IS NOW SUFFICIENT FUNDING TO SUPPORT THE TWO PROGRAMS FOR A NUMBER OF YEARS. IN PREPARATION FOR FUND-RAISING THE COMMUNITY AWARENESS WAS ADDRESSED AND WAS SUCCESSFUL AS MEASURED BY SIGNIFICANT FUNDS RAISED. D. EDUCATION ON AWARENESS AND UNDERSTANDING OF SELF ESTEEMTHE EDUCATION ON AWARENESS AND UNDERSTANDING OF SELF-ESTEEM WILL START WHEN THE "SOURCES OF STRENGTH" PROGRAM LAUNCHES IN OCTOBER, 2020. THE SECOND INITIATIVE THAT OPERATES UNDER THE NAME "BLUES PROGRAM" WILL BEGIN IN LATE JANUARY 2021. CONTRACT NEGOTIATIONS FOR THAT PROGRAM BEGAN IN JUNE 2020 AND ARE EXPECTED TO CONCLUDE EARLY ENOUGH IN JANUARY 2021 TO HAVE THE PROGRAM COMMENCE ON SCHEDULE. E. ADDRESS MENTAL HEALTH DISORDER "TRIGGERS"THE TWO PROGRAMS ARE DESIGNED TO ADDRESS MENTAL HEALTH TRIGGERS. THEY WILL BE TAUGHT AT THE HIGH SCHOOL LEVEL THROUGH 2021. SOURCES OF STRENGTH WILL BEGIN IN THE MIDDLE SCHOOL IN 2021. THE STEERING COMMITTEE HAS ALSO RAISED SUFFICIENT FUNDS TO EXPAND THE PROGRAM TO THE NOKOMIS SCHOOL DISTRICT, WHICH LIES IN THE HOSPITAL'S SECONDARY SERVICE AREA. THE HOSPITAL ALSO ADDED TWO PROFESSIONALS TO THE INTEGRATED BEHAVIORAL MEDICINE STAFF IN 2020. THE FOUR PERSON DEPARTMENT IS OVERSEEN BY BOTH HOSPITAL NURSING AND OUR CONTRACTED PSYCHIATRIST. PATIENTS ARE BEING SEEN AND TREATED AND AN AREA HEALTH SYSTEM IS IN DISCUSSIONS WITH THE HOSPITAL TO EXPAND INTO ONE OF THEIR SERVICE AREAS TO OUR SOUTH. PURSUIT OF TELEPSYCH SERVICES HAS BEEN ACTIVE BUT UNSUCCESSFUL TO THIS POINT. ATTEMPTS TO CONTRACT FOR THIS SERVICE HAVE FAILED WHEN THE CONTRACTING AGENCY IS UNABLE TO FIND QUALIFIED STAFF. 2. FLEXIBLE TRANSPORTATION IN THE AREAA. EXPLORE A PARTNERSHIP WITH MACOUPIN COUNTY PUBLIC HEALTH AND OTHER HOSPITALS TO EXPAND PUBLIC TRANSPORTATIONB. EXPLORE VOUCHER AGREEMENTS WITH LOCAL TAXI SERVICESAVAILABLE TRANSPORTATION CONTINUES TO BE A STRUGGLE IN OUR RURAL COMMUNITY. THERE HAS BEEN BROAD BASED NETWORKING TO FIND SUCCESSFUL TRANSPORTATION MODELS IN OTHER RURAL COMMUNITIES. WE ARE RESEARCHING POSSIBLE PARTNERSHIPS WITH LOCAL CHURCHES TO UTILIZE THEIR VANS; HOWEVER, NO SOLUTION HAS YET BEEN IMPLEMENTED. WE ASSIST WITH SCHEDULING RIDES WITH QUAD COUNTY HEALTH AND CENTRAL ILLINOIS PUBLIC TRANSPORTATION. WHEN THIS IS NOT POSSIBLE AND THE PATIENT CANNOT AFFORD TO PAY, THE HOSPITAL ASSISTS WITH PAYMENT TO THE TAXI SERVICE SERVING THE WESTERN SECTION OF THE COUNTY. JULY 2019-TRANSPORTATION FOR THE FREE SUMMER LUNCH PROGRAM WAS PROVIDED BY THE HILLSBORO SCHOOL DISTRICT BUS SERVICE, AND THE HOSPITAL REIMBURSES THEM FOR THIS SERVICE. MANY CHILDREN WOULD NOT BE ABLE TO PARTICIPATE IN THE SUMMER LUNCH PROGRAM IF TRANSPORTATION WAS NOT PROVIDED.JUNE JULY 2020 - DUE TO COVID-19, THE SUMMER LUNCH PROGRAM WAS REDESIGNED. VOLUNTEERS DELIVERED BAGS OF GROCERIES TO FAMILIES IN NEED IN 7 COMMUNITIES (HILLSBORO, WITT, IRVING, COFFEEN, BUTLER, DONNELLSON, & PANAMA). 3700 MEALS WERE PROVIDED.3. EXPAND HOSPITAL INVOLVEMENT WITH YOUTH AND SCHOOLS IN ORDER TO IMPROVE AWARENESS OF HEALTH ISSUES, HEALTHY LIVING AND LIFESTYLES, AND HEALTH CAREERS.A. EXPAND AN IN-HOUSE PILOT EMPLOYEE WELLNESS PROGRAM TO CREATE A BEHAVIORAL HEALTH WELLNESS MODEL FOR BUSINESSES IN THE COMMUNITY TO ADDRESS HEALTHY FOODS, EXERCISE, AND FINANCIAL ADVICE.WORKPLACE WELLNESS CONTINUES AT THE HOSPITAL AS PART OF THE EMPLOYEE HEALTH PLAN TO ENCOURAGE PHYSICAL AND MENTAL HEALTH WITH A POINT SYSTEM TO PROVIDE HEALTH INSURANCE DISCOUNT RATES FOR PARTICIPATION.AN EMPLOYEE WELLNESS PROGRAM FROM ALLSCRIPTS WAS ADDED IN DECEMBER 2019. THE ALLSCRIPTS WELLNESS PLAN PROVIDES WELLNESS BENEFITS TO PARTICIPANTS BY OFFERING A PERSONALIZED COACHING EXPERIENCE. THE COACH CAN HELP TEAM MEMBERS WITH MANY DIFFERENT ASPECTS OF THEIR HEALTH, INCLUDING WEIGHT MANAGEMENT, HEALTHY EATING, DIABETES, HYPERTENSION, SMOKING CESSATION AND MANY MORE. EACH TEAM MEMBER WAS PROVIDED A SCALE, BLOOD PRESSURE CUFF, AND ACTIVITY TRACKER. THE DATA IS TRACKED THROUGH APPS THAT ARE VIEWABLE BY THE WELLNESS COACH.B. EXPLORE AFTER-SCHOOL AND SUMMER PROGRAMS TO CREATE AWARENESS OF HEALTH PROFESSIONS, WELLNESS, AND OTHER ISSUES FOR YOUTH. JULY 2019 SPECIAL PRESENTATIONS WERE PROVIDED FOR THE SUMMER LUNCH PARTICIPANTS ON HEALTH PROFESSIONS AND LIVING A HEALTHY LIFE. SPECIAL ATTENTION WAS PAID TO PROVIDING LUNCHES TO CHILDREN THAT WERE WELL BALANCED AND INCLUDED FRESH FRUIT AND VEGETABLES. WE FOCUSED ON THE IMPORTANCE OF EXERCISE BY ALLOWING THE CHILDREN TO SWIM 4 DAYS A WEEK AND EXERCISE IN THE GYM ONE DAY A WEEK.JUNE & JULY 2020 DUE TO COVID-19, WE WERE UNABLE TO BRING THE CHILDREN INTO THE HOSPITAL FOR LUNCH. A BAG OF GROCERIES WITH HEALTHY MENU OPTIONS WERE DELIVERED TO FAMILIES IN NEED WEEKLY. NOV. 2019 - PASSPORT FOR A HEALTHY LIFE - HAH PARTNERS WITH FUSION FITNESS AND AQUATICS AND SPRINGFIELD CLINIC TO PROVIDE A HEALTH FAIR DESIGNED FOR ELEMENTARY SCHOOL AGE CHILDREN. THIS FAIR PROVIDES 20-25 STATIONS TO EDUCATE STUDENTS AND THEIR PARENTS ON HEALTHY LIFESTYLES. HEALTH CAREER EXPLORATION IS A PROGRAM FOR HIGH SCHOOL STUDENTS WHO WANT TO LEARN MORE ABOUT SPECIFIC HEALTH CAREERS AND OBSERVE THE WORKPLACE OF VARIOUS HEALTHCARE PROFESSIONALS. EXPLORERS MAY ATTEND MONTHLY MEETINGS WHERE THEY CAN STUDY HEALTH-RELATED TOPICS AND COMPLETE RELATED ACTIVITIES. IT IS ALSO AN OPPORTUNITY TO FIND INDIVIDUALS WHO WOULD BE AN ASSET TO THE ORGANIZATION AND COULD BE UTILIZED AS INTERNS.SESSIONS WERE OFFERED EVENINGS AND DURING THE DAY ON NON-SCHOOL DAYS. STUDENTS WERE ABLE TO VISIT VARIOUS DEPARTMENTS, LOOK AT DIFFERENT SKILLS AND DEPARTMENTS AND REALLY EXPLORE HEALTH CAREERS. COMMUNITY EDUCATION NOVEMBER 20, 2019 DR. KATE ENDICOTT COMPLETED WHAT WAS THE FIRST OF A SERIES OF HEALTH TOPICS AS LUNCH AND LEARNS FOR THE COMMUNITY. THE PRESENTATION TITLED "AN APPLE A DAY KEEPS THE DOCTOR AWAY" FOCUSED ON HEALTHY DIETS AND EATING HABITS. DUE TO COVID-19, ALL ADDITIONAL PRESENTATIONS WERE POSTPONED. MARCH 3, 2020 GIRLS' NIGHT OUT SESSION WITH THE TOPIC OF "WORKOUTS FOR ALL AGES & FITNESS LEVELS". THE APRIL EVENT WAS POSTPONED BECAUSE OF COVID-19.4. INCREASE LOCAL ACCESS TO URGENT CARE.THE HOSPITAL RECOGNIZES A CONTINUING NEED FOR SERVICES FOR PERSONS WHO ARE UNDERINSURED AND UNINSURED AND WILL EXPLORE THE CREATION OF A MEDICAID PROVIDER'S OFFICE THAT WILL OFFER WALK-IN SERVICES.HAH HAS BEEN UNABLE TO RECRUIT A PHYSICIAN TO ESTABLISH SUCH A SERVICE. THIS EFFORT WILL CONTINUE.5. ADDRESS CHRONIC ILLNESSES AND CAUSES, INCLUDING OBESITY, DIABETES, HEART DISEASE, CANCER, AND CHRONIC OBSTRUCTIVE PULMONARY DISORDER.A. EXPAND WELLNESS PROGRAMMING TO BUSINESSES AND THE COMMUNITY.B. EXPAND NUTRITION EDUCATION PROGRAMMINGC. CONTINUE PARTICIPATION IN A STUDY OF LOCAL CANCER WITH SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE.D. CONTINUE A RELATIONSHIP WITH A PULMONOLOGIST.LUNG CANCER IN 2019 HAH PARTNERED WITH SIU SCHOOL OF MEDICINE TO CONDUCT A LUNG CANCER RESEARCH SURVEY. THERE WERE 270 SURVEYS COMPLETED AND RESULTS WILL BE USED FOR THE CONTINUED RESEARCH BY SIU SCHOOL OF MEDICINE. THE RESEARCH FOCUSED ON THE HIGH RATE OF LUNG CANCER IN OUR COMMUNITY AND THE DETRIMENTS OF NOT BEING SCREENED OR TREATED. EDUCATIONAL MATERIAL WAS DEVELOPED TO EDUCATE THE COMMUNITY ABOUT THE IMPORTANCE OF LUNG CANCER SCREENING. A BILLBOARD WILL BE INSTALLED IN DEC. 2020 TO BRING AWARENESS TO THE COMMUNITY.HAH HAS CONTINUED THE CONTRACTUAL RELATIONSHIP WITH A PULMONOLOGIST FROM SPRINGFIELD CLINIC.
HILLSBORO AREA HOSPITALPART V, SECTION B, LINE 20E: A MINIMUM OF 2 STATEMENTS AND 1 LETTER ARE SENT PRIOR TO SENDING THE ACCOUNT TO COLLECTIONS, EACH NOTING HOW TO CONTACT THE HOSPITAL FOR FINANCIAL ASSISTANCE.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - TREMONT RIDGE ASSISTED LIVING
801 E TREMONT STREETHILLSBOROIL62049ASSISTED LIVING FACILITY
2 - TEAMWORK REHAB NOKOMIS
207 W STATE STREETNOKOMISIL62075OUTPATIENT PHYSICAL THERAPY
3 - TEAMWORK REHAB LITCHFIELD
120 W SAINT JOHN STREET SUITE 2LITCHFIELDIL62056OUTPATIENT PHYSICAL & OCCUPATIONAL THERAPY

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:HILLSBORO AREA HOSPITAL USES THE FEDERAL POVERTY GUIDELINES AS ONE MEANS OF DETERMINING ELIGIBILITY FOR CHARITY CARE. THE FEDERAL POVERTY GUIDELINES ARE UPDATED AND PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. AS A GENERAL RULE, A PATIENT'S INCOME, BASED ON FAMILY SIZE, MUST BE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES TO BE ELIGIBLE FOR THE CHARITY CARE PROGRAM AND AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE UNINSURED/UNDERINSURED CHARITY DISCOUNT. A SLIDING SCALE BASED ON THE PATIENT'S INCOME LEVEL UNDER THE FEDERAL POVERTY GUIDELINES WILL BE USED TO DETERMINE THE PRECISE AMOUNT OF CHARITY CARE FOR WHICH A PATIENT WILL BE ELIGIBLE. SOME PATIENTS' INCOME MAY EXCEED THESE GUIDELINES, BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO ONE TO ACT ON THEIR BEHALF, MEDICAID ELIGIBILITY NOT ON THE DATE OF SERVICE (IE SPENDDOWN UNMET) OR NON-COVERED SERVICE, CURRENTLY ENROLLED IN A COMMUNITY PROGRAM REQUIRING POVERTY LEVEL INCOME, INCARCERATION IN A PENAL INSTITUTION WITHOUT OTHER COVERAGE AVAILABLE, SELF-ADMINISTERED DRUGS-MEDICARE/MEDICAID DUAL ELIGIBILITY ONLY, MEDICAID DHS SERVICES ONLY (IE. MENTAL HEALTH SERVICES ONLY), DRUG AND ALCOHOL REHAB PATIENTS, MEDICAID ELIGIBLE FOR HEALTH WOMEN'S BENEFITS (IE. COVERAGE FOR PAPS, MAMM, ONLY), AND OUT OF STATE MEDICAID.
PART I, LINE 7:THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART I, LINE 7G:SUBSIDIZED HEALTH SERVICES AT THE HOSPITAL INCLUDES THE OPERATION OF THE EMERGENCY ROOM. THE EMERGENCY ROOM IS OPERATED 24 HOURS A DAY, 7 DAYS A WEEK, AND IS STAFFED BY A HIGHLY TRAINED GROUP OF NURSING STAFF AND PHYSICIANS WHO DO THEIR BEST TO PROVIDE EXCEPTIONAL CARE TO MEMBERS OF THE COMMUNITY IN NEED OF EMERGENCY CARE. THE EMERGENCY DEPARTMENT HAS A LARGE AMOUNT OF FIXED EXPENSES WHICH ARE NECESSARY TO PROVIDE THE SERVICE ON A 24 HOUR A DAY BASIS, WHICH IS A REQUIREMENT OF OPERATING A CRITICAL ACCESS HOSPITAL. THE HOSPITAL TREATS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY, IN ITS EMERGENCY ROOM AND FOR THESE REASONS IT IS A SUBSIDIZED SERVICE WHICH THE HOSPITAL PROVIDES AND OFFERS TO THE COMMUNITY FOR THOSE IN NEED.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,901,110.
SCHEDULE H, PART I, LINE 6AALTHOUGH NOT REQUIRED TO BE COMPLETED AS A CRITICAL ACCESS HOSPITAL, AN INFORMAL COMMUNITY BENEFITS REPORT IS PREPARED ANNUALLY.
PART II, COMMUNITY BUILDING ACTIVITIES:COVID-19 RESPONSE DURING FY 2020 - HILLSBORO AREA HOSPITAL HAS BEEN IMPLEMENTING PROCESSES TO ENSURE THE SAFETY AND WELLNESS OF OUR TEAM MEMBERS, PATIENTS, AND THE COMMUNITY. THROUGH THE EMERGENCY DEPARTMENT, THE HOSPITAL HAD THE ONLY DAILY COVID-19 TESTING SITE IN HILLSBORO. OUR TEAM MEMBERS HAVE UNDERGONE TRAINING TO RESPOND TO THE PANDEMIC AND PROVIDE SERVICES TO PATIENTS WHILE MAINTAINING THEIR OWN SAFETY AND THE SAFETY OF OTHERS IN THE HOSPITAL AND COMMUNITY. HOSPITAL LEADERS HAVE WORKED TIRELESSLY WITH THE MONTGOMERY COUNTY HEALTH DEPARTMENT AND OTHERS IN THE COMMUNITY TO ENSURE THAT PROCEDURES ARE IN PLACE TO RESPOND TO OUTBREAKS AND ALSO INFORM THE PUBLIC OF HEALTH PRECAUTIONS. COALITION WITH PANA AND CARLINVILLE HOSPITALS - THIS ALLIANCE WILL ESTABLISH THE FRAMEWORK TO ALLOW THESE CRITICAL ACCESS HOSPITALS TO COLLABORATE ON MUTUALLY BENEFICIAL OPPORTUNITIES IN ORDER TO MAINTAIN PROFESSIONAL, COMMUNITY-BASED, HIGH QUALITY HEALTHCARE IN THEIR LOCAL COMMUNITIES. THIS ALLIANCE IS NOT A FORMAL AFFILIATION, MERGER OR ACQUISITION, AND WILL NOT CHANGE THE INDEPENDENT STATUS OF EACH HOSPITAL. WHILE THE THREE HOSPITALS SERVE DISTINCT, RURAL, SOUTH-CENTRAL ILLINOIS COMMUNITIES, THEY SHARE SIMILAR MISSIONS, GOALS AND CHALLENGES, AND CURRENTLY COLLABORATE IN A VARIETY OF WAYS. ALL THREE HOSPITAL LEADERS ALONG WITH THEIR BOARDS OF DIRECTORS BELIEVE THAT THE HOSPITALS CAN BE STRONGER TOGETHER THROUGH THIS COLLABORATIVE ALLIANCE. CRITICAL ACCESS HOSPITALS FACE MAJOR REGULATORY, GEOGRAPHIC, SOCIAL AND ECONOMIC CHALLENGES WHICH DEMAND CREATIVE, COLLABORATIVE THINKING TO ENSURE RURAL COMMUNITIES CONTINUE TO HAVE ACCESS TO LOCAL, HIGH-QUALITY HEALTHCARE, INCLUDING NEW TECHNOLOGY AND PHYSICIAN SPECIALISTS, WHILE AT THE SAME TIME INCREASING EFFICIENCIES AND LOWERING COSTS. THIS ALLIANCE BETWEEN CARLINVILLE, HILLSBORO AND PANA WILL BETTER POSITION THE THREE HOSPITALS TO FACE CURRENT AND FUTURE CHALLENGES AND ENABLE THEM TO CONTINUE TO PROVIDE HIGH-QUALITY CARE LOCALLY.
PART III, LINE 2:THE COSTING METHODOLOGY USED WAS THE RATIO OF PATIENT CARE COST-TO-CHARGES.
PART III, LINE 3:THE HOSPITAL BELIEVES THAT THE COMMUNITY BENEFIT OBTAINED FROM ITS CHARITY CARE IS UNDERSTATED DUE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT DO NOT APPLY OR PROVIDE INCOMPLETE INFORMATION. SOME CARE PROVIDED TO PATIENTS IS NOT CLASSIFIED AS CHARITY CARE DUE TO PATIENTS MISSING DOCUMENTATION THAT PROVES THEY QUALIFY FOR CHARITY CARE. THE HOSPITAL'S BAD DEBT DOES INCLUDE AMOUNTS THAT COULD BE CLASSIFIED AS CHARITY CARE IF THE PATIENTS WOULD APPLY OR PROVIDE THE APPROPRIATE INFORMATION TO COMPLETE THE CHARITY CARE APPLICATION.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL 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 WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL 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 WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (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 HOSPITAL 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 SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITS EXPENSE BECAUSEPROVIDING MEDICAL CARE AT A SHORTFALL IMPACTS THE HOSPITAL'S OPERATIONSAND GROWTH. THE CARE IS PROVIDED BECAUSE THERE IS A NEED AND A DESIRE TOPROVIDE MEDICAL CARE IN THIS COMMUNITY.THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:COLLECTION ACTIONS ARE STOPPED ON PATIENT BALANCES THAT ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:HILLSBORO AREA HOSPITAL CONDUCTS A NEEDS ASSESSMENT AS ITS STRATEGIC PLANNING AND LONG-RANGE BUDGETING PROCESS. THIS PROCESS INCLUDES OBTAINING AND ANALYZING VARIOUS DATA AND MARKET DEMOGRAPHICS. THE DATA IS THEN SUPPLEMENTED WITH VIEWS AND CONCERNS FROM OUR COMMUNITY BOARD MEMBERS, OTHER COMMUNITY OUTREACH RELATIONSHIPS, AND OTHER COMMUNITY ORGANIZATIONS TO DEVELOP AN IMPLEMENTATION PLAN.
PART VI, LINE 3:UNINSURED PATIENTS AND PERSONS WHO SEEK AND / OR OBTAIN SERVICES FROM THE HOSPITAL, ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE VIA SIGNAGE THROUGHOUT THE PATIENT ACCESS AREAS OF THE FACILITY, BROCHURES, ADMISSION PACKETS, DISCLOSURE ON THE PATIENT BILL, IN PERSON AND TELEPHONE ASSISTED CUSTOMER SERVICE, AS WELL AS INFORMATION SUCH AS THE GUIDELINES AND APPLICATION BEING PREDOMINATELY POSTED ON THE HOSPITAL'S WEBSITE.
PART VI, LINE 4:HILLSBORO AREA HOSPITAL DEFINED ITS PRIMARY SERVICE AREA AND POPULATIONS AS THE GENERAL POPULATION WITHIN THE GEOGRAPHIC AREA IN AND SURROUNDING THE CITY OF HILLSBORO, DEFINED IN DETAIL BELOW. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. THE SERVICE AREA CONSISTS OF THE FOLLOWING RURAL COMMUNITIES. CITIES: HILLSBORO, NOKOMIS, WITTVILLAGES AND UNINCORPORATED COMMUNITIES: FILLMORE, IRVING, COFFEEN, RAYMOND, BUTLER, DONNELLSONACCORDING TO U.S. CENSUS DATA, THE POPULATION IN THE HILLSBORO AREA HOSPITAL SERVICE AREA FELL FROM 19,425 PEOPLE TO 18,938 PEOPLE BETWEEN THE YEARS 2000 AND 2010, A 2.51% DECREASE. THE HISPANIC POPULATION IN BOND COUNTY INCREASED BY 294 (116.21%), INCREASED IN CHRISTIAN COUNTY BY 126 (36.52%), INCREASED IN FAYETTE COUNTY BY 130 (74.71%), INCREASED IN MACOUPIN COUNTY BY 113 (37.05%), AND INCREASED IN MONTGOMERY COUNTY BY 133 (40.8%). IN BOND COUNTY, ADDITIONAL POPULATION CHANGES WERE AS FOLLOWS: WHITE 0.89%, BLACK -17.3%, AMERICAN INDIAN/ALASKA NATIVE 13.58%, ASIAN 47.83%, AND NATIVE HAWAIIAN/PACIFIC ISLANDER -62.5%. IN CHRISTIAN COUNTY, ADDITIONAL POPULATION CHANGES WERE AS FOLLOWS: WHITE -1.37%, BLACK -34.7%, AMERICAN INDIAN/ALASKA NATIVE -10.53%, ASIAN 26.52%, AND NATIVE HAWAIIAN/PACIFIC ISLANDER -27.27%
PART VI, LINE 5:DESIGNATED AS CRITICAL ACCESS HOSPITAL THE HOSPITAL USES ANY LIMITED SURPLUS FUNDS TO FURTHER ITS EXEMPT PURPOSE BY PROVIDING PROGRAMS AND ACCESS AS NOTED IN FORM 990, LINE 1 AND 4A. THE BOARD OF DIRECTORS IS MADE UP OF VOLUNTEER COMMUNITY LEADERS WITHIN ITS PRIMARY SERVICE AREA THAT ARE APPROVED BY THE MEMBER ORGANIZATION.
PART VI, LINE 6:THE HOSPITAL IS PART OF A CRITICAL ACCESS NETWORK THAT INCLUDES HILLSBORO AREA HEALTH SYSTEM NFP, ITS SOLE CORPORATE MEMBER, WHICH PROVIDES HEALTH AND SUPPORTIVE SERVICES TO THE COMMUNITIES THEY SERVE. THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ACTIVITIES AND SERVICES THAT MEET UNMET COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, HEALTH FAIRS AND EVENTS, HEALTH SCREENINGS AND ASSESSMENTS, SPACE FOR DAYCARE PROGRAMS OFFERED BY THE LOCAL SCHOOL SYSTEM, SUPPORT FOR VITAL COMMUNITY SERVICES, TRAUMA CARE, AND VARIOUS COMMUNITY EDUCATIONAL SERVICES.HILLSBORO AREA HOSPITAL RECEIVED LEED CERTIFICATION FOR THE BUILDING ADDITION COMPLETED IN JULY 2010. THE ENVIRONMENTAL BENEFITS OF LEED INCLUDE: REDUCTION OF WASTE SENT TO LANDFILLS, CONSERVATION OF ENERGY AND WATER, REDUCTION OF HARMFUL GREENHOUSE GASES, AND A HEALTHIER AND SAFER PLACE FOR EMPLOYEES, PATIENTS, AND THE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE CHAMBER OF COMMERCE AND PARTNERS WITH THE MONTGOMERY COUNTY ECONOMIC DEVELOPMENT CORPORATION TO OBTAIN GRANTS AND EXPAND THE SERVICES NEEDED IN THE COMMUNITY.THE HOSPITAL PROVIDES THE USE OF SPACE AT NO CHARGE TO THE HILLSBORO COMMUNITY SCHOOL DISTRICT FOR A DAYCARE FACILITY AND FUNDS STUDER GROUP CONSULTING FEES FOR THE SCHOOL'S COMMITMENT TO A CULTURE OF EXCELLENCE. THE HOSPITAL ALSO PROVIDES GRAND ADVANTAGE SENIOR EXERCISE CLASSES TO THE SENIORS IN THE AREA AT NO CHARGE AND PROVIDES THE DIAMOND CLUB TO SENIORS FOR ASSISTANCE WITH THE UNDERSTANDING AND ORGANIZATION OF MEDICAL BILLS AND INSURANCE. HOSPITAL EMPLOYEES ALSO SHARE THEIR EXPERTISE THROUGH COMMUNITY SPEAKING AT LOCAL ORGANIZATIONS AND EVENTS. SEVERAL MONETARY DONATIONS ARE MADE BY THE HOSPITAL THROUGHOUT THE YEAR TO OTHER NON-PROFIT ORGANIZATIONS. AN AUTOMATIC BLOOD PRESSURE MACHINE IS LOCATED IN THE HOSPITAL LOBBY WHERE THE COMMUNITY MEMBERS CAN USE IT FREE OF CHARGE, AND THE HOSPITAL PROVIDES A BOOTH AT THE LOCAL COMMUNITY FAIR EACH YEAR WHERE EMPLOYEES TAKE BLOOD PRESSURES AND PROVIDES HEALTH INFORMATION TO THE PUBLIC.THE HOSPITAL UTILIZED A USDA DISTANCE LEARNING & TELEMEDICINE GRANT TO EXPAND CERTIFIED NURSING ASSISTANT INSTRUCTION TO HIGH SCHOOL STUDENTS IN OUR COMMUNITY. IN COMBINATION WITH THE HOSPITAL'S MATCHING FUNDS, VIDEO CONFERENCING EQUIPMENT WAS PURCHASED AND PLACED IN 4 COMMUNITY HIGH SCHOOLS SO THAT THE STUDENTS CAN REMAIN IN THEIR OWN CLASSROOMS INSTEAD OF BEING TRANSPORTED TO THE HOSPITAL'S CAMPUS FOR CNA INSTRUCTION. IN ADDITION, THE HOSPITAL PROVIDES THE USE OF SPACE ON ITS CAMPUS FOR THE CLASSES FREE OF CHARGE, SO THE COMBINATION OF FREE SPACE USAGE AND REDUCED TRANSPORTATION COSTS PROVIDES GREAT BENEFITS FOR THIS STATE-APPROVED PROGRAM. THE HOSPITAL ALSO HAS THE HILLSBORO AREA HOSPITAL JUNIOR BOARD WHICH IS COMPRISED OF STUDENT VOLUNTEERS AGES 9-16. THE JUNIOR BOARD MEMBERS LEARN HOW THE ORGANIZATION WORKS, DEVELOP LEADERSHIP SKILLS, AND PLAN AND EXECUTE COMMUNITY IMPROVEMENT ACTIVITIES WITH THE HELP OF THE HOSPITAL STAFF MEMBERS.THE HOSPITAL ALSO PARTICIPATED IN THE STATE COLORECTAL CANCER SCREENING INITIATIVE, HELPED COORDINATE APPOINTMENTS FOR OTHER CANCER SCREENS IN COORDINATION WITH THE MONTGOMERY COUNTY CANCER ASSOCIATION, AND HAS ASSISTED SIU SCHOOL OF MEDICINE WITH RESEARCH PROJECTS IN THE COMMUNITY RELATED TO CHILD DEVELOPMENT, LUNG CANCER SCREENINGS AND YOUTH ASSESSMENTS. FURTHERMORE, THE HOSPITAL HAS HISTORICALLY BEEN RECOGNIZED AS HILLSBORO'S BUSINESS OF THE YEAR FOR ITS POSITIVE ECONOMIC AND CIVIC IMPACT AND ITS OVERWHELMING SUPPORT OF THE COMMUNITY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
SIU SCHOOL OF MEDICINE DEPT OF POPULATION SCIENCE AND POLICY
201 E MADISON STSPRINGFIELDIL62794364143823UNIV$62,794ASSISTANCE WITH COMMUNITY RESEARCH PROJECTS RE. CHILD BRAIN DEVELOPMENT, LUN
HILLSBORO COMMUNITY SCHOOL DISTRICT
1311 VANDALIA ROADHILLSBOROIL62049376014445GOV$44,065ASSISTANCE WITH CONSULTING FEES FOR SCHOOL'S COMMITMENT TO A CULTURE OF EXCE
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE FOR CERTAIN COMMUNITY PROGRAMS AS APPROVED BY THE BOARD OF DIRECTORS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW OTT
PODIATRIST$216,218$0$25,000$0$0$0$7,209$0$13,684$0$262,111$0$0$0
ELVIS HARRISON
VP OF PATIENT CARE SERVICE$159,511$0$4,293$0$0$0$1,489$0$25,094$0$190,387$0$0$0
ABBY BUGG
TEAMWORK REHAB DIRECTOR$108,241$0$5,796$0$0$0$3,792$0$42,170$0$159,999$0$0$0
TERRI CARROLL
VP OF FINANCIAL SERVICES$168,660$0$5,209$0$0$0$5,333$0$27,136$0$206,338$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1BFormAndLineReferenceDesc
ExplanationALL FULL TIME EMPLOYEES HAVE THE OPTION TO BE A MEMBER OF THE HILLSBORO AREA HEALTH SERVICES' FUSION WELLNESS FACILITY WHICH THE HOSPITAL PAYS DIRECTLY TO HILLSBORO AREA HEALTH SERVICES AS A BENEFIT TO HOSPITAL EMPLOYEES.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF HILLSBORO MONTGOMERY COUNTY ILLINOISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN376001658BondIssuerEIN
Bond Issued2008-09-30BondIssuedDt
Issue Price$7,220,000IssuePriceAmt
PurposeCAPITAL IMPROVEMENT PROJECTPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$2,733,694RetiredAmt
Total Proceeds$7,220,000TotalProceedsAmt
Issuance Costs From Proceeds$83,500IssuanceCostsFromProceedsAmt
Capital Expenditures$7,030,981CapitalExpendituresAmt
Other Spent Proceeds$105,519OtherSpentProceedsAmt
Substantial Completion2010SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE K, PART IV, LINE 2C:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION QUALIFIED FOR AN EXCEPTION TO REBATE. THE BOND QUALIFIES FOR THE 2-YEAR SPENDING EXCEPTION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3HEALTHTECH MANAGEMENT SERVICES, INC. DBA HEALTHTECHS3, PROVIDES MANAGEMENT AND CEO SERVICES. REX BROWN, PRESIDENT & CEO OF HILLSBORO AREA HOSPITAL, IS EMPLOYED BY HEALTHTECHS3. THE AMOUNT PAID IN TOTAL TO HEALTHTECHS3 IS INCLUDED IN PART VII, SECTION B.
FORM 990, PART VI, SECTION A, LINE 6HILLSBORO AREA HEALTH SYSTEM NFP, A NOT-FOR-PROFIT CORPORATION IS THE SOLE CORPORATE MEMBER OF HILLSBORO AREA HOSPITAL, INC. THE HOSPITAL ALSO HAS INDIVIDUAL MEMBERS. THERE ARE TWO CLASSES OF INDIVIDUAL MEMBERS. ANNUAL (REGULAR) AND LIFE MEMBERS MAKE UP THE CLASSES OF INDIVIDUAL MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7AONLY THE INDIVIDUAL MEMBERS CAN ELECT MEMBERS TO THE GOVERNING BODY. THE VOTING OF DIRECTORS TO THE BOARD ONLY OCCURS IN OCTOBER. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE CORPORATE MEMBER, HILLSBORO AREA HEALTH SYSTEM NFP, APPROVES ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR TO THE BYLAWS OF THE CORPORATION AND APPROVES HOSPITAL BOARD MEMBERS ELECTED. THE ONLY VOTING RIGHT OF THE INDIVIDUAL MEMBERS IS THE RIGHT TO ELECT DIRECTORS. IN ADDITION, HILLSBORO AREA HEALTH SYSTEM NFP MUST APPROVE SUCH ITEMS AS BUDGETS, STRATEGIC PLANS, LARGE UNBUDGETED CAPITAL EXPENDITURES, LAND SALES, ETC.
FORM 990, PART VI, SECTION B, LINE 11BTHE VP OF FINANCIAL SERVICES REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE 990 TO EACH MEMBER OF THE BOARD FOR REVIEW. THE BOARD THEN VOTES ON THE APPROVAL OF THE 990 AS IT IS OR CONTINGENT UPON CHANGES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, EMPLOYEES COMPLETE AND SIGN A DISCLOSURE STATEMENT AND THE BOARD OF DIRECTORS COMPLETE AND SIGN A CONFLICT OF INTEREST FORM. THE BOARD REVIEWS THE DISCLOSURES AND TAKES APPROPRIATE ACTION TO RESOLVE ANY ISSUES. IF A CONFLICT EXISTS, THE BOARD MEMBER SHALL ABSTAIN FROM VOTING ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15A PERFORMANCE EVALUATION IS COMPLETED AND DISCUSSED IN EXECUTIVE SESSION BY THE BOARD OF DIRECTORS FOR EXECUTIVE EMPLOYEES. THE PROCESS FOR DETERMINING COMPENSATION INCLUDES REVIEWS OF SALARY RANGES FOR THE POSITIONS PER VARIOUS DATABASES AND/OR MATERIAL AVAILABLE. THE DELIBERATION AND DECISION BY THE BOARD OF DIRECTORS IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GEMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,236,358. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,236,358. OTHER PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 439,290. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 439,290. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,590,819. MANAGEMENT AND GENERAL EXPENSES 607,175. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,197,994.
FORM 990, PART XI, LINE 9:NET ASSETS RELEASED FROM RESTRICTIONS -11,351. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 26,687. TRANSFER TO HILLSBORO AREA HEALTH SYSTEM NFP -1,000,000.
FORM 990, PART XII, LINE 2CTHE BOARD OF DIRECTORS OF THE ORGANIZATION WORK CLOSELY WITH HILLSBORO AREA HEALTH SYSTEM NFP AND THE OTHER RELATED ENTITIES TO SELECT AND APPOINT THE AUDITOR OF THE FINANCIAL STATEMENTS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HILLSBORO AREA HEALTH SYSTEM NFP
1200 E TREMONT STHILLSBOROWI62049364539688MANAGEMENT AND OVERSIGHT OF HEALTH CARE SYSTEMIL501(C)(3)LINE 12C, III-FI0
HILLSBORO AREA HEALTH FOUNDATION
1200 E TREMONT STHILLSBOROIL62049371247796PROVIDE SUPPORT FOR HILLSBORO AREA HOSPITALIL501(C)(3)LINE 7Yes (1)HILLSBORO AREA HEALTH SYSTEM NFP
HILLSBORO AREA HEALTH SERVICES INC
1210 E TREMONT STHILLSBOROIL62049371240643ESTABLISH AND OPERATE FACILITIES FOR WELLBEING OF PERSONS IN AREAIL501(C)(3)LINE 10Yes (1)HILLSBORO AREA HEALTH SYSTEM NFP
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd