ANDERSON HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
ANDERSON HOSPITAL (EIN 37-0662561)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-12
IRS object ID
202013179349302576
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)
Return2020-11-12T09:34:30-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1211 N BROADWAY SUITE 600AddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631022733ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370662561EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Southwestern Illinois Health Facilities IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MICHAEL MARSHALLInCareOfNm
Business Name ControlSOUTBusinessNameControlTxt
Phone6183916400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL MARSHALLPersonNm
Person TitleCFOPersonTitleTxt
Phone6183916400PhoneNum
Signature2020-11-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDonna J LarsonPreparerPersonNm
PTINP00043751PTIN
Phone3142315544PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43032820203175000000FederalOriginalSubmissionId
Federal Original Submission Id2020-11-12FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id039BC1633B95B4199F385E2AAE9FA36DFDA012D1AtSubmissionCreationDeviceId
At Submission Filing Device Id21C0A33B05BB10A7E11EA1CEA729BD9A82E61B8CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerKEITH PAGEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$225,973,694GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ANDERSONHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionOUR COMMUNITY TURNS TO ANDERSON FIRST FOR ALL HEALTHCARE NEEDS.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent20VotingMembersIndependentCnt
Total Employee1783TotalEmployeeCnt
Total Volunteers250TotalVolunteersCnt
Total Gross UBI$116,870TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$23,554NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$120,000CYContributionsGrantsAmt
PY Program Service Revenue$181,276,833PYProgramServiceRevenueAmt
CY Program Service Revenue$190,647,373CYProgramServiceRevenueAmt
PY Investment Income$3,509,296PYInvestmentIncomeAmt
CY Investment Income$4,929,049CYInvestmentIncomeAmt
PY Other Revenue$3,252,590PYOtherRevenueAmt
CY Other Revenue$3,196,030CYOtherRevenueAmt
PY Total Revenue$188,038,719PYTotalRevenueAmt
CY Total Revenue$198,892,452CYTotalRevenueAmt
PY Grants And Similar Paid$33,506PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$47,750CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$78,201,060PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$84,009,700CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$100,186,092PYOtherExpensesAmt
CY Other Expenses$104,797,803CYOtherExpensesAmt
PY Total Expenses$178,420,658PYTotalExpensesAmt
CY Total Expenses$188,855,253CYTotalExpensesAmt
PY Revenues Less Expenses$9,618,061PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$10,037,199CYRevenuesLessExpensesAmt
Total Assets BOY$249,626,331TotalAssetsBOYAmt
Total Assets EOY$294,958,515TotalAssetsEOYAmt
Total Liabilities BOY$81,855,748TotalLiabilitiesBOYAmt
Total Liabilities EOY$103,130,299TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$167,770,583NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$191,828,216NetAssetsOrFundBalancesEOYAmt
MissionTO EXCEED EXPECTATIONS IN PROVIDING PERSONAL, CONVENIENT, QUALITY HEALTHCARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$148,134,121ExpenseAmt
Grant$47,750GrantAmt
Revenue$190,703,382RevenueAmt
DescNURSING AND ANCILLARY SERVICES FOR 27,686 INPATIENT DAYS, 97,187 OUTPATIENT VISITS, 8,955 OUTPATIENT SURGERIES AND 35,740 EMERGENCY VISITSDesc
Total Program Service Expenses$148,134,121TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1783EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member20IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMICHAEL MARSHALLPersonNm
Phone6183916402PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
KEITH PAGE
PRESIDENT40.05.0Yes (X)$503,221$0$142,236
RAFE HENG
PHYSICIAN40.00.0$579,412$0$33,484Yes (X)
TIBOR KOPJAS
PHYSICIAN40.00.0$421,355$0$17,043Yes (X)
ERIN WRIGHT
PHYSICIAN40.00.0$342,170$0$19,000Yes (X)
MICHAEL MARSHALL
CFO40.05.0Yes (X)$303,765$0$38,413
EDDIE PAULK
PHYSICIAN40.00.0$314,237$0$7,348Yes (X)
PATRICE STATEN
PHYSICIAN40.00.0$306,655$0$7,491Yes (X)
MILLIE BELOBRAYDIC
SECRETARY0.310.0Yes (X)$0$0$0Yes (X)
LAURA BERNAIX PHD RN
TRUSTEE0.150.0$0$0$0Yes (X)
GARY CERETTO
TRUSTEE0.30.0$0$0$0Yes (X)
ROBERT CIUFERI
TREASURER0.370.0Yes (X)$0$0$0Yes (X)
GREGORY COFFEY
TRUSTEE0.320.0$0$0$0Yes (X)
RICHARD DAWDY
TRUSTEE0.450.0$0$0$0Yes (X)
MAX EAKIN MD
TRUSTEE0.232.0$0$0$0Yes (X)
FRANK FLANIGAN
VICE CHAIRPERSON0.330.0Yes (X)$0$0$0Yes (X)
JOSEPH HAGERTY
TRUSTEE0.390.0$0$0$0Yes (X)
BERNICE HENKE
TRUSTEE0.190.0$0$0$0Yes (X)
DON KASUBKE
TRUSTEE0.20.0$0$0$0Yes (X)
MARK MAYNARD
TRUSTEE0.20.0$0$0$0Yes (X)
JEFFREY PARRES MD
TRUSTEE0.120.0$0$0$0Yes (X)
LENDELL PHELPS
TRUSTEE0.352.0$0$0$0Yes (X)
DALE SAUER
TRUSTEE0.10.0$0$0$0Yes (X)
MARK SHASHEK
CHAIRPERSON0.62.0Yes (X)$0$0$0Yes (X)
JOSEPH SMITH
TRUSTEE0.570.0$0$0$0Yes (X)
NANCY THOMAS
TRUSTEE0.140.0$0$0$0Yes (X)
GINGER TRUCANO
TRUSTEE0.120.0$0$0$0Yes (X)
KAY WERNER
ASST SECRETARY0.260.0$0$0$0Yes (X)
PATRICK ZIMMERMAN MD
TRUSTEE0.20.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,770,815TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$265,015TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K78IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GENERAL AND LAPAROSCOPIC SURGERY AN
6810 STATE ROUTE 162MARYVILLEIL62062PHYSICIAN SERVICES$2,225,104
CENTER FOR ADVANCED ORTHO
6812 STATE ROUTE 162MARYVILLEIL62062PHYSICIAN SERVICES$1,808,492
MID AMERICA PLASTIC SURGERY
4955 S STATE RTE 159GLEN CARBONIL62062PHYSICIAN SERVICES$1,346,052
ILLINOIS HOSPITALISTS LLP
PO BOX 677979DALLASTX75267PHYSICIAN SERVICES$1,701,042
FAMILY CARE SPECIALISTS
20-B PROFESSIONAL DRIVEMARYVILLEIL62062PHYSICIAN SERVICES$1,309,421
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K54CntrctRcvdGreaterThan100KCnt
Related Organizations$120,000RelatedOrganizationsAmt
Total Contributions$120,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$190,647,373TotalRevenueColumnAmt
Related Or Exempt Func Income$190,647,373RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$190,647,373TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,039,113TotalRevenueColumnAmt
Exclusion$3,039,113ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,069,572RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,069,572RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,069,572TotalRevenueColumnAmt
Unrelated Business Revenue$60,861UnrelatedBusinessRevenueAmt
Exclusion$2,008,711ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$28,971,178SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$27,023,167SecuritiesAmt
Other$58,075OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,948,011SecuritiesAmt
Other-$58,075OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,889,936TotalRevenueColumnAmt
Exclusion$1,889,936ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
MEDICAL RECORDS FEES561000$74,961$74,961
SISHA CONTRACT624310$56,009$56,009
CREDIT CARD SHARING900099$59,657$59,657

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$935,831TotalRevenueColumnAmt
Exclusion$935,831ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,126,458OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$198,892,452TotalRevenueColumnAmt
Related Or Exempt Func Income$190,647,373RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$116,870UnrelatedBusinessRevenueAmt
Exclusion$8,008,209ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$47,750TotalAmt
Program Services$47,750ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$987,905TotalAmt
Management And General$987,905ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$68,520,612TotalAmt
Program Services$59,167,348ProgramServicesAmt
Management And General$9,353,264ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,320,973TotalAmt
Program Services$1,260,153ProgramServicesAmt
Management And General$60,820ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,777,715TotalAmt
Program Services$7,616,257ProgramServicesAmt
Management And General$1,161,458ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,402,495TotalAmt
Program Services$3,801,542ProgramServicesAmt
Management And General$600,953ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,558,201TotalAmt
Management And General$1,558,201ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$195,338TotalAmt
Program Services$13,223ProgramServicesAmt
Management And General$182,115ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$29,687,315TotalAmt
Program Services$17,913,585ProgramServicesAmt
Management And General$11,773,730ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$382,259TotalAmt
Program Services$1,120ProgramServicesAmt
Management And General$381,139ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$39,353,572TotalAmt
Program Services$30,945,577ProgramServicesAmt
Management And General$8,407,995ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,799,661TotalAmt
Program Services$9,194,286ProgramServicesAmt
Management And General$4,605,375ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$118,503TotalAmt
Program Services$105,670ProgramServicesAmt
Management And General$12,833ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,336,824TotalAmt
Program Services$1,336,824ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,551,292TotalAmt
Program Services$7,551,292ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,137,203TotalAmt
Program Services$1,001,119ProgramServicesAmt
Management And General$1,136,084ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt Expense$8,096,490$8,096,490
Dues and Subscriptions$384,008$56,486$327,522
Education$74,723$25,399$49,324
Other - less than 5% of total$122,414$122,414

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$188,855,253TotalAmt
Program Services$148,134,121ProgramServicesAmt
Management And General$40,721,132ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,404,872BOYAmt
EOY$6,321,904EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,014,125BOYAmt
EOY$6,936,217EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$22,226,540BOYAmt
EOY$27,223,136EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,952,167BOYAmt
EOY$2,892,630EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,533,670BOYAmt
EOY$2,269,123EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$197,352,751LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$82,498,641LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$97,521,893BOYAmt
EOY$114,854,110EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$89,843,060BOYAmt
EOY$102,026,922EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$23,155,783BOYAmt
EOY$24,355,783EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$5,189,153EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,974,221BOYAmt
EOY$2,889,537EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$249,626,331BOYAmt
EOY$294,958,515EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,087,433BOYAmt
EOY$17,118,267EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,421,671BOYAmt
EOY$44,012,694EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,746,724BOYAmt
EOY$5,594,802EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,599,920BOYAmt
EOY$36,404,536EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$81,855,748BOYAmt
EOY$103,130,299EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$167,770,583BOYAmt
EOY$191,828,216EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$167,770,583BOYAmt
EOY$191,828,216EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$249,626,331BOYAmt
EOY$294,958,515EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$10,037,199ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$12,670,434NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,350,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$40,635GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$40,635TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE FFormAndLineReferenceDesc
ExplanationGRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES THE AMOUNT REPRESENTS THE PORTION OF DUES PAID TO PROFESSIONAL ORGANIZATIONS THAT IS ALLOCATED TO THE LOBBYING ACTIVITIES OF THOSE ORGANIZATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,243,182OtherCostOrOtherBasisAmt
Book Value$6,243,182BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$122,397,100OtherCostOrOtherBasisAmt
Depreciation$46,851,680DepreciationAmt
Book Value$75,545,420BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$624,593OtherCostOrOtherBasisAmt
Depreciation$624,593DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$56,801,854OtherCostOrOtherBasisAmt
Depreciation$32,436,238DepreciationAmt
Book Value$24,365,616BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,286,022OtherCostOrOtherBasisAmt
Depreciation$2,586,130DepreciationAmt
Book Value$8,699,892BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$114,854,110TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescInvestment in SubsidiaryDesc
Book Value$24,355,783BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$24,355,783TotalBookValueProgramRltdAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Due to Third Party Payers$8,223,908
Estimated Self-Insurance Costs$22,981,000
Lease Liability$5,199,628
FieldValueIRS element (for citing)
Total Liability$36,404,536TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS THE FUNDS ARE DESIGNATED FOR CAPITAL IMPROVEMENTS, TO PROVIDE SELF-INSURANCE COVERAGE, TO MEET BOND REQUIREMENTS, AND TO PROVIDE FUNDS FOR HEALTH CARE PROGRAMS. HOWEVER, NONE OF THE FUNDS MEETS THE DEFINITION OF AN ENDOWMENT FUND UNDER SFAS 117, THEREFORE, PART V HAS NOT BEEN COMPLETED.
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS UNDER FIN 48 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,928,805TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,928,805NetCommunityBenefitExpnsAmt
Total Expense0.01070TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$32,720,855TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,258,583DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,462,272NetCommunityBenefitExpnsAmt
Total Expense0.04680TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,649,660TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,258,583DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,391,077NetCommunityBenefitExpnsAmt
Total Expense0.05750TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$460,224TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$460,224NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,724,839TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,724,839NetCommunityBenefitExpnsAmt
Total Expense0.00950TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,750TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$47,750NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,232,813TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,232,813NetCommunityBenefitExpnsAmt
Total Expense0.01230TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,882,473TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,258,583DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,623,890NetCommunityBenefitExpnsAmt
Total Expense0.06980TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$8,096,490BadDebtExpenseAmt
Reimbursed By Medicare$36,113,863ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$40,573,789CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,459,926MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVLLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.ANDERSONHOSPITAL.ORGWebsiteAddressTxt
State License0004119StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)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 (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
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 (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5IN CONDUCTING THE MOST RECENT CHNA, ANDERSON HOSPITAL ELICITED INPUT FROM THE COMMUNITY MEMBERS THROUGH A VARIETY OF METHODS. WE PARTNERED WITH THE MADISON COUNTY HEALTH DEPARTMENT TO HOLD FOCUS GROUPS, CONDUCT A COMMUNITY HEALTH SURVEY, AND ORGANIZE MEETINGS TO SET TOP HEALTH PRIORITIES. THE STAKEHOLDER FOCUS GROUPS ALLOWED US TO OBTAIN PERTINENT INFORMATION FROM OUR COMMUNITY LEADERS AND STAFF MEMBERS TO ESTABLISH KEY HEALTH CONCERNS. EIGHT TOTAL FOCUS GROUPS WERE HELD THROUGHOUT THE COMMUNITY IN MADISON COUNTY, WITH ONE BEING HELD AT ANDERSON HOSPITAL. THE ATTENDEES OF THE STAKEHOLDER FOCUS GROUPS WERE INDIVIDUALS WHO ARE INVOLVED WITH THE HEALTH OF THE COMMUNITY THROUGH THEIR PROFESSION OR PERSONAL INTEREST IN HEALTH AND WELLNESS. EXAMPLES INCLUDED HEALTH EDUCATORS AND ADMINISTRATORS FROM HOSPITALS AND ASSISTED LIVING FACILITIES IN THE AREA, FACULTY FROM LOCAL UNIVERSITIES AND COLLEGES, PHARMACISTS, HEALTH EDUCATORS FROM THE MADISON COUNTY HEALTH DEPARTMENT, COLLEAGUES THAT WORK WITH SPECIFIC POPULATIONS AND PERSONS WITH DISABILITIES, AND STAFF FROM ORGANIZATIONS THAT FOCUS ON THE HEALTH AND WELLBEING OF THE COMMUNITY. THE FOCUS GROUP QUESTIONS TARGETED WHAT IS IMPORTANT TO THE HEALTH OF OUR COMMUNITY, WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT ARE THE CAUSES OF THESE PROBLEMS, WHAT ARE THE STRENGTHS OF THE SERVICES IN THE COMMUNITY, AND WHAT ARE THE GREATEST OBSTACLES. PARTICIPANTS WERE ASKED FOR FURTHER INVOLVEMENT IN PROMOTING COMPLETION OF THE COMMUNITY HEALTH SURVEY. THE COMMUNITY HEALTH SURVEY WAS DISSEMINATED ELECTRONICALLY THROUGH EMAIL AND THROUGH PAPER SURVEYS THAT WERE PLACED AROUND THE COMMUNITY AND AT ANDERSON HOSPITAL. THE SURVEY YIELDED 389 RESPONSES FROM OUR PRIMARY SERVICE AREA. QUESTIONS FOCUSED ON WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT KEEPS PEOPLE FROM BEING HEALTHY, WHY PEOPLE DO NOT GET NEEDED HEALTH CARE, AND RATE HEALTH ISSUES ON A SCALE OF MOST URGENT TO NOT A PROBLEM. FROM THE SURVEY RESULTS, TEN TOP HEALTH CONCERNS WERE IDENTIFIED. ANDERSON HOSPITAL PARTICIPATED IN THE MADISON COUNTY HEALTH DEPARTMENT MEETINGS TO IDENTIFY THEIR TOP CONCERNS TO GAIN INSIGHT, THEN MET WITH OUR INTERNAL TEAM TO DETERMINE WHAT THE TOP CONCERNS WERE FOR OUR SPECIFIC SERVICE AREA. ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE MET AND MEMBERS INDIVIDUALLY CHOSE THEIR TOP CONCERNS, AND THEN DISCUSSED EACH TOPIC AS A COMMITTEE TO ULTIMATELY DETERMINE OUR TOP 4 PRIORITY TOPICS. THE TOPICS INCLUDED CANCER, POVERTY, OBESITY, AND SUBSTANCE ABUSE.
SCHEDULE H, PART V, SECTION B, LINE 7 & 7DCHNA WEBSITE: WWW.ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AVAILABILITY OF CHNA THE CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE, UPON REQUEST VIA PHONE OR IN PERSON, AND HARDCOPIES ARE AVAILABLE IN LOBBY AREA AT THE HOSPITAL. THE ORGANIZATION'S IMPLEMENTATION STRATEGY IS INCLUDED WITH THE CHNA THAT IS AVAILABLE ON THE HOSPITAL'S WEBSITE.
SCHEDULE H, PART V, SECTION B, LINE 11ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE FACILITATES AND MAINTAINS AN ANNUAL DASHBOARD FOCUSED ON THE TOP HEALTH PRIORITIES FOR 2019-2021 THAT WERE IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED IN 2018. ANDERSON CHOSE A TOTAL OF FOUR INTERNAL AND EXTERNAL HEALTH PRIORITIES BASED ON TOP HEALTH CONCERNS IN OUR SERVICE AREA. EACH HEALTH PRIORITY HAS A LIST OF OBJECTIVES THAT WERE THE PRIMARY FOCUS OVER THE LAST THREE YEARS. ANDERSON WORKED CLOSELY WITH OUR COMMUNITY PARTNERS TO MEET THESE OBJECTIVES. ALTHOUGH THERE WERE MANY HEALTH CONCERNS IN OUR COMMUNITY THAT NEEDED TO BE ADDRESSED, WE PRIORITIZED ON THE TOP FOUR WITH THE BEST INTEREST OF IMPROVING THESE CONCERNS OVER THE THREE YEAR TIME PERIOD. THE HEALTH EDUCATION PLANNING COMMITTEE MEETS AT LEAST QUARTERLY TO UPDATE THE DASHBOARD WITH THE OBJECTIVES THAT HAVE BEEN MET, AS WELL AS DOCUMENT IF A PARTICULAR OBJECTIVE COULD NOT BE MET AND WHY. ADDITIONALLY, WE RECORD AND MAINTAIN ALL COMMUNITY BENEFIT DATA FOR ANDERSON HOSPITAL IN THE CIBSA DATABASE. WITH THIS INFORMATION, WE CAN IDENTIFY HOW WE HAVE MET OUR GOALS AND OBJECTIVES, AND FOCUS ON AREAS OF GROWTH IN THE FUTURE.
SCHEDULE H, PART V, SECTION B, LINE 10AIMPLEMENTATION STRATEGY WEBSITE: WWW.ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16CWEBSITE URL FOR FAP: THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE ALL FOUND AT THE FOLLOWING LINK: HTTPS://WWW.ANDERSONHOSPITAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE
FieldValueIRS element (for citing)
Facility14FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
SOUTHERN ILLINOIS SPECIALIZED HEALTH
53 EAST ELMALTONIL62002REHAB SERVICES
MARYVILLE IMAGING
2023 VADALABENE DRMARYVILLEIL62062IMAGING SERVICES
ANDERSON SLEEP CENTER
2809 NORTH CENTERMARYVILLEIL62062SLEEP STUDY
COLLINSVILLE EXPRESS CARE
1103 BELT LINE RDCOLLINSVILLEIL62234ER - OTHER
GLEN CARBON EXPRESS CARE
17 GINGER CREEKGLEN CARBONIL62034ER - OTHER
HIGHLAND EXPRESS CARE
2504 COMMERCE LNHIGHLANDIL62249ER - OTHER
WELLNESS CENTER
2133 VADALABENE DRMARYVILLEIL62062REHAB SERVICES
ANDERSON HOME HEALTH
6800 STATE ROUTE 162MARYVILLEIL62062HOME HEALTH SERVICES
BETHALTO EXPRESS CARE
159 E MCARTHURBETHALTOIL62010ER - OTHER
ANDERSON CANCER CENTER
2227 VADALABENEMARYVILLEIL62062CANCER TREATMENT
ANDERSON PEDIATRIC CENTER
6820 STATE ROUTE 162MARYVILLEIL62062PEDIATRIC SERVICES
ONCOLOGY TREATMENT CENTER
6836 STATE ROUTE 162MARYVILLEIL62062CANCER TREATMENT
ANDERSON REHAB SERVICES
1212 BROADWAYHIGHLANDIL62249REHAB SERVICES
TROY EXPRESS CARE
108 WEST US HIGHWAY 40TROYIL62294ER - OTHER

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART III, SECTION A, LINE 2BAD DEBTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS 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 UNCOLLECTIBLE ACCOUNTS 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 OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
SCHEDULE H, PART III, SECTION A, LINE 4SEE PAGES 9 AND 15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8MEDICARE COSTING METHODOLOGY IS BASED ON COST-TO-CHARGE RATIOS. MEDICARE SHORTFALLS SHOULD BE RECORDED AS COMMUNITY BENEFIT AS RATES ARE SET BY THE GOVERNMENT AT LEVELS SIGNIFICANTLY BELOW COSTS. 30% OR MORE OF ANDERSON'S TOTAL BUSINESS IS PATIENTS IN OUR COMMUNITY WITH MEDICARE COVERAGE.
SCHEDULE H, PART III, SECTION C, LINE 9BCOLLECTION PRACTICES ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF ANDERSON HOSPITAL, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. ANDERSON HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIR AND CONSISTENTLY APPLIED WITHIN EACH ENTITY. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE PROVIDED THAT ASSISTANCE AND THEIR ACCOUNTS ARE WRITTEN OFF AND NO FURTHER COLLECTION ACTIVITY OCCURS ON THE PORTION OF THE BILL THAT QUALIFIES FOR CHARITY.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT THE COMMUNITY BENEFIT PLAN IDENTIFIES COMMUNITY HEALTH NEEDS AND GAPS THROUGH COMMUNITY, EMPLOYEE, AND VOLUNTEER SURVEYS, PERIOD MEETINGS WITH THE LOCAL MAYOR, AND COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNS THOSE WITH THE HOSPITAL'S INITIATIVES. THE PLAN IS DEVELOPED BY THE HEALTH EDUCATION PLANNING COMMITTEE IN COLLABORATION WITH THE MADISON COUNTY PARTNERSHIP FOR COMMUNITY HEALTH AND COMMUNITY LEADERS.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL COUNSELORS ASSIST PATIENTS WITH THEIR HEALTH INSURANCE OR FINANCIAL ASSISTANCE NEEDS. DURING THE BILLING CYCLE, PATIENT FINANCIAL SERVICES WORKS WITH PATIENTS WHO NEED ASSISTANCE OR PAYMENT PLANS. FINANCIAL ASSISTANCE INFORMATION IS POSTED ON THE ANDERSON HOSPITAL WEBSITE.
SCHEDULE H, PART VI, LINE 4COMMUNITY INFORMATION ANDERSON HOSPITAL SERVES PATIENTS IN MADISON COUNTY, AND THE ILLINOIS CITIES OF TROY, MARYVILLE, EDWARDSVILLE, GLEN CARBON, GRANITE CITY, AND HIGHLAND. THE COMMUNITY IS MOSTLY A WHITE COLLAR COMMUNITY WITH LITTLE INDUSTRY.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH TO CONTINUE MCPCH INVOLVEMENT WITH COMMITTEE REPRESENTATION FROM ANDERSON HOSPITAL, INCLUDING: MOTOR VEHICLE COMMITTEE, ADDICTIVE BEHAVIOR COMMITTEE, SEXUAL RISK BEHAVIORS COMMITTEE, CANCER COMMITTEE, CARDIOVASCULAR COMMITTEE, AND MCPCH COMMITTEE MEMBERS TO REPORT AT HEPC. TO CONTINUE TO INCREASE AWARENESS OF DISASTER PREPAREDNESS IN THE COMMUNITY BY: AUGMENTING MCPCH COMMUNITY DISASTER PLANS AND PRESENTING TO LOCAL BUSINESSES. TO EDUCATE AND DISSEMINATE INFORMATION TO THE COMMUNITY REGARDING INFECTION CONTROL, TARGETING MRSA, INFLUENZA A, H1N1, AND PREVENTATIVE PRACTICES AND EDUCATION OF THESE TO LOCAL SCHOOLS. TO MAINTAIN PARTNERSHIP WITH LOCAL BUSINESSES AND PUBLIC SERVICES TO MEET THEIR EMPLOYEES' SPECIFIC HEALTHCARE NEEDS. TO EXPAND HEALTH AND WELLNESS EXPOSURE AT ANDERSON HOSPITAL. TO INCREASE COMMUNITY AWARENESS RELATED TO CONGESTIVE HEART FAILURE. IN COLLABORATION WITH COMMUNITY LEADERS, ANDERSON'S COMMUNITY INCLUDES SEMI-ANNUAL MEETINGS WITH THE LOCAL MAYORS TO DISCUSS THE STRATEGIC PLAN OF THE HOSPITAL, PROVIDE UPDATES ON PLANNED CAPITAL SPENDING, DISCUSS NEW SERVICES, AND TO RECEIVE FEEDBACK FROM THE COMMUNITY REGARDING CURRENT SERVICES OR THE NEEDS FOR ADDITIONAL SERVICES.
SCHEDULE H, PART VI, LINE 6OTHER INFORMATION ANDERSON HOSPITAL WILL PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE AND STRIVES TO INCREASE ACCESS TO CARE FOR ALL MEMBERS OF THE COMMUNITY. ANDERSON HOSPITAL IS AN EMS RESOURCE HOSPITAL PROVIDING TRAINING AND EDUCATION TO LOCAL EMS PERSONNEL.
SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT ILLINOIS
SCHEDULE H, PART I, LINE 7FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7, USED A RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS.
SCHEDULE H, PART I, LINE 7, COLUMN FFINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS - PERCENT OF TOTAL EXPENSE THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $8,096,490 REPORTED ON PART IX, LINE 25; HOWEVER IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN.
SCHEDULE H, PART I, LINE 3CFACTORS OTHER THAN FPG IN ADDITION TO FPG, THE ORGANIZATION USES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 OrgsTotalCompensationRltdOrgsAmt
MICHAEL MARSHALL
CFO$302,812$0$0$0$953$0$22,587$0$15,826$0$342,178$0
KEITH PAGE
PRESIDENT$500,281$0$0$0$2,940$0$115,530$0$26,706$0$645,457$0
RAFE HENG
PHYSICIAN$578,773$0$0$0$639$0$19,000$0$14,484$0$612,896$0
TIBOR KOPJAS
PHYSICIAN$418,764$0$0$0$2,591$0$0$0$17,043$0$438,398$0
ERIN WRIGHT
PHYSICIAN$341,290$0$0$0$880$0$19,000$0$0$0$361,170$0
EDDIE PAULK
PHYSICIAN$311,716$0$0$0$2,521$0$0$0$7,348$0$321,585$0
PATRICE STATEN
PHYSICIAN$306,003$0$0$0$652$0$0$0$7,491$0$314,146$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4BFormAndLineReferenceDesc
ExplanationKEITH PAGE PARTICIPATES IN A SEC. 457(F) PLAN. A CONTRIBUTION IN THE AMOUNT OF $74,837 WAS ACCRUED FOR 2019.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY
A3712346842016-05-17$18,258,036NOTE IN PART VIfalsefalsefalse
VILLAGE OF MARYVILLE ILLINOIS
B3709224632016-06-01$7,541,971NOTE IN PART VIfalsefalsefalse
VILLAGE OF MARYVILLE ILLINOIS
C3709224632016-06-16$8,480,753NOTE IN PART VIfalsefalsefalse
VILLAGE OF MARYVILLE ILLINOIS
D3709224632016-07-01$5,175,473NOTE IN PART VIfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$3,900,957$0$18,258,036$0$0$0$300,989$0$0$0$17,957,047$02008Yes (true)Yes (true)Yes (true)Yes (true)
B$2,254,201$0$7,541,971$0$0$0$120,657$0$0$0$7,421,314$01999Yes (true)falseYes (true)Yes (true)
C$1,965,081$0$8,480,753$0$0$0$94,614$0$0$0$8,386,139$02011Yes (true)falseYes (true)Yes (true)
D$1,107,948$0$5,175,473$0$0$0$59,501$0$0$0$5,115,972$02011Yes (true)falseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalseYes (true)Yes (true)Yes (true)false0.005000.00500falsefalsefalseYes (true)
BfalsefalseYes (true)Yes (true)false0falsefalsefalseYes (true)
Cfalsefalsefalsefalse0falsefalsefalseYes (true)
Dfalsefalsefalsefalse0falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsIndException To RebateExceptionToRebateInd
0
AfalseYes (true)falsefalsefalse0Yes (true)Yes (true)
0
Bfalsefalsefalsefalse0falseYes (true)Yes (true)
0
Cfalsefalsefalsefalse0falseYes (true)Yes (true)
0
Dfalsefalsefalsefalse0falseYes (true)Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)
DYes (true)

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, LINE A, COLUMN FADVANCE REFUND 2006 BONDS (ORIGINALLY ISSUED ON 12/15/2016) AND CURRENT REFUND 2011B BONDS (ORIGINALLY ISSUED ON 12/29/2011).
SCHEDULE K, PART I, LINE B, COLUMN FCURRENT REFUND 2011A BONDS (ORIGINALLY ISSED ON 12/29/2011).
SCHEDULE K, PART I, LINE C, COLUMN FCURRENT REFUND 2011 BONDS (ORIGINALLY ISSUED ON 8/4/2011).
SCHEDULE K, PART I, LINE D, COLUMN FCURRENT REFUND 2012 BONDS (ORIGINALLY ISSUED ON 02/17/2012).
SCHEDULE K, PART II, COLUMN A, LINE 3BOND PROCEEDS WERE USED TO REFUND PRIOR BOND ISSUES. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT AND ESCROW FUND HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS.
SCHEDULE K, PART II, COLUMN A, LINE 11THIS AMOUNT REPRESENTS $7,278,189 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011B BONDS, $10,676,030 USED TO ADVANCE REFUND THE 2006 BONDS, AND $2,828 USED TO PAY INTEREST ON THE BONDS.
SCHEDULE K, PART II, COLUMN B, LINE 3BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS.
SCHEDULE K, PART II, COLUMN B, LINE 11THIS AMOUNT REPRESENTS $7,419,803 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011A BONDS AND $1,511 USED TO PAY INTEREST ON THE BONDS.
SCHEDULE K, PART II, COLUMN C, LINE 3BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS.
SCHEDULE K, PART II, COLUMN C, LINE 11THIS AMOUNT REPRESENTS $8,384,440 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011 BONDS AND $1,700 USED TO PAY INTEREST ON THE BONDS.
SCHEDULE K, PART II, COLUMN D, LINE 11THIS AMOUNT REPRESENTS $5,115,116 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2012 BONDS AND $856 USED TO PAY INTEREST ON THE BONDS.
SCHEDULE K, PART III, COLUMN APART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003.
SCHEDULE K, PART III, COLUMN A, LINE 4AMOUNT REPRESENTS THE MAXIMUM AMOUNT OF BOND PROCEEDS USED IN A PRIVATE BUSINESS USE.
SCHEDULE K, PART III, COLUMN BPART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003.
SCHEDULE K, PART IV, COLUMN A, LINE 6BOND PROCEEDS WERE DEPOSITED AND INVESTED IN A YIELD RESTRICTED ESCROW FUND UNTIL THE REDEMPTION OF THE 2006 BONDS.
SCHEDULE K, PART IV, COLUMN A, LINE 2CARBITRAGE ANALYSIS COMPLETED AS OF 2/15/2017.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN371234684BondIssuerEIN
Bond Issued2019-05-30BondIssuedDt
Issue Price$15,229,849IssuePriceAmt
PurposeNOTE IN PART IVPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$670,518RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$15,255,430TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$217,399IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$15,038,031OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2019SubstantialCompletionYr
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
No Rebate DueYes (true)NoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K PART I, LINE A, COLUMN (F)ACQUIRE, CONSTRUCT, FURNISH AND EQUIP HOSPITAL FACILITIES.
SCHEDULE K PART II, COLUMN A, LINE 3TOTAL PROCEEDS OF THE ISSUE DOES NOT EQUAL ISSUE PRICE REPORTED IN PART I AS A RESULT OF INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD.
SCHEDULE K PART II, COLUMN A, LINE 13ALL BOND PROCEEDS WERE SPENT AS OF THE FISCAL YEAR END; HOWEVER, NOT ALL PROJECTS WERE COMPLETED AS OF THE FICAL YEAR END.
SCHEDULE K PART II, COLUMN A, LINE 16THE FINAL WRITTEN ALLOCATION WILL BE COMPLETED BY THE NEXT FISCAL YEAR END.
SCHEDULE K PART IV, COLUMN A, LINE 2(c)ARBITRAGE ANALYSIS COMPLETED AS OF 12/1/2019.

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
BANK OF EDWARDSVILLE
>35% OWNED BY DIRECTOR$142,571PAID INTERESTfalse
BANK OF EDWARDSVILLE
>35% OWNED BY DIRECTOR$1,698,787EARNED INTERESTfalse
BANK OF EDWARDSVILLE
>35% OWNED BY DIRECTOR$160,413TRUSTEE FEESfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BPROCESS TO REVIEW THE FORM 990 THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND CONTROLLER. INFORMATION FOR THE RETURN IS GATHERED BY THE HOSPITAL'S FINANCE DEPARTMENT AND GIVEN TO AN INDEPENDENT AUDITOR FOR FILING PREPARATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12CPROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE COMPLIANCE OFFICER REVIEWS AND MONITORS THE POLICY ANNUALLY. PERSONS COVERED UNDER THE POLICY INCLUDE TRUSTEES/DIRECTORS/MANAGERS, OFFICERS AND COMMITTEE MEMBERS OF THE ANDERSON ENTITIES; DEPARTMENT DIRECTORS, ADMINISTRATIVE DIRECTORS, ASSISTANT DIRECTORS, MEMBERS OF SENIOR MANAGEMENT AND MEDICAL STAFF LEADERS OF ANDERSON, MEDICAL STAFF MEMBERS AND NON-MANAGEMENT STAFF. CONFLICTS ARE REVIEWED, IDENTIFIED AND MAINTAINED BY THE COMPLIANCE OFFICER. EXPLANATION OF ANY RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND AT EVERY ANNUAL MEETING OF THE ANDERSON ENTITY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; AND C. WHEN THE COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED AT A BOARD OR COMMITTEE MEETING. FOR MANAGERS AND MEDICAL STAFF LEADERS: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO THE COMPLIANCE OFFICER AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; AND B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; C. WHEN A COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED ON BEHALF OF ANDERSON AND THE COVERED INDIVIDUAL IS IN A POSITION TO INFLUENCE THE OUTCOME OF THE CONSIDERATION. DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST MADE AT THE MEETING AT WHICH THE TRANSACTION OR ARRANGEMENT IS BEING CONSIDERED SHALL BE MADE TO ALL INDIVIDUALS PRESENT AT THE MEETING. FOR OTHER MEDICAL STAFF MEMBERS: DISCLOSURE OCCURS AT APPOINTMENT AND REAPPOINTMENT UNLESS THEY ARE BOARD MEMBERS - THESE PHYSICIANS FOLLOW THE BOARD OF TRUSTEE REQUIREMENTS. EMPLOYEES NOT IN MANAGEMENT POSITIONS: AT TIME OF HIRE AND AT EACH ANNUAL EMPLOYEE EVALUATION.
FORM 990, PART VI, SECTION B, LINE 15AREVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION THE CEO SALARY AND BONUS STRUCTURE IS DETERMINED ON AN ANNUAL BASIS BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES, AND APPROVED BY THE FULL BOARD BASED ON AN EVALUATION DONE BY THE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15BREVIEW OF OTHER OFFICER OR KEY EMPLOYEE COMPENSATION THE ADMINISTRATIVE DIRECTOR SALARY STRUCTURE IS DETERMINED BY A REVIEW AND MARKET COMPENSATION STUDY BASED ON OFFICIAL SURVEYS BY SUCH COMPANIES AS TOWERS, PERRIN AND MERCER. RECOMMENDATIONS ARE MADE TO THE CEO BY HUMAN RESOURCES, AND ARE APPROVED BY THE CEO BASED ON PERFORMANCE EVALUATION.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS OR FUND BALANCES: INVESTMENT IN ANDERSON SURGERY CENTER: 1,200,000 NONCONTROLLING INTEREST IN ANDERSON SURG. CENTER: 150,000 ------------- 1,350,000
FORM 990 PART IX LINE 11GDESCRIPTION:SURGERY CONTRACT SERVICES TOTAL FEES:813661
FORM 990 PART IX LINE 11GDESCRIPTION:REFERENCE LAB CONTRACT SERVICE TOTAL FEES:756899
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:3676223
FORM 990 PART IX LINE 11GDESCRIPTION:ADMIN & OTHER FACILITY SERVICE TOTAL FEES:11409415
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:13031117

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
MARYVILLE MEDICAL SERVICES LLC
6800 STATE ROUTE 162MARYVILLEIL62062200654708PHYS SERVICESIL$107,453$208,918SW IL HEALTH
MARYVILLE PHYSICIAN SERVICES LLC
6800 STATE ROUTE 162MARYVILLEIL62062200802394PHYS SERVICESIL$17,639,348$6,075,734SW IL HEALTH
MARYVILLE IMAGING LLC
6800 STATE ROUTE 162MARYVILLEIL62062452588783IMAGING SERVIL$3,923,432$2,606,834SW IL HEALTH
ANDERSON REAL ESTATE LLC
6800 STATE ROUTE 162MARYVILLEIL62062452681347REAL ESTATEIL$1,055,864$24,058,192SW IL HEALTH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
AUXILIARY OF ANDERSON HOSPITAL
6800 STATE ROUTE 162MARYVILLEIL62062376080063SUPPORT ORGIL501(C)(3)12, III-ONAfalse
ANDERSON HOSPITAL FOUNDATION
6800 STATE ROUTE 162MARYVILLEIL62062274548522SUPPORT ORGIL501(C)(3)7SW IL HEALTHYes (true)
COMMUNITY HOSPITAL OF STAUNTON
400 N CALDWELL STREETSTAUNTONIL62088370624255HOSPITALIL501(C)(3)3SW IL HEALTHYes (true)
FRIENDS OF COMMUNITY MEMORIAL HOSPITAL
400 N CALDWELL STREETSTAUNTONIL62088363913722FUNDRAISINGIL501(C)(3)10CMHYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON SURGERY CENTER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd
FieldValueIRS element (for citing)
EIN834200085EIN
Primary ActivitiesSURGERYPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SW IL HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of EOY Assets$1,200,000ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd
Ownership0.88900OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COMMUNITY HOSPITAL OF STAUNTON
L$3,370,531COST
COMMUNITY HOSPITAL OF STAUNTON
D$2,169,842FMV
ANDERSON HOSPITAL FOUNDATION
C$120,000CASH

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