ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-1208459)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-05-19
- IRS object ID
- 202021409349302122
- Schema version
- 2018v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-05-19T21:32:46-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 West Wacker Drive Suite 2600 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371208459 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital - Hospital Sisters - Third Order of St Francis | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 6185264511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE PO BOX 99 | AddressLine1Txt |
| City | Breese | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622300099 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | David Nosacka | PersonNm |
| Person Title | Division CFO | PersonTitleTxt |
| Signature | 2020-05-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Mallory Fairless | PreparerPersonNm |
| PTIN | P01321579 | PTIN |
| Phone | 3128997000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Chris Klay | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE PO BOX 99 | AddressLine1Txt |
| City | Breese | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622300099 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $63,111,488 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STJOEBREESE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION OF ST. JOSEPH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 393 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $311,511 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $551,486 | PYContributionsGrantsAmt |
| CY Contributions Grants | $91,222 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $55,884,518 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $58,586,895 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,181,464 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,543,841 | CYInvestmentIncomeAmt |
| PY Other Revenue | $806,720 | PYOtherRevenueAmt |
| CY Other Revenue | $367,640 | CYOtherRevenueAmt |
| PY Total Revenue | $60,424,188 | PYTotalRevenueAmt |
| CY Total Revenue | $62,589,598 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,908,861 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,666,654 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $30,830,725 | PYOtherExpensesAmt |
| CY Other Expenses | $33,795,991 | CYOtherExpensesAmt |
| PY Total Expenses | $51,739,586 | PYTotalExpensesAmt |
| CY Total Expenses | $54,462,645 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,684,602 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,126,953 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $176,869,199 | TotalAssetsBOYAmt |
| Total Assets EOY | $180,877,074 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,303,913 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $35,756,558 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $143,565,286 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $145,120,516 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION OF ST. JOSEPH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $43,292,570 | ExpenseAmt |
| Revenue | $58,643,024 | RevenueAmt |
| Desc | SEE SCHEDULE O - PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $43,292,570 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 862 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 393 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | Yes (true) | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN JEFFRIES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6185265312 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE | AddressLine1Txt |
| City | BREESE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62230 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| CHRIS KLAY | |||||||||
| PRESIDENT & CEO | 60.0 | 0 | Yes (X) | Yes (X) | $0 | $261,203 | $84,206 | ||
| JOHN HUDSPETH | |||||||||
| 2018 Chair | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM BROECKLING | |||||||||
| 2018 SECRETARY & 2019 Vice Chair | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GEORGE KRUSE | |||||||||
| 2018 VICE CHAIR & 2019 Chair | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Richelle Rennegarbe PHD | |||||||||
| 2019 Secretary | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID BEACH | |||||||||
| BOARD MEMBER | 1.0 | 59.0 | Yes (X) | $0 | $424,615 | $85,521 | |||
| SISTER MARGUERITE COOK OSF | |||||||||
| BOARD MEMBER | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | |||
| ANN Doll-Pollard MD | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Tom Freker | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| John Fridley | |||||||||
| BOARD MEMBER | 0.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| ERIN GAGEN MD | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Dennis Litteken | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| JULIE MASCHHOFF | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| JENE BIERI | |||||||||
| DIRECTOR OF PROF. SERVICES | 13.3 | 26.7 | Yes (X) | $91,360 | $99,566 | $8,253 | |||
| ANN M CARR | |||||||||
| TREASURER | 0.3 | 59.7 | Yes (X) | $0 | $329,829 | $110,463 | |||
| JAMES DOVER | |||||||||
| CEO SOUTHERN IL DIV - Thru June 2019 | 7.8 | 52.2 | Yes (X) | $0 | $627,463 | $125,470 | |||
| HELEN ESSENPREIS | |||||||||
| CNO | 40.0 | 0 | Yes (X) | $160,152 | $0 | $69,695 | |||
| JACQUELYNNE N HOLST | |||||||||
| DIVISION ASSOCIATE GENERAL COUNSEL | 7.8 | 29.0 | Yes (X) | $0 | $198,903 | $44,598 | |||
| MARGARET A LUNA | |||||||||
| DIVISION CPO | 4.2 | 29.0 | Yes (X) | $0 | $261,775 | $79,409 | |||
| DAVID NOSACKA | |||||||||
| CFO Southern IL Division | 8.0 | 52.0 | Yes (X) | $0 | $358,453 | $52,011 | |||
| JOHN JEFFRIES | |||||||||
| DIRECTOR OF FINANCE | 40.0 | 0 | $177,880 | $0 | $40,503 | Yes (X) | |||
| Barbara Eilers | |||||||||
| Nurse Supervisor | 40.0 | 0 | $111,410 | $0 | $53,281 | Yes (X) | |||
| EILEEN HAGEN | |||||||||
| Nurse Supervisor | 40.0 | 0 | $106,366 | $0 | $45,616 | Yes (X) | |||
| JOEL A TUCKER | |||||||||
| DIRECTOR OF PHARMACY | 40.0 | 0 | $103,132 | $0 | $23,570 | Yes (X) | |||
| Serra Morton | |||||||||
| Director of Women & Infants | 40.0 | 0 | $101,410 | $0 | $3,412 | Yes (X) | |||
| AMY M BALLANCE | |||||||||
| Interim CEO (partial year)/Division VP of Strategy | 7.8 | 29.0 | $0 | $235,605 | $62,543 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $851,710 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,797,412 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $888,551 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CEP AMERICA | |||||
| 2100 Powell St | Emeryville | CA | 94608 | ED Coverage | $896,170 |
| Comprehensive Anesthesia | |||||
| 19 Willow Creek Dr | Highland | IL | 62249 | Anesthesia Services | $622,176 |
| Compass One Healthcare | |||||
| PO Box 102289 | Atlanta | GA | 30368 | Food Services | $400,685 |
| SSM Cardinal Glennon Childrens | |||||
| 1195 Corporate Lake Dr | St Louis | MO | 63132 | Nursing Coverage | $302,623 |
| Midwest Emergency Department | |||||
| 320 E Hwy 50 | OFallon | IL | 62269 | ED Coverage | $248,277 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $77,059 | RelatedOrganizationsAmt |
| Government Grants | $14,163 | GovernmentGrantsAmt |
| Total Contributions | $91,222 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 621990 | $58,510,663 | $58,510,663 |
| Medical Office Rent from Affiliate | 900099 | $76,232 | $76,232 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $58,586,895 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $858,595 | TotalRevenueColumnAmt |
| Exclusion | $858,595 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $324,776 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $521,890 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$197,114 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$197,114 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$197,114 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,685,246 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,685,246 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,685,246 | TotalRevenueColumnAmt |
| Exclusion | $2,685,246 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Miscellaneous | 900099 | $160,616 | $160,616 | |
| Exercise Programs | 713940 | $404,138 | $92,627 | $311,511 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $564,754 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $62,589,598 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,643,024 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $311,511 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,543,841 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,007 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $323,007 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,396,005 | TotalAmt |
| Program Services | $9,661,323 | ProgramServicesAmt |
| Management And General | $4,734,682 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,438 | TotalAmt |
| Program Services | $29,600 | ProgramServicesAmt |
| Management And General | $14,838 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,831,174 | TotalAmt |
| Program Services | $3,218,045 | ProgramServicesAmt |
| Management And General | $1,613,129 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,072,030 | TotalAmt |
| Program Services | $857,624 | ProgramServicesAmt |
| Management And General | $214,406 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,217 | TotalAmt |
| Management And General | $553,217 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,335,329 | TotalAmt |
| Program Services | $3,111,792 | ProgramServicesAmt |
| Management And General | $1,223,537 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,175,897 | TotalAmt |
| Program Services | $4,140,718 | ProgramServicesAmt |
| Management And General | $1,035,179 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,027,131 | TotalAmt |
| Program Services | $821,705 | ProgramServicesAmt |
| Management And General | $205,426 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406,051 | TotalAmt |
| Program Services | $324,841 | ProgramServicesAmt |
| Management And General | $81,210 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,482,051 | TotalAmt |
| Program Services | $1,985,641 | ProgramServicesAmt |
| Management And General | $496,410 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $562,877 | TotalAmt |
| Program Services | $450,302 | ProgramServicesAmt |
| Management And General | $112,575 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $15,496,052 | $15,496,052 | |
| Assessment | $1,780,023 | $1,424,018 | $356,005 |
| Bad Debt | $945,094 | $945,094 | $0 |
| Maintenance & Repairs | $251,031 | $200,825 | $50,206 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $781,238 | TotalAmt |
| Program Services | $624,990 | ProgramServicesAmt |
| Management And General | $156,248 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,462,645 | TotalAmt |
| Program Services | $43,292,570 | ProgramServicesAmt |
| Management And General | $11,170,075 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,040,670 | BOYAmt |
| EOY | $624,213 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,309,246 | BOYAmt |
| EOY | $11,861,747 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $691,072 | BOYAmt |
| EOY | $644,072 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,963 | BOYAmt |
| EOY | $136,511 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $77,849,649 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,795,799 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,006,770 | BOYAmt |
| EOY | $28,053,850 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,737,478 | BOYAmt |
| EOY | $139,556,681 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,869,199 | BOYAmt |
| EOY | $180,877,074 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,022,582 | BOYAmt |
| EOY | $7,926,040 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,536,607 | BOYAmt |
| EOY | $16,125,968 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,744,724 | BOYAmt |
| EOY | $11,704,550 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,303,913 | BOYAmt |
| EOY | $35,756,558 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,959,755 | BOYAmt |
| EOY | $143,604,769 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,595,376 | BOYAmt |
| EOY | $1,505,092 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,155 | BOYAmt |
| EOY | $10,655 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,565,286 | BOYAmt |
| EOY | $145,120,516 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,869,199 | BOYAmt |
| EOY | $180,877,074 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,126,953 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$430,572 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$6,141,151 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $16,011 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $16,011 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | ST. JOSEPH'S HOSPITAL, (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HOSPITAL ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 22.73% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.52% LOBBYING EXPENSE - ILLINOIS HOSPITAL ASSOCIATION ("IHA") AT 35.00% LOBBYING EXPENSE - NATIONAL ASSOCIATION FOR HOME CARE & HOSPICE AT 15.00% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,704,211 | OtherCostOrOtherBasisAmt |
| Book Value | $1,704,211 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,826,018 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,882,483 | DepreciationAmt |
| Book Value | $15,943,535 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,632,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,242,110 | DepreciationAmt |
| Book Value | $4,390,619 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,686,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,671,206 | DepreciationAmt |
| Book Value | $6,015,485 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $28,053,850 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| RETIREMENT OBLIGATION-ASBESTOS | $2,884,427 |
| ACCRUED BENEFIT LIABILITY | $4,726,627 |
| Derivative Instruments | $4,093,496 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,704,550 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501 (c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2018 and 2017 in the accompanying consolidated financial statements due to the uncertainty of realization. Hshs recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2018 and 2017, HSHS does not have any liabilities for unrecognized tax benefits. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $852,258 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $852,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0159 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,800,537 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,832,214 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,968,323 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0555 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,652,795 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,832,214 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,820,581 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0714 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,691 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,745,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,614,603 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,130,643 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0211 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,716 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8,759,653 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,614,603 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,145,050 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0214 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $16,412,448 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,446,817 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,965,631 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0928 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $115,174 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $115,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0022 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $115,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $115,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0022 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $945,094 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $94,509 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,835,898 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,829,182 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,993,284 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH'S HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE | AddressLine1Txt |
| City | BREESE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622300099 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STJOEBREESE.COM | WebsiteAddressTxt |
| State License | 0002527 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.stjoebreese.com/www-sjb/media/SJB-PDF-Documents/FY2018-SJB-CHNA-Report.pdf. | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.stjoebreese.com/www-sjb/media/SJB-PDF-Documents/FY2018-SJB-Implementation-Plan.pdf. | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.hshs.org/FAP | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.hshs.org/FAP | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.hshs.org/FAP | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3E | Yes, the significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - HSHS St. Joseph's Hospital Breese. HSHS St. Joseph's Hospital, Breese completed its FY 2018 community health needs assessment (CHNA) in June 2018. In addition to reviewing available secondary data, St. Joseph's Hospital conducted engagement sessions to gain input from those representing the broader community and vulnerable populations. Three focus group meetings were held, and attendees included individuals who work in city government, education, health care, senior services, social service agencies and public health. To gain community input for the FY2018 CHNA, a variety of stakeholders were asked to participate in the engagement sessions. Engagement session participants were identified in coordination with the University of Illinois Survey Research Office (UIS SRO). Organizations and institutions represented included the following: * Breese District 12 Elementary School* * Catholic Charities* * City of Breese * City of New Baden * Clinton County Coroner's Office * Clinton County Health Department* * Community Link, serving the developmentally disabled* * Community Physicians * Community Resource Center - Centralia* * Countryside Manor Nursing Home - Aviston * Hoyleton Youth and Family Services * * HSHS Home Care Southern IL * Kaskaskia College, an area community college * SAFE* (Sexual Assault and Family Emergencies Center) * South Central Transit, public transportation provider * Trenton Village Retirement * University of Illinois Extension * Wesclin CUSD #3* * YMCA *Denotes group representing medically underserved, low-income, and/or minority populations. In addition, St. Joseph's Hospital, Breese is one of the leading members of the Clinton County Health Improvement Coalition. Organized in 2014, the adopted purpose of the Coalition is to "collaborate with community partners to advance the health and quality of life for the residents of Clinton County through the assessment of needs and development of education and preventative initiatives". The Coalition consists of 20 not-for-profit organizations and social service agencies. Coalition Steering Committee members were first presented the community health needs assessment for review; the group of seven reviewed the primary and secondary data gathered during the assessment. Following discussion, the group supported the identified priorities and recommended the information for the full Coalition membership to review. With nine members present at the May 2018 meeting, Clinton County Health Improvement Coalition members validated the findings and priority community health needs. Prior to presentation to the hospital's Board of Directors, the Community Health Needs Assessment (CHNA) was shared with the hospital's internal Community Benefit team, which includes administration, finance, nursing, social services, and strategic planning leadership. Following their input, the CHNA and Implementation Plan was presented at a meeting of the St. Joseph's Hospital's Board of Directors, which also includes members of the hospital's Senior Leadership Team as well as HSHS Southern Illinois Division executive leadership. Funding for implementation was approved in the upcoming fiscal year's budget. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - HSHS St. Joseph's Hospital Breese. Yes, the hospital conducted its FY2018 CHNA with Breese District 12 Elementary School, Catholic Charities, City of Breese, City of New Baden, Clinton County Coroner's Office, Clinton County Health Department, Community Link, Community Physicians, Community Resource Center - Centralia, Countryside Manor Nursing Home - Aviston, Hoyleton Youth and Family Services, HSHS Home Care Southern IL, Kaskaskia College, SAFE (Sexual Assault and Family Emergencies Center), South Central Transit (public transportation provider), Trenton Village Retirement, University of Illinois Extension, Wesclin CUSD #3, and the YMCA. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - HSHS St. Joseph's Hospital Breese. In addition to the organizations on the Clinton County Health Improvement Coalition, the CHNA was presented during a meeting of the Carlyle Rotary Club and distributed in a news release to area newspapers. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - HSHS St. Joseph's Hospital Breese. As part of the identification and prioritization of health needs, the internal Community Benefit team considered the estimated feasibility and effectiveness of possible interventions by the hospital to impact health priorities. Prioritization was based on scope, severity, and burden; health disparities associated with the need; the importance the community places on addressing the health need; the hospital and community assets and resources available to address the health need; and local expertise and input. Based on the CHNA planning and development process described, the following priority community health needs were identified: Access to Care; Obesity; Mental Health; and Alcohol, Tobacco, and Other Drug Use. Implementation Strategies established to address these needs through specific initiatives included: Access to Care Goal: Increase access to care for Breese area community members, with a focus on low-income and elderly populations. FY2019 Outcomes Clinton County is in an area designated as a shortage area for primary care health professionals (HPSA). Additional points of access to medical care were subsidized for those in need through walk-in clinics and rural health clinics located in the small surrounding communities of Carlyle, Germantown, New Baden and Trenton. Operations are financially subsidized by St. Joseph's Hospital, Breese (SJB). Resources were dedicated to improving the minority Hispanic population's access to care through an interpreter/navigator program assisting in 4,500 encounters with individuals during the fiscal year. Many residents do not have a reliable means of transportation. In turn, transportation to and from medical appointments can be difficult. In partnership with the Healthcare Foundation, a new van was obtained to provide residents with reliable transportation to medical, dental, and other personal appointments. Travelling within a 20-mile radius of the hospital, the new van service transported approximately 2,000 individuals in FY2019. The National Kidney Foundation of Illinois brought their Kidney Mobile to the community and offered free health exams and screenings for hypertension, diabetes, and kidney disease. Ninety-six individuals were provided free screenings. Audiology Services at St. Joseph's Hospital, Breese (SJB) has been assisting individuals with hearing impairment since 2010. SJB collaborates with the State of Illinois public insurance program and the Lions of Illinois Foundation to provide care to vulnerable populations. Support groups provide individuals affected by illness, their family members and caregivers an opportunity to learn more about their illness. This support system can be crucial to their maintenance of health and well-being. Support for women with cancer was provided by helping them cope with appearance related side effects of cancer through the American Cancer Society's "Look Good, Feel Better" program with 14 individuals attending during the year. St. Joseph's Hospital also continued to operate a "Wig Closet". Space was dedicated to maintaining wigs, scarves, and hats for the program and served approximately 13 women from Clinton and surrounding counties. Information and support was provided to individuals with diabetes helping them with self-management through the Diabetes Support Group. Education was provided at six support group meetings held during the year with an average of 20 people attending each group meeting. Topics covered included how to identify and eliminate added sugar, spirituality and coping with diabetes, and managing diabetes during an emergency. SJB's diabetes program has been certified by the American Diabetes Association since 2007. To increase access to health education, a four-week Diabetes Wellness Workshop series was rotated between HSHS's three ministries in Greenville, Breese and Highland. It was offered free of charge and is an opportunity for individuals to have interactive education about their chronic disease including guidance on managing diabetes, healthy eating, and monitoring blood glucose. Using social media, a diabetes support group was also launched by the diabetes educator and team of nutritionists during the year. St. Joseph's Hospital, Breese (SJB) shared tips with the community through local media about choosing their health plan. In addition to providing information about the insurance plans and state health insurance programs that include SJB as a participating provider, information about open enrollment in the marketplace health insurance exchange was provided. A phone number and internet site were included for residents to learn more. A certified application counselor was also available during an open enrollment event at sister hospital St. Joseph's Hospital, Highland to assist individuals and families with signing up for health care coverage during open enrollment. The event was open and advertised to anyone served in the counties of Madison, Bond, and Clinton. Obesity Goal: Make nutrition and healthy living education and programs available for all members of the community. FY2019 Outcomes The services of the SJB dietician were made available to other organizations free of charge for education about nutrition and healthy eating. The dietitian participated in local health and safety fairs offered through the local schools. Nutrition information was also presented at the Breese Farmer's Market. Exercise programs through the YMCA's partnership with the hospital also continue at the hospital's on-site exercise facility. In addition to the financial support of the YMCA, three hospitals colleagues are on the YMCA's Board including the hospital's president and chief executive officer. The YMCA has brought several programs to the community that would not otherwise be available: * Livestrong, an exercise class for cancer survivors. * Exercise for Parkinson's, a class designed for persons diagnosed with Parkinson's. * The Clinton County YMCA offers youth basketball, flag football and volleyball leagues for children ages 4 years to 8th grade. Practices and games take place at locations throughout Clinton County including schools and community facilities. * The Clinton County YMCA offers a summer day camp located at a local park. * An after-school program for students who attend Aviston Elementary School is offered every day that school is in session. Students are given time to complete their homework, physical activity in the gym or outside, snacks, and time for arts and craft. With the YMCA's presence in the community, county municipalities have sought out the YMCA's expertise with youth programs. The YMCA now manages one community's local pool and manages the summer youth league sports program for another community. HSHS St. Joseph's Hospital, Breese (SJB) gained international recognition as a Designated Baby-Friendly Hospital by Baby-Friendly USA. Baby-Friendly USA, Inc. is the U.S. authority for the implementation of the Baby-Friendly Hospital Initiative, which is a global program sponsored by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). The Baby-Friendly initiative encourages and recognizes hospitals and birthing centers that offer an optimal level of care for breastfeeding mothers and their babies. SJB also provides free breastfeeding classes and breastfeeding support groups to all mothers in the community - participation is not contingent on delivery at SJB. Participants are provided support from hospital colleagues specially trained in this area. For the second year, a Kids Safety Fair was hosted in the community to promoted health and well-being. Educational booths and demonstrations such as car seat safety checks, swimming and life jacket safety, nutritional tips and bike helmet fitting are part of this free, family-friendly event. A 5K and kid's fun run were sponsored by SJB and HSHS Athletes Advantage Sports Medicine program. The event provided a family-friendly physical activity for participation of all ages. HSHS St. Joseph's Hospital Breese continues to be a leading member of the Clinton County Health Improvement Coalition (CCHIC). The Coalition began in 2014 and is comprised of over 25 members including local organizations, social service agencies and individuals using their skills to improve the health of county residents. With March recognized by the Academy of Nutrition and Dietetics as National Nutrition Month, the CCHIC promoted ways to improve health through nutrition. An activity led by Coalition members included a food drive for county food pantries and the Snack Pack Program with suggestions made for healthy options. Daily tips on healthy cooking ideas and simple ways to improve healthy eating were also posted on the group's Facebook page and participating organizations throughout the county were encouraged to promote events and programs to their organization's clients and employees. |
| Schedule H, Part V, Section B, Line 11 Facility , 2 | Facility , 2 - HSHS St. Joseph's Hospital, Breese. Mental Health Goal: In partnership with other community organizations, create awareness of and access to mental health services in the community. FY2019 Outcomes The Clinton County Health Department's current IPlan includes the establishment of an outpatient mental health clinic. The Health Department is working through approvals for a new building, which will have space dedicated to outpatient mental health. SJB will continue to be involved and prepared to assist with available resources as appropriate. A representative from St. Joseph's Hospital continues to serve on the Clinton County Mental Health Coalition. The group is comprised of mental health and social work professionals. To inform community residents about mental health services in the area, a resource guide was in development in FY2019. The guide will be available in FY2020. Alcohol, Tobacco, and Other Drug Use Goal: Reduce the instances of abuse of alcohol, tobacco, and other drug use in Clinton County. FY2019 Outcomes Take Action Coalition of Clinton County started meeting in the fall of 2018 to address the growing issue of drug use and alcoholism in the area. The group includes outpatient mental health and substance abuse service providers, local schoolteachers and administrators, Clinton County law enforcement and probation offices, and representatives from other social service agencies. The group meets monthly and includes not only professionals, but also those with substance abuse disorder as well as family and friends of those who have suffered from drug use and alcoholism. A colleague from St. Joseph's Hospital is an active participant in the Coalition. The formal mission of the Take Action Coalition of Clinton County is to mobilize community members and develop comprehensive strategies focused on substance abuse education and prevention, law enforcement, and treatment and recovery services. With this coalition in place, the county received resources through grant funding from the Illinois Department of Human Services' Division of Substance Use Prevention and Recovery. The grant award was made to Chestnut Health Systems, an organization focused on substance abuse disorder treatment and mental health care. The grant is intended to extend services, including medication-assisted treatment, to counties that have few available resources. Clinton County was one of five counties targeted in the grant. In March 2019, funds from the grant were utilized by Chestnut to hire a recovery coach for the area. The recovery coach is available to assist individuals in overcoming their addictions as well as sustaining recovery. St. Joseph's Hospital Breese and sister hospitals St. Joseph's Hospital, Highland and Holy Family Hospital, Greenville are also working with Chestnut Healthy Systems, HSHS Medical Group, the Bond County Health Department, and Community Resource Center in Clinton County to organize and strengthen medical treatment options between the three counties. Through relationships created with area coalitions, St. Joseph's Hospital, Breese, St. Joseph's Hospital, Highland, and Holy Family Hospital, Greenville, are distribution partners with Hoyleton Youth Family Services for the DETERRA drug deactivation pouches. The contents in the pouch are designed to neutralize unused medications. Up to 45 pills, 6 ounces of liquid or 6 patches can be deactivated in the pouch by adding warm water and then disposed in normal trash as the bags are environmentally friendly. Hoyleton Youth Family Services is the region's distribution hub for this Rx Abuse Leadership Initiative from the Community Anti-Drug Coalitions of America. Information was distributed to local media outlets and included on the hospital's social media page regarding National Prescription Drug Take Back Day - October 27, 2018. Residents were encouraged to take unwanted, unused, or expired prescription medications to local participating police departments. Police departments with drop off facilities were included in the information distributed. St. Joseph's Hospital, Breese along with HSHS, included in their advocacy efforts legislation supporting the increase in age for the purchase and possession of tobacco products from 18 years of age to 21 years of age. A video produced by the System's Communications department supporting the legislation was placed on the local ministry's social media. In addition to sharing the video, information was published in the colleague weekly newsletter asking for their help in encouraging state legislators to support the Tobacco 21 legislation and sharing the video posted on the SJB Facebook page with their family and friends. In March of 2019, the Tobacco 21 legislation was passed by both the Illinois House of Representatives and Illinois Senate. Governor J.B. Pritzker signed the legislation on April 7, 2019 which took effect on July 1, 2019. A representative of SJB is a member of the Community that Cares Coalition. Organized through Hoyleton Youth Family Services, the coalition plans and supports initiatives for youth prevention initiatives in Clinton County which includes classroom education in the grade schools and junior high schools. Additional Community Benefit Initiatives and Programs HSHS St. Joseph's Hospital, Breese partnered with sister hospitals HSHS St. Joseph's, Highland and HSHS Holy Family, Greenville to sponsor a women's wellness event. Women from all three hospitals' service area counties - Bond, Clinton and Madison Counties, were invited to attend the event that provided health information specific to women; approximately 300 women attended. HSHS St. Joseph's Hospital, Breese is a clinical education site for nurses and medical imaging students. Students are actively enrolled in their health career program at Kaskaskia College. Biannually, SJB offers a baby-sitting training class for youth ages 11 to 15 years old. The course provides information on proper supervision, basic caregiving skills and how to respond to ill and injured children and infants. As an outcome of the prioritization process, the following community health needs were also identified and were not addressed directly by the hospital for the reasons indicated: Based on the number of dental care providers compared to Clinton County's population, additional providers of dental care are needed. Few of the current providers accept the public insurance provided to the disadvantaged and low-income populations. With other health needs prioritized higher, dental care will not be a focus area for the hospital. A dental clinic is operated through the health department in an adjacent county and available to Clinton County residents as appointment times permit. The Clinton County Health Department's IPlan includes the establishment of an outpatient dental health clinic. The hospital will be supportive as appropriate, and resources allow. |
| Schedule H, Part V, Section B, Line 13 Facility , 1 | Facility , 1 - St. Joseph's Hospital. Presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 7. Wisconsin Department of Health Services Housing Assistance Program 8. Participation in Women, Infants and Children programs (WIC); 9. Supplemental Nutrition Assistance Program (SNAP) eligibility; 10. Illinois Free Lunch and Breakfast Program; 11. Wisconsin Free Lunch Program; 12. Low Income Home Energy Assistance Program (LIHEAP); 13. Wisconsin Home Energy Assistance Program (WHEAP); 14. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 15. Receipt of grant assistance for medical services |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7g Subsidized Health Services | Substantially all of the expenses reported on Part I, Line 7g for subsidized health services, are attributable to physician clinics. |
| Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 945094 |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | To determine the actual cost of these services, the hospital uses a cost-to-charge ratio (derived from IRS worksheet 2) based on our audited financial statements to calculate the amounts reported on Line 7a through 7i. |
| Schedule H, Part II Community Building Activities | St. Joseph's Hospital, Breese partnered with Central Community High School for the school's annual college and career success program. The hospital provided the space for their annual program. Central High School teachers and counselors provided students information about college and employment opportunities. A meal was served to the group by the hospital's food services department at no cost. To improve access to care, a goal for this Community Health Needs Assessment priority is to strengthen support of advocacy efforts for policy change around insurance programs and payments to hospitals. Opportunities were sought to share the negative impact state and federal policies have on local ministries and utilized to discuss improvements. Administrative representatives from SJB attended the Illinois Hospital Association's annual Hospital Advocacy Day in Springfield on April 30 along with the Chairman of the SJB Board of Directors. Collective efforts in communicating with legislators are crucial to address issues of Medicaid managed care and Medicaid funding. More than a fourth of SJB's service area residents are publicly insured compared to the state rate of 31%. As part of our ongoing advocacy efforts, individual meetings with Representative Charlie Meier and Senator Jason Plummer were also hosted at HSHS St. Joseph's Hospital Highland on April 26. The meeting provided a time for members of the Breese, Greenville and Highland Senior Leadership Team, along with System and Southern Illinois Division advocacy colleagues, to talk more in-depth about legislation affecting the local ministries. Senator Jason Plummer was newly elected, and the April 26th meeting also provided Senator Plummer an overview of the three hospitals' services. Five blood drives were held during the year at St. Joseph's Hospital. Sponsored by the Mississippi Valley Regional Blood Center, the drives are available to hospital colleagues and the community. Community Link offers comprehensive programming for individuals with development disabilities to build skills for daily living and enhance their quality of life. Individuals work one-on-one with Community Link staff on their personal goals and also participate in group activities. St. Joseph's Hospital was a presenting sponsor for Community Link's Buddy Walk, which is one of their main fundraisers that supports the organization's mission and initiatives. To ensure continued operation and availability of the Illinois Poison Control, St. Joseph's Hospital provided a stipend to cover their 2019 fair share. St. Joseph's Hospital was the host site for the Clinton County Emergency Preparedness and Medical Reserve Corps table-top drill. The drill simulating a pandemic influenza outbreak tested the county's preparedness to respond. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors who do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 600% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. The Hospital reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP). |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | HSHS St. Joseph's Hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | THE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 19 OF THE HSHS CONSOLIDATED AUDIT REPORT. PLEASE ALSO REFERENCE FOOTNOTE 2Q ON PAGE 14 FOR AN EXPLANATION OF HOW THE FINANCIALS ACCOUNT FOR BAD DEBT. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | HSHS St. Joseph's Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, St. Joseph's Hospital, Breese is relieving the burdens of the government. Accordingly, this shortfall restricts St. Joseph's Hospital's ability to make funds available to provide for charity care and other community benefits. The hospital Medicare shortfall at cost for fiscal year 2019 was $9,993,284. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care. |
| Schedule H, Part V, Section B, Line 16a FAP website | - ST. JOSEPH'S HOSPITAL: Line 16a URL: http://www.hshs.org/FAP; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - ST. JOSEPH'S HOSPITAL: Line 16b URL: http://www.hshs.org/FAP; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - ST. JOSEPH'S HOSPITAL: Line 16c URL: http://www.hshs.org/FAP; |
| Schedule H, Part VI, Line 2 Needs assessment | St. Joseph's Hospital is a leading member of the Clinton County Health Improvement Coalition. The Coalition consists of 30 individuals representing 20 agencies. Their meetings are held quarterly and the Steering Committee for the group also meets an additional four times during the year. During the meetings held, members provide an update on activities of their organization and the needs of those they serve. This provides the hospital with an ongoing assessment of the health needs in the community. In addition to representatives from public health, attendees include representatives of a local minority population. Meetings of the hospital's Patient Family Advisory Committee, Community Engagement Council, and HSHS St. Joseph's Hospital Foundation are held each quarter. Members are provided updates on the hospital's services and how the hospital is meeting the community's health needs. During the meeting, members are also provided an opportunity to provide feedback about any concerns heard from other community residents. Members of the Board of Directors and Foundation Leadership Council are asked for input throughout the year. In addition, hospital colleagues represent the hospital at various community group meetings, which provides a way to learn of any emerging needs and to offer support. Feedback is also obtained through ongoing patient surveys to patients receiving care on the inpatient unit, emergency department, surgical services and outpatient areas. Community members attending the eight local health fairs held throughout the year are also asked to complete a survey. The survey asks for their input about needs in the community. Individuals are also asked to identify what they consider to be the highest priority need. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The Registration Department provides brochures to patients upon registration regarding the Financial Assistance Program available to them at HSHS St. Joseph's Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. To better serve our patient population, HSHS St. Joseph's Hospital offers information on our financial assistance program in Spanish. This publication allows the hospital to serve populations in Clinton County and the surrounding area for whom Spanish is their primary language. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A third-party vendor also assists individuals in determining their eligibility for state health plans or insurance on the open health insurance marketplace. They can also assist with the application process. |
| Schedule H, Part VI, Line 4 Community information | St. Joseph's Hospital's service area is comprised of approximately 503 square miles with a population of approximately 37,760 residents and a population density of 75 people per square mile. The service area consists of the following cities and rural communities: Albers, Aviston, Bartelso, Beckemeyer, Breese, Carlyle, Centralia, Damiansville, Germantown, Hoffman, Huey, Keyesport, New Baden, and Trenton. St. Joseph's is the sole hospital provider in the county and does not exclude Medically Underserved Areas (MUAs), low income or minority populations from its service area. Based on the U.S. Census Bureau's information, the population of the entire county has held about the same over the past six years. The median age is 39 years of age with 15.7% of the population over the age of 65 compared to 13.5% over the age of 65 in the state of Illinois. Cultural diversity is increasing with slight growth seen in the Hispanic population. A higher proportion of the Clinton County population (11.8%) is disabled than the state (10.73%). Current unemployment rate is 4.5% (source - County Health Rankings 2018). Median household income has risen to $63,929, which is slightly above the median household income for Illinois at $59,588. Persons living below the federal poverty level are 8.87% of the population, an increase of 1%. The proportion of residents who are food insecure in Clinton County (9.4%) is lower than the state (12.9%), though the percent of the food insecure population ineligible for assistance (45%) is higher than the state rate of 32%. The percent of households receiving SNAP benefits in Clinton County (7.14%) is lower than the state rate (13.06%). Just over eleven percent of children in Clinton County live in poverty, while 38% are eligible for the free lunch program. Per the most recent US Census information, 4.5% of Clinton County residents under the age of 65 years old are without health insurance. Of those insured under 65 years of age, 28% are covered by public insurance. Clinton County is in an area designed as a shortage area for primary care health professionals (HPSA). This designation is made by the U.S. Department of Health & Human Services. The designation is also in place for mental health professionals. Rural populations can be disadvantaged regarding access to fresh and health food as well as physical activity locations leading to obesity and chronic health conditions. Nearly 30% of men in Clinton County were obese, notably higher than the state rate. The rate in women, 28.6%, was slightly below the state rate of 30.5%. A smaller proportion of adults in Clinton County consume five or more fruits and vegetables a day (12.8%) than the state (22.6%). The proportion of adults who report getting exercise (73.7%) is slightly lower than the state rate (75.2%). Just under two out of three of Clinton County residents (60%) had access to exercise opportunities, compared to 89% of residents statewide. The prevalence of high cholesterol in Clinton County (40.6%) has increased by nearly 8% since the 2007-2009 series of surveys, and is now higher than the state rate (36%). More Medicare beneficiaries in Clinton County have high cholesterol (47.36%) than the state rate for Medicare beneficiaries (46.19%), while for hypertension, both the county and state rate for Medicare beneficiaries is 56.4%. In general, Clinton County (9.76%) has a similar prevalence of diabetes to the state (9.71%), though the rate for Clinton County is increasing at a higher pace. Specific programs to raise awareness about obesity and healthy living will benefit the population with a focus on improving overall health. In addition, an individual's physical environment can contribute to or deter healthy behavior. The percentage of Clinton County residents who report heavy drinking is 16%, compared to a state rate of 9.9%. The percentage of Clinton County residents who report binge drinking is 31%, compared to 22.4% for the state. Over a third (36%) of Clinton County eighth graders had used alcohol, cigarettes, inhalants or marijuana in the past year, compared to the state rate of 27%. Secondary data in the CHNA indicated there is a much higher density of bars and drinking establishments in Clinton County (74.1 per 100,000) than the state density (20.6 per 100,000). The rate of establishments that provide accommodations or food service in Clinton County is 224.1 per 100,000; this compares to 201.75 per 100,000 in the state. There are 134.97 video gaming establishments per 100,000 in Clinton County compared to 69.51 per 100,000 for the state of Illinois. The smoking rate in Clinton County is 17.79%, higher than the state rate of 13.68%. Both men (18.7%) and women (16.92%) of Clinton County smoke at a higher rate than the state rate for males and females (14.89% and 12.52% respectively). The rate of infants born to mothers who smoke was 227.4 per 100,000 compared to the statewide rate of 89.9 per 100,000. |
| Schedule H, Part VI, Line 5 Promotion of community health | As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), St. Joseph's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1897, the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Breese and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that St. Joseph's Hospital is responding to community need. In FY2019, for example, reports are provided to Board members throughout the year to update them on community health initiatives as well as an annual report. This provides them an opportunity to give input and directional guidance. In addition, St. Joseph's Hospital receives community support and guidance through the Patient Family Advisory Council, Community Engagement Council, and HSHS St. Joseph's Foundation Leadership Council. The Family Advisory Council and Community Engagement Council meeting quarterly, while the Foundation Leadership Council meetings every other month. These groups provide feedback from the community on additional services or improvements needed, as well as helps the hospital understand the community's perception of those services and identify potentials opportunities for improvement. St. Joseph's Hospital is blessed with a strong volunteer program. Volunteers are active in many hospital departments daily and donate many more hours throughout the year to hospital-sponsored community programs. Consistent with its exempt purpose, St. Joseph's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Joseph's Hospital reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Joseph's Hospital reinvested surplus funds in FY2019 to convert a no longer utilized 14-bed hospital wing into an outpatient medical office. A team of three general surgeons now provide clinical services in the renovated area. With this change, a building expansion can be completed in the primary care medical office during FY2020 to provide space for additional family medicine physicians and nurse practitioners. Information technology equipment was upgraded to support a new electronic medical record, Epic. St. Joseph's Hospital is a clinical training site for nurses and medical imaging students from Kaskaskia College. St. Joseph's Hospital also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2019, St. Joseph's Hospital provided more than $5.1 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2019, St. Joseph's Hospital provided $852,258 (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than $10 million (at cost) in excess of Medicare payment for health care services. St. Joseph's Hospital provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by St. Joseph's Hospital and they often relieve a burden that would otherwise be carried by government. |
| Schedule H, Part VI, Line 6 Affiliated health care system | Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 16 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. In FY2019, HSHS collectively provided $211.7 million in Community Benefit (9.2% of total hospital expenses). This amount included $27.7 million provided for Financial Assistance (a.k.a. Charity Care) and $142.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $279.9 million. HSHS hospitals also recorded $41.1 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMY M BALLANCE | ||||||||||||||
| Interim CEO (partial year)/Division VP of Strategy | $0 | $232,394 | $0 | $0 | $0 | $3,211 | $0 | $40,467 | $0 | $22,076 | $0 | $298,148 | $0 | $0 |
| CHRIS KLAY | ||||||||||||||
| PRESIDENT & CEO | $0 | $230,806 | $0 | $19,445 | $0 | $10,952 | $0 | $58,746 | $0 | $25,460 | $0 | $345,409 | $0 | $0 |
| DAVID BEACH | ||||||||||||||
| BOARD MEMBER | $0 | $381,102 | $0 | $9,042 | $0 | $34,471 | $0 | $56,956 | $0 | $28,565 | $0 | $510,136 | $0 | $0 |
| JENE BIERI | ||||||||||||||
| DIRECTOR OF PROF. SERVICES | $90,651 | $99,566 | $0 | $0 | $709 | $0 | $0 | $0 | $1,800 | $6,453 | $93,160 | $106,019 | $0 | $0 |
| ANN M CARR | ||||||||||||||
| TREASURER | $0 | $268,272 | $0 | $4,360 | $0 | $57,197 | $0 | $89,873 | $0 | $20,590 | $0 | $440,292 | $0 | $28,431 |
| JAMES DOVER | ||||||||||||||
| CEO SOUTHERN IL DIV - Thru June 2019 | $0 | $590,693 | $0 | $19,406 | $0 | $17,364 | $0 | $87,150 | $0 | $38,320 | $0 | $752,933 | $0 | $0 |
| HELEN ESSENPREIS | ||||||||||||||
| CNO | $152,854 | $0 | $6,983 | $0 | $315 | $0 | $62,963 | $0 | $6,732 | $0 | $229,847 | $0 | $0 | $0 |
| JACQUELYNNE N HOLST | ||||||||||||||
| DIVISION ASSOCIATE GENERAL COUNSEL | $0 | $196,187 | $0 | $0 | $0 | $2,716 | $0 | $17,813 | $0 | $26,785 | $0 | $243,501 | $0 | $0 |
| MARGARET A LUNA | ||||||||||||||
| DIVISION CPO | $0 | $258,410 | $0 | $0 | $0 | $3,365 | $0 | $62,379 | $0 | $17,030 | $0 | $341,184 | $0 | $0 |
| DAVID NOSACKA | ||||||||||||||
| CFO Southern IL Division | $0 | $347,932 | $0 | $0 | $0 | $10,521 | $0 | $28,146 | $0 | $23,865 | $0 | $410,464 | $0 | $0 |
| JOHN JEFFRIES | ||||||||||||||
| DIRECTOR OF FINANCE | $162,934 | $0 | $9,248 | $0 | $5,698 | $0 | $19,272 | $0 | $21,231 | $0 | $218,383 | $0 | $0 | $0 |
| Barbara Eilers | ||||||||||||||
| Nurse Supervisor | $109,524 | $0 | $1,886 | $0 | $0 | $0 | $39,518 | $0 | $13,763 | $0 | $164,691 | $0 | $0 | $0 |
| EILEEN HAGEN | ||||||||||||||
| Nurse Supervisor | $103,954 | $0 | $2,412 | $0 | $0 | $0 | $44,661 | $0 | $955 | $0 | $151,982 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Tax indemnification and gross-up payments | A TAX GROSS-UP WAS PAID TO VARIOUS INDIVIDUALS DURING THE YEAR IN THE AMOUNT OF $50 OR LESS. THE FAIR VALUE WAS INCLUDED IN THEIR ANNUAL TAXABLE INCOME. |
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). DAVID BEACH -- $50,003 ANN CARR -- $29,653 JAMES DOVER -- $80,581 Chris Klay -- $25,513 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2018 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $28,431 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS | ST. JOSEPH'S HOSPITAL, BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS PROVIDES QUALITY HEALTH CARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS ESSENTIAL TO THE CONTINUED OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS ARE ABLE TO AFFORD REQUIRED MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH THE BEST QUALITY HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. INHERENT IN OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF COMMUNITY SUPPORT ACTIVITIES. IN OUR TAX YEAR BEGINNING JULY 1, 2018 AND ENDING JUNE 30, 2019, ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 1,502 INPATIENTS UTILIZING 4,177 DAYS OF CARE. IN ADDITION, ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 86,698 OUTPATIENTS. ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO THE POOR AT NO COST THROUGH OUR CHRISTIAN CARE PROGRAM. IN ADDITION, THE HOSPITAL PARTICIPATES IN THE ILLINOIS MEDICAID PROGRAM, WHICH REIMBURSES THE HOSPITAL AT RATES SUBSTANTIALLY BELOW THE COST OF PROVIDING THE SERVICES. FULFILLING OUR MISSION TO THE COMMUNITY, SERVICES WERE PROVIDED TO 314 MEDICAID INPATIENTS UTILIZING 759 DAYS OF CARE. THE COST OF PROVIDING SERVICES TO MEDICAID PATIENTS EXCEEDED REIMBURSEMENT UNDER THE STATE OF ILLINOIS MEDICAID PROGRAM BY $2,968,323. THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THE POOR IS $3,820,581. ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO MEMBERS OF THE BROADER COMMUNITY THROUGH PARTICIPATION IN THE MEDICARE PROGRAM AND THROUGH EDUCATIONAL PROGRAMS AND ACTIVITIES AT A REDUCED PRICE, OR AT NO COST. ST. JOSEPH'S HOSPITAL, BREESE PROVIDED MEDICAL SERVICES TO 599 MEDICARE INPATIENTS UTILIZING 1,907 DAYS OF CARE. |
| Form 990, Part IV, Line 24a TAX EXEMPT BONDS | ST JOSEPH'S HOSPITAL, BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. |
| Form 990, Part IV, Line 10 ENDOWMENT FUNDS | THE ORGANIZATION MAINTAINS TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS ON ITS BALANCE SHEET. SUCH FUNDS ARE HELD BY HOSPITAL SISTERS OF ST. FRANCIS FOUNDATION, INC., A RELATED TAX-EXEMPT ORGANIZATION. WHILE THESE FUNDS ARE HELD TO FURTHER ONE OR MORE EXEMPT PURPOSES OF THE FILING ORGANIZATION, THEY ARE NOT MAINTAINED EXCLUSIVELY FOR THE FILING ORGANIZATION. THE BOARD OF DIRECTORS OF HOSPITAL SISTERS OF ST. FRANCIS FOUNDATION, INC. MAINTAINS OWNERSHIP AND ULTIMATELY AUTHORITY AND DISCRETION OVER THE USE OF THESE FUNDS. BASED ON THE ABOVE, THE RELATED AMOUNTS HAVE NOT BEEN REPORTED AS ENDOWMENT FUNDS ON PART V OF SCHEDULE D. |
| Form 990, Part V, Line 1a NUMBER REPORTED IN BOX 3 OF FORM 1096 | THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498, AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS, ON THEIR BEHALF. HOWEVER, AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE. |
| Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| Form 990, Part VI, Line 1a COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF GOVERNING BODY | PER ARTICLE 5.5 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH AND MAY IN ITS DISCRETION EXERCISE THE FULL POWERS, DUTIES, RESPONSIBILITIES, AND AUTHORITY OF THE BOARD EXCEPT WHERE PROHIBITED BY LAW AND SUBJECT TO ANY LIMITATIONS IMPOSED BY THE BYLAWS OR THE BOARD OF DIRECTORS. AS PROVIDED IN THE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF THREE TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD. |
| Form 990, Part VI, Line 16b JOINT VENTURES | HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. JOHN'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES SACRED HEART HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD SACRED HEART HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE SOLE CORPORATE MEMBER OF ST. JOSEPH'S HOSPITAL BREESE (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. JOSEPH'S HOSPITAL BREESE (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER. (H) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (I)APPROVE THE STRATEGIC PLAN AND ANNUAL GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND SYSTEM CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN USED SINCE JANUARY, 2010 TO ESTABLISH THE PRACTICE OF MANAGING CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS, AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE, AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL HSHS EXECUTIVES, (the top management official, other officers and key employees). INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES (derived from a full market review conducted every other year) TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. The process for reviewing compensation by the compensation committee is completed each fiscal year. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A. |
| Form 990, Part VI, Line 19 Required documents available to the public | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT | ST. JOSEPH'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Change in fair value of interest rate swap - -1499296; Swap Payments - -276599; Changes to Temporarily Restricted Net Assets - -90283; Changes to Permanently Restricted Net Assets - 500; Transfer to/from affiliates - -1060485; Pension-related changes other than net periodic pension costs - -3214988; |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| KIARA CLINICAL INTEGRATION NETWORK LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 261417684 | HEALTHCARE | IL | -$1,945,270 | $3,230,896 | HSSI |
| PHYSICIAN CLINICAL INTEGRATION NETWORK LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371668647 | HEALTHCARE | IL | $563,783 | $11,970,191 | KCIN |
| HSHS ACO LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 320465666 | HEALTHCARE & SOCIAL ASSISTANCE | IL | -$381,285 | $458,242 | KCIN |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL SISTERS HEALTH SYSTEM | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371058692 | HEALTHCARE | IL | 501(c)(3) | Type III-FI | NA | false |
| HOSPITAL SISTERS OF ST FRANCIS FOUNDATION | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(c)(3) | 7 | HSHS | Yes (true) |
| HOSPITAL SISTERS HEALTHCARE WEST INC | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | WI | 501(c)(3) | Type I | HSSI | Yes (true) |
| SACRED HEART HOSPITAL | ||||||||||
| 990 WEST CLAIREMONT AVENUE | EAU CLAIRE | WI | 54701 | 390807060 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST ANTHONY'S HOSPITAL | ||||||||||
| 503 N MAPLE STREET | EFFINGHAM | IL | 62401 | 370661233 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST ELIZABETH'S HOSPITAL | ||||||||||
| ONE ST ELIZABETHS BLVD | OFALLON | IL | 62269 | 370663567 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST NICHOLAS HOSPITAL | ||||||||||
| 3100 SUPERIOR AVENUE | SHEBOYGAN | WI | 53081 | 390808480 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST JOHN'S HOSPITAL | ||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 370661238 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 390810545 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST MARY'S HOSPITAL | ||||||||||
| 1800 E LAKE SHORE DRIVE | DECATUR | IL | 62521 | 370661244 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST MARY'S HOSPITAL | ||||||||||
| 111 SPRING STREET | STREATOR | IL | 61364 | 362169181 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST MARY'S MEDICAL CENTER | ||||||||||
| 1762 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST VINCENT HOSPITAL | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 51301 | 390817529 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 12866 TROXLER AVENUE | HIGHLAND | IL | 62249 | 370663568 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| ST FRANCIS HOSPITAL | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| HOSPITAL SISTERS SERVICES INC | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163402 | HEALTHCARE | IL | 501(c)(3) | Type III-FI | HSHS | Yes (true) |
| HSHS MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 263956318 | HEALTHCARE | IL | 501(c)(3) | Type III-FI | HSSI | Yes (true) |
| HSHS WISCONSIN MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 264515959 | HEALTHCARE | WI | 501(c)(3) | Type III-FI | HSSI | Yes (true) |
| ORANGE CROSS AMBULANCE INC | ||||||||||
| 919 ASHLAND AVENUE | SHEBOYGAN | WI | 53081 | 391860942 | HEALTHCARE | WI | 501(c)(3) | 10 | ST NICHOLAS | Yes (true) |
| UNITY LIMITED PARTNERSHIP | ||||||||||
| 2366 OAK RIDGE CIRCLE | DE PERE | WI | 54115 | 391750729 | HEALTHCARE | WI | 501(c)(3) | 10 | HSSI | Yes (true) |
| PRAIRIE EDUCATION & RESEARCH COOPERATIVE | ||||||||||
| 317 NORTH 5TH STREET | SPRINGFIELD | IL | 62701 | 371157915 | HEALTHCARE | IL | 501(c)(3) | 4 | HSSI | Yes (true) |
| ST CLARE MEMORIAL HOSPITAL | ||||||||||
| 855 S MAIN STREET | OCONTO FALLS | WI | 54154 | 390848401 | HEALTHCARE | WI | 501(c)(3) | 3 | HSSI | Yes (true) |
| HSHS HOLY FAMILY HOSPITAL | ||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 370792770 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| UTLAUT MEMORIAL FOUNDATION | ||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 371140166 | FUNDRAISING | IL | 501(c)(3) | Type II | HSSI | Yes (true) |
| HSHS GOOD SHEPHERD HOSPITAL INC | ||||||||||
| 200 SOUTH CEDAR STREET | SHELBYVILLE | IL | 62565 | 370512290 | HEALTHCARE | IL | 501(c)(3) | 3 | HSSI | Yes (true) |
| SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST | ||||||||||
| 200 SOUTH CEDAR STREET | SHELBYVILLE | IL | 62565 | 371778753 | TRUST | IL | 501(a) | GSS | Yes (true) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAIN CENTER OF WISCONSIN | ||||||||||||||
| 4131 W LOOMIS ROAD | SUITE 300 | GREENFIELD | WI | 53221 | 263155343 | HEALTHCARE | WI | ST VINCENT | Related | $742,948 | $556,009 | false | false | 0.5 |
| PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC | ||||||||||||||
| 4131 W LOOMIS ROAD | SUITE 300 | GREENFIELD | WI | 53221 | 364717036 | HEALTHCARE | WI | ST CLARE | Related | $26,375 | $142,266 | false | false | 0.5 |
| CARPENTER STREET HOTEL LLC | ||||||||||||||
| 525 NORTH SIXTH STREET | SPRINGFIELD | IL | 62702 | 364128127 | HOTEL | IL | LASANTE INC | N/A | 0 | |||||
| SPRINGFIELD URGENT CARE REAL ESTATE LLC | ||||||||||||||
| PO BOX 19456 | SPRINGFIELD | IL | 627949456 | 030413258 | RENTAL REAL ESTATE | IL | LASANTE INC | N/A | 0 | |||||
| PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC | ||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 261479945 | MEDICAL | IL | HSHS | Related | -$6,697 | $9,753 | false | Yes (true) | 1 | |
| SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP | ||||||||||||||
| 4000 NORTH ILLINOIS STREET | SWANSEA | IL | 62226 | 823633320 | REAL ESTATE | IL | ST ELIZABETH'S | Related | $337,078 | $1,174,120 | false | false | 0.5 | |
| PRAIRIE HEART INSTITUTE ST JOHN'S | ||||||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 371321197 | HEALTHCARE | IL | HSHS | Related | $0 | $0 | false | false | 1 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KIARA INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163401 | HEALTHCARE | IL | HSHS | C Corporation | -$42,394,446 | $28,694,534 | 1 | Yes (true) | |||||
| LASANTE WISCONSIN INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 391572196 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| LASANTE INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163400 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| PRAIRIE CARDIOVASCULAR | |||||||||||||||||
| 619 EAST MASON SUITE 4P57 | SPRINGFIELD | IL | 62701 | 371071858 | HEALTHCARE | IL | KIARA INC | C Corporation | Yes (true) | ||||||||
| PREVEA HEALTH SERVICES INC | |||||||||||||||||
| 2710 EXECUTIVE DRIVE | GREEN BAY | WI | 54304 | 391839351 | HEALTHCARE | WI | HSSI | C Corporation | -$830,459 | $45,532,956 | 0.5 | Yes (true) | |||||
| PREVEA CLINIC INC | |||||||||||||||||
| 2710 EXECUTVE DRIVE | GREEN BAY | WI | 54304 | 391839349 | HEALTHCARE | WI | PHSI | C Corporation | Yes (true) | ||||||||
| RENAISSANCE QUALITY INSURANCE LTD | |||||||||||||||||
| 980669953 | self-INSURANCE | HSSI | C Corporation | $0 | $136,781,581 | 1 | Yes (true) | PO BOX 1159 | GRAND CAYMAN | CJ | KY11102 | CJ | |||||
| OJV INC | |||||||||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 460873384 | HEALTHCARE | IL | LASANTE INC | C Corporation | Yes (true) | ||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ENTITIES | FormAndLineReferenceDesc |
| Explanation | ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION. | ExplanationTxt |
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