RICHLAND MEMORIAL HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- RICHLAND MEMORIAL HOSPITAL INC (EIN 37-1363001)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-16
- IRS object ID
- 202023219349311447
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-16T13:20:05-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4000 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371363001 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICHLAND MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DENNIS HESCH | InCareOfNm |
| Business Name Control | RICH | BusinessNameControlTxt |
| Phone | 6183952131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 East Locust Street | AddressLine1Txt |
| City | Olney | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62450 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS HESCH | PersonNm |
| Person Title | Director of Business | PersonTitleTxt |
| Phone | 6183952131 | PhoneNum |
| Signature | 2020-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENNIFER D RHODERICK | PreparerPersonNm |
| PTIN | P00395735 | PTIN |
| Phone | 3176817000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.136.161.74 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 35057220203215000033 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-11-16 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8A643FFA55DAADCC2D7DB737B1A92A286D034D88 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 34163F381DEDE5EE0CABDD6E8F3BD042227F3C04 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Christina Bare | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 East Locust Street | AddressLine1Txt |
| City | Olney | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $55,890,164 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.richlandmemorial.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | To provide excellent healthcare, promote wellness, and educate patients, staff, and the community. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 695 | TotalEmployeeCnt |
| Total Volunteers | 77 | TotalVolunteersCnt |
| Total Gross UBI | $153,140 | TotalGrossUBIAmt |
| PY Contributions Grants | $25,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $25,000 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,984,712 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $54,499,558 | CYProgramServiceRevenueAmt |
| PY Investment Income | $385,742 | PYInvestmentIncomeAmt |
| CY Investment Income | $78,830 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,413,630 | PYOtherRevenueAmt |
| CY Other Revenue | $918,823 | CYOtherRevenueAmt |
| PY Total Revenue | $52,809,084 | PYTotalRevenueAmt |
| CY Total Revenue | $55,522,211 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $45,584 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,230,505 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $38,718,242 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,332,726 | PYOtherExpensesAmt |
| CY Other Expenses | $27,450,692 | CYOtherExpensesAmt |
| PY Total Expenses | $59,563,231 | PYTotalExpensesAmt |
| CY Total Expenses | $66,214,518 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,754,147 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,692,307 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $33,259,131 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,782,143 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,111,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,945,001 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,147,893 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,837,142 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $52,279,676 | ExpenseAmt |
| Grant | $45,584 | GrantAmt |
| Revenue | $54,932,012 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $52,279,676 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| 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 | Yes (true) | 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 | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 47 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 695 | 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 | false | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS HESCH | PersonNm |
| Phone | 2173833311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 W PARK ST | AddressLine1Txt |
| City | URBANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOHN SNYDER | |||||||||
| TRUSTEE, EX VP & COO THRU 6/19 | 2.0 | 18.0 | Yes (X) | $0 | $2,476,327 | $2,177,803 | |||
| JARROD ALMAROAD MD | |||||||||
| TRUSTEE & PHYSICIAN(THRU 9/19) | 1.0 | 39.0 | Yes (X) | $0 | $811,688 | $46,210 | |||
| MATTHEW KOLB | |||||||||
| TRUSTEE & COO (Start 06/19) | 5.0 | 35.0 | Yes (X) | $0 | $703,948 | $129,541 | Yes (X) | ||
| LAUREN SCHMID | |||||||||
| EXEC VP, CHIEF HR OFFICER | 2.0 | 38.0 | $0 | $430,309 | $98,880 | Yes (X) | |||
| PRASHANTH ANAND MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $472,659 | $0 | $41,007 | Yes (X) | |||
| HARRY BROCKUS | |||||||||
| CEO | 36.0 | 4.0 | $400,330 | $0 | $99,514 | Yes (X) | |||
| SALLY SALMONS MD | |||||||||
| TRUSTEE & PHYSICIAN Start 9/19 | 2.0 | 38.0 | Yes (X) | $0 | $405,652 | $77,564 | |||
| H TIMOTHY GARRETT DO | |||||||||
| TRUSTEE & PHYSICIAN | 3.0 | 37.0 | Yes (X) | $384,692 | $0 | $51,497 | |||
| MARY WALLER MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $378,949 | $0 | $29,326 | Yes (X) | |||
| NIRANAT DEJTIRANUKUL | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $364,980 | $0 | $37,154 | Yes (X) | |||
| Paul Sutherland MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $347,354 | $0 | $45,507 | Yes (X) | |||
| STEPHEN REID MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $351,902 | $0 | $40,264 | Yes (X) | |||
| Regina Thomas | |||||||||
| CNO & DIR PATIENT CARE SVS | 40.0 | 0.0 | $208,434 | $0 | $21,560 | Yes (X) | |||
| CHRISTINA BARE | |||||||||
| DIRECTOR OF BUSINESS OPS | 40.0 | 0.0 | $150,711 | $0 | $17,560 | Yes (X) | |||
| CAROL SCHAFER | |||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DAN EICHELBERGER | |||||||||
| CHAIR OF THE BOARD | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Gary Houchin | |||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JASON GLOVER | |||||||||
| SECRETARY/ TREASURER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Jennifer Cummins-Zuber | |||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROB MCCLAIN | |||||||||
| VICE CHAIR OF BOARD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| TOMMIE FEHRENBACHER | |||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| PATRICIA KESSLER-BOOKH | |||||||||
| TRUSTEE (Start 09/19) | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT ANNIS | |||||||||
| TRUSTEE (THRU 09/19) | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,060,011 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,827,924 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,913,387 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 |
|---|---|---|---|---|---|
| CARLE PHYSICIAN GROUP | |||||
| 611 WEST PARK | URBANA | IL | 61801 | ER & HOSP PROVIDERS | $2,998,277 |
| The Carle Foundation Hospital | |||||
| 611 WEST PARK | URBANA | IL | 61801 | MANAGEMENT SERVICES | $2,565,671 |
| SODEXHO | |||||
| 4880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | FOOD SERVICES | $900,202 |
| THE CARLE FOUNDATION | |||||
| 611 WEST PARK | URBANA | IL | 61801 | MANAGEMENT SERVICES | $694,583 |
| QUORUM HEALTH RESOURCES | |||||
| 1573 MALLORY LANE 200 | BRENTWOOD | TN | 37027 | CONSULTING SERVICES | $657,005 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $25,000 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $25,000 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $54,499,558 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,499,558 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $54,499,558 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,263 | TotalRevenueColumnAmt |
| Exclusion | $79,263 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $367,520 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $367,953 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$433 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$433 | TotalRevenueColumnAmt |
| Exclusion | -$433 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| AMBULANCE REVENUE FROM PROPERTY TAX | 900099 | $275,403 | $275,403 | ||
| CAFETERIA SERVICES | 722331 | $219,335 | $219,335 | ||
| LAUNDRY SERVICES | 812331 | $127,000 | $127,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $297,085 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $157,051 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $26,140 | UnrelatedBusinessRevenueAmt |
| Exclusion | $113,894 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $918,823 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,522,211 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,932,012 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $153,140 | UnrelatedBusinessRevenueAmt |
| Exclusion | $412,059 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,584 | TotalAmt |
| Program Services | $30,584 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Program Services | $15,000 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,383,849 | TotalAmt |
| Program Services | $1,126,904 | ProgramServicesAmt |
| Management And General | $256,945 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,303 | TotalAmt |
| Program Services | $184,149 | ProgramServicesAmt |
| Management And General | $65,154 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,928,853 | TotalAmt |
| Program Services | $22,018,400 | ProgramServicesAmt |
| Management And General | $4,910,453 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,117,286 | TotalAmt |
| Program Services | $924,399 | ProgramServicesAmt |
| Management And General | $192,887 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,174,013 | TotalAmt |
| Program Services | $5,873,513 | ProgramServicesAmt |
| Management And General | $1,300,500 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,864,938 | TotalAmt |
| Program Services | $1,523,227 | ProgramServicesAmt |
| Management And General | $341,711 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,129 | TotalAmt |
| Management And General | $140,129 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,588 | TotalAmt |
| Management And General | $54,588 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,973 | TotalAmt |
| Management And General | $14,973 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,426,401 | TotalAmt |
| Program Services | $2,069,608 | ProgramServicesAmt |
| Management And General | $356,793 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,115 | TotalAmt |
| Management And General | $362,115 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,495,709 | TotalAmt |
| Program Services | $3,800,249 | ProgramServicesAmt |
| Management And General | $695,460 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,786 | TotalAmt |
| Program Services | $372,487 | ProgramServicesAmt |
| Management And General | $55,299 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,083,613 | TotalAmt |
| Program Services | $842,275 | ProgramServicesAmt |
| Management And General | $241,338 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,954 | TotalAmt |
| Program Services | $207,734 | ProgramServicesAmt |
| Management And General | $134,220 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,727 | TotalAmt |
| Program Services | $144,184 | ProgramServicesAmt |
| Management And General | $59,543 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,984 | TotalAmt |
| Program Services | $204,114 | ProgramServicesAmt |
| Management And General | $54,870 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,485,577 | TotalAmt |
| Program Services | $1,757,102 | ProgramServicesAmt |
| Management And General | $728,475 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,090,161 | TotalAmt |
| Program Services | $1,000,833 | ProgramServicesAmt |
| Management And General | $89,328 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER PURCHASED SERVICES | $4,936,639 | $1,858,731 | $3,077,908 |
| PATIENT CARE SUPPLIES | $3,257,205 | $3,257,205 | $0 |
| INTERNAL PURCHASED SERVS | $3,437,221 | $2,860,520 | $576,701 |
| PROVIDER ASSESSMENT TAX | $2,205,551 | $2,205,551 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,359 | TotalAmt |
| Program Services | $2,907 | ProgramServicesAmt |
| Management And General | $225,452 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,214,518 | TotalAmt |
| Program Services | $52,279,676 | ProgramServicesAmt |
| Management And General | $13,934,842 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,742,281 | BOYAmt |
| EOY | $1,317,147 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,708,982 | BOYAmt |
| EOY | $7,303,754 | 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) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,130,170 | BOYAmt |
| EOY | $1,103,347 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,221 | BOYAmt |
| EOY | $873,309 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,799 | BOYAmt |
| EOY | $446,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,747,337 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,693,158 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,218,870 | BOYAmt |
| EOY | $18,054,179 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,900,579 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,039,229 | BOYAmt |
| EOY | $683,485 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,259,131 | BOYAmt |
| EOY | $29,782,143 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,866,146 | BOYAmt |
| EOY | $9,019,392 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,025,709 | BOYAmt |
| EOY | $5,696,073 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,219,383 | BOYAmt |
| EOY | $7,229,536 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,111,238 | BOYAmt |
| EOY | $21,945,001 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,754,145 | BOYAmt |
| EOY | $7,425,293 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,748 | BOYAmt |
| EOY | $411,849 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,147,893 | BOYAmt |
| EOY | $7,837,142 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,259,131 | BOYAmt |
| EOY | $29,782,143 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$10,692,307 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $363,454 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $18,102 | 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| 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 | $14,973 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $14,973 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART IV | FormAndLineReferenceDesc |
| Explanation | $14,973 PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,005,119 | OtherCostOrOtherBasisAmt |
| Book Value | $1,005,119 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,532,724 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,714,279 | DepreciationAmt |
| Book Value | $9,818,445 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $487,119 | OtherCostOrOtherBasisAmt |
| Depreciation | $411,909 | DepreciationAmt |
| Book Value | $75,210 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,722,375 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,566,970 | DepreciationAmt |
| Book Value | $7,155,405 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,054,179 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLES | $815,085 |
| DUE TO BLUE CROSS | $1,650,217 |
| OPERATING LEASE LIABILITY | $68,101 |
| RMH - SAVINGS ACCOUNT | $1,739,453 |
| ASSET RETIREMENT OBLIGATION | $2,956,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,229,536 | 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(ASC740) FOOTNOTE | FormAndLineReferenceDesc |
| Explanation | THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2019 AND 2018. | 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 |
| Percent300 | Yes (X) | Percent300Ind |
| 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 | $1,421,201 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,421,201 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,434,064 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,907,431 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,526,633 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12880 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,855,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,907,431 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,947,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $133,348 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $133,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,220 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,618,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,112,311 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,505,958 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05290 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,145 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $91,145 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,844,982 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,112,311 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,732,671 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05630 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,700,247 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,019,742 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,680,505 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20660 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,038 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,038 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $797 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $797 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,206 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,206 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $544 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $544 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,585 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,585 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,258,481 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $629,241 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,506,499 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,099,619 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$16,593,120 | 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 | Richland Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 East locust | AddressLine1Txt |
| City | Olney | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62450 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CARLERMH.COM | WebsiteAddressTxt |
| State License | 0004788 | 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 | RICHLAND MEMORIAL 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | 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. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| 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 | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, RICHLAND MEMORIAL HOSPITAL, PART V, LINE 3E | The needs identified and prioritized throughout the 2018 CHNA carried forward variants of previous CHNAs and added others. The identified and prioritized needs selected include: 1) Access to mental health services 2) Access to dental care for youth and adults 3) Improved access to prevention, treatment, and recovery resources for substance abuse for youth and adults. 4) Access to case managers 5) Transportation 6) After hour and weekend access to care FACILITY 1, RICHLAND MEMORIAL HOSPITAL - PART V, SECTION B, LINE 5 Provisions in the Affordable Care Act (ACA) require charitable hospitals to conduct a community health needs assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. Richland Memorial Hospital, Inc. (RMH) conducted its first CHNA in 2013 and second in 2016. The 2018 CHNA was conducted in June, July, and august of 2018. This community health needs assessment and implementation plan of RMH was approved by the board of trustees on the 13th day of October, 2018. RMH led the planning, implementation, and completion of the community health needs assessment through a consulting arrangement with the Illinois critical access hospital network. Terry Madsen, an ICAHN consultant, attorney, and former educator and community development specialist, met with hospital executive staff to define the community, scope of the project, and special needs and concerns. An internal working group, possible local sources for secondary data and key external contacts were identified, and a timeline was established. For the 2018 CHNA, qualitative data was reviewed to help validate the selection of health priorities. In alignment with IRS treasury notice 2011-52,2 and the subsequent final rules reported at 79 FR 78953, the qualitative/primary data received and reviewed included primary input from (1) at least one state, local, tribal, or regional governmental public health department (or equivalent department or agency) with knowledge, information, or expertise relevant to the health needs of the community and, (2) members of medically underserved, low-income, and minority populations in the community, or individuals or organizations serving or representing the interests of such populations. Data was also gathered representing the broad interests of the community. The hospital took into account input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge of, or expertise in public health (local, regional, state and/or tribal). Members of medically underserved, low-income, and minority populations served by the hospital or individuals or organizations representing the interests of such populations also provided input. The medically underserved are members of a population who experience health disparities, are at risk of not receiving adequate medical care as a result of being uninsured or underinsured, and/or experiencing barriers to health care due to geographic, language, financial or other barriers. Members of the CHNA steering committee, those who both participated in focus groups and the needs identification and prioritization process, were chosen based on their unique expertise and experience, informed perspectives and involvement with the community. The organizations and persons that participated are: NAPOLEON KNIGHT, MD EMERGENCY MEDICAL DIRECTOR, CARLE FELICIA NOHREN RICHLAND COUNTY SHERIFF DEPARTMENT SARA BUEHNERKEMPER RICHLAND COUNTY ADDICTIONS PREVENTION COALITION ANDI PAMPE OLNEY CENTRAL COLLEGE SHERRY SLANKARD RICHLAND COUNTY SCHOOL DISTRICT, SOCIAL SERVICES TIM LOOMIS RICHLAND COUNTY MINISTERIAL ASSOCIATION SYLVIA LANCASTER EMBARRASS RIVER BASIN AGENCY PAT STALEY EMBARRASS RIVER BASIN AGENCY LINDA BOOKWALTER - STOPPING WOMEN ABUSE NOW (SWAN) LISA TOTTEN - DEPARTMENT OF HUMAN SERVICES DEANNA MITCHELL - RICHLAND COUNTY HOUSING AUTHORITY DEBORAH LAMB - RICHLAND COUNTY TB & HEALTH OFFICE LEEANN HYDER - CRAWFORD COUNTY HEALTH DEPARTMENT BRENT TODD - LINCOLN TRAIL COLLEGE KENDRA GROUNDS - WABASH COUNTY HEALTH DEPARTMENT MELISSA SEMPLE - JASPER COUNTY SCHOOL DISTRICT ANDREW JOHNSON - JASPER COUNTY SCHOOL DISTRICT JEANNIE JOHNSON - JASPER COUNTY HEALTH DEPARTMENT WILLARD ANDERSON - THE MASTERS HANDS AMY MARLEY - LAWRENCE COUNTY HEALTH DEPARTMENT KAYCEE MILLER - RIDES MASS TRANSIT DISTRICT DANA HAGERSTROM - CARLE HEALTH SYSTEM JENNIFER HENDRICKS-KAUFMANN - CARLE HEALTH SYSTEM TARA LEMKE RICHLAND MEMORIAL HOSPITAL, INC. ERIC TOLIVER - RICHLAND MEMORIAL HOSPITAL, INC. DEBORAH RIDDLE - JASPER COUNTY HEALTH DEPARTMENT HOLLY OBRIEN - HOME HEALTH/HOSPICE OF SE IL PART V, SECTION C, LINES 7B The CHNA and implementation strategy are available at https://www.carle.org/chna |
| PART V, SECTION C, LINE 11 | The first CHNA was conducted in 2013 and identified three significant needs: - Mental health and related services -Access to health services health providers, health department -Chronic disease The second CHNA was conducted in 2016 and identified: -Behavioral health -Increasing access to healthcare services -Chronic disease Behavioral health has been considered a major need in the hospitals service area. Until 2017, RMH had an inpatient psychiatric unit, but due to lack of a psychiatrist, it had to be closed. Since then, the hospital has been working on finding outpatient psychiatric providers. In 2018, RMH hired a psychiatric nurse practitioner (PNP). In 2019, RMH hired an additional psychiatric nurse practitioner (PNP) to continue its commitment to the field. The hospital is currently recruiting more PNPs and anticipates adjusting space meant for mental health services in 2020 to a 'private suite' model in order to focus on safety and security of patients. In 2019, RMH also began offering mental health first aid programs to local businesses and organizations. To address the need for improved access to healthcare services, the RMH opened the Newton Clinic in Jasper County in 2013. When it opened, it employed a family nurse practitioner (FNP), a nurse practitioner (NP), a womens health NP, and over the last few years, has added a pediatric NP, general surgery consults, and orthopedic consults. In 2019, the newton clinic provided family practice and pediatrics services. In 2015, RMH purchased the West Salem Rural Health Clinic in Edwards County. The clinic was already established in the area with a family practice physician and a FNP, and the hospital added another FNP. In 2019 the clinic is housed one physician and two FNPs. The hospital opened a primary care clinic on main street in Olney in 2017. It has been successful utilizing one family medicine/OB physician and one FNP. Both providers are natives of the community. This location is also where a convenient care clinic opened at the beginning of September 2017, providing walk-in only care to patients seven days a week. This clinic has proven to be a significant asset to the community, and continues to provide a long-sought solution to an identified need of past and current CHNAs. In 2019, RMH expanded hours, and added a full time nurse practitioner to the location to meet the growing needs and utilization of the community. RMH has continued to care for needs of the community through the better breathers club, which is hosted monthly by the respiratory therapy department. Those with COPD are encouraged to attend and learn ways they can best manage their disease, including "harmonica therapy." RMH works to check in regularly with the members of this club to ensure ongoing best practices and safety. The hospital added a cardiology clinic in 2017 which in 2019 housed a cardiologist and a cardiology NP. This service has allowed RMH to bring a service to the community that had not previously been available. In 2019, patients travelled from across RMHs service area and beyond to access this care. In January of 2018, doctors for the emergency room transitioned to a group provided by Carle health system. 2019 continues to show the transition to have improved services, according to patients and staff. Integration with the Carle health System in April 2017 has led to many partnerships and easier transition of care for patients who have health issues that require further evaluation. This integration has also helped resolve many identified local health needs in significant ways. In 2019, the new Carle relationship continued to improve local health circumstances for all patients, especially those who may have been underserved in the past. RMH also contributed a significant amount of cash and in-kind donations to the community in 2019. Community-building activities focused on economic development, community-building activities focused on economic development, including cash, in-kind donations and budgeted expenditures for the city, business associations, and other programs in Richland County. In addition to more than $28,000 in cash donation in 2019, RMH leadership provided in-kind support of over $19,000 by serving on numerous community boards and committees. The CHNA is influenced by circumstances and conditions that existed prior to the integration with the Carle Health System. The CHNA is also influenced by the large rural service area of RMH. In addition, it is noted that local health conditions are possibly impacted by the fact that Richland County and Edwards County are the only counties in Illinois that have no local health department. The needs identified and prioritized throughout the 2018 CHNA carried forward variants of previous CHNAs and added others. The identified and prioritized needs selected include: 1) access to mental health services, including: A. Access to inpatient mental health care, especially for patients that rely on Illinois Medicaid B. Access to all levels of mental health services for youth, especially youth on medical cards C. Better public information about available mental health services and resources, especially for college age young adults D. Local access to a psychiatrist E. Access to outpatient mental health services, including counselors 2) access to dental care for youth and adults that are uninsured, underinsured, or reliant on Medicaid or medical card; 3) improved access to prevention, treatment, and recovery resources for substance abuse for youth and adults; 4) access to case managers to help patients with transition of care, transportation, and other issues 5) transportation, including; A. Addressing transportation needs of patients that arrive at the hospital via ambulance or another means that is not available to return them home B. Better information about how to obtain transportation to and from healthcare 6) after hour and weekend access to care. The implementation plan developed by the senior staff at RMH is specific and thorough. The plan, set out in the report, includes these highlights: 1. Partnering with Carle Foundation Hospital to provide mental healthcare at the pavilion behavioral health system, begin tele- psychiatry services, and to improve mental health services for youth 2. Encouraging a dental care partnership among outside local providers 3. Continuing to support local substance abuse prevention coalitions and other community-based efforts to address substance misuse and disorders, recovery, And rehabilitation 4. Working with community groups to sponsor substance abuse awareness events 5. Continuing to utilize the Carle addiction recovery center 6. Exploring additional case manager services 7. Partnering with public transportation to improve access information 8. Creating evening and weekend clinic services While there are a number of additional concerns identified by the focus groups including adult day cares, non-emergency transportation, diabetes, and vision care, RMH will not focus on addressing those challenges at this time. The hospital and implementation committee determined these issues are lower priority because the needs are not as significant, they are not central to the hospitals mission, and/or RMH does not have the ability to make a measurable impact in those areas. |
| PART V, SECTION C, LINE 16 | The financial assistance policy, application form, and plain language summary is available at https://www.carle.org/chna |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| OUTPATIENT THERAPY | ||||
| 800 E LOCUST ST | OLNEY | IL | 62450 | OUTPATIENT THERAPY |
| HOME HEALTH | ||||
| 800 E LOCUST ST | OLNEY | IL | 62450 | HOME HEALTH AGENCY |
| RMH PROFESSIONAL SERVICES | ||||
| 1200 N EAST ST | OLNEY | IL | 62450 | PHYSICIAN PRACTICE (GENERAL SURGERY) |
| HOSPICE | ||||
| 800 E LOCUST ST | OLNEY | IL | 62450 | HOSPICE SERVICES |
| RMH PROFESSIONAL SERVICES - ENT | ||||
| 800 E LOCUST ST | OLNEY | IL | 62450 | PHYSICIAN PRACTICE (EAR, NOSE THROAT) |
| RMH PROFESSIONAL SERVICES | ||||
| 1200 N EAST ST | OLNEY | IL | 62450 | PHYSICIAN PRACTICE (UROLOGY, ORTHO, FAMILY Practice) |
| RMH PROFESSIONAL SERVICES - PRIMARY | ||||
| 800 E LOCUST ST | OLNEY | IL | 62450 | PRIMARY CARE PHYSICIANS |
| WEST SALEM HEALTH CLINIC | ||||
| 100 S MAIN ST | WEST SALEM | IL | 62476 | RURAL HEALTH CLINIC |
| JASPER COUNTY MEDICAL CENTER | ||||
| 500 S SCOTT AVE | NEWTON | IL | 62448 | PRIMARY CARE |
| CARLE - RICHLAND PRIMARY CARE | ||||
| 605 E MAIN ST | OLNEY | IL | 62450 | PRIMARY CARE |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | Subsidized health services are net costs for billed services that are subsidized by the hospital. These include services offered despite a financial loss because they are needed in the community and either other providers are unwilling to provide the services or the services would otherwise not be available in sufficient amount. We included as unreimbursed costs of subsidized health services, $1,913,856for physician clinics $2,240,064 for emergency room, and $2,665,161 for ambulance service. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST, A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP -BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCURRED. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE RICHLAND MEMORIAL HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE RICHLAND MEMORIAL HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. SCHEDULE H, PART II A large portion of Richland Memorial Hospitals community-building activities focused on economic development, including cash, in-kind donations and budgeted expenditures for the city, business associations and other programs in Richland County. In addition to the more than $28,000 in cash donations, leadership provided in-kind support of over $19,000 by serving on numerous community boards and committees. PART III, LINE 3 - BAD DEBT, MEDICARE, & COLLECTION PRACTICES RMH uses 50% as a general estimate of bad debt expense attributable to patients eligible under the organizations financial assistance policy. PART III, LINE 4 - BAD DEBT FOOTNOTE The footnote pertaining to bad debt expense can be found on page 28 of the attached consolidated financial statements. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, AND THOSE LESS FORTUNATE DEMOGRAPHICS THAT HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | RMH applies its collection practices equally to all patients, both those eligible for financial assistance and those that arent eligible. The procedures are as follows: 1. We will send two statements and two collection letters in a 28 day cycle. We will send statements based upon patient portion of $10 or greater. 2. The patient's account will age through the statement process before being written off to bad debt. A. Private pay accounts will receive a statement within nine days of the discharge date. B. Accounts with a patient portion after insurance will be eligible to receive a statement approximately fourteen days after the insurance payment has been posted. C. Twenty-eight days later the patient is mailed a third statement D. Twenty-eight days later the patient is mailed the first collection letter E. Twenty-eight days later the patient is mailed the final collection letter F. Approximately fifteen days later the patient is written off to bad debt. 3. RMH will attempt to contact the guarantor via phone after they receive the first statement on balances greater than $1,000. 4. RMH will attempt to contact the guarantor via phone after the second statement on balances less than $1,000. 5. RMH will make a second attempt to contact the guarantor via phone if payment or contact has not been made, usually around the same time the second collection letter is sent. 6. RMH will send two collection letters to the patient. The patient has fifteen days after the final letter to pay before being written off to bad debt. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | The determination of current and future health care needs of the communities served are based on the following factors: existence or nonexistence of services, opportunity, supply, demonstrated need, requests from patients, and/or combined efforts with outside entities that would help fill a need or strengthen a current service. We are constantly collecting data that would help make these decisions and often consult with various departments within the hospital including nursing, information technology, finance, and physicians. This information is then reviewed and the hospital's administrative team incorporates the identified health care needs into the strategic plan. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSITANCE | All patient billing statements include a statement that mentions contacting the hospital if they wish to apply for financial assistance or would like to set up payments on the account. If a patient contacts the patient financial services department about the inability to pay, they are informed of the available options, including financial assistance, Medicare, and Medicaid applications. Patient financial services will also explain how the patient can apply for assistance. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | RMH defined its primary service area and populations as the general population within the geographic area in and surrounding the city of Olney including eight southeastern Illinois counties. The hospitals patient population includes all who receive care, without regard to insurance coverage or eligibility for assistance. RMHs service area is comprised of approximately 3,178 square miles, with a population of approximately 107,185 and a population density of 34 people per square mile. We provide services to patients without regard to age, sex, race, color, national origin, religious creed, gender identity, sexual orientation, disability, insurance coverage or ability to pay. The population of RMH 's service area is economically disadvantaged making it more difficult to afford healthcare. Furthermore, there is no health department in Richland County making the hospital the primary source for healthcare services and health education. Poverty is considered a key driver of health status. In the RMH service area, 13.34% or 13,346 individuals are living in households with income below the federal poverty level (FPL). This indicator is relevant because poverty creates barriers to access including health services, healthy food, and other necessities that contribute to poor health status. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | RMH has an open medical staff and is governed by a community board that serves on a volunteer basis. Surplus funds are reinvested into the organization for technology replacement and advancement, clinical service expansion and quality improvement. Funds are also invested into our communities to meet identified health needs which contribute to the overall well-being of the residents of the communities we serve. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | RMH is a 104 bed, not-for-profit healthcare facility located in Olney, IL and became part of the Carle Health System on April 1, 2017. As part of the Carle Health System, it currently serves eight southeastern Illinois counties, with a total population of more than 107,000 individuals. The integration of Carle and RMH allows for expanded access to healthcare in the region. Though RMH falls under the umbrella of the Carle Foundation, it maintains a separate board of directors and senior leadership. While RMHs CHNA and community benefit reporting is separate from the Carle Foundation Hospital, it follows the same guidelines and principles as Carle. RMH staff is involved in the CHNA and implementation plan, and serve on human services agency boards and committees to provide support to help address identified community health needs. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | RMH files an Illinois community benefit report. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Educational Scholarships | GrantTypeTxt |
| Recipient | 15 | RecipientCnt |
| Cash Grant | $15,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE I | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS ANY CHARITABLE ORGANIZATION WISHING TO REQUEST FUNDS IS ASKED TO SUBMIT THEIR REQUEST IN WRITING. EMAILED REQUESTS ARE ACCEPTABLE. THE REQUEST MUST INCLUDE A DESCRIPTION OF THE PURPOSE OF THE CONTRIBUTION AND OTHER RELEVANT INFORMATION SUCH AS REQUESTORS NAME, AMOUNT OF THE REQUEST, ETC. THE REQUESTS ARE REVIEWED, EVALUATED, AND ADMINISTERED BY THE MARKETING AND COMMUNICATIONS (PUBLIC RELATIONS) DEPARTMENT, SEEKING ADDITIONAL INFORMATION FROM THE REQUESTOR, AS NEEDED, AND INPUT FROM ANY APPROPRIATE CARLE ADMINISTRATOR OR DIRECTOR. A SET OF ESTABLISHED GUIDELINES DRIVE THESE DECISIONS WHILE MOST ARE MADE TO IMPROVE HEALTHCARE/ACCESS TO HEALTHCARE OR ARE IN LINE WITH OUR ROLE AS A CORPORATE CITIZEN. ASSESSED NEED IS A COMMON CRITERIA. IN THE CASE OF MOST DONATIONS OF $5,000 OR MORE, SUCH AS TO COLLEGES AND UNIVERSITIES OR COMMUNITY CLINICS, WRITTEN AGREEMENTS ARE IN PLACE AND WE HAVE REGULAR CONTACT WITH THOSE ORGANIZATIONS, OFTENTIMES THROUGH A CARLE CONTACT PERSON TO ASSURE THAT THE DONATIONS ARE BEING USED AS AGREED UPON. THE RECORDS ARE EITHER MAINTAINED IN ADMINISTRATION OR PUBLIC RELATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JARROD ALMAROAD MD | ||||||||||||||
| TRUSTEE & PHYSICIAN(THRU 9/19) | $0 | $802,576 | $0 | $2,500 | $0 | $6,612 | $0 | $22,542 | $0 | $23,668 | $0 | $857,898 | $0 | |
| JOHN SNYDER | ||||||||||||||
| TRUSTEE, EX VP & COO THRU 6/19 | $0 | $482,857 | $0 | $298,156 | $0 | $1,695,314 | $0 | $2,161,020 | $0 | $16,783 | $0 | $4,654,130 | $0 | $1,076,615 |
| CHRISTINA BARE | ||||||||||||||
| DIRECTOR OF BUSINESS OPS | $150,399 | $0 | $0 | $0 | $312 | $0 | $17,014 | $0 | $546 | $0 | $168,271 | $0 | $0 | $0 |
| HARRY BROCKUS | ||||||||||||||
| CEO | $306,805 | $0 | $39,773 | $0 | $53,752 | $0 | $77,284 | $0 | $22,230 | $0 | $499,844 | $0 | $44,733 | $0 |
| Regina Thomas | ||||||||||||||
| CNO & DIR PATIENT CARE SVS | $186,661 | $0 | $0 | $0 | $21,773 | $0 | $17,322 | $0 | $4,238 | $0 | $229,994 | $0 | $0 | $0 |
| MARY WALLER MD | ||||||||||||||
| PHYSICIAN | $378,287 | $0 | $0 | $0 | $662 | $0 | $28,430 | $0 | $896 | $0 | $408,275 | $0 | $0 | $0 |
| Paul Sutherland MD | ||||||||||||||
| PHYSICIAN | $346,464 | $0 | $0 | $0 | $890 | $0 | $33,542 | $0 | $11,965 | $0 | $392,861 | $0 | $0 | $0 |
| PRASHANTH ANAND MD | ||||||||||||||
| PHYSICIAN | $471,997 | $0 | $0 | $0 | $662 | $0 | $27,542 | $0 | $13,465 | $0 | $513,666 | $0 | $0 | $0 |
| STEPHEN REID MD | ||||||||||||||
| PHYSICIAN | $351,240 | $0 | $0 | $0 | $662 | $0 | $33,542 | $0 | $6,722 | $0 | $392,166 | $0 | $0 | $0 |
| H TIMOTHY GARRETT DO | ||||||||||||||
| TRUSTEE & PHYSICIAN | $384,030 | $0 | $0 | $0 | $662 | $0 | $39,513 | $0 | $11,984 | $0 | $436,189 | $0 | $0 | $0 |
| MATTHEW KOLB | ||||||||||||||
| TRUSTEE & COO (Start 06/19) | $0 | $537,981 | $0 | $58,621 | $0 | $107,346 | $0 | $104,199 | $0 | $25,342 | $0 | $833,489 | $0 | $40,837 |
| SALLY SALMONS MD | ||||||||||||||
| TRUSTEE & PHYSICIAN Start 9/19 | $0 | $350,208 | $0 | $48,601 | $0 | $6,843 | $0 | $62,826 | $0 | $14,738 | $0 | $483,216 | $0 | $0 |
| LAUREN SCHMID | ||||||||||||||
| EXEC VP, CHIEF HR OFFICER | $0 | $322,593 | $0 | $40,818 | $0 | $66,898 | $0 | $76,250 | $0 | $22,630 | $0 | $529,189 | $0 | $44,771 |
| NIRANAT DEJTIRANUKUL MD | ||||||||||||||
| PHYSICIAN | $364,876 | $0 | $0 | $0 | $104 | $0 | $33,542 | $0 | $3,612 | $0 | $402,134 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Question 3 | THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. |
| Schedule J, Part I, Question 4a | JOHN SNYDER RECEIVED SEVERANCE PAYMENTS IN 2019 IN THE AMOUNT OF $586,504. |
| Schedule J, Part I, Question 4B | THE 2019 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THAT ARE LISTED IN THE 990 PART VII INCLUDE HARRY BROCKUS, MATTHEW KOLB, SALLY SALMONS, MD, LAUREN SCHMIDT, AND JOHN SNYDER. IN 2019, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO HARRY BROCKUS ($44,733), MATTHEW KOLB ($40,837), LAUREN SCHMIDT ($44,771), AND JOHN SNYDER ($1,076,615). |
| Schedule J, Part I, Question 7 | PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Marcia Vaughn | |||
| FAMILY MEMBER OF TRUSTEE | $94,766 | Employment | false |
| Ray Vaughn | |||
| FAMILY MEMBER OF TRUSTEE | $65,154 | Legal Fees | false |
| WHITNEY HOUCHIN | |||
| FAMILY MEMBER OF TRUSTEE | $89,383 | Employment | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule L, Part V | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTERESTED PERSON & ORGANIZATION MARCIA VAUGHN IS AN EMPLOYEE OF RICHLAND MEMORIAL HOSPITAL AND HAS A FAMILY RELATIONSHIP WITH CAROL SCHAFER WHO SERVES AS A TRUSTEE OF THE BOARD. RAY VAUGHN PROVIDES LEGAL SERVICES TO RICHLAND MEMORIAL HOSPITAL AND HAS A FAMILY RELATIONSHIP WITH CAROL SCHAFER WHO SERVES AS A TRUSTEE OF THE BOARD. WHITLEY HOUCHIN IS AN EMPLOYEE OF RICHLAND MEMORIAL HOSPITAL AND HAS A FAMILY RELATIONSHIP WITH GARY HOUCHIN WHO SERVES AS A TRUSTEE OF THE BOARD. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT | RICHLAND MEMORIAL HOSPITAL, INC., DBA CARLE RICHLAND MEMORIAL HOSPITAL (RMH) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, DISABILITY, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THE MISSION OF RMH IS TO SERVE OUR COMMUNITY WITH RESPECT IN PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE OFFER: - FREE CARE TO QUALIFIED INDIVIDUALS UNDER THE RMH FINANCIAL ASSISTANCE PROGRAM - CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND - HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT AND EDUCATE THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, PROFESSIONAL EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING THE PERIOD JANUARY 1, 2019 THROUGH DECEMBER 31, 2019, RMH RECORDED 14,400 PATIENT DAYS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. THE HOSPITAL ALSO PROVIDES CARE TO PERSONS COVERED BY COMMERCIAL INSURANCE AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECOGNIZES THESE AMOUNTS AS COST INCURRED IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. FINANCIAL ASSISTANCE WAS ALSO PROVIDED THROUGH RMHS FINANCIAL ASSISTANCE POLICY OFFERED IN 2019. THE HOSPITAL ALSO OFFERS AND PARTICIPATES IN PROGRAMS THROUGHOUT THE COMMUNITY. THESE INCLUDE: 1. AMBULANCE COVERAGE 2. MEETINGS / CONFERENCE FACILITIES 3. SCHOLARSHIPS 4. SUPPORT OF COMMUNITY ORGANIZATIONS, EVENTS AND ACTIVITIES INCLUDING: AMERICAN CANCER SOCIETY BIG BROTHERS/BIG SISTERS BLUE KNIGHT TIP OFF CLUB CLAREMONT-BONPAS FIRE PROTECTION DISTRICT FLORA HIGH SCHOOL ATHLETIC DEPT. FRIENDS OF FR.JERRY 5K FRIENDS OF OLNEY JASPER COUNTY CHAMBER OF COMMERCE JASPER COUNTY FAIR LAWRENCE COUNTY JR FAIR ASSOCIATION LAWRENCE COUNTY YOUTH LIVESTOCK AUCTION LINCOLN'S PLACE FUND MISS RICHLAND COUNTY FAIR QUEEN PAGEANT MS "JOIN THE MOVEMENT" NATONAL FIRE SAFETY COUNCIL, INC NEWTON COMMUNITY HIGH SCHOOL CHORUS NEWTON COMMUNITY HIGH SCHOOL NICK'S RACE OLNEY & RICHLAND COUNTY CHAMBER OF COMMERCE OLNEY ARTS COUNCIL FINE ARTS SHOWCASE OLNEY CENTRAL COLLEGE FOUNDATION OLNEY ELKS CLUB OLNEY LITTLE LEAGUE OLNEY ROTARY CLUB OLNEY TIGER SHARKS OLNEY TIGER WRESTLING OUTREACH MISSIONS IMMAN UNITED METH CHURCH RED HILL FUTURE FARMERS OF AMERICA RICHLAND COUNTY 4-H FOUNDATION RICHLAND COUNTY FARM AND FAIR ASSOCIATION RICHLAND COUNTY HIGH AFTER PROM RICHLAND COUNTY HIGH SCHOOL AGRICULTURE DEPARTMENT RICHLAND COUNTY HIGH SCHOOL INTERACT CLUB RICHLAND COUNTY HIGH SCHOOL LADY TIGERS SOFTBALL RICHLAND COUNTY HIGH SCHOOL TENNIS RICHLAND COUNTY HIGH SCHOOL THEATER DEPT RICHLAND COUNTY SOCCER ASSOCIATION ST JOSEPH SCHOOL ST. THOMAS SCHOOL DUCK RACE SWAN ANNUAL GOLF OUTING VOLUNTEER FIREMAN'S ASSOC OF WEST SALEM WEST SALEM DEVELOPMENT ASSOCIATION WEST SALEM GRADE SCHOOL PTO 5. VARIOUS WELLNESS EVENTS, COMMUNITY CLINICS, SUPPORT GROUPS, MEDICAL OUTREACH AND EDUCATION INCLUDING: BLOOD PRESSURE SCREENING CLINICS DIABETIC EDUCATION DAY HEALTHFEST NATIONAL HOSPITAL WEEK SCREENING CLINIC OLNEY SENIOR EXPO SUPPORT GROUPS BREAST CANCER SUPPORT GROUP TICKET FOR THE CURE BREAST HEALTH OUTREACH/EDUCATION TICKET FOR THE CURE CPR CLASSES DIABETES SUPPORT GROUP FIRST AID CLASSES INFECTION CONTROL IN-SERVICES TO LOCAL SCHOOLS LIFE SMART FOR WOMEN EDUCATIONAL CLASSES PREPARED CHILDBIRTH CLASSES REGIONAL PSYCHIATRIC CENTER PATIENT SUPPORT GROUP 6. SPECIAL ASSISTANCE PROGRAMS INCLUDING: - MAMMOGRAPHY ASSISTANCE (ILLINOIS BREAST AND CERVICAL CANCER PROGRAM SERVICE PROVIDER LITTLE EGYPT AND EAST CENTRAL REGION) FORM 990, PART VI, QUESTION 6 RICHLAND MEMORIAL HOSPITAL, INC. HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. |
| FORM 990, PART VI, LINE 7A - ELECTION OF MEMBERS AND THEIR RIGHTS | RICHLAND MEMORIAL HOSPITAL INC.S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PART VI, LINE 7B - DECISIONS SUBJECT TO APPROVAL OF MEMBERS RICHLAND MEMORIAL HOSPITAL, INC. MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF GOVERNING DOCUMENTS; RECOMMENDING THE CEO TO THE BOARD; APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS; APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND BOARD OF TRUSTEES FOR THEIR EXPENSES OR COMPENSATION FOR SERVICES; APPROVING ANY NEW, LONG-TERM OR MASTER INSTITUTIONAL PLANS OR CHANGES TO SUCH PLANS; APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC; APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE; APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED (CON) APPROVAL; APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATIONS ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION; APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS; AND APPROVING NON-BUDGETED EXPENDITURES OR SALE EXCEEDING THE CHIEF EXECUTIVE OFFICERS (CEO) AUTHORIZED SPENDING AUTHORITY. |
| FORM 990, PART VI, LINE 11B - ORGANIZATION'S PROCESS TO REVIEW FORM 990 | THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. |
| FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY | 1. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER IS DISCLOSED TO THE OTHER MEMBERS OF THE BOARD BY THE BOARD MEMBER WHO HAS THE CONFLICT AND MADE A MATTER OF RECORD THROUGH THE BOARDS ANNUAL FILING OF CONFLICT OF INTEREST STATEMENTS OR WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. 2. ANY BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER DOES NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER, AND HE/SHE IS NOT TO BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. 3. THE FOREGOING REQUIREMENTS SHOULD NOT BE CONSTRUED AS PREVENTING THE BOARD MEMBER FROM ANSWERING PERTINENT QUESTIONS OF OTHER BOARD MEMBERS, SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. HOWEVER, THE MEMBER WITH THE CONFLICT MUST ABSTAIN FROM MAKING MOTIONS, PARTICIPATING IN RELEVANT DELIBERATIONS, VOTING, EXECUTING AGREEMENTS, ATTEMPTING TO INFLUENCE OTHERS VOTES, OR TAKING ANY SIMILAR DIRECT ACTION ON BEHALF OF THE CORPORATION WHERE THE CONFLICT OF INTEREST MIGHT PERTAIN. 4. ALL MEMBERS OF THE BOARD (INCLUDING EX-OFFICIO MEMBERS) ARE REQUIRED TO COMPLETE AND RETURN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT NO LATER THAN NOVEMBER 30TH OF EACH YEAR OR WITHIN 30 DAYS OF THE CREATION OR OCCURRENCE OF ANY NEW CONFLICT. MEMBERS(S) WHO DO NOT RETURN THE CONFLICT OF INTEREST STATEMENT WILL BE ADDRESSED IN ACCORDANCE WITH THE BYLAWS. 5. RESPONSES MAY BE COMPLIED INTO PACKETS FOR DISTRIBUTION AND DISCUSSION ANNUALLY (AT THE NEXT BOARD MEETING FOLLOWING THE DUE DATE), SEMI-ANNUALLY (SIX MONTHS FOLLOWING THE INITIAL REVIEW), AND AS ANY NEW CONFLICT IS IDENTIFIED. 6. THE POLICY ON CONFLICT OF INTEREST WILL BE DISCUSSED WITH CANDIDATES FOR BOARD POSITIONS DURING THEIR INTERVIEW WITH THE NOMINATING COMMITTEE. THE IMPORTANCE OF AVOIDING CONFLICT OF INTEREST SITUATIONS WILL BE EMPHASIZED. 7. WHEN A CONFLICT OF INTEREST SITUATION IS IDENTIFIED, THE INDIVIDUAL BOARD MEMBER HAS THE PRIMARY RESPONSIBILITY TO BRING A POTENTIAL OR ACTUAL CONFLICT OF INTEREST SITUATION TO THE ATTENTION OF THE BOARD. A CONFLICT OF INTEREST SITUATION MAY ALSO COME TO THE ATTENTION OF THE BOARD DUE TO THE CONCERNS OF A BOARD MEMBER WHO MAY NOT BE INVOLVED IN THE SITUATION. THAT BOARD MEMBER SHOULD NOTIFY THE CHAIRPERSON OF THE CONFLICT OF INTEREST CONCERN AND THE BOARD CHAIRPERSON SHOULD BRING THE SITUATION TO THE ATTENTION OF THE FULL BOARD. REGARDLESS OF THE METHOD BY WHICH THE CONFLICT IS BROUGHT UP, THERE SHOULD BE FULL AND OPEN DISCUSSION BY BOARD MEMBERS OF THE POTENTIAL OR ACTUAL CONFLICT OF INTEREST SITUATION. THE FURTHER PARTICIPATION OF THE BOARD MEMBER IN THE DISCUSSION SHOULD BE AGREED UPON AND APPROVED BY THE BOARD. 8. AS A RESULT OF DISCUSSIONS ON CONFLICT OF INTEREST SITUATIONS, THERE MAY BE CONSIDERATIONS FOR A BOARD MEMBERS RESIGNATION. THE BOARD MEMBER MAY WISH TO RESIGN TO AVOID A FUTURE CONFLICT OF INTEREST SITUATION DUE TO A DESIRE TO BID ON A PARTICULAR BOARD PROJECT OR TO AVOID A FURTHER CONFLICT OF INTEREST CONCERN. IN THE EVENT THAT THE BOARD MEMBER DOES NOT LEAVE AND A CONFLICT OF INTEREST SITUATION EXISTS, IN ACCORDANCE WITH ORGANIZATIONS BYLAWS ARTICLE VI, SECTION 5, THE BOARD MAY ASK THE BOARD MEMBER TO RESIGN. 9. THE POLICY IS REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF BOARD MEMBERS |
| FORM 990, PART VI, LINE 15B - COMPENSATION PROCESS FOR OFFICERS | THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. |
| FORM 990, PART VI, LINE 19 - GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | RICHLAND MEMORIAL HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, Line 9 | THE OTHER CHANGES IN NET ASSETS INCLUDES THE INCREASE IN INTEREST IN RICHLAND MEMORIAL HOSPITAL FOUNDATION ($18,102). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| THE CARLE FOUNDATION | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 370673465 | PARENT/INVMGT | IL | 501(c)(3) | 12C, III-FI | NA | false |
| THE CARLE FOUNDATION HOSPITAL | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 371119538 | HOSPITAL SVCS | IL | 501(c)(3) | 3 | TCF | Yes (true) |
| THE CARLE DEVELOPMENT FOUNDATION | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 371159978 | Fundraising | IL | 501(c)(3) | 7 | TCF | Yes (true) |
| CARLE RETIREMENT CENTERS INC | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 371160033 | Retirement | IL | 501(c)(3) | 10 | TCF | Yes (true) |
| CARLE COMMUNITY HEALTH CORPORATION | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 364458371 | FNDN MISSION | IL | 501(c)(3) | 12A, TYPE I | TCDF | Yes (true) |
| HOOPESTON COMMUNITY MEMORIAL HOSPITAL | ||||||||||
| 701 E ORANGE ST | HOOPESTON | IL | 60942 | 363637465 | HOSPITAL SVCS | IL | 501(c)(3) | 3 | TCF | Yes (true) |
| CARLE HEALTH CARE INCORPORATED | ||||||||||
| 611 W PARK ST | URBANA | IL | 61801 | 371140016 | VAR MED SVCS | IL | 501(c)(3) | 10 | TCF | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAMPAIGN SURGICENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 W PARK ST | AddressLine1Txt |
| City | URBANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 618012595 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201915925 | EIN |
| Primary Activities | SURG CNTR | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH SYSTEMS INSURANCE LIMITED | ||||||||||||
| Governors Square 2nd Floor Bldg 3 | GRAND CAYMEN | CJ | INSURANCE | CJ | C Corp | Yes (true) | ||||||
| CARLE RISK MANAGEMENT COMPANY | ||||||||||||
| RISK MANAGEMENT | C Corp | Yes (true) | 611 W PARK ST | URBANA | IL | 618012595 | 371217973 | IL | ||||
| EVALIDATA INC | ||||||||||||
| PHYS CREDENTIALS | C Corp | Yes (true) | 611 W PARK ST | URBANA | IL | 618012595 | 462022658 | IL | ||||
| CHA HOLDING INC | ||||||||||||
| HOLDING COMPANY | C Corp | Yes (true) | 3310 SOUTH FIELDS DR | CHAMPAIGN | IL | 61822 | 471854275 | IL | ||||
| CARLE HOLDING COMPANY INC | ||||||||||||
| HOLDING COMPANY | C Corp | Yes (true) | 611 W PARK ST | URBANA | IL | 618012595 | 371188284 | IL | ||||
| HEALTH ALLIANCE MEDICAL PLANS INC | ||||||||||||
| HEALTH COVERAGE | C Corp | Yes (true) | 3310 SOUTH FIELDS DR | CHAMPAIGN | IL | 61822 | 371260731 | IL | ||||
| HEALTH ALLIANCE CONNECT INC | ||||||||||||
| HEALTH CARE COORD | C Corp | Yes (true) | 3310 SOUTH FIELDS DR | CHAMPAIGN | IL | 61822 | 464796891 | IL | ||||
| HEALTH ALLIANCE NORTHWEST HOLDING INC | ||||||||||||
| HOLDING COMPANY | C Corp | Yes (true) | 820 N CHELAN AVE | WENATCHEE | WA | 98801 | 461717578 | WA | ||||
| HEALTH ALLIANCE NORTHWEST HLTH PLAN INC | ||||||||||||
| Health CoveraGE | C Corp | Yes (true) | 820 N CHELAN AVE | WENATCHEE | WA | 98801 | 461966323 | WA | ||||
| HEALTH ALLIANCE-MIDWEST INC | ||||||||||||
| HEALTH COVERAGE | C Corp | Yes (true) | 3310 SOUTH FIELDS DR | CHAMPAIGN | IL | 61822 | 371354502 | IL | ||||
| 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 | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HEALTH ALLIANCE CONNECT INC | ||
| L | $153,746 | BOOK |
| HEALTH ALLIANCE MEDICAL PLANS | ||
| L | $1,434,110 | BOOK |
| HEALTH ALLIANCE MEDICAL PLANS | ||
| M | $451,640 | BOOK |
| CARLE HEALTH CARE INCORPORATED | ||
| M | $3,059,214 | BOOK |
| THE CARLE FOUNDATION HOSPITAL | ||
| M | $721,997 | BOOK |
| CARLE HEALTH CARE INCORPORATED | ||
| O | $2,437,700 | BOOK |
Comments