MENDOTA COMMUNITY HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: MENDOTA COMMUNITY HOSPITAL (EIN 36-2167785)
Tax period: 2018-10-01 to 2019-09-30
Filed: 2020-08-13
IRS object ID: 202032269349301103
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-08-13T08:30:29-05:00	ReturnTs
Tax Period End	2019-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	225 West Wacker Drive Suite 2600	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606061224	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	362167785	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mendota Community Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MEND	BusinessNameControlTxt
Phone	8155397461	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Michael M Allen	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2020-08-13	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Jennifer Burke	PreparerPersonNm
PTIN	P01342224	PTIN
Phone	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-11-06 18:47:13Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	OSF Saint Paul Medical Center	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Michael Allen	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$36,479,388	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.osfhealthcare.org/practices/44/1217/osf-saint-paul-medical-center	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1944	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	169	TotalEmployeeCnt
Total Volunteers	86	TotalVolunteersCnt
Total Gross UBI	$2,621	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$110	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$40,196	PYContributionsGrantsAmt
CY Contributions Grants	$69,087	CYContributionsGrantsAmt
PY Program Service Revenue	$36,040,571	PYProgramServiceRevenueAmt
CY Program Service Revenue	$36,012,475	CYProgramServiceRevenueAmt
PY Investment Income	$8,945	PYInvestmentIncomeAmt
CY Investment Income	-$82,892	CYInvestmentIncomeAmt
PY Other Revenue	$248,927	PYOtherRevenueAmt
CY Other Revenue	$152,771	CYOtherRevenueAmt
PY Total Revenue	$36,338,639	PYTotalRevenueAmt
CY Total Revenue	$36,151,441	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$15,432,961	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$15,331,653	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$20,355,001	PYOtherExpensesAmt
CY Other Expenses	$17,697,994	CYOtherExpensesAmt
PY Total Expenses	$35,787,962	PYTotalExpensesAmt
CY Total Expenses	$33,029,647	CYTotalExpensesAmt
PY Revenues Less Expenses	$550,677	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$3,121,794	CYRevenuesLessExpensesAmt
Total Assets BOY	$34,342,051	TotalAssetsBOYAmt
Total Assets EOY	$33,074,155	TotalAssetsEOYAmt
Total Liabilities BOY	$33,058,937	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$29,275,455	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,283,114	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$3,798,700	NetAssetsOrFundBalancesEOYAmt
Mission	IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$26,142,961	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$36,141,771	RevenueAmt
Desc	MENDOTA COMMUNITY HOSPITAL PROVIDED 25 BEDS IN FISCAL YEAR 2019. THE HOSPITAL GAVE $1,253,839 IN CHARITY CARE. THE HOSPITAL PROVIDED 1,970 PATIENT DAYS. THE HOSPITAL PROVIDED 33,030 OUTPATIENT VISITS AND THE EMERGENCY ROOM HAD 5,591 PATIENT VISITS.	Desc
Total Program Service Expenses	$26,142,961	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	6	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	169	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	9	GoverningBodyVotingMembersCnt
Independent Voting Member	7	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	Yes (true)	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Michael Allen	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8155397461	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	800 NE GLEN OAK AVE	AddressLine1Txt
City	PEORIA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61603	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Sister Judith Ann Duvall OSF
Chairperson	1.0	43.0	Yes (X)	Yes (X)	$0	$5,280	$0
Robert C Sehring
Vice Chairperson CEO	1.0	43.0	Yes (X)	Yes (X)	$0	$1,660,098	$67,133
Sister Diane Marie McGrew OSF
President and Treasurer	1.0	43.0	Yes (X)	Yes (X)	$0	$5,280	$0
Sister Theresa Ann Brazeau OSF
Secretary	1.0	43.0	Yes (X)	Yes (X)	$0	$5,280	$0
Sister Agnes Joseph Williams OSF
Assistant Secretary	1.0	43.0	Yes (X)	Yes (X)	$0	$5,280	$0
Brian Silverstein MD
Board Member	1.0	3.0	Yes (X)		$0	$45,000	$0
Gerald J McShane MD
Board Member	1.0	42.0	Yes (X)		$0	$382,453	$75,243
Sister M Mikela Meidl FSGM
Board Member	1.0	43.0	Yes (X)		$0	$0	$0
Sister Rose Therese Mann OSF
Board Member	1.0	43.0	Yes (X)		$0	$0	$0
Chad E Boore
Chief Executive Officer Eastern Region	1.0	41.0		Yes (X)	$0	$489,065	$46,488
Divya-Devi Joshi
CEO Children SL	1.0	41.0		Yes (X)	$0	$654,128	$27,672
Dwight D Stapleton
Vice President Clinical Specialty Services	1.0	41.0		Yes (X)	$0	$502,198	$31,423
James J Mormann
Chief Information Officer	1.0	41.0		Yes (X)	$0	$749,665	$67,244
Jeffry M Tillery
SVP Chief Transformation Officer	1.0	41.0		Yes (X)	$0	$709,263	$72,449
John R Evancho
SVP Chief Compliance Officer	1.0	41.0		Yes (X)	$0	$334,877	$48,158
John C Horne
SVP Chief Supply Chain Officer	1.0	41.0		Yes (X)	$0	$445,187	$62,583
Leon A Yeh MD
VP CMO Emergency Serv	1.0	41.0		Yes (X)	$0	$591,246	$64,894
Lori L Wiegand
Chief Nursing Officer	1.0	41.0		Yes (X)	$0	$504,267	$72,769
Mark A Nafziger
CEO Ambulatory Care	1.0	41.0		Yes (X)	$0	$757,602	$32,595
Michael M Allen
CFO	1.0	42.0		Yes (X)	$0	$783,568	$60,528
Michael A Cruz MD
Chief Executive Officer Central Region	1.0	41.0		Yes (X)	$0	$776,655	$78,958
Michelle D Conger
Chief Strategy Officer	1.0	41.0		Yes (X)	$0	$587,557	$41,654
Ralph R Velazquez MD
System Chief Medical Officer	1.0	42.0		Yes (X)	$0	$611,021	$71,108
Robert L Brandfass
SVP Chief Legal Officer	1.0	41.0		Yes (X)	$0	$678,404	$67,458
Roxanna Crosser
Chief Executive Officer Western Region	1.0	41.0		Yes (X)	$0	$475,072	$50,580
Stephen E Hippler MD
Chief Clinical Officer	1.0	41.0		Yes (X)	$0	$749,430	$78,944
Thomas G Hammerton
President OSF Healthcare Foundation Chief Development Officer	1.0	43.0		Yes (X)	$0	$460,304	$60,184
Caitlin J Engels-Arteaga
Physician Assistant	40.0	0			$108,003	$0	$19,216	Yes (X)
Jane A Battles
APN	40.0	0			$136,087	$0	$29,739	Yes (X)
Katherine R Riva-Foster MD
Physician	40.0	0			$222,382	$0	$29,887	Yes (X)
Kenneth K Potts MD
Physician	40.0	0			$229,849	$0	$35,288	Yes (X)
Stacy A Piller
Advanced Practice Nurse	40.0	0			$107,012	$0	$27,127	Yes (X)
Anthony M Avellino MD
Former - CEO NSSL/INI	0.0	0.0			$0	$498,495	$38,364		Yes (X)
David A Schertz
Former - CEO Northern Region	0.0	0.0			$0	$825,174	$50,342		Yes (X)
Kenneth E Berkovitz MD
Former - CEO CVSL	0.0	0.0			$0	$489,523	$42,199		Yes (X)
Kenneth J Natzke
Former CEO East Region	0.0	0.0			$0	$160,000	$20,250		Yes (X)
Kevin D Schoeplein
Former - Vice Chairperson CEO	0.0	0.0			$0	$2,850,403	$42,655		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$803,332	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$17,791,774	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,513,131	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	5	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Emergency Physician Staffing Solutions	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1504 Timber Trail	AddressLine1Txt
City	Washington	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61571	ZIPCd

Field	Value	IRS element (for citing)
Services	Emergency Services Physicians	ServicesDesc
Compensation	$2,241,824	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$59,791	RelatedOrganizationsAmt
Government Grants	$0	GovernmentGrantsAmt
All Other Contributions	$9,296	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$69,087	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PATIENT REVENUE	622110	$34,420,534	$34,420,534	$0	$0
CONTRACTED PHARMACY	622110	$1,540,891	$1,540,891	$0	$0
MEDICAL DIRECTORSHIPS	624200	$51,050	$51,050	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$36,012,475	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$467	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$467	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$8,411	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$8,411	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,411	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$8,411	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$186,995	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$270,354	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	-$83,359	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$83,359	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	-$83,359	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$70,036	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$57,593	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,443	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$12,443	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA	Desc
Business	624200	BusinessCd
Total Revenue Column	$60,891	TotalRevenueColumnAmt
Related Or Exempt Func Income	$60,891	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$71,026	TotalRevenueColumnAmt
Related Or Exempt Func Income	$68,405	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,621	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$131,917	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$36,151,441	TotalRevenueColumnAmt
Related Or Exempt Func Income	$36,141,771	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,621	UnrelatedBusinessRevenueAmt
Exclusion	-$62,038	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$11,964,094	TotalAmt
Program Services	$9,675,315	ProgramServicesAmt
Management And General	$2,288,779	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$360,717	TotalAmt
Program Services	$291,710	ProgramServicesAmt
Management And General	$69,007	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,487,026	TotalAmt
Program Services	$2,011,243	ProgramServicesAmt
Management And General	$475,783	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$519,816	TotalAmt
Program Services	$420,372	ProgramServicesAmt
Management And General	$99,444	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$14,191	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$14,191	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,186,842	TotalAmt
Program Services	$2,144,669	ProgramServicesAmt
Management And General	$42,173	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,970,596	TotalAmt
Program Services	$2,269,530	ProgramServicesAmt
Management And General	$701,066	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$321,993	TotalAmt
Program Services	$52,142	ProgramServicesAmt
Management And General	$269,851	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$100,007	TotalAmt
Program Services	$66,641	ProgramServicesAmt
Management And General	$33,366	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$25,664	TotalAmt
Program Services	$11,260	ProgramServicesAmt
Management And General	$14,404	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,289,917	TotalAmt
Program Services	$1,024,065	ProgramServicesAmt
Management And General	$265,852	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$5,027,126	TotalAmt
Program Services	$3,637,490	ProgramServicesAmt
Management And General	$1,389,636	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$813,737	TotalAmt
Program Services	$646,026	ProgramServicesAmt
Management And General	$167,711	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$148,433	TotalAmt
Program Services	$33,648	ProgramServicesAmt
Management And General	$114,785	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
CONTRACTS AND REPAIRS	$2,157,507	$1,277,429	$880,078	$0
BAD DEBTS	$1,713,145	$1,713,145	$0	$0
PROVIDER TAX	$818,388	$818,388	$0	$0
COLLECTION FEES	$35,414	$35,414	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$75,034	TotalAmt
Program Services	$14,474	ProgramServicesAmt
Management And General	$60,560	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$33,029,647	TotalAmt
Program Services	$26,142,961	ProgramServicesAmt
Management And General	$6,886,686	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,192,506	BOYAmt
EOY	$1,262,564	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$127,936	BOYAmt
EOY	$57,235	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	$5,605,973	BOYAmt
EOY	$4,066,617	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$775,070	BOYAmt
EOY	$670,364	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$113,426	BOYAmt
EOY	$106,028	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$33,450,948	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$19,295,800	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$13,834,932	BOYAmt
EOY	$14,155,148	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$74,420	BOYAmt
EOY	$137,723	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$12,617,788	BOYAmt
EOY	$12,618,476	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$34,342,051	BOYAmt
EOY	$33,074,155	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,890,403	BOYAmt
EOY	$2,636,171	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	$18,750	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)
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	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	$30,168,534	BOYAmt
EOY	$26,620,534	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$33,058,937	BOYAmt
EOY	$29,275,455	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$516,803	BOYAmt
EOY	$1,998,095	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,179,408	BOYAmt
EOY	$1,180,096	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$620,509	BOYAmt
EOY	$620,509	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,283,114	BOYAmt
EOY	$3,798,700	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$34,342,051	BOYAmt
EOY	$33,074,155	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$3,121,794	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$606,208	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$14,191	OtherActivitiesAmt
Total Lobbying Expenditures	$14,191	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION'S LOBBYING ACTIVITIES INCLUDE PAYING MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION, WHO PARTICIPATE IN LOBBYING ACTIVITIES ON BEHALF OF HEALTHCARE ORGANIZATIONS.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$801,256	BeginningYearBalanceAmt
Investment Earnings Or Losses	$3,961	InvestmentEarningsOrLossesAmt
End Year Balance	$805,217	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$731,914	BeginningYearBalanceAmt
Investment Earnings Or Losses	$69,342	InvestmentEarningsOrLossesAmt
End Year Balance	$801,256	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$644,870	BeginningYearBalanceAmt
Investment Earnings Or Losses	$87,044	InvestmentEarningsOrLossesAmt
End Year Balance	$731,914	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$591,555	BeginningYearBalanceAmt
Investment Earnings Or Losses	$53,315	InvestmentEarningsOrLossesAmt
End Year Balance	$644,870	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$0	BeginningYearBalanceAmt
Contributions	$620,509	ContributionsAmt
Investment Earnings Or Losses	-$28,954	InvestmentEarningsOrLossesAmt
End Year Balance	$591,555	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.7706	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.2294	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,927,000	OtherCostOrOtherBasisAmt
Book Value	$1,927,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,249,923	OtherCostOrOtherBasisAmt
Depreciation	$7,334,343	DepreciationAmt
Book Value	$8,915,580	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,047,602	OtherCostOrOtherBasisAmt
Depreciation	$1,677,710	DepreciationAmt
Book Value	$369,892	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,196,155	OtherCostOrOtherBasisAmt
Depreciation	$10,283,747	DepreciationAmt
Book Value	$2,912,408	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$30,268	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$30,268	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$14,155,148	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
GOODWILL	$10,817,871
RESTRICTED FOUNDATION ASSETS	$1,800,605

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$12,618,476	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
ASSET RETIREMENT OBLIGATION	$24,538
ADVANCES DUE CORP-TERM	$25,949,996
OTHER NOTES - LOANS PAYABLE	$646,000

Field	Value	IRS element (for citing)
Total Liability	$26,620,534	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule D, Part I, Line 1(a) PART 1, LINE 1A	Prior year ENDOWMENT Balances Were REDUCED to REMOVE FUNDS Restricted UNDER A MORTGAGE AGREEMENT. THESE FUNDS ARE NOT DONOR-RESTRICTED GIFTS AND WILL NOT BE HELD IN PERPETUITY BY THE HOSPITAL TO FUND A PERMANENT SOURCE OF INCOME and have therefore been adjusted appropriately.
Schedule D, Part V, Line 4 Intended uses of endowment funds	PROCEEDS OF THE ENDOWMENT, AS DICTATED BY THE DONORS, ARE USED AS BEST DETERMINED BY THE FOUNDATION COUNCIL.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	OSF IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED BY SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPTED FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. UNDER ASC SUBTOPIC 740-10,ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES -AN INTERPRETATION OF FASB STATEMENT NO.109, OSF MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AS OF SEPTEMBER 30, 2019 AND 2018, OSF AND PCI DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS. ON DECEMBER 22, 2017, THE PRESIDENT SIGNED INTO LAW H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT. THE NEW LAW (PUBLIC LAW NO. 115-97) INCLUDES SUBSTANTIAL CHANGES TO THE TAXATION OF INDIVIDUALS, BUSINESSES, MULTINATIONAL ENTERPRISES, AND OTHERS. IN ADDITION TO MANY GENERALLY APPLICABLE PROVISIONS, THE LAW CONTAINS SEVERAL SPECIFIC PROVISIONS THAT RESULT IN CHANGES TO THE TAX TREATMENT OF TAX-EXEMPT ORGANIZATIONS AND THEIR DONORS. OSF HAS REVIEWED THESE PROVISIONS AND THE POTENTIAL IMPACT AND CONCLUDED THE ENACTMENT OF H.R. 1 WILL NOT HAVE A MATERIAL EFFECT OF THE OPERATIONS OF THE ORGANIZATION.

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

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	125	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
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	$539,062	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$539,062	NetCommunityBenefitExpnsAmt
Total Expense	0.0163	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,989,810	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,111,667	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$878,143	NetCommunityBenefitExpnsAmt
Total Expense	0.0266	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$5,528,872	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,111,667	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,417,205	NetCommunityBenefitExpnsAmt
Total Expense	0.0429	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,569	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,500	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,069	NetCommunityBenefitExpnsAmt
Total Expense	0.0006	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$106,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$106,500	NetCommunityBenefitExpnsAmt
Total Expense	0.0032	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,008,982	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,825,579	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$183,403	NetCommunityBenefitExpnsAmt
Total Expense	0.0056	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,955	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,955	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,144,006	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,827,079	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$316,927	NetCommunityBenefitExpnsAmt
Total Expense	0.0096	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$7,672,878	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,938,746	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,734,132	NetCommunityBenefitExpnsAmt
Total Expense	0.0525	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$706,501	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$13,420,368	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,462,396	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$42,028	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	MENDOTA COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1401 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTPS://WWW.OSFHEALTHCARE.ORG/SAINT-PAUL/	WebsiteAddressTxt
State License	IL0005819	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MENDOTA COMMUNITY 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	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	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	https://www.osfhealthcare.org/about/community-health/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	false	StrategyPostedWebsiteInd
Strategy Attached	Yes (true)	StrategyAttachedInd
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	125.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.osfhealthcare.org/billing/financial-assistance/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.osfhealthcare.org/billing/financial-assistance/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.osfhealthcare.org/billing/financial-assistance/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (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 (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	The significant health needs were prioritized as significant health needs of the community and identified through the CHNA. See CHNA for further information.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. FOR THE 2019 CHNA, MENDOTA COMMUNITY HOSPITAL d/b/a SAINT PAUL MEDICAL CENTER SOLICITED AND TOOK INTO ACCOUNT INPUT FROM THE FOLLOWING SOURCES: 1) CURRENT PUBLIC HEALTH ADMINISTRATOR AT THE LASALLE COUNTY HEALTH DEPT. and CURRENT HEALTH EDUCATOR AND PUBLIC INFORMATION FROM THE LASALLE COUNTY HEALTH DEPT. 2) PRIMARY DATA WAS COLLECTED FROM THE AT-RISK AND ECONOMICALLY DISADVANTAGED POPULATION BY COLLECTING A STRATIFIED SAMPLE OF SURVEYS DISTRIBUTED IN ENGLISH AND SPANISH AT ALL HOMELESS SHELTERS, FOOD PANTRIES AND SOUP KITCHENS. 3) THE CHNA WAS MADE WIDELY AVAILABLE TO THE COMMUNITY AND FEEDBACK RECEIVED FROM COMMUNITY SERVICE ORGANIZATIONS WAS TAKEN INTO ACCOUNT. 4) ADDITIONAL SOURCES OF INPUT WAS RECEIVED FROM A COLLABORATIVE TEAM CREATED TO CONDUCT THE 2019 CHNA, WHICH INCLUDED CONSUMER ADVOCATES, REPRESENTATIVES FROM NONPROFIT AND COMMUNITY-BASED ORGANIZATIONS, ACADEMIC EXPERTS AND HEALTH EDUCATORS, LOCAL GOVERNMENT OFFICIALS, ADMINISTRATORS FROM LOCAL SCHOOL DISTRICTS, HEALTH CARE PROVIDERS AND COMMUNITY HEALTH CENTERS, EXECUTIVE DIRECTOR OF IL VALLEY PADS HOMELESS SHELTER PROGRAM, PROGRAM COORDINATOR FOR THE YOUTH SERVICE BUREAU OF IL VALLEY SERVING THE LATINO POPULATION ENROLLED IN PUBLIC BENEFITS, EXECUTIVE DIRECTOR OF UNITED WAY, AND EXECUTIVE DIRECTOR OF MENDOTA AREA SENIOR SERVICES. MEMBERS OF THE COLLABORATIVE TEAM BY NAME, AFFILIATIONS, TITLE AND EXPERTISE ARE LISTED IN APPENDIX 1 OF THE 2019 CHNA.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER - MENDOTA, IL. THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2019 FOR LASALLE COUNTY WAS A COLLABORATIVE UNDERTAKING BY OTTAWA REGIONAL HOSPITAL AND HEALTHCARE CENTER DBA OSF SAINT ELIZABETH MEDICAL CENTER AND MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER. THE CHNA HIGHLIGHTS THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN LASALLE COUNTY.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R)(3). THE FINAL CHNA FOR THE HOSPITAL WAS APPROVED AND ADOPTED BY THE SYSTEM'S BOARD OF DIRECTORS ON JULY 29, 2019. THIS CHNA IS EFFECTIVE FOR FISCAL YEARS 2020, 2021 AND 2022. THE FOLLOWING INCLUDES A SUMMARY OF EACH FACILITIES ACCOMPLISHMENTS FOR FY19. THE CHNA ACTIVE FOR FY19 WAS APPROVED AND ADOPTED BY THE SYSTEM'S BOARD OF DIRECTORS ON JULY 25, 2016. THIS REPORT HAS BEEN ACTIVE FOR, FISCAL YEAR(S) 2017, 2018 AND 2019. THE LASALLE COUNTY CHNA WAS DONE AS A COLLABORATIVE UNDERTAKING BY OSF SAINT ELIZABETH AND OSF SAINT PAUL MEDICAL CENTERS TO HIGHLIGHT THE HEALTH NEEDS AND WELL BEING OF RESIDENTS IN LASALLE COUNTY. THE COLLABORATIVE TEAM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AS A PRIORITY: HEALTHY BEHAVIORS AND BEHAVIORAL HEALTH. HEALTHY BEHAVIORS IS DEFINED AS ACTIVE LIVING AND HEALTHY EATING AND THEIR IMPACT ON OBESITY. BEHAVIORAL HEALTH INCLUDES MENTAL HEALTH AND SUBSTANCE ABUSE. IN RESPONSE TO THESE PRIORITY HEALTH NEEDS, THE HOSPITALS DEVELOPED AN IMPLEMENTATION STRATEGY DESCRIBING THE ACTIONS THE HOSPITALS INTEND TO TAKE TO ADDRESS BOTH PRIORITY HEALTH NEEDS, THE RESOURCES THE HOSPITALS PLAN TO COMMIT TO ADDRESS THE HEALTH NEEDS, AND ANY PLANNED COLLABORATIONS WITH OTHER ORGANIZATIONS TO ADDRESS THE HEALTH NEEDS. THE HOSPITALS REVIEW THEIR IMPLEMENTATION STRATEGY AT LEAST ANNUALLY AND MAKE REVISIONS AS NEEDED TO MAXIMIZE THE IMPACT ON IDENTIFIED PRIORITY HEALTH NEEDS. A SUMMARY OF HOW THE HOSPITALS HAVE ADDRESSED THE PRIORITY HEALTH NEEDS IS PROVIDED BELOW. FY2017 - 2019 HEALTHY BEHAVIORS DEFINED AS - ACTIVE LIVING, HEALTHY EATING AND OBESITY GOALS. GOALS -BRING TOGETHER COMMUNITY ORGANIZATIONS PROVIDING EDUCATION, INCREASING AWARENESS, AND ENGAGING IN HEALTH NUTRITION, INCLUDING EXERCISE DECISIONS, IN ORDER TO BENEFIT COMMUNITY MEMBERS IN THEIR EVERYDAY LIFE AND OVERALL HEALTH. -INCREASE KNOWLEDGE, AWARENESS AND ENGAGEMENT IN HEALTHY BEHAVIORS IN ORDER TO IMPROVE LASALLE COUNTY RESIDENTS' OVERALL HEALTH. HEALTHY BEHAVIORS MEASUREMENT AND KEY ACCOMPLISHMENTS (1) TRACKED NUMBER OF IMMUNIZATIONS PROVIDED AND THE IMPACT ON SCHOOL ABSENCES. DATA FOR OTTAWA/STREATOR/MENDOTA: 8/1/2016-5/31/2017 21,136 IMMUNIZATIONS GIVEN 8/1/2017-4/20/2018 23,231 IMMUNIZATIONS GIVEN 8/1/2018 TO PRESENT 22,536 IMMUNIZATIONS GIVEN NOTE: THIS PROJECT HAS INCREASED THE IMMUNIZATION COMPLIANCE RATES OF 2 YEAR OLDS IN THE OTTAWA/STREATOR PRACTICES FROM 23.2% IN 2/2016 TO 39.02% AS OF 4/2018 TO 52% AS OF 2/2019. (2) TRACKED HOURS SPENT WITH STUDENT ATHLETES AND THE NUMBER OF INJURIES. 2017 STREATOR HIGH SCHOOL - 451 HOURS/58 INJURIES 2017 OTTAWA HIGH SCHOOL - 232 HOURS/32 INJURIES 2018 STREATOR HIGH SCHOOL - 699 HOURS/90 INJURIES 2018 OTTAWA HIGH SCHOOL - 409 HOURS/20 INJURIES 2018 EARLVILLE HIGH SCHOOL - 245 HOURS/20 INJURIES 2019 STREATOR HIGH SCHOOL / 872 HOURS / 40 INJURIES 2019 OTTAWA HIGH SCHOOL / 449 HOURS / 28 INJURIES 2019 EARLVILLE HIGH SCHOOL / 538 HOURS / 6 INJURIES (3) TRACKED NUMBER OF EDUCATIONAL EVENTS AND ATTENDANCE ADDRESSING HEALTH AND WELLNESS. 2017: 74 EVENTS: 4115 ATTENDEES 2018: 114 EVENTS: 7500 ATTENDEES (4) TRACKED NUMBER OF SPORTS PHYSICALS PROVIDED. 2016: STREATOR HIGH SCHOOL - 57; OTTAWA HIGH SCHOOL - 59 2017: STREATOR HIGH SCHOOL - 51; OTTAWA HIGH SCHOOL - 69 2018: STREATOR HIGH SCHOOL - 41; OTTAWA HIGH SCHOOL - 79; EARLVILLE HIGH SCHOOL - 11 (5) TRACKING OF SOCIAL MEDIA POSTS. IN 2017, SAINT ELIZABETH MEDICAL CENTER HAD FACEBOOK POSTS REACHING 1,070,284 RESIDENTS. CENTER FOR HEALTH'S FACEBOOK POSTS REACHING 441,387 RESIDENTS. IN 2018, SAINT PAUL MEDICAL CENTER HAD FACEBOOK POSTS REACHING LOCAL RESIDENTS 437,000 TIMES IN 2018, SAINT ELIZABETH MEDICAL CENTER FACEBOOK POSTS REACHED LOCAL RESIDENTS 752,000 TIMES CENTER FOR HEALTH'S FACEBOOK POSTS REACHED LOCAL RESIDENTS 305,000 TIMES (6) POUNDS OF FOOD DONATED TO COMMUNITY AGENCIES FROM OUR COMMUNITY GARDEN. 2017 - 1500 POUNDS 2018 - 1500 POUNDS 2019 - 1749 POUNDS (7) TRACKED PARTICIPATION IN OSF4LIFE - INCREASED PARTICIPATION. 2017 - HEALTH RISK ASSESSMENT AT SAINT ELIZABETH MEDICAL CENTER - 39% 2017 - HEALTH RISK ASSESSMENT AT SAINT PAUL MEDICAL CENTER - 63% WELLNESS CHALLENGE VIRTUE AT SAINT PAUL MEDICAL CENTER HAD 49 PARTICIPANTS WELLNESS CHALLENGE VIRTUE AT SAINT ELIZABETH MEDICAL CENTER HAD 35 PARTICIPANTS TAKE THE FIRST STEP CHALLENGE AT SAINT PAUL MEDICAL CENTER HAD 83 PARTICIPANTS TAKE THE FIRST STEP CHALLENGE AT SAINT ELIZABETH MEDICAL CENTER HAD 53 PARTICIPANTS 2018 HEALTH RISK ASSESSMENT AT SAINT ELIZABETH MEDICAL CENTER - 42% 2018 HEALTH RISK ASSESSMENT AT SAINT PAUL MEDICAL CENTER - 66.5% 2019 HRA : SEMC - 45% SPMC - 69%. (8) TRACKED PARTICIPATION IN POUNDS WITH THE HEALTHY YOU PROGRAM FOR SAINT PAUL MEDICAL CENTER. 2016: 259 PARTICIPANTS; 2300 POUNDS 2017: 251 PARTICIPANTS; 2339 POUNDS 2018: 283 PARTICIPANTS; 2441 POUNDS 2019 CHANGED PROGRAM. BEGAN COLLABORATIVE/PARTNERSHIP INITIATIVE - LIVE WELL STREATOR; HELD MONTHLY MEETINGS ON HEALTHY EATING, ACTIVITY AND OPIOID USE DISORDER PARTICIPATES IN ACTION WALK WITH GREENWAY TRAIL IN STREATOR; 100 PARTICIPANTS WALKED 2.8 MILES COLLABORATED AND ROLLED OUT PIECES IRIS, CASE MANAGEMENT PLATFORM THAT EXTENDS HEALTH SYSTEM AND HEALTHY PLAN NETWORKS TO INCLUDE COMMUNITY BASED ORGANIZATIONS TO ADDRESS HEALTH RELATED SOCIAL NEEDS. PARTICIPATING ORGANIZATIONS INCLUDE: SERVANT'S HEART; SAFE JOURNEY; BEST, INC; OTTAWA/PERU PADS; LASALLE CO. HEALTH DEPT; OTTAWA/STREATOR YMCA; STREATOR ELEMENTARY/HIGH SCHOOL; SALVATION ARMY - STREATOR; TRI-COUNTY OPPORTUNITIES COUNCIL. FY2017 - 2019 BEHAVIORAL HEALTH DEFINED AS - MENTAL HEALTH AND SUBSTANCE ABUSE GOAL GOALS: -INCREASE ACCESS TO AND AWARENESS OF MENTAL HEALTH SERVICES IN LASALLE COUNTY. -INCREASE AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY. -COMMIT TO TEACHING, EMPOWERING, AND ADVOCATING FOR MENTAL HEALTH ISSUES. -DEVELOP AND IMPLEMENT STRATEGIES TO FACILITATE ACCESS AND IMPROVE COMMUNITY AGENCY ALIGNMENT TO MEET THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. -INCREASE AWARENESS AND ENGAGEMENT TO DECREASE INSTANCES OF RISKY BEHAVIOR AND SUBSTANCE ABUSE IN LASALLE COUNTY. -PROVIDE AWARENESS OF FUTURE POTENTIAL RISKS RELATED TO SUBSTANCE ABUSE. -DEVELOP AND IMPLEMENT STRATEGIES TO FACILITATE SERVICES / ACCESS AND IMPROVE COMMUNITY AGENCY ALIGNMENT IN ADDRESSING ALCOHOL AND ILLICIT SUBSTANCE ABUSE BY YOUTHS WITHIN THE COMMUNITY. BEHAVIORAL HEALTH MEASUREMENT AND KEY ACCOMPLISHMENTS (1) DEVELOPED A STRATEGIC SYSTEM OF CARE PLAN FOR MENTAL HEALTH (STREATOR INITIATIVE). IMPLEMENTED BEHAVIORAL HEALTH NAVIGATOR, REFERRAL ALGORITHM, AND EMBEDDED BEHAVIORIST IN PRIMARY CARE PRACTICE, TELE-PSYCH, NCBH COLOCATION, LIVE WELL STREATOR SUBSTANCE ABUSE FOCUS. *DRUG TAKE BACK EVENT PRODUCED. 242 POUNDS IN 2019. (2) MONITORED COUNSELING VISITS PROVIDING EARLY INTERVENTION, DEPRESSION SCREENING AND SUPPORT. EMBEDDED A THERAPIST IN CENTER FOR HEALTH-STREATOR. (3) TRACKED PATIENT WISDOM DATA. A SURVEY TOOL USED TO ASK COMMUNITY MEMBERS QUESTIONS SPECIFIC TO BEHAVIORAL HEALTH. 149 RESPONDENTS GAVE THEIR VIEW ON HOW TO ADDRESS BEHAVIORAL HEALTH IN COMMUNITY. 20% IDENTIFIED SUBSTANCE ABUSE AS NEEDING MORE COMMUNITY ATTENTION. IN 2018 THE DATA USAGE CONTINUES TO VALIDATE STRATEGIES. (4) TRACKED UNIQUE PATIENTS FOR BEHAVIORAL HEALTH SERVICES THROUGH TELE-PSYCH. 236 TELE-PSYCH UNIQUE PATIENTS (5) TRACKED TELE-PSYCH VISITS. 367 TELE-PSYCH OUTPATIENT VISITS 105 ECO SILT PSYCH VISITS 15% OF CHOICES OUTPATIENTS FROM STREATOR-PSYCHIATRY AND THERAPY SERVICES IN 2018, 939 TELE-PSYCH OUTPATIENT VISITS 99 OF THE VISITS WERE IN CENTER FOR HEALTH TELE-PSYCH FOR A TOTAL OF 939 TELE-PSYCH PATIENTS ADDED ADDITIONAL HOURS FOR TELE-PSYCH 2019, 1416 OP VISITS. (6) TRACKED THE BEHAVIORAL HEALTH NAVIGATOR CALLS. BEHAVIORAL HEALTH NAVIGATORS SERVED OVER 300 COMMUNITY MEMBERS. (7) TRACKED SILVER CLOUD (BEHAVIORAL HEALTH APP). 200 COMMUNITY MEMBERS JOINED IN THE PAST TWO YEARS. *2019 ADDED 113.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. CATASTROPHIC FINANCIAL ASSISTANCE IS AVAILABLE WHEN CHARGES EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT BILLED IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES THIS ADJUSTMENT IS THE MOST GENERAL ASSISTANCE.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. PRESUMPTIVE FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDES FOR A DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO A PATIENT WITH NO INSURANCE BENEFITS, WHEN THE PATIENT ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA: HOMELESSNESS; DECEASED WITH NO ESTATE; MENTAL INCAPACITATION WITH NO ONE TO ACT ON THE PATIENT'S BEHALF; AND CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE.
Schedule H, Part V, Section B, Line 15 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. THE FINANCIAL ASSISTANCE POLICY DIRECTS PATIENTS TO STAFF IN THE PATIENT FINANCIAL SERVICES AND ADMITTING AREAS AT OSF HOSPITALS FOR ASSISTANCE IN OBTAINING ANSWERS TO QUESTIONS REGARDING THE POLICY.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - MENDOTA COMMUNITY HOSPITAL. A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS, INFORMATION ABOUT FINANCIAL ASSISTANCE AND THE APPLICATION PROCESS IS INCLUDED ON OR WITH THE OSF PATIENT BILLING STATEMENT, AND OSF PROVIDES COPIES OF THE PLAIN LANGUAGE SUMMARY AND THE FAP APPLICATION FORM TO REFERRING STAFF PHYSICIANS.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c SCH H, PART I, LINE 3C	-CATASTROPHIC CHARITY ASSISTANCE REGARDLESS OF INCOME OR ASSET LEVELS FOR MEDICALLY NECESSARY SERVICES WHICH EXCEED 25% OF ANNUAL FAMILY INCOME. THE AMOUNT DUE IS ADJUSTED TO 25% OF FAMILY INCOME WHEN OSF DETERMINES CATASTROPHIC CHARITY IS MORE GENEROUS. -PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; - DECEASED WITH NO ESTATE; - MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR - CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. - ALL PATIENTS RECEIVE THE GREATEST REQUESTED DISCOUNT AVAILABLE UNDER ANY OF THE OSF PROGRAMS. NO ASSET TESTS ARE USED. - EXCEPT AS OTHERWISE NOTED, THESE POLICIES APPLY BOTH TO UNINSURED PATIENTS AND TO INSURED PATIENTS WITH RESPECT TO THE PATIENT RESPONSIBILITY AMOUNT.
Schedule H, Part I, Line 7g Subsidized Health Services	COSTS REPORTED ON LINE 7G DO NOT INCLUDE PHYSICIAN CLINIC COSTS. THESE COSTS REFLECT A HOSPITAL DEPARTMENT THAT IS ELIGIBLE TO BE CLAIMED BUT HAD NOT BEEN CLAIMED IN PAST RETURNS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	MEDICARE COST TO CHARGE RATIO
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	IN GENERAL, AND IN ACCORDANCE WITH MEDICARE REGULATIONS, PATIENT ACCOUNT BALANCES ARE WRITTEN OFF TO BAD DEBT EXPENSE AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY OR LAW FIRM. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, OSF ANALYZES PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, OSF ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE PATIENTS ARE SCREENED AGAINST THE OSF FINANCIAL ASSISTANCE POLICY AND UNINSURED DISCOUNT POLICY. FOR ANY REMAINING PATIENT RESPONSIBILITY BALANCE, OSF RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BAD DEBT EXPENSE OF 1,713,145 ON FORM 990, PART IX, LINE 24B IS BASED UPON ACCRUAL ACCOUNTING REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THIS AMOUNT CONSEQUENTLY DIFFERS FROM THE BAD DEBT EXPENSE OF 706,501 ON SCHEDULE H, PART III, LINE 2 WHICH REQUIRES THE ORGANIZATION TO REPORT AGGREGATE BAD DEBT AT COST. BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS THEREFORE CALCULATED BY MULTIPLYING GROSS CHARGES WRITTEN OFF TO BAD DEBT EXPENSE TIMES THE MEDICARE COST-TO-CHARGE RATIO DERIVED FROM THE MEDICARE COST REPORT. DISCOUNTS, INCLUDING ANY APPLICABLE THIRD PARTY PAYER CONTRACTUAL ALLOWANCES AND ANY CHARITY CARE DISCOUNTS (VALUED AT GROSS CHARGES), ARE APPLIED TO PATIENT ACCOUNT GROSS CHARGES TO DETERMINE THE ACCOUNT BALANCE BEFORE PATIENT PAYMENTS. THE AGGREGATE AMOUNT OF ALL PATIENT PAYMENTS IS THEN APPLIED TO THE ACCOUNT BALANCE. WHEN DETERMINATION IS MADE THAT NO FURTHER AMOUNTS CAN BE COLLECTED IN ACCORDANCE WITH THE CORPORATION'S BAD DEBT POLICY, THE REMAINING BALANCE IS WRITTEN OFF TO BAD DEBT EXPENSE. PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; -DECEASED WITH NO ESTATE; -MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR -CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. THEREFORE, THE CORPORATION DOES NOT BELIEVE THAT BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 INCLUDES ANY AMOUNTS THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY UNDER THE CORPORATION'S FINANCIAL ASSISTANCE POLICY.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	PLEASE SEE PAGE 19 OF NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	100% OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. OSF IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY USING THE MEDICARE COST TO CHARGE RATIO. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UN-REIMBURSED COSTS FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE CORPORATION HAS A FAIR BILLING/COLLECTION POLICY WHICH APPLIES FOR ALL PATIENTS. THE POLICY INCLUDES: -REQUIRED INFORMATION PROVIDED IN BILLS TO PATIENTS (INCLUDING A REQUIREMENT THAT INFORMATION BE PROVIDED ON HOW THE PATIENT MAY APPLY FOR FINANCIAL ASSISTANCE). -PROCESS FOR PATIENTS TO INQUIRE ABOUT OR DISPUTE A BILL, INCLUDING TOLL-FREE TELEPHONE NUMBER, ADDRESS, CONTACT NAME AND E-MAIL ADDRESS. -REQUIREMENTS FOR TIMELY RESPONSE TO PATIENT INQUIRIES. -CONDITIONS WHICH MUST BE SATISFIED BEFORE PATIENT MAY BE SENT TO A COLLECTION AGENCY OR ATTORNEY. -LEGAL ACTION FOR NON-PAYMENT OF A PATIENT BILL MAY NOT BE INITIATED UNTIL AN AUTHORIZED HOSPITAL OFFICIAL HAS DETERMINED THAT ALL CONDITIONS IN THE CORPORATION'S POLICY (INCLUDING ALL THE FOREGOING POLICY PROVISIONS) HAVE BEEN SATISFIED FOR INITIATING LEGAL ACTION. -LEGAL ACTION MAY NOT BE PURSUED AGAINST UNINSURED PATIENTS WHO HAVE CLEARLY DEMONSTRATED THAT THEY HAVE NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET THEIR FINANCIAL OBLIGATIONS - EVEN IF SUCH PATIENTS DO NOT APPLY FOR FINANCIAL ASSISTANCE. -THE CORPORATION SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS, SUCH AS SUBMITTING REPORTS TO CREDIT AGENCIES BEFORE REASONABLE ATTEMPTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE HAVE BEEN COMPLETED. -IF A PATIENT RECEIVES AN APPLICATION FOR FINANCIAL ASSISTANCE BUT FAILS TO RETURN IT, OSF WILL TRY TO USE SECONDARY SOURCES TO DETERMINE THE PATIENT'S ELIGIBILITY FOR NON COMPLIANT CHARITY BEFORE PURSUING LEGAL ACTION FOR NONPAYMENT. IF A COMPLETE APPLICATION IS RECEIVED DURING THE APPLICATION PERIOD, OSF WILL SUSPEND EXTRAORDINARY COLLECTION ACTIONS AND MAKE A DETERMINATION OF ELIGIBILITY FOR ASSISTANCE. IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, OSF WILL ISSUE APPROPRIATE REFUNDS AND REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN, AS MORE FULLY DESCRIBED IN THE OSF FAIR BILLING - COLLECTION POLICY.
Schedule H, Part V, Section B, Line 16a FAP website	- MENDOTA COMMUNITY HOSPITAL: Line 16a URL: https://www.osfhealthcare.org/billing/financial-assistance/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- MENDOTA COMMUNITY HOSPITAL: Line 16b URL: https://www.osfhealthcare.org/billing/financial-assistance/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- MENDOTA COMMUNITY HOSPITAL: Line 16c URL: https://www.osfhealthcare.org/billing/financial-assistance/;
Schedule H, Part VI, Line 2 Needs assessment	MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") DURING FISCAL YEAR 2019 AS PREVIOUSLY STATED. THE CHNA IS UPDATED EVERY 3 YEARS AND CORRESPONDING IMPLEMENTATION STRATEGY IS REFRESHED YEARLY. NOT ONLY DOES THE PLAN GET REFRESHED YEARLY, BUT EACH ACTION ITEM HAS A RESPONSIBLE PARTY INVOLVED TO GET THE WORK ASSOCIATED WITH THE NEED ACCOMPLISHED. THE NEW CHNA WAS APPROVED AND ADOPTED BY THE OSF BOARD OF DIRECTORS ON JULY 29, 2019 AND THE CORRESPONDING IMPLEMENTATION STRATEGY WAS APPROVED JANUARY 27, 2020. THE ASSOCIATED PLAN GOALS AND ACCOMPLISHMENTS WILL BE IN OUR NEXT FISCAL YEAR 2020 FILING. LEADERSHIP WITHIN OSF SIT ON VARIOUS COMMUNITY ADVISORY BOARDS TO STAY CONNECTED TO THE OTHER AGENCIES WITHIN THE COMMUNITY. THIS WORK ALIGNS WITH OUR MISSION STATEMENT TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE CORPORATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER GOVERNMENT PROGRAMS AND THE CORPORATION'S FINANCIAL ASSISTANCE POLICY, IN ENGLISH AND IN ANY OTHER LANGUAGE SPOKEN BY POPULATIONS WITH LIMITED ENGLISH PROFICIENCY THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY OF THE HOSPITAL, IN THE FOLLOWING WAYS: -SIGNS ARE POSTED IN PATIENT REGISTRATION AREAS (INCLUDING EMERGENCY DEPARTMENT REGISTRATION) INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, THE AVAILABILITY OF FINANCIAL ASSISTANCE COUNSELORS, AND HOW TO OBTAIN A COPY OF THE OSF FINANCIAL ASSISTANCE POLICY AND APPLICATION. -A PLAIN LANGUAGE SUMMARY OF THE OSF FINANCIAL ASSISTANCE POLICY IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS AND INCLUDED IN THE BILLING STATEMENT MAILED PRIOR TO INITIATING EXTRAORDINARY COLLECTION ACTIONS. IN ADDITION, THE PLAIN LANGUAGE SUMMARY AND APPLICATION ARE PROVIDED TO REFERRING STAFF PHYSICIANS. -OSF MAKES REASONABLE EFFORTS TO ORALLY NOTIFY PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN ASSISTANCE IN APPLYING. -A NOTICE OF AVAILABILITY OF THE CORPORATION'S FINANCIAL ASSISTANCE AND UNINSURED PATIENT DISCOUNT POLICIES IS PROMINENTLY AVAILABLE ON THE CORPORATION'S WEB SITE. THE APPLICATION FORM WITH INSTRUCTIONS AND THE PLAIN LANGUAGE SUMMARY IS AVAILABLE FOR DOWNLOAD. -A NOTE REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE (TOGETHER WITH CONTACT PHONE NUMBERS) APPEARS ON EVERY PATIENT BILLING STATEMENT AS WELL AS THE WEBSITE WHERE COPIES OF THE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY MAY BE OBTAINED. -FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND BY PHONE TO ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AND IN DETERMINING ELIGIBILITY AND APPLYING FOR GOVERNMENT PROGRAM BENEFITS, INCLUDING MEDICAID. -THE CORPORATION'S FINANCIAL ASSISTANCE POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC.
Schedule H, Part VI, Line 4 Community information	MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER IS LOCATED IN LASALLE COUNTY. DATA ESTABLISHES THAT LASALLE COUNTY IS THE RESIDENCE OF OVER 90% OF ALL PATIENTS RECEIVING SERVICES FROM SAINT PAUL MEDICAL CENTER AND SAINT ELIZABETH MEDICAL CENTER. THE HOSPTIAL IS A CRITICAL ACCESS HOSPTIAL SERVING AN AGING POPULATION. THE HISPANIC POULATION COMPRISES 9.4% OF THE POPULATION. RESIDENTS HAVE A MEDIAN HOUSEHOLD INCOME LOWER THEN THE STATE OF ILLINOIS. UNEMPLOYMENT REMAINS SLIGHTLY HIGHER THEN THE STATE OF ILLINOIS UNEMPLOYMENT RATE.
Schedule H, Part VI, Line 5 Promotion of community health	THE CORPORATION'S SPONSORING ORGANIZATION IS A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS. IN ACCORDANCE WITH CANON LAW OF THE ROMAN CATHOLIC CHURCH AND FEDERAL TAX LAW APPLICABLE TO SUPPORTING ORGANIZATIONS, A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION ARE PROFESSED MEMBERS OF THE SPONSORING RELIGIOUS CONGREGATION. EACH HOSPITAL OPERATED BY THE CORPORATION HAS A COMMUNITY ADVISORY BOARD CONSISTING OF MEMBERS OF THE COMMUNITY WHO ARE NOT DIRECTORS, OFFICERS, OR CONTRACTORS OF THE CORPORATION. THE CORPORATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE SURPLUS FUNDS WERE USED DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 FOR IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. THE CORPORATION MEETS THE REQUIREMENTS OF REVENUE RULING 69-545 BY: -OPERATING AN EMERGENCY DEPARTMENT WHICH IS STAFFED 24 HOURS PER DAY BY QUALIFIED PHYSICIANS AND OTHER MEDICAL PERSONNEL AND WHICH IS OPEN TO ALL PERSONS WITHOUT REGARD TO ABILITY TO PAY. -HAVING A MEDICAL STAFF WHICH IS OPEN TO ALL QUALIFIED PHYSICIANS, MID-LEVEL PROVIDERS, PODIATRISTS, AND DENTISTS IN THE COMMUNITY (EXCEPT WHERE RESTRICTED IN RARE CASES FOR CLINICAL QUALITY REASONS BY ACTION OF THE MEDICAL STAFF AND THE BOARD OF DIRECTORS). -ACCEPTING MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAM PATIENTS. ACCEPTING ALL PATIENTS, INCLUDING UNINSURED PATIENTS, WITHOUT REGARD TO THEIR ABILITY TO PAY. -USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. MENDOTA COMMUNITY HOSPITAL DBA OSF SAINT PAUL MEDICAL CENTER IS INVOLVED IN THE PROMOTION OF COMMUNITY HEALTH IN SEVERAL WAYS INCLUDING BUT NOT LIMITIED TO; ADOPTING IMPLEMENTATION STRATEGIES TO ADDRESS SIGNIFCANT HEALTH NEEDS IDENFIED IN THE 2019 CHNA; PROVIDING HEALTH SCREENING BOOTHS AT COMMUNITY EVENTS; PROVIDING BEHAVIORAL HEALTH REFERRALS; PERFORMING WELLNESS SCREENINGS AT VARIOUS BUSINESSES IN THE COMMUNITY; AND PREPARING AND DELIVERING MEALS TO COMMUNITY MEMBERS IN NEED WITH OUR MEALS ON WHEELS PROGRAM. OSF ON CALL OFFERS A 24/7 ONLINE ACCESS TO MEDICAL CARE VIA SMARTPHONE, TABLET OR COMPUTER.
Schedule H, Part VI, Line 6 Affiliated health care system	The Corporation is part of an affiliated health care system (the "OSF System"), which is an integrated health system that operates acute care hospitals, home health care services, two colleges of nursing, a medical training simulation center, emergency medical transportation, and other health care facilities in Illinois and Michigan. The OSF System includes many other entities which are controlled, directly or indirectly by the Sisters of the Third Order of St. Francis (the "Congregation"). All affiliated entities apply and follow the charity care policies of the Corporation and are operated in furtherance of the mission to provide comprehensive, integrated quality care to the communities served by the Corporation. The OSF System's corporate office in Peoria, Illinois (the "Corporate Office"), provides corporate management services as well as direction, consultation and assistance to the administration of the OSF System's health care facilities and subsidiary corporations. The primary affiliated corporations of the OSF System are the following: The Congregation, which works exclusively in the health care apostolate, holds the assets of the religious congregation and directs all other corporations in the affiliated health care system through board representation and the exercise of reserved powers. OSF Multi-Specialty Group was incorporated in 2011. Virtually all physicians and advance practice providers providing professional services through the OSF System's acute care hospital facilities and ambulatory practice settings (with a few limited exceptions) provide services pursuant to employment agreements or professional service agreements with the Multi-Specialty Group. OSF Medical Group is a d/b/a of Multi-Specialty Group. Pointcore, Inc., formerly known as OSF Saint Francis, Inc., was originally incorporated in 1986 and is engaged in the following lines of business: retail pharmacies, retail shops, a mobile medical system, durable medical equipment, home therapeutics, real estate, equipment technology services, telecommunications, electronic health records, telehealth services, and consulting services. Pointcore, Inc. also participates in various health related joint ventures. OSF Healthcare Foundation was incorporated in 1989 to conduct fundraising and other activities for the benefit of OSF Healthcare System and in support of the mission of the Congregation. Ottawa Regional Hospital & Healthcare Center, formerly known as Community Hospital of Ottawa was incorporated in 1964. OSF Healthcare System became the sole member of Ottawa Regional Hospital & Healthcare Center in 2012, and the hospital was renamed as d/b/a/ OSF Saint Elizabeth Medical Center. Mendota Community Hospital, formerly known as Mendota Hospital Foundation, was incorporated in 1944. OSF Healthcare System became the sole member of Mendota Community Hospital in 2015, and the hospital was renamed as d/b/a/ OSF Saint Paul Medical Center.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (28 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
Kevin D Schoeplein
Former - Vice Chairperson CEO	$0	$0	$0	$760,000	$0	$2,090,403	$0	$41,061	$0	$1,594	$0	$2,893,058	$0	$0
Robert C Sehring
Vice Chairperson CEO	$0	$1,198,952	$0	$433,312	$0	$27,834	$0	$44,400	$0	$22,733	$0	$1,727,232	$0	$0
Gerald J McShane MD
Board Member	$0	$373,046	$0	$0	$0	$9,407	$0	$52,500	$0	$22,743	$0	$457,696	$0	$0
Anthony M Avellino MD
Former - CEO NSSL/INI	$0	$497,432	$0	$0	$0	$1,063	$0	$25,763	$0	$12,601	$0	$536,859	$0	$0
David A Schertz
Former - CEO Northern Region	$0	$522,872	$0	$136,072	$0	$166,231	$0	$34,000	$0	$16,342	$0	$875,516	$0	$0
Kenneth E Berkovitz MD
Former - CEO CVSL	$0	$486,977	$0	$0	$0	$2,546	$0	$28,022	$0	$14,177	$0	$531,722	$0	$0
Kenneth J Natzke
Former CEO East Region	$0	$160,000	$0	$0	$0	$0	$0	$20,250	$0	$0	$0	$180,250	$0	$0
Chad E Boore
Chief Executive Officer Eastern Region	$0	$375,351	$0	$100,633	$0	$13,081	$0	$17,684	$0	$28,804	$0	$535,554	$0	$0
Divya-Devi Joshi
CEO Children SL	$0	$518,376	$0	$134,278	$0	$1,474	$0	$17,800	$0	$9,872	$0	$681,800	$0	$0
Dwight D Stapleton
Vice President Clinical Specialty Services	$0	$415,537	$0	$86,547	$0	$114	$0	$21,850	$0	$9,573	$0	$533,621	$0	$0
James J Mormann
Chief Information Officer	$0	$586,086	$0	$154,715	$0	$8,864	$0	$40,350	$0	$26,894	$0	$816,909	$0	$0
Jeffry M Tillery
SVP Chief Transformation Officer	$0	$557,443	$0	$147,333	$0	$4,487	$0	$52,069	$0	$20,380	$0	$781,713	$0	$0
John R Evancho
SVP Chief Compliance Officer	$0	$257,513	$0	$68,752	$0	$8,611	$0	$19,430	$0	$28,728	$0	$383,035	$0	$0
John C Horne
SVP Chief Supply Chain Officer	$0	$344,936	$0	$92,045	$0	$8,206	$0	$36,300	$0	$26,283	$0	$507,770	$0	$0
Leon A Yeh MD
VP CMO Emergency Serv	$0	$490,398	$0	$100,800	$0	$47	$0	$36,300	$0	$28,594	$0	$656,140	$0	$0
Lori L Wiegand
Chief Nursing Officer	$0	$384,623	$0	$99,683	$0	$19,961	$0	$52,500	$0	$20,269	$0	$577,036	$0	$0
Mark A Nafziger
CEO Ambulatory Care	$0	$593,148	$0	$154,190	$0	$10,264	$0	$21,630	$0	$10,965	$0	$790,196	$0	$0
Michael M Allen
CFO	$0	$600,496	$0	$181,366	$0	$1,707	$0	$33,525	$0	$27,004	$0	$844,097	$0	$0
Michael A Cruz MD
Chief Executive Officer Central Region	$0	$612,279	$0	$161,133	$0	$3,243	$0	$52,500	$0	$26,458	$0	$855,613	$0	$0
Michelle D Conger
Chief Strategy Officer	$0	$457,618	$0	$119,634	$0	$10,305	$0	$15,297	$0	$26,356	$0	$629,211	$0	$0
Ralph R Velazquez MD
System Chief Medical Officer	$0	$474,101	$0	$122,124	$0	$14,796	$0	$52,500	$0	$18,608	$0	$682,129	$0	$0
Robert L Brandfass
SVP Chief Legal Officer	$0	$530,487	$0	$137,920	$0	$9,997	$0	$40,350	$0	$27,108	$0	$745,862	$0	$0
Roxanna Crosser
Chief Executive Officer Western Region	$0	$359,201	$0	$93,006	$0	$22,866	$0	$42,212	$0	$8,368	$0	$525,652	$0	$0
Stephen E Hippler MD
Chief Clinical Officer	$0	$592,624	$0	$152,023	$0	$4,782	$0	$52,500	$0	$26,444	$0	$828,373	$0	$0
Thomas G Hammerton
President OSF Healthcare Foundation Chief Development Officer	$0	$337,111	$0	$88,059	$0	$35,134	$0	$40,120	$0	$20,064	$0	$520,487	$0	$0
Jane A Battles
APN	$126,192	$0	$8,475	$0	$1,419	$0	$9,684	$0	$20,055	$0	$165,825	$0	$0	$0
Katherine R Riva-Foster MD
Physician	$222,336	$0	$0	$0	$46	$0	$9,832	$0	$20,055	$0	$252,268	$0	$0	$0
Kenneth K Potts MD
Physician	$229,566	$0	$0	$0	$282	$0	$15,851	$0	$19,437	$0	$265,137	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3 SCH J, PART I, LINE 3	THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS, COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	THE CORPORATION REIMBURSES CERTAIN EXECUTIVES FOR SOCIAL CLUB DUES PAID BY SUCH EXECUTIVES. ELIGIBILITY FOR CLUB DUES REIMBURSEMENT IS DETERMINED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS AND IS TAKEN INTO CONSIDERATION BY THE COMMITTEE IN DETERMINING FAIR MARKET COMPENSATION. SEE FORM 990 - SCHEDULE O - PART VI - LINES 15A AND 15B FOR AN EXPLANATION OF THE ROLE OF THE HUMAN RESOURCES COMMITTEE AND THE MANNER IN WHICH FAIR MARKET COMPENSATION IS DETERMINED. CLUB DUES ARE NOT ELIGIBLE FOR REIMBURSEMENT IF THE CLUB IN QUESTION DISCRIMINATES ON THE BASIS OF RACE, RELIGION, SEX, NATIONAL ORIGIN, OR OTHER PROHIBITED FACTORS. DUES REIMBURSEMENT IS TREATED AND REPORTED AS TAXABLE COMPENSATION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DURING 2018, OSF HEALTHCARE SYSTEM MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: KEVIN D. SCHOEPLEIN DURING 2018, THE FOLLOWING CONTRIBUTIONS WERE MADE BY OSF HEALTHCARE SYSTEM TO THE PLAN: KEVIN D. SCHOEPLEIN - $-0- DURING 2018, DISTRIBUTIONS WERE MADE BY OSF HEALTHCARE SYSTEM FROM THE PLAN: KEVIN D. SCHOEPLEIN - $2,087,403

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 1 PART I	THE TAX LAW REQUIRES THAT EACH LEGAL ENTITY WITHIN THE OSF HEALTHCARE SYSTEM COMPLETE A SEPARATE TAX RETURN WHICH APPROPRIATELY REFLECTS THE ACTIVITIES AND FINANCIAL POSITION OF THE PARTICULAR ORGANIZATION. THIS REPORTING, HOWEVER, IS NOT REFLECTIVE OF THE OSF HEALTHCARE SYSTEM AS A WHOLE. PLEASE SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS OF OSF HEALTHCARE SYSTEM AND SUBSIDIARIES FOR A COMPLETE OVERVIEW OF THE SYSTEM.
Form 990, Part VI, Line 6 Classes of members or stockholders	OSF HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	OSF HEALTHCARE SYSTEM AS A SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL HAS THE POWER TO ELECT MEMBERS OF THE BOARD.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	RESERVED POWERS: THE FOLLOWING POWERS ARE RESERVED FOR THE MEMBER: A) TO ESTABLISH, APPROVE, OR MODIFY THE PHILOSOPHY, VISION, VALUES, AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. (B) TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (C) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION. (D) TO MERGE OR CONSOLIDATE THE CORPORATION WITH OTHER ENTITIES OR TO DISSOLVE THE CORPORATION. (E) TO ACQUIRE AN INTEREST IN AN EXISTING ENTITY OR TO ESTABLISH A NEW ENTITY. (F) TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE ANY REAL PROPERTY OR INTEREST IN REAL PROPERTY OF THE CORPORATION. (G) TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. (H) TO APPROVE ANY BORROWING OR DEBT FINANCING ON BEHALF OF THE CORPORATION. (I) TO APPOINT, DISCIPLINE, TERMINATE AND REMOVE THE CORPORATION'S OPERATING DIVISION PRESIDENT. (J) TO APPOINT AND REMOVE THE CORPORATION'S CHAIRPERSON, VICE CHAIRPERSON(S), CHIEF EXECUTIVE OFFICER, PRESIDENT, SECRETARY, AND TREASURER, AND THE ASSISTANT SECRETARY AND ASSISTANT TREASURER, IF ANY. (K) TO APPROVE OR AMEND STRATEGIC PLANS, MANAGEMENT OBJECTIVES, AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. (L) TO APPROVE ANY PURCHASE OR OTHER AQUISITION BY THE CORPORATION THAT IS NOT INCLUDED IN ITS CAPITAL BUDGET AND EXCEEDS ONE MILLION DOLLARS ($1,000,000) PER ITEM. (M) TO NAME OR RENAME ANY HOSPITAL OR MEDICAL CENTER OWNED AND OPERATED BY THE CORPORATION. (N) TO REQUIRE A CERTIFIED AUDIT OF FINANCES OF THE CORPORATION AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. (O) TO APPROVE THE ENGAGEMENT OF AND TO DISMISS ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS OR IN CONNECTION WITH ANY MATTER DEEMED BY THE MEMBER, IN GOOD FAITH, TO HAVE SIGNIFICANCE FOR THE CORPORATION AS A WHOLE. (P) TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WILL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY. (Q) TO TAKE ANY AND ALL ACTIONS DEEMED NECESSARY, IN THE SOLE JUDGEMENT OF THE MEMBER BOARD TO PROTECT AND PRESERVE THE TAX-EXEMPT STATUS AND PUBLIC CHARITY STATUS OF THE CORPORATION OR THE MEMBER AND ANY TAX-EXEMPT AFFILIATE OF THE CORPORATION OR THE MEMBER (INCLUDING FEDERAL AND STATE INCOME TAX EXEMPTIONS, PROPERTY TAX EXEMPTIONS, AND SALES TAX EXEMPTIONS); PROVIDED THE MEMBER BOARD HAS GIVEN A WRITTEN REQUEST TO THE BOARD TO TAKE ACTION OR REFRAIN FROM TAKING ACTION, WHICH WOULD HAVE SUFFICIENTLY PROTECTED AND PRESERVED SUCH TAX-EXEMPT AND PUBLIC CHARITY STATUS, AND THE BOARD HAS FAILED TO PROMPTLY TAKE SUCH ACTION OR REFRAIN FROM TAKING SUCH ACTION.
Form 990, Part VI, Line 9 Interested person not at organization's address	BRIAN SILVERSTEIN, M.D. 711 APPLE TREE LANE GLENCOE, IL 60022
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE PROPOSED FINAL VERSION OF THE 990 IS SENT VIA E-MAIL TO ALL OFFICERS AND MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES FOR FILING.
Form 990, Part VI, Line 12c Conflict of interest policy	DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTION DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM ON AN ANNUAL BASIS. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION ON AN ANNUAL BASIS. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION ABOUT THE INTEREST. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISION OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITEE. THE COMMITEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATION FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVEIWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY IN NOVEMBER.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBER OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHED THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED. THE COMPENSATION REVIEW IS DONE ANNUALLY IN NOVEMBER.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	OTHER - Total Revenue: 71026, Related or Exempt Function Revenue: 68405, Unrelated Business Revenue: 2621, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Inter-company Contributions - -8065; Net assets Released from Restrictions - 687; Equity Transfers - -598830;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 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
SISTERS OF THE THIRD ORDER OF ST FRANCIS
800 NE GLEN OAK AVE	PEORIA	IL	61603	371259286	PARENT/SU ORG	IL	501(c)(3)	Type II	NA	false
OSF HEALTHCARE FOUNDATION
800 NE GLEN OAK AVE	PEORIA	IL	61603	371259284	SUPPORT ORG	IL	501(c)(3)	Type II	NA	false
OTTAWA REGIONAL HOSP & HEALTHCARE CTR
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	362604009	HOSPITAL	IL	501(c)(3)	3	OSF	false
OTTAWA REGIONAL HOSPITAL FOUNDATION
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	364007569	SUPPORT ORG	IL	501(c)(3)	Type I	ORHHC	false
OSF MULTI-SPECIALTY GROUP
800 NE GLEN OAK AVE	PEORIA	IL	61603	383852646	HLTHCARE SVCS	IL	501(c)(3)	Type I	OSF	false
OSF HEALTHCARE SYSTEM
800 NE GLEN OAK AVE	PEORIA	IL	61603	370813229	HOSPITAL	IL	501(c)(3)	3	SIS 3RD OSF	false
OTTAWA REGIONAL HOSPITAL AUXILIARY
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	363854788	SUPPORT ORG	IL	501(c)(3)	Type I	OSF	false
OSF College of Health Sciences
800 NE Glen Oak Avenue	Peoria	IL	61603	364868939	COLLEGE OF NURSING	IL	501(c)(3)	2	OSF	false
St Francis Community Clinic
530 NE Glen Oak Ave	Peoria	IL	61637	370661235	Free clinic	IL	501(c)(3)	7	Sis 3rd osf	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
CENTER FOR HEALTH AMBULATORY
8800 RTE 91 N	PEORIA	IL	61615	205557171	SURGICAL CENTER	IL	OSF	Related	false	Yes (true)	0
EASTLAND MEDICAL PLAZA
1505 EASTLAND DRIVE	Bloomington	IL	61701	371400643	SURGICAL CENTER	IL	OSF	Related	false	Yes (true)	0
FORT JESSE IMAGING CENTER LLC
2200 FT JESSE ROAD	NORMAL	IL	61761	460515604	MEDICAL IMAGING	IL	OSF	Related	false	Yes (true)	0
SAINT CLARE'S VILLA
915 EAST 5TH STREET	ALTON	IL	62002	371397289	LOW INC HOUSING	IL	OSF	Related	false	Yes (true)	0
FOX RIVER CANCER CENTER
1211 STARFISH DRIVE	OTTAWA	IL	61350	870805865	ONCOLOGY	IL	ORHHC	Related	false	Yes (true)	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
POINTCORE INC
800 NE GLEN OAK AVE	PEORIA	IL	61603	363484677	HLTHCARE SVCS	IL	OSF	C Corporation	false
ILLINOIS PATHOLOGIST SERVICES LLC
5666 EAST STATE STREET	ROCKFORD	IL	61108	800439081	PATHOLOGY SVCS	IL	OSF	C Corporation	false
Lakeview Medical Office Building
812 N Logan Ave	Danville	IL	61832	371100761	Condominium Association	IL	OSF	C Corporation	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	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	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd