FERRELL HOSPITAL COMMUNITY FOUNDATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
FERRELL HOSPITAL COMMUNITY FOUNDATION (EIN 20-1244058)
Tax period
2017-04-01 to 2018-03-31
Filed
2019-02-11
IRS object ID
201930429349300863
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-02-11T12:38:39-06:00ReturnTs
Tax Period End2018-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12650 EASTPOINT PKWY SUITE 300AddressLine1Txt
CityLOUISVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP40223ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201244058EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FERRELL HOSPITAL COMMUNITY FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFERRBusinessNameControlTxt
Phone6182733361PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11201 PINE STREETAddressLine1Txt
CityELDORADOCityNm
State AbbreviationILStateAbbreviationCd
ZIP62930ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWOODROW W HATHAWAY JRPersonNm
Person TitleACTING CFOPersonTitleTxt
Phone6182733361PhoneNum
Signature2019-02-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCARRIE A MERRILL CPAPreparerPersonNm
PTINP00832283PTIN
Phone5029923500PhoneNum
Preparation2019-02-07PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address38.109.186.2IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-02-07IPDt
IP Tm15:11:45IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id40D01492EFE2F690046E9D2F334ADE9DD83D6A88AtSubmissionCreationDeviceId
At Submission Filing Device IdDFFF94E40E6042B53F95D34511187C45F8C68B42AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWOODROW W HATHAWAY JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11201 PINE STREETAddressLine1Txt
CityELDORADOCityNm
State AbbreviationILStateAbbreviationCd
ZIP62930ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$21,544,007GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FERRELLHOSP.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionOPERATE ACUTE CARE HOSPITAL - DEDICATED TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee234TotalEmployeeCnt
Total Volunteers17TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$51,852PYContributionsGrantsAmt
CY Contributions Grants$40,314CYContributionsGrantsAmt
PY Program Service Revenue$20,809,772PYProgramServiceRevenueAmt
CY Program Service Revenue$20,416,305CYProgramServiceRevenueAmt
PY Investment Income$11,414PYInvestmentIncomeAmt
CY Investment Income$22,947CYInvestmentIncomeAmt
PY Other Revenue$57,734PYOtherRevenueAmt
CY Other Revenue$1,064,441CYOtherRevenueAmt
PY Total Revenue$20,930,772PYTotalRevenueAmt
CY Total Revenue$21,544,007CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,505,460PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,199,967CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,319,005PYOtherExpensesAmt
CY Other Expenses$8,951,112CYOtherExpensesAmt
PY Total Expenses$19,824,465PYTotalExpensesAmt
CY Total Expenses$20,151,079CYTotalExpensesAmt
PY Revenues Less Expenses$1,106,307PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,392,928CYRevenuesLessExpensesAmt
Total Assets BOY$10,285,037TotalAssetsBOYAmt
Total Assets EOY$10,591,604TotalAssetsEOYAmt
Total Liabilities BOY$6,777,660TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,691,299TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,507,377NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,900,305NetAssetsOrFundBalancesEOYAmt
MissionOPERATE ACUTE CARE HOSPITAL - DEDICATED TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$17,650,044ExpenseAmt
Revenue$21,384,803RevenueAmt
DescFERRELL HOSPITAL COMMUNITY FOUNDATION (FHCF) OFFERS QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. FHCF PROVIDES MEDICAL CARE TO OUTPATIENTS AND INPATIENTS AS WELL AS PROVIDES VARIOUS COMMUNITY BENEFITS TO THE COMMUNITY.Desc
Total Program Service Expenses$17,650,044TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document24IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee234EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH HOHENBERGERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6182733361PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11201 PINE STREETAddressLine1Txt
CityELDORADOCityNm
State AbbreviationILStateAbbreviationCd
ZIP62930ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CLIFFORD EUGENE MORRIS
CHAIRMAN5.00Yes (X)Yes (X)$0$0$0
E T SEELY
VICE-CHAIRMAN5.00Yes (X)Yes (X)$0$0$0
ALBERT BLEDIG MD 417-817
BOARD MEMBER/PHYSICIAN40.00Yes (X)$132,181$0$0
BILL JONES
BOARD MEMBER2.00Yes (X)$0$0$0
NATE OLDHAM MD
BOARD MEMBER/PHYSICIAN60.00Yes (X)$401,555$0$20,029
JASON KASIAR
BOARD MEMBER2.00Yes (X)$0$0$0
BARB DEVOUS
SECRETARY2.00Yes (X)Yes (X)$0$0$0
NIKKI ROSER
BOARD MEMBER2.00Yes (X)$0$0$0
SHAWN MCCOY
BOARD MEMBER2.00Yes (X)$0$0$0
DR JAMES PORTER
BOARD MEMBER2.00Yes (X)$0$0$0
JARED FLORENCE
BOARD MEMBER2.00Yes (X)$0$0$0
ALISA COLEMAN
CEO50.00Yes (X)$0$0$0
JOSEPH HOHENBERGER
CFO50.00Yes (X)$0$0$0
ELLIOTT PARTRIDGE MD
PHYSICIAN40.00$194,092$0$0Yes (X)
DALLAS C BASINGER
PHARMACIST40.00$124,651$0$7,927Yes (X)
JOSEPH A JACKSON MD
PHYSICIAN50.00$237,402$0$17,228Yes (X)
JANNA PATHI MD
SURGEON30.00$314,271$0$0Yes (X)
SAMIR ABDO MD
SURGEON30.00$238,018$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,642,170TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$45,184TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CROSSROADS EMERGENCY PHYSICIANS
PO BOX 677979DALLASTX75267ER PHYSICIANS$831,095
DEACONESS REGIONAL HEALTHCARE SERVICES
600 MARY STEVANSVILLEIN47747ER PHYSICIANS, MANAGEMENT FEES$592,269
PROGRESSIVE HEALTH OF INDIANA LLC
PO BOX 6890EVANSVILLEIN47719PHYSICAL AND OCCUPATIONAL THERAPIST$520,494
MEDHOST OF TENNESSEE INC
6550 CAROTHERS PARKWAYFRANKLINTN37067DATA PROCESSING$287,964
RANDY WIENTJES CRBA MA
3042 LAKEVIEW DRMETROPOLISIL62960ANESTHESIOLOGY$267,736
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$37,975GovernmentGrantsAmt
All Other Contributions$2,339AllOtherContributionsAmt
Total Contributions$40,314TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621110BusinessCd
Total Revenue Column$20,416,305TotalRevenueColumnAmt
Related Or Exempt Func Income$20,416,305RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$20,416,305TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,947TotalRevenueColumnAmt
Exclusion$22,947ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$8,325RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$8,325RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,325TotalRevenueColumnAmt
Exclusion$8,325ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
340B INCOME621110$809,718$809,718
EHR INCENTIVE PAYMENT900099$158,780$158,780
OTHER REVENUE900099$52,949$52,949

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,669TotalRevenueColumnAmt
Exclusion$34,669ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,056,116OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,544,007TotalRevenueColumnAmt
Related Or Exempt Func Income$21,384,803RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$118,890ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$857,614TotalAmt
Program Services$771,853ProgramServicesAmt
Management And General$85,761ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,476,741TotalAmt
Program Services$7,215,270ProgramServicesAmt
Management And General$1,261,471ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$81,688TotalAmt
Program Services$67,801ProgramServicesAmt
Management And General$13,887ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,106,432TotalAmt
Program Services$920,626ProgramServicesAmt
Management And General$185,806ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$677,492TotalAmt
Program Services$568,788ProgramServicesAmt
Management And General$108,704ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$120,000TotalAmt
Management And General$120,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,680,039TotalAmt
Program Services$3,954,633ProgramServicesAmt
Management And General$725,406ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$65,987TotalAmt
Program Services$65,987ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,265,697TotalAmt
Program Services$2,265,697ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$292,453TotalAmt
Program Services$292,453ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$71,261TotalAmt
Program Services$71,261ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$162,951TotalAmt
Program Services$162,951ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$478,512TotalAmt
Program Services$478,512ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$179,282TotalAmt
Program Services$179,282ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PROVIDER TAX$445,433$445,433
FOOD$96,530$96,530
DUES & SUBSCRIPTIONS$92,967$92,967

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,151,079TotalAmt
Program Services$17,650,044ProgramServicesAmt
Management And General$2,501,035ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,034BOYAmt
EOY$387,843EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$970,783BOYAmt
EOY$936,624EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,517,783BOYAmt
EOY$3,068,788EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$217,999BOYAmt
EOY$225,708EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$220,481BOYAmt
EOY$409,738EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,495,966LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,661,251LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,351,957BOYAmt
EOY$4,834,715EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$728,188EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,285,037BOYAmt
EOY$10,591,604EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,143,264BOYAmt
EOY$1,599,830EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,634,396BOYAmt
EOY$4,091,469EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,777,660BOYAmt
EOY$5,691,299EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,507,377BOYAmt
EOY$4,900,305EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,507,377BOYAmt
EOY$4,900,305EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,285,037BOYAmt
EOY$10,591,604EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,392,928ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$6,487OtherActivitiesAmt
Total Lobbying Expenditures$6,487TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAYS DUES TO IHA ANNUALLY. 39% OF THESE DUES ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$183,412OtherCostOrOtherBasisAmt
Book Value$183,412BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,289,503OtherCostOrOtherBasisAmt
Depreciation$1,498,025DepreciationAmt
Book Value$1,791,478BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,892OtherCostOrOtherBasisAmt
Depreciation$41,962DepreciationAmt
Book Value$1,930BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,803,156OtherCostOrOtherBasisAmt
Depreciation$4,121,264DepreciationAmt
Book Value$681,892BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,176,003OtherCostOrOtherBasisAmt
Book Value$2,176,003BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,834,715TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$397,839
THIRD PARTY PAYOR$330,349
FieldValueIRS element (for citing)
Total Book Value Other Assets$728,188TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$21,544,007TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$21,544,007RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$21,544,007TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,151,079TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$20,151,079ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$20,151,079TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF MARCH 31, 2018 AND 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other100.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$143,978TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$143,978NetCommunityBenefitExpnsAmt
Total Expense0.00710TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,270,071TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,364,389DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,905,682NetCommunityBenefitExpnsAmt
Total Expense0.14420TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,414,049TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,364,389DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,049,660NetCommunityBenefitExpnsAmt
Total Expense0.15130TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,414,049TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,364,389DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,049,660NetCommunityBenefitExpnsAmt
Total Expense0.15130TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$978,116BadDebtExpenseAmt
Reimbursed By Medicare$6,610,439ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,283,070CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,672,631MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FERRELL HOSPITAL COMMUNITY FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11201 PINE STREETAddressLine1Txt
CityELDORADOCityNm
State AbbreviationILStateAbbreviationCd
ZIP62930ZIPCd
FieldValueIRS element (for citing)
Website AddressFERRELLHOSP.ORGWebsiteAddressTxt
State License0005363StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FERRELL HOSPITAL COMMUNITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.FERRELLHOSP.ORG/ABOUT-US/DOCUMENTS-ABOUT-US/HOME-PAGE-LINK-COMMUNITY-HEOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.FERRELLHOSP.ORG/ABOUT-US/DOCUMENTS-ABOUT-US/HOME-PAGE-LINK-COMMUNITY-HEStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSISTFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSISTFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSISTFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FERRELL HOSPITAL COMMUNITYPART V, SECTION B, LINE 3J: POTENTIAL INFORMATION GAPS WERE DISCUSSED RELATED TO RESIDENTS LIVING IN POVERTY IN ELDORADO AND CARMI AND THE FERRELL HOSPITAL PRIMARY SERVICE AREA.
FERRELL HOSPITAL COMMUNITYPART V, SECTION B, LINE 5: THIS ASSESSMENT HAS EXPLORED THE INSULAR NEEDS OF THE IDENTIFIED GROUPS BY SPECIFICALLY SEEKING INPUT FROM PERSONS WITH KNOWLEDGE OF THE SPECIFIC HEALTH CONCERNS. INPUT WAS ALSO SOUGHT FROM MEMBERS OF THE COMMUNITY CHARGED PROFESSIONALLY WITH ADVANCING THE HEALTH AND EDUCATION OF THE COMMUNITY AND ALL ITS MEMBERS INCLUDING SCHOOL OFFICIALS DEALING DAILY WITH YOUTH AND FAMILIES. THOSE CONSULTED INCLUDE HOSPITAL EXECUTIVE STAFF AND AN INTERNAL WORKING GROUP. THE FOCUS GROUP AND INTERVIEW PARTICIPANTS INCLUDE ANDREA MAY, RN COMMUNITY NURSE LIAISON, TONYA ASHFORD, RN DIRECTOR, JERRY DOUG WATSON, JUNE CSERAY, BSN AUXILIARY PRESIDENT, LISA ANDERSON, RB CHIEF NURSE EXECUTIVE, MARTHA VAUGHN,BSN MEDSURG DIRECTOR, JACQUE TRIPP RN EMERGENCY ROOM SUPERVISOR, ANGIE HAMPTON, EXECUTIVE DIRECTOR, JAMIE BYRD, OVERSIGHT AND PLANNING COMMITTEE, TOM CLORE, PRESIDENT, FLECTHER JOHNSON, REAL ESTATE BROKER, GINA SIRACH, MSN DEAN OF NURSING, AND JIM MORSE, CITY COUNCIL REPRESENTATIVE.
FERRELL HOSPITAL COMMUNITYPART V, SECTION B, LINE 7D: HTTPS://WWW.FERRELLHOSP.ORG/ABOUT-US/DOCUMENTS-ABOUT-US/HOME-PAGE-LINK-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-7
FERRELL HOSPITAL COMMUNITYPART V, SECTION B, LINE 11: HOSPITAL PERSONNEL AND COMMUNITY ADVISORS MEET TO EVALUATE THE FINDINGS IN THE CHNA AND ASSESS THE PERFORMANCE OF THE HOSPITAL IN EACH OF THE TARGETED AREAS. MANAGEMENT MONITORS PROGRESS AND DEVOTES RESOURCES TO THE ACCOMPLISHMENT OF IDENTIFIED PLANS TO MEET THE NEEDS IDENTIFIED.
FERRELL HOSPITAL COMMUNITYPART V, SECTION B, LINE 23: THE HOSPITAL CHARGES THE SAME AMOUNT FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE FOR FAP-ELIGIBLE PATIENTS AND ALL OTHER PATIENTS.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - FERRELL HOSPITAL FAMILY PRACTICE
1036 MAPLE STREETELDORADOIL62930RURAL HEALTH CLINIC
2 - ELDORADO FAMILY MEDICINE
1407 LOCUST STREETELDORADOIL62930RURAL HEALTH CLINIC
3 - CARMI FAMILY MEDICINE
1340 IL HWY 1 SUITE ACARMIIL62821RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE HOSPITAL USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2; RATIO OF PATIENT CARE COST TO CHARGES INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINE 7A OF PART 1 OF SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES:FERRELL HOSPITAL COMMUNITY FOUNDATION OFFERS VARIOUS BENEFITS TO THE COMMUNITY INCLUDING BUT NOT LIMITED TO CPR/FIRST AID, PARTICIPATION IN THE SALINE COUNTY HEALTHY COALITION, PARTICIPATION IN HEALTH FAIRS AT LOCAL HIGH SCHOOLS AND COLLEGES, POISON PREVENTION AND HEALTH CARE CAREER PRESENTATIONS TO LOCAL SCHOOLS, PROVIDE TOURS OF THE HOSPITAL, HOLD FLU VACCINATION CLINICS, PERIODIC BLOOD PRESSURE AND GLUCOSE SCREENINGS, SPEAKING ENGAGEMENTS FOR COMMUNITY ORGANIZATIONS, CO-SPONSOR THE KIDNEY MOBILE, SPONSOR THE LOCAL HIGH SCHOOL PROM, PARTICIPATE IN THE RELAY FOR LIFE, SPONSOR FUNCTIONS AT THE LOCAL SENIOR CITIZENS CENTER, HOLD WELLNESS WORKSHOPS, PROVIDE A TRAINER FOR THE LOCAL HIGH SCHOOL SPORTS TEAMS, PROVIDE FIRST AID KITS FOR LOCAL SPORTS TEAMS, PROVIDE CLOTHING FOR DOMESTIC ABUSE VICTIMS AND PARTICIPATE IN THE SAFE HAVEN PROGRAM.
PART III, LINE 2:SEE THE PAGES 6 & 7 OF THE ATTACHED AUDITED FINANCIAL STATEMENT.
PART III, LINE 3:FINANCIAL ASSISTANCE COUNSELORS ARE IN PLACE TO CONTACT ANY PATIENT EXPRESSING INTEREST IN THE PROGRAM. PROCEDURES ARE IN PLACE TO MAKE DETERMINATIONS OF ALL PATIENTS' ELIGIBILITY AND TO PROVIDE THE APPROPRIATE ASSISTANCE.
PART III, LINE 4:SEE THE PAGES 6 & 7 OF THE ATTACHED AUDITED FINANCIAL STATEMENT.
PART III, LINE 8:THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE BASED ON THE 2017 MEDICARE COST REPORT. THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT DUE TO THE HOSPTIAL PROVIDING CARE TO MEDICARE PATIENTS AT LESS THAN THE ALLOWABLE MEDICARE COSTS.
PART III, LINE 9B:FERRELL HOSPITAL COMMUNITY FOUNDATION PROVIDES ASSISTANCE TO MEET THE NEEDS OF THE UNINSURED PATIENTS TO WHICH THEY SERVE. FOR THOSE PATIENTS WHO ARE EXPECTED TO QUALIFY UNDER THEIR FINANCIAL ASSISTANCE POLICY, THE HOSPITAL ASSIGNS THE FINANCIAL CARRIER FOR CHARITY CARE AT THE TIME OF THE REQUEST FOR THE HEALTH ASSISTANCE PROGRAM (HAP) APPLICATION. ONCE ASSIGNED, SEVERAL PROCEDURES ARE IN PLACE TO COMPLETE THE PROCESS INCLUDING INVESTIGATION FOR ANY OTHER AVAILABLE FUNDING SOURCES SUCH AS MEDICAID AND INCOME VERIFICATION. THOSE THAT COMPLETE THE HAP ACCURATELY AND QUALIFY UNDER THE HOSPITALS POLICY RECEIVE FREE OR DISCOUNTED CARE.
PART VI, LINE 2:FCHF IS INVOLVED IN COMMUNITY ORGANIZATIONS, INCLUDING CHURCHES, CIVIC GROUPS AND PROFESSIONAL ORGANIZATIONS.
PART VI, LINE 3:OUR FINANCIAL ASSISTANCE PROGRAM IS EASILY ACCESSED THROUGH OUR WEBSITE AND HAS THE FORMS LISTED FOR THE PATIENT TO PRINT OFF IF NEEDED. THE CONTACT PHONE NUMBERS OF OUR FINANCIAL COUNSELORS ARE ALSO LISTED. THERE ARE FERRELL HOSPITAL FINANCIAL ASSISTANCE BROUCHURES IN THE LOBBY AREAS OF THE HOSPITAL. ALL SELF PAY PATIENTS IN THE HOSPITAL ARE VISITED BY THE FINANCIAL COUNSELOR AND GIVEN THE NECESSARY PAPERWORK IF THE PATIENT REQUESTS IT. IF THE FINANCIAL COUNSELOR DOES NOT GET TO SEE THE PATIENT OR FAMILY, THEN A LETTER IS MAILED ALONG WITH THE APPLICATION TO THE PATIENT. UPON REGISTRATION OF THE PATIENT, THE REGISTRATION STAFF INFORMS THE PATIENT OF THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS AND GIVES THEM A BROCHURE. IF THE PATIENT REQUESTS TO TALK TO THE FINANCIAL COUNSELOR THEN THAT PERSON IS CALLED.
PART VI, LINE 4:THE MAJORITY OF FERRELL HOSPITAL PATIENTS RESIDE IN SALINE, GALLATIN, WHITE AND HAMILTON COUNTIES. WE ALSO SEE SEVERAL PATIENTS FROM POPE AND HARDIN COUNTIES. OUR FACILITIES ARE LOCATED IN SALINE AND GALLATIN COUNTIES. THE UNEMPLOYMENT RATE AND POVERTY RATE OF THESE COUNTIES ARE HIGHER THAN THE NATIONAL AVERAGE AND VERY CLOSE TO THE STATE OF ILLINOIS AVERAGE. THE PAYER MIX IS HEAVILY MEDICAID/MEDICARE DEPENDENT.
PART VI, LINE 7, REPORTS FILED WITH STATESIL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NATE OLDHAM MD
BOARD MEMBER/PHYSICIAN$360,155$0$0$0$41,400$0$8,501$0$11,528$0$421,584$0$0$0
ELLIOTT PARTRIDGE MD
PHYSICIAN$194,092$0$0$0$0$0$0$0$0$0$194,092$0$0$0
JOSEPH A JACKSON MD
PHYSICIAN$237,402$0$0$0$0$0$5,700$0$11,528$0$254,630$0$0$0
JANNA PATHI MD
SURGEON$314,271$0$0$0$0$0$0$0$0$0$314,271$0$0$0
SAMIR ABDO MD
SURGEON$238,018$0$0$0$0$0$0$0$0$0$238,018$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2DR. ALBERT BLEDIG AND BILL JONES HAVE A BUSINESS RELATIONSHIP. GENE MORRIS AND DR. NATE OLDHAM HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3EFFECTIVE JANUARY 1, 2016, THE HOSPITAL ENTERED INTO A FIVE-YEAR MANAGEMENT SERVICES AGREEMENT. MANAGEMENT SERVICES PROVIDED TO THE HOSPITAL CONSIST OF MANAGEMENT PERSONNEL INCLUDING A CEO AND CFO, FACILITY PLANNING, STRATEGIC PLANNING, RECRUITING, AND SEVERAL OTHER SUPPORT AND OVERSIGHT SERVICES. THE INITIAL TERM OF THE AGREEMENT IS FOR A FIVE-YEAR PERIOD, WHICH CAN BE EXTENDED BEYOND THE INITIAL FIVE-YEAR PERIOD, IF SO DESIRED. THE AGREEMENT CAN BE TERMINATED BY EITHER PARTY WITH A ONE HUNDRED AND EIGHTY DAY NOTICE WITHOUT RECOURSE SUBSEQUENT TO THE INITIAL FIVE-YEAR TERM. IF THE AGREEMENT IS TERMINATED BY THE HOSPITAL WITHIN THE INITIAL FIVE YEAR TERM OF THE AGREEMENT, THE HOSPITAL WILL BE ASSESSED A PENALTY IN THE AMOUNT OF $500,000 TO BE PAYABLE TO THE MANAGEMENT SERVICE ORGANIZATION. THE HOSPITAL WILL REIMBURSE THE MANAGEMENT SERVICE PROVIDER THE ACTUAL COST OF PROVIDING THE MANAGEMENT SERVICES ON A MONTHLY BASIS FOR THE YEARS ENDED MARCH 31, 2018 AND 2017, MANAGEMENT FEES INCURRED WERE $120,000 PER YEAR DURING THE 2017 YEAR, THE FOLLOWING INDIVIDUALS WERE COMPENSATED BY THE MANAGEMENT SERVICE PROVIDER IN THE FOLLOWING AMOUNTS: ALISA COLEMAN, CHIEF EXECUTIVE OFFICER, $235,729 AND JOSEPH HOHENBERGER, CHIEF FINANCIAL OFFICER $127,720.
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO AND CFO REVIEW THE COMPLETED FORM 990 AS PREPARED BY THE PAID PROVIDER FOR COMPLETENESS AND ACCURACY. THE BOARD CHAIR AND THE CEO AND CFO SUBMIT THE FORM TO THE BOARD FOR FINAL APPROVAL IMMEDIATELY PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CCOPIES OF THE CONFLICT OF INTEREST POLICY ARE PROVIDED TO EACH DIRECTOR, OFFICER, AND MANAGEMENT PERSON AT LEAST ONCE PER YEAR, WITH REQUIREMENT THAT THEY COMPLETE A CERTIFICATE. THE CERTIFICATE CONFIRMS THAT THEY UNDERSTAND THIS POLICY, AGREE TO COMPLY, INDICATE ANY KNOWN CONFLICTS, AND HAVE NO KNOWLEDGE OF ANY ADDITIONAL VIOLATIONS OF THE POLICY. ANY PERSON WITH A CONFLICT IS REQUIRED TO COMPLETE A SPECIFIC DISCLOSURE NOTICE.
FORM 990, PART VI, SECTION B, LINE 15THE CEO'S SALARY WAS DETERMINED BY COMPARISON WITH PRIOR PERSONS EMPLOYED IN THE POSITION, INDUSTRY COMPARISONS, RELATIVE EXPERIENCE AND KNOWLEDGE. THE CEO'S SALARY WAS APPROVED BY THE BOARD OF DIRECTORS. ALL DELIBERATIONS ARE INCLUDED IN BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2016. THE CFO'S SALARY WAS DETERMINED AND APPROVED IN THE SAME MANNER AS THE CEO'S SALARY. ALL OTHER EXECUTIVE SALARIES ARE APPROVED BY EXECUTIVE MANAGEMENT AND ANALYZED BASED ON INDUSTRY COMPARATIVE DATA AND POSITION DESCRIPTIONS, COMMENSURATE EXPERIENCE, EXPERTISE AND TRAINING. THIS PROCESS WAS LAST COMPLETED IN 2016.
FORM 990, PART VI, SECTION C, LINE 19FERRELL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 TAX RETURNS ARE AVAILABLE TO THE PUBLIC BY REQUEST.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,649,347. MANAGEMENT AND GENERAL EXPENSES 476,782. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,126,129. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 208,919. MANAGEMENT AND GENERAL EXPENSES 39,793. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 248,712. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,067,746. MANAGEMENT AND GENERAL EXPENSES 203,380. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,271,126. RECRUITMENT FEES: PROGRAM SERVICE EXPENSES 28,621. MANAGEMENT AND GENERAL EXPENSES 5,451. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,072.
FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHTTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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