2018-11-15T09:06:50-06:00 2017-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRSTE 4000 INDIANAPOLIS IN 46204 990 2017-01-01 363637465 HOOPESTON COMMUNITY MEMORIAL HOSPITAL % DENNIS HESCH EXEC VP & CFO HOOP 2172835531 701 E Orange Street Hoopeston IL 60942 DENNIS HESCH EVP/CFO 2173833311 2018-11-13 true JENNIFER RHODERICK P00395735 3176817000 65.30.190.147 35057220183195000002 2018-11-15 P 6DFBA33F1DAEE8CAFFEB9AC40683ECF49AA6169A 64C7932F6DA8C69ACB63BCEE0D766797A910B2A0 2017 2019-02-21 02:37:17Z CARLE HOOPESTON REGIONAL HEALTH CTR DENNIS HESCH EVP CFO 611 W PARK ST URBANA IL 61801 60841816 false X www.carle.org/hoopeston X 1956 IL TO PROVIDE QUALITY HEALTH CARE AND OTHER MEDICALLY RELATED SERVICES AND EDUCATION TO THE COMMUNITY THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS. 7 3 340 0 27532 -583 9710 384415 53756043 60179554 14484 -68696 318743 249594 54098980 60744867 26873 40735 0 0 18392331 19669126 0 0 0 36708118 37521465 55127322 57231326 -1028342 3513541 33962186 29058644 40558545 32125651 -6596359 -3067007 MISSION STATEMENT SECTION 1. GENERAL PURPOSES. THE CORPORATION IS ORGANIZED AND SHALL BE EXCLUSIVELY OPERATED AS A NOT-FOR-PROFIT CORPORATION FOR CHARITABLE, BENEVOLENT, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW (THE "CODE"). AND, IN FURTHERANCE OF SUCH CHARITABLE PURPOSES, THE CORPORATION SHALL ENGAGE IN THE ACTIVITIES DESCRIBED IN SECTION 2 OF THIS STATEMENT. SECTION 2. SPECIFIC PURPOSES. THE CORPORATION'S PURPOSES SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING: (A) TO PROVIDE AND TO ASSIST IN PROVIDING FACILITIES FOR THE RENDERING OF HEALTH CARE SERVICES ON AN INPATIENT OR OTHER BASIS THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS, AND OTHER CLINICAL SERVICES THROUGH ALL OTHER APPROPRIATE MEANS; AND (B) TO TRAIN AND TO PROVIDE CONTINUING EDUCATION FOR PERSONS ENGAGED IN PROVIDING HEALTH false false 53574518 40735 60185018 HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH), A 24 BED CRITICAL ACCESS HOSPITAL LOCATED IN HOOPESTON, IL SERVES HOOPESTON, VERMILION COUNTY AND THE SURROUNDING AREA. HCMH EMPLOYS MORE THAN 300 STAFF MEMBERS AND 75 PROVIDERS. HCMH IS COMMITTED TO PROVIDING QUALITY, DEPENDABLE HEALTH SERVICES. HCMH OFFERS SPECIALTY SERVICES WITH CARDIOLOGY, ORTHOPEDICS, GYNECOLOGY, MENTAL HEALTH, UROLOGY AND DIAGNOSTIC SERVICES INCLUDING NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, RADIOLOGY AND LABORATORY. EMERGENCY MEDICINE AND SURGICAL SERVICES ARE PROVIDED IN STATE OF THE ART FACILITIES, WHICH OPENED IN 2012. HCMH PROVIDES ACCESS TO PRIMARY CARE WITH CLINICS IN HOOPESTON, ROSSVILLE, MILFORD, CISSNA PARK, DANVILLE, WATSEKA, TUSCOLA AND MATTOON, IL. HCMH HAS BEEN DEDICATED TO CARING FOR THOSE IN THE AREA FOR OVER 60 YEARS. 53574518 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true true false false true 18 0 true 340 true true true false false false false false false false false false X 7 3 true false false false true true true true true false false true true true true true true false false false IL X X DENNIS HESCH EXEC VP CFO 2173833311 611 W PARK ST URBANA IL 61801 X RUSS LEIGH CHAIR OF BOARD 2.0 0.0 X X 0 0 0 LYNN GALLOWAY SECRETARY/TREASURER OF BOARD 1.0 0.0 X X 0 0 0 ED LAYDEN JR TRUSTEE 1.0 0.0 X 0 0 0 KARLA COON TRUSTEE 1.0 0.0 X 0 0 0 HENRY HORNBECK TRUSTEE 1.0 0.0 X 0 0 0 LETHA KRAMER TRUSTEE & VP-RISK 5.0 35.0 X 0 230622 49497 SALLY SALMONS MD TRUSTEE & PHYSICIAN 20.0 20.0 X 0 344084 44065 HARRY BROCKUS EX-OFFICIO, CEO 12.0 28.0 X 0 283098 77449 DENNIS HESCH EXEC VP & CFO 1.0 39.0 X 0 1220302 264292 LAURENCE FALLON EXEC VP-LEGAL AFFAIRS & HR 0.2 39.8 X 0 916265 200598 DOUGLAS MORTON MD MED DIR-RADIOLOGY 1.0 39.0 X 0 687994 29274 IKECHUKWU UZOARU MD MED DIR-LAB 2.0 38.0 X 0 521591 41428 PAMELA BIGLER SVP-NURSING & CNO 1.0 39.0 X 0 463477 108561 ANDY ARWARI MD MED DIR-REGIONAL 1.0 39.0 X 0 535236 42114 LYNETTE BARNES COO-CFH & SVP-FACILITIES 1.0 39.0 X 0 526074 104365 LARRY GERDOM PHYSICIAN ASSISTANT 40.0 0.0 X 141963 0 26648 LARRY WHITAKER JR PHYSICIAN ASSISTANT 40.0 0.0 X 135346 0 33177 KATRINA DESHANEY PHYSICIAN ASSISTANT 40.0 0.0 X 127671 0 16504 HOWARD HUGHES DIRECTOR-FACILITIES & SAFETY 40.0 0.0 X 123771 0 21730 HEATHER TUCKER DIR-E REGION PRIM CARE SVCS 40.0 0.0 X 121298 0 32005 DANIEL CHASE MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 447652 42835 CORTNEY JONEIKIS ROSSER MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 225411 40512 WILLIAM MCCARTHY MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 296315 23361 ALBERT TANLIM MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 238778 39606 650049 6936899 1238021 23 true true false HOOPESTON EMERGENCY MEDICINE SPECIA PO BOX 5977 CAROL STREAM IL 601976599 Staffing 1312590 SIGHTPATH MEDICAL INC PO BOX 204253 DALLAS TX 753204253 Staffing & Equipment 272487 SENTRY DATA SYSTEMS INC PO BOX 505353 ST LOUIS MO 631505353 Software 240600 SHARED IMAGING LOCK BOX 88544 MILWAUKEE WI 532880544 Imaging Services 177333 RENOVO SOLUTIONS 4 EXECUTIVE CIRCLE IRVINE CA 92614 Consulting 165894 8 0 371250 13165 0 384415 NET PATIENT SERVICES 622110 60179554 60179554 0 0 60179554 15750 15750 0 0 13836 12503 1333 0 1333 1333 0 84446 -84446 -84446 -84446 0 0 0 0 0 0 0 0 0 CATERING 722320 27532 0 27532 0 COFFEE SHOP 722212 15955 0 0 15955 PERPETUAL TRUST INTEREST 900099 150000 0 0 150000 54774 5464 49310 248261 60744867 60185018 27532 147902 40735 40735 0 0 0 0 0 0 0 0 0 0 236393 236393 0 0 14931142 14033912 897230 0 873941 819581 54360 0 2513426 2329250 184176 0 1114224 998217 116007 0 0 0 0 0 902 0 902 0 0 0 0 0 10075 0 10075 0 0 0 0 0 0 0 1393075 1389151 3924 0 3529 1741 1788 0 1247389 1080358 167031 0 950538 742550 207988 0 0 0 0 0 2088651 1623509 465142 0 97958 86147 11811 0 0 0 0 0 35126 26239 8887 0 275705 275705 0 0 0 0 0 0 2046301 1698867 347434 0 384352 375203 9149 0 INTERNAL PURCHASED SERVICES 13081059 13081059 INTERNAL MANAGEMENT FEES 7751943 7049172 702771 PATIENT CARE SUPPLIES 5324352 5290008 34344 OTHER PURCHASED SERVICES 1985283 1836767 148516 845227 559954 285273 57231326 53574518 3656808 0 0 3961714 12088 0 0 0 0 5561806 6029236 0 0 0 0 0 0 0 0 131469 160893 24103171 9879916 15705585 14223255 0 0 0 0 0 0 4444690 4444690 4156922 4188482 33962186 29058644 1760681 1792566 0 0 0 0 0 0 0 0 0 0 6177235 5859588 0 0 32620629 24473497 40558545 32125651 X -10228253 -6714711 45532 45790 3586362 3601914 -6596359 -3067007 33962186 29058644 X 3513541 0 0 0 0 15811 X X false true X true false X false false false 0 false 0 false 0 false 0 false 0 false 0 true 10075 10075 false PART II-B, LINE 1I OTHER ACTIVITIES $6,612 - PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) DUES ATTRIBUTABLE TO LOBBYING $3,106 - PORTION OF AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING $357 - PORTION OF MISCELLANEOUS HEALTH CARE ORGANIZATION DUES ATTRIBUTABLE TO LOBBYING 0 104595 104595 0 11181061 3441914 7739147 0 1735646 905372 830274 0 9803764 5119098 4684666 0 1278105 413532 864573 14223255 DEVL LIMITED ASSETS 45790 HRHC FCS ESCROW 540778 LONG TERM INVESTMENTS 3601914 4188482 0 ACCOUNTS PAYABLE - MEDICARE 3060047 DUE TO BLUE CROSS 453166 HRHC / FNDN NOTES PAYABLE 3262799 ASSET RETIREMENT OBLIGATION 248089 INTERCOMPANY PAYABLES 17351931 MISC LIABILITIES 97465 24473497 X SCHEDULE D, PART X, LINE 2 FIN 48 (ASC740) FOOTNOTE THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2017 AND 2016. true true X true X true X true true false false 2141729 2141729 0.03740 13030353 11218902 1811451 0.03170 15172082 11218902 3953180 0.06910 170554 0 170554 0.00300 36610 36610 0.00060 207164 0 207164 0.00360 15379246 11218902 4160344 0.07270 2271 2271 0.00000 11346 11346 0.00000 2230 2230 0.00000 15847 15847 0.00000 true 874136 437068 12242986 14596004 -2353018 X true true 1 1 HOOPESTON COMMUNITY MEMORIAL HOSPITAL 701 E ORANGE ST HOOPESTON IL 609421801 WWW.CARLE.ORG/HOOPESTON 0004200 X X X X HOOPESTON COMMUNITY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X CARLE.ORG/CHNA X true 16 true CARLE.ORG/CHNA false true X 200. 400. X true true X X X true X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X X X X X X true X false X X X X true X false false COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 5) THOUGH HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH) PREVIOUSLY CONDUCTED ITS OWN COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IN 2013, HCMH JOINED EFFORTS WITH OTHER STAKEHOLDERS IN VERMILION COUNTY IN 2014, WITH A PARTNERSHIP THAT CONTINUES TO THIS DAY AS THE CHAMPAIGN-VERMILION COUNTY REGIONAL EXECUTIVE COMMITTEE. RESEARCH WAS ACCOMPLISHED WITH DIRECT CONTRIBUTION FROM MORE THAN 40 INDIVIDUALS REPRESENTING A VARIETY OF AGENCIES AND ORGANIZATIONS FROM ACROSS THE COUNTY. THERE WAS ALSO DIRECT INPUT FROM OVER 1,200 COUNTY RESIDENTS VIA A COMMUNITY SURVEY. EACH OF THE COMMUNITY PARTNERS INVOLVED IN THE ASSESSMENT PLAYS A ROLE IN REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS IN VERMILION COUNTY. THOSE COMMUNITY PARTNERS ARE: AUNT MARTHA'S HEALTH CENTER (FQHC); BIG BROTHERS/BIG SISTERS; BOARD OF HEALTH; CARLE PHYSICIAN GROUP, DANVILLE; CENTER FOR CHILDREN SERVICES; CENTRAL CHRISTIAN CHURCH; CHANNEL 3 NEWS; COMMERCIAL NEWS; CRIS SENIOR SERVICES; CROSSPOINT; DANVILLE AREA COMMUNITY COLLEGE; DANVILLE FAMILY YMCA; DANVILLE MASS TRANSIT; DANVILLE SCHOOL DISTRICT 118; HCMH; HOOPESTON MULTI-AGENCY; LAKEVIEW COLLEGE OF NURSING; 708 MENTAL HEALTH BOARD; NEW LIFE CHURCH OF FAITH; OSF HEALTHCARE SACRED HEART MEDICAL CENTER (FORMERLY PRESENCE UNITED SAMARITANS MEDICAL CENTER); PROJECT SUCCESS/CAPIT; PRESENCE REGIONAL EMS; SALVATION ARMY; STATE OF ILLINOIS; UNIVERSITY OF ILLINOIS COLLEGE OF NURSING; UNITED WAY OF DANVILLE AREA; VA ILLIANA HEALTHCARE SYSTEM; VERMILION ADVANTAGE; VERMILION COUNTY BOARD; VERMILION COUNTY HEALTH DEPARTMENT; VERMILION COUNTY REGIONAL OFFICE OF EDUCATION; VILLAGE OF FITHIAN; VILLAGE OF OAKWOOD; WOMEN'S CARE CLINIC; WORKSOURCE; YOUR FAMILY RESOURCE CENTER (YFRC). IN 2014, THE GROUP CONDUCTED A REASSESSMENT TO MAKE SURE THE PRIORITIES WERE STILL VALID AND TO MAINTAIN REQUIREMENTS FOR HEALTH FACILITIES THAT NEEDED REASSESSMENT EVERY THREE YEARS. AGENCIES IN THE COMMUNITY WITH THIS REQUIREMENT WERE BROUGHT TOGETHER TO FORM AN EXECUTIVE COMMITTEE, CONSISTING OF MEMBERS FROM HCMH, CARLE, OSF HEALTHCARE SACRED HEART MEDICAL CENTER (FORMERLY PRESENCE UNITED SAMARITANS MEDICAL CENTER), UNITED WAY, I SING THE BODY ELECTRIC, AND THE VERMILION COUNTY HEALTH DEPARTMENT. THE EXECUTIVE COMMITTEE ALSO ENLISTED THE SERVICES OF THE UNIVERSITY OF ILLINOIS. FOR HCMH, REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT INFORMATION BEGAN IN 2014 FOR UPDATED AND NEW DATA, AND COMMUNITY AND STAKEHOLDER SURVEYS WERE COLLABORATIVELY DISTRIBUTED BY THE UNIVERSITY OF ILLINOIS COLLEGE OF NURSING, DANVILLE AREA COMMUNITY COLLEGE OF NURSING, AND LAKEVIEW COLLEGE OF NURSING. TOP COMMUNITY HEALTH CONCERNS WERE TEEN PREGNANCY, ALCOHOL/SUBSTANCE ABUSE, AND OBESITY; THE SAME TOP THREE HEALTH ISSUES, IDENTIFIED IN THE PRIOR PLAN. HCMH CONTINUED TO WORK ON IMPLEMENTATION OF THESE PRIORITIES IN 2015-2016, AND RECEIVED FINAL APPROVAL ON THE IMPLEMENTATION PLAN BY THE HCMH BOARD ON OCTOBER 27, 2016. COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 6A) CARLE FOUNDATION HOSPITAL, OSF HEALTHCARE SACRED HEART MEDICAL CENTER (FORMERLY PRESENCE UNITED SAMARITANS MEDICAL CENTER) COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 6B) UNITED WAY, I SING THE BODY ELECTRIC, VERMILION COUNTY HEALTH DEPARTMENT COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 11) HCMH CONTINUES ITS WORK TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH SERVICE TO ITS PATIENTS, INCLUDING EMPHASIS ON ACCESS TO HEALTH SERVICES AND OTHER SPECIALTIES AND SERVICES THE HOSPITAL OR CARLE HEALTH SYSTEM PROVIDES. THE CARLE FOUNDATION IS DILIGENTLY WORKING TO IMPROVE ACCESS AND SERVICES THROUGHOUT THE EAST CENTRAL ILLINOIS REGION, NOT JUST WITHIN VERMILION COUNTY. MANY OF THE OTHER CONCERNS ARE ALSO ADDRESSED THROUGH SERVICES PROVIDED FOR CARLE PATIENTS, BUT THESE AREAS ARE NOT THE PRIMARY EMPHASIS OF THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WHICH TARGETS MORE SPECIFIC LOW-INCOME POPULATIONS IN VERMILION COUNTY. HOW HCMH IS ADDRESSING SIGNIFICANT HEALTH NEEDS THROUGH THESE EFFORTS, HCMH INTENDS TO HELP IMPROVE THE OVERALL HEALTH OF THE COMMUNITY BY ADDRESSING THE MOST SIGNIFICANT NEEDS FACING THE POPULATION, WITH EMPHASIS ON THOSE IN GREATEST NEED. PRIORITY #1: TEEN PREGNANCY TEEN AND ADOLESCENT HEALTH HAS BEEN A CONCERN IN VERMILION COUNTY FOR MANY YEARS. IN THE PREVIOUS IMPLEMENTATION PLAN, HCMH WORKED TO ADDRESS THIS SIGNIFICANT NEED BY IMPLEMENTING A NUMBER OF SAFE-SEX AND SEXUALLY TRANSMITTED DISEASE (STD) PREVENTION PROGRAMS IN THE REGION, AND THROUGH APPROPRIATE TESTING, TREATMENT AND CARE IN OUTPATIENT FACILITIES. THESE PROGRAMS CONTINUE TODAY, WITH EVERY-OTHER-YEAR AGREEMENTS WITH HOOPESTON AREA HIGH SCHOOL AND MILFORD HIGH SCHOOL. BOTH SCHOOLS USED THIS PROGRAM IN 2015 AND AGAIN IN 2017. A QUALITY NURSE SPECIALIST ON HCMH STAFF CONTINUES TO WORK CLOSELY WITH THE LOCAL PUBLIC HEALTH DEPARTMENT TO TRACK TRENDS IN TEEN PREGNANCY AND STDS IN OUR REGION, AND SUPPORTS EDUCATIONAL PROGRAMS THROUGH THE PUBLIC HEALTH DEPARTMENT. HCMH CONTINUES TO PROMOTE WOMEN'S HEALTH SERVICES, ENCOURAGING YOUNG WOMEN TO RECEIVE THE APPROPRIATE CARE, WHICH THEY CAN RECEIVE FROM OBSTETRICS AND GYNECOLOGY PROVIDERS AT CARLE IN DANVILLE, AS WELL AS TWICE EACH MONTH AT THE OUTPATIENT FACILITY IN HOOPESTON. IN AN EFFORT TO HELP YOUNG MOTHERS IN NEED, HCMH CONTINUES TO PROVIDE "NECESSITY KITS" FOR ALL MOTHERS OR BABIES WHO VISIT THE EMERGENCY DEPARTMENT AND WOULD NOT BE ABLE TO PURCHASE THE SUPPLIES FOR THEMSELVES. THE KIT INCLUDES A PEDIATRIC INFORMATION BOOKLET, THERMOMETER, BASIC FIRST AID SUPPLIES, TEETHING TOYS, BOTTLES AND OTHER ESSENTIAL PRODUCTS TO HELP YOUNG MOTHERS THROUGH THEIR CHILD'S FIRST YEARS. SUPPLIES WERE BOUGHT THROUGH A GRANT FROM ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK, AND EMERGENCY DEPARTMENT NURSES USED THEIR WORK TIME TO PUT TOGETHER THE KITS. AS PART OF HCMH'S COMMITMENT TO ENSURING THAT STRIDES ARE MADE IN THESE AREAS, EMPLOYEES FROM THE HEALTH SYSTEM PARTICIPATE IN SEVERAL COUNTY-WIDE WORKGROUPS THAT WERE ESTABLISHED AS PART OF THE JOINT CHNA. ONE OF THESE WORKGROUPS WAS ESTABLISHED TO ADDRESS TEEN PREGNANCY RATES IN VERMILION COUNTY. THE GROUP'S MAIN GOAL IS TO INCREASE AWARENESS AMONG TEENS BY PARTICIPATING IN LOCAL EVENTS, HEALTH FAIRS AND PUBLIC EDUCATION OPPORTUNITIES. PRIORITY #2: SUBSTANCE AND ALCOHOL ABUSE THOUGH SUBSTANCE ABUSE WAS IDENTIFIED AS A LOWER PRIORITY IN THE PREVIOUS CHNA CONDUCTED IN 2013, THIS WAS IDENTIFIED AS A MUCH HIGHER PRIORITY IN THE LATEST CHNA. HCMH CONTINUES TO EXPAND BEHAVIORAL HEALTH SERVICES IN THE REGION AND PROVIDE FINANCIAL SUPPORT TO AGENCIES IN AN EFFORT TO MAKE AN IMPACT. TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, HCMH AGAIN PARTNERED WITH IROQUOIS MENTAL HEALTH TO OFFER COUNSELING AT HOOPESTON'S OUTPATIENT CLINIC FOR HCMH PATIENTS. THIS PARTNERSHIP OFFERS ADDITIONAL HOURS AT THE HOOPESTON OUTPATIENT CLINIC, WHICH HELPS ADDRESS THE LACK OF MENTAL HEALTH ACCESS IN THE REGION. IN ADDITION, THE CARLE HEALTH SYSTEM RECOGNIZES THE NEED FOR MORE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES THROUGHOUT THE SERVICE AREA, AND CONTINUES TO RECRUIT PSYCHIATRY PROVIDERS FOR CLINICAL LOCATIONS IN DANVILLE. THE CARLE FOUNDATION HOSPITAL STARTED A PSYCHOLOGY RESIDENCY PROGRAM IN 2017, WHICH PROVIDES ADDITIONAL TRAINING FOR MENTAL HEALTH PROFESSIONALS, AND ALSO OFFERS AN EMPLOYEE ASSISTANCE PROGRAM WHICH PROVIDES SERVICE FOR SUBSTANCE AND ALCOHOL ABUSE FOR EMPLOYEES ACROSS THE SYSTEM, INCLUDING OUR IROQUOIS AND NORTHERN VERMILION LOCATIONS. TO SUPPORT AGENCIES THAT PROVIDE BEHAVIORAL HEALTH SERVICES, HCMH HAS PROVIDED IN-KIND SUPPORT TO MULTIPLE SERVICE AGENCIES IN VERMILION COUNTY, INCLUDING AUNT MARTHA'S YOUTH SERVICE CENTER IN DANVILLE FOR COUNSELING OR SUPPORT SERVICES TO THOSE WITH ALCOHOL OR SUBSTANCE ABUSE PROBLEMS, AND HOOPESTON AND ARMSTRONG-ELLIS SCHOOL DISTRICTS FOR POSITIVE BEHAVIORAL INTERVENTION PROGRAMS. PRIORITY #3: OBESITY WITH THE CONNECTION TO MANY HEALTH PROBLEMS, INCLUDING HEART DISEASE, STROKE AND DIABETES, HCMH WORKS TO EDUCATE PATIENTS AND THE COMMUNITY ABOUT RESOURCES AVAILABLE TO COMBAT OBESITY AND RELATED CONCERNS. HCMH HAS NUTRITION COUNSELORS AND DIABETIC EDUCATORS IN DANVILLE WHO TRAVEL TO HOOPESTON ONCE A MONTH AND CONTINUE TO SUPPORT ACTIVITIES AIMED AT IMPROVING THE HEALTH OF CHILDREN AND ADULTS THROUGHOUT THE COMMUNITY. THIS INCLUDES FUNDING INITIATIVES IN HOOPESTON GRADE SCHOOLS' JUMP ROPE FOR HEART PROGRAMS, FELLOWSHIP OF CHRISTIAN ATHLETES, HOOPESTON HEAD START AND MORE. RECEIVING A GRANT THROUGH THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK, A HCMH NURSE PRACTITIONER WAS APPROVED TO START A FREE EXERCISE PROGRAM CALLED "DRUMS ALIVE." THE GRANT COVERED THE COST OF EQUIPMENT AND CERTIFICATION FOR THIS PROGRAM, WHICH USES EXERCISE BALLS AS DRUMS TO HELP KIDS AND ADULTS EXERCISE WHILE MAKING RHYTHMS. THE PROGRAM HAS PROVEN TO BE A BIG SUCCESS IN THE GRADE SCHOOLS IN VERMILION AND IROQUOIS COUNTIES, AND THE NURSE PRACTITIONER HAS ALSO PRESENTED IN LONG-TERM CARE FACILITIES AND ASSISTED LIVING COMMUNITIES. IN ADDITION, THE NURSE PRACTITIONER HAS PROVIDED TRAINING COURSES THROUGHOUT THE TWO COUNTIES AND HAS CERTIFIED SEVERAL LOCAL PHYSICAL EDUCATION TEACHERS SO THEY CAN IMPLEMENT THE PROGRAM IN THEIR SCHOOLS. THIS AMOUNTED TO MORE THAN $5,600 IN IN-KIND SUPPORT TO THE COMMUNITY, NOT COUNTING THE GRANT FUNDS THAT WERE AWARDED FOR THE PROGRAM ITSELF. HCMH IS SUPPORTING HEALTHY VERMILION COUNTY IN SEVERAL EDUCATIONAL AND OUTREACH EFFORTS. BY PARTNERING WITH THIS WORKGROUP TO PRODUCE QUALITY INFORMATIONAL MATERIALS ON HEALTHY FOODS, AND PROVIDING IN-KIND SUPPORT TO AGENCIES HELPING WITH FOOD INSECURITY, HCMH INTENDS TO POSITIVELY IMPACT CHILDREN'S VIEW OF HEALTHY FOODS. CONTINUING INTO 2017, THE GROUP'S CAMPAIGN CALLED "RETHINK YOUR DRINK" IS AIMED AT EDUCATING PEOPLE ABOUT THE HIDDEN CALORIE AND SUGAR CONTENT OF MANY POPULAR DRINKS AND ENCOURAGING HEALTHIER OPTIONS. THIS CAMPAIGN CONTINUES THROUGH SOCIAL MEDIA, SIGNAGE AT AREA SCHOOLS AND PRESENCE IN LOCAL HEALTH FAIRS, AND HCMH OFFERS IN-KIND SUPPORT BY FUNDING MANY OF THE PRINTING COSTS. OTHER COMMUNITY NEEDS/SCHOOL-BASED EDUCATION - HCMH STAFF MAINTAINED A PRESENCE IN THE LOCAL SCHOOL SYSTEM, PROVIDING HEAD LICE CHECKS, HANDWASHING EDUCATION, AND VISION AND HEARING TESTING FOR SCHOOLS IN THE REGION. - THE HOSPITAL PROVIDED FULL-TIME ATHLETIC TRAINERS TO SCHOOLS IN HOOPESTON, CISSNA PARK AND MILFORD. SERVICE IS PROVIDED TO ALL STUDENT ATHLETES, REGARDLESS OF WHERE THEY RECEIVE CARE, AND IS FREE OF CHARGE TO THE SCHOOL DISTRICTS. - HCMH CONTINUED TO FUND THE DELTA DENTAL OF ILLINOIS' LAND OF SMILES PROGRAM IN VERMILION COUNTY WITH A $3,000 ANNUAL DONATION. THIS PROGRAM TEACHES CHILDREN IN THE COMMUNITY HOW TO TAKE CARE OF THEIR TEETH BY DEMONSTRATING PROPER BRUSHING AND FLOSSING TECHNIQUES, REVIEWING GOOD AND BAD FOODS FOR TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST REGULARLY. IN 2017, THE PROGRAM REACHED 210 CHILDREN IN PAXTON AND ARMSTRONG, TWO RURAL COMMUNITIES LOCATED WITHIN THE SERVICE AREA WHERE IT HAS BEEN IDENTIFIED THAT YOUTH LACK EDUCATION ABOUT THE IMPORTANCE OF DENTAL CARE. PRE- AND POST-TESTING ILLUSTRATES THAT CHILDREN IMPROVE THEIR KNOWLEDGE OF THE IMPORTANCE OF DENTAL CARE BOTH AT HOME AND AT THE DENTIST AFTER PARTICIPATING IN THE SESSION. OVER FOUR YEARS, THIS SUPPORT HAS HELPED LAND OF SMILES REACH NEARLY 1,800 CHILDREN IN NINE SCHOOLS IN FOUR COUNTIES. CASH AND IN-KIND DONATIONS HCMH CONTRIBUTED NEARLY $37,000 TO CHARITABLE ORGANIZATIONS IN THE COMMUNITY VIA CASH AND IN-KIND DONATIONS, INCLUDING PROGRAMS AIMED TO HELP YOUTH, HEALTH IMPROVEMENT, HEALTH EDUCATION AND HEALTH PROFESSIONS EDUCATION. A SIGNIFICANT PORTION OF HCMH'S CASH DONATIONS - NEARLY $14,000 - WENT TOWARDS HEALTH IMPROVEMENT. THE LARGEST OF THIS CATEGORY, $5,000 WAS DONATED TO THE HOOPESTON MULTI AGENCY TO ENHANCE THE MULTITUDE OF IMPORTANT COMMUNITY BENEFIT SERVICES THEY OFFER, INCLUDING A FREE AFTER-SCHOOL PROGRAM FOR TEENS, COMPLETE WITH HEALTHY MEALS AND TUTORING. THE ORGANIZATION ALSO ADDRESSES NEEDS FOR DISABLED AND ELDERLY PATIENTS, INCLUDING RIDES THROUGHOUT HOOPESTON AND DANVILLE TO HELP MAINTAIN THEIR HEALTH AND LIFESTYLE, AND ASSISTING CLIENTS IN COORDINATING CARE APPOINTMENTS AND FINDING RESOURCES. HCMH CONTRIBUTED A SIGNIFICANT AMOUNT TO YOUTH-RELATED PROGRAMMING IN THE COMMUNITY - MORE THAN $8,000 - INCLUDING SCHOLARSHIP FUNDS TO HOOPESTON STUDENTS FOR DANVILLE AREA COMMUNITY COLLEGE, HOOPESTON AREA FFA ALUMNI, HOOPESTON AREA CUSD, CISSNA PARK COMMUNITY SCHOOLS AND HOOPESTON JAYCEES. SUPPORT OF YOUTH SERVICES AND TEEN PROGRAMMING ALSO INCLUDED POST PROMS AND POSITIVE BEHAVIOR INTERVENTION. HCMH ALSO SUPPORTS SEVERAL STATEWIDE AND NATIONWIDE ORGANIZATIONS WITH REGIONAL CHAPTERS, INCLUDING ALL LIONS CLUB CHAPTERS IN VERMILION COUNTY, KNOWN FOR THEIR HUMANITARIAN EFFORTS ON BEHALF OF THE DEAF AND BLIND AND FOR PROVIDING EYEGLASSES FOR UNDERPRIVILEGED CHILDREN. OTHER LOCAL CHAPTERS INCLUDE HOOPESTON ROTARY CLUB, SPECIAL OLYMPICS OF ILLINOIS AND FELLOWSHIP OF CHRISTIAN ATHLETES. EACH OF THESE ORGANIZATIONS HAS A MISSION AIMED TO IMPROVE HEALTH, ACTIVITY AND WELL-BEING OF OUR YOUTH. NEEDS THAT HCMH IS NOT ADDRESSING WHILE THERE ARE A NUMBER OF ADDITIONAL CONCERNS IDENTIFIED BY THE DATA THAT ARE NOT MEETING STATE AND NATIONAL BENCHMARKS, INCLUDING SMOKING RATES, DIABETES, MOTOR VEHICLE CRASH DEATHS AND VIOLENCE, HCMH IS NOT FOCUSING ON ADDRESSING THOSE CHALLENGES AT THIS TIME. THE HOSPITAL AND IMPLEMENTATION COMMITTEE DETERMINED THESE ISSUES ARE LOWER PRIORITY BECAUSE THE NEEDS ARE NOT AS SIGNIFICANT; THEY ARE NOT CENTRAL TO THE HOSPITAL'S MISSION; AND HCMH DOES NOT HAVE THE ABILITY TO MAKE A MEASURABLE IMPACT IN THOSE AREAS, MANY REQUIRING IMPLEMENTATION FROM THE GROUND-UP. 8 CARLE DANVILLE ON FAIRCHILD 311 W FAIRCHILD DANVILLE IL 61832 RURAL HEALTH CLINIC CARLE MATTOON ON HURST 2512 HURST DRIVE MATTOON IL 61938 RURAL HEALTH CLINIC CHARLOTTE ANN RUSSELL MEDICAL CENTER 801 E ORANGE ST HOOPESTON IL 60342 RURAL HEALTH CLINIC CARLE AT TUSCOLA 301 E SOUTHLINE ROAD TUSCOLA IL 61953 RURAL HEALTH CLINIC CARLE AT WATSEKA 1490 EAST WALNUT ST SUITE C WATSEKA IL 60970 RURAL HEALTH CLINIC ROSSVILLE MEDICAL CLINIC 619 N CHICAGO ST ROSSVILLE IL 60963 RURAL HEALTH CLINIC MILFORD CLINIC 322 N CHICAGO ST MILFORD IL 60953 RURAL HEALTH CLINIC CISSNA PARK MEDICAL CLINIC 141 W GARFIELD AVE CISSNA PARK IL 60924 RURAL HEALTH CLINIC SCHEDULE H, SUPPLEMENTAL INFORMATION SCHEDULE H, PART VI 1 - REQUIRED DESCRIPTIONS FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA (PART I, LINE 3C) PATIENTS MAY REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IN ADDITION TO PATIENTS COMPLETING APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM, WE HAVE ROBUST PRESUMPTIVE ELIGIBILITY PROCESSES IN PLACE. WE HAVE PARTNERED WITH EXPERIAN INFORMATION SOLUTIONS, INC. TO HELP US IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. THESE PATIENTS MAY BE APPROVED WITHOUT COMPLETING AN APPLICATION OR EXPRESSING A NEED FOR FINANCIAL ASSISTANCE. IN ADDITION, WE PRESUME ELIGIBILITY FOR PATIENTS WHO ARE VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTALLY INCAPACITATED, ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR WOMEN, INFANTS, AND CHILDERN NUTRITION PROGRAM (WIC), TOWNSHIP ASSISTANCE, LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM OR COVERED BY ILLINOIS MEDICAID. EXPLANATION OF COSTING METHODOLOGY (PART I, LINE 7 AND PART III, LINE 2) TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. COMMUNITY BUILDING ACTIVITIES (PART VI AND PART II) HCMH'S SUPPORT OF COMMUNITY-BUILDING ACTIVITIES IS AN IMPORTANT PART OF CONTRIBUTING TO THE ECONOMIC VIABILITY OF THE COMMUNITY. A SIGNIFICANT PORTION OF THESE ACTIVITIES IS FOCUSED ON COMMUNITY SUPPORT AND ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN HOOPESTON. OF THE MORE THAN $15,000 IN COMMUNITY BUILDING, NEARLY $9,000 WAS IN CASH DONATIONS. - HCMH LEADERSHIP CONTINUED TO SIT ON A BOARD OF DIRECTORS FOR THE PRESERVATION OF THE HISTORIC LORRAINE THEATER IN HOOPESTON, AMOUNTING TO MORE THAN $1,200 IN SUPPORT TO THE COMMUNITY. - LEADERSHIP AND STAFF AT BOTH THE MATTOON-CHARLESTON AND TUSCOLA BRANCHES, RURAL FACILITIES OPERATED BY HCMH, PARTICIPATED IN TWO COMMITTEES: THE CHARLESTON CHAMBER OF COMMERCE, AMOUNTING TO MORE THAN $2,200 IN IN-KIND SUPPORT IN COLES COUNTY, AND THE PLANNING COMMITTEE FOR THE ATWOOD APPLE DUMPLING 5K, AMOUNTING TO MORE THAN $500 IN SUPPORT FOR THE TUSCOLA COMMUNITY. - THE HOSPITAL CEO SERVED IN A NUMBER OF BOARD AND COMMITTEE ROLES THAT WERE DEDICATED TO THE IMPROVEMENT OF HOOPESTON, INCLUDING HOOPESTON COMMUNITY ALLIANCE, VERMILION ADVANTAGE, HOOPESTON ECONOMIC DEVELOPMENT AND HOOPESTON RETIREMENT VILLAGE FOUNDATION. HOWEVER, BECAUSE OF REALLOCATION OF ALL ADMINISTRATORS' SALARIES, HE IS NOW PAID BY THE CARLE FOUNDATION AND THOSE HOURS ARE NO LONGER PAID BY HCMH. INCLUDING HERE AS SUPPLEMENTAL INFORMATION ONLY. - ADDITIONAL COMMUNITY BUILDING FUNDS ($263) WERE FOR DISASTER READINESS -THOSE HOURS AND STAFF TIME SPENT ABOVE AND BEYOND NORMAL REQUIREMENTS FOR A HOSPITAL. AT HCMH, EMERGENCY PREPAREDNESS IS A PRIORITY, WITH ONE STAFF MEMBER SERVING AS THE DISASTER PREPAREDNESS COORDINATOR. THIS INDIVIDUAL SAT ON THE HOOPESTON EMERGENCY MANAGEMENT AGENCY AS A REPRESENTATIVE OF HCMH, ATTENDED DISASTER MEETINGS, AND PARTICIPATED IN DRILLS. SHE ALSO CONTINUED TO PARTICIPATE IN REGULAR DISCUSSIONS WITH THE REGION, INCLUDING THE CARLE EMERGENCY MANAGEMENT COMMITTEE, WORKING TOGETHER TO PREPARE AND STANDING READY IF THE NEED OCCURS. BAD DEBT, MEDICARE, & COLLECTION PRACTICES (PART III, LINE 3) HCMH USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. BAD DEBT FOOTNOTE (PART III, LINE 4) THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 27 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS. EXPLANATION OF MEDICARE COST REPORT COSTING METHODOLOGY (PART III, LINE 8) THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, AND THOSE LESS FORTUNATE DEMOGRAPHICS THAT HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. COLLECTION PRACTICES (PART III, LINE 9B) THE CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP) PROVIDES DISCOUNTED OR FREE CARE TO THOSE WHO NEED IT WITHIN THE CARLE FOUNDATION, INCLUDING HCMH. NOT ONLY DOES THIS RESULT IN A MORE TIMELY APPLICATION PROCESS, BUT MOST IMPORTANTLY, IT MEANS PATIENTS RECEIVE THE SAME DISCOUNT AT THE HOOPESTON HOSPITAL AND CLINICS IF THEY MIGHT NEED AN ADDITIONAL LEVEL OF SPECIALTY OR HOSPITAL CARE AT THE CARLE FOUNDATION HOSPITAL IN URBANA. WITH THIS PROGRAM, HCMH HAS A ROBUST PRESUMPTIVE ELIGIBILITY PROCESS. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, RECIPIENTS OF WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FRANCES NELSON HEALTH CENTER (PROMISE HEALTHCARE FQHC) DISCOUNT REFERRALS, MEDICAID TITLE XIX, XXI, AND IN-NETWORK MEDICAID MANAGED CARE PLANS. IN ADDITION, WE UTILIZE A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC., TO PROACTIVELY IDENTIFY PATIENTS WHO MAY BE PRESUMPTIVELY-QUALIFIED FOR ASSISTANCE - NOT ONLY FOR PUBLIC PROGRAMS LIKE MEDICAID, BUT ALSO BASED ON A NUMBER OF KEY FINANCIAL INDICATORS, INCLUDING CREDIT HISTORY, DEMOGRAPHICS AND GROSS INCOME. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE AND AUTOMATICALLY ENROLLED IN THE PROGRAM, OR THEY MAY BE CONTACTED AND ENCOURAGED TO APPLY FOR ASSISTANCE. PATIENTS WHO ARE NOT DEEMED PRESUMPTIVELY-ELIGIBLE WOULD NEED TO REQUEST AND COMPLETE AN APPLICATION. IF THE PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. FOR PATIENTS THAT DO NOT QUALIFY FOR CFAP, AND WHO MAY BE UNINSURED OR UNDERINSURED, HCMH HAS OTHER DISCOUNT OPTIONS AVAILABLE, SUCH AS PROMPT PAY, ILLINOIS UNINSURED DISCOUNT, AND CAPPED DISCOUNT - WHERE A PATIENT'S OUT-OF-POCKET MEDICAL EXPENSES ARE LIMITED TO 40% OF THEIR ANNUAL GROSS INCOME IF THEY EARN AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT AND SET UP PAYMENT ARRANGEMENTS ON THE REMAINING BALANCE DUE. THE CURRENT MINIMUM IS 5% OF THE TOTAL BALANCE DUE OR $25.00 A MONTH. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE BILLING STAFF MEMBERS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT UNTIL THEY CAN MAKE THE MINIMUM PAYMENT. IF THEY ARE UNABLE TO MAKE PAYMENT ON THE BALANCE DUE, THEN THE BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATION IS MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND, THE ACCOUNT IS GIVEN A FINAL NOTICE, EITHER BY LETTER OR PHONE, AND SENT TO AN OUTSIDE COLLECTION AGENCY. HCMH WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE AN AGENCY TO USE SO-CALLED "BODY ATTACHMENTS." THE AGENCIES ARE AWARE OF THE CFAP AND HAVE BEEN ADVISED TO REFER THE PATIENTS BACK TO HCMH IF THEY DEEM THE PATIENT IS UNABLE TO PAY. BILLING STAFF WILL THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT TO SEE IF HELP IS AVAILABLE. IF STAFF DETERMINES THAT THE PATIENT MIGHT QUALIFY, WE SEND THE PATIENT A CFAP APPLICATION AND INSTRUCT THE AGENCY TO PUT A HOLD ON THE ACCOUNT; THE AVERAGE HOLD IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED WITH THE AGENCY. IF THE PATIENT IS APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY AND THE AGENCY WILL BEGIN COLLECTION EFFORTS ON ANY REMAINING BALANCE. 2 - NEEDS ASSESSMENT HCMH USED EXISTING DATA, INFORMAL DISCUSSIONS, AND A COMPREHENSIVE QUALITATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE IF EXISTING PROGRAMS ARE ON TRACK; WHAT NEEDS TO BE ADDED, DELETED OR ENHANCED; AND WHERE OUR FOCUS NEEDED TO BE PLACED IN THE FUTURE. THE CHNA INCLUDED DISCUSSIONS WITH COMMUNITY LEADERS, INCLUDING HUMAN SERVICE AGENCY ADMINISTRATORS, PUBLIC HEALTH REPRESENTATIVES AND HCMH LEADERSHIP. 3 - PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCE THE PRACTICE OF HCMH IS TO REVIEW EACH PATIENT'S FINANCIAL STATUS IN RELATION TO OUR CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP) AND THE CRITERIA OF THE UNINSURED PATIENT DISCOUNT ACT, AND TO PROVIDE THE PATIENT WITH THE DEEPEST DISCOUNT AVAILABLE. BY EXPANDING THE PRESUMPTIVE ELIGIBILITY SCREENING PROCESSES AND DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO HELP. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERE'S ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE. HCMH HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THESE INCLUDE: - ADVERTISING THE CARLE FINANCIAL ASSISTANCE PROGRAM, USING PRINT, BILLBOARDS AND WEB, CONTINUED PRESENCE IN APPROPRIATE COMMUNITY PUBLICATIONS, AND ON-SITE VIA DISPLAYS THROUGHOUT THE HOSPITAL AND CLINICS - SIMPLIFIED APPLICATION FORM, INCLUDING A VERSION IN SPANISH, THAT CONTAINS INFORMATION REGARDING THE CARLE FINANCIAL ASSISTANCE PROGRAM - PUBLICATION OF A PLAIN LANGUAGE SUMMARY AND ALL OTHER FINANCIAL ASSISTANCE RELATED INFORMATION ON CARLE.ORG/FINANCIALASSISTANCE - INFORMATION ABOUT THE CARLE FINANCIAL ASSISTANCE PROGRAM ON ALL STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - CARLE FINANCIAL ASSISTANCE PROGRAM INFORMATION AND APPLICATIONS AT ALL REGISTRATION POINTS, HOSPITAL MAIN LOBBY AND CARLE.ORG - MEETINGS WITH LOCAL LEGISLATORS TO HELP THEM ASSIST CONSTITUENTS WITH HEALTHCARE NEEDS, INCLUDING FINANCIAL ASSISTANCE 4 - COMMUNITY INFORMATION THE PRIMARY SERVICE AREA OF HCMH IS DEFINED AS THE GEOGRAPHICAL BOUNDARY OF VERMILION COUNTY, ILLINOIS. WHILE SOME RESIDENTS OF SURROUNDING COUNTIES UTILIZE HCMH'S SERVICES, OUR MOST RECENT CHNA TARGETED VERMILION COUNTY RESIDENTS, WHO MAKE UP THE MAJORITY OF HCMH PATIENTS. COMMUNITY BENEFIT REPORTING FOR HCMH ALSO INCLUDES OUTPATIENT FACILITIES IN CISSNA PARK, HOOPESTON, MILFORD, ROSSVILLE, WATSEKA, DANVILLE, MATTOON AND TUSCOLA. POCKETS OF EXTREME POVERTY EXIST THROUGHOUT THIS REGION, WITH RATES HIGHEST AROUND THE CITY OF DANVILLE. THE PROGRAMS WITHIN OUR COMMUNITY BENEFIT PLAN GENERALLY HAVE IMPACT UPON ALL THE TARGETED COMMUNITIES, WITH CERTAIN PROGRAMS DIRECTED AT SPECIFIC POPULATIONS. 5 - PROMOTION OF COMMUNITY HEALTH HCMH HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY AN 11-MEMBER COMMUNITY BOARD THAT SERVES ON A VOLUNTEER BASIS, WITH 7 VOTING MEMBERS AND 4 NON-VOTING STAFF MEMBERS. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE. 6 - AFFILIATED HEALTH CARE SYSTEM HCMH IS A CRITICAL ACCESS HOSPITAL COMMITTED TO IMPROVING QUALITY OF LIFE IN NORTHERN VERMILION COUNTY AND THE SURROUNDING AREA. HCMH INTEGRATED WITH THE CARLE FOUNDATION IN 2012 TO PROVIDE MORE ACCESS TO PRIMARY AND SPECIALTY CARE. THOUGH HCMH FALLS UNDER THE UMBRELLA OF THE CARLE FOUNDATION, IT MAINTAINS A SEPARATE BOARD OF DIRECTORS AND SENIOR LEADERSHIP. WHILE HCMH'S CHNA AND COMMUNITY BENEFIT REPORTING IS SEPARATE FROM THE CARLE FOUNDATION HOSPITAL, IT FOLLOWS THE SAME GUIDELINES AND PRINCIPLES AS CARLE. HCMH STAFF IS INVOLVED IN THE CHNA AND IMPLEMENTATION PLAN, AND SERVE ON HUMAN SERVICES AGENCY BOARDS AND COMMITTEES TO PROVIDE SUPPORT TO HELP ADDRESS IDENTIFIED COMMUNITY NEEDS IN VERMILION COUNTY, INCLUDING TEEN PREGNANCY, ALCOHOL AND SUBSTANCE ABUSE, AND OBESITY. 7 - STATE FILING OF COMMUNITY BENEFIT REPORT AS A CRITICAL ACCESS HOSPITAL, HCMH IS NOT RESPONSIBLE FOR FILING A STATE COMMUNITY BENEFIT REPORT. false true false false false false false true false LETHA KRAMER TRUSTEE & VP-RISK 0 185717 0 24787 0 20118 0 41245 0 8252 0 280119 0 0 HARRY BROCKUS EX-OFFICIO, CEO 0 214995 0 29462 0 38641 0 56758 0 20691 0 360547 0 36230 DENNIS HESCH EXEC VP & CFO 0 711268 0 153966 0 355068 0 242507 0 21785 0 1484594 0 200952 LAURENCE FALLON EXEC VP-LEGAL AFFAIRS & HR 0 537231 0 119461 0 259573 0 180529 0 20069 0 1116863 0 143395 DOUGLAS MORTON MD MED DIR-RADIOLOGY 0 679102 0 0 0 8892 0 21756 0 7518 0 717268 0 0 IKECHUKWU UZOARU MD MED DIR-LAB 0 497077 0 0 0 24514 0 21756 0 19672 0 563019 0 0 PAMELA BIGLER SVP-NURSING & CNO 0 299335 0 56661 0 107481 0 94403 0 14158 0 572038 0 76543 SALLY SALMONS MD TRUSTEE & PHYSICIAN 0 310961 0 29796 0 3327 0 28058 0 16007 0 388149 0 0 LARRY GERDOM PHYSICIAN ASSISTANT 137007 0 450 0 4506 0 10381 0 16267 0 168611 0 0 0 LARRY WHITAKER JR PHYSICIAN ASSISTANT 134612 0 450 0 284 0 10328 0 22849 0 168523 0 0 0 DANIEL CHASE MD HIGHLY COMP EMP - FORMER 0 445366 0 0 0 2286 0 21756 0 21079 0 490487 0 0 CORTNEY JONEIKIS ROSSER MD HIGHLY COMP EMP - FORMER 0 223638 0 0 0 1773 0 18342 0 22170 0 265923 0 0 WILLIAM MCCARTHY MD HIGHLY COMP EMP - FORMER 0 263629 0 0 0 32686 0 21756 0 1605 0 319676 0 0 ALBERT TANLIM MD HIGHLY COMP EMP - FORMER 0 236721 0 25 0 2032 0 18990 0 20616 0 278384 0 0 ANDY ARWARI MD MED DIR-REGIONAL 0 498994 0 22464 0 13778 0 21756 0 20358 0 577350 0 0 LYNETTE BARNES COO-CFH & SVP-FACILITIES 0 331742 0 60180 0 134152 0 104365 0 0 0 630439 0 106819 HEATHER TUCKER DIR-E REGION PRIM CARE SVCS 109903 0 9255 0 2140 0 8701 0 23304 0 153303 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HCMH, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. SCHEDULE J, PART I, QUESTION 4B THE 2017 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF HCMH, THAT ARE LISTED IN THE 990 PART VII INCLUDE LYNETTE BARNES, PAMELA BIGLER, HARRY BROCKUS, LAURENCE FALLON, DENNIS HESCH, LETHA KRAMER, AND SALLY SALMONS, MD. IN 2017, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO LYNETTE BARNES ($106,819), PAMELA BIGLER ($76,543), HARRY BROCKUS ($36,230), LAURENCE FALLON ($143,395), AND DENNIS HESCH ($200,952). SCHEDULE J, PART I, QUESTION 7 PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. Bradley D Cristy Jr Family member of Officer 34453 Employment false Heather Moore Family member of Trustee 111653 Employment false Kimberly S Houmes Family member of Trustee 90287 Employment false RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION BRADLEY D. CRISTY, JR. IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH HARRY BROCKUS WHO SERVES AS CEO. HEATHER MOORE IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE. KIMBERLY S. HOUMES IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE. FORM 990, PART VI, QUESTION 2 DENNIS HESCH (OFFICER), LAURENCE FALLON (KEY EMPLOYEE), AND PAMELA BIGLER (KEY EMPLOYEE) HAD A BUSINESS RELATIONSHIP. FORM 990, PART VI, QUESTION 6 HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH) HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. FORM 990, PART VI, QUESTION 7A HCMH'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PART VI, QUESTION 7B HCMH'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF INCORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $50,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED AND FOR RECOMMENDING THE CEO OF THE CORPORATION TO THE HOOPESTON BOARD OF TRUSTEES. FORM 990, PART VI, QUESTION 11B THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. FORM 990, PART VI, QUESTION 12C THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER, DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, QUESTIONS 15A & 15B THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HCMH, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. FORM 990, PART VI, QUESTIONS 18 & 19 THE CARLE FOUNDATION, THE SOLE MEMBER OF HCMH, PUBLISHES THROUGH WWW.DACBOND.COM AND https://emma.msrb.org/ ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. FORM 990, PART VII, SECTION A, COLUMN B THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK. FORM 990, PART XI, LINE 9 PERMANANTLY RESTRICTED ASSETS INCREASED AS A RESULT OF A CHANGE IN VALUE OF THE BENEFICIAL INTEREST IN A PERPETUAL TRUST OF $15,553. TEMPORARILY RESTRICTED ASSETS INCREASED BY $258 RESULTING FROM CHANGES IN THE POLAND TRUST ACCOUNT WHICH IS A TEMPORARILY RESTRICTED FUND USED TO PROVIDE TUITION ASSITANCE FOR NURSING STUDENTS. FORM 990, PART XII, LINES 2A, B, C AND PART IV, LINES 12A & 12B THE FINANCIAL STATEMENTS FOR HCMH WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR. THE CARLE FOUNDATION 611 W PARK ST URBANA IL 61801 370673465 PARENT/INVMGT IL 501(C)(3) 12c, III-FI NA false THE CARLE FOUNDATION HOSPITAL 611 W PARK ST URBANA IL 61801 371119538 HOSPITAL SVCS IL 501(C)(3) 3 TCF true CARLE HEALTH CARE INCORPORATED 611 W PARK ST URBANA IL 61801 371140016 VAR MED SVCS IL 501(C)(3) 10 TCF true CARLE RETIREMENT CENTERS INC 611 W PARK ST URBANA IL 61801 371160033 RTRMT LIVING IL 501(C)(3) 10 TCF true THE CARLE DEVELOPMENT FOUNDATION 611 W PARK ST URBANA IL 61801 371159978 FUNDRAISING IL 501(C)(3) 7 TCF true CARLE COMMUNITY HEALTH CORPORATION 611 W PARK ST URBANA IL 61801 364458371 FNDN MISSION IL 501(C)(3) 12a, Type I TCDF true RICHLAND MEMORIAL HOSPITAL INC 800 EAST LOCUST STREET OLNEY IL 62450 371363001 HOSPITAL SVCS IL 501c(3) 3 TCF true CHAMPAIGN SURGICENTER LLC 611 W PARK ST URBANA IL 618012595 201915925 SURGICAL CENTER IL NA HEALTH SYSTEMS INSURANCE LIMITED GOVERNORS SQ 2ND FL BLDG 3 grand cayman CJ ky1-1102 INSURANCE CJ NA C CORP true CARLE RISK MANAGEMENT COMPANY 611 W PARK ST URBANA IL 618012595 371217973 RISK MANAGEMENT IL NA C CORP true EVALIDATA INC 611 W PARK ST URBANA IL 618012595 462022658 PHYS CREDENTIALS IL NA C CORP true CHA HOLDING INC 301 S VINE ST URBANA IL 61801 471854275 HOLDING COMPANY IL NA C CORP true CARLE HOLDING COMPANY INC 611 W PARK ST URBANA IL 618012595 371188284 HOLDING COMPANY IL NA C CORP true HEALTH ALLIANCE MEDICAL PLANS INC 301 S VINE ST URBANA IL 61801 371260731 HEALTH COVERAGE IL NA C CORP true HEALTH ALLIANCE CONNECT INC 301 S VINE ST URBANA IL 61801 464796891 HEALTH CARE COORD IL NA C CORP true HEALTH ALLIANCE NORTHWEST HOLDING 820 N CHELAN AVE WENATCHEE WA 98801 461717578 HOLDING COMPANY WA NA C CORP true HEALTH ALLIANCE NORTHWEST HEALTH PLAN 820 N CHELAN AVE WENATCHEE WA 98801 461966323 HEALTH COVERAGE WA NA C CORP true HEALTH ALLIANCE MIDWEST INC 301 S VINE ST URBANA IL 61801 371354502 HEALTH COVERAGE IL NA C CORP true false false false false false false false false false false false true true false false true false false true HEALTH ALLIANCE MEDICAL PLANS INC l 5782824 BOOK VALUE HEALTH ALLIANCE CONNECT INC l 3152838 BOOK VALUE THE CARLE FOUNDATION HOSPITAL m 600897 BOOK VALUE CARLE HEALTH CARE INCORPORATED m 12403551 BOOK VALUE HEALTH SYSTEMS INSURANCE LIMITED m 1305970 BOOK VALUE THE CARLE FOUNDATION HOSPITAL p 53476 BOOK VALUE THE CARLE FOUNDATION HOSPITAL s 2200920 BOOK VALUE