2018-05-04T15:27:44-05:00 2017-06-30 430352985 KERBER ECK & BRAECKEL LLP 3200 ROBBINS RD STE 200A SPRINGFIELD IL 62704 990 2016-07-01 364143823 SIU PHYSICIANS & SURGEONS INC SIUP 2175458000 PO BOX 19639 SPRINGFIELD IL 62794 NELSON WEICHOLD TREASURER/EXECUTIVE DIRECTOR 2175458000 2018-05-03 1 DANIELLE M HUNT P00343541 2177890960 2018-05-03 2016 2022-09-23 18:48:47Z SIU HEALTHCARE NELSON WEICHOLD PO BOX 19639 SPRINGFIELD IL 627949639 105355108 0 X WWW.SIUMED.ORG X 1997 IL ASSIST SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE'S MEDICAL EDUCATION ACTIVITIES THROUGH PROVIDING PATIENT CARE. 11 3 301 0 0 0 0 0 107180653 103878227 604249 708244 0 0 107784902 104586471 0 0 0 0 33237293 33146071 0 0 0 69930217 68973348 103167510 102119419 4617392 2467052 56272232 58280434 9072314 9152965 47199918 49127469 TO BE A LEADER IN QUALITY HEALTH CARE TO ALL PEOPLE OF CENTRAL AND SOUTHERN ILLINOIS IN SUPPORT OF THE MISSION OF THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. 0 0 95960852 103878227 HEALTH CARE DELIVERY: PHYSICIANS AND OTHER HEALTHCARE PROVIDERS OF SIU PHYSICIANS AND SURGEONS, INC. ASSISTED IN THE TRAINING OF 293 UNDERGRADUATE MEDICAL STUDENTS AND 332 MEDICAL RESIDENTS AND FELLOWS WHILE PROVIDING MEDICAL SERVICES IN THE COMMUNITIES WE SERVE. (OVER 548,000 PATIENT VISITS) 95960852 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 51 0 1 301 1 0 0 0 0 0 0 0 0 0 0 X 11 3 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X SIU SCHOOL OF MEDICINE 2175455791 327 W CALHOUN SPRINGFIELD IL 62794 ALBERS MD JANET SECRETARY 2.00 48.00 X X 0 363838 31978 BUESCHER MD LUCINDA FACULTY BOARD MEMBER 24.50 25.50 X 130511 156678 46520 CARLSON MD DOUGLAS FACULTY BOARD MEMBER 24.50 25.50 X 22667 441557 41868 DECKARD MD ALAN VICE CHAIR 24.50 25.50 X X 21815 214859 30282 HAZELRIGG MD STEPHEN FACULTY BOARD MEMBER 24.50 25.50 X 417656 503750 79465 HOFFMAN ZACHARY CHAIR 2.00 0.00 X X 0 0 0 KRUSE MD JERRY DEAN AND CEO 24.50 25.50 X X 437852 347499 105700 MINER MD MICHELLE FACULTY BOARD MEMBER 24.50 25.50 X 91904 125033 37447 NEUMEISTER MD MICHAEL FACULTY BOARD MEMBER 24.50 25.50 X 242922 747402 87560 O'KEEFE DWIGHT BOARD MEMBER 2.00 0.00 X 0 0 0 SMITH JR HD BOARD MEMBER 2.00 0.00 X 0 0 0 WEICHOLD NELSON TREASURER 50.00 0.00 X 171342 140721 58925 ABRAMS MD ROBERT PHYSICIAN 24.50 25.50 X 398585 499100 111476 LORET DE MOLA MD RICARDO PHYSICIAN 24.50 25.50 X 372170 528529 88076 MCVARY MD KEVIN PHYSICIAN 24.50 25.50 X 204204 495926 82692 STEVENS MD WILLIAM PHYSICIAN 24.50 25.50 X 481829 253750 69013 COZZENS MD JEFFREY PHYSICIAN 24.50 25.50 X 121587 549454 43308 BRADLEY JOHN FORMER FACULTY BOARD MEMBER 24.50 25.50 X 36480 0 9346 COX-LARGENT WENDY FORMER OFFICER 10.00 40.00 X 45000 228949 24057 DORSEY MD PHD J KEVIN FORMER FACULTY BOARD MEMBER 10.00 40.00 X 60867 333335 28080 GILCHRIST MD JAMES FORMER FACULTY BOARD MEMBER 24.50 25.50 X 48169 359858 46005 HODGSON KIM FORMER FACULTY BOARD MEMBER 24.50 25.50 X 126624 502211 57473 SOLTYS STEPHEN FORMER FACULTY BOARD MEMBER 24.50 25.50 X 20780 141942 10947 3452964 6934391 1090218 97 1 1 0 ANTHELIO HEALTHCARE SOLUTIONS ONE LINCOLN CENTRE 5400 LBJ FREEWA DALLAS TX 75240 CONSULTING SERVICES 1089917 MEMORIAL MEDICAL CENTER 701 N FIRST ST SPRINGFIELD IL 62702 REFERENCE LAB/CATERING/RESEARCH SUPPORT 345740 WEATHERBY LOCUMS INCORPORATED PO BOX 972633 DALLAS TX 75397 CLINICAL SERVICES 231338 HEALTHLINK INCORPORATED 1831 CHESTNUT ST ST LOUIS MO 63103 ADMINISTRATION FEE 180000 JOHN A SHOUDEL 7 QUAIL CROSSING ROCHESTER IL 62563 CLINICAL SERVICES 173908 10 MEDICAL FEES 621110 94468369 94468369 CONTRACTUAL SERVICES 621110 5252859 5252859 TRAUMA/ON CALL FEES 621110 2511030 2511030 MEANINGFUL USE/MGMT & PROVIDER SV 621110 1645969 1645969 103878227 724361 724361 752520 752273 16364 247 -16364 -16117 -16117 104586471 103878227 0 708244 1580550 1009750 570800 29903726 26913353 2990373 1661795 1473830 187965 2941610 2941610 211027 211027 13808153 11736930 2071223 1380058 1380058 82849 82849 44475 44475 21643 21643 295531 251201 44330 488882 488882 UNIVERSITY OVERHEAD 41025420 41025420 ACADEMIC DEVELOPMENT 8321495 8321495 MISCELLANEOUS 352205 352205 102119419 95960852 6158567 0 15504682 1925712 19441951 23605292 1994068 1695631 76967 5969 4017534 3174678 952852 842856 12851288 24837006 5450424 5367968 56272232 58280434 5685796 6117900 3386518 3035065 9072314 9152965 X 46247066 48284613 952852 842856 0 0 47199918 49127469 56272232 58280434 2467052 -539501 0 X X 0 1 X 1 0 X X 1 BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY 376005961 6 1 49346634 0 1 49346634 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X SCHEDULE A SECTION E 1C THE ORGANIZATION OPERATES AS A MULTI-SPECIALTY PHYSICIAN GROUP WHICH BOTH AIDS IN THE TRAINING OF MEDICAL STUDENTS AND RESIDENTS AND PROVIDES CLINICAL SERVICES. THE REVENUES RECEIVED BY SIUHC ARE IN PART USED TO SUPPORT RESEARCH AND EDUCATIONAL ACTIVITIES OF THE SCHOOL OF MEDICINE, WHICH IN TURN, SUPPORTS THE OVERALL EDUCATIONAL MISSION OF THE BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY. 3997629 3158713 838916 19905 15965 3940 842856 DEPOSITS WITH SOUTHERN ILLINOIS UNIVERSITY 5069771 ACCRUED INTEREST RECEIVABLE 298197 5367968 DUE TO SOUTHERN ILLINOIS UNIVERSITY 3035065 3035065 104063333 -539501 -539501 104602834 -16363 -16363 104586471 102135782 16363 16363 102119419 0 102119419 PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS PART X, LINE 2 SIU PHYSICIANS AND SURGEONS OWES SOUTHERN ILLINOIS UNIVERSITY FOR SERVICES PERFORMED ON OUR BEHALF. THESE SERVICES INCLUDE STAFF, SUPPLIES, AND FACILITIES EXPENSES. X X X X 0 0 0 0 0 0 0 0 0 ALBERS MD JANET SECRETARY 0 363838 0 0 0 0 0 0 0 31978 0 395816 0 0 BUESCHER MD LUCINDA FACULTY BOARD MEMBER 130511 156678 0 0 0 0 13050 0 1492 31978 145053 188656 0 0 CARLSON MD DOUGLAS FACULTY BOARD MEMBER 22667 441557 0 0 0 0 5667 0 1985 34216 30319 475773 0 0 DECKARD MD ALAN VICE CHAIR 21815 214859 0 0 0 0 3925 0 1119 25238 26859 240097 0 0 HAZELRIGG MD STEPHEN FACULTY BOARD MEMBER 417656 503750 0 0 0 0 41892 0 1985 35588 461533 539338 0 0 KRUSE MD JERRY DEAN AND CEO 374852 347499 63000 0 0 0 32793 46865 1985 24057 472630 418421 0 0 MINER MD MICHELLE FACULTY BOARD MEMBER 91904 125033 0 0 0 0 9189 0 1158 27100 102251 152133 0 0 NEUMEISTER MD MICHAEL FACULTY BOARD MEMBER 242922 747402 0 0 0 0 49987 0 1985 35588 294894 782990 0 0 WEICHOLD NELSON TREASURER 112842 140721 58500 0 0 0 25558 0 1389 31978 198289 172699 0 0 ABRAMS MD ROBERT PHYSICIAN 398585 499100 0 0 0 0 77513 0 1985 31978 478083 531078 0 0 LORET DE MOLA MD RICARDO PHYSICIAN 372170 528529 0 0 0 0 53050 0 1985 33041 427205 561570 0 0 MCVARY MD KEVIN PHYSICIAN 204204 495926 0 0 0 0 50826 0 1985 29881 257015 525807 0 0 STEVENS MD WILLIAM PHYSICIAN 481829 253750 0 0 0 0 31440 0 1985 35588 515254 289338 0 0 COZZENS MD JEFFREY PHYSICIAN 121587 549454 0 0 0 0 17108 0 1985 24215 140680 573669 0 0 BRADLEY JOHN FORMER FACULTY BOARD MEMBER 36480 0 0 0 0 0 9120 0 226 0 45826 0 0 0 COX-LARGENT WENDY FORMER OFFICER 0 228949 45000 0 0 0 0 0 0 24057 45000 253006 0 0 DORSEY MD PHD J KEVIN FORMER FACULTY BOARD MEMBER 60867 333335 0 0 0 0 15217 0 1985 10878 78069 344213 0 0 GILCHRIST MD JAMES FORMER FACULTY BOARD MEMBER 48169 359858 0 0 0 0 12042 0 1985 31978 62196 391836 0 0 HODGSON KIM FORMER FACULTY BOARD MEMBER 126624 502211 0 0 0 0 31431 0 1985 24057 160040 526268 0 0 SOLTYS STEPHEN FORMER FACULTY BOARD MEMBER 20780 141942 0 0 0 0 2078 0 615 8254 23473 150196 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS AS DESCRIBED IN THE ORGANIZATIONAL BYLAWS. THESE BYLAWS LAY OUT THE SPECIFIC REQUIREMENT FOR MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A FOUR DIRECTORS ARE ELECTED BY THE MEMBERSHIP REPRESENTING EACH OF THE MAJOR PRIMARY CARE OR SPECIALTY DEPARTMENTS AND 1 MEMBER-AT-LARGE. A NOMINATING COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS WHO SOLICITS NOMINATIONS FROM THE MEMBERSHIP. THE MEMBERS THEN VOTE IN ONE OF THE CATEGORIES FOR A DIRECTOR. EACH DIRECTOR IS ELECTED TO A THREE YEAR TERM AND CAN SERVE NO MORE THAN TWO CONSECUTIVE TERMS. FORM 990, PART VI, SECTION A, LINE 7B THE ONLY DECISION OF THE GOVERNING BOARD THAT IS SUBJECT TO THE MEMBERSHIP IS A CHANGE IN THE BYLAWS. A BYLAWS CHANGE REQUIRES A SIMPLE MAJORITY OF THE VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS INITIALLY REVIEWED BY THE CHIEF FINANCIAL OFFICER. A COPY IS PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND RECOMMENDATION TO THE BOARD FOR APPROVAL. ANY QUESTIONS OR CHANGES ARE ADDRESSED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED ANNUALLY TO THE CORPORATE COMPLIANCE OFFICER WHO REVIEWS FOR POTENTIAL CONFLICTS. AT BOARD OF DIRECTORS MEETINGS, THE DIRECTORS ARE ASKED AT EACH MEETING OF ANY POTENTIAL CONFLICTS RELATED TO THE MEETING AGENDA. POTENTIAL CONFLICTS ARE DISCUSSED AND WHEN THEY EXIST, BOARD MEMBERS EITHER RECUSE THEMSELVES FROM DISCUSSION,VOTING, OR THE MEETING AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 EXTERNAL COMPENSATION DATA IS USED FOR ALL DIRECTORS AND OFFICERS. DATA TYPICALLY USED WOULD INCLUDE NATIONAL TRADE ASSOCIATION DATA SUCH AS MGMA OR AAMC. COMPENSATION CAPS ARE SET FROM MEDIUM TO NO GREATER THAN THE 90 PERCENTILE. ONCE AN EMPLOYEE EXCEEDS THE ABSOLUTE COMPENSATION CAP, NO ADDITIONAL INCOME CAN BE EARNED. THE COMPENSATION COMMITTEE, WHICH CONSISTS OF INDEPENDENT VOTING MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE RECOMMENDATIONS AND MAKE CHANGES OR APPROVE. THIS PROCESS OCCURS ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 SIU PHYSICIANS AND SURGEONS MAKES ITS MOST RECENT BOARD MEEETING MINUTES, BYLAWS AND CONFLICT OF INTEREST POLICY AVAILABLE ON ITS PUBLIC WEBSITE. EACH BOARD MEETING STARTS WITH A REQUEST FOR DISCLOSURE OF CONFLICTS OF INTEREST FOR THE MEETING AGENDA. FINANCIAL STATEMENTS ARE POSTED ON ANOTHER WEBSITE, GUIDESTAR. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. SOUTHERN ILLINOIS UNIVERSITY 1263 LINCOLN DRIVE CARBONDALE IL 629016899 376005961 HIGHER EDUCATION IL 170(B)(1)(A)(V) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 SOUTHERN ILLINOIS UNIVERSITY P 41025139 CASH SOUTHERN ILLINOIS UNIVERSITY R 8321495 CASH