2018-07-03T14:04:05-05:00 2017-09-30 430352985 KERBER ECK & BRAECKEL LLP 1116 W MAIN ST CARBONDALE IL 629012335 990 2016-10-01 371363001 RICHLAND MEMORIAL HOSPITAL RICH 6183952131 800 EAST LOCUST STREET OLNEY IL 62450 CHRISTINA BARE DIRECTOR OF BUS OPS 6183952131 2018-06-28 true MARK DALLAS P00187265 6185291040 2018-07-03 2016 2022-09-23 18:48:47Z CARLE RICHLAND MEMORIAL HOSPITAL CHRISTINA BARE 800 EAST LOCUST STREET OLNEY IL 62450 52964206 false X WWW.RICHLANDMEMORIAL.COM X 1953 IL TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY. 14 10 652 0 430104 143742 49518144 51520404 287651 79461 1180644 1220599 51416543 52964206 0 0 32707692 34045637 0 0 18428525 18854078 51136217 52899715 280326 64491 38517843 38997322 11904280 11482100 26613563 27515222 X TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY. false false 52899715 52964206 SEE SCH O RICHLAND MEMORIAL HOSPITAL, INC., D/B/A CARLE RICHLAND MEMORIAL HOSPITAL (THE HOSPITAL) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THE MISSION OF THE HOSPITAL IS TO SERVE OUR COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE OFFER > FREE CARE > CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND > HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT AND EDUCATE THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, PROFESSIONAL EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FISCAL YEAR 2017, THE HOSPITAL RECORDED 16,652 PATIENT DAYS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. THE HOSPITAL ALSO PROVIDES CARE TO PERSONS COVERED BY COMMERCIAL INSURANCE AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECOGNIZES THESE AMOUNTS AS COSTS INCURRED IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. CHARITY CARE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY OFFERED IN FY 2017. THE HOSPITAL ALSO OFFERS AND PARTICIPATES IN PROGRAMS THROUGHOUT THE COMMUNITY. THESE INCLUDE: 1. AMBULANCE COVERAGE 2. MEETINGS/CONFERENCE FACILITIES 3. SCHOLARSHIPS 4. SUPPORT OF COMMUNITY ORGANIZATIONS/EVENTS/ACTIVITIES: > AINAD SHRINE TEMPLE > AMATEUR SPORTS PROMOTION > AMBASSADOR COMPANY > AMERICAN HEART ASSOCIATION > BIG BROTHERS BIG SISTERS > BLUE KNIGHT TIP OFF CLUB > BUILD COMMUNITY > BUSINESS AFTER HOURS EVENTS > CHRISTMAS TREE / SANTA PRETZEL - 100 > RICHLAND COUNTY HIGHSCHOOL POST PROM > EDWARDS COUNTY FAIR > RICHLAND COUNTY HIGH SCHOOL TIGER BASEBALL > FIRST PRESBYTERIAN CHURCH > HOLIDAY TOUR OF HOMES > HOME / BUSINESS EXPO > HOSPICE OF SOUTH EASTERN ILLINOIS MEMORY MILES > ILLINOIS SOCIETY OF HEALTHCARE > LAGALA BOARD MEETING AND EVENT > LINCOLNLAND DISTRICT > MUSCULAR DYSTROPHY ASSOCIATION > NATIONAL MULTIPLE SCLEROSIS > NEWTON ROTARY CLUB > OLNEY COUNTY COLLEGE FOUNDATION > OLNEY COUNTY COLLEGE MUSIC DEPT > OLNEANS YEARBOOK > OLNEY ARTS COUNCIL > OLNEY CENTRAL COLLEGE > OLNEY CHAMBER OF COMMERCE > OLNEY CHRISTMAS PARADE > OLNEY CITY COUNCIL > OLNEY ELKS CLUB > OLNEY FUTURE FARMERS OF AMERICA > OLNEY LADY TIGERS SOFTBALL > OLNEY LITTLE LEAGUE > OLNEY TIGER FOOTBALL > OLNEY TIGERS ATHLETICS > OLNEY TIGERSHARKS SWIM TEAM > OLNEY WHITE SQUIRREL COUNT > OUTREACH MISSION > RICHLAND COUNTY RECRETIONAL COUNCIL WHITE SQUIRREL TRIATHLON > RICHLAND COUNTY 4-H > RICHLAND COUNTY DEVELOPMENT CORPORATION > RICHLAND COUNTY FARM & FAIR WEEK > RICHLAND COUNTY RECREATION COUNCIL > RICHLAND COUNTY COUNTY WALK AND ROLL > RICHLAND COUNTY YOUTH SOCCER (RCYS) > RIDGWAY CHAPTER ILLINOIS AUDUBON SOCIETY > CARLE RICHLAND MEMORIAL HOSPITAL & COMMUNITY GOLF OUTINGS > ROTARY CLUB OF OLNEY > RUCKERS WHOLESALE > SHRINE CLUB > SOUTHEASTEN ILLINOIS CONCERT ASSOCIATION > ST JOSEPH SCHOOL > ST THOMAS GOLF OUTING > SWAN > U.S. ROUTE 50 FOUR-LANE COALITION 5. WELLNESS EVENTS/COMMUNITY CLINICS/SUPPORT GROUPS/ OUTREACH/EDUCATION > BLOOD PRESSURE SCREENING CLINICS > DIABETIC EDUCATION DAY > HEALTHFEST > NATIONAL HOSPITAL WEEK CHOLESTEROL/PSA SCREENING CLINIC > OLNEY SENIOR EXPO > SUPPORT GROUPS/EDUCATION A. BREAST CANCER SUPPORT GROUP - TICKET FOR THE CURE B. BREAST HEALTH OUTREACH/EDUCATION - TICKET FOR THE CURE C. CPR CLASSES D. DIABETES SUPPORT GROUP E. FIRST AID CLASSES F. INFECTION CONTROL IN-SERVICES TO LOCAL SCHOOLS G. LIFE SMART FOR WOMEN EDUCATIONAL CLASSES H. PREPARED CHILDBIRTH CLASSES I. REGIONAL PSYCHIATRIC CENTER PATIENT SUPPORT GROUP 6. SPECIAL ASSISTANCE PROGRAMS > MAMMOGRAPHY ASSISTANCE - ILLINOIS BREAST AND CERVICAL CANCER PROGRAM SERVICE PROVIDER (LITTLE EGYPT & EAST CENTRAL REGION) > MAMMOGRAPHY ASSISTANCE - SUSAN G. KOMEN FOR THE CURE GRANT 52899715 true true false true false false false false false false true false false true false true true false false false false false false false false false true true false false true false false false false false true true true false false false false false true true true false false true 32 0 true 652 true false false false false false false false false false false false false X 14 10 false false true false true true true true true false false true true true true true true true true false X MIKE STOVERINK 6183952131 800 EAST LOCUST ST OLNEY IL 62450 HARRY GARRETT MD BOARD MEMBER 1.00 X 327280 0 15982 PAT BURKE BOARD MEMBER 3.50 X 0 0 0 TOM FEHRENBACHER BOARD MEMBER 1.00 X 0 0 0 RICK BUSSARD BOARD MEMBER 0.50 X 0 0 0 DENNIS GRAVES BOARD MEMBER 1.00 X 0 0 0 HERBERT BROKHOF BOARD MEMBER 1.00 X 0 0 0 JARROD ALMAROAD MD BOARD MEMBER 0.50 X 0 0 0 CAROL SCHAFER SECRETARY/TR 7.00 X 0 0 0 DAN EICHELBERGER VICE CHAIR 4.00 X 0 0 0 HERMAN ZUBER CHAIRMAN 4.00 X 0 0 0 ROBERT ANNISS BOARD MEMBER 1.00 X 0 0 0 JASON GLOVER BOARD MEMBER 2.00 X 0 0 0 ROB MCCLAIN BOARD MEMBER 0.50 X 0 0 0 JOHN SNYDER BOARD MEMBER 1.00 X 0 0 0 DAVE ALLEN CEO 40.00 X 215776 0 13543 CHRISTINA BARE DIRECTOR OF 40.00 X 91203 0 4106 PRASHANTH ANAND PHYSICIAN 40.00 X 396340 0 14621 MARY WALLER PHYSICIAN 40.00 X 380412 0 10775 STEPHEN REID PHYSICIAN 40.00 X 341475 0 12712 PAUL SUTHERLAND MD PHYSICIAN 40.00 X 339539 0 13218 NIRANAT DEJTIRANUKUL ENT DOCTOR 40.00 X 322973 0 13006 2414998 97963 19 false true false SODEXHO 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICE PR 839000 EMERGENCY DEPARTMENT ASSOCIATION PC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ER PHYSICIANS 806842 PHARMACY SYSTEMS INC 5050 BRADENTON AVE DUBLIN OH 43017 PHARMACY DIRECT 272480 CARRIER CORPORATION PO BOX 93844 CHICAGO IL 606733844 MAINTENANCE 234546 CARLE PHYSICIAN GROUP 611 WEST PARK URBANA IL 61801 HOSPITALIST FEE 215340 8 65493 78249 143742 NET PATIENT SERVICE REVENUE 51520404 51520404 51520404 79461 79461 PROPERTY TAX 430327 430327 MISC. OTHER REVENUE 331349 331349 CAFETERIA SERVICES 257394 257394 201529 201529 1220599 52964206 51520404 1300060 306979 306979 24212352 24212352 767637 767637 7107923 7107923 1650746 1650746 123666 123666 18419 18419 5048663 5048663 376063 376063 4093392 4093392 869283 869283 110915 110915 142864 142864 263318 263318 2195013 2195013 725310 725310 PROVIDER TAX ASSESSMENT 1862050 1862050 PURCHASE OF DRUGS 1423918 1423918 REPAIRS/MAINTENANCE 1410629 1410629 OTHER EXPENSES 190575 190575 52899715 52899715 0 0 6142724 4843932 7299554 8317430 828234 768037 509545 548563 49815774 35554295 14227618 14261479 6781045 7662253 2729123 2595628 38517843 38997322 5415803 5293017 6488477 6189083 11904280 11482100 X 26309702 27195128 303861 320094 26613563 27515222 38517843 38997322 64491 820935 16233 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 18419 18419 false SCHEDULE C, PART II-B, LINE 1 18,419 - PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING 188315 188315 25675773 18441794 7233979 487119 370319 116800 23464567 16742182 6722385 14261479 MISCELLANEOUS RECEIVABLES 1591869 INTEREST IN NET ASSETS OF FOUNDATION 320094 DUE TO THIRD PARTY PAYORS 230222 DUE FROM COUNTY-AMBULANCE SUBSIDY 220435 EST. MEDICAL MALPRACTICE RECEIVABLE 220000 DUE FROM PHYSICIANS 13008 2595628 X 53785141 820935 820935 52964206 52964206 52899715 52899715 52899715 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC TOPIC 740-10-25 ON SEPTEMBER 30, 2012. AT SEPTEMBER 30, 2017 NO INTEREST OR PENALTIES WERE ATTRIBUTED TO THE HOSPITAL. TAX RETURNS FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE HOSPITAL ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND PRIOR. true true true X true X true true false true true 991000 991000 0.01870 17583000 8505000 9078000 0.17160 18574000 8505000 10069000 0.19030 216000 216000 0.00410 8712000 3872000 4840000 0.09150 8928000 3872000 5056000 0.09560 27502000 12377000 15125000 0.28590 true 628188 314094 16347000 24740000 -8393000 X true true 1 1 RICHLAND MEMORIAL HOSPITAL 800 EAST LOCUST OLNEY IL 62450 X X X RICHLAND MEMORIAL HOSPITAL 1 false false true X X X X X X X X 15 true false false true X WWW.RICHLANDMEMORIAL.COM true 15 true WWW.RICHLANDMEMORIAL.COM false false true X 200.000000000000 300.000000000000 X X X true true X X X true X HTTP://WWW.RICHLANDMEMORIAL.COM X HTTP://WWW.RICHLANDMEMORIAL.COM X X X X X true X false X X X X true X false false FACILITY 1, RICHLAND MEMORIAL HOSPITAL - PART V, LINE 2 RICHLAND MEMORIAL HOSPITAL, INC. INTEGRATED INTO THE CARLE FOUNDATION THROUGH A MEMBERSHIP SUBSTITUTION EFFECTIVE APRIL 1, 2017. THE ORGANIZATION CONTINUES TO BE ORGANIZED AND 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. FACILITY 1, RICHLAND MEMORIAL HOSPITAL - PART V, LINE 5 INPUT RECEIVED THROUGH FOCUS GROUPS CONSISTING OF INDIVIDUALS FROM OUR SURROUNDING COMMUNITIES. FACILITY 1, RICHLAND MEMORIAL HOSPITAL - PART V, LINE 11 COMPLETED IMPLMENTATION ACTIONS: HEALTH NEED 1: MENTAL HEALTH AND RELATED SOCIAL ISSUES -DISCUSSIONS WITH SOUTHERN ILLINOIS HEALTH CARE FOUNDATION REGARDING RECRUITMENT STRATEGIES/INTENTIONS FOR MENTAL HEALTH SERVICES -RMH OUTREACH SPECIALIST INITIATING RESEARCH INTO VARIOUS OPTIONS FOR THE INCREASED PROVISION OF MENTAL HEALTH SERVICES: -RMH ACTED AS A LIAISON TO LOCAL SCHOOL SYSTEM FOR LINK TO LAWRENCE COUNTY HEALTH DEPARTMENT BEHAVIORAL HEALTH SERVICES FOR ON-SITE,AT- RISK PROGRAMMING. -DISCUSSIONS WITH CENTERPOINTE HOSPITAL FOR PROVISION OF MENTAL HEALTH SERVICES (INPATIENT AND OUTPATIENT) -DISCUSSION WITH LOCAL MENTAL HEALTH PROVIDERS FOR IDEAS/LEADS ON RECRUITMENT OF PROVIDERS. -ONGOING EXPLORATION OF VIABLE OPTIONS TO INCREASE MENTAL HEALTH SERVICES. HEALTH NEED 2: ACCESS TO HEALTH SERVICES -RECRUITED SEVERAL NEW PROVIDERS AND INCEASED NUMBER OF ATHLETIC TRAINERS IN REHABILITATION SERVICES. -AFFILIATION AGREEMENT WITH CARLE CLINIC IN CHAMPAIGN-URBANA -CONTINUED INVESTMENT IN MEDICAL SCHOOL STUDENTS TO PROVIDE FOR FUTURE RMH STAFFING. -PARTICIPATED IN RICHLAND COUNTY INTERAGENCY STEERING COMMITTEE - DISCUSSION ON THE DEVELOPMENT OF A LOCAL HEALTH DEPARTMENT HEALTH NEET 3: CHRONIC DISEASE MANAGEMENT -PROVIDE SPACE FOR MEDASSIST PROGRAM TO ASSIST WITH MEDICATION AQUISITION -PROVIDE DIABETES EDUCATION AND SUPPORT GROUP, LEAD BY RMH CERTIFIED DIABETIC EDUCATOR -COLLABORATE WITH SIHF TO PROVIDE CERTIFIED APPLICATION COUNSELORS TO ASSIST WITH ACA DIRECTED INSURANCE MARKETPLACE -PROVIDE SODIUM REDUCTION PROGRAM TO RMH PATIENTS, STAFF, AND COMMUNITY -HIRED TRANSITIONAL CARE SPECIALIST TO PROVIDE FOLLOW-UP/PREVENTION EDUCATION WITH PATIENTS AT HIGHER RISK OF READMISSION DUE TO CHRONIC ILLNESS. -DEVELOP SMOKING CESSATION PROGRAM TO BE OFFERED TO PATIENTS, COMMUNITY MEMBER, AND AREA CORPORATIONS. NO COMMUNITY NEEDS WERE LEFT UNADDRESSED. FACILITY 1, RICHLAND MEMORIAL HOSPITAL - PART V, LINE 18E OUTSOURCED TO OUTSIDE COLLECTION AGENCY. 10 OUTPATIENT THERAPY 800 E LOCUST STREET OLNEY IL 62450 OUTPATIENT THERAPY HOME HEALTH 800 E LOCUST STREET OLNEY IL 62450 HOME HEALTH AGENCY RMH PROFESSIONAL SERVICES 1200 NORTH EAST STREET OLNEY IL 62450 PHYSICIAN PRACTICE (GENERAL SURGERY) HOSPICE 800 E LOCUST STREET OLNEY IL 62450 HOSPICE SERVICES RMH PROFESSIONAL SERVICES-ENT 800 E LOCUST STREET OLNEY IL 62450 PHYSICIAN PRACTICE (EAR, NOSE,THROAT) RMH PROFESSIONAL SERVICES 1200 NORTH EAST STREET OLNEY IL 62450 PHYSICIAN PRACTICE RMH PROFESSIONAL SERVICES - PRIMARY 800 E LOCUST STREET OLNEY IL 62450 PRIMARY CARE PHYSICIANS WEST SALEM HEALTH CLINIC 100 S MAIN STREET WEST SALEM IL 62476 RURAL HEALTH CLINIC JASPER COUNTY MEDICAL CENTER 500 S SCOTT AVE NEWTON IL 62448 PRIMARY CARE CARLE-RICHLAND PRIMARY CARE 605 E MAIN STREET OLNEY IL 62450 PRIMARY CARE PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES ARE NET COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. THESE INCLUDE SERVICES OFFERED DESPITE A FINANCIAL LOSS BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND EITHER OTHER PROVIDERS ARE UNWILLING TO PROVIDE THE SERVICES OR THE SERVICES WOULD OTHERWISE NOT BE AVAILABLE IN SUFFICIENT AMOUNT.WE INCLUDED AS UNREIMBURSED COSTS OF SUBSIDIZED HEALTH SERVICES, 3,421,000 FOR PHYSICIAN CLINICS 935,000 FOR EMERGENCY ROOM, 230,000 FOR PSYCHIATRIC CENTER, AND 255,000 FOR AMBULANCE SERVICE. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION WE USED A COST-TO-CHARGE RATIO AS CALCULATED UTILIZING DATA FROM AN INTERNAL COST ACCOUNTING SYSTEM AND USING A METHODOLOGY CONSISTENT WITH SCEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. WE USED ACTUAL COSTS AS REPORTED IN THE GENERAL LEDGER SYSTEM TO DETERMINE THE AMOUNTS ON LINES 7E AND 7I OF SCHEDULE H PART I. SCHEDULE H, PART I, LINE 7G WAS DETERMINED USING BOTH ACTUAL AMOUNTS FROM THE GENERAL LEDGER AND A COST-TO-CHARGE RATIO SPECIFIC TO EACH PROGRAM. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY WE CALCULATED BAD DEBT EXPENSE AT COST USING A COST-TO-CHARGE RATIO AS CALCULATED UTILIZING DATA FROM AN INTERNAL COST ACCOUNTING SYSTEM AND USING A METHODOLOGY CONSISTENT WITH SCEDULE H INSTRUCTIONS. AFTER EXHAUSTING ALL COLLECTION PROCEDURES PATIENT ACCOUNTS ARE THEN WRITTEN OFF TO BAD DEBT EXPENSE. WE ESTIMATE THAT 50% OF OUR PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE BUT THE PATIENTS CHOSE NOT TO APPLY. THE FOLLOWING IS THE FOOTNOTE RELATING TO BAD DEBT EXPENSE EXACTLY AS IT APPEARS IN THE FOOTNOTES TO OUR AUDITED FINANCIAL STATEMENTS: FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. DURING THE YEAR ENDED SEPTEMBER 30, 2017 THE HOSPITAL REPORTED PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS OF 2,229,130. PART III, LINE 8 - MEDICARE EXPLANATION THE HOSPITAL UTILIZED THE INTERNAL COST ACCOUNTING SYSTEM TO CALCULATE UNREIMBURSED MEDICARE COSTS. SOME MEDICARE CHARGES NOT ASSOCIATED WITH ITEMS PAID ON THE COST REPORT, THE COSTS ASSOCIATED WITH THOSE CHARGES, AND OTHER COST PER THE HOSPITAL'S COST ACCOUNTING SYSTEM HAVE BEEN INCLUDED. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION CARLE RICHLAND MEMORIAL HOSPITAL (RMH) APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE ELIGIBLE AND NON-CHARITY CARE PATIENTS. THE PROCEDURES ARE AS FOLLOWS: 1. WE WILL SEND 2 STATEMENTS AND 2 COLLECTION LETTERS IN A 28 DAY CYCLE. WE WILL SEND STATEMENTS BASED UPON PATIENT PORTION OF 10 OR GREATER. 2. THE PATIENT'S ACCOUNT WILL AGE THROUGH THE STATEMENT PROCESS BEFORE BEING WRITTEN OFF TO BAD DEBT. A.PRIVATE PAY ACCOUNTS WILL RECEIVE A STATEMENT WITHIN 9 DAYS OF THE DISCHARGE DATE. B.ACCOUNTS WITH A PATIENT PORTION AFTER INSURANCE WILL BE ELIGIBLE TO RECEIVE A STATEMENT APPROXIMATELY 14 DAYS AFTER THE INSURANCE PAYMENT HAS BEEN POSTED. C.28 DAYS LATER THE PATIENT IS MAILED A THIRD STATEMENT D.28 DAYS LATER THE PATIENT IS MAILED THE FIRST COLLECTION LETTER E.28 DAYS LATER THE PATIENT IS MAILED THE FINAL COLLECTION LETTER F.APPROXIMATELY 15 DAYS LATER THE PATIENT IS WRITTEN OFF TO BAD DEBT. 3. RMH WILL ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE AFTER THEY RECEIVE THE FIRST STATEMENT ON BALANCES GREATER THAN 1,000. 4. RMH WILL ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE AFTER THE SECOND STATEMENT ON BALANCES LESS THAN 1,000 5. RMH WILL MAKE A SECOND ATTEMPT TO CONTACT THE GUARANTOR VIA PHONE IF PAYMENT OR CONTACT HAS NOT BEEN MADE USUALLY AROUND THE SAME TIME THE SECOND COLLECTION LETTER IS SENT. 6. RMH WILL SEND 2 COLLECTION LETTERS TO THE PATIENT. PATIENT HAS 15 DAYS AFTER THE FINAL LETTER TO PAY BEFORE BEING WRITTEN OFF TO BAD DEBT. PART VI, LINE 2 - NEEDS ASSESSMENT THE DETERMINATION OF CURRENT AND FUTURE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED ARE BASED ON THE FOLLOWING FACTORS: EXISTENCE OR NONEXISTENCE OF SERVICES, OPPORTUNITY, SUPPLY, DEMONSTRATED NEED, REQUESTS FROM PATIENTS, AND/OR COMBINED EFFORTS WITH OUTSIDE ENTITIES THAT WOULD HELP FILL A NEED OR STRENGTHEN A CURRENT SERVICE. WE ARE CONSTANTLY COLLECTING DATA THAT WOULD HELP MAKE THESE DECISIONS AND OFTEN CONSULT WITH VARIOUS DEPARTMENTS WITHIN THE HOSPITAL INCLUDING NURSING, INFORMATION TECHNOLOGY, FINANCE, AND PHYSICIANS. THIS INFORMATION IS THEN REVIEWED AND THE HOSPITAL'S ADMINISTRATIVE TEAM WOULD INCORPORATE THE NEWLY IDENTIFIED HEALTH CARE NEEDS INTO THE STRATEGIC PLAN. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ALL PATIENT BILLING STATEMENTS INCLUDE A STATEMENT THAT MENTIONS CONTACTING THE HOSPITAL IF THEY WISH TO APPLY FOR FINANCIAL ASSISTANCE OR WOULD LIKE TO SET UP PAYMENTS ON THE ACCOUNT. IF A PATIENT CONTACTS THE PATIENT FINANCIAL SERVICES DEPARTMENT ABOUT THE INABILITY TO PAY, THEY ARE INFORMED OF THE AVAILABLE OPTIONS, INCLUDING FINANCIAL ASSISTANCE, MEDICARE, AND MEDICAID APPLICATIONS. PATIENT FINANCIAL SERVICES WILL ALSO EXPLAIN HOW THE PATIENT CAN APPLY FOR ASSISTANCE. PART VI, LINE 4 - COMMUNITY INFORMATION CARLE RICHLAND MEMORIAL HOSPITAL'S (RMH) PRIMARY SERVICE AREA INCLUDES PORTIONS OF EIGHT SOUTHEASTERN ILLINOIS COUNTIES WITH A TOTAL PATIENT POPULATION OF ABOUT 60,000. THERE ARE EIGHT COUNTIES WITHIN THE HOSPITAL'S PRIMARY SERVICE AREA. RMH FURTHER EXTENDS HOME HEALTH AND HOSPICE SERVICES TO INDIVIDUALS LIVING IN FIVE ADDITIONAL COUNTIES. WE PROVIDE SERVICES TO PATIENTS WITHOUT REGARD TO AGE, SEX, RACE, COLOR, NATIONAL ORIGIN, RELIGIOUS CREED, GENDER IDENTITY, SEXUAL ORIENTATION, DISABILITY, INSURANCE COVERAGE OR ABILITY TO PAY. THE POPULATION OF RMH'S SERVICE AREA IS ECONOMICALLY DISADVANTAGED MAKING IT MORE DIFFICULT TO AFFORD HEALTHCARE. FURTHERMORE, THERE IS NO HEALTH DEPARTMENT IN RICHLAND COUNTY MAKING THE HOSPITAL THE PRIMARY SOURCE FOR HEALTHCARE SERVICES AND HEALTH EDUCATION. ACCORDING TO THE UNITED STATES CENSUS WEBSITE, THE MEDIAN HOUSEHOLD INCOME IN THE HOSPITAL'S SERVICE AREA FALLS WELL BELOW THE STATE MEDIAN OF 56,797, WHERE RICHLAND COUNTY'S MEDIAN INCOME IS 45,597. THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH CENTER FOR RURAL HEALTH INDICATES ON ITS WEB SITE THAT ALL OF THE COUNTIES IN THE HOSPITAL'S SERVICE AREA HAVE AT LEAST A PARTIAL FEDERAL HPSA DESIGNATION, WITH THE LOW-INCOME POPULATION BEING A PRIMARY CONCERN. X X X false false false false false false false false false HARRY GARRETT MD BOARD MEMBER/PHYSN 327280 12506 3476 343262 DAVE ALLEN CEO 215776 8788 4755 229319 PRASHANTH ANAND PHYSICIAN 396340 10023 4598 410961 MARY WALLER PHYSICIAN 380412 9895 880 391187 STEPHEN REID PHYSICIAN 341475 10069 2643 354187 PAUL SUTHERLAND MD PHYSICIAN 339539 10069 3149 352757 NIRANAT DEJTIRANUKUL ENT DOCTOR 322973 10100 2906 335979 RICK BUSSARD INSURANCE AGENT 742366 INSURANCE PREMIUM false HERMAN ZUBER FAMILY MEMBER 45408 REPORTABLE COMPENSAT false THRIFTY HOME MEDICAL BUSINESS 52587 CONTRACTED SERVICES false HARRY GARRETT EMPLOYEE 327280 REPORTABLE COMPENSAT false FORM 990, PAGE 2, PART III, LINE 4A RICHLAND MEMORIAL HOSPITAL, INC., D/B/A CARLE RICHLAND MEMORIAL HOSPITAL (THE HOSPITAL) PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THE MISSION OF THE HOSPITAL IS TO SERVE OUR COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, WE OFFER > FREE CARE > CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND > HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT AND EDUCATE THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, PROFESSIONAL EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FISCAL YEAR 2017, THE HOSPITAL RECORDED 16,652 PATIENT DAYS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. THE HOSPITAL ALSO PROVIDES CARE TO PERSONS COVERED BY COMMERCIAL INSURANCE AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECOGNIZES THESE AMOUNTS AS COSTS INCURRED IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. CHARITY CARE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY OFFERED IN FY 2017. THE HOSPITAL ALSO OFFERS AND PARTICIPATES IN PROGRAMS THROUGHOUT THE COMMUNITY. THESE INCLUDE: 1. AMBULANCE COVERAGE 2. MEETINGS/CONFERENCE FACILITIES 3. SCHOLARSHIPS 4. SUPPORT OF COMMUNITY ORGANIZATIONS/EVENTS/ACTIVITIES: > AINAD SHRINE TEMPLE > AMATEUR SPORTS PROMOTION > AMBASSADOR COMPANY > AMERICAN HEART ASSOCIATION > BIG BROTHERS BIG SISTERS > BLUE KNIGHT TIP OFF CLUB > BUILD COMMUNITY > BUSINESS AFTER HOURS EVENTS > CHRISTMAS TREE / SANTA PRETZEL - 100 > RICHLAND COUNTY HIGHSCHOOL POST PROM > EDWARDS COUNTY FAIR > RICHLAND COUNTY HIGH SCHOOL TIGER BASEBALL > FIRST PRESBYTERIAN CHURCH > HOLIDAY TOUR OF HOMES > HOME / BUSINESS EXPO > HOSPICE OF SOUTH EASTERN ILLINOIS MEMORY MILES > ILLINOIS SOCIETY OF HEALTHCARE > LAGALA BOARD MEETING AND EVENT > LINCOLNLAND DISTRICT > MUSCULAR DYSTROPHY ASSOCIATION > NATIONAL MULTIPLE SCLEROSIS > NEWTON ROTARY CLUB > OLNEY COUNTY COLLEGE FOUNDATION > OLNEY COUNTY COLLEGE MUSIC DEPT > OLNEANS YEARBOOK > OLNEY ARTS COUNCIL > OLNEY CENTRAL COLLEGE > OLNEY CHAMBER OF COMMERCE > OLNEY CHRISTMAS PARADE > OLNEY CITY COUNCIL > OLNEY ELKS CLUB > OLNEY FUTURE FARMERS OF AMERICA > OLNEY LADY TIGERS SOFTBALL > OLNEY LITTLE LEAGUE > OLNEY TIGER FOOTBALL > OLNEY TIGERS ATHLETICS > OLNEY TIGERSHARKS SWIM TEAM > OLNEY WHITE SQUIRREL COUNT > OUTREACH MISSION > RICHLAND COUNTY RECRETIONAL COUNCIL WHITE SQUIRREL TRIATHLON > RICHLAND COUNTY 4-H > RICHLAND COUNTY DEVELOPMENT CORPORATION > RICHLAND COUNTY FARM & FAIR WEEK > RICHLAND COUNTY RECREATION COUNCIL > RICHLAND COUNTY COUNTY WALK AND ROLL > RICHLAND COUNTY YOUTH SOCCER (RCYS) > RIDGWAY CHAPTER ILLINOIS AUDUBON SOCIETY > CARLE RICHLAND MEMORIAL HOSPITAL & COMMUNITY GOLF OUTINGS > ROTARY CLUB OF OLNEY > RUCKERS WHOLESALE > SHRINE CLUB > SOUTHEASTEN ILLINOIS CONCERT ASSOCIATION > ST JOSEPH SCHOOL > ST THOMAS GOLF OUTING > SWAN > U.S. ROUTE 50 FOUR-LANE COALITION 5. WELLNESS EVENTS/COMMUNITY CLINICS/SUPPORT GROUPS/ OUTREACH/EDUCATION > BLOOD PRESSURE SCREENING CLINICS > DIABETIC EDUCATION DAY > HEALTHFEST > NATIONAL HOSPITAL WEEK CHOLESTEROL/PSA SCREENING CLINIC > OLNEY SENIOR EXPO > SUPPORT GROUPS/EDUCATION A. BREAST CANCER SUPPORT GROUP - TICKET FOR THE CURE B. BREAST HEALTH OUTREACH/EDUCATION - TICKET FOR THE CURE C. CPR CLASSES D. DIABETES SUPPORT GROUP E. FIRST AID CLASSES F. INFECTION CONTROL IN-SERVICES TO LOCAL SCHOOLS G. LIFE SMART FOR WOMEN EDUCATIONAL CLASSES H. PREPARED CHILDBIRTH CLASSES I. REGIONAL PSYCHIATRIC CENTER PATIENT SUPPORT GROUP 6. SPECIAL ASSISTANCE PROGRAMS > MAMMOGRAPHY ASSISTANCE - ILLINOIS BREAST AND CERVICAL CANCER PROGRAM SERVICE PROVIDER (LITTLE EGYPT & EAST CENTRAL REGION) > MAMMOGRAPHY ASSISTANCE - SUSAN G. KOMEN FOR THE CURE GRANT FORM 990, PAGE 6, PART VI, LINE 4 UPON INTEGRATION WITH THE CARLE FOUNDATION, AS THE SOLE MEMBER OF RICHLAND MEMORIAL HOSPITAL INC., A NEW SET OF BYLAWS WAS ESTABLISHED. THE MOST SUBSTANTIVE CHANGES IN ADDITION TO INCORPORATING CERTAIN POLICIES OF THE CARLE FOUNDATION AND RICHLAND MEMORIAL HOSPITAL INC., WAS THE CREATION OF CERTAIN EXCLUSIVE POWERS WHICH ARE RETAINED BY THE CARLE FOUNDATION. THOSE POWERS INCLUDE ELECTING AND REMOVING BOARD MEMBERS AND FILLING VACANCIES ON THE BOARD; APPROVING AMENDMENTS TO GOVERNING DOCUMENTS; RECOMMENDING THE CEO TO THE BOARD; APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS; APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND BOARD OF TRUSTEES FOR THEIR EXPENSES OR COMPENSATION FOR SERVICES; APPROVING ANY NEW, LONG- TERM OR MASTER INSTITUTIONAL PLANS OR CHANGES TO SUCH PLANS; APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC; APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE; APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED (CON) APPROVAL; APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION; APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS; AND APPROVING NON- BUDGETED EXPENDITURES OR SALE EXCEEDING THE CHIEF EXECUTIVE OFFICER'S (CEO) AUTHORIZED SPENDING AUTHORITY. FORM 990, PAGE 6, PART VI, LINE 6 RICHLAND MEMORIAL HOSPITAL, INC. HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION, AS OF INTEGRATION ON APRIL 1, 2017. FORM 990, PAGE 6, PART VI, LINE 7A RICHLAND MEMORIAL HOSPITAL INC.'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PAGE 6, PART VI, LINE 7B RICHLAND MEMORIAL HOSPITAL, INC. MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF GOVERNING DOCUMENTS; RECOMMENDING THE CEO TO THE BOARD; APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS; APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND BOARD OF TRUSTEES FOR THEIR EXPENSES OR COMPENSATION FOR SERVICES; APPROVING ANY NEW, LONG-TERM OR MASTER INSTITUTIONAL PLANS OR CHANGES TO SUCH PLANS; APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC; APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE; APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED (CON) APPROVAL; APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION; APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS; AND APPROVING NON- BUDGETED EXPENDITURES OR SALE EXCEEDING THE CHIEF EXECUTIVE OFFICER'S (CEO) AUTHORIZED SPENDING AUTHORITY. FORM 990, PAGE 6, PART VI, LINE 11B 990 IS REVIEWED BY ALL BOARD MEMBERS DURING SCHEDULED MEETINGS BEFORE IT IS FILED. FORM 990, PAGE 6, PART VI, LINE 12C 1. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY BOARD MEMBER IS DISCLOSED TO THE OTHER MEMBERS OF THE BOARD BY THE BOARD MEMBER WHO HAS THE CONFLICT, AND MADE A MATTER OF RECORD, THROUGH THE BOARD'S ANNUAL FILING OF CONFLICT OF INTEREST STATEMENTS OR WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. 2. ANY BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER DOES NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER, AND HE/SHE IS NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. 3. THE FOREGOING REQUIREMENTS SHOULD NOT BE CONSTRUED AS PREVENTING THE BOARD MEMBER FROM ANSWERING PERTINENT QUESTIONS OF OTHER BOARD MEMBERS, SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. HOWEVER, THE MEMBER WITH A CONFLICT MUST ABSTAIN FROM MAKING MOTIONS, PARTICIPATING IN RELEVANT DELIBERATIONS, VOTING, EXECUTING AGREEMENTS, ATTEMPTING TO INFLUENCE OTHERS VOTES, OR TAKING ANY SIMILAR DIRECT ACTION ON BEHALF OF THE CORPORATION WHERE THE CONFLICT OF INTEREST MIGHT PERTAIN. 4. ALL MEMBERS OF THE BOARD (INCLUDING EX-OFFICIO MEMBERS) ARE REQUIRED TO COMPLETE AND RETURN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT NO LATER THAN NOVEMBER 30TH OF EACH YEAR OR WITHIN 30 DAYS OF THE CREATION OR OCCURRENCE OF ANY NEW CONFLICT. MEMBER(S) WHO DO NOT RETURN THE CONFLICT OF INTEREST STATEMENT WILL BE ADDRESSED IN ACCORDANCE WITH THE BYLAWS. 5. RESPONSES MAY BE COMPILED INTO PACKETS FOR DISTRIBUTION AND DISCUSSION ANNUALLY - AT THE NEXT BOARD MEETING FOLLOWING THE DUE DATE SEMI-ANNUALLY - SIX MONTHS FOLLOWING THE INITIAL REVIEW; AND, AS ANY NEW CONFLICT IS IDENTIFIED. 6. THE POLICY ON CONFLICT OF INTEREST WILL BE DISCUSSED WITH CANDIDATES FOR BOARD POSITIONS DURING THEIR INTERVIEW WITH THE NOMINATING COMMITTEE. THE IMPORATANCE OF AVOIDING CONFLICT OF INTEREST SITUATIONS WILL BE EMPHASIZED. 7. WHEN A CONFLICT OF INTEREST SITUATION IS IDENTIFIED: THE INDIVIDUAL BOARD MEMBER HAS THE PRIMARY RESPONSIBILITY TO BRING A POTENTIAL OR ACTUAL CONFLICT OF INTEREST SITUATION TO THE ATTENTION OF THE BOARD A CONFLICT OF INTEREST SITUATION MAY ALSO COME TO THE ATTENTION OF THE BOARD DUE TO THE CONCERNS OF A BOARD MEMBER WHO MAY NOT BE INVOLVED IN THE SITUATION. THAT BOARD MEMBER SHOULD NOTIFY THE CHAIRPERSON OF THE CONFLICT OF INTEREST CONCERN AND THE BOARD CHAIRPERSON SHOULD BRING THE SITUATION TO THE ATTENTION OF THE FULL BOARD. REGARDLESS OF THE METHOD BY WHICH THE CONFLICT IS BROUGHT UP, THERE SHOULD BE FULL AND OPEN DISCUSSION BY BOARD MEMBERS OF THE POTENTIAL OR ACTUAL CONFLICT OF INTEREST SITUATION. THE FURTHER PARTICIPATION OF THE BOARD MEMBER IN THE DISCUSSION SHOULD BE AGREED UPON AND APPROVED BY THE BOARD. 8. AS A RESULT OF DISCUSSIONS ON CONFLICT OF INTEREST SITUATIONS, THERE MAY BE CONSIDERATIONS FOR A BOARD MEMBER'S RESIGNATION. THE BOARD MEMBER MAY WISH TO RESIGN TO AVOID A FUTURE CONFLICT OF INTEREST SITUATION DUE TO A DESIRE TO BID ON A PARTICULAR BOARD PROJECT OR TO AVOID A FURTHER CONFLICT OF INTEREST CONCERN. IN THE EVENT THAT THE BOARD MEMBER DOES NOT LEAVE AND A CONFLICT OF INTEREST SITUATION EXISTS, IN ACCORDANCE WITH BYLAWS SECTION III.11 "REMOVAL OF DIRECTORS" THE BOARD MAY ASK THE BOARD MEMBER TO RESIGN IF NINE OF THE TWELVE VOTING MEMBERS VOTE AFFIRMATIVELY ON A MOTION OF REMOVAL. 9. THIS POLICY WILL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF BOARD MEMBERS. FORM 990, PAGE 6, PART VI, LINE 15A THE HUMAN RESOURCES DEPARTMENT USES AN EXECUTIVE SURVEY FROM THE ILLINOIS HOSPITAL ASSOCIATION (IHA) TO GET A STARTING POINT FOR THE SALARY. THEN THEY FACTOR IN YEARS OF EXPERIENCE AND NEGOTIATIONS ON BOTH ENDS. ULTIMATELY THE BOARD DETERMINES THE SALARY AND THE CONTRACT IS SET ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15B SALARIES ARE BASED OFF OF THE SOUTHERN ILLINOIS HUMAN RESOURCE SURVEY. YEARS OF EXPERIENCE AND NEGOTIATION ARE FACTORS THAT ARE CONSIDERED. ONCE A SALARY IS SET A % INCREASE IS GIVEN ANNUALLY DETERMINED BY THE CEO. FORM 990, PAGE 6, PART VI, LINE 19 RICHLAND MEMORIAL HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AFTER A REQUEST IS MADE TO ADMINISTRATION. FORM 990, PART XI, LINE 9 CHANGE IN INTEREST IN NET ASSETS OF RMH FOUNDATION 16,233 RMH FOUNDATION 800 EAST LOCUST STREET OLNEY IL 62450 371178290 FUNDRAISIN 501C3 10 N/A false THE CARLE FOUNDATION 611W PARK ST URBANA IL 618012595 370673465 PARENT/INV IL 501C3 12C N/A false THE CARLE FOUNDATION HOSPITAL 611 W PARK ST URBANA IL 618012595 371119538 HSPTL SVCS IL 501C3 3 THE CARLE FOUNDATION true CARLE HEALTH CARE INCORPORATED 611 W PARK ST URBANA IL 618012595 371140016 MED SVCS IL 501C3 10 THE CARLE FOUNDATION true CARLE RETIREMENT CENTERS INC 611 W PARK ST URBANA IL 618012595 371160033 RETIREMENT IL 501C3 10 THE CARLE FOUNDATION true THE CARLE DEVELOPMENT FOUNDATION 611 W PARK ST URBANA IL 618012595 371159978 FUNDRAISIN IL 501C3 7 THE CARLE FOUNDATION true HOOPESTON COMMUNITY MEMORIAL HOSPIT 701 E ORANGE ST HOOPESTON IL 609421801 363637465 HSPTL SVCS IL 501C3 3 THE CARLE FOUNDATION true CARLE COMMUNITY HEALTH CORP 611 W PARK ST URBANA IL 618012595 364458371 FNDN MSSN IL 501C3 12A THE CARLE DEVELOPMENT FOUNDATION true CHAMPAIGN SURGICENTER LLC 611 W PARK ST URBANA IL 618012595 201915925 SURG CNTR IL N/A false false HEALTH SYSTEMS INSURANCE LIMITED GOVERNERS SQUARE 2ND FLOOR BLDG 3 23 LINE TREE BAY AVE GRAND CAYMEN CJ INSURANCE CJ N/A C CORP true CARLE RISK MANAGEMENT COMPANY 611 W PARK ST URBANA IL 618012595 371217973 RISK MGMT IL N/A C CORP true EVALIDATA INC 611 W PARK ST URBANA IL 618012595 462022658 PHYS CRED IL N/A C CORP true CHA HOLDING INC 601 S VINE ST URBANA IL 61801 471854275 HOLDING CO IL N/A C CORP true CARLE HOLDING COMPANY INC 611 W PARK ST URBANA IL 618012595 371188284 HOLDING CO IL N/A C CORP true HEALTH ALLIANCE MEDICAL PLANS INC 301 S VINE ST URBANA IL 61801 371260731 HEALTH COV IL N/A C CORP true HEALTH ALLIANCE CONNECT INC 301 S VINE ST URBANA IL 61801 464796891 HEALTH CAR IL N/A C CORP true HEALTH ALLIANCE NORTHWEST HOLDING INC 820 N CHELAN AVE WENATCHEE WA 98801 461717578 HOLDING CO WA N/A C CORP true HEALTH ALLIANCE NORTHWEST HEALTH PLAN INC 820 N CHELAN AVE WENATCHEE WA 98801 461966323 HEALTH COV WA N/A C CORP true HEALTH ALLIANCE-MIDWEST INC 301 S VINE ST URBANA IL 61801 371354502 HEALTH COV IL N/A C CORP true false false false false false false false false false false false true true false false false false false false HEALTH ALLIANCE MEDICAL PLAND INC L 2072895 BOOK CARLE HEALTH CARE INCORPORATED M 339957 BOOK HEALTH ALLIANCE MEDICAL PLANS INC M 318971 BOOK