St Margaret's Health-Peru: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
St Margaret's Health-Peru (EIN 36-2852553)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-02
IRS object ID
201841229349300934
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-02T11:35:52-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1211 N BROADWAY SUITE 600AddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631022733ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362852553EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% BRAD REACHInCareOfNm
Business Name ControlILLIBusinessNameControlTxt
Phone8152233300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTOMMY HOBBSPersonNm
Person TitleCEOPersonTitleTxt
Signature2018-04-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTroy A LindseyPreparerPersonNm
PTINP01041237PTIN
Phone3142315544PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43032820181225000012FederalOriginalSubmissionId
Federal Original Submission Id2018-05-02FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id6112290188EC7584480059BFC4E6D4FC4B0067C2AtSubmissionCreationDeviceId
At Submission Filing Device Id78F200CBDB52BE849E85D9D5A86FA3880170894DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTOMMY HOBBSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$93,099,678GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.IVCH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee803TotalEmployeeCnt
Total Volunteers185TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$111,521PYContributionsGrantsAmt
CY Contributions Grants$65,842CYContributionsGrantsAmt
PY Program Service Revenue$80,187,869PYProgramServiceRevenueAmt
CY Program Service Revenue$85,248,108CYProgramServiceRevenueAmt
PY Investment Income$501,567PYInvestmentIncomeAmt
CY Investment Income$663,776CYInvestmentIncomeAmt
PY Other Revenue$605,919PYOtherRevenueAmt
CY Other Revenue$418,551CYOtherRevenueAmt
PY Total Revenue$81,406,876PYTotalRevenueAmt
CY Total Revenue$86,396,277CYTotalRevenueAmt
PY Grants And Similar Paid$46,460PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$36,310CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$39,960,312PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,032,636CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,146,019PYOtherExpensesAmt
CY Other Expenses$46,586,576CYOtherExpensesAmt
PY Total Expenses$86,152,791PYTotalExpensesAmt
CY Total Expenses$87,655,522CYTotalExpensesAmt
PY Revenues Less Expenses-$4,745,915PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,259,245CYRevenuesLessExpensesAmt
Total Assets BOY$70,206,482TotalAssetsBOYAmt
Total Assets EOY$69,614,943TotalAssetsEOYAmt
Total Liabilities BOY$51,208,115TotalLiabilitiesBOYAmt
Total Liabilities EOY$48,473,043TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,998,367NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,141,900NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$74,757,530ExpenseAmt
Grant$36,310GrantAmt
Revenue$85,248,108RevenueAmt
DescILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) IS A SMALL, INTEGRATED COMMUNITY HEALTH CARE DELIVERY SYSTEM. SERVICES RANGE FROM EMPLOYED PHYSICIANS AND MID-LEVELS IN THE SPECIALTIES OF FAMILY MEDICINE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, OTORHINOLARYNGOLOY, AND SLEEP MEDICINE. IN ADDITION TO THESE PHYSICIAN PRACTICES, IVCH ALSO OFFERS A FAST CARE AND CARE TODAY CLINIC WHICH PROVIDES A LOWER-COST, CONVENIENT ALTERNATIVE TO EMERGENCY ROOM CARE. CONTRACTED PHYSICIAN SERVICES ARE PROVIDED FOR EMERGENCY MEDICINE, ANESTHESIOLOGY AND HOSPITALISTS SERVICES. INPATIENT HOSPITAL SERVICES PROVIDED BY IVCH INCLUDE MEDICAL AND SURGICAL SERVICES, ICU, OBSTETRICS, SWING BEDS, DIAGNOSTIC, REHAB AND TREATMENT SERVICES. OUTPATIENT SERVICES INCLUDE SURGERY, EMERGENCY ROOM, LABORATORY, DIAGNOSTIC IMAGING, REHAB SERVICES, PAIN MANAGEMENT, SLEEP THERAPY, WOUND MANAGEMENT, RESPIRATORY CARE, EKG, OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES. HOSPICE AND ADULT DAY CARE SERVICES ARE ALSO PROVIDED. IVCH IS A MEDICARE DEPENDENT HOSPITAL AND QUALIFIES FOR DISPROPORTIONATE SHARE PAYMENTS. IVCH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR FINANCIAL STATUS OR ABILITY TO PAY. IVCH SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNABLE TO PAY AND THOSE WHO RECEIVE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. STATISTICS: INPATIENT ADMISSIONS: 2,428 INPATIENT DAYS: 6,837 NEWBORN DELIVERIES: 437 INPATIENT SURGERIES: 749 OUTPATIENT SURGERIES: 5,002 OUTPATIENT VISITS: 96,110 EMERGENCY ROOM VISITS: 15,290 CLINIC VISITS: 71,280Desc
Total Program Service Expenses$74,757,530TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee803EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBRAD REACHPersonNm
Phone8157803574PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CYNTHIA KURKOWSKI
DIRECTOR1.01.0Yes (X)$0$0$0
DAVID SICKLEY
TREASURER1.02.0Yes (X)$0$0$0Yes (X)
JAMES CLINARD
VICE PRESIDENT1.02.0Yes (X)$0$0$0Yes (X)
JAMES LOVELAND
PRESIDENT1.02.0Yes (X)$0$0$0Yes (X)
JOSEPH HOGAN
DIRECTOR1.02.0Yes (X)$0$0$0
KRISTINE A PAUL
DIRECTOR1.02.0Yes (X)$0$0$0
MICHAEL ROONEY OD
DIRECTOR1.01.0Yes (X)$0$0$0
RICHARD MARTUZZO
SECRETARY1.03.0Yes (X)$0$0$0Yes (X)
WILLIAM VLASNIK
DIRECTOR1.03.0Yes (X)$0$0$0
JOEL LEIFHEIT MD
DIRECTOR1.01.0Yes (X)$0$0$0
TOMMY HOBBS
CEO34.06.0$255,583$0$18,828Yes (X)
BRAD REACH
CFO34.06.0$59,295$0$2,436Yes (X)
BRANDON MUSGRAVE MD
PHYSICIAN40.00.0$715,650$0$13,250Yes (X)
PETER J MEIER MD
PHYSICIAN40.00.0$701,822$0$13,250Yes (X)
JAMES MURPHY
PHYSICIAN40.00.0$499,497$0$13,250Yes (X)
ROBERT J MITCHELL MD
PHYSICIAN40.00.0$551,687$0$13,250Yes (X)
MARIO E COTE MD
PHYSICIAN40.00.0$507,435$0$13,250Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,290,969TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$87,514TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K42IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PERU EMERGENCY PHYSICIANS LLP
PO BOX 674579DETROITMI48267PHYSICIAN SERVICES$3,390,110
IVAA
925 WEST STREETPERUIL61354ANESTHESIOLOGY$1,357,250
TATUM - RANDSTAD NORTH AMERICAN IN
PO BOX 847872DALLASTX75284EXECUTIVE RECRUITING$398,447
BECKER EUGENE MD
14637 RIVER OAKS DRIVELINCOLNSHIREIL60069ANESTHESIOLOGY$450,000
FIDELITY ON CALL
9006 N INDUSTRIAL ROADPEORIAIL61615NURSE STAFFING$389,203
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Related Organizations$43,353RelatedOrganizationsAmt
All Other Contributions$22,489AllOtherContributionsAmt
Total Contributions$65,842TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621110$84,893,108$84,893,108
EHR INCENTIVE REVENUE621110$355,000$355,000
FieldValueIRS element (for citing)
Total Program Service Revenue$85,248,108TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$568,404TotalRevenueColumnAmt
Exclusion$568,404ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$427,896RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$569,572RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$141,676RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$141,676TotalRevenueColumnAmt
Exclusion-$141,676ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,194,383SecuritiesAmt
Other$34,818OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,078,636SecuritiesAmt
Other$55,193OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$115,747SecuritiesAmt
Other-$20,375OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,372TotalRevenueColumnAmt
Exclusion$95,372ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA REVENUE721000$41,601$41,601
MANAGEMENT FEES541610$60,500$60,500
TRANSPORT VEHICLE REVENUE900099$221,064$221,064

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$237,062TotalRevenueColumnAmt
Exclusion$237,062ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$560,227OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$86,396,277TotalRevenueColumnAmt
Related Or Exempt Func Income$85,248,108RelatedOrExemptFuncIncomeAmt
Exclusion$1,082,327ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$36,310TotalAmt
Program Services$36,310ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$293,302TotalAmt
Management And General$293,302ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,884,959TotalAmt
Program Services$29,524,890ProgramServicesAmt
Management And General$3,360,069ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,072,982TotalAmt
Program Services$886,176ProgramServicesAmt
Management And General$186,806ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,647,147TotalAmt
Program Services$3,838,079ProgramServicesAmt
Management And General$809,068ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,134,246TotalAmt
Program Services$1,762,674ProgramServicesAmt
Management And General$371,572ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$260,080TotalAmt
Management And General$260,080ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$78,000TotalAmt
Management And General$78,000ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$32,500TotalAmt
Management And General$32,500ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,042,209TotalAmt
Program Services$4,042,209ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$809,536TotalAmt
Program Services$277,590ProgramServicesAmt
Management And General$531,946ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$581,295TotalAmt
Program Services$331,338ProgramServicesAmt
Management And General$249,957ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,102,943TotalAmt
Program Services$735,332ProgramServicesAmt
Management And General$367,611ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$561,325TotalAmt
Program Services$496,211ProgramServicesAmt
Management And General$65,114ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$23,132TotalAmt
Program Services$14,208ProgramServicesAmt
Management And General$8,924ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$121,442TotalAmt
Program Services$109,298ProgramServicesAmt
Management And General$12,144ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$589,446TotalAmt
Program Services$499,298ProgramServicesAmt
Management And General$90,148ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,929,073TotalAmt
Program Services$3,413,895ProgramServicesAmt
Management And General$515,178ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,164,835TotalAmt
Program Services$944,099ProgramServicesAmt
Management And General$220,736ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$8,033,293$7,859,774$173,519
PURCHASED SERVICES$14,025,913$9,899,441$4,126,472
BAD DEBT EXPENSE$4,249,741$4,249,741
REPAIRS & MAINTENANCE$1,799,796$1,457,280$342,516

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,182,017TotalAmt
Program Services$4,379,687ProgramServicesAmt
Management And General$802,330ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$87,655,522TotalAmt
Program Services$74,757,530ProgramServicesAmt
Management And General$12,897,992ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,020,840BOYAmt
EOY$1,338,280EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,713,374BOYAmt
EOY$14,859,171EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,103,813BOYAmt
EOY$2,456,056EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,399,649BOYAmt
EOY$1,410,045EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$115,926,011LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$84,052,170LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$35,457,002BOYAmt
EOY$31,873,841EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,869,250BOYAmt
EOY$11,191,724EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$396,652BOYAmt
EOY$370,187EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,245,902BOYAmt
EOY$6,115,639EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$70,206,482BOYAmt
EOY$69,614,943EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,711,642BOYAmt
EOY$12,099,113EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,610,000BOYAmt
EOY$19,769,916EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$918,663BOYAmt
EOY$713,394EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,967,810BOYAmt
EOY$15,890,620EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$51,208,115BOYAmt
EOY$48,473,043EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,754,190BOYAmt
EOY$19,888,754EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,244,177BOYAmt
EOY$1,253,146EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,998,367BOYAmt
EOY$21,141,900EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$70,206,482BOYAmt
EOY$69,614,943EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,259,245ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$158,992NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$3,243,786OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$32,500OtherActivitiesAmt
Total Lobbying Expenditures$32,500TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationALLOCATED PORTION OF MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND MEDICARE DEPENDENT RURAL HOSPITAL COALITION.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,476,235OtherCostOrOtherBasisAmt
Book Value$1,476,235BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,403,141OtherCostOrOtherBasisAmt
Depreciation$33,027,430DepreciationAmt
Book Value$20,375,711BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$325,067OtherCostOrOtherBasisAmt
Depreciation$226,571DepreciationAmt
Book Value$98,496BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$59,268,152OtherCostOrOtherBasisAmt
Depreciation$49,683,327DepreciationAmt
Book Value$9,584,825BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,453,416OtherCostOrOtherBasisAmt
Depreciation$1,114,842DepreciationAmt
Book Value$338,574BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$31,873,841TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$3,290,516
INTEREST IN IVCH FOUNDATION$1,253,146
OTHER ASSETS$1,571,977
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,115,639TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
PENSION OBLIGATION$6,461,207
ESTIMATED THIRD PARTY PAYOR SE$3,465,380
ESTIMATED SELF-INSURANCE COSTS$4,307,481
DUE TO AFFILIATES$1,656,552
FieldValueIRS element (for citing)
Total Liability$15,890,620TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$294,918TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$294,918NetCommunityBenefitExpnsAmt
Total Expense0.00350TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,809,681TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,967,020DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,842,661NetCommunityBenefitExpnsAmt
Total Expense0.08200TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,104,599TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,967,020DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,137,579NetCommunityBenefitExpnsAmt
Total Expense0.08550TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$734,977TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$258,740DirectOffsettingRevenueAmt
Net Community Benefit Expns$476,237NetCommunityBenefitExpnsAmt
Total Expense0.00570TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,467TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$17,467NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,093,634TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$857,290DirectOffsettingRevenueAmt
Net Community Benefit Expns$236,344NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,310TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$36,310NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,882,388TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,116,030DirectOffsettingRevenueAmt
Net Community Benefit Expns$766,358NetCommunityBenefitExpnsAmt
Total Expense0.00910TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,986,987TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,083,050DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,903,937NetCommunityBenefitExpnsAmt
Total Expense0.09460TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$4,249,741BadDebtExpenseAmt
Bad Debt Expense Attributable$415,000BadDebtExpenseAttributableAmt
Reimbursed By Medicare$23,048,308ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$21,313,430CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,734,878MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.IVCH.ORGWebsiteAddressTxt
State License0003418StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherVARIOUS PHYSICIAN CLINICS & OUTPATIENT SERVICESOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
OtherYes (X)OtherInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3JINDUSTRY DATA RELATED TO PROJECTED GROWTH IN NEED FOR VARIOUS SERVICES SPECIFIC TO THE POPULATION OF THIS AREA
SCHEDULE H, PART V, SECTION B, LINE 5COMMUNITY INPUT FOR CHNA: THE CHNA STAKEHOLDERS WORKING GROUP, COMPRISED OF MEMBERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, WAS RESPONSIBLE FOR THE CHNA PROCESS. THE STAKEHOLDER GROUP INCLUDED MEMBERS FROM: IVCH, IVCH MEDICAL GROUP, LA SALLE COUNTY HEALTH DEPT., ALTERNATIVES FOR THE OLDER ADULT, YOUTH SERVICE BUREAU, NORTH CENTRAL BEHAVIORAL HEALTH SERVICES, HYGIENIC INSTITUTE, OGLESBY PUBLIC SCHOOLS AND ILLINOIS VALLEY UNITED WAY. THE WORKING GROUP DEVELOPED A SURVEY INSTRUMENT, EVALUATED SURVEY RESPONSES, COLLECTED AND EVALUATED SECONDARY DATA, SYNTHESIZED THE PRIMARY AND SECONDARY DATA, AND IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. PRIMARY DATA FOR THIS ASSESSMENT CAME FROM TWO SOURCES, A COMMUNITY STUDY PERFORMED FOR IVCH BY LEEDE RESEARCH IN 2008 AND A SURVEY DEVELOPED, DISTRIBUTED AND ANALYZED BY THE STAKEHOLDERS WORKING GROUP SPECIFICALLY FOR CHNA.
SCHEDULE H, PART V, SECTION B, LINE 7Ahttps://www.ivch.org/documents/CHNA-Final-2015.pdf
SCHEDULE H, PART V, SECTION B, LINE 10Ahttps://www.ivch.org/documents/CHNA-Final-2015.pdf
SCHEDULE H, PART V, SECTION B, LINE 11THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES A DESCRIPTION OF THE ACTIONS TAKEN TO MEET NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE AREAS OF CONCERN THAT HAVE BEEN IDENTIFIED HISTORICALLY, AND WERE FURTHER ELEVATED IN THE NEW 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, RELATE TO MENTAL HEALTH/ADDICTION SERVICES AND DENTAL CARE. REGARDING DENTAL CARE, IVCH HAS DEVELOPED A LISTING OF SERVICES AVAILABLE IN THE AREA WHICH IS PROVIDED TO PATIENTS. THE MOST SIGNIFICANT NEED IS THE MENTAL HEALTH AND ADDICTION SERVICES. IN ADDITION TO THE ALREADY IDENTIFIED NEED, A SIGNIFICANT MENTAL HEALTH AGENCY IN THE SERVICE AREA HAS GREATLY REDUCED ITS SERVICES DUE TO THE REDUCTION IN ITS GRANT FUNDING. THIS IS CURRENTLY SIGNIFICANTLY IMPACTING ACCESS TO MENTAL HEALTH CARE. INADEQUATE AVAILABILE MENTAL HEALTH INPATIENT CARE IS RESULTING IN A BACKUP OF PATIENTS IN EMERGENCY CARE. IVCH IS EXPLORING PSYCHIATRY TELEHEALTH SERVICES AS WELL AS A POTENTIAL JOINT VENTURE OF PSYCHIATRY SERVICES WITH A HOSPITAL IN THE ADJACENT SERVICE AREA.
SCHEDULE H, SECTION B., LINES 16A, 16B & 16CLINES 16A & 16B - FINANCIAL ASSISTANCE POLICY AND APPLICATION FORM https://www.ivch.org/patients-visitors/patient/financial-assistance/ LINE 16C - PLAIN LANGUAGE SUMMARY https://www.ivch.org/documents/FAP-Plain_Language_Summary.pdf
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
CENTER FOR PHYSICAL REHABILITATION
300 WALNUT STPERUIL61354OUTPATIENT PHYSICAL REHABILITATION
IVCH WOUND & HYPERBARIC CENTER
1403 6TH STPERUIL61354WOUND AND HYPERBARIC THERAPY
ILLINOIS VALLEY ADULT DAY CENTER
1040 SECOND STLA SALLEIL61301ADULT DAY CARE
IVCH CARE TODAY
300 WALNUT STPERUIL61354URGENT CARE ALTERNATIVE TO ER
IVCH FAST CARE
5307 ST ROUTE 251PERUIL63154RETAIL CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART III, SECTION A, LINE 2THE ORGANIZATION RECORDS CONTRACTUAL DISCOUNTS AT THE TIME OF THE POSTING OF THE PAYMENT FOR SERVICES FROM THIRD PARTY PAYORS. BAD DEBT IS RECORDED AT THE TIME THE ACCOUNT IS EITHER PRESUMED UNCOLLECTIBLE OR TURNED OVER TO COLLECTION. FURTHER, THE ORGANIZATION RECORDS APPROPRIATE ALLOWANCES FOR CONTRACTUAL DISCOUNTS AND BAD DEBT/CHARITY CARE IN ORDER TO REFLECT ACCOUNTS RECEIVABLE AT THE EXPECTED COLLECTIBLE AMOUNT. CONTRACTUAL DISCOUNTS/MEDICARE/MEDICAID: MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYORS IN EVALUATING THE REASONABLE ESTIMATE OF THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. FOR SERVICES PROVIDED TO PATIENTS THAT HAVE THIRD PARTY COVERAGE, THE CORPORATION ANALYZES THE DISCOUNT RATES FOR EACH MAJOR PAYOR. THE DIFFERENCE BETWEEN THE NEGOTIATED RATES FOR THE MEDICARE/MEDICAID STANDARD RATES ARE USED TO DETERMINE THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. SELF-PAY ACCOUNTS RECEIVABLE INCLUDE THE PATIENT RESPONSIBILITY FOR SERVICES AFTER THE THIRD PARTY COVERAGE HAS BEEN APPLIED TO THE PATIENT ACCOUNT AS WELL AS THE UNINSURED. AN ALLOWANCE FOR BAD DEBT IS ESTIMATED BASED ON PAST EXPERIENCE AS WELL AS THE AGE OF THE ACCOUNTS. THE ORGANIZATION HAS A COLLECTIONS PRACTICES POLICY THAT IS USED TO SET GUIDELINES ON THE APPROACH AND TIMELINE TO MAKE REASONABLE COLLECTION EFFORTS BEFORE ANY ACCOUNTS ARE TURNED OVER TO A COLLECTION AGENCY. THE ORGANIZATION HAD BAD DEBT EXPENSE TOTALING $4,249,741. THIS REFLECTS THE COMBINED IMPACT OF WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS, PROVISIONS RECORDED TO ESTIMATE BAD DEBT ON ACCOUNTS RECEIVABLE. DURING FISCAL 2017 THERE WERE NO CHANGES IN THE ORGANIZATION'S POLICIES OR PRACTICES.
SCHEDULE H, PART III, SECTION A, LINE 310% OF BAD DEBT IS ASSUMED TO BE PROVIDED INCLUDE AMOUNTS WRITTEN OFF FOR PATIENTS THAT WOULD HAVE QUALIFIED FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE RATIONALE FOR THE PERCENTAGE BEING THIS IS BECAUSE OF THE SIGNIFICANT STEPS TAKEN WITH PATIENTS TO FACILITATE MEDICAID OR FINANCIAL ASSISTANCE QUALIFICATION.
SCHEDULE H, PART III, SECTION A, LINE 4ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 79 PERCENT AT JUNE 30, 2017.
SCHEDULE H, PART III, SECTION B, LINE 8IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON-PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM WORKSHEET D OF THE FY 2017 MEDICARE COST REPORT.
SCHEDULE H, PART III, SECTION C, LINE 9BWHEN A PATIENT IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE THE ACCOUNT IS PLACED ON HOLD AND NO FURTHER COLLECTION EFFORTS ARE MADE UNTIL THE REQUEST FOR ASSISTANCE HAS BEEN RESOLVED. THE APPLICATION PROCESS INCLUDES FACILITATING THE PATIENT'S APPLICATION FOR VARIOUS ASSISTANCE PROGRAMS, AND IDENTIFYING WHERE THE PATIENT FALLS IN THE DISCOUNT SCALE OF THE ORGANIZATION BASED ON INCOME LEVEL AND SIZE OF FAMILY. IF THERE IS A BALANCE REMAINING AFTER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE HAS BEEN APPLIED, A MUTUALLY AGREED UPON PAYMENT PLAN IS DEVELOPED AND THE ACCOUNT FOLLOWS THE SAME COLLECTION PROCEDURES AS ALL OTHER SELF-PAY ACCOUNTS. MONTHLY PAYMENTS ARE REQUIRED AND BALANCES ARE TYPICALLY EXPECTED TO BE PAID IN FULL WITHIN ONE YEAR. EXTENSIONS MAY BE APPROVED FOR UNEXPECTED CHANGES IN ABILITY TO MEET THE PAYMENT SCHEDULE. COLLECTION PROCEDURES INCLUDE STATEMENTS, PAST DUE NOTICES, PHONE CALLS AND, IF AGREED UPON PAYMENT ARRANGEMENTS CAN NOT BE MET, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY.
SCHEDULE H, PART VI, LINE 2THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY IVCH IS BASED ON A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON-EXISTENCE OF APPROPRIATE SERVICES, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, COLLABORATION WITH COMMUNITY ORGANIZATIONS, GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS, BENCHMARKING MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT AND MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS.
SCHEDULE H, PART VI, LINE 3DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDING CONTACT INFORMATION FOR THE PATIENT FINANCIAL SERVICES DEPT. BASIC INFORMATION AND CONTACT INFORMATION IS ALSO AVAILABLE AT WWW.ICVH.ORG ON THE PATIENTS AND VISITORS TAB ON THE HOME PAGE. WHEN CONTACTED BY A PATIENT, FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT TO DETERMINE ELIGIBILITY FOR CHARITY OR FINANCIAL ASSISTANCE. NOTICES ABOUT FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE REGISTRATION AREAS AND INFORMATION IS ALSO INCLUDED ON THE PATIENT STATEMENTS. THE SOCIAL SERVICES DEPARTMENT NOTIFIES EACH INPATIENT OF FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT IVCH AS WELL AS LOCAL, STATE AND FEDERAL PROGRAMS THEY MAY BE ELIGIBLE FOR.
SCHEDULE H, PART VI, LINE 4ILLINOIS VALLEY COMMUNITY HOSPITAL SERVES THE RESIDENTS OF RURAL COMMUNITIES LOCATED IN LA SALLE, BUREAU AND PUTNAM COUNTIES, IN NORTH CENTRAL ILLINOIS. THE HOSPITAL IS LOCATED NEAR THE JUNCTION OF INTERSTATES 80 AND 39 AND IS 62 MILES WEST OF JOLIET AND 64 MILES NORTH OF BLOOMINGTON. THE PRIMARY SERVICE AREA OF THE HOSPITAL HAS A POPULATION OF ABOUT 35,000. NO POPULATION GROWTH IS PROJECTED FOR THE AREA. THE LARGEST AREA EMPLOYERS ARE INVOLVED IN TRANSPORTATION, WAREHOUSING, AGRICULTURE, LIGHT INDUSTRY AND RETAIL SERVICES. THE SERVICE AREA RACE AND ETHNICITY IS COMPOSED OF 88% WHITE, 2% AFRICAN AMERICAN, 9% HISPANIC AND 1% ASIAN. ACCORDING TO THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, THE 2015 UNEMPLOYMENT RATE IN LA SALLE COUNTY WAS 8.3%, WHICH WAS HIGHER THAN THE STATE OF ILLINOIS (7.1%) AND THE UNITED STATES (6.2%). THE MEDIAN HOUSEHOLD INCOME IN LA SALLE ($49,487), BUREAU ($49,062) AND PUTNAM ($56,212) COUNTIES WERE ALL BELOW THE STATE OF ILLINOIS FIGURE OF $58,438. THE PROPORTION OF LA SALLE COUNTY RESIDENTS LIVING BELOW THE FEDERAL POVERTY LEVEL (13.2%) IS SLIGHTLY LESS THAN THE STATE AVERAGE OF 14.4%. IVCH SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE OR ABILITY TO PAY. APPROXIMATELY 64% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM PARTICIPATION IN THE MEDICARE AND MEDICAID PROGRAMS FOR THE YEAR ENDING JUNE 30, 2017.
SCHEDULE H, PART VI, LINE 5THE BOARD OF DIRECTORS OF IVCH IS COMPOSED OF 10 COMMUNITY MEMBERS RESIDING IN OUR SERVICE AREA. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT. IVCH MAINTAINS AN OPEN MEDICAL STAFF AND IS CONSTANTLY RECRUITING NEW PHYSICIANS TO MEET IDENTIFIED NEEDS. ALL AVAILABLE CASH FLOW GENERATED BY THE ORGANIZATION IS REINVESTED BACK INTO THE HOSPITAL THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT MEET THE NEEDS OF THE SERVICE AREA. THE COMMUNITY OUTREACH DEPARTMENT OFFERS A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMMING, INCLUDING TAI CHI CLASSES, FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS, HEMOGLOBIN A1C SCREENINGS, LIPID PROFILE SCREENINGS, HEALTHY HEART SCREENINGS, PROSTATE CANCER SCREENINGS, SMOKING CESSATION CLASSES, BABYSITTING CLINICS, CPR INSTRUCTION AND FIRST AID.
SCHEDULE H, PART VI, LINE 6NOT APPLICABLE
SCHEDULE H, PART VI, LINE 7ILLINOIS
SCHEDULE H, PART I, LINE 7THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS.
SCHEDULE H, PART I, LINE 7, COLUMNF FTHE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $4,249,741. HOWEVER, THIS EXPENSE HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN.
SCHEDULE H, PART I, LINE 7GTHE AMOUNTS REPORTED ON ROW 7G DO NOT CONTAIN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
TOMMY HOBBS
CEO$254,755$0$0$0$828$0$0$0$18,828$0$274,411$0
BRANDON MUSGRAVE MD
PHYSICIAN$476,170$0$233,230$0$6,250$0$13,250$0$0$0$728,900$0
PETER J MEIER MD
PHYSICIAN$694,988$0$551$0$6,283$0$13,250$0$0$0$715,072$0
JAMES MURPHY
PHYSICIAN$495,346$0$4,051$0$100$0$13,250$0$0$0$512,747$0
ROBERT J MITCHELL MD
PHYSICIAN$523,872$0$25,401$0$2,414$0$13,250$0$0$0$564,937$0
MARIO E COTE MD
PHYSICIAN$287,830$0$211,334$0$8,271$0$13,250$0$0$0$520,685$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationEMPLOYED PHYSICIANS OF THE ORGANIZATION RECEIVE A BASE SALARY BASED ON THE MARKET FOR PHYSICIANS IN THEIR MEDICAL SPECIALTY. EACH PHYSICIAN HAS AN EMPLOYMENT CONTRACT WHICH MAY INCLUDE A COMPONENT OF INCENTIVE COMPENSATION. INCENTIVE COMPENSATION IS BASED ON THEIR INDIVIDUAL PROFESSIONAL PRODUCTION, PROVIDING AN OPPORTUNITY TO EARN ABOVE THE BASE SALARY LEVEL. THE BASE SALARY IS RECONCILED WITH THE PHYSICIAN'S PROFESSIONAL PRODUCTION ON A QUARTERLY AND ANNUAL BASIS. ANY AMOUNTS DUE TO THE PHYSICIANS FOR INCENTIVE COMPENSATION ARE PAID WITHIN 30 DAYS OF THE END OF THE PERIOD.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ILLINOIS FINANCING AUTHORITY
A86109196745203HK352014-12-15$10,000,000RE-FINANCING OF EXISTING DEBTfalsefalsefalse
ILLINOIS FINANCING AUTHORITY
B86109196745203HK432014-12-15$8,000,000RE-FINANCING OF EXISTING DEBTfalsefalsefalse
ILLINIOS FINANCING AUTHORITY
C86109196745203HK602014-12-15$3,160,000RE-FINANCING OF EXISTING DEBTfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$664,000$0$10,000,000$0$0$10,000,000$0$0$0$0$0$02015Yes (true)falseYes (true)Yes (true)
B$530,000$0$8,000,000$0$0$8,000,000$0$0$0$0$0$02015Yes (true)falseYes (true)Yes (true)
C$209,000$0$3,160,000$0$0$3,160,000$0$0$0$0$0$02015Yes (true)falseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalseYes (true)falsefalse0.010000.01000falsefalsefalseYes (true)
BfalseYes (true)falsefalse0.010000.01000falsefalsefalseYes (true)
CfalseYes (true)falsefalse0.010000.01000falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalseYes (true)falsefalseYes (true)falsefalse0falseYes (true)
0
BfalseYes (true)falsefalseYes (true)falsefalse0falseYes (true)
0
CfalseYes (true)falsefalseYes (true)falsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6ILLINOIS VALLEY COMMUNITY HOSPITAL IS A SUBSIDIARY OF ITS SOLE CORPORATE MEMBER, ILLINOIS VALLEY HEALTH CORP., INC.
FORM 990, PART VI, SECTION A, LINE 7AMEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, ILLINOIS VALLEY HEALTH CORP., INC., ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO AS IT RELATES TO THE OPERATIONS OF IVCH: APPOINT AND REMOVE DIRECTORS, RATIFY AND REMOVE OFFICERS, ADOPT, AMEND, OR REPEAL THE ARTICLES OF INCORPORATION AND/OR BY-LAWS, ADOPT A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION, APPROVE THE PURCHASE, SALE, TRANSFER, LEASE ENCUMBRANCE OF PROPERTY, APPROVE BORROWING WITH A TERM GREATER THAN A ONE YEAR TERM OR WHICH REQUIRES A MORTGAGE OF REAL PROPERTY, AND SELECTION OR MODIFICATION OF THE BUSINESS/LEGAL NAME OF THE ENTITY.
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO AND CFO REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE IRS. THE FINAL VERSION OF THE FORM 990 IS E-MAILED OR HAND DELIVERED TO EACH BOARD MEMBER FOR THEIR REVIEW AND A BOARD MEETING IS HELD TO REVIEW AND ANSWER QUESTIONS REGARDING THE 990 PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CTHE OFFICERS AND DIRECTORS OF IVCH ARE COVERED UNDER THE POLICY AND HAVE A DUTY TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. ALL PERSONS COVERED UNDER THE POLICY ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSE ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS. ANY TRANSACTIONS WITH COVERED PERSONS, OR ENTITIES IN WHICH A COVERED PERSON HAS ANY TYPE OF INTEREST, MUST BE AN ARM'S LENGTH TRANSACTION. THE DIRECTORS WILL REVIEW ANY TRANSACTIONS IN QUESTION AND DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PERSON MAY MAKE A PRESENTATION, BUT MUST LEAVE THE MEETING DURING DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15AAN ADHOC COMMITTEE OF THE BOARD OF DIRECTORS (INCLUDING THE BOARD PRESIDENT, CHAIRPERSON OF THE PERSONNEL COMMITTEE AND AT LEAST ONE OTHER MEMBER) CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND DETERMINE ANY CHANGE/INCREASE IN THE COMPENSATION, IF ANY, BASED UPON BENCHMARK COMPENSATION SURVEYS AND AREA NORMS. THE CEO HAS A WRITTEN EMPLOYMENT CONTRACT. RENEWAL OF THE CONTRACT OR INCREASE IN COMPENSATION MUST BE APPROVED BY A MAJORITY OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: CHANGE IN MINIMUM PENSION LIABILITY $ 3,269,226 CHANGES DUE TO FOUNDATION CONTRIBUTIONS ( 34,409) CHANGE IN INTEREST IN IVCH FOUNDATION 8,969 ----------- TOTAL $ 3,243,786

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
HYGIENIC INSTITUTE
925 WEST STREETPERUIL61354362167742PRIMARY CAREIL501(C)(3)10IVHCYes (true)
IVCH FOUNDATION
925 WEST STREETPERUIL61354371211780FUNDRAISINGIL501(C)(3)12AIVHCYes (true)
IV HEALTH CORP INC
925 WEST STREETPERUIL61354371211890HEALTH CAREIL501(C)(3)12BIVHCYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1VALLEY RG HLTH SRVCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14391 VENTURE DRAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
EIN273891281EIN
Primary ActivitiesCANCER CAREPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1IVCHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$29,098ShareOfTotalIncomeAmt
Share Of EOY Assets$455,199ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V$0UBICodeVAmt
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.50000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
VALLEY HEALTH ENTERPRISES
925 WEST STREETPERUIL61354363476877DMEILNAC CORPYes (true)
IV HEALTH SERVICES INC
925 WEST STREETPERUIL61354364050682DORMANTILNAC CORPYes (true)
ILLINOIS VALLEY PHO
925 WEST STREETPERUIL61354363978381PPO CONTRACTINGILIVCHC CORPfalse$12,925$48,2600.50000
IVCH GENERAL PROF LIABILITY LOSS FUND
925 WEST STREETPERUIL61354366673231DORMANTILNATRUSTYes (true)
HEALTH CARE BUILDING CORP
925 WEST STREETPERUIL61354363306917DORMANTILNAC CORPYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HYGIENIC INSTITUTE
O$727,135CASH
VALLEY HEALTH ENTERPRISES
O$397,813CASH
HYGIENIC INSTITUTE
R$138,085CASH
HYGIENIC INSTITUTE
S$326,955CASH
VALLEY HEALTH ENTERPRISES
S$391,000CASH

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