2017-11-15T12:31:53-06:00 2016-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2016-01-01 363637465 Hoopeston Community Memorial Hospital % DENNIS HESCH EXEC VP & CFO HOOP 2172835531 701 E Orange Street Hoopeston IL 60942 DENNIS HESCH EXEC VP, CFO 2173833311 2017-11-15 true JENNIFER RHODERICK P00395735 3176817000 164.57.159.253 35057220173195000034 2017-11-15 P E1B97F0B523BF91F5EE03E781B24D2D618402045 67B2BC73841294F920BAF1B46A562EAEE307B1D6 2016 2021-01-29 14:40:06Z Carle Hoopeston Regional Health Ctr DENNIS HESCH EXEC VP CFO 611 W PARK ST URBANA IL 61801 54118176 false X www.carle.org/hoopeston X 1956 IL TO PROVIDE QUALITY HEALTH CARE AND OTHER MEDICALLY RELATED SERVICES AND EDUCATION TO THE COMMUNITY THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS. 7 2 333 0 23039 1019 13758 9710 46388236 53756043 15910 14484 293148 318743 46711052 54098980 29463 26873 0 0 18191075 18392331 0 0 0 34071606 36708118 52292144 55127322 -5581092 -1028342 35204465 33962186 40756854 40558545 -5552389 -6596359 X MISSION STATEMENT SECTION 1. GENERAL PURPOSES. THE CORPORATION IS ORGANIZED AND SHALL BE EXCLUSIVELY OPERATED AS A NOT-FOR-PROFIT CORPORATION FOR CHARITABLE, BENEVOLENT, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW (THE "CODE"). AND, IN FURTHERANCE OF SUCH CHARITABLE PURPOSES, THE CORPORATION SHALL ENGAGE IN THE ACTIVITIES DESCRIBED IN SECTION 2 OF THIS STATEMENT. SECTION 2. SPECIFIC PURPOSES. THE CORPORATION'S PURPOSES SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING: (A) TO PROVIDE AND TO ASSIST IN PROVIDING FACILITIES FOR THE RENDERING OF HEALTH CARE SERVICES ON AN INPATIENT OR OTHER BASIS THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS, AND OTHER CLINICAL SERVICES THROUGH ALL OTHER APPROPRIATE MEANS; AND (B) TO TRAIN AND TO PROVIDE CONTINUING EDUCATION FOR PERSONS ENGAGED IN PROVIDING HEALTH false false 622110 51072040 26873 53828897 HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH), A 24 BED CRITICAL ACCESS HOSPITAL LOCATED IN HOOPESTON, IL SERVES HOOPESTON, VERMILION COUNTY AND THE SURROUNDING AREA. HCMH EMPLOYS MORE THAN 300 STAFF MEMBERS AND 75 PROVIDERS. HCMH IS COMMITTED TO PROVIDING QUALITY, DEPENDABLE HEALTH SERVICES. HCMH OFFERS SPECIALTY SERVICES WITH CARDIOLOGY, ORTHOPEDICS, GYNECOLOGY, MENTAL HEALTH, UROLOGY AND DIAGNOSTIC SERVICES INCLUDING NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, RADIOLOGY AND LABORATORY. EMERGENCY MEDICINE AND SURGICAL SERVICES ARE PROVIDED IN STATE OF THE ART FACILITIES, WHICH OPENED IN 2012. HCMH PROVIDES ACCESS TO PRIMARY CARE WITH CLINICS IN HOOPESTON, ROSSVILLE, MILFORD, CISSNA PARK, DANVILLE, WATSEKA, TUSCOLA AND MATTOON, IL. HCMH HAS BEEN DEDICATED TO CARING FOR THOSE IN THE AREA FOR OVER 60 YEARS. 51072040 true false false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true true false false true 23 0 true 333 true true true false false false false false false false false false X 7 2 true false false false true true true true true false false true true true true true true false false false IL X X DENNIS HESCH EXEC VP CFO 2173833311 611 W PARK ST URBANA IL 61801 X RUSS LEIGH CHAIR OF BOARD 2.0 0.0 X X 0 0 0 LYNN GALLOWAY SECRETARY/TREASURER OF BOARD 2.0 0.0 X X 0 0 0 ED LAYDEN JR TRUSTEE 1.0 0.0 X 0 0 0 KARLA COON TRUSTEE 1.0 0.0 X 0 0 0 HENRY HORNBECK TRUSTEE 1.0 0.0 X 0 0 0 JOSEPH BARKMEIER MD TRUSTEE 0.5 39.5 X 0 427577 89563 LETHA KRAMER TRUSTEE 1.0 39.0 X 0 203295 28301 HARRY BROCKUS EX-OFFICIO, CEO 32.0 8.0 X 0 269109 75150 DENNIS HESCH EXEC VP & CFO 1.0 39.0 X 0 998170 249197 LAURENCE FALLON EXEC VP-LEGAL AFFAIRS & HR 0.2 39.8 X 0 760462 194127 DOUGLAS MORTON MD MED DIR-RADIOLOGY 39.0 1.0 X 0 636462 28429 IKECHUKWU UZOARU MD MED DIR-LAB 2.0 38.0 X 0 527644 37780 PAMELA BIGLER SVP-NURSING & CNO 5.0 35.0 X 0 447517 106418 SCOTT HARDING VP-FACILITIES & SUPPORT SVCS 4.0 36.0 X 0 383976 93912 SALLY SALMONS MD MED DIR-PRIM CARE & PED SPEC. 40.0 0.0 X 0 285234 36778 LARRY GERDOM PHYSICIAN ASSISTANT 40.0 0.0 X 135918 0 25932 LARRY WHITAKER JR PHYSICIAN ASSISTANT 40.0 0.0 X 131626 0 33088 KATRINA DESHANEY PHYSICIAN ASSISTANT 40.0 0.0 X 124375 0 16139 HOWARD HUGHES DIRECTOR-FACILITIES & SAFETY 40.0 0.0 X 122206 0 6242 KIMBERLY LONGFELLOW DIRECTOR-HOSPITAL NURSING 40.0 0.0 X 115519 0 29556 DANIEL CHASE MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 448588 41568 CORTNEY JONEIKIS ROSSER MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 307980 27376 WILLIAM MCCARTHY MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 279451 22587 ALBERT TANLIM MD HIGHLY COMP EMP - FORMER 40.0 0.0 X 0 215313 36473 SUSAN BERG MD HIGHLY COMP EMP - FORMER 20.0 0.0 X 0 153505 14525 629644 6344283 1193141 20 true true false HOOPESTON EMERGENCY MEDICINE SPECIA 6523 26TH PLACE BERWYN IL 60402 STAFFING 1369150 SIGHTPATH MEDICAL INC PO BOX 204253 DALLAS TX 753204253 STAFFING 288992 SHARED IMAGING LOCK BOX 88544 MILWAUKEE WI 532880544 IMAGING SERVICES 187649 DMS IMAGING INC 2101 N UNIVERSITY DRIVE FARGO ND 58102 IMAGING SERVICES 161786 SENTRY DATA SYSTEMS INC PO BOX 505353 ST LOUIS MO 631505353 SOFTWARE 146751 5 9710 9710 NET PATIENT SERVICES 622110 53756043 53756043 53756043 15800 15800 0 0 20518 17880 2638 0 2638 2638 1316 -1316 -1316 -1316 0 0 0 0 0 0 0 0 0 CATERING 722320 23039 23039 COFFEE SHOP 722212 16271 16271 PERPETUAL TRUST INTEREST 900099 152047 152047 124748 72854 51894 316105 54098980 53828897 23039 237334 26873 26873 0 0 0 0 0 228315 228315 14003720 13311700 692020 771137 735925 35212 2370678 2236361 134317 1018481 949072 69409 0 16317 16317 0 11314 11314 0 0 1516298 1433465 82833 5112 560 4552 1582324 1296016 286308 742634 557139 185495 0 2101261 1630641 470620 74698 62228 12470 0 47082 39748 7334 335777 335777 0 1981222 1436881 544341 357585 349349 8236 INTERNAL PURCHASED SERVICES 13793509 13779446 14063 INTERNAL MANAGEMENT FEES 7727179 7068031 659148 PATIENT CARE SUPPLIES 4719543 4675826 43717 OTHER PURCHASED SERVICES 998365 865504 132861 697898 53183 644715 55127322 51072040 4055282 0 4034476 3961714 0 0 0 0 5745938 5561806 0 0 0 0 0 0 0 0 208552 131469 23617827 7912242 16614052 15705585 0 0 0 0 0 0 4444690 4444690 4156757 4156922 35204465 33962186 1504874 1760681 0 0 0 0 0 0 0 0 0 0 6592335 6177235 0 0 32659645 32620629 40756854 40558545 X -9199911 -10228253 55584 45532 3591938 3586362 -5552389 -6596359 35204465 33962186 X -1028342 0 0 0 0 -15628 X X false true X true false X false false false 0 false 0 false 0 false 0 false 0 false 0 true 11314 11314 false PART II-B, LINE 1I OTHER ACTIVITIES $8,063 - PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) DUES ATTRIBUTABLE TO LOBBYING $3,106 - PORTION OF AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING $145 - PORTION OF MISCELLANEOUS HEALTH CARE ORGANIZATION DUES ATTRIBUTABLE TO LOBBYING 104595 104595 11046244 2748461 8297783 1735646 560714 1174932 9440900 4278359 5162541 1290442 324708 965734 15705585 DEVL LIMITED ASSETS 45532 HRHC FCS ESCROW 525028 LONG TERM INVESTMENTS 3586362 4156922 0 ACCTS PAYABLE-MEDICARE 3060073 DUE TO BLUE CROSS 331580 HRHC/FNDN NOTES PAYABLE 3423813 ASSET RETIREMENT OBLIGATION 144350 INTERCOMPANY PAYABLES 25660813 32620629 X SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2016 AND 2015. true true X true X true X true true true false false 2298388 2298388 0.04170 13029215 10784120 2245095 0.04070 15327603 10784120 4543483 0.08240 171588 0 171588 0.00310 31461 31461 0.00060 203049 0 203049 0.00370 15530652 10784120 4746532 0.08610 2140 2140 0.00000 14152 14152 0.00000 2426 2426 0.00000 18718 18718 0.00000 true 352434 176217 11112156 14032423 -2920267 X true true 1 1 HOOPESTON COMMUNITY MEMORIAL HOSPITAL 701 E ORANGE ST HOOPESTON IL 609421801 WWW.CARLE.ORG/HOOPESTON 0004200 X X X X HOOPESTON COMMUNITY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X CARLE.ORG/CHNA X true 16 true CARLE.ORG/CHNA false true X 200. 400. X true true X X X true X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X X X X X X true X false X X X X true X false false COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 5) THOUGH HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH) PREVIOUSLY CONDUCTED ITS OWN COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IN 2013, THERE WAS A COUNTY-WIDE ASSESSMENT DONE IN 2012 THAT INVOLVED A NUMBER OF OTHER STAKEHOLDERS IN VERMILION COUNTY. CALLED THE VERMILION COUNTY COMMUNITY HEALTH PLAN (IPLAN), THIS RESEARCH WAS ACCOMPLISHED WITH DIRECT CONTRIBUTION FROM MORE THAN 40 INDIVIDUALS REPRESENTING A VARIETY OF AGENCIES AND ORGANIZATIONS FROM ACROSS THE COUNTY. THERE WAS ALSO DIRECT INPUT FROM OVER 1,200 COUNTY RESIDENTS VIA A COMMUNITY SURVEY. each of the community partners involved in the assessment plays a role in representing the medically underserved, low-income or minority populations in vermilion county. THOSE COMMUNITY PARTNERS aRE: AUNT MARTHA'S HEALTH CENTER (FQHC); BIG BROTHERS/BIG SISTERS; BOARD OF HEALTH; CARLE PHYSICIAN GROUP, DANVILLE; CENTER FOR CHILDREN SERVICES; CENTRAL CHRISTIAN CHURCH; CHANNEL 3 NEWS; COMMERCIAL NEWS; CRIS SENIOR SERVICES; CROSSPOINT; DANVILLE AREA COMMUNITY COLLEGE; DANVILLE FAMILY YMCA; DANVILLE MASS TRANSIT; DANVILLE SCHOOL DISTRICT 118; HCMH; HOOPESTON MULTI-AGENCY; LAKEVIEW COLLEGE OF NURSING; 708 MENTAL HEALTH BOARD; NEW LIFE CHURCH OF FAITH; PRESENCE UNITED SAMARITANS MEDICAL CENTER; PROJECT SUCCESS/CAPIT; PRESENCE REGIONAL EMS; SALVATION ARMY; STATE OF ILLINOIS; UIUC COLLEGE OF NURSING; UNITED WAY OF DANVILLE AREA; VA ILLIANA HEALTHCARE SYSTEM; VERMILION ADVANTAGE; VERMILION COUNTY BOARD; VERMILION COUNTY HEALTH DEPARTMENT; VERMILION COUNTY REGIONAL OFFICE OF EDUCATION; VILLAGE OF FITHIAN; VILLAGE OF OAKWOOD; WOMEN'S CARE CLINIC; WORKSOURCE; YOUR FAMILY RESOURCE CENTER (YFRC) IN 2014, THE HEALTH PLAN CONDUCTED A REASSESSMENT TO MAKE SURE THE PRIORITIES WERE STILL VALID AND TO MAINTAIN REQUIREMENTS FOR HEALTH FACILITIES THAT NEEDED REASSESSMENT EVERY THREE YEARS. AGENCIES IN THE COMMUNITY WITH THIS REQUIREMENT WERE BROUGHT TOGETHER TO FORM AN EXECUTIVE COMMITTEE, CONSISTING OF MEMBERS FROM HCMH, CARLE, PRESENCE UNITED SAMARITANS MEDICAL CENTER, UNITED WAY, I SING THE BODY ELECTRIC, AND THE VERMILION COUNTY HEALTH DEPARTMENT. THE EXECUTIVE COMMITTEE ALSO ENLISTED THE SERVICES OF THE UNIVERSITY OF ILLINOIS. FOR HCMH, REVIEW OF THE HEALTH PLAN INFORMATION BEGAN IN 2014 FOR UPDATED AND NEW DATA, AND COMMUNITY AND STAKEHOLDER SURVEYS WERE COLLABORATIVELY DISTRIBUTED BY THE UNIVERSITY OF ILLINOIS COLLEGE OF NURSING, DANVILLE AREA COMMUNITY COLLEGE OF NURSING, AND LAKEVIEW COLLEGE OF NURSING. TOP COMMUNITY HEALTH CONCERNS IDENTIFIED IN THE 2012 IPLAN WERE TEEN PREGNANCY, ALCOHOL/SUBSTANCE ABUSE, AND OBESITY; THIS REASSESSMENT IDENTIFIED THE SAME TOP THREE HEALTH ISSUES. HCMH CONTINUED TO WORK ON IMPLEMENTATION OF THESE PRIORITIES IN 2015-2016, AND RECEIVED FINAL APPROVAL ON THE IMPLEMENTATION PLAN from THE HOSPITALS BOARD ON OCTOBER 27, 2016. COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 6A) CARLE FOUNDATION HOSPITAL, PRESENCE UNITED SAMARITANS MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 6B) UNITED WAY, I SING THE BODY ELECTRIC, VERMILION COUNTY HEALTH DEPARTMENT COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 11) HCMH CONTINUES ITS WORK TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY THROUGH SERVICE TO ITS PATIENTS, INCLUDING EMPHASIS ON ACCESS TO HEALTH SERVICES AND OTHER SPECIALTIES AND SERVICES THE HOSPITAL OR CARLE HEALTH SYSTEM PROVIDES. THE CARLE FOUNDATION IS DILIGENTLY WORKING TO IMPROVING ACCESS AND SERVICES THROUGHOUT THE EAST CENTRAL ILLINOIS REGION, NOT JUST FOR THIS GEOGRAPHIC AREA. MANY OF THE OTHER CONCERNS ARE ALSO ADDRESSED THROUGH SERVICES PROVIDED FOR CARLE PATIENTS, BUT THESE AREAS ARE NOT THE PRIMARY EMPHASIS OF THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WHICH TARGETS MORE SPECIFIC LOW-INCOME POPULATIONS IN VERMILION COUNTY. HOW HCMH IS ADDRESSING SIGNIFICANT HEALTH NEEDS THROUGH THESE EFFORTS, HCMH INTENDS TO HELP IMPROVE THE OVERALL HEALTH OF THE COMMUNITY BY ADDRESSING THE MOST SIGNIFICANT NEEDS FACING THE POPULATION. PRIORITY #1: TEEN PREGNANCY TEEN AND ADOLESCENT HEALTH HAS BEEN A CONCERN IN VERMILION COUNTY FOR MANY YEARS. IN THE PREVIOUS IMPLEMENTATION PLAN, HCMH WORKED TO ADDRESS THIS SIGNIFICANT NEED BY IMPLEMENTING A NUMBER OF SAFE-SEX AND SEXUALLY TRANSMITTED DISEASE (STD) PREVENTION PROGRAMS IN THE REGION, AND THROUGH APPROPRIATE TESTING, TREATMENT AND CARE IN OUTPATIENT FACILITIES. THESE PROGRAMS CONTINUE TODAY, WITH EVERY-OTHER-YEAR AGREEMENTS WITH HOOPESTON AREA HIGH SCHOOL AND MILFORD HIGH SCHOOL. BOTH SCHOOLS USED THIS PROGRAM IN 2015 AND WILL AGAIN IN 2017. HCMH ALSO HIRED A QUALITY NURSE SPECIALIST IN 2015 WHO WORKS CLOSELY WITH THE LOCAL PUBLIC HEALTH DEPARTMENT TO TRACK TRENDS IN TEEN PREGNANCY AND STDS IN OUR REGION, AND SUPPORTS EDUCATIONAL PROGRAMS THROUGH THE PUBLIC HEALTH DEPARTMENT. IN 2016, THE OBSTETRICS AND GYNECOLOGY PROVIDER DEDICATED TO THE HOOPESTON REGION LEFT THE ORGANIZATION. THE FACILITY IS RECRUITING; HOWEVER, RECRUITMENT FOR THIS SPECIALTY IN THE RURAL MARKET HAS PROVEN DIFFICULT. HCMH CONTINUES TO PROMOTE WOMEN'S HEALTH PROVIDERS, ENCOURAGING YOUNG WOMEN TO RECEIVE THE APPROPRIATE CARE, WHICH THEY CAN RECEIVE FROM OB-GYN PROVIDERS AT CARLE DANVILLE. IN AN EFFORT TO HELP YOUNG MOTHERS IN NEED, HCMH PROVIDES "NECESSITY KITS" FOR ALL MOTHERS OR BABIES WHO VISIT THE EMERGENCY DEPARTMENT AND WOULD NOT BE ABLE TO PURCHASE THE SUPPLIES FOR THEMSELVES. THE KIT INCLUDES A PEDIATRIC INFORMATION BOOKLET, THERMOMETER, BASIC FIRST AID SUPPLIES, TEETHING TOYS, BOTTLES AND OTHER ESSENTIAL PRODUCTS TO HELP YOUNG MOTHERS THROUGH THEIR CHILDS FIRST YEARS. SUPPLIES WERE BOUGHT THROUGH A GRANT FROM ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK, AND EMERGENCY DEPARTMENT NURSES USED THEIR WORK TIME TO PUT TOGETHER THE KITS. AS PART OF HCMH'S COMMITMENT TO ENSURING THAT STRIDES ARE MADE IN THESE AREAS, EMPLOYEES FROM THE HEALTH SYSTEM PARTICIPATE IN SEVERAL COUNTY-WIDE WORKGROUPS THAT WERE ESTABLISHED AS PART OF THE JOINT CHNA. ONE OF THESE WORKGROUPS WAS ESTABLISHED TO ADDRESS TEEN PREGNANCY RATES IN VERMILION COUNTY, AND AN OB/GYN PROVIDER FROM HCMH'S DANVILLE CLINIC ACTIVELY PARTICIPATES IN THIS WORKGROUP. THE GROUP'S MAIN GOAL IS TO INCREASE AWARENESS AMONG TEENS BY PARTICIPATING IN LOCAL EVENTS, HEALTH FAIRS AND PUBLIC EDUCATION OPPORTUNITIES. THIS GROUP SPENT MOST OF 2016 RECRUITING MEMBERS, DEVELOPING STRATEGIES AND PRODUCING INFORMATION CARDS. PRIORITY #2: SUBSTANCE AND ALCOHOL ABUSE THOUGH SUBSTANCE ABUSE WAS IDENTIFIED AS A LOWER PRIORITY IN THE PREVIOUS CHNA CONDUCTED IN 2013, THIS WAS IDENTIFIED AS A MUCH HIGHER PRIORITY IN THE LATEST CHNA. HCMH CONTINUES TO EXPAND BEHAVIORAL HEALTH SERVICES IN THE REGION AND PROVIDE FINANCIAL SUPPORT TO AGENCIES IN AN EFFORT MAKE AN IMPACT. TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, HCMH PARTNERED WITH IROQUOIS MENTAL HEALTH TO OFFER COUNSELING AT HOOPESTONS OUTPATIENT CLINIC FOR HCMH PATIENTS. THIS PARTNERSHIP EXPANDED IN 2016 WITH IROQUOIS MENTAL HEALTH OFFERING ADDITIONAL HOURS AT THE HOOPESTON CLINIC, WHICH HELPS ADDRESS THE LACK OF MENTAL HEALTH ACCESS IN THE REGION. IN ADDITION, THE CARLE HEALTH SYSTEM RECOGNIZES THE NEED FOR MORE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES THROUGHOUT THE SERVICE AREA, AND CONTINUES TO RECRUIT PSYCHIATRY PROVIDERS FOR ALL CLINICAL LOCATIONS. the CARLE FOUNDATION HOSPITAL IS STARTING A psychiatry RESIDENCY PROGRAM, WHICH WILL PROVIDE ADDITIONAL TRAINING FOR MENTAL HEALTH PROFESSIONALS, AND ALSO OFFERS AN EMPLOYEE ASSISTANCE PROGRAM WHICH PROVIDES SERVICE FOR SUBSTANCE AND ALCOHOL ABUSE FOR EMPLOYEES ACROSS THE SYSTEM, INCLUDING OUR IROQUOIS AND NORTHERN VERMILION county LOCATIONS. TO SUPPORT AGENCIES THAT PROVIDE BEHAVIORAL HEALTH SERVICES, HCMH HAS PROVIDED IN-KIND SUPPORT TO MULTIPLE SERVICE AGENCIES IN VERMILION COUNTY WHO OFFER COUNSELING OR SUPPORT SERVICES TO THOSE WITH ALCOHOL OR SUBSTANCE ABUSE PROBLEMS, WHICH HAS INCLUDED AUNT MARTHA'S YOUTH SERVICE CENTER AND CROSSPOINT HUMAN SERVICES; BOTH IN DANVILLE. PRIORITY #3: OBESITY WITH THE CONNECTION TO MANY HEALTH PROBLEMS, INCLUDING HEART DISEASE, STROKE AND DIABETES, HCMH WILL WORK TO EDUCATE PATIENTS AND THE COMMUNITY ABOUT RESOURCES AVAILABLE TO COMBAT OBESITY AND RELATED CONCERNS SUCH AS NUTRITION AND DIABETES COUNSELORS IN DANVILLE AND CONTINUE TO SUPPORT ACTIVITIES AIMED AT IMPROVING THE HEALTH OF CHILDREN AND ADULTS THROUGHOUT THE COMMUNITY. THIS INCLUDES FUNDING INITIATIVES LIKE THE MAPLE AND HONEYWELL GRADE SCHOOLS' JUMP ROPE FOR HEART PROGRAMS, HOOPESTON SWEETCORN FESTIVAL 5K, FELLOWSHIP OF CHRISTIAN ATHLETES, HEALTHY KIDS DAY AT THE DANVILLE YMCA AND MORE. HCMH IS SUPPORTING HEALTHY VERMILION COUNTY IN SEVERAL EDUCATIONAL AND OUTREACH EFFORTS. BY PARTNERING WITH THIS WORKGROUP TO PRODUCE QUALITY INFORMATIONAL MATERIALS ON HEALTHY FOODS, AND PROVIDING IN-KIND SUPPORT TO AGENCIES HELPING WITH FOOD INSECURITY, HCMH INTENDS TO POSITIVELY IMPACT CHILDRENS VIEW OF HEALTHY FOODS. IN 2016, THE GROUP LAUNCHED A CAMPAIGN CALLED "RETHINK YOUR DRINK", AIMED AT EDUCATING PEOPLE ABOUT THE HIDDEN CALORIE AND SUGAR CONTENT OF MANY POPULAR DRINKS AND ENCOURAGING HEALTHIER OPTIONS. THIS CAMPAIGN CONTINUES THROUGH SOCIAL MEDIA, SIGNAGE AT AREA SCHOOLS AND PRESENCE IN LOCAL HEALTH FAIRS, AND HCMH OFFERS IN-KIND SUPPORT BY FUNDING MANY OF THE PRINTING COSTS. OTHER COMMUNITY NEEDS/SCHOOL-BASED EDUCATION - HCMH STAFF MAINTAINED A PRESENCE IN THE LOCAL SCHOOL SYSTEM, PROVIDING HEAD LICE CHECKS, HANDWASHING EDUCATION, AND VISION AND HEARING TESTING FOR SCHOOLS IN THE REGION. - THE HOSPITAL ALSO PROVIDED FULL-TIME ATHLETIC TRAINERS TO SCHOOLS IN HOOPESTON, CISSNA PARK AND MILFORD. SERVICE IS PROVIDED TO ALL STUDENT ATHLETES, REGARDLESS OF WHERE THEY RECEIVE CARE, AND IS FREE OF CHARGE TO THE SCHOOL DISTRICTS. - HCMH CONTINUED TO FUND THE DELTA DENTAL OF ILLINOIS LAND OF SMILES PROGRAM IN VERMILION COUNTY. THIS PROGRAM TEACHES CHILDREN IN THE COMMUNITY HOW TO TAKE CARE OF THEIR TEETH BY DEMONSTRATING PROPER BRUSHING AND FLOSSING TECHNIQUES, REVIEWING GOOD AND BAD FOODS FOR TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST REGULARLY. IN 2016, THIS PROGRAM REACHED HUNDREDS OF CHILDREN IN CISSNA PARK AND WATSEKA, TWO RURAL COMMUNITIES LOCATED WITHIN THE SERVICE AREA WHERE IT HAS BEEN IDENTIFIED THAT YOUTH LACK EDUCATION ABOUT THE IMPORTANCE OF DENTAL CARE. PRE- AND POST-TESTING ILLUSTRATES THAT CHILDREN IMPROVE THEIR KNOWLEDGE OF THE IMPORTANCE OF DENTAL CARE BOTH AT HOME AND AT THE DENTIST AFTER PARTICIPATING IN THE SESSION. CASH AND IN-KIND DONATIONS HCMH CONTRIBUTED NEARLY $31,000 TO CHARITABLE ORGANIZATIONS IN THE COMMUNITY VIA CASH AND IN-KIND DONATIONS, INCLUDING PROGRAMS AIMED TO HELP YOUTH, HEALTH IMPROVEMENT, HEALTH EDUCATION AND HEALTH PROFESSIONS EDUCATION. BECAUSE THE NEEDS ARE GREAT AND IT WOULD BE UNREASONABLE TO ADDRESS EACH AND EVERY IDENTIFIED NEED, RESOURCES ARE FOCUSED PRIMARILY ON IDENTIFIED NEEDS WITHIN THE COMMUNITY BENEFIT PRIORITIES SET. MANY OF THESE NEEDS ARE ADDRESSED THROUGH PARTNERSHIPS AND COLLABORATIVE EFFORTS. ONE SIGNIFICANT CONTRIBUTION WAS TO THE HOOPESTON MULTI AGENCY OF $5,000 TO ENHANCE THE MULTITUDE OF IMPORTANT COMMUNITY BENEFIT SERVICES THEY OFFER FOR DISABLED AND ELDERLY PATIENTS, INCLUDING RIDES THROUGHOUT HOOPESTON AND DANVILLE TO HELP MAINTAIN THEIR HEALTH AND LIFESTYLE. THE ORGANIZATION ALSO ADDRESSES TWO OTHER CRITICAL AREAS OF NEED IN VERMILION COUNTY BY PROVIDING A FREE AFTER-SCHOOL PROGRAM FOR TEENS. THIS PROGRAM PROVIDES THE PARTICIPANT WITH A MEAL AND TUTORING, HELPING KEEP YOUTH FED, HEALTHY AND IN SCHOOL. THE FINAL SERVICE PROVIDED BY THE MULTI AGENCY IS HEALTH NAVIGATION. THEY ASSIST CLIENTS IN COORDINATING CARE APPOINTMENTS, AND FINDING RESOURCES TO ASSIST THEM WITH ALL THEIR DIFFICULTIES. HCMH ALSO SUPPORTS ALL LIONS CLUB CHAPTERS IN VERMILION COUNTY. THE LIONS CLUB IS KNOWN FOR THEIR HUMANITARIAN EFFORTS ON BEHALF OF THE DEAF AND BLIND, AND SPECIFICALLY PROVIDES EYE GLASSES FOR UNDERPRIVILEGED CHILDREN. THERE ARE ALSO SEVERAL STATEWIDE AND NATIONWIDE ORGANIZATIONS THAT HAVE REGIONAL CHAPTERS THAT RECEIVE SUPPORT FROM HCMH. THOSE INCLUDE: ROTARY OF HOOPESTON, SPECIAL OLYMPICS OF ILLINOIS AND FELLOWSHIP OF CHRISTIAN ATHLETE 8 CARLE DANVILLE ON FAIRCHILD 311 W FAIRCHILD DANVILLE IL 61832 RURAL HEALTH CLINIC CARLE MATTOON ON HURST 2512 HURST DRIVE MATTOON IL 61938 rural health clinic CHARLOTTE ANN RUSSELL MEDICAL CENTER 801 E ORANGE ST HOOPESTON IL 60342 RURAL HEALTH CLINIC CARLE AT TUSCOLA 301 E SOUTHLINE ROAD TUSCOLA IL 61953 RURAL HEALTH CLINIC CARLE AT WATSEKA 1490 EAST WALNUT STREET SUITE C WATSEKA IL 60970 RURAL HEALTH CLINIC ROSSVILLE MEDICAL CLINIC 619 N CHICAGO ST ROSSVILLE IL 60963 RURAL HEALTH CLINIC MILFORD CLINIC 322 CHICAGO ST MILFORD IL 60953 RURAL HEALTH CLINIC CISSNA PARK MEDICAL CLINIC 141 W GARFIELD AVE CISSNA PARK IL 60924 RURAL HEALTH CLINIC SCHEDULE H, SUPPLEMENTAL INFORMATION SCHEDULE H, PART VI 1 - REQUIRED DESCRIPTIONS FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA (PART I, LINE 3C) PATIENTS MAY REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IN ADDITION TO PATIENTS COMPLETING APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM, WE HAVE ROBUST PRESUMPTIVE ELIGIBILITY PROCESSES IN PLACE. WE HAVE PARTNERED WITH EXPERIAN INFORMATION SOLUTIONS, INC. TO HELP US IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. THESE PATIENTS MAY BE APPROVED WITHOUT EVER COMPLETING AN APPLICATION OR EXPRESSING A NEED FOR FINANCIAL ASSISTANCE. IN ADDITION, WE PRESUME ELIGIBILITY FOR PATIENTS WHO ARE VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTALLY INCAPACITATED, ELIGIBLE FOR SNAP OR WIC, TOWNSHIP ASSISTANCE, LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM OR COVERED BY ILLINOIS MEDICAID. EXPLANATION OF COSTING METHODOLOGY (PART I, LINE 7 AND PART III, LINE 2) TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFIT COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUALS FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. COMMUNITY BUILDING ACTIVITIES (PART II) HCMHS SUPPORT OF COMMUNITY-BUILDING ACTIVITIES IS AN IMPORTANT PART OF CONTRIBUTING TO THE ECONOMIC VIABILITY OF THE COMMUNITY. A SIGNIFICANT PORTION OF THESE ACTIVITIES IS FOCUSED ON COMMUNITY SUPPORT AND ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN HOOPESTON. OF THE MORE THAN $16,000 IN COMMUNITY BUILDING, MORE THAN $8,600 WAS IN CASH DONATIONS. -TWO MEMBERS OF HCMH LEADERSHIP AND STAFF WERE A PART OF THE HOOPESTON COMMUNITY ALLIANCE IN 2016, A COMMITTEE DEDICATED TO THE IMPROVEMENT OF HOOPESTON. in TOTAL, 29 HOURS OF MEETINGS AND PREPARATION WERE SPENT ON THE COMMITTEE AND VARIOUS SUB-COMMITTEES FOR THE ALLIANCE, AMOUNTING TO NEARLY $2,000 IN COMMUNITY BENEFIT. -THE HOSPITAL CEO SERVED IN HIS THIRD YEAR FOR THE VERMILION ADVANTAGE BOARD, AS WELL AS THE HOOPESTON ECONOMIC DEVELOPMENT COMMITTEE TO DISCUSS A NUMBER OF ISSUES THAT IMPACT THE COMMUNITYS HEALTH AND SAFETY. -THE DIRECTOR OF QUALITY CONTINUED TO SIT ON A BOARD FOR THE PRESERVATION OF THE HISTORIC LORRAINE THEATER IN HOOPESTON, AMOUNTING TO MORE THAN $1,200 IN SUPPORT TO THE COMMUNITY. -THE ADDITIONAL FUNDS INCLUDED IN COMMUNITY BUILDING ($293) WERE FOR DISASTER READINESS THOSE HOURS AND STAFF TIME SPENT ABOVE AND BEYOND NORMAL REQUIREMENTS FOR A HOSPITAL. AT HCMH, EMERGENCY PREPAREDNESS IS A PRIORITY, WITH ONE STAFF MEMBER SERVING AS THE DISASTER PREPAREDNESS COORDINATOR. THIS INDIVIDUAL SAT ON THE HOOPESTON EMERGENCY MANAGEMENT AGENCY AS A REPRESENTATIVE OF HCMH, ATTENDED DISASTER MEETINGS, AND PARTICIPATED IN DRILLS. SHE ALSO CONTINUED TO PARTICIPATE IN REGULAR DISCUSSIONS WITH THE REGION, INCLUDING THE CARLE EMERGENCY MANAGEMENT COMMITTEE, WORKING TOGETHER TO PREPARE AND STANDING READY IF THE NEED OCCURS. BAD DEBT, MEDICARE, & COLLECTION PRACTICES (PART III, LINE 3) HCMH USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY. BAD DEBT FOOTNOTE (PART III, LINE 4) THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 27 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS. EXPLANATION OF MEDICARE COST REPORT COSTING METHODOLOGY (PART III, LINE 8) THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, and those less fortunate DEMOGRAPHICs THAT HAve EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. COLLECTION PRACTICES (PART III, LINE 9B) EFFECTIVE 1/1/16, CARLE COMBINED THE CARLE COMMUNITY CARE DISCOUNT PROGRAM WITH THE HCMH CHARITY PROGRAM TO MAKE ONE PROGRAM: THE CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP). CFAP PROVIDES DISCOUNTED OR FREE CARE TO THOSE WHO NEED IT WITHIN THE CARLE FOUNDATION, INCLUDING HCMH. NOT ONLY DOES THIS MEAN A MORE TIMELY APPLICATION PROCESS, BUT MOST IMPORTANTLY, IT MEANS PATIENTS RECEIVE THE SAME DISCOUNT AT THE HOOPESTON HOSPITAL AND CLINICS IF THEY MIGHT NEED AN ADDITIONAL LEVEL OF SPECIALTY OR HOSPITAL CARE AT the CARLE FOUNDATION HOSPITAL IN URBANA. WITH THIS PROGRAM, HCMH HAS A ROBUST PRESUMPTIVE ELIGIBILITY PROCESS. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, RECIPIENTS OF WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FRANCES NELSON HEALTH CENTER (PROMISE HEALTHCARE FQHC) DISCOUNT REFERRALS, MEDICAID TITLE XIX, XXI, AND IN-NETWORK MEDICAID MANAGED CARE PLANS. IN ADDITION, WE UTILIZE A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC., TO PROACTIVELY IDENTIFY PATIENTS WHO MAY BE PRESUMPTIVELY-QUALIFIED FOR ASSISTANCE NOT ONLY FOR PUBLIC PROGRAMS LIKE MEDICAID, BUT ALSO BASED ON A NUMBER OF KEY FINANCIAL INDICATORS, INCLUDING CREDIT HISTORY, DEMOGRAPHICS AND GROSS INCOME. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE AND AUTOMATICALLY ENROLLED IN THE PROGRAM, OR THEY MAY BE CONTACTED AND ENCOURAGED TO APPLY FOR ASSISTANCE. PATIENTS WHO ARE NOT DEEMED PRESUMPTIVELY-ELIGIBLE WOULD NEED TO REQUEST AND COMPLETE AN APPLICATION. IF THE PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. FOR PATIENTS THAT DO NOT QUALIFY FOR CFAP, AND WHO MAY BE UNINSURED OR UNDERINSURED, HCMH HAS OTHER DISCOUNT OPTIONS AVAILABLE, SUCH AS PROMPT PAY, ILLINOIS UNINSURED DISCOUNT, AND CAPPED DISCOUNT WHERE A PATIENTS OUT-OF-POCKET MEDICAL EXPENSES ARE LIMITED TO 40% OF THEIR ANNUAL GROSS INCOME IF THEY EARN AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT AND SET UP PAYMENT ARRANGEMENTS ON THE REMAINING BALANCE DUE. THE CURRENT MINIMUM IS 5% OF THE TOTAL BALANCE DUE OR $25.00 A MONTH. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE BILLING STAFF MEMBERS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT UNTIL THEY CAN MAKE THE MINIMUM PAYMENT. IF THEY ARE UNABLE TO MAKE PAYMENT ON THE BALANCE DUE, THEN THE BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATION IS MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND, THE ACCOUNT IS GIVEN A FINAL NOTICE, EITHER BY LETTER OR PHONE, AND SENT TO AN OUTSIDE COLLECTION AGENCY. HCMH WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE AN AGENCY TO USE SO-CALLED "BODY ATTACHMENTS". THE AGENCIES ARE AWARE OF CFAP AND HAVE BEEN ADVISED TO REFER THE PA 2 - NEEDS ASSESSMENT HCMH USED EXISTING DATA, INFORMAL DISCUSSIONS, AND A COMPREHENSIVE QUALITATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE IF EXISTING PROGRAMS ARE ON TRACK; WHAT NEEDS TO BE ADDED, DELETED OR ENHANCED; AND WHERE OUR FOCUS NEEDED TO BE PLACED IN THE FUTURE. THE CHNA INCLUDED DISCUSSIONS WITH COMMUNITY LEADERS, INCLUDING HUMAN SERVICE AGENCY ADMINISTRATORS, PUBLIC HEALTH REPRESENTATIVES AND HCMH LEADERSHIP. 3 - PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCE HCMH IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE AND AS A RESULT, OFFERS A STRONG FINANCIAL ASSISTANCE PROGRAM THAT IS BASED IN A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS AND BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITYS RESOURCES. BY DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO HELP. STAFF are ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERES ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE. HCMH HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THESE INCLUDE: - ADVERTISING THE CARLE FINANCIAL ASSISTANCE PROGRAM, USING PRINT, BILLBOARDS AND WEB; CONTINUED PRESENCE IN APPROPRIATE COMMUNITY PUBLICATIONS; AND ON-SITE VIA DISPLAYS THROUGHOUT THE HOSPITAL AND CLINICS - SIMPLIFIED APPLICATION FORM, INCLUDING A VERSION IN SPANISH, THAT CONTAINS INFORMATION REGARDING THE CARLE FINANCIAL ASSISTANCE PROGRAM - PUBLICATION OF A PLAIN LANGUAGE SUMMARY AND ALL OTHER FINANCIAL ASSISTANCE RELATED INFORMATION ON CARLE.ORG/FINANCIALASSISTANCE - INFORMATION ABOUT THE CARLE FINANCIAL ASSISTANCE PROGRAM ON ALL STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - CARLE FINANCIAL ASSISTANCE PROGRAM INFORMATION AND APPLICATIONS AT ALL REGISTRATION POINTS, HOSPITAL MAIN LOBBY AND CARLE.ORG - MEETINGS WITH LOCAL LEGISLATORS TO HELP THEM ASSIST CONSTITUENTS WITH HEALTHCARE NEEDS, INCLUDING FINANCIAL ASSISTANCE 4 - COMMUNITY INFORMATION THE SERVICE AREA OF HCMH IS DEFINED AS THE GEOGRAPHICAL BOUNDARY OF VERMILION COUNTY, ILLINOIS. WHILE SOME RESIDENTS OF SURROUNDING COUNTIES UTILIZE HCMHS SERVICES, OUR MOST RECENT CHNA TARGETED VERMILION COUNTY RESIDENTS, WHO MAKE UP THE MAJORITY OF HCMH PATIENTS. POCKETS OF EXTREME POVERTY EXIST THROUGHOUT THIS REGION, WITH RATES HIGHEST AROUND THE CITY OF DANVILLE. THE PROGRAMS WITHIN OUR COMMUNITY BENEFIT PLAN GENERALLY HAVE IMPACT UPON ALL THE TARGETED COMMUNITIES, WITH CERTAIN PROGRAMS DIRECTED AT SPECIFIC POPULATIONS. 5 - PROMOTION OF COMMUNITY HEALTH HCMH HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY AN 11-MEMBER COMMUNITY BOARD THAT SERVES ON A VOLUNTEER BASIS, WITH 7 VOTING MEMBERS AND 4 NON-VOTING STAFF MEMBERS. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE. 6 - AFFILIATED HEALTH CARE SYSTEM HCMH IS A CRITICAL ACCESS HOSPITAL COMMITTED TO IMPROVING QUALITY OF LIFE IN VERMILION COUNTY AND THE SURROUNDING AREA. HCMH INTEGRATED WITH THE CARLE FOUNDATION IN 2012 TO PROVIDE MORE ACCESS TO PRIMARY AND SPECIALTY CARE. THOUGH HMCH FALLS UNDER THE UMBRELLA OF THE CARLE FOUNDATION, IT MAINTAINS A SEPARATE BOARD OF DIRECTORS AND SENIOR LEADERSHIP. WHILE HCMHS CHNA AND COMMUNITY BENEFIT REPORTING IS SEPARATE FROM the CARLE FOUNDATION HOSPITAL, IT FOLLOWS THE SAME GUIDELINES AND PRINCIPLES AS CARLE. HCMH STAFF IS INVOLVED IN THE CHNA AND IMPLEMENTATION PLAN, AND SERVE ON HUMAN SERVICES AGENCY BOARDS AND COMMITTEES TO PROVIDE SUPPORT TO HELP ADDRESS IDENTIFIED COMMUNITY NEEDS IN NORTHERN VERMILION COUNTY, INCLUDING TEEN PREGNANCY, ALCOHOL AND SUBSTANCE ABUSE, AND OBESITY. 7 - STATE FILING OF COMMUNITY BENEFIT REPORT AS A CRITICAL ACCESS HOSPITAL, HCMH IS NOT RESPONSIBLE FOR FILING A STATE COMMUNITY BENEFIT REPORT. false true false false false false false true false JOSEPH BARKMEIER MD TRUSTEE 0 267283 0 36340 0 123954 0 77441 0 12122 0 517140 0 116663 LETHA KRAMER TRUSTEE 0 180385 0 21563 0 1347 0 20736 0 7565 0 231596 0 0 HARRY BROCKUS EX-OFFICIO, CEO 0 213811 0 25975 0 29323 0 55409 0 19741 0 344259 0 27062 DENNIS HESCH EXEC VP & CFO 0 656169 0 146042 0 195959 0 226314 0 22883 0 1247367 0 164751 LAURENCE FALLON EXEC VP-LEGAL AFFAIRS & HR 0 500157 0 115258 0 145047 0 173433 0 20694 0 954589 0 117672 DOUGLAS MORTON MD MED DIR-RADIOLOGY 0 627433 0 0 0 9029 0 21480 0 6949 0 664891 0 0 IKECHUKWU UZOARU MD MED DIR-LAB 0 502971 0 0 0 24673 0 21480 0 16300 0 565424 0 0 PAMELA BIGLER SVP-NURSING & CNO 0 292058 0 55286 0 100173 0 92120 0 14298 0 553935 0 74154 SCOTT HARDING VP-FACILITIES & SUPPORT SVCS 0 258290 0 36396 0 89290 0 74719 0 19193 0 477888 0 45851 SALLY SALMONS MD MED DIR-PRIM CARE & PED SPEC. 0 262167 0 19796 0 3271 0 21480 0 15298 0 322012 0 0 LARRY GERDOM PHYSICIAN ASSISTANT 133702 0 450 0 1766 0 10237 0 15695 0 161850 0 0 0 LARRY WHITAKER JR PHYSICIAN ASSISTANT 130829 0 450 0 347 0 10160 0 22928 0 164714 0 0 0 DANIEL CHASE MD HIGHLY COMP EMP - FORMER 0 445585 0 0 0 3003 0 21480 0 20088 0 490156 0 0 CORTNEY JONEIKIS ROSSER MD HIGHLY COMP EMP - FORMER 0 305690 0 0 0 2290 0 21480 0 5896 0 335356 0 0 WILLIAM MCCARTHY MD HIGHLY COMP EMP - FORMER 0 246778 0 0 0 32673 0 21480 0 1107 0 302038 0 0 ALBERT TANLIM MD HIGHLY COMP EMP - FORMER 0 213208 0 0 0 2105 0 16819 0 19654 0 251786 0 0 SUSAN BERG MD HIGHLY COMP EMP - FORMER 0 124376 0 25000 0 4129 0 11217 0 3308 0 168030 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HCMH, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. SCHEDULE J, PART I, QUESTION 4B THE 2016 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF HCMH, THAT ARE LISTED IN THE 990 PART VII INCLUDE JOSEPH BARKMEIER, MD, PAMELA BIGLER, HARRY BROCKUS, LAURENCE FALLON, SCOTT HARDING, DENNIS HESCH, AND LEATHA KRAMER. IN 2016, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO JOSEPH BARKMEIER, MD ($116,663), PAMELA BIGLER ($74,154), HARRY BROCKUS ($27,062), LAURENCE FALLON ($117,672), SCOTT HARDING ($45,851), AND DENNIS HESCH ($164,751). SCHEDULE J, PART I, QUESTION 7 PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT. BRADLEY D CRISTY JR FAMILY MEMBER OF OFFICER 33384 EMPLOYMENT false HEATHER MOORE FAMILY MEMBER OF TRUSTEE 103885 EMPLOYMENT false KIMBERLY S HOUMES FAMILY MEMBER OF TRUSTEE 91046 EMPLOYMENT false RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION FORM 990, SCHEDULE L, PART IV, COLUMN D BRADLEY D CRISTY, JR IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH HARRY BROCKUS WHO SERVES AS CEO OF THE HOSPITAL'S BOARD OF DIRECTORS. KIMBERLY HOUMES IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE FOR THE HOSPITAL. HEATHER MOORE IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE FOR THE HOSPITAL. FORM 990, SUPPLEMENTAL INFORMATION FORM 990, PART VI, QUESTION 2 TRUSTEE, JOSEPH BARKMEIER, MD AND OFFICER, DENNIS HESCH HAD A BUSINESS RELATIONSHIP. FORM 990, PART VI, QUESTION 6 HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. FORM 990, PART VI, QUESTION 7A HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PART VI, QUESTION 7B HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF INCORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $50,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED AND FOR RECOMMENDING THE CEO OF THE CORPORATION TO THE HOOPESTON BOARD OF TRUSTEES. FORM 990, PART VI, QUESTION 11B THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. FORM 990, PART VI, QUESTION 12C THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, QUESTIONS 15A & 15B THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO OF THE CARLE FOUNDATION, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. FORM 990, PART VI, QUESTIONS 18 & 19 THE CARLE FOUNDATION, THE SOLE MEMBER OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE also AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. FORM 990, PART VII, SECTION A, COLUMN B THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK. FORM 990, PART XI, LINE 9 PERMANANTLY RESTRICTED ASSETS DECREASED AS A RESULT OF A CHANGE IN VALUE OF THE BENEFICIAL INTEREST IN A PERPETUAL TRUST OF $5,576. TEMPORARILY RESTRICTED ASSETS DECREASED BY $10,052 RESULTING FROM CHANGES IN THE POLAND TRUST ACCOUNT WHICH IS A TEMPORARILY RESTRICTED FUND USED TO PROVIDE TUITION ASSITANCE FOR NURSING STUDENTS. FORM 990, PART XII, LINES 2A, B, C AND PART IV, LINES 12A & 12B THE FINANCIAL STATEMENTS FOR HOOPESTON COMMUNITY MEMORIAL HOSPITAL WERE audited ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR. THE CARLE FOUNDATION 611 W PARK ST URBANA IL 618012595 370673465 PARENT/INVMGT IL 501(C)(3) 12c, III-FI NA false THE CARLE FOUNDATION HOSPITAL 611 W PARK ST URBANA IL 618012595 371119538 HOSPITAL SERV IL 501(C)(3) 3 TCF true CARLE HEALTH CARE INCORPORATED 611 W PARK ST URBANA IL 618012595 371140016 VAR MED SVCS IL 501(C)(3) 10 TCF true CARLE RETIREMENT CENTERS INC 611 W PARK ST URBANA IL 618012595 371160033 RTRMT LIVING IL 501(C)(3) 10 TCF true THE CARLE DEVELOPMENT FOUNDATION 611 W PARK ST URBANA IL 618012595 371159978 FUNDRAISING IL 501(C)(3) 7 TCF true CARLE COMMUNITY HEALTH CORPORATION 611 W PARK ST URBANA IL 618012595 364458371 FNDN MISSION IL 501(C)(3) 12a, Type I TCDF true CHAMPAIGN SURGICENTER LLC 611 W PARK ST URBANA IL 618012595 201915925 Surgical Center IL NA N/A HEALTH SYSTEMS INSURANCE LIMITED GOVERNORS SQ 2ND FL BLDG 3 grand cayman CJ ky1-1102 INSURANCE CJ NA C CORP true CARLE RISK MANAGEMENT COMPANY 611 W PARK ST URBANA IL 618012595 371217973 RISK MANAGEMENT IL NA C CORP true EVALIDATA INC 611 W PARK ST URBANA IL 618012595 462022658 PHYS CREDENTIALS IL NA C CORP true CHA HOLDING INC 301 S VINE ST URBANA IL 61801 471854275 HOLDING COMPANY IL NA C CORP true CARLE HOLDING COMPANY INC 611 W PARK ST URBANA IL 618012595 371188284 HOLDING COMPANY IL NA C CORP true HEALTH ALLIANCE MEDICAL PLANS INC 301 S VINE ST URBANA IL 61801 371260731 HEALTH COVERAGE IL NA C CORP true HEALTH ALLIANCE CONNECT INC 301 S VINE ST URBANA IL 61801 464796891 HEALTH CARE COORD IL NA C CORP true HEALTH ALLIANCE NORTHWEST HOLDING 820 N CHELAN AVE WENATCHEE WA 98801 461717578 HOLDING COMPANY WA NA C CORP true HEALTH ALLIANCE NORTHWEST HEALTH PLAN 820 N CHELAN AVE WENATCHEE WA 98801 461966323 HEALTH COVERAGE WA NA C CORP true HEALTH ALLIANCE MIDWEST INC 301 S VINE ST URBANA IL 61801 371354502 HEALTH COVERAGE IL NA C CORP true false false false false false false false false false false true true true false false true false true true THE CARLE FOUNDATION HOSPITAL l 68258 BOOK VALUE THE CARLE FOUNDATION HOSPITAL m 546561 BOOK VALUE THE CARLE FOUNDATION HOSPITAL p 50128 BOOK VALUE CARLE HEALTH CARE INCORPORATED m 13173628 BOOK VALUE HEALTH SYSTEMS INSURANCE LIMITED m 166490 BOOK VALUE HEALTH ALLIANCE MEDICAL PLANS INC l 6043706 BOOK VALUE HEALTH ALLIANCE CONNECT INC l 8479682 BOOK VALUE THE CARLE FOUNDATION HOSPITAL s 2066389 BOOK VALUE