MEMORIAL HEALTH SYSTEM: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HEALTH SYSTEM (EIN 37-0646367)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-04-06
IRS object ID
201710969349300416
Schema version
2015v3.0
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)
Return2017-04-06T10:36:12-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11 SOUTH WACKER SUITE 600AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370646367EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MENTAL HEALTH CENTERSBusinessNameLine1Txt
Business Name Line2OF CENTRAL ILLINOISBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlMENTBusinessNameControlTxt
Phone2175251064PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 NORTH EIGHTH STEETAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP627026395ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJANICE GAMBACHPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone2175251064PhoneNum
Signature2017-03-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonZACHARY FORTSCHPreparerPersonNm
PTINP00052725PTIN
Phone3126343400PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL BEHAVIORAL HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJANICE GAMBACHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 NORTH EIGHTH STEETAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP627026395ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,799,454GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption5670GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MHCCI.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH OF THE PEOPLE AND THE COMMUNITIES WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee382TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,465,618PYContributionsGrantsAmt
CY Contributions Grants$3,630,471CYContributionsGrantsAmt
PY Program Service Revenue$8,878,037PYProgramServiceRevenueAmt
CY Program Service Revenue$10,676,396CYProgramServiceRevenueAmt
PY Investment Income$308,798PYInvestmentIncomeAmt
CY Investment Income$263,320CYInvestmentIncomeAmt
PY Other Revenue$123,429PYOtherRevenueAmt
CY Other Revenue$104,656CYOtherRevenueAmt
PY Total Revenue$12,775,882PYTotalRevenueAmt
CY Total Revenue$14,674,843CYTotalRevenueAmt
PY Grants And Similar Paid$3,083PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,971CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,660,758PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,149,649CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,244,060PYOtherExpensesAmt
CY Other Expenses$3,124,729CYOtherExpensesAmt
PY Total Expenses$13,907,901PYTotalExpensesAmt
CY Total Expenses$15,280,349CYTotalExpensesAmt
PY Revenues Less Expenses-$1,132,019PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$605,506CYRevenuesLessExpensesAmt
Total Assets BOY$18,047,745TotalAssetsBOYAmt
Total Assets EOY$18,068,252TotalAssetsEOYAmt
Total Liabilities BOY$1,167,343TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,766,328TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,880,402NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,301,924NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE THE HEALTH OF THE PEOPLE AND THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,883,324ExpenseAmt
Revenue$2,184,287RevenueAmt
DescLINCOLN CENTER FOR DEVELOPMENTAL REHABILITATION (LCDR) PROVIDES DEVELOPMENTAL TRAINING SERVICES FOR DEVELOPMENTALLY DISABLED ADULTS. THE SERVICES ARE DESIGNED TO ENHANCE THE INDIVIDUAL'S SKILLS IN ACTIVITIES OF DAILY LIVING, TO LEAD THE INDIVIDUAL TO INDEPENDENCE AND ECONOMIC SELF-SUFFICIENCY THROUGH INSTRUCTION AND TRAINING. THE INDIVIDUAL IS PREPARED FOR LESS RESTRICTIVE INSTRUCTIONAL AND WORK SETTINGS. DEVELOPMENTAL TRAINING PROVIDES A THREE-FOLD APPROACH TO MEETING THE NEEDS OF THE DEVELOPMENTALLY DISABLED ADULT. THESE OBJECTIVES ARE (1) THERAPEUTIC DEVELOPMENTAL, (2) HUMAN INTERACTION DEVELOPMENT, AND (3) VOCATIONAL SKILLS. SERVICE UNITS ARE MEASURED BY CLIENT HOURS. LCDR OPERATED 244 DAYS AND PROVIDED 116,843 CLIENT HOURS OF SERVICE IN FISCAL YEAR 2016.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,331,381ExpenseAmt
Revenue$622,683RevenueAmt
DescTHE PSYCHIATRIC LEADERSHIP SERVICES PROGRAM PROVIDES PSYCHIATRIC SERVICES FOR CHILDREN, ADOLESCENTS AND ADULTS. ITS PURPOSE IS TO DIAGNOSE AND TREAT SYMPTOMS OF MENTAL ILLNESSES, WHICH ARE KNOWN TO RESPOND TO PSYCHOTROPIC MEDICATION, TO MAINTAIN STABILITY AND PROMOTE OPTIMAL LEVELS OF CLIENT FUNCTIONING THROUGH THE UTILIZATION OF PSYCHOTROPIC MEDIATION, TO PROMOTE THE RECOVERY PROCESS BY PARTICIPATING IN A TEAM TREATMENT APPROACH WITH OTHER TREATMENT STAFF AND BY PROVIDING MEDICAL LEADERSHIP WHEN APPROPRIATE, AND TO ENSURE THAT PSYCHIATRIC SERVICES MEET ACCEPTED COMMUNITY AND PROFESSIONAL STANDARDS OF PRACTICE. SERVICE UNITS ARE MEASURED BY CLIENT HOURS. MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS, (MHCCI) PROVIDED 6,251 CLIENT HOURS OF SERVICE IN FISCAL YEAR 2016.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,039,343ExpenseAmt
Revenue$952,638RevenueAmt
DescTHE CRISIS/ACCESS PROGRAM PROVIDES RAPID RESPONSE TO INDIVIDUALS IN MENTAL HEALTH CRISIS, TO MEMBERS OF HIS/HER SUPPORT SYSTEM, AND THE COMMUNITY 24-HOURS/DAY. THE PROGRAM PROVIDES CRISIS INTERVENTION SERVICES, WALK-INS, & MOBILE SERVICES. SHORT-TERM CRISIS INTERVENTION OF THERAPY/COUNSELING AND PSYCHIATRIC CARE IS DESIGNED TO ADDRESS THE PRESENTING SYMPTOMS OF A PSYCHIATRIC EMERGENCY & TO AMELIORATE A CLIENT'S DISTRESS SO THAT RESOURCES & SUPPORTS CAN BE MOBILIZED & PLANNING FOR FURTHER TREATMENT CAN OCCUR. CRISIS WALK-IN IS SUPPORT & INTERVENTION OFFERED AT AN IDENTIFIED LOCATION ON AN UNSCHEDULED BASIS FOR THE PURPOSE OF STABILIZING OR RESOLVING A CRISIS SITUATION. MOBILE CRISIS SERVICE IS DELIVERED WHERE & WHEN THE CRISIS OCCURS TO ASSURE SERVICE BY MH PROFESSIONALS. MHCCI PROVIDED 6,781 CLIENT HOURS IN FISCAL YEAR 2016.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (3 entries)

ExpenseExpenseAmtGrantGrantAmtRevenueRevenueAmtDescDesc
$627,299$4,575$805,987OTHER DEVELOPMENTAL DISABILITY PROGRAMS
$7,875,925$1,396$6,188,352OTHER MENTAL HEALTH PROGRAMS
$48,257$24,398HOUSING SERVICES
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$8,551,481TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$5,971TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$7,018,737TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$12,805,529TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document24IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee382EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form1098 C FiledYes (1)Form1098CFiledInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EMILY EBERT FINANCE DIRECTORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2175887777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1710 N EIGHTH STREETAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP627026395ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MICHAEL O'SHEA
CHAIR0.70Yes (X)Yes (X)$0$0$0
JENNIFER MORRISON
VICE CHAIR0.70Yes (X)Yes (X)$0$0$0
CATHERINE J GONZALEZ JD
TREASURER0.70Yes (X)Yes (X)$0$0$0
SANDY ROBINSON II
SECRETARY0.70Yes (X)Yes (X)$0$0$0
RANDALL S GERMERAAD
DIRECTOR0.70Yes (X)$0$0$0
BRENT BORAH
DIRECTOR0.70Yes (X)$0$0$0
DR VIRGINIA DOLAN
DIRECTOR0.20Yes (X)$0$383,936$122,603
GINA LATHAN
DIRECTOR0.70Yes (X)$0$0$0
JOHN MILHISER
DIRECTOR0.70Yes (X)$0$0$0
ANNE MORGAN
DIRECTOR0.70Yes (X)$0$0$0
WANDA LEE ROHLFS
DIRECTOR0.70Yes (X)$0$0$0
SCOTT SABIN
DIRECTOR0.70Yes (X)$0$0$0
LEIGH STEINER PHD
DIRECTOR0.70Yes (X)$0$0$7,000
JANET S STOVER
DIRECTOR0.70Yes (X)$0$0$0
DOMINIC WATSON
DIRECTOR0.70Yes (X)$0$0$0
DANIEL WRIGHT
DIRECTOR0.70Yes (X)$0$0$0
CYNTHIA THOMAS MD
DIRECTOR0.50Yes (X)$0$0$0
JANICE GAMBACH
PRESIDENT55.00Yes (X)Yes (X)$0$200,998$22,078
TIMOTHY SCHMITZ THRU 93015
CFO55.00Yes (X)$83,257$0$12,864
EMILY EBERT STARTED 1416
FINANCE DIRECTOR55.00Yes (X)$0$0$0
RAYMOND BLAND
PSYCHIATRIST40.00$168,990$0$30,838Yes (X)
CYNTHIA A BUTLER
ADMINISTRATOR CLINICAL SERVICES45.00$115,564$0$18,034Yes (X)
BETTEANNE MACINTOSH
PSYCHIATRIST40.00$149,646$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$517,457TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$584,934TotReportableCompRltdOrgAmt
Total Other Compensation$213,417TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$19,141FederatedCampaignsAmt
Related Organizations$777,597RelatedOrganizationsAmt
Government Grants$2,073,273GovernmentGrantsAmt
All Other Contributions$760,460AllOtherContributionsAmt
Noncash Contributions$56,755NoncashContributionsAmt
Total Contributions$3,630,471TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MENTAL HEALTH SERVICES621400$7,744,340$7,744,340
DEVELOPMENTAL DISABILI621400$2,907,658$2,907,658
HOUSING SERVICES621400$24,398$24,398
FieldValueIRS element (for citing)
Total Program Service Revenue$10,676,396TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$254,329TotalRevenueColumnAmt
Exclusion$254,329ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,707RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,707RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,707TotalRevenueColumnAmt
Exclusion$2,707ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$999,433SecuritiesAmt
Other$16,206OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$992,675SecuritiesAmt
Other$13,973OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$6,758SecuritiesAmt
Other$2,233OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,991TotalRevenueColumnAmt
Exclusion$8,991ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$186,168GrossSalesOfInventoryAmt
Cost Of Goods Sold$117,963CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$68,205TotalRevenueColumnAmt
Related Or Exempt Func Income$68,205RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RECORD FEES900099$12,002$12,002
PROMPT PAY INTEREST900099$6,657$6,657

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,085TotalRevenueColumnAmt
Related Or Exempt Func Income$15,085RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$33,744OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,674,843TotalRevenueColumnAmt
Related Or Exempt Func Income$10,778,345RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$266,027ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$5,971TotalAmt
Program Services$5,971ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$229,672TotalAmt
Program Services$3,992ProgramServicesAmt
Management And General$225,680ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,404,716TotalAmt
Program Services$8,296,628ProgramServicesAmt
Management And General$1,108,088ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$510,547TotalAmt
Program Services$460,832ProgramServicesAmt
Management And General$49,715ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,310,960TotalAmt
Program Services$1,158,384ProgramServicesAmt
Management And General$152,576ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$693,754TotalAmt
Program Services$634,220ProgramServicesAmt
Management And General$59,534ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$7,275TotalAmt
Program Services$3,952ProgramServicesAmt
Management And General$3,323ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$44,356TotalAmt
Program Services$39,249ProgramServicesAmt
Management And General$5,107ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$1,394TotalAmt
Management And General$1,394ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$481,438TotalAmt
Program Services$417,955ProgramServicesAmt
Management And General$63,483ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,238TotalAmt
Program Services$6,383ProgramServicesAmt
Management And General$855ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$386,082TotalAmt
Program Services$285,491ProgramServicesAmt
Management And General$100,591ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$160,923TotalAmt
Program Services$98,382ProgramServicesAmt
Management And General$62,541ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$623,483TotalAmt
Program Services$565,775ProgramServicesAmt
Management And General$57,708ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$217,088TotalAmt
Program Services$204,658ProgramServicesAmt
Management And General$12,430ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$52,250TotalAmt
Program Services$32,630ProgramServicesAmt
Management And General$19,620ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$355,509TotalAmt
Program Services$307,971ProgramServicesAmt
Management And General$47,538ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$102,820TotalAmt
Program Services$102,820ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
MANAGEMENT FEES$452,214$452,214
FOOD & DIETARY SUPPLIES$75,484$1,691$73,793
PUBLICATIONS & MEMBERSH$41,558$39,092$2,466
DRUGS$21,060$139$20,921

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$94,557TotalAmt
Program Services$83,056ProgramServicesAmt
Management And General$11,501ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,280,349TotalAmt
Program Services$12,805,529ProgramServicesAmt
Management And General$2,474,820ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$899BOYAmt
EOY$830EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,993,712BOYAmt
EOY$4,075,502EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,102,248BOYAmt
EOY$2,764,729EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$224,384BOYAmt
EOY$240,128EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,689,641LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,908,719LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,779,244BOYAmt
EOY$3,780,922EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,866,238BOYAmt
EOY$7,136,766EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$81,020BOYAmt
EOY$69,375EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,047,745BOYAmt
EOY$18,068,252EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$961,300BOYAmt
EOY$1,493,332EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$206,043BOYAmt
EOY$272,996EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,167,343BOYAmt
EOY$1,766,328EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,880,402BOYAmt
EOY$16,301,924EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,880,402BOYAmt
EOY$16,301,924EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,047,745BOYAmt
EOY$18,068,252EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$605,506ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$27,028NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,081,725CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,682,304CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,594,448CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,465,618CurrentTaxYearMinus1YearAmt
Current Tax Year$3,630,471CurrentTaxYearAmt
Total$17,454,566TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,081,725CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,682,304CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,594,448CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,465,618CurrentTaxYearMinus1YearAmt
Current Tax Year$3,630,471CurrentTaxYearAmt
Total$17,454,566TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$17,454,566PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$146,138CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$155,956CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$296,161CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$253,265CurrentTaxYearMinus1YearAmt
Current Tax Year$257,036CurrentTaxYearAmt
Total$1,108,556TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$315,725CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$128,982CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$100,507CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$60,742CurrentTaxYearMinus1YearAmt
Current Tax Year$33,744CurrentTaxYearAmt
Total$639,700TotalAmt
FieldValueIRS element (for citing)
Total Support$19,202,822TotalSupportAmt
Gross Receipts Rltd Activities$47,173,411GrossReceiptsRltdActivitiesAmt
Public Support CY1700.90900PublicSupportCY170Pct
Public Support PY1700.90590PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationNET INCOME FROM SALES OF INVENTORY - 2011 AMOUNT: $ 53,487. MENTAL HEALTH TRAINING - REGISTRATION FEES - 2011 AMOUNT: $ 1,228. 2012 AMOUNT: $ 30,745. 2013 AMOUNT: $ 27,440. 2014 AMOUNT: $ 8,173. 2015 AMOUNT: $ 7,770. RECORD COPY FEES - 2011 AMOUNT: $ 22,097. 2014 AMOUNT: $ 15,400. 2015 AMOUNT: $ 12,002. OTHER REVENUE - 2011 AMOUNT: $ 24,730. 2012 AMOUNT: $ 29,113. 2013 AMOUNT: $ 54,349. 2014 AMOUNT: $ 195. 2015 AMOUNT: $ 3,772. PROMPT PAY INTEREST - 2011 AMOUNT: $ 214,183. 2014 AMOUNT: $ 43,367. 2015 AMOUNT: $ 6,657. MEANINGFUL USE - MEDICAID - 2012 AMOUNT: $ 42,500. PARTNERSHIP INCOME - 2012 AMOUNT: $ 26,624. 2013 AMOUNT: $ 18,718. 2014 AMOUNT: $ -35,773. 2015 AMOUNT: $ -11,645. NON-RECORD FEES - 2014 AMOUNT: $ 7,120. 2015 AMOUNT: $ 8,578. TRAINING CONFERENCES - 2014 AMOUNT: $ 22,260. 2015 AMOUNT: $ 6,610.ExplanationTxt

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)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$1,394GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$1,394TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationMHCCI IS A DUES PAYING MEMBER OF THE ILLINOIS ASSOCIATION OF REHABILITATION FACILITIES, INC. (IARF). A PERCENTAGE OF MHCCI'S DUES TO IARF GO TOWARDS LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,012,762OtherCostOrOtherBasisAmt
Book Value$1,012,762BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,526,884OtherCostOrOtherBasisAmt
Depreciation$5,362,468DepreciationAmt
Book Value$2,164,416BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$77,462OtherCostOrOtherBasisAmt
Depreciation$45,935DepreciationAmt
Book Value$31,527BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,065,791OtherCostOrOtherBasisAmt
Depreciation$2,500,316DepreciationAmt
Book Value$565,475BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,742OtherCostOrOtherBasisAmt
Book Value$6,742BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,780,922TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMHCCI IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE UNITED STATE INTERNAL REVENUE CODE. MHCCI IS NOT CONSIDERED A PRIVATE FOUNDATION. IN ACCORDANCE WITH FASB ACS 740-10 WHICH ADDRESSES INCOME TAXES, MHCCI BELIEVES THERE ARE NO SIGNIFICANT UNCERTAIN TAX POSITIONS RESULTING IN LIABILITIES THAT WOULD HAVE BEEN REQUIRED FOR THE YEAR ENDED JUNE 30, 2016. MHCCI'S FORM 990 FOR 2013, 2014, AND 2015 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS), GENERALLY FOR THREE YEARS AFTER THEY WERE FILED.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
SPECIFIC ASSIST - TRANSPORTATION304$1,060FMVTRANSPORTATION INCLUDES BUS TOKENS AND TAXI FARE.
SPECIFIC ASSEST - CLOTHING9$456FMVCLOTHING INCLUDES CLOTHES NEEDED RELATED TO THE SERVICES WE ARE PROVIDING.
SPECIFIC ASSIST - MEDICAL28$3,531FMVMEDICAL INCLUDES DOCTOR AND DENTAL VISITS, AND MEDICATION FOR OUR CILA RESIDENTS.
SPECIFIC ASSIST - FURNISHINGS2$924FMVFURNISHINGS INCLUDES REPLACEMENT FURNITURE NEEDED FOR OUR CILA RESIDENTS.

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationMHCCI PROVIDES ASSISTANCE TO CLIENTS CURRENTLY RECEIVING SERVICES IN ONE OF THE FOLLOWING PROGRAMS: SUPPORTED EMPLOYMENT, PROJECTS IN ASSISTANCE FOR TRANSITION FROM HOMELESSNESS (PATH), COMMUNITY INTEGRATED LIVING ARRANGEMENTS (CILA), MONEY FOLLOWS THE PERSON (MFP). TO BE ELIGIBLE FOR THE ASSISTANCE, THE CLIENT MUST HAVE BEEN DIAGNOSED WITH A MENTAL ILLNESS OR A DEVELOPMENTAL DISABILITY, AND CURRENTLY BE RECEIVING SERVICES AT MHCCI. THE CLIENT IS ASSIGNED A CASE MANAGER WHO IS RESPONSIBLE FOR DETERMINATION OF THE TYPE OF ASSISTANCE NEEDED. BEFORE THE ASSISTANCE IS PROVIDED, THE SUPERVISOR OF THE CASE MANAGER MUST PRE-APPROVE THE ASSISTANCE TO BE PURCHASED. THE CASE MANAGER INITIATES THE PURCHASE. THE CHECK IS MADE PAYABLE DIRECTLY TO THE VENDOR AND/OR LANDLORD. THE CLIENT IS REQUIRED TO SIGN THE VENDOR RECEIPT TO ACKNOWLEDGE THAT HE OR SHE RECEIVED THE GOODS, SERVICES, OR RENTAL ASSISTANCE. CLIENTS DO NOT DIRECTLY RECEIVE CASH.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR VIRGINIA DOLAN
DIRECTOR$0$314,198$0$31,309$0$38,429$0$64,609$0$57,994$0$506,539$0$0
JANICE GAMBACH
PRESIDENT$0$175,527$0$24,480$0$991$0$14,026$0$8,052$0$223,076$0$0
RAYMOND BLAND
PSYCHIATRIST$168,039$0$300$0$651$0$12,592$0$18,246$0$199,828$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationMEMBERS OF SENIOR MANAGEMENT RECEIVE COMPENSATION UNDER PLANS SPONSORED BY MEMORIAL HEALTH SYSTEM. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II COLUMN (B) (II). THE PLANS ARE DESIGNED TO CONDITION A PORTION OF COMPENSATION ON PERFORMANCE AGAINST PREDETERMINED FINANCIAL, MISSION, AND INDIVIDUAL GOALS APPROVED IN ADVANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MEMORIAL HEALTH SYSTEM. THE LEADERSHIP COMPENSATION COMMITTEE OF THE BOARD HAS REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DID NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES RENDERED.ExplanationTxt

Schedule M IRS990ScheduleM

Cars And Other Vehicles CarsAndOtherVehiclesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$56,755NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationONE CONTRIBUTION AND ONE ITEM WERE RECEIVED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERSHIP OF THE CORPORATION CONSISTS OF ONE CORPORATE MEMBER, MEMORIAL HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7ATHE CORPORATE MEMBER OF THE CORPORATION ELECTS THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE BYLAWS OF THE CORPORATION REQUIRE THE ADVANCE APPROVAL OF THE CORPORATE MEMBER FOR CORPORATE, ADMINISTRATIVE AND OPERATIONAL ACTIONS WHICH INCLUDE, BUT ARE NOT LIMITED TO, THE APPROVAL OF ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATING BUDGET, AMENDMENT, ALTERATION OR REPEAL OF THE ARTICLES OF INCORPORATION OR BYLAWS, CREATION OR ELIMINATION OF A PROGRAM OR SERVICE, APPROVAL OF BORROWING WHICH EXCEEDS $250,000, APPROVAL OF ANY QUANTITY OF DEBT WHICH EXCEEDS $250,000, APPROVAL OF ANY DISSOLUTION, MERGER OR CONSOLIDATION OR SALE OF THE ASSETS OF THE CORPORATION WHICH EXCEED $250,000, APPROVAL OF THE ORGANIZATION OF AN AFFILIATE/SUBSIDIARY, APPROVAL FOR APPLICATION OF CERTIFICATE OF NEED, APPROVAL TO ADOPT ANY LONG-TERM OR MASTER INSTITUTIONAL PLAN, APPROVAL TO SELL OR PURCHASE REAL PROPERTY WHICH EXCEEDS $250,000, APPROVAL TO CHANGE INSURANCE SPECIFICATIONS OR LIMITS, APPROVAL TO SELECT OR CHANGE INDEPENDENT AUDITORS AND LEGAL COUNSEL, APPROVAL TO ENTER INTO, RENEW OR MODIFY CONTRACTS TO PROVIDE COVERED MENTAL HEALTH CARE SERVICES TO BENEFICIARIES OF HEALTH MAINTENANCE ORGANIZATIONS, HEALTH CARE SERVICE PLANS, INDEPENDENT PRACTICE ASSOCIATIONS, PREFERRED PROVIDER ORGANIZATIONS, INSURANCE COMPANIES AND OTHER PURCHASERS OF HEALTH SERVICES, APPROVAL TO ENTER INTO ANY CONTRACT OR AGREEMENT WHICH I) PROVIDES FOR THE PAYMENT OR PERFORMANCE BY EITHER PARTY EXCEEDING AN AGGREGATE VALUE OF $250,000, II) IS NOT TERMINABLE WITHOUT PAYMENT OR PENALTY OF 60 DAYS OR LESS NOTICE III)IS BETWEEN THE CORPORATION OR AN AFFILIATE AND AN OFFICER, DIRECTOR OR KEY EMPLOYEE THEREOF.
FORM 990, PART VI, SECTION B, LINE 11MANAGEMENT PREPARES AND REVIEWS THE RETURN. AN OUTSIDE TAX ADVISOR THEN REVIEWS THE RETURN, PROVIDING COMMENTS AND GUIDANCE AS NEEDED. MHCCI BOARD MEMBERS ARE THEN PROVIDED WITH A FINAL COPY OF FORM 990 AND ITS SUPPORTING SCHEDULES FOR REVIEW AT A REGULARLY SCHEDULED BOARD MEETING. REVIEW, DISCUSSION, AND RATIFICATION OF THE FORM ARE AN AGENDA ITEM.
FORM 990, PART VI, SECTION B, LINE 12CMHCCI BOARD MEMBERS RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY. BOARD MEMBERS COMPLETE CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS; BOARD MEMBERS ARE REMINDED TO UPDATE THEIR STATEMENTS IF CIRCUMSTANCES CHANGE. BOARD MEMBERS ARE REMINDED OF THE NEED TO ABSTAIN FROM VOTING WHEN BOARD RESOLUTIONS REQUIRE SUCH ACTION. BOARD MEMBERS ARE APPRAISED BY MANAGEMENT OF POTENTIAL CONFLICTS WITH MEETING AGENDA ITEMS.
FORM 990, PART VI, SECTION B, LINE 15AMHCCI'S CEO IS AN EMPLOYEE OF MEMORIAL HEALTH SYSTEM. THE HEALTH SYSTEM ANNUALLY ENGAGES A CONSULTING FIRM TO CONDUCT A COMPENSATION REVIEW, WHICH INCLUDES A COMPARABILITY STUDY FOR ALL EXECUTIVES. THE COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD OF DIRECTORS REVIEWS THE CONSULTANT REPORT. COMPENSATION COMMITTEE DECISIONS AND REPORTS ARE CONTEMPORANEOUSLY DOCUMENTED IN THE BOARD OF DIRECTOR AND COMPENSATION COMMITTEE MINUTES AS APPROPRIATE. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF MHCCI IS REVIEWED ANNUALLY BY THE HR DEPARTMENT. THIS REVIEW INCLUDES A COMPARABILITY STUDY AND BENEFITS ANALYSIS.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS OF MENTAL HEALTH CENTER OF CENTRAL ILLINOIS, SUCH AS ARTICLES OF INCORPORATION AND ANY AMENDMENTS THERETO, ARE AVAILABLE TO THE GENERAL PUBLIC THROUGH THE ILLINOIS SECRETARY OF STATE'S OFFICE. THESE GOVERNING DOCUMENTS, AS WELL AS THE BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS, ARE AVAILABLE UPON REQUEST FROM THE CORPORATION. THESE DOCUMENTS ARE AVAILABLE FOR THE SAME PERIOD OF TIME AS SET FORTH IN IRC SECTION 6104(D).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
SPRINGFIELD RESIDENTIAL SERVICES
710 NORTH EIGHTH STREETSPRINGFIELDIL62702371298589RESIDENTIAL HUD HOUSING PROJECT FOR MENTALLY ILLIL501(C)(3)170(B)(1)(A) (VI)MENTAL HEALTH CENTERS OF CENTRAL ILLINOISYes (1)
MEMORIAL HEALTH SYSTEM
701 NORTH FIRST STSPRINGFIELDIL627810001371110690UMBRELLAIL501(C)(3)509(A)(3) TYPE II0N/A
MEMORIAL MEDICAL CENTER
701 NORTH FIRST STSPRINGFIELDIL627810001370661220HOSPITAL SERVICESIL501(C)(3)170(B)(1)(A) (III)MEMORIAL HEALTH SYSTEM0
MEMORIAL HEALTH VENTURES
701 NORTH FIRST STSPRINGFIELDIL627810001363492266HEALTHCARE ACTIVITIESIL501(C)(3)509(A)(2)MEMORIAL HEALTH SYSTEM0
ABRAHAM LINCOLN MEMORIAL HOSPITAL
315 EIGHTH STLINCOLNIL62656370723793HOSPITAL SERVICESIL501(C)(3)170(B)(1)(A) (III)MEMORIAL HEALTH SYSTEM0
TAYLORVILLE MEMORIAL HOSPITAL
201 EAST PLEASANTTAYLORVILLEIL62568370661250HOSPITAL SERVICESIL501(C)(3)170(B)(1)(A) (III)MEMORIAL HEALTH SYSTEM0
MEMORIAL HOME SERVICES
720 NORTH BONDSPRINGFIELDIL627024915370714225HOME HEALTH, HOSPICE, AND CONTINUOUS CARE SERVICESIL501(C)(3)170(B)(1)(A) (VI)MEMORIAL HEALTH SYSTEM0
MEMORIAL PHYSICIAN SERVICES
701 NORTH FIRST STSPRINGFIELDIL627810001371181194HEALTH CLINICSIL501(C)(3)509(A)(2)MEMORIAL HEALTH SYSTEM0
MEMORIAL MEDICAL CENTER FOUNDATION
1 MEMORIAL PLAZASPRINGFIELDIL62781371110301GRANTS TO HOSPITALS, OTHER CHARITABLE ORGANIZATIONS, AND SCHOLARSHIPSIL501(C)(3)170(B)(1)(A) (VI)MEMORIAL MEDICAL CENTER0
TAYLORVILLE MEMORIAL HOSPITAL FOUNDATION INC
201 EAST PLEASANTTAYLORVILLEIL62568371337485GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALSIL501(C)(3)170(B)(1)(A) (VI)0N/A
ABRAHAM LINCOLN HEALTHCARE FOUNDATION
315 EIGHTH STLINCOLNIL62656363492268GRANTS TO OTHER CHARITABLE ORGANIZATIONS AND HOSPITALSIL501(C)(3)170(B)(1)(A) (VI)MEMORIAL HEALTH SYSTEM0
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
1600 WEST WALNUT STREETJACKSONVILLEIL62650370661230HOSPITAL SERVICESIL501(C)(3)170(B)(1)(A) (III)MEMORIAL HEALTH SYSTEM0
PASSAVANT AREA HOSPITAL FOUNDATION
1600 WEST WALNUT STREETJACKSONVILLEIL62650461037396SUPPORTING THE HOSPITALIL501(C)(3)509(A)(3) TYPE IPASSAVANT MEMORIAL AREA HOSPITAL0
JACKSONVILLE CRNA'S INC
1600 WEST WALNUT STREETJACKSONVILLEIL62650273093265CRNA SERVICESIL501(C)(3)509(A)(3) TYPE I0N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
MEMORIAL HOME SERVICES OF CENTRAL ILLINOIS
701 NORTH FIRST STREETSPRINGFIELDIL62781371190216PROVIDE DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTSILMEMORIAL HOMES SERVICES NFPC1.000000
PASSAVANT PHYSICIAN ASSOCIATION
1600 WEST WALNUT STREETJACKSONVILLEIL62650261200566PHYSICIAN SERVICESILPASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATIONC1.000000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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