MENDOTA COMMUNITY HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: MENDOTA COMMUNITY HOSPITAL (EIN 36-2167785)
Tax period: 2015-10-01 to 2016-09-30
Filed: 2017-08-15
IRS object ID: 201742279349302129
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-08-15T11:17:47-05:00	ReturnTs
Tax Period End	2016-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	191 West Nationwide Blvd Ste 500	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	432152568	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	362167785	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mendota Community Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% Dawn Trompeter	InCareOfNm
Business Name Control	MEND	BusinessNameControlTxt
Phone	8155397461	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1401 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SISTER DIANE MARIE MCGREW	PersonNm
Person Title	TREASURER	PersonTitleTxt
Signature	2017-08-10	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MOLLIE P LONGHOUSE	PreparerPersonNm
PTIN	P00294881	PTIN
Phone	6142492300	PhoneNum
Preparation	2017-08-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	OSF Saint Paul Medical Center	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	JENNIFER JUNIS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1401 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$36,907,785	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.OSFHEALTHCARE.ORG/SAINT-PAUL/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1944	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	260	TotalEmployeeCnt
Total Volunteers	80	TotalVolunteersCnt
Total Gross UBI	$2,369	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,369	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$27,371	PYContributionsGrantsAmt
CY Contributions Grants	$393,476	CYContributionsGrantsAmt
PY Program Service Revenue	$16,772,373	PYProgramServiceRevenueAmt
CY Program Service Revenue	$34,837,983	CYProgramServiceRevenueAmt
PY Investment Income	$45,331	PYInvestmentIncomeAmt
CY Investment Income	-$17,082	CYInvestmentIncomeAmt
PY Other Revenue	$38,989	PYOtherRevenueAmt
CY Other Revenue	$1,150,928	CYOtherRevenueAmt
PY Total Revenue	$16,884,064	PYTotalRevenueAmt
CY Total Revenue	$36,365,305	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$7,936,967	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$17,485,759	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$9,346,178	PYOtherExpensesAmt
CY Other Expenses	$17,985,428	CYOtherExpensesAmt
PY Total Expenses	$17,283,145	PYTotalExpensesAmt
CY Total Expenses	$35,471,187	CYTotalExpensesAmt
PY Revenues Less Expenses	-$399,081	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$894,118	CYRevenuesLessExpensesAmt
Total Assets BOY	$38,730,652	TotalAssetsBOYAmt
Total Assets EOY	$38,658,000	TotalAssetsEOYAmt
Total Liabilities BOY	$37,532,550	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$36,512,465	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,198,102	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,145,535	NetAssetsOrFundBalancesEOYAmt
Mission	IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$17,748,349	ExpenseAmt
Revenue	$35,904,331	RevenueAmt
Desc	MENDOTA COMMUNITY HOSPITAL PROVIDED 25 BEDS IN FISCAL YEAR 2016. THIS HOSPITAL GAVE $485,357 IN CHARITY CARE, AND PROVIDED 5,988 MEALS ON WHEELS TO MEMBERS OF OUR COMMUNITY. THE NET COMMUNITY BENEFIT EXPENSE FOR MEALS ON WHEELS WAS $35,806. MENDOTA COMMUNITY HOSPITAL OFFERS FLU AND IMMUNIZATION CLINICS ALONG WITH MANY OTHER CLINICS IN MENDOTA AND OTHER OUTREACH COMMUNITES. THE HOSPITAL HELD CPR CLASSES, DIABETIC SUPPORT GROUPS, PROVIDED FREE DIABETIC AND NUTRITION EDUCATION CLASSES, AND OFFERED SEVERAL OTHER PROGRAMS THROUGHOUT THE YEAR. THE NET COMMUNITY BENEFIT EXPENSE FOR THESE PROGRAMS WAS $16,384.	Desc
Total Program Service Expenses	$17,748,349	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (true)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	39	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	260	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	Yes (true)	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Dawn Trompeter	PersonNm
Phone	8155397461	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1401 E 12th Steet	AddressLine1Txt
City	Mendota	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
SISTER JUDITH ANN DUVALL OSF
CHAIRPERSON	1.0	40.0	Yes (X)	Yes (X)	$0	$4,880	$0
SISTER DIANE MARIE MCGREW OSF
PRESIDENT/TREASURER	1.0	40.0	Yes (X)	Yes (X)	$0	$4,880	$0
SISTER AGNES JOSEPH WILLIAMS
ASSISTANT SECRETARY	1.0	40.0	Yes (X)	Yes (X)	$0	$4,880	$0
SISTER THERESA ANN BRAZEAU
SECRETARY	1.0	40.0	Yes (X)	Yes (X)	$0	$4,880	$0
SISTER ROSE THERESE MANN OSF
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$0	$0
SISTER M MIKELA MEIDL FSGM
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$0	$0
KEVIN D SCHOEPLEIN
VICE CHAIRPERSON	1.0	40.0	Yes (X)	Yes (X)	$0	$1,839,068	$51,216
GERALD J MCSHANE MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$776,476	$49,808
BRIAN SILVERSTEIN MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$45,000	$0
SISTER MARIA ELENA PADILLA
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$0	$0
JAMES W GIRARDY MD
BOARD MEMBER	1.0	40.0	Yes (X)		$0	$0	$0
JENNIFER JUNIS
PRESIDENT	40.0	0.0		Yes (X)	$0	$171,576	$16,063
DAWN TROMPETER
CFO	40.0	1.0		Yes (X)	$0	$196,390	$25,137
ALLEN U VAN MD
PHYSICIAN	40.0	0.0			$881,838	$0	$40,563	Yes (X)
ERIC A KIVISTO MD
PHYSICIAN	40.0	0.0			$431,734	$0	$26,190	Yes (X)
MARY M CHINN MD
PHYSICIAN	40.0	0.0			$487,548	$0	$39,719	Yes (X)
DAVID A SCHOLL MD
PHYSICIAN	40.0	0.0			$262,531	$0	$35,691	Yes (X)
AMY M MATHEIS-SOLIMAN MD
PHYSICIAN	40.0	0.0			$240,648	$0	$48,926	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,304,299	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,048,030	TotReportableCompRltdOrgAmt
Total Other Compensation	$333,313	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	9	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ER DOCTORS LTD
7 WOOD DUCK LANE	OTTAWA	IL	61350	ER SERVICES	$1,691,032
MEDICAL OUTSOURCING SOLUTIONS INC
1735 DEKALB AVE	SYCAMORE	IL	60178	IMAGING SERVICES	$567,850
DRINKER BIDDLE AND REATH LLP
ONE LOGAN SQUARE	PHILADELPHIA	PA	19103	LEGAL	$216,723
BKD LLP
211 N BROADWAY SUITE 600	ST LOUIS	MO	63102	AUDIT	$118,653
DELTA HEALTHCARE PROVIDERS STAFFING
PO BOX 202940	DALLAS	TX	75320	MEDICAL STAFFING	$103,477

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$374,742	RelatedOrganizationsAmt
All Other Contributions	$18,734	AllOtherContributionsAmt
Total Contributions	$393,476	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Patient Revenue	Desc
Business	900099	BusinessCd
Total Revenue Column	$34,837,983	TotalRevenueColumnAmt
Related Or Exempt Func Income	$34,837,983	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$34,837,983	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,471	TotalRevenueColumnAmt
Exclusion	$6,471	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$75,398	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$75,398	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$75,398	TotalRevenueColumnAmt
Exclusion	$75,398	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$507,327	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$530,880	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$23,553	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$23,553	TotalRevenueColumnAmt
Exclusion	-$23,553	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$18,413	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$11,600	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,813	TotalRevenueColumnAmt
Exclusion	$6,813	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Contracted Pharmacy	$719,945	$719,945
MEANINGFUL USE	$104,520	$104,520
MANAGED CARE FEES	$67,075	$67,075

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$177,177	TotalRevenueColumnAmt
Related Or Exempt Func Income	$174,808	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,369	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,068,717	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$36,365,305	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,904,331	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,369	UnrelatedBusinessRevenueAmt
Exclusion	$65,129	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$402,248	TotalAmt
Management And General	$402,248	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$13,452,197	TotalAmt
Program Services	$10,296,536	ProgramServicesAmt
Management And General	$3,155,661	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$614,959	TotalAmt
Management And General	$614,959	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,305,819	TotalAmt
Program Services	$611,443	ProgramServicesAmt
Management And General	$1,694,376	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$710,536	TotalAmt
Management And General	$710,536	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	-$21,773	TotalAmt
Management And General	-$21,773	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$124,683	TotalAmt
Management And General	$124,683	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,416,283	TotalAmt
Program Services	$2,367,465	ProgramServicesAmt
Management And General	$48,818	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,263	TotalAmt
Program Services	$2,691	ProgramServicesAmt
Management And General	$572	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,424,128	TotalAmt
Program Services	$2,268,119	ProgramServicesAmt
Management And General	$2,156,009	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$392,017	TotalAmt
Program Services	$8,137	ProgramServicesAmt
Management And General	$383,880	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$131,643	TotalAmt
Program Services	$71,509	ProgramServicesAmt
Management And General	$60,134	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,399,165	TotalAmt
Management And General	$1,399,165	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$1,192,073	TotalAmt
Management And General	$1,192,073	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,597,761	TotalAmt
Program Services	$813,099	ProgramServicesAmt
Management And General	$1,784,662	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$763,367	TotalAmt
Program Services	$71,137	ProgramServicesAmt
Management And General	$692,230	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
CONTRACTS AND REPAIRS	$2,392,208	$1,127,955	$1,264,253
BAD DEBTS	$1,351,586		$1,351,586
PROVIDER TAX	$486,560		$486,560
COLLECTION FEES	$96,226		$96,226

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$236,238	TotalAmt
Program Services	$110,258	ProgramServicesAmt
Management And General	$125,980	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$35,471,187	TotalAmt
Program Services	$17,748,349	ProgramServicesAmt
Management And General	$17,722,838	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$87,113	BOYAmt
EOY	$400,074	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$3,619,164	BOYAmt
EOY	$5,029,299	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,134,368	BOYAmt
EOY	$4,356,029	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$556,029	BOYAmt
EOY	$810,048	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,099,031	BOYAmt
EOY	$683,260	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$37,198,345	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$22,292,344	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$16,505,967	BOYAmt
EOY	$14,906,001	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$313,927	BOYAmt
EOY	$28,878	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$12,415,053	BOYAmt
EOY	$12,444,411	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$38,730,652	BOYAmt
EOY	$38,658,000	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,947,097	BOYAmt
EOY	$5,652,365	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$32,536,084	BOYAmt
EOY	$30,835,000	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$49,369	BOYAmt
EOY	$25,100	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$37,532,550	BOYAmt
EOY	$36,512,465	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$399,081	BOYAmt
EOY	$518,993	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$976,674	BOYAmt
EOY	$1,006,033	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$620,509	BOYAmt
EOY	$620,509	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,198,102	BOYAmt
EOY	$2,145,535	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$38,730,652	BOYAmt
EOY	$38,658,000	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$894,118	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$53,315	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$16,072	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$16,072	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1F	FormAndLineReferenceDesc
Explanation	NATURE OF LOBBYING ACTIVITIES: THE ORGANIZATION'S LOBBYING ACTIVITIES INCLUDE PAYING MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION and America Hospital Association, WHo PARTICIPATE IN LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$591,555	BeginningYearBalanceAmt
Investment Earnings Or Losses	$53,315	InvestmentEarningsOrLossesAmt
End Year Balance	$644,870	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,222,501	BeginningYearBalanceAmt
Contributions	$170,224	ContributionsAmt
Investment Earnings Or Losses	-$24,080	InvestmentEarningsOrLossesAmt
Other Expenditures	$61,027	OtherExpendituresAmt
End Year Balance	$3,307,618	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,908,566	BeginningYearBalanceAmt
Investment Earnings Or Losses	$123,950	InvestmentEarningsOrLossesAmt
Other Expenditures	$810,015	OtherExpendituresAmt
End Year Balance	$3,222,501	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,797,903	BeginningYearBalanceAmt
Investment Earnings Or Losses	$154,423	InvestmentEarningsOrLossesAmt
Other Expenditures	$43,760	OtherExpendituresAmt
End Year Balance	$3,908,566	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,638,248	BeginningYearBalanceAmt
Investment Earnings Or Losses	$170,921	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,011,266	OtherExpendituresAmt
End Year Balance	$3,797,903	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.96220	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.03780	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$1,927,000	OtherCostOrOtherBasisAmt
Book Value	$1,927,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$17,332,301	OtherCostOrOtherBasisAmt
Depreciation	$7,080,003	DepreciationAmt
Book Value	$10,252,298	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,405,200	OtherCostOrOtherBasisAmt
Depreciation	$1,723,510	DepreciationAmt
Book Value	$681,690	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$15,533,844	OtherCostOrOtherBasisAmt
Depreciation	$13,488,831	DepreciationAmt
Book Value	$2,045,013	BookValueAmt

Field	Value	IRS element (for citing)
Other Land Buildings		OtherLandBuildingsGrp
Total Book Value Land Buildings	$14,906,001	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
GOODWILL	$10,817,871
RESTRICTED FOUNDATION ASSETS	$1,626,540

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$12,444,411	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ASSET RETIREMENT OBLIGATION	Desc
Amt	$25,100	Amt

Field	Value	IRS element (for citing)
Total Liability	$25,100	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$35,049,277	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	$46,168	OtherRevenueAmt
Revenue Not Reported	$46,168	RevenueNotReportedAmt
Revenue Subtotal	$35,003,109	RevenueSubtotalAmt
Other Revenues Not Included	$1,362,196	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$1,362,196	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$36,365,305	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$34,131,201	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$11,600	OtherExpensesIncludedAmt
Expenses Not Reported	$11,600	ExpensesNotReportedAmt
Expenses Subtotal	$34,119,601	ExpensesSubtotalAmt
Other Expenses Not Included	$1,351,586	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$1,351,586	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$35,471,187	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM SCH D PART V LINE 1A	BEGINNING ENDOWMENT BALANCE waS REDUCED in the current fiscal year TO REMOVE FUNDS RESTRICED UNDER A MORTGAGE AGREEMENT. THESE FUNDS ARE NOT DONOR-RESTRICTED GIFTS AND WILL NOT BE HELD IN PERPETUITY BY THE HOSPITAL TO FUND A PERMANENT SOURCE OF INCOME. Form Sch D Part V Line 4 INTENDED USES OF ENDOWMENT FUNDS: PROCEEDS OF THE ENDOWMENT, AS DICTATED BY THE DONORS, ARE USED AS BEST DETERMINED BY THE FOUNDATION COUNCIL.
Form Sch D Part X Line 2	OSF Healthcare System (OSF) adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an interpretation of FASB Statement No. 109. The interpretation addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, OSF must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of September 30, 2016 and 2015, OSF does not have any uncertain tax positions.
Form Sch D Part XI Line 2d	OTHER REVENUE INCLUDED ON RETURN BUT NOT ON BOOKS: Cost of Goods Sold $11,600 Net Assets released from restrictions $34,568 TOTAL $46,168
Form Sch D Part XI Line 4b	OTHER REVENUE INCLUDED ON RETURN BUT NOT ON BOOKS: PROVISION FOR BAD DEBT $1,351,586 RESTRICTED CONTRIBUTIONS $ 10,610 TOTAL $1,362,196
Form Sch D Part XII Line 2d	OTHER EXPENSES INCLUDED ON RETURN BUT NOT ON BOOKS: GIFT SHOP EXPENSES $11,600 TOTAL $11,600
Form Sch D Part XII Line 4b	OTHER EXPENSES INCLUDED ON RETURN BUT NOT ON BOOKS: PROVISION FOR BAD DEBT $1,351,586 TOTAL $1,351,586

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	125.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$485,357	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$485,357	NetCommunityBenefitExpnsAmt
Total Expense	0.01420	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,860,327	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,454,297	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,406,030	NetCommunityBenefitExpnsAmt
Total Expense	0.07050	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,345,684	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,454,297	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,891,387	NetCommunityBenefitExpnsAmt
Total Expense	0.08470	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$112,718	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$87,638	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$50,510	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$50,510	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$168,728	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$143,648	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,514,412	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,479,377	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,035,035	NetCommunityBenefitExpnsAmt
Total Expense	0.08900	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$582,939	BadDebtExpenseAmt
Reimbursed By Medicare	$13,677,297	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,007,897	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$669,400	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MENDOTA COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1401 E 12TH STREET	AddressLine1Txt
City	MENDOTA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61342	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.OSFHEALTHCARE.ORG/SAINT-PAIL/	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Mendota Community Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	false	StrategyPostedWebsiteInd
Strategy Attached	Yes (true)	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	125.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE SCHEDULE H, PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE SCHEDULE H, PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3	Treasury regulation 1.501(r)-3(d)(1) provides that a newly acquired Hospital facility must meet the CHNA requirements by the last day of the Second taxable year beginning after the date the hospital facility was Acquired. The hospital facility was acquired on April 1, 2015 and has changed to a fiscal year starting on October 1, therefore, it is not required to meet the CHNA requirements until the tax year ended September 30, 2017. This most recent CHNA was conducted in 2016 for mendota community hospital dba osf Saint Paul Medical Center and was approved and adopted by the OSF board of directors on July 25, 2016. This CHNA is effective for fiscal years 2017, 2018 and 2019. SCHEDULE H, PART V, SECTION B, LINE 5 FOR THE 2016 CHNA, MENDOTA COMMUNITY HOSPITAL dba OSF Saint Paul Medical Center TOOK INTO ACCOUNT THE INPUT OF THE COMMUNITY MEMBERS BY HAVING THESE INDIVIDUALS HELP PRIOrITIZE THE IDENTIFIED NEEDS WITHIN EACH COMMUNITY. IN ADDITION, MENDOTA COMMUNITY HOSPITAL OBTAINED AND USED RESOURCES FROM OR RESOURCES PROVIDED BY THESE COMMUNITY MEMBERS.
SCHEDULE H, PART V, SECTION B, LINE 6A	mendota community hospital dba osf Saint Paul medical center Mendota, IL The COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2016 FOR LASALLE County WAS a collaborative undertaking by Ottawa Regional Hospital and Healthcare Center DBA OSF Saint Elizabeth Medical Center and Mendota Community Hospital DBA OSF Saint Paul Medical Center. The CHNA highlights the health needs and well-being of residents in Lasalle County. Schedule H, Part V, Section B, Line 7a Https://www.osfhealthcare.org/about/community-health/ Schedule H, Part V, Section B, Line 11 See Part VI, Line 2, "Needs Assessment" - for detailed description of how significant community health needs are being addressed along with the needs not addressed.
SCHEDULE H, PART V, SECTION B, LINE 13B and 13h	Please Refer to the response to Schedule H, Part I, Line 3C for a description of how Saint Paul Medical center explained the basis for calculating amounts charged to patients using factors other than FPG.
Schedule h, part v, section b, line 16a & 16b	FAP application form: Https://www.osfhealthcare.org/billing/financial-assistance/ Schedule H, Part V, Section B, Line 16F & 16I A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS, INFORMATION ABOUT FINANCIAL ASSISTANCE AND THE APPLICATION PROCESS IS INCLUDED ON OR WITH THE OSF PATIENT BILLING STATEMENT, AND OSF PROVIDES COPIES OF THE PLAIN LANGUAGE SUMMARY AND THE FAP APPLICATION FORM TO REFERRING STAFF PHYSICIANS. SCHEDULE H, PART V, SECTION B, LINE 20E ALL OSF HOSPITALS SCREEN ALL PATIENTS WITH NO INSURANCE BENEFITS, OR INSUFFICIENT INSURANCE BENEFITS FOR PRESUMPTIVE CHARITY CARE.
Schedule h, part v, section b, line 22d	The hospital determined the amounts billed to individuals who did not have insurance covering emergency or other medically necessary care in the following ways. The amount billed to the individual was the lowest Amount determined under any of the following methods which apply to the Individual: -for Illinois residents who incur gross charges in excess of $300 for any One inpatient admission or outpatient encounter, who apply for financial Assistance, and whose family income is 125% or less of the federal Poverty guideline for family size, the amount billed is $0.00. If family Income is between 126% and 300% of the federal poverty guideline for their family size, the amount billed is calculated by multiplying gross Charges times the hospital's cost to charge ratio determined from its Most recently filed Medicare cost report and then multiplying that Product times 135%. The amount billed to patients regardless of residency whose family income is not more than 200% of federal poverty guidelines for their family size is $0.00. Discounted financial assistance is available on a sliding scale to Patients regardless of residency whose family income is between 201% and 400% of federal poverty guidelines for their family size. Catastrophic financial assistance is available when charges exceed 25% OF Annual family income. The amount billed is adjusted to 25% of family Income when OSF determines this is the most generous Assistance. -the maximum amount that can be collected in a 12 month period for Emergency or other medically necessary care to any patient who applies For financial assistance does not exceed 25% of family income. -the amount billed to FAP-eligible individuals is never more than the Amount generally billed (AGB) to individuals who have insurance covering such Care. This maximum charge billed to FAP-eligible individuals is Determined by multiplying the gross charges for all emergency and other Medically necessary care by a percentage calculated annually and equal To: (i) the aggregate dollar amount of claims allowed for all medical Services during the 12-month period ended on the preceding September 30 By both medicare ffs private insurers, together with any associated portions of these Claims the medicare beneficiaries and insured individuals are responsible for paying in the form of Co-payments, co-insurance, or deductibles, divided by (ii) the sum of the Associated gross charges for those claims. If the amount a health insurer will allow for a claim has not been finally determined as of the last day of the 12 month period used to calculate the AGB percentage, the hospital excludes the amount of the claim from that calculation and includes it in the subsequent 12 month period during which the amount allowed is finally determined. The amount billed to a patient eligible for financial assistance is less than the amount of the gross charges.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule h, part i, line 3c	The corporation provides: -Catastrophic charity assistance regardless of income or asset levels for medically necessary services which exceed 25% of annual family income. The amount due is adjusted to 25% of family income when OSF determines catastrophic charity is more generous. -PRESUMPTIVE CHARITY: CHARGES MAY BE ADJUSTED TO PROVIDE FOR A CHARITY DISCOUNT OF 100% OF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES PROVIDED TO AN UNINSURED PATIENT WHO ESTABLISHES FINANCIAL NEED AT TIME OF REGISTRATION BY SATISFYING ONE OF THE FOLLOWING CATEGORIES OF PRESUMPTIVE ELIGIBILITY CRITERIA. PRESUMPTIVE CHARITY CATEGORIES FOR ALL OSF HOSPITALS: -HOMELESSNESS; -DECEASED WITH NO ESTATE; -MENTAL INCAPACITATION WITH NO ONE TO ACT ON PATIENT'S BEHALF; OR -CURRENT MEDICAID ELIGIBILITY, BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE. -All patients receive the greatest requested discount available under any of the OSF programs. No asset tests are used. -Except as otherwise noted, these policies apply both to uninsured patients and to insured patients with respect to the patient responsibility amount.
Schedule h, part i, line 7, column f	Bad Debt Expense in the amount of 1,351,586 is included on Form 990, Part IX, Line 24B, Column (A), but was subtracted for purposes of calculating the percentages in Schedule H, Part I, Line 7, Column (F).
Schedule h, part iii, section a, lines 2, 3, 4, and 8	In general, and in accordance with Medicare regulations, patient account balances are written off to bad debt expense after reasonable collection efforts have been exhausted and the account has been sent to a collection agency or law firm. Patients' accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of patients' accounts receivable, OSF analyzes past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, OSF analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. for receivables associated with patient responsibility (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the patients are screened against the OSF financial assistance policy and uninsured discount policy. For any remaining patient responsibility balance, OSF records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Bad debt expense of 1,351,586 on form 990, part ix, line 24b is based upon Accrual accounting required by generally accepted accounting principles. This amount consequently differs from the bad debt expense of 582,939 on Schedule h, part iii, line 2 which requires the organization to report Aggregate bad debt at cost. Bad debt expense reported on part iii, line 2 is therefore calculated by multiplying gross charges written off to bad Debt expense times the ratio of patient care cost-to-charges derived from Worksheet 2.
Schedule h, part iii, section a, lines 2, 3, 4 and 8	Discounts, including any applicable third party payer contractual Allowances and any charity care discounts (valued at gross charges), are Applied to patient account gross charges to determine the account balance before patient payments. The aggregate amount of all patient payments is then applied to the account balance. When determination is made that no further amounts can be collected in accordance with the corporation's bad debt policy, the remaining balance is written off to bad debt expense. Presumptive charity: charges may be adjusted to provide for a charity Discount of 100% of billed charges for medically necessary services provided to an uninsured patient who establishes financial need at time of registration by satisfying one of the following categories of Presumptive eligibility criteria. Presumptive charity categories for all OSF hospitals: -homelessness; -deceased with no estate; -mental incapacitation with no one to act on patient's behalf; or -current Medicaid eligibility, but not on date of service or for Non-covered service. Therefore, the corporation does not believe that bad debt expense reported on part iii, line 3 includes any amounts that reasonably could be attributable to patients who would likely qualify under the Corporation's financial assistance policy.
Schedule H, part iii, section c, line 9b	The corporation has a fair billing/collection policy which applies for all patients. The policy includes: -required information provided in bills to patients (including a Requirement that information be provided on how the patient may apply for financial assistance). -process for patients to inquire about or dispute a bill, including Toll-free telephone number, address, contact name and e-mail address. -requirements for timely response to patient inquiries. -conditions which must be satisfied before patient may be Sent to a collection agency or attorney. -legal action for non-payment of a patient bill may not be initiated until an authorized hospital official has determined that all conditions in the corporation's policy (including all the foregoing policy Provisions) have been satisfied for initiating legal action. -legal action may not be pursued against uninsured patients who have Clearly demonstrated that they have neither sufficient income nor assets to meet their financial obligations - even if such patients do not apply For financial assistance. -the corporation shall not engage in any extraordinary collection Actions, such as submitting reports to credit agencies before reasonable Attempts to determine eligibility for financial assistance have been Completed. -If a patient receives an application for financial assistance but fails to return it, OSF will try to use secondary sources to determine the patients eligibility for noncompliant charity before pursuing legal action for nonpayment. -The hospital shall not obtain a body attachment against any patient or guarantor.
Schedule h, part vi, line 2	Mendota Community Hospital dba OSF Saint Paul Medical Center Completed a Community Health Needs Assessment ("CHNA") during fiscal year 2016 as required by Internal Revenue Code section 501(r)(3). The final CHNA for the hospital was approved and adopted by the system's board of directors on July 25, 2016. This most recent CHNA is effective for fiscal years 2017, 2018 and 2019 for the hospital. In response to the significant health needs identified in the hospital's 2016 CHNA, the hospital completed and adopted an implementation strategy to address these critical health needs. The LaSalle County CHNA was done as a collaborative undertaking by Mendota Community Hospital dba OSF Saint Paul Medical Center and Ottawa Regional Hospital and Healthcare Center dba Saint Elizabeth Medical Center to highlight the health needs and well being of residents in LaSalle County. The joint group identified the following significant community health needs as a priority: Healthy Behaviors and Behavioral Health. Healthy behaviors is defined as active living and healthy eating and their impact on society. Behavioral Health includes mental health and substance abuse. ACTIVE LIVING: A HEALTHY LIFESTYLE, COMPRISED OF REGULAR PHYSICAL ACTIVITY AND BALANCED DIET, HAS BEEN SHOWN TO INCREASE PHYSICAL, MENTAL, AND EMOTIONAL WELL-BEING. nOTE THAT 73% OF RESPONDENTS IN LASALLE COUNTY INDICATED THAT THEY DO NOT EXERCISE AT ALL, OR 1-2 TIMES PER WEEK. HEALTHY EATING: WELL OVER HALF (68%) OF LASALLE COUNTY RESIDENTS REPORT NO CONSUMPTION OR LOW CONSUMPTION (1-2 SERVINGS PER DAY) OF FRUITS AND VEGETABLES PER DAY. nOTE THAT THE PERCENTAGE OF LASALLE COUNTY RESIDENTS WHO CONSUME FIVE OR MORE SERVINGS PER DAY IS ONLY 5%. OBESITY: IN LASALLE COUNTY, THE NUMBER OF PEOPLE DIAGNOSED WITH OBESITY AND BEING OVERWEIGHT HAS INCREASED OVER THE YEARS FROM 2007-2009 TO 2010-2014. NOTE SPECIFICALLY THAT THE PERCENTAGE OF OBESE AND OVERWEIGHT PEOPLE HAS INCREASED FROM 63.5% TO 68.5%. OVERWEIGHT AND OBESITY RATES IN ILLINOIS HAVE DECREASED FROM 2009 (64.0%) TO 2014 (63.7%). BEHAVIORAL HEALTH - MENTAL HEALTH AND SUBSTANCE ABUSE MENTAL HEALTH: FOR 2009, JUST OVER 25% OF RESIDENTS IN LASALLE COUNTY REPORTED THEY HAD EXPERIENCED 1-7 DAYS WITH POOR MENTAL HEALTH PER MONTH, AND 13.6% FELT MENTALLY UNHEALTHY ON EIGHT OR MORE DAYS PER MONTH. IN 2014, THERE WAS A MODERATE DECREASE IN THE NUMBER OF PEOPLE THAT REPORTED POOR MENTAL HEALTH FOR 1-7 DAYS (18.7%) AND A SLIGHT INCREASE OF PEOPLE THAT REPORTED POOR MENTAL HEALTH 8 OR MORE DAYS PER MONTH (14.3%). SUBSTANCE ABUSE: aLCOHOL AND DRUGS IMPAIR DECISION-MAKING OFTEN LEADING TO ADVERSE CONSEQUENCES AND OUTCOMES. RESEARCH SUGGESTS THAT ALCOHOL IS A GATEWAY DRUG FOR YOUTH, LEADING TO INCREASED USAGE OF CONTROLLED SUBSTANCES IN ADULT YEARS. ACCORDINGLY, THE SUBSTANCE ABUSE VALUES AND BEHAVIORS OF STUDENTS IS A LEADING INDICATOR OF ADULT SUBSTANCE ABUSE IN LATER YEARS. dATA FROM THE 2014 ILLINOIS YOUTH SURVEY MEASURES ILLEGAL SUBSTANCE USE (ALCOHOL, TOBACCO, AND OTHER DRUGS - MAINLY MARIJUANA) AMONG ADOLESCENTS. LASALLE COUNTY IS AT OR ABOVE STATE AVERAGES IN ALL CATEGORIES AMONG 8TH GRADERS EXCEPT FOR ALCOHOL AND MARIJUANA. FOR 12TH GRADERS, LASALLE COUNTY IS AT OR ABOVE THE STATE IN ALL CATEGORIES. OVERALL TOBACCO USAGE IS ALSO A CONCERN IN LASALLE COUNTY.
Schedule h, part vi, line 3	The corporation informs and educateS patients and persons who are billed for patient care about their eligibility for assistance under government Programs and the corporation's financial assistance policy, in english and in any other language spoken by populations with limited english proficiency that constitute the lesser of 1,000 individuals or 5% of the community of the hospital, in the following Ways: -signs are posted in patient registration areas (including emergency Department registration) informing patients of the availability of Financial assistance, the availability of financial assistance counselors, and how to obtain a copy of the OSF financial assistance policy and application. -a plain language summary of the OSF Financial Assistance Policy is offered to patients as part of the intake or discharge process and included in the billing statement mailed prior to initiating extraordinary collection actions. In addition, the plain language summary and application are provided to referring staff physicians. -OSF makes reasonable efforts to orally notify patients about the financial assistance policy and how to obtain assistance in applying. -a notice of availability of the corporation's financial assistance and uninsured Patient discount policies is prominently available on the corporation's Web site. The application form with instructions and the plain language summary is available for Download. -a note regarding the availability of financial assistance (together with contact phone numbers) appears on every patient billing Statement as well as the website where copies of the policy, application and plain language summary may be obtained. -financial assistance counselors are available in person and by phone to Assist patients in completing the financial assistance Application and in determining eligibility and applying for government Program benefits, including Medicaid. -THE CORPORATION'S financial assistance POLICY IS FILED WITH THE ILLINOIS ATTORNEY GENERAL AND IS AVAILABLE TO THE PUBLIC.
Schedule h, part vi, line 4	Mendota Community Hospital dba OSF Saint Paul Medical Center is located in Lasalle County. Its population in 2014 was 111,241. For Lasalle County, the median household income from 2009-2013 Was $52,640 and the percent of persons below poverty level was 12.2%.
Schedule h, part vi, line 5	The corporation's sponsoring organization is a religious congregation of the Roman Catholic Church known as the sisters of the third order of Saint Francis. In accordance with canon law of the Roman Catholic Church And federal tax law applicable to supporting organizations, a majority of the members of the board of directors of the corporation are professed Members of the sponsoring religious congregation. Each hospital operated by the corporation has a community advisory board consisting of members of the community who are not directors, officers, or contractors of the Corporation. The corporation extends medical staff privileges to all qualified physicians in its communities. The corporation meets the requirements of revenue ruling 69-545 by: -operating an emergency department which is staffed 24 hours per day by Qualified physicians and other medical personnel and which are open to All persons without regard to ability to pay. -having a medical staff which ARE open to all qualified physicians, Mid-level providers, podiatrists, and dentists in the community (except where restricted in rare cases for clinical quality reasons by action of The medical staff and the board of directors). -accepting Medicare, Medicaid and other government program patients. Accepting all patients, including uninsured patients, without regard to their ability to pay. -USING SURPLUS FUNDS TO IMPROVE THEIR FACILITIES, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION, AND RESEARCH AS DESCRIBED ABOVE. mendota community hospital dba OSF Saint Paul medical center is involved in the community by providing health screening Booths at community events, performing wellness screenings at various Businesses in the community, and preparing and delivering meals to Community members in need with our meals on wheels program.
Schedule h, part vi, line 6	Affiliated health care system roles: The corporation is part of an affiliated health care system (the "osf HEALTHCARE system") which provides integrated health care services throughout central Illinois, parts of northern Illinois, and parts of the upper peninsula of Michigan. The OSF system includes the other corporations listed below, all of which are controlled, directly or indirectly, by the sisters of the third order of St. Francis (the "congregation"). all affiliated corporations (whether taxable or exempt) apply and follow the charity care policy of the corporation and are operated in furtherance of the mission of the congregation to provide comprehensive, integrated, quality care, including preventive, primary, acute, continuous and rehabilitative health services to the communities served by the corporation and the osf system. Special emphasis is placed on meeting the physical, spiritual, emotional, and social needs of everyone who is cared for in the OSF system regardless of race, color, religion and ability to pay. The affiliated corporations are: -The sisters of the third order of St. Francis, which holds the assets of the religious congregation and directs all other corporations in the affiliated health care system through board representation and the exercise of reserved powers. -OSF saint Francis, Inc., which provides home infusion and durable medical equipment services, mobile medical imaging services, medical equipment maintenance and repair services, medical staffing services, billing services, and other services in support of the affiliated health care system. -OSF Aviation, LLC, which is an FAA Part 135 certified carrier providing EMS helicopter services througHout Central Illinois and Parts of Northern Illinois. -OSF lifeline ambulance, llc, which provides ground ambulance transportation services in parts of northern Illinois. -OSF multispecialty group - Peoria, llc, which provides pediatric cardiology physician services in central Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group which is a separate corporation of which OSF Healthcare System is the sole member. -Illinois neurological institute - physicians, llc, which provides physician neurosurgery services in central Illinois effective until December 31, 2016. These providers and services after december 31, 2016 are provided under OSF Multi-specialty group. -Heartcare Midwest, ltd., which provides cardiology and cardiovascular surgery physician services in central illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -Cardiovascular institute at OSF, llc, which provides cardiology and cardiovascular surgery physician services in parts of northern Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -OSF multispecialty group - eastern region, llc, which provides primary and specialty physician services in parts of central Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -Illinois pathologist services, llc, which provides professional pathology services in parts of northern Illinois. -Illinois specialty physician services at OSF, llc, which provides pulmonology and critical care physician services in central Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -OSF perinatal associates, llc, which provides maternal fetal medicine physician services in central Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -OSF multispecialty group - western region, llc, which provides primary and specialty physician services in western Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -OSF children's medical group- congenital heart center, llc which provides pediatric care for cardiovascular illnesses in northern Illinois effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -Preferred emergency physicians of Illinois, llc which provides physician coverage for emergency departments effective until December 31, 2016. These providers and services after December 31, 2016 are provided under OSF multi-specialty group. -Saint Anthony physician group which provides a variety of general and specialty physicians services in Alton, Illinois.
Schedule h, part vi, line 7	IL

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN D SCHOEPLEIN
VICE CHAIRPERSON	$0	$1,037,970	$0	$719,984	$0	$81,114	$0	$36,850	$0	$14,366	$0	$1,890,284	$0	$0
GERALD J MCSHANE MD
BOARD MEMBER	$0	$576,571	$0	$156,839	$0	$43,066	$0	$36,850	$0	$12,958	$0	$826,284	$0	$0
JENNIFER JUNIS
PRESIDENT	$0	$116,956	$0	$48,253	$0	$6,367	$0	$5,039	$0	$11,024	$0	$187,639	$0	$0
DAWN TROMPETER
CFO	$0	$166,581	$0	$28,271	$0	$1,538	$0	$13,898	$0	$11,239	$0	$221,527	$0	$0
ALLEN U VAN MD
PHYSICIAN	$872,087	$0	$2,143	$0	$7,608	$0	$24,101	$0	$16,462	$0	$922,401	$0	$0	$0
ERIC A KIVISTO MD
PHYSICIAN	$429,660	$0	$0	$0	$2,074	$0	$10,600	$0	$15,590	$0	$457,924	$0	$0	$0
MARY M CHINN MD
PHYSICIAN	$355,497	$0	$111,480	$0	$20,571	$0	$27,918	$0	$11,801	$0	$527,267	$0	$0	$0
DAVID A SCHOLL MD
PHYSICIAN	$208,501	$0	$35,883	$0	$18,147	$0	$20,287	$0	$15,404	$0	$298,222	$0	$0	$0
AMY M MATHEIS-SOLIMAN MD
PHYSICIAN	$219,122	$0	$15,285	$0	$6,241	$0	$33,518	$0	$15,408	$0	$289,574	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Form Sch J Part I Line 3

THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERs OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMAnCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS, COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED.

Form Sch J Part I Line 4B

OSF HEALTHCARE SYSTEM HAS A DEFERRED COMPENSATION PLAN FOR SELECT KEY EXECUTIVES. THIS PLAN WAS DEVELOPED TO ASSIST WITH ATTRACTING AND RETAINING CERTAIN KEY EXECUTIVES IN THE CORPORATION. THE PLAN IS DESIGNED TO ENCOURAGE THE PARTICIPANTS TO STAY UNTIL A CERTAIN RETIREMENT DATE. IF THE PARTICIPAnTS TERMINATE PRIOR TO THEIR TARGET RETIREMENT DATE, THEY FORFEIT WHAT IS IN THE PLAN. THE CORPORATION DETERMINES THE REQUIRED DEPOSITS FOR THE PLAN AT A CONSOLIDATED LEVEL. DURING 2016, $412,000 IN DEPOSITS WERE MADE TO THE PLAN AND NO DISTRIBUTIONS WERE MADE TO THE PLAN.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990 PART I	The tax law requires that each legal entity within the OSF Healthcare System complete a separate tax return which appropriately reflects the activities and financial position of the particular organization. This reporting, however, is not reflective of the OSF Healthcare System as a whole. Please see the attached audited financial statements of OSF Healthcare System and Subsidiaries for a complete overview of the system. Form 990, Part I, Line 1 IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE. FORM 990 Part I Line 8 through Line 19 The 2015 Mendota Community Hospital Form 990 includes financial activity for a full fiscal year for the year ended September 30, 2016. However, the return also includes "comparative" financial information from the most recently filed return. The prior year return information will vary significantly from the current year amounts since the prior return was a "short period return" only reflecting six months of activity as a result of the organization's change in year-end so as to align with the year-end of OSF Healthcare System. Form 990 Part VI Line 1a DELEGATING BROAD AUTHORITY: BY ADOPTING CERTAIN PROVISIONS OF THE CORPORATE BYLAWS, THE BOARD OF DIRECTORS HAS DELEGATED BROAD AUTHORITY TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE BYLAWS PROVIDE THAT THE EXECUTIVE COMMITEE SHALL BE AUTHORIZED TO TAKE SUCH ACTION AS MAY BE NECESSARY ON BEHALF OF THE CORPORATION DURING PERIODS WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION. of OSF Healthcare System.
Form 990 Part VI Line 6	DESCRIPTION OF MEMBERS: OSF HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF MENDOTA COMMUNITY HOSPITAL.
Form 990 Part VI Line 7a	ELECTION OF BOARD MEMBERS: OSF HEALTHCARE SYSTEM AS A SOLE CORPORATE MEMBER OF Mendota Community Hospital HAS THE POWER TO ELECT MEMBERS OF THE BOARD.
Form 990 Part VI Line 7b	RESERVED POWERS: THE FOLLOWING POWERS ARE RESERVED FOR THE MEMBER: (A) TO ESTABLISH, APPROVE, OR MODIFY THE PHILOSOPHY, VISION, VALUES, AND MISSION ACCORDING TO WHICH THE CORPORATION OPERATES. (B) TO AMEND THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (C) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION. (D) TO MERGE OR CONSOLIDATE THE CORPORATION WITH OTHER ENTITIES OR TO DISSOLVE THE CORPORATION. (E) TO ACQUIRE AN INTEREST IN AN EXISTING ENTITY OR TO ESTABLISH A NEW ENTITY. (F) TO LEASE, SELL, ENCUMBER OR OTHERWISE ALIENATE ANY REAL PROPERTY OR INTEREST IN REAL PROPERTY OF THE CORPORATION. (G) TO APPROVE ANY TRANSFER, LEASE, SALE OR ENCUMBRANCE OF PERSONAL PROPERTY OF THE CORPORATION EXCEPT IN THE ORDINARY COURSE OF BUSINESS. (H) TO APPROVE ANY BORROWING OR DEBT FINANCING ON BEHALF OF THE CORPORATION. (I) TO APPOINT, DISCIPLINE, TERMINATE AND ReMoVE THE CORPORATION'S OPERATING DIVISION PRESIDENT. (J) TO APPOINT AND REMOVE THE CORPORATION'S CHAIRPERSON, VICE CHAIRPERSON(S), CHIEF EXECUTIVE OFFICER, PRESIDENT, SECRETARY, AND TREASURER, AND THE ASSISTANT SECRETARY AND ASSISTANT TREASURER, IF ANY. (K) TO APPROVE OR AMEND STRATEGIC PLANS, MANAGEMENT OBJECTIVES, AND CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. (L) TO APPROVE ANY PURCHASE OR OTHER AQUISITION BY THE CORPORATION THAT IS NOT INCLUDED IN ITS CAPITAL BUDGET AND EXCEEDS ONE MILLION DOLLARS ($1,000,000) PER ITEM. (M) TO NAME OR RENAME ANY HOSPITAL OR MEDICAL CENTER OWNED AND OPERATED BY THE CORPORATION. (N) TO REQUIRE A CERTIFIED AUDIT OF FINANCES OF THE CORPORATION AND TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANT TO PERFORM THE AUDIT. (O) TO APPROVE THE ENGAGEMENT OF AND TO DiSMISS ANY OUTSIDE LEGAL COUNSEL TO REPRESENT THE CORPORATION ON A REGULAR BASIS OR IN CONNECTION WITH ANY MATTER DEEMED BY THE MEMBER, IN GOOD FAITH, TO HAVE SIGNIFICANCE FOR THE CORPORATION AS A WHOLE. (P) TO GIVE PRELIMINARY APPROVAL PRIOR TO THE DEVELOPMENT OF, AND TO GIVE FINAL APPROVAL PRIOR TO THE EXECUTION OF, ALL DOCUMENTS TO WHICH THE CORPORATION IS OR WiLL BE A PARTY AND WHICH RELATE TO THE CREATION, FORMATION, ORGANIZATION, OR TERMINATION OF ANY OTHER LEGAL ENTITY (WHETHER A CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, OR ANY OTHER ENTITY) IN WHICH THE CORPORATION WILL HAVE ANY OWNERSHIP INTEREST, MEMBERSHIP INTEREST, POWER TO ELECT OR APPOINT BOARD MEMBERS OR OFFICERS, OR ANY OTHER FORMAL PARTICIPATION ARRANGEMENT, WHETHER ACTING ALONE OR IN CONJUNCTION WITH ANY OTHER PERSON OR ENTITY. (Q) TO TAKE ANY AND ALL ACTIONS DEEMED NECESSARY, IN THE SOLE JUDGEMENT OF THE MEMBER BOARD TO PROTECT AND PRESERVE THE TAX-EXEMPT STATUS AND PUBLIC CHARITY STATUS OF THE CORPORATION OR THE MEMBER AND ANY TAX-EXEMPT AFFILIATE OF THE CORPORATION OR THE MEMBER (INCLUDING FEDERAL AND STATE INCOME TAX EXEMPTIONS, PROPERTY TAX EXEMPTIONS, AND SALES TAX EXEMPTIONS); PROVIDED THE MEMBER BOARD HAS GIVEN A WRITTEN REQUEST TO THE BOARD TO TAKE ACTION OR REFRAIN FROM TAKING ACTION, WHICH WOULD HAVE SUFFICIENTLY PROTECTED AND PRESERVED SUCH TAX-EXEMPT AND PUBLIC CHARITY STATUS, AND THE BOARD HAS FAILED TO PROMPTLY TAKE SUCH ACTION OR REFRAIN FROM TAKING SUCH ACTION. FORM 990 PART VI SECTION A LINE 9 JAMES W. GIRARDY, M.D. 5666 EAST STATE STREET ROCKFORD, IL 61108
Form 990 Part VI Line 11b	REVIEW OF 990: THE PROPOSED FINAL VERSION OF THE 990 IS SENT VIA E-MAIL TO ALL OFFICERS AND MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ANY APPROPRIATE CHANGES REQUESTED BY THE OFFICERS AND DIRECTORS ARE THEN INCORPORATED INTO THE FINAL FORM 990 AND ALL SCHEDULES FOR FILING.
Form 990 Part VI Line 12c	COMPLIANCE WITH WRITTEN CONFLICT OF INTEREST POLICY: DISCLOSURES BY OFFICERS, DIRECTORS AND TRUSTEES, AS WELL AS KEY EMPLOYEES AND EMPLOYEES CHARGED WITH PURCHASING, PROCUREMENT AND CONTRACTION DECISION-MAKING ARE MADE THROUGH AN ELECTRONIC REPORTING SYSTEM. DISCLOSURES ARE RECEIVED AND REVIEWED BY THE CORPORATE COMPLIANCE DIVISION. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED, THEN THE DISCLOSING EMPLOYEE IS NOTIFIED OF THE POTENTIAL CONFLICT AND MAY BE ASKED FOR ADDITIONAL INFORMATION ABOUT THE INTEREST. THE CORPORATE COMPLIANCE DIVISION DETERMINES WHETHER A PLAN TO MANAGE A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS NEEDED, DISCUSSES THE MANGEMENT PLAN WITH THE EMPLOYEE AND MONITORS THE EMPLOYEE'S COMPLIANCE WITH THE PLAN. PLANS TO MANAGE CONFLICTS ARE TRACKED THROUGH THE ELECTRONIC DISCLOSURE SYSTEM.
Form 990 Part VI Line 15a	COMPENSATION DETERMINATION: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISION OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITEE. THE COMMITEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATION FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVEIWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXESS BENEFIT AMOUNT IS PAID OR FURNISHED.
Form 990 Part VI Line 15b	COMPENSATION DETERMINATION: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBER OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF SAINT FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMiTTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMAnCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHED THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED.
Form 990 Part VI Line 19	AVAILABLE TO PUBLIC: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
SISTERS OF THE THIRD ORDER OF STFRANCIS
800 NE GLEN OAK AVE	PEORIA	IL	61603	371259286	PARENT/SU ORG	IL	501(C)(3)	LN11 TYPEII	NA	false
OSF HEALTHCARE FOUNDATION
800 NE GLEN OAK AVE	PEORIA	IL	61603	371259284	SUPPORT ORG	IL	501(C)(3)	LN11 TYPEII	NA	false
ST FRANCIS COMMUNITY CLINIC
530 NE GLEN OAK AVE	PEORIA	IL	61637	370661235	FREE CLINIC	IL	501(C)(3)	ln7	SIS 3RD OSF	false
OTTAWA REGIONAL HOSP & HEALTHCARE CTR
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	362604009	HOSPITAL	IL	501(C)(3)	LN3	osf	false
OTTAWA REGIONAL HOSPITAL FOUNDATION
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	364007569	SUPPORT ORG	IL	501(C)(3)	LN11A TYPEI	orhhc	false
OSF MULTI-SPECIALTY GROUP
800 NE GLEN OAK AVE	PEORIA	IL	61603	383852646	HLTHCARE SVCS	IL	501(C)(3)	LN11A TYPEI	osf	false
OSF HEART & VASCULAR INSTITUTE
800 NE GLEN OAK AVE	PEORIA	IL	61603	352422385	HLTHCARE SVCS	IL	501(C)(3)	LN11A TYPEI	osf	false
CHILDREN'S HOSPITAL OF ILLINOIS MED GRP
800 NE GLEN OAK AVE	PEORIA	IL	61603	320353954	HLTHCARE SVCS	IL	501(C)(3)	LN11A TYPEI	osf	false
ILLINOIS NEUROSCIENCE INSTITUTE
800 NE GLEN OAK AVE	PEORIA	IL	61603	364709999	HLTHCARE SVCS	IL	501(C)(3)	LN11A TYPEI	osf	false
OSF HEALTHCARE SYSTEM
800 NE GLEN OAK AVE	PEORIA	IL	61603	370813229	HOSPITAL	IL	501(C)(3)	ln3	SIS 3RD OSF	false
SAINT ANTHONY'S PHYSICIAN GROUP
PO BOX 340	ALTON	IL	62002	371365059	HLTHCARE SVCS	IL	501(C)(3)	LN9	osf	false
SISTERS OF ST FRANCIS MARTYR ST GEORGE
1 FRANCISCAN WAY PO BOX 9020	ALTON	IL	62002	376034163	RELIGIOUS	IL	501(C)(3)	LN1	osf	false
IPMR
6501 N SHERIDAN ROAD	PEORIA	IL	61614	370681567	REHAB	IL	501(C)(3)	LN3	osf	false
OTTAWA REGIONAL HOSPITAL AUXILIARY
1100 EAST NORRIS DRIVE	PEORIA	IL	61350	363854788	SUPPORT ORG	IL	501(C)(3)	LN11A TYPEI	osf	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd
CENTER FOR HEALTH AMBULATORY SURGERY
8800 RTE 91 N	PEORIA	IL	61615	205557171	SURGICAL CENTER	IL	OSF	related	$0	$0	false	$0	Yes (true)
STATE AND ROXBURY LLC
1725 HUNTWOOD DR	CHERRY VALLEY	IL	61016	261728983	REAL ESTATE MGMT	IL	OSF	related	$0	$0	false	$0	Yes (true)
EASTLAND MEDICAL PLAZA SURGICENTER LLC
1505 EASTLAND DRIVE	BLOOMINGTON	IL	61701	371400643	SURGICAL CENTER	IL	OSF	related	$0	$0	false	$0	Yes (true)
FORT JESSE IMAGING CENTER LLC
2200 FT JESSE ROAD	NORMAL	IL	61761	460515604	MEDICAL IMAGING	IL	OSF	related	$0	$0	false	$0	Yes (true)
RADIATIO ONCOLOGY OF NORTHERN ILLINOIS
1200 STARFIRE DRIVE	OTTAWA	IL	61350	753247165	RADIATION ONCOLOG	IL	ORHHC	related	$0	$0	false	$0	Yes (true)
POINT CORE NETWORK SERVICES LLC
222 3RD AVE SE SUITE 500	CEDAR RAPIDS	IA	52401	465393141	IT SERVICES	IA	POINTCORE LLC	related	$0	$0	false	$0	Yes (true)
SAINT CLARE'S VILLA LIMITED PARTNERSHIP
915 EAST 5TH STREET	ALTON	IL	62002	371397289	LOW INC HOUSING	IL	osf	unrelated	$0	$0	false	$0	Yes (true)
FOX RIVER CANCER CENTER
1211 STARFIRE DRIVE	OTTAWA	IL	61350	870805865	ONCOLOGY	IL	ORHHC	related	$0	$0	false	$0	Yes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd
OSF SAINT FRANCIS INC
800 NE GLEN OAK AVE	PEORIA	IL	61603	363484677	HLTHCARe SVCS	IL	osf	C Corp	$0	$0	false
HEARTCARE MIDWEST LTD
5405 N KNOXVILLE AVENUE	PEORIA	IL	61614	370996868	CARDIOVASCULAR	IL	osf	C Corp	$0	$0	false
CARDIOVASCULAR INSTITUTE AT OSF LLC
444 ROXBURY ROAD	ROCKFORD	IL	61107	264225726	CARDIOVASCULAR	IL	osf	C Corp	$0	$0	false
ILLINOIS PATHOLOGIST SERVICES LLC
5666 EAST STATE STREET	ROCKFORD	IL	61108	800439081	PATHOLOGY SVCS	IL	osf	C Corp	$0	$0	false
OSF MULTISPECIALTY GRP-EASTERN REG LLC
1701 E COLLEGE AVENUE	BLOOMINGTON	IL	61704	300561892	MULTISPEC CLINIC	IL	osf	C Corp	$0	$0	false
OSF MULTISPECIALTY GROUP-PEORIA LLC
530 NE GLEN OAK AVENUE	PEORIA	IL	61637	262800379	PEDIATRIC CARDIOV	IL	osf	C Corp	$0	$0	false
ILLINOIS NEUROLOGICAL INSTITUTE-PHYLLC
719 N WILLIAM KUMPF BLVD	PEORIA	IL	61605	263109118	PEDIATRIC NEUROLO	IL	osf	C Corp	$0	$0	false
ILLINOIS SPEC PHY SVCS AT OSF LLC
1001 MAIN STREET	PEORIA	IL	61606	800462209	PULMONOLOGY	IL	osf	C Corp	$0	$0	false
OSF PERINATAL ASSOCIATES LLC
4911 EXECUTIVE DRIVE	PEORIA	IL	61614	800498373	MATERNAl FET MED	IL	osf	C Corp	$0	$0	false
OSF MULTISPECIALTY GR-WESTERN REGION
3315 NORTH SEMINARY STREET	GALESBURG	IL	61401	800608541	MULTISPEC CLINIC	IL	osf	C Corp	$0	$0	false
OSF CHILDREN'S MEDICAL GROUP-CONGENITAL
5701 STRATHMOOR DRIVE	ROCKFORD	IL	61107	900714643	PEDIATRIC CARDIOV	IL	osf	C Corp	$0	$0	false
PREFERRED EMERGENCY PHY OF ILLINOIS LLC
800 NE GLEN OAK AVENUE	PEORIA	IL	61603	900749855	EMERGENCY ROOM	IL	osf	C Corp	$0	$0	false
OTTAWA REG HEALTHCARE AFFILIATES INC
1100 EAST NORRIS DRIVE	OTTAWA	IL	61350	263937519	HOLDING COMPANY	IL	ORHHC	C Corp	$0	$0	false
OTTAWA REGIONAL MEDICAL CENTER INC
1614 EAST NORRIS DRIVE	OTTAWA	IL	61350	271036071	OUTPATIENT DIAG	IL	ORHHC	C Corp	$0	$0	false
ASSOC MED INSTITUTE CONDO ASSOC
6501 N SHERIDAN ROAD	PEORIA	IL	61614	371402305	CONDO ASSOC	IL	OSF	C CORP	$0	$0	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM SCH R PART III	FormAndLineReferenceDesc
Explanation	For purposes of completion, the related organizations listed below are taxable as a partnership. Center for Health Ambulatory Surgery Center, LLC 20-5557171 8800 Route 91 North, Peoria, IL 61615 State and Roxbury, LLC 26-1728983 1725 Huntwood Dr., Ste 400, Cherry Valley, IL 61016 Eastland Medical Plaza Surgicenter, LLC 37-1400643 1505 Eastland Drive, Bloomington, IL 61701 Fort Jesse Imaging Center, LLC 46-0515604 2200 Ft. Jesse Road, Suite B, Normal, IL 61761 Radiation Oncology of Northern Illinois, LLC 75-3247165 1200 Starfire Drive, Ottawa, IL 61350 Point Core Network Services, LLC 46-5393141 222 3rd Ave. S.E. Suite 500, Cedar Rapids, Iowa 52401 Saint Clare's Villa Limited Partnership 37-1397289 915 East 5th Street, Alton, IL 62002 Fox River Cancer Center 87-0805865 1211 Starfire Drive, Ottawa, IL 61350	ExplanationTxt