HSHS HOLY FAMILY HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- HSHS HOLY FAMILY HOSPITAL INC (EIN 37-0792770)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-24
- IRS object ID
- 201622379349300752
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-24T08:52:36-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370792770 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENVILLE REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREE | BusinessNameControlTxt |
| Phone | 6186641230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HEALTH CARE DRIVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622461156 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN NALL | PersonNm |
| Person Title | CHIEF OPERATING OFFICER | PersonTitleTxt |
| Phone | 6186641230 | PhoneNum |
| Signature | 2016-08-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF PARKER | PreparerPersonNm |
| PTIN | P00970069 | PTIN |
| Phone | 3149254300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN NALL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HEALTH CARE DRIVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622461156 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,381,500 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HSHSHOLYFAMILY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE COMPASSIONATE CARE AND EXCELLENT SERVICE IN A MODERN AND EFFICIENT HEALTHCARE ORGANIZATION STAFFED BY HIGHLY TRAINED PROFESSIONALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 432 | TotalEmployeeCnt |
| Total Volunteers | 520 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $95,689 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,471,975 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,295,577 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,340,153 | CYProgramServiceRevenueAmt |
| PY Investment Income | $51,869 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,481 | CYInvestmentIncomeAmt |
| PY Other Revenue | $715,050 | PYOtherRevenueAmt |
| CY Other Revenue | $493,389 | CYOtherRevenueAmt |
| PY Total Revenue | $34,158,185 | PYTotalRevenueAmt |
| CY Total Revenue | $33,335,998 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,113,077 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $78,107 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,132,984 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,572,112 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,552 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,309,611 | PYOtherExpensesAmt |
| CY Other Expenses | $16,237,883 | CYOtherExpensesAmt |
| PY Total Expenses | $35,555,672 | PYTotalExpensesAmt |
| CY Total Expenses | $33,888,102 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,397,487 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$552,104 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,017,907 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,089,217 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,461,936 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,104,309 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,555,971 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,984,908 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE COMPASSIONATE CARE AND EXCELLENT SERVICE IN A MODERN AND EFFICIENT HEALTHCARE ORGANIZATION STAFFED BY HIGHLY TRAINED PROFESSIONALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,706,843 | ExpenseAmt |
| Grant | $78,107 | GrantAmt |
| Revenue | $30,953,478 | RevenueAmt |
| Desc | GREENVILLE REGIONAL HOSPITAL IS A FULL-SERVICE, ACUTE CARE FACILITY OFFERING 42 LICENSED BEDS, A GERIATRIC BEHAVIORAL HEALTH UNIT, A 24-HOUR EMERGENCY DEPARTMENT, FAMILY BIRTH CENTER, SURGERY DEPARTMENT, REHABILITATION DEPARTMENT, SLEEP DISORDERS CENTER, OUTPATIENT PSYCHIATRIC/MENTAL HEALTH SERVICES, AND OUTPATIENT SPECIALTY CLINICS. DIAGNOSTIC SERVICES INCLUDE A LABORATORY, CARDIOPULMONARY DEPARTMENT, AND IMAGING SERVICES DEPARTMENT. THE HOSPITAL IS CERTIFIED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). IN ADDITION TO PROVIDING INPATIENT ACUTE CARE, GREENVILLE REGIONAL HOSPITAL OFFERS "SWING BEDS". MEDICARE PATIENTS QUALIFYING FOR TRANSITIONAL CARE CAN RECEIVE TREATMENT AT GREENVILLE REGIONAL THROUGH THE "SWING BED" PROGRAM. THE GERIATRIC BEHAVIORAL HEALTH UNIT IS A 10-BED INPATIENT UNIT INTENDED FOR SENIORS NEEDING MEDICATION ADJUSTMENT AND THERAPY PROGRAMS DESIGNED FOR BEHAVIORAL ISSUES. THE GERIATRIC BEHAVIORAL HEALTH UNIT SERVES SENIOR PATIENTS FROM A 150-MILE RADIUS. A PSYCHIATRIST DIRECTS THE CARE PROVIDED. WHITE OAKS SENIOR WELLNESS IS AN OUTPATIENT, GERIATRIC DAY-CARE PROGRAM INTENDED FOR PATIENTS DISCHARGED FROM A BEHAVIORAL HEALTH UNIT, OR THOSE EXPERIENCING BEHAVIORAL ISSUES. MEDICARE PATIENTS QUALIFYING FOR OUTPATIENT BEHAVIORAL HEALTH TREATMENTS CAN RECEIVE CARE THROUGH THE WHITE OAKS PROGRAM. BOND COUNTY EMERGENCY MEDICAL SERVICES IS BASED AT AND OPERATED BY THE HOSPITAL. THE SERVICE PROVIDES ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND THE ORGANIZATION HAS ALSO ACHIEVED "RESOURCE HOSPITAL" STATUS. SOME YEARS AGO, THE HOSPITAL WAS ASKED BY THE BOND COUNTY BOARD TO ASSUME OPERATION OF THE AMBULANCE SERVICE AND PROVIDE EMERGENCY MEDICAL TREATMENT AT THE SCENE AFTER IT BECAME APPARENT THAT A PRIVATE COMPANY COULD NO LONGER REMAIN OPERATIONAL. THE HOSPITAL EMERGENCY DEPARTMENT IS STAFFED 24-HOURS PER DAY BY A PHYSICIAN. FOUR MAJOR TRAUMA SUITES, THREE EXAMINATION ROOMS, A TRIAGE ROOM, AND AN IV THERAPY ROOM ARE LOCATED WITHIN THE DEPARTMENT. WHEN NEEDED, HELICOPTER AMBULANCE SERVICE IS AVAILABLE. IN 2015, 222 INFANTS WERE DELIVERED AT THE GREENVILLE REGIONAL FAMILY BIRTH CENTER. PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPY ARE OFFERED ON BOTH AN INPATIENT AND OUTPATIENT BASIS. THE HOSPITAL OUTPATIENT SPECIALTY CLINIC OFFERS 13 MEDICAL SPECIALTIES AND CONTAINS 13 EXAMINATION ROOMS. FOUR CLINICS CAN BE IN OPERATION SIMULTANEOUSLY. THE HOSPITAL MAY HOST AS MANY AS 100 CLINICS IN JUST 27 WORKING DAYS. THE HOSPITAL'S LABORATORY CAN PERFORM A WIDE ARRAY OF BLOOD, TISSUE, AND FLUID TESTING. THE IMAGING SERVICES DEPARTMENT OFFERS IN-HOUSE X-RAY, CAT SCAN, MRI, ULTRASOUND, NUCLEAR SCAN, BONE DENSITY, AND 3-D DIGITAL MAMMOGRAPHY TECHNOLOGY. MOBILE PET SCANS ARE ALSO AVAILABLE. THE HOSPITAL HAS THE CAPABILITY OF TRANSMITTING IMAGES TO ON-CALL RADIOLOGISTS FOR SCANS PERFORMED AFTER NORMAL BUSINESS HOURS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $309,667 | RevenueAmt |
| Desc | EMERALD POINTE IS AN INDEPENDENT, SENIOR LIVING DEVELOPMENT LOCATED ON THE HOSPITAL CAMPUS. THE DEVELOPMENT CONSISTS OF A 15-UNIT APARTMENT BUILDING, FIVE DUPLEX STRUCTURES, AND A SINGLE UNIT PROVIDING 11 RESIDENCES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $77,008 | RevenueAmt |
| Desc | THE ORGANIZATION OWNS AND OPERATES THREE CLINIC STRUCTURES ON THE HOSPITAL CAMPUS, A FOURTH CLINIC LOCATED ON THE SOUTH SIDE OF GREENVILLE, AND ANOTHER IN NEARBY POCAHONTAS, IL. ALL FACILITIES ARE CERTIFIED RURAL HEALTH CLINICS. THE CLINICS ARE UTILIZED BY PRIMARY CARE AND SPECIALTY PHYSICIANS, AS WELL AS MID-LEVEL PRACTITIONERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $28,706,843 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 432 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN NALL COO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6186641230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HEALTH CARE DRIVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 622461156 | 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 |
|---|---|---|---|---|---|---|---|---|
| JEFF MOLLET | ||||||||
| CHAIRMAN OF THE BOARD | 5.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOUG STROUD | ||||||||
| ASSISTANT TREASURER & SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LEONARD TAYLOR | ||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BART CALDIERARO | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BETTY IMBODEN | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSIE YORK | ||||||||
| TREASURER | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ERNIE CHAPPEL | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY GAFFNER | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE SUESS | ||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR KELSEY HOPKINS | ||||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | 1.00 | Yes (X) | $268,434 | $0 | $11,579 | ||
| BRIAN NALL | ||||||||
| COO | 40.00 | 2.00 | Yes (X) | $247,061 | $0 | $11,622 | ||
| MARK ENNEN | ||||||||
| DIRECTOR OF ACCOUNTING | 40.00 | 2.00 | Yes (X) | $95,668 | $0 | $7,310 | ||
| TAMMY LETT | ||||||||
| CNO | 40.00 | 2.00 | Yes (X) | $143,438 | $0 | $7,002 | ||
| DR MICHAEL SCHULTHEIS | ||||||||
| PHYSICIAN | 40.00 | 1.00 | $380,656 | $0 | $3,458 | Yes (X) | ||
| DR BOYD MCCRACKEN | ||||||||
| PHYSICIAN | 40.00 | 1.00 | $290,136 | $0 | $11,069 | Yes (X) | ||
| DR RICHARD FUNNEMAN | ||||||||
| PHYSICIAN | 40.00 | 1.00 | $228,890 | $0 | $12,041 | Yes (X) | ||
| DR PHILIP SIEFKEN | ||||||||
| PHYSICIAN | 40.00 | 1.00 | $231,084 | $0 | $12,164 | Yes (X) | ||
| STEVEN DONNAN | ||||||||
| CRNA | 40.00 | 1.00 | $219,614 | $0 | $8,875 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,104,981 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $85,120 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ILLIANA EMERGENCY PHYSICIANS | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | ER PHYSICIAN SERVICES | $1,295,975 |
| APEXNETWORK PHYSICAL THERAPY | |||||
| 15 APEX DR | HIGHLAND | IL | 62249 | THERAPY SERVICES | $968,077 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 72651 | PROVIDES OB DOCTOR COVERAGE | $229,495 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 14730 | ST LOUIS | MO | 63150 | REFERENCE LABS | $215,836 |
| SPECIALCARE HOSPITAL MANAGMENT | |||||
| 1551 WALL ST SUITE 210 | ST CHARLES | MO | 63303 | NEW VISION MEDICAL STABILIZATION SVCS | $164,876 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,410,943 | RelatedOrganizationsAmt |
| Government Grants | $34,039 | GovernmentGrantsAmt |
| All Other Contributions | $26,993 | AllOtherContributionsAmt |
| Total Contributions | $1,471,975 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUES | 621110 | $29,588,903 | $29,588,903 |
| PHARMACEUTICALS | 446110 | $1,201,236 | $1,201,236 |
| SENIOR LIVING | 623000 | $309,667 | $309,667 |
| EHR REIMBURSEMENTS | 621110 | $163,339 | $163,339 |
| CLINIC | 621110 | $77,008 | $77,008 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,340,153 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,625 | TotalRevenueColumnAmt |
| Exclusion | $63,625 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $250 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $250 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $250 | TotalRevenueColumnAmt |
| Exclusion | $250 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $12,358 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,502 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$33,144 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$33,144 | TotalRevenueColumnAmt |
| Exclusion | -$33,144 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| GIFT SHOP | 453220 | $335,775 | $335,775 |
| CAFETERIA | 722210 | $138,946 | $138,946 |
| MISCELLANEOUS INCOME | 624100 | $18,418 | $18,418 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $493,139 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,335,998 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,340,153 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $523,870 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,107 | TotalAmt |
| Program Services | $78,107 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $779,039 | TotalAmt |
| Program Services | $297,899 | ProgramServicesAmt |
| Management And General | $477,588 | ManagementAndGeneralAmt |
| Fundraising | $3,552 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,434,021 | TotalAmt |
| Program Services | $11,289,505 | ProgramServicesAmt |
| Management And General | $2,144,516 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,411 | TotalAmt |
| Program Services | $118,837 | ProgramServicesAmt |
| Management And General | $22,574 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,266,644 | TotalAmt |
| Program Services | $1,904,812 | ProgramServicesAmt |
| Management And General | $361,832 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $950,997 | TotalAmt |
| Program Services | $799,186 | ProgramServicesAmt |
| Management And General | $151,811 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,384 | TotalAmt |
| Management And General | $144,384 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,993 | TotalAmt |
| Management And General | $79,993 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,338 | TotalAmt |
| Program Services | $16,338 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,546,329 | TotalAmt |
| Program Services | $4,920,352 | ProgramServicesAmt |
| Management And General | $625,977 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,645 | TotalAmt |
| Program Services | $145,085 | ProgramServicesAmt |
| Management And General | $27,560 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,212,099 | TotalAmt |
| Program Services | $3,539,708 | ProgramServicesAmt |
| Management And General | $672,391 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,181 | TotalAmt |
| Program Services | $223,690 | ProgramServicesAmt |
| Management And General | $42,491 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,635,373 | TotalAmt |
| Program Services | $1,374,313 | ProgramServicesAmt |
| Management And General | $261,060 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,862 | TotalAmt |
| Program Services | $71,315 | ProgramServicesAmt |
| Management And General | $13,547 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,501 | TotalAmt |
| Management And General | $24,501 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $391,185 | TotalAmt |
| Program Services | $328,739 | ProgramServicesAmt |
| Management And General | $62,446 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,834,300 | TotalAmt |
| Program Services | $1,834,300 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,231 | TotalAmt |
| Program Services | $220,370 | ProgramServicesAmt |
| Management And General | $41,861 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROVISION FOR BAD DEBT | $1,422,284 | $1,422,284 | |
| DUES/ FEES | $98,870 | $83,087 | $15,783 |
| MISCELLANEOUS | $46,308 | $38,916 | $7,392 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,888,102 | TotalAmt |
| Program Services | $28,706,843 | ProgramServicesAmt |
| Management And General | $5,177,707 | ManagementAndGeneralAmt |
| Fundraising | $3,552 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,722 | BOYAmt |
| EOY | $39,550 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,930,276 | BOYAmt |
| EOY | $1,262,243 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,560,884 | BOYAmt |
| EOY | $5,296,605 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $508,066 | BOYAmt |
| EOY | $492,931 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,246 | BOYAmt |
| EOY | $363,920 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $43,019,384 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,409,369 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,431,038 | BOYAmt |
| EOY | $17,610,015 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190,565 | BOYAmt |
| EOY | $915,754 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,110 | BOYAmt |
| EOY | $108,199 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,017,907 | BOYAmt |
| EOY | $26,089,217 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,896,538 | BOYAmt |
| EOY | $3,245,648 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,398 | BOYAmt |
| EOY | $348,655 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,001,266 | BOYAmt |
| EOY | $7,490,713 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,939 | BOYAmt |
| EOY | $151,084 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,886,795 | BOYAmt |
| EOY | $2,868,209 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,461,936 | BOYAmt |
| EOY | $14,104,309 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,543,312 | BOYAmt |
| EOY | $11,979,963 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,659 | BOYAmt |
| EOY | $4,945 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,555,971 | BOYAmt |
| EOY | $11,984,908 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,017,907 | BOYAmt |
| EOY | $26,089,217 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$552,104 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$18,959 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $16,338 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $16,338 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING COSTS WERE FROM THE FOLLOWING MEMBERSHIPS: IHA DUES, AHA DUES AND MCHC DUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,170,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,719,593 | DepreciationAmt |
| Book Value | $15,450,617 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,770,677 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,689,776 | DepreciationAmt |
| Book Value | $2,080,901 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $78,497 | OtherCostOrOtherBasisAmt |
| Book Value | $78,497 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,610,015 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $364,258 |
| DUE TO THIRD PARTY PAYORS | $1,370,025 |
| LIFE RESIDENCY FEES | $1,133,926 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,868,209 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CONSOLIDATED AFFILIATES ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, THUS THERE IS NO PROVISION FOR INCOME TAXES AT DECEMBER 31, 2015 AND 2014. THE HOSPITAL APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE HOSPITAL DOES NOT CURRENTLY INCLUDE AN INCOME TAX PROVISION IN THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT MONITORS THE REPORTING OF UNCERTAIN TAX POSITIONS, WHICH COULD RESULT IN RECORDING OF AN INCOME TAX PROVISION IN THE FUTURE. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $143,856 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $143,856 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,257,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,831,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,426,898 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07480 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,401,801 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,831,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,570,754 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07920 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3310 | PersonsServedCnt |
| Total Community Benefit Expns | $93,774 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $143,452 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$49,678 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 15 | PersonsServedCnt |
| Total Community Benefit Expns | $18,046 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 34491 | PersonsServedCnt |
| Total Community Benefit Expns | $5,843,999 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,525,140 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,318,859 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,987 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $42,987 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 37816 | PersonsServedCnt |
| Total Community Benefit Expns | $5,998,806 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,668,592 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,330,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04250 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 37816 | PersonsServedCnt |
| Total Community Benefit Expns | $11,400,607 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,499,639 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,900,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,422,284 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $55,588 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,288,240 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,097,541 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,809,301 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | GREENVILLE REGIONAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HEALTHCARE DRIVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENVILLE REGIONAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GREENVILLEREGIONALHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.GREENVILLEREGIONALHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.GREENVILLEREGIONALHOSPITAL.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.GREENVILLEREGIONALHOSPITAL.COM | FAPSummaryOnWebsiteURLTxt |
| 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GREENVILLE REGIONAL HOSPITAL | PART V, SECTION B, LINE 5: THE NEEDS ASSESSMENT SOUGHT INPUT FROM PERSONS WITH KNOWLEDGE OF THE SPECIFIC HEALTH CONCERNS OF THE COMMUNITY. INPUT WAS ALSO SOUGHT FROM MEMBERS OF THE COMMUNITY CHARGED PROFESSIONALLY WITH ADVANCING THE HEALTH AND EDUCATION OF THE COMMUNITY AND ALL ITS MEMBERS, INCLUDING SCHOOL OFFICIALS AND FAMILIES. A SERIES OF THREE FOCUS GROUPS WERE HELD. SPECIFIC EXAMPLES INCLUDE: PHYSICIANS, REPRESENTATIVES FROM THE BOND COUNTY HEALTH DEPARTMENT, THE GREENVILLE MAYOR, 911 COORDINATOR, COUNTY OFFICIALS, REPRESENTATIVES FROM THE LIONS CLUB, BUSINESS OWNERS, AND OTHERS. |
| GREENVILLE REGIONAL HOSPITAL | PART V, SECTION B, LINE 11: ESTABLISHED A WALK-IN CLINIC, AMONG OTHER GOALS MET. HAVE BEEN UNSUCCESSFUL RECRUITING FAMILY PRACTICE PHYSICIANS. SEVERAL HAVE INTERVIEWED BUT NONE HAVE COMMITTED FOR VARIOUS REASONS. EFFORTS CONTINUE. |
| GREENVILLE REGIONAL HOSPITAL | PART V, SECTION B, LINE 13H: STATE REGULATION |
| GREENVILLE REGIONAL HOSPITAL | PART V, SECTION B, LINE 16I: IN ADDITION TO THE ABOVE, A PLAIN LANGUAGE SUMMARY OF THE FAP IS SENT WITH EACH BILLING STATEMENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - GRH MEDICAL GROUP - MOB B | ||||
| 150 HEALTH CARE DRIVE | GREENVILLE | IL | 62246 | OB/GYN PHYSICIAN CLINIC |
| 2 - GRH MEDICAL GROUP - MOB A | ||||
| 101 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | FAMILY PRACTICE PHYSICIAN CLINIC |
| 3 - GRH MEDICAL GROUP - MOB C | ||||
| 201 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | FAMILY PRACTICE PHYSICIAN CLINIC |
| 4 - EMERALD POINTE | ||||
| 105 HONEY LOCUST LANE | GREENVILLE | IL | 62246 | INDEPENDENT LIVING FACILITY |
| 5 - CONVENIENT CARE | ||||
| 1345 S ROUTE 127 | GREENVILLE | IL | 62246 | WALK IN CLINIC STAFFED BY A NURSE PRACTITIONER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE UTLAUT MEMORIAL FOUNDATION'S ANNUAL REPORT CONTAINS THE COMMUNITY BENEFIT INFORMATION. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO SHOWN IN THE MEDICARE COST REPORT IS APPLIED TO THE GROSS AMOUNTS FOR CHARITY, MEDICAID, ETC. TO DETERMINE THE TRUE COST OF THESE PROGRAMS. FOR THE OTHER SUBSIDIZED PROGRAMS, SOME COSTS ARE ESTIMATED BASED ON CERTAIN ALLOCATIONS: SQUARE FOOTAGE, STATISTICS, STAFF TIME, SUPPLIES USED, AND OTHER VARIOUS FACTORS. |
| PART I, LINE 7G: | THE SERVICE OF PHYSICIAN PRACTICE OPERATIONS INCLUDES COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. SOME OF THE COSTS INCLUDED IN THIS SUBSIDIZED SERVICE ARE SALARIES, BENEFITS, SUPPLIES, OUTSOURCED PHYSICIAN FEES, AND OTHER VARIOUS EXPENSES. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,422,284. |
| PART III, LINE 2: | THE ORGANIZATION APPLIES THE COST TO CHARGE RATIO FROM THE MOST RECENTLY FILED MEDICARE COST REPORT TO ITS AMOUNT OF GROSS BAD DEBT EXPENSE, PER THE GENERAL LEDGER. THIS METHODOLOGY CONVERTS THE GROSS AMOUNT TO NET COST. DISCOUNTS AND PAYMENTS ARE APPLIED TO THE ACCOUNT BEFORE ESTABLISHING THE GROSS BAD DEBT EXPENSE. |
| PART III, LINE 3: | THE COST TO CHARGE RATIO FROM THE MOST RECENT MEDICARE COST REPORT IS APPLIED TO THE ORGANIZATION'S BAD DEBT EXPENSE FOR THE FISCAL YEAR. THE ORGANIZATION EMPLOYS A FINANCIAL COUNSELOR THAT WORKS WITH ALL SELF-PAY PATIENTS. BASED ON REVIEW OF TAX RETURNS, BANK STATEMENTS, AND OTHER FINANCIAL DOCUMENTS PROVIDED BY THE PATIENT, AN ESTIMATE EQUAL TO 10% OF BAD DEBT PATIENTS WOULD QUALIFY FOR CHARITY CARE BUT FAILED TO PROVIDE THE APPROPRIATE LEVEL OF DOCUMENTATION AND INFORMATION. |
| PART III, LINE 4: | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WITHIN 15 DAYS AFTER BILLING. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT AFTER 90 DAYS. AT DECEMBER 31, 2015 AND 2014, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $1,658,000 AND $1,734,000, RESPECTIVELY. DURING FISCAL YEAR 2015, THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM AN AVERAGE OF 75% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2014 TO AN AVERAGE OF 69% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2015. IN ADDITION, THE HOSPITAL'S SELF-PAY WRITE-OFFS DECREASED APPROXIMATELY $321,000 FROM $1,743,000 FOR FISCAL YEAR 2014 TO $1,422,000 FOR FISCAL YEAR 2015. |
| PART III, LINE 8: | THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT IS UTILIZED IN DETERMINING THE ORANIZATION'S COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY INCLUDES A "PRESUMPTIVE ELIGIBILITY" SECTION. THE ORGANIZATION MAY DEEM A PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE WITHOUT ADDITIONAL SCRUTINY. THE PATIENT MUST DEMONSTRATE ONE OR MORE OF THE FOLLOWING TO MEET PRESUMPTIVE ELIGIBILITY CRITERIA: HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO REPRESENTATIVE, MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE OR FOR NON-COVERED SERVICE, INCARCERATION. IF THE PATIENT MEETS THE PRESUMPTIVE ELIGIBILITY CRITERIA OR IF THE PATIENT'S FAMILY INCOME IS BELOW THE FEDERAL POVERTY GUIDELINES, THE PATIENT IS NOT REQUIRED TO PROVIDE MONTHLY EXPENSE INFORMATION OR ESTIMATED EXPENSE FIGURES. |
| PART VI, LINE 2: | GREENVILLE REGIONAL HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES USING A VARIETY OF FORMAL AND INFORMAL METHODS. NRC PICKER SURVEYS WERE UTILIZED TO MONITOR THE QUALITY OF SERVICES PROVIDED AT THE HOSPITAL. FEEDBACK REGARDING HEALTH CARE NEEDS IS RECEIVED CONTINUALLY FROM FREQUENT INTERACTION AND ENCOUNTERS WITHIN THE COMMUNITY. SERVING A CLOSELY-KNIT AREA, GREENVILLE REGIONAL HOSPITAL'S MANAGEMENT TEAM IS INVOLVED IN MANY COMMUNITY CLUBS, ORGANIZATIONS, CHURCHES, TEAMS, AND COMMITTEES. THE BOARD OF DIRECTORS REPRESENTS A DIVERSE, CROSS SECTION OF THE COMMUNITY. BOARD MEMBERS RECEIVE AND SHARE COMMENTS RELATED TO HEALTH CARE NEEDS AND NEW SERVICES DESIRED. IN ADDITION, AN EVALUATION FORM IS SENT TO EACH "HEALTH FAIR" PARTICIPANT. THESE INDIVIDUALS ARE AFFORDED THE OPPORTUNITY TO PROVIDE FEEDBACK REGARDING THE EVENT AND THEIR NEED FOR LOW COST HEALTH SCREENINGS AND TESTING. ANY HEALTH TRENDS DETECTED THROUGH THE TESTING OFFERED AT THE HEALTH FAIR CAN BE ASSESSED AND USED TO SHAPE SERVICES PROVIDED BY THE HOSPITAL. MONTHLY MEDICAL STAFF MEETINGS OFFER PHYSICIANS THE OPPORTUNITY TO INTERACT WITH HOSPITAL MANAGEMENT AND DISCUSS SERVICES NEEDED BY THEIR PATIENTS. A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2013 AND ANOTHER WILL BE COMPLETED IN 2016. |
| PART VI, LINE 3: | THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO WORKS WITH ALL SELF-PAY PATIENTS. THE COUNSELOR ASSESSES THE PATIENTS FINANCIAL POSITION AND WILL ASSIST THE PATIENT IN COMPLETING THE NECESSARY PAPERWORK TO APPLY FOR MEDICAID OR CHARITY CARE ASSISTANCE (IF APPLICABLE). |
| PART VI, LINE 4: | GREENVILLE REGIONAL HOSPITAL SERVES THE RESIDENTS OF BOND COUNTY AND THE SURROUNDING FOUR COUNTIES (FAYETTE, CLINTON, MONTGOMERY, AND MADISON). THE HOSPITAL HAS A PRIMARY MARKET AREA CONSISTING OF APPROXIMATELY 20,000 INDIVIDUALS. THE MARKET AREA INCLUDES AN ABOVE AVERAGE NUMBER OF SENIOR CITIZENS. RESIDENTS OVER THE AGE OF 55 ACCOUNT FOR 28 PERCENT OF THE HOSPITAL'S PRIMARY MARKET. THE MARKET AREA IS RURAL IN ITS COMPOSITION. THE AGRICULTURAL ECONOMY IS SIGNIFICANT WITHIN THE AREA. SOME MANUFACTURING DOES EXIST IN THE LOCAL COMMUNITIES. MEDICARE, MEDICAID, AND UNCOMPENSATED CARE PATIENTS COMPRISE A MAJORITY OF THOSE SERVED BY THE HOSPITAL. THE INCOME LEVELS OF THE MARKET AREA ARE NOT HIGH. MANY OF THE RESIDENTS IN THE REGION RELY ON THE HOSPITAL TO PROVIDE ROUTINE DIAGNOSTIC SERVICES SUCH AS LAB AND IMAGING SERVICES. THE HOSPITAL IS THE PRIMARY SOURCE OF AMBULANCE, EMERGENCY, AND REHABILITATION SERVICES. GREENVILLE REGIONAL IS THE ONLY FACILITY IN THE COUNTY, AND ONE OF ONLY TWO HOSPITALS IN THE AREA, THAT PROVIDES OBSTETRICAL SERVICES. THE NEXT CLOSEST OB UNIT WOULD REQUIRE A MINIMUM DRIVE TIME OF 30 MINUTES. THE HOSPITAL PROVIDES INFANT DELIVERY SERVICES FOR PATIENTS SPANNING AN 80 MILE RADIUS. GREENVILLE REGIONAL HOSPITAL IS THE LARGEST EMPLOYER IN BOND COUNTY WITH APPROXIMATELY 375 FULL-AND PART-TIME EMPLOYEES. THE FACILITY'S ANNUAL PAYROLL IS APPROXIMATELY $14.3 MILLION WITHOUT BENEFITS AND 18.1 MILLION WITH BENEFITS. THE HOSPITAL'S ECONOMIC IMPACT EXCEEDS $74 MILLION. |
| PART VI, LINE 5: | GREENVILLE REGIONAL HOSPITAL, AND ITS AFFILIATED DIVISIONS, EXISTS ONLY TO PROVIDE HEALTH CARE SERVICES FOR RESIDENTS OF THE AREA. IN 2015, THE HOSPITAL'S COMMUNITY BENEFIT TOTAL WAS DETERMINED TO BE APPROXIMATELY $4 MILLION. THE HOSPITAL IS INTENTIONALLY STRUCTURED AS A NOT-FOR-PROFIT ORGANIZATION IN THAT ITS ONLY PURPOSE IS TO SERVE OTHERS. NO SINGLE INDIVIDUAL OR GROUP OF INVESTORS PROFITS FROM THE ACTIVITIES OF THE HOSPITAL. AS IS EVIDENT BY THE FINANCIAL LOSSES REPORTED IN THIS DOCUMENT, THE HOSPITAL BOARD OF DIRECTORS IS COMMITTED TO SERVING THE HEALTH CARE NEEDS OF THE REGION. MEDICAL SERVICES CRITICAL TO THE HEALTH AND WELL-BEING OF THOSE SERVED BY THE HOSPITAL ARE PROVIDED EVEN THOUGH THE REVENUES GENERATED MAY NOT COVER THE OPERATIONAL COSTS. THE HOSPITAL'S NOT-FOR-PROFIT" STATUS IS VITAL TO THE ORGANIZATION'S EXISTENCE. GREENVILLE REGIONAL ADHERES TO A "NON-DISCRIMINATION TREATMENT POLICY". REGARDLESS OF A PATIENT'S FINANCIAL OR HEALTH INSURANCE STATUS, CARE IS PROVIDED. NO PATIENT IS REFUSED TREATMENT BASED UPON THEIR ABILITY TO PAY. GREENVILLE REGIONAL HOSPITAL FUNDS ITS OWN "HEALTH CARE ASSISTANCE PROGRAM". IN 2015, $141,270 IN CHARITY ASSISTANCE (AT COST) WAS PROVIDED TO PATIENTS WHO QUALIFIED FOR BILLING REDUCTIONS UP TO 100 PERCENT. INCOME GUIDELINES AND FAMILY SIZE ARE USED TO DETERMINE ELIGIBILITY FOR THIS SELF-FUNDED PROGRAM. OBSTETRICAL PATIENTS FROM A WIDE GEOGRAPHICAL RADIUS USE THE GREENVILLE REGIONAL OBSTETRICAL DEPARTMENT. GREENVILLE REGIONAL IS ONE OF ONLY TWO HOSPITALS IN THE IMMEDIATE AREA THAT PROVIDE INFANT DELIVERY SERVICES. AN ANNUAL LOSS ASSOCIATED WITH PROVIDING INFANT DELIVERIES HAS BECOME AN EXPECTED PRACTICE. THE HOSPITAL'S BOARD OF DIRECTORS HAS ACCEPTED THE LOSS AS A RESULT OF THE PAYER MIX AND THE LACK OF OBSTETRICAL SERVICES WITHIN THE AREA. SIX OF EVERY TEN BIRTHS AT THE HOSPITAL ARE OF MEDICAID STATUS. THE STATE OF ILLINOIS MEDICAID PROGRAM DOES NOT MEET THE COST OF PROVIDING CARE. THE BOARD OF DIRECTORS BELIEVES THAT THE AVAILABILITY OF INFANT DELIVERY SERVICES IS VITALLY IMPORTANT FOR THE HEALTH AND WELL BEING OF THE MULTI-COUNTY AREA SERVED BY THE HOSPITAL. THE HOSPITAL-OWNED FAMILY, OB/GYN, PSYCHIATRIC, SPORTS MEDICINE, ONCOLOGY, PULMONOLOGY, AND SURGERY PRACTICES EXPERIENCED A LOSS OF $1.4M IN 2015. DURING THE 2014 FISCAL YEAR, THE OPERATIONAL LOSS AT FAIR OAKS NURSING HOME WAS $178K. BOND COUNTY EMERGENCY MEDICAL SERVICES IS OPERATED BY THE HOSPITAL AND REPRESENTS A UNIQUE PRIVATE-PUBLIC PARTNERSHIP. GREENVILLE REGIONAL HOSPITAL IS A "COMMUNITY RESOURCE" THAT IMPROVES THE HEALTH AND QUALITY OF LIFE FOR THOSE RESIDING IN THE AREA. IN ADDITION TO THE AVAILABILITY OF EMERGENCY, DIAGNOSTIC, TREATMENT, AND REHABILITATION SERVICES, GREENVILLE REGIONAL HOSPITAL OFFERS NO-COST LANGUAGE TRANSLATION FOR PATIENTS IN NEED OF THIS SERVICE. THE HOSPITAL OWNS A MEDICAL CLINIC IN A SMALL, NEIGHBORING COMMUNITY. THIS MEDICAL OFFICE SAVES TIME AND COST FOR MANY WHO WOULD HAVE TO DRIVE GREATER DISTANCES TO RECEIVE PRIMARY CARE. THE FACILITY IS A CERTIFIED RURAL HEALTH CLINIC. MID LEVEL PRACTITIONERS AND PHYSICIANS STAFF THE OUTREACH FACILITY. FOR THE PAST 30 YEARS, GREENVILLE REGIONAL HOSPITAL HAS SPONSORED A MULTI-FACETED HEALTH FAIR. THE EVENT IS ONE OF THE LARGEST HEALTH FAIRS IN THE ST. LOUIS METROPOLITAN AREA. THE EVENT FEATURES MANY FREE HEALTH TESTS IN ADDITION TO FOUR, LOW-COST COMPREHENSIVE BLOOD TESTS. IN 2015, APPROXIMATELY 2,800 BLOOD TESTS WERE PERFORMED IN CONJUNCTION WITH THE HEALTH FAIR. THE PARTICIPANTS RECEIVE THE DIRECT COMMUNITY BENEFIT OF THE FREE AND REDUCED PRICE TESTING OFFERED BY THE HOSPITAL. PARTICIPANTS COULD CHOOSE FROM A COMPREHENSIVE BLOOD TEST, PROSTATE SPECIFIC ANTIGEN BLOOD TEST (PSA), HEMOGLOBIN A1-C, VITAMIN D BLOOD TEST, OR A COMBINATION OF THE FOUR BLOOD TESTS. THE OPPORTUNITY COST INCURRED BY GREENVILLE REGIONAL HOSPITAL FOR OFFERING THESE DISCOUNTED SERVICES WAS $1,332,935. THE ORGANIZATION CONSIDERS THE OPPORTUNITY COST AS THE REDUCTION IN REVENUE THAT WOULD HAVE BEEN RECEIVED HAD THE HEALTH FAIR TESTING BEEN PROVIDED AT TYPICAL RETAIL PRICING. MORE THAN 250 VOLUNTEERS ASSIST WITH THE EVENT. IN ADDITION TO THE SERVICES PROVIDED ON THE DAY OF THE HEALTH FAIR, THE HOSPITAL ALSO PERFORMS THE LOW-COST BLOOD TESTS AT SEVERAL OFF-SITE LOCATIONS FOR THE EMPLOYEES OF AREA SCHOOLS, BUSINESSES, AND MANUFACTURERS. THROUGH THE YEARS, A NUMBER OF LIFE-THREATENING AND SERIOUS MEDICAL CONDITIONS HAVE BEEN DISCOVERED BY TESTING PERFORMED IN ASSOCIATION WITH THE EVENT. THE $964,820 VIOLA THOMPSON SCHOLARSHIP FUND, ADMINISTERED BY GREENVILLE REGIONAL HOSPITAL, PROVIDES TUITION ASSISTANCE FOR INDIVIDUALS PURSUING A HEALTH OR MEDICAL CAREER. IN 2015, SCHOLARSHIPS TOTALING $18K WERE AWARDED. NURSING STUDENTS, MEDICAL STUDENTS, PHYSICIAN RESIDENTS, AND GREENVILLE COLLEGE PSYCHOLOGY STUDENTS UTILIZE THE HOSPITAL FACILITY FOR TRAINING AND LEARNING OPPORTUNITIES. THE HOSPITAL IS OFFERED AS A TRAINING SITE AT NO COST TO THE STUDENTS. THE HOSPITAL IS ALSO THE SITE OF REGULARLY SCHEDULED BLOOD COLLECTION DRIVES. THESE ORGANIZATIONS ARE NOT CHARGED FOR USE OF THE HOSPITAL. THE LEMUAL RHODES CANCER FUND BOARD OF DIRECTORS MEETS AT THE HOSPITAL AND AWARDS FUNDING TO PATIENTS UNDERGOING TREATMENT FOR CANCER. RETIRED TEACHERS, COMMUNITY CLUBS, AND ORGANIZATIONS MEET AT THE HOSPITAL. TWO SCOREBOARDS LOCATED AT THE LOCAL HIGH SCHOOL ARE CO-SPONSORED BY THE HOSPITAL. GREENVILLE REGIONAL HOSPITAL SUPPORTS VARIOUS COMMUNITY ORGANIZATIONS AND ACTIVITIES THAT PROMOTE HEALTHY LIFESTYLES AND WORK TO IMPROVE QUALITY OF LIFE ISSUES.GREENVILLE REGIONAL HOSPITAL HAS A STRONG AND VIBRANT RELATIONSHIP WITH A NUMBER OF PUBLIC, PRIVATE, AND MEDICAL PROVIDERS WHO PARTNER WITH THE ORGANIZATION DURING THE YEAR. THE COOPERATING AGENCIES ASSIST WITH BOTH ON-GOING, AS WELL AS SPECIAL PROJECTS. THE HOSPITAL PARTNERS WITH COUNTY GOVERNMENT TO OPERATE BOND COUNTY EMERGENCY MEDICAL SERVICES. FINALLY, NUMEROUS MEDICAL PROVIDERS AND ORGANIZATIONS WITH VARIOUS SPECIALTIES PARTICIPATE IN THE ANNUAL GREENVILLE REGIONAL HOSPITAL HEALTH FAIR. |
| PART VI, LINE 6: | THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENVILLE REGIONAL HEALTHCARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HEALTH CARE DRIVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 371139987 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $78,107 | CashGrantAmt |
| Purpose Of Grant | HOSPITAL/AUXILIARY ACTIVITY | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S GENERAL LEDGER PROGRAM MONITORS TRANSACTIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR KELSEY HOPKINS | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $267,197 | $0 | $0 | $0 | $1,237 | $0 | $5,019 | $0 | $6,560 | $0 | $280,013 | $0 | $0 | $0 |
| BRIAN NALL | ||||||||||||||
| COO | $245,075 | $0 | $0 | $0 | $1,986 | $0 | $4,566 | $0 | $7,056 | $0 | $258,683 | $0 | $0 | $0 |
| TAMMY LETT | ||||||||||||||
| CNO | $135,083 | $0 | $7,500 | $0 | $855 | $0 | $1,627 | $0 | $5,375 | $0 | $150,440 | $0 | $0 | $0 |
| DR MICHAEL SCHULTHEIS | ||||||||||||||
| PHYSICIAN | $370,517 | $0 | $10,000 | $0 | $139 | $0 | $1,411 | $0 | $2,047 | $0 | $384,114 | $0 | $0 | $0 |
| DR BOYD MCCRACKEN | ||||||||||||||
| PHYSICIAN | $289,079 | $0 | $0 | $0 | $1,057 | $0 | $5,595 | $0 | $5,474 | $0 | $301,205 | $0 | $0 | $0 |
| DR RICHARD FUNNEMAN | ||||||||||||||
| PHYSICIAN | $227,540 | $0 | $0 | $0 | $1,350 | $0 | $4,724 | $0 | $7,317 | $0 | $240,931 | $0 | $0 | $0 |
| DR PHILIP SIEFKEN | ||||||||||||||
| PHYSICIAN | $230,150 | $0 | $0 | $0 | $934 | $0 | $4,505 | $0 | $7,659 | $0 | $243,248 | $0 | $0 | $0 |
| STEVEN DONNAN | ||||||||||||||
| CRNA | $219,034 | $0 | $0 | $0 | $580 | $0 | $2,262 | $0 | $6,613 | $0 | $228,489 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE GROSS-UP PAYMENT IS FOR LONG-TERM DISABILITY. BRIAN NALL, KELSEY HOPKINS, BOYD MCCRACKEN, PHILIP SIEFKEN, AND RICHARD FUNNEMAN RECEIVED THE PAYMENT. THE PAYMENT WAS TREATED AS TAXABLE COMPENSATION. BRIAN NALL RECEIVED SOCIAL CLUB DUES. THIS AMOUNT IS INCLUDED IN HIS TAXABLE COMPENSATION. |
| PART I, LINE 7 | GENERAL RETENTION BONUS |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF GREENVILLE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 376000403 | BondIssuerEIN |
| Bond Issued | 2011-10-20 | BondIssuedDt |
| Issue Price | $10,000,000 | IssuePriceAmt |
| Purpose | REFUND PRIOR ISSUE (04/01/03) CONSTRUCTION / REMODEL PROJECTS AND EQUIPMENT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,509,287 | RetiredAmt |
| Total Proceeds | $10,000,000 | TotalProceedsAmt |
| In Reserve Fund | $952,249 | InReserveFundAmt |
| Issuance Costs From Proceeds | $115,223 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,288,060 | CapitalExpendituresAmt |
| Other Spent Proceeds | $7,631,344 | OtherSpentProceedsAmt |
| Unspent | $13,124 | UnspentAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.01140 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.01140 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE BOARD OF DIRECTORS SHALL NOW CONSIST OF AT LEAST SEVEN BUT NO MORE THAN ELEVEN PERSONS. ALSO, THE BOARD OF DIRECTORS SHALL NOW REVIEW THE BYLAWS AT LEAST EVERY THREE YEARS. |
| FORM 990, PART VI, SECTION A, LINE 6 | GREENVILLE REGIONAL HEALTHCARE, INC., AN ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH DIRECTOR IS ELECTED BY THE MEMBER, GREENVILLE REGIONAL HEALTHCARE INC. |
| FORM 990, PART VI, SECTION B, LINE 11 | REVIEWED BY KEY EMPLOYEES (CFO, CEO, CNO) AND DISTRIBUTED TO THE BOARD OF DIRECTORS VIA EMAIL BEFORE FINAL SUBMISSION. AMPLE TIME IS ALLOWED FOR BOARD MEMBERS TO REVIEW THE 990 AND SUGGEST ANY CHANGES PRIOR TO FINAL SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR, THE BOARD OF DIRECTORS AND ANY KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND MEMBERS OF MANAGEMENT COMPLETE A RELATIONSHIP/CONFLICT OF INTEREST QUESTIONAIRE. ANY CONFLICTS THAT ARISE ARE DEALT WITH ACCORDINGLY BY THE ORGANIZATION'S OFFICERS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD AND THE HOSPITAL'S HUMAN RESOURCES' COLLABORATE AND MAKE A FINAL DETERMINATION BY REVIEWING COMPARABLE SALARIES OF THE REGION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GREENVILLE REGIONAL HOSPITAL MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, BUT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,295,366. MANAGEMENT AND GENERAL EXPENSES 625,977. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,921,343. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,624,986. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,624,986. |
| FORM 990, PART XI, LINE 9: | NET TRANSFERS BETWEEN AFFILIATE -18,959. |
| FORM 990, PART XII, LINE 2C: | PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GREENVILLE REGIONAL HEALTHCARE INC | |||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 371139987 | HEALTHCARE | IL | 501(C)(3) | LINE 11B, II | N/A | 0 | |
| UTLAUT MEMORIAL FOUNDATION INC | |||||||||||
| 200 HEALTHCARE DRIVE | GREENVILLE | IL | 62246 | 371140166 | FUNDRAISING | IL | 501(C)(3) | LINE 11B, II | 0 | GREENVILLE REGIONAL HEALTHCARE INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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