HOOPESTON COMMUNITY MEMORIAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
HOOPESTON COMMUNITY MEMORIAL HOSPITAL (EIN 36-3637465)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-14
IRS object ID
201643199349311194
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-14T17:48:19-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4000AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363637465EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hoopeston Community Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DENNIS HESCH EXEC VP & CFOInCareOfNm
Business Name ControlHOOPBusinessNameControlTxt
Phone2172835531PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 E Orange StreetAddressLine1Txt
CityHoopestonCityNm
State AbbreviationILStateAbbreviationCd
ZIP60942ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENNIS P HESCHPersonNm
Person TitleEXEC VP & CFOPersonTitleTxt
Phone2173833311PhoneNum
Signature2016-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER RHODERICKPreparerPersonNm
PTINP00395735PTIN
Phone3176817000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Carle Hoopeston Regional Health CtrBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDENNIS HESCH EXEC VP CFOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1611 W PARK STAddressLine1Txt
CityURBANACityNm
State AbbreviationILStateAbbreviationCd
ZIP61801ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$46,730,885GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.carle.org/hoopestonWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY HEALTH CARE AND OTHER MEDICALLY RELATED SERVICES AND EDUCATION TO THE COMMUNITY THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL and rural health clinics.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee354TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$23,223TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$1,479NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$28,016PYContributionsGrantsAmt
CY Contributions Grants$13,758CYContributionsGrantsAmt
PY Program Service Revenue$35,348,183PYProgramServiceRevenueAmt
CY Program Service Revenue$46,388,236CYProgramServiceRevenueAmt
PY Investment Income$10,053PYInvestmentIncomeAmt
CY Investment Income$15,910CYInvestmentIncomeAmt
PY Other Revenue$242,009PYOtherRevenueAmt
CY Other Revenue$293,148CYOtherRevenueAmt
PY Total Revenue$35,628,261PYTotalRevenueAmt
CY Total Revenue$46,711,052CYTotalRevenueAmt
PY Grants And Similar Paid$28,586PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$29,463CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,779,900PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,191,075CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,343,549PYOtherExpensesAmt
CY Other Expenses$34,071,606CYOtherExpensesAmt
PY Total Expenses$39,152,035PYTotalExpensesAmt
CY Total Expenses$52,292,144CYTotalExpensesAmt
PY Revenues Less Expenses-$3,523,774PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,581,092CYRevenuesLessExpensesAmt
Total Assets BOY$36,308,585TotalAssetsBOYAmt
Total Assets EOY$35,204,465TotalAssetsEOYAmt
Total Liabilities BOY$36,283,096TotalLiabilitiesBOYAmt
Total Liabilities EOY$40,756,854TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,489NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$5,552,389NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMISSION STATEMENT SECTION 1. GENERAL PURPOSES. THE CORPORATION IS ORGANIZED AND SHALL BE EXCLUSIVELY OPERATED AS A NOT-FOR-PROFIT CORPORATION FOR CHARITABLE, BENEVOLENT, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW (THE "CODE"). AND, IN FURTHERANCE OF SUCH CHARITABLE PURPOSES, THE CORPORATION SHALL ENGAGE IN THE ACTIVITIES DESCRIBED IN SECTION 2 OF THIS STATEMENT. SECTION 2. SPECIFIC PURPOSES. THE CORPORATION'S PURPOSES SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING: (A) TO PROVIDE AND TO ASSIST IN PROVIDING FACILITIES FOR THE RENDERING OF HEALTH CARE SERVICES ON AN INPATIENT OR OTHER BASIS THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS, AND OTHER CLINICAL SERVICES THROUGH ALL OTHER APPROPRIATE MEANS; AND (B) TO TRAIN AND TO PROVIDE CONTINUING EDUCATION FOR PERSONS ENGAGED IN PROVIDING HEALTHMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Activity622110ActivityCd
Expense$47,788,419ExpenseAmt
Grant$29,463GrantAmt
Revenue$46,442,957RevenueAmt
DescHOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH), A 24 BED CRITICAL ACCESS HOSPITAL LOCATED IN HOOPESTON, IL SERVES HOOPESTON, VERMILION COUNTY AND THE SURROUNDING AREA. HCMH EMPLOYS MORE THAN 237 STAFF MEMBERS, 40 PHYSICIANS AND 33 ADVANCED PRACTICE PROVIDERS. HCMH IS COMMITTED TO PROVIDING QUALITY, DEPENDABLE HEALTH SERVICES. HCMH OFFERS SPECIALTY SERVICES WITH CARDIOLOGY, ORTHOPEDICS, GYNECOLOGY, MENTAL HEALTH, UROLOGY AND DIAGNOSTIC SERVICES INCLUDING NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, RADIOLOGY AND LABORATORY. EMERGENCY MEDICINE AND SURGICAL SERVICES ARE PROVIDED IN STATE OF THE ART FACILITIES WHICH OPENED IN 2012. HCMH PROVIDES ACCESS TO PRIMARY CARE WITH CLINICS IN HOOPESTON, ROSSVILLE, MILFORD, CISSNA PARK, DANVILLE, WATSEKA, TUSCOLA AND MATTOON, IL. HCMH HAS BEEN DEDICATED TO CARING FOR THOSE IN THE AREA FOR OVER 50 YEARS.Desc
Total Program Service Expenses$47,788,419TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee354EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDENNIS HESCH EXEC VP CFOPersonNm
Phone2173833311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1611 WEST PARK STAddressLine1Txt
CityURBANACityNm
State AbbreviationILStateAbbreviationCd
ZIP61801ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Russ Leigh
Chair of Board2.00.0Yes (X)Yes (X)$0$0$0
Lynn Galloway
Secretary/Treasurer of Board2.00.0Yes (X)Yes (X)$0$0$0
Ed Layden Jr
Trustee0.250.0Yes (X)$0$0$0
Karla Coon
Trustee0.50.0Yes (X)$0$0$0
Henry Hornbeck
Trustee0.250.0Yes (X)$0$0$0
Joseph Barkmeier MD
Trustee0.539.5Yes (X)$0$360,789$87,922
Letha Kramer
Trustee4.036.0Yes (X)$0$175,393$23,627
Harry Brockus
Ex-Officio Board, CEO24.016.0Yes (X)$219,325$0$70,209
Dennis Hesch
Exec VP & CFO1.039.0Yes (X)$0$995,505$243,060
Laurence Fallon
Exec VP-Legal Affairs & HR1.039.0$0$750,214$192,695Yes (X)
Douglas Morton MD
Med Dir-Radiology39.01.0$0$618,219$30,910Yes (X)
Ikechukwu Uzoaru MD
Med Dir-Lab2.038.0$0$484,715$40,231Yes (X)
Pamela Bigler
SVP-Nursing & CNO5.035.0$0$451,350$98,106Yes (X)
Scott Harding
VP-Facilities & Support Svcs4.036.0$0$349,513$93,285Yes (X)
Sally Salmons MD
Med Dir-Prim Care & Ped Spec.20.020.0$0$294,375$38,406Yes (X)
Dennis Price
Physician Assistant40.00.0$161,464$0$16,603Yes (X)
Pamela Armstrong
Advanced Practice Nurse40.00.0$131,857$0$8,916Yes (X)
Larry Whitaker Jr
Physician Assistant40.00.0$127,643$0$33,473Yes (X)
Larry Gerdom
Physician Assistant40.00.0$122,408$0$25,180Yes (X)
Katrina Deshaney
Physician Assistant40.00.0$121,029$0$15,863Yes (X)
Daniel Chase MD
Highly Comp Emp - Former40.00.0$0$437,536$41,498Yes (X)
William McCarthy MD
Highly Comp Emp - Former40.00.0$0$274,301$22,827Yes (X)
Albert Tanlim MD
Highly Comp Emp - Former40.00.0$0$208,777$36,114Yes (X)
Cortney Joneikis MD MS
Highly Comp Emp - Former40.00.0$0$337,122$40,802Yes (X)
Susan Berg MD
Highly Comp Emp - Former40.00.0$0$266,477$27,834Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$883,726TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,004,286TotReportableCompRltdOrgAmt
Total Other Compensation$1,187,561TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HOOPESTON EMERGENCY MEDICINE SPECIA
6523 26TH PLACEBERWYNIL60402PHYSICIAN STAFFING$1,350,400
JJ DEVELOPMENT OF WATSEKA INC
PO BOX 461WATSEKAIL60970CONSTRUCTION$983,273
SHARED IMAGING
LOCK BOX 461MILWAUKEEWI532880544IMAGING SERVICES$445,762
SIGHTPATH MEDICAL INC
PO BOX 204253DALLASTX753204253STAFFING$308,944
DMS IMAGING INC
26273 NETWORK PLCHICAGOIL606731262IMAGING SERVICES$183,471
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$13,758GovernmentGrantsAmt
Total Contributions$13,758TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICESDesc
Business622110BusinessCd
Total Revenue Column$46,388,236TotalRevenueColumnAmt
Related Or Exempt Func Income$46,388,236RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$46,388,236TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,910TotalRevenueColumnAmt
Exclusion$15,910ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$20,452RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$19,833RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$619RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$619TotalRevenueColumnAmt
Exclusion$619ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
CATERING722320$23,223$23,223
COFFEE SHOP722212$16,038$16,038
PERPETUAL TRUST INTEREST900099$174,537$174,537

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$78,731TotalRevenueColumnAmt
Related Or Exempt Func Income$54,721RelatedOrExemptFuncIncomeAmt
Exclusion$24,010ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$292,529OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,711,052TotalRevenueColumnAmt
Related Or Exempt Func Income$46,442,957RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$23,223UnrelatedBusinessRevenueAmt
Exclusion$231,114ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$29,463TotalAmt
Program Services$29,463ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$300,061TotalAmt
Management And General$300,061ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$198,802TotalAmt
Program Services$198,802ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,642,534TotalAmt
Program Services$12,989,444ProgramServicesAmt
Management And General$653,090ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$725,316TotalAmt
Program Services$690,238ProgramServicesAmt
Management And General$35,078ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,311,552TotalAmt
Program Services$2,209,286ProgramServicesAmt
Management And General$102,266ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,012,810TotalAmt
Program Services$935,300ProgramServicesAmt
Management And General$77,510ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$220TotalAmt
Management And General$220ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$11,827TotalAmt
Management And General$11,827ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,621,677TotalAmt
Program Services$1,530,275ProgramServicesAmt
Management And General$91,402ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$4,248TotalAmt
Program Services$1,762ProgramServicesAmt
Management And General$2,486ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,495,973TotalAmt
Program Services$1,160,276ProgramServicesAmt
Management And General$335,697ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$637,861TotalAmt
Program Services$431,497ProgramServicesAmt
Management And General$206,364ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,203,526TotalAmt
Program Services$1,699,362ProgramServicesAmt
Management And General$504,164ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$102,103TotalAmt
Program Services$82,674ProgramServicesAmt
Management And General$19,429ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$56,481TotalAmt
Program Services$44,900ProgramServicesAmt
Management And General$11,581ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$354,755TotalAmt
Program Services$354,755ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,057,827TotalAmt
Program Services$1,321,525ProgramServicesAmt
Management And General$736,302ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$484,149TotalAmt
Program Services$474,295ProgramServicesAmt
Management And General$9,854ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
INTERNAL PURCHASED SERVICES$12,446,872$12,438,435$8,437
INTERNAL MANAGEMENT FEES$6,629,444$5,719,241$910,203
PATIENT CARE SUPPLIES$4,315,553$4,315,553$0
UNRELATED BUSINESS INCOME TAX$1,250$0$1,250

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,647,840TotalAmt
Program Services$1,161,336ProgramServicesAmt
Management And General$486,504ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$52,292,144TotalAmt
Program Services$47,788,419ProgramServicesAmt
Management And General$4,503,725ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,118,020BOYAmt
EOY$4,034,476EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,164,549BOYAmt
EOY$5,745,938EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

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

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$340,227BOYAmt
EOY$208,552EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,576,184LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,962,132LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,041,832BOYAmt
EOY$16,614,052EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$4,444,690BOYAmt
EOY$4,444,690EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,199,267BOYAmt
EOY$4,156,757EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$36,308,585BOYAmt
EOY$35,204,465EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,519,914BOYAmt
EOY$1,504,874EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,094,839BOYAmt
EOY$6,592,335EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,668,343BOYAmt
EOY$32,659,645EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,283,096BOYAmt
EOY$40,756,854EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,618,818BOYAmt
EOY-$9,199,911EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$57,646BOYAmt
EOY$55,584EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,586,661BOYAmt
EOY$3,591,938EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,489BOYAmt
EOY-$5,552,389EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,308,585BOYAmt
EOY$35,204,465EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,581,092ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$3,214OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$11,827OtherActivitiesAmt
Total Lobbying Expenditures$11,827TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationOTHER ACTIVITIES $8,063 - PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) DUES ATTRIBUTABLE TO LOBBYING $3,133 - PORTION OF AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING $631 - PORTION OF MISCELLANEOUS HEALTH CARE ORGANIZATION DUES ATTRIBUTABLE TO LOBBYINGExplanationTxt

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,230OtherCostOrOtherBasisAmt
Book Value$84,230BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,656,354OtherCostOrOtherBasisAmt
Depreciation$2,059,721DepreciationAmt
Book Value$8,596,633BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,720,249OtherCostOrOtherBasisAmt
Depreciation$216,871DepreciationAmt
Book Value$1,503,378BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,721,951OtherCostOrOtherBasisAmt
Depreciation$3,431,270DepreciationAmt
Book Value$5,290,681BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,393,400OtherCostOrOtherBasisAmt
Depreciation$254,270DepreciationAmt
Book Value$1,139,130BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,614,052TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
HRHC FCS ESCROW$509,234
DEVL LIMITED ASSETS$55,584
LONG TERM INVESTMENTS$3,591,939
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,156,757TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ACCTS REC-MEDICARE$1,816,251
DUE TO BLUE CROSS$279,269
HRHC/FNDN NOTES PAYABLE$3,575,473
ASSET RETIREMENT OBLIGATION$144,350
INTERCOMPANY PAYABLES$26,844,302
FieldValueIRS element (for citing)
Total Liability$32,659,645TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationFIN 48 (ASC740) FOOTNOTE THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2015 AND 2014.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other125.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,140,680TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,140,680NetCommunityBenefitExpnsAmt
Total Expense0.04090TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,386,720TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,088,757DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,297,963NetCommunityBenefitExpnsAmt
Total Expense0.02480TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,527,400TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,088,757DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,438,643NetCommunityBenefitExpnsAmt
Total Expense0.06570TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$164,525TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$164,525NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,041TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,041NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,285TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$33,285NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$215,851TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$215,851NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,743,251TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,088,757DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,654,494NetCommunityBenefitExpnsAmt
Total Expense0.06970TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,165TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,165NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,032TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,032NetCommunityBenefitExpnsAmt

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$338TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$338NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,535TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,535NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$176,183BadDebtExpenseAmt
Bad Debt Expense Attributable$88,091BadDebtExpenseAttributableAmt
Reimbursed By Medicare$8,735,106ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,071,287CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$5,336,181MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HOOPESTON COMMUNITY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 E ORANGE STAddressLine1Txt
CityHOOPESTONCityNm
State AbbreviationILStateAbbreviationCd
ZIP609421801ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.CARLE.ORG/HOOPESTONWebsiteAddressTxt
State License0004200StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HOOPESTON COMMUNITY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
OtherYes (X)OtherInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLCARLE.ORG/CHNAOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLCARLE.ORG/CHNAStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care125.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SUPPLEMENTAL INFORMATIONFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SUPPLEMENTAL INFORMATIONFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentfalseFAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V SUPPLEMENTAL INFORMATION (Part V, Sect B, Line 3)A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS COMPLETED IN 2013 TO COVER PROGRAMS FOR 2014-2016. SURVEYS AND ASSESSMENTS WERE DISCUSSED AT THE ANNUAL STRATEGIC PLANNING SESSION WITH THE COMMUNITY BOARD OF DIRECTORS. SUBSEQUENTLY, THE 2014-16 CHNA AND IMPLEMENTATION PLAN WAS APPROVED BY THE BOARD IN DECEMBER 2013. COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 5) CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS, EVALUATED OUTSIDE RESEARCH, PRIORITIZED NEEDS BASED ON THAT INFORMATION. PHONE AND IN-PERSON INTERVIEWS WERE CONDUCTED IN SEPTEMBER 2013. KEY INFORMANTS PARTICIPATED IN INTERVIEWS RANGING FROM 30-90 MINUTES IN LENGTH: KAREN LANGDON, PA-C, AND MISTI RUNGE, INFECTION CONTROL MANAGER & QUALITY NURSE SPECIALIST,HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH); MARCIE SHERIDAN, EXECUTIVE DIRECTOR OF HOOPESTON MULTI-AGENCY; JOSIE SIDDENS, RN, SCHOOL NURSE AT BISMARCK-HENNING SCHOOL DISTRICT AND ALSO REGISTERED NURSE AT PRESENCE UNITED SAMARITANS MEDICAL CENTER EMERGENCY DEPARTMENT; JENNY TRIMMELL, BSN, DIRECTOR OF COMMUNITY HEALTH SERVICES AT THE VERMILION COUNTY HEALTH DEPARTMENT; DIANA CORENZA, ASSOCIATE DIRECTOR OF THE VETERAN'S AFFAIRS (VA) ILLIANA HEALTH CARE SYSTEM; ALICE MARIE JACOBS, PHD, PRESIDENT OF DANVILLE AREA COMMUNITY COLLEGE; AND THOM POLLOCK, EXECUTIVE DIRECTOR OF CROSSPOINT HUMAN SERVICES.
COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 11)HCMH CONTINUES ITS WORK TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY AND THAT WILL INCLUDE EMPHASIS ON ACCESS TO HEALTH SERVICES, HEART DISEASE AND STROKE AND THE OTHER SPECIALTIES AND SERVICES THE HOSPITAL OR CARLE HEALTH SYSTEM PROVIDES. THE CARLE FOUNDATION IS DILIGENTLY WORKING TO IMPROVING ACCESS AND SERVICES THROUGHOUT THE EAST CENTRAL ILLINOIS REGION, NOT JUST FOR THIS GEOGRAPHIC AREA. MANY OF THE OTHER CONCERNS ARE ALSO ADDRESSED THROUGH SERVICES PROVIDED, BUT THESE AREAS ARE NOT THE PRIMARY EMPHASIS OF THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WHICH TARGETS MORE SPECIFIC LOW INCOME POPULATIONS IN VERMILION COUNTY. HOW HCMH IS ADDRESSING SIGNIFICANT HEALTH NEEDS 1. CHILDRENS HEALTH HCMH STAFF MAINTAINED A PRESENCE IN THE LOCAL SCHOOL SYSTEM, PROVIDING HEAD LICE CHECKS, HANDWASHING EDUCATION, AND VISION AND HEARING TESTING FOR SCHOOLS IN THE REGION. THE HOSPITAL ALSO PROVIDED FULL-TIME ATHLETIC TRAINERS TO SCHOOLS IN HOOPESTON, CISSNA PARK AND MILFORD. SERVICE IS PROVIDED TO ALL STUDENT ATHLETES, REGARDLESS OF WHERE THEY RECEIVE CARE, AND IS FREE OF CHARGE TO THE SCHOOL DISTRICTS. IN 2015, THE ORGANIZATION WAS ABLE TO MAINTAIN AND ADD TO ITS STAFF OF PEDIATRICIANS FOR THE REGION. THESE FULL-TIME PEDIATRICIANS LAUNCHED SUCCESSFUL PRACTICES IN WATSEKA AND HOOPESTON, ATTRACTING PATIENTS AND PROVIDING MUCH NEEDED PEDIATRIC CARE TO NORTHERN VERMILION AND SOUTHERN IROQUOIS COUNTIES. 2. TEEN AND ADOLESCENT HEALTH HCMH CONTINUED A SCHOOL-BASED EDUCATION PROGRAM FOR SEXUALLY TRANSMITTED DISEASE EDUCATION, PRESENTING TO THE STUDENTS OF MILFORD HIGH SCHOOL ON A BI-ANNUAL BASIS. THE POSSIBILITY OF EXPANDING THIS PROGRAM INTO MANY DIFFERENT LOCATIONS WAS DISCUSSED AND GAINED INTEREST FROM SEVERAL SCHOOLS IN THE COUNTY, BUT NO OTHER PROGRAMS HAVE BEEN SCHEDULED AS OF YET. AN OB-GYN PROVIDER IN DANVILLE, LORAINE NOLLA, MD, CONTINUED TO PROVIDE CONSISTENT WOMENS SERVICES IN HOOPESTON, OFFERING TWICE-MONTHLY VISITS TO HCMH. 3. ORAL HEALTH HCMH CONTINUES TO FUND THE DELTA DENTAL OF ILLINOIS LAND OF SMILES PROGRAM IN VERMILION COUNTY. THIS PROGRAM TEACHES CHILDREN IN THE COMMUNITY HOW TO TAKE CARE OF THEIR TEETH BY DEMONSTRATING PROPER BRUSHING AND FLOSSING TECHNIQUES, REVIEWING GOOD AND BAD FOODS FOR TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST REGULARLY. IN 2015, THIS PROGRAM REACHED HUNDREDS OF CHILDREN IN CISSNA PARK AND WATSEKA, TWO RURAL COMMUNITIES LOCATED WITHIN THE SERVICE AREA WHERE IT HAS BEEN IDENTIFIED THAT YOUTH LACK EDUCATION ABOUT THE IMPORTANCE OF DENTAL CARE. PRE- AND POST-TESTING ILLUSTRATES THAT CHILDREN IMPROVE THEIR KNOWLEDGE OF THE IMPORTANCE OF DENTAL CARE BOTH AT HOME AND AT THE DENTIST AFTER PARTICIPATING IN THE SESSION. 4. CANCER CANCER-RELATED DEATHS IN VERMILION COUNTY ILLUSTRATED THE NEED FOR FURTHER PROGRAMS AND INITIATIVES, CENTERING PRIMARILY AROUND EARLY DETECTION AND SCREENINGS. HCMH CONTINUES TO OFFER DIGITAL MAMMOGRAPHY, PROVIDING CLEARER IMAGES FOR WOMEN RECEIVING SCREENINGS. WOMEN COULD ALSO CONTINUE TO RECEIVE IN-OFFICE BIOPSIES AT HOOPESTON FACILITIES. HCMH HAS ALSO WORKED WITH MILLS BREAST CANCER INSTITUTE (MBCI) TO DO AT LEAST ONE SCREENING EVENT IN HOOPESTON EACH YEAR. IN 2015, BREAST CANCER RISK ASSESSMENTS WERE OFFERED TO RESIDENTS DURING A COMMUNITY HEALTH FAIR. 5. DIABETES ONE OF THE MOST SIGNIFICANT PROCESSES WE IMPLEMENTED WAS THE SHIFT TO A PATIENT-CENTERED MEDICAL HOME. THIS MODEL OF CARE IS INTENDED TO HELP MANAGE PATIENTS CHRONIC CONDITIONS, LIKE DIABETES. THROUGH THE PATIENT-CENTERED MEDICAL HOME, HCMH IS ABLE TO OFFER MANY DIFFERENT SERVICES UNDER ONE ROOF THAT IMPROVE CARE CONTINUUM AND ARE TAILORED TO EACH INDIVIDUALS MEDICAL NEED. HAVING ALL SPECIALISTS AND PROVIDERS COLLABORATE TO PROVIDE A CONTINUITY OF CARE FOR DIABETIC PATIENTS GREATLY REDUCES THE AMOUNT OF APPOINTMENTS, AND HELPS THEIR OVERALL HEALTH. THE SECOND STRATEGY WAS TO ADD A NURSE NAVIGATOR TO HELP COORDINATE CARE FOR THOSE WITH DIABETES AND CHRONIC CONDITIONS. IN 2015, A SECOND RN WAS ADDED TO OUR CASE MANAGEMENT TEAM WHO ARE BOTH IN CHARGE OF CONTINUITY OF CARE FOR NOT ONLY INPATIENTS BUT OUTPATIENTS AS WELL. THEY ARE BOTH RESPONSIBLE FOR FOLLOW-UP CALLS AND ASSISTING PATIENTS IN MAKING FOLLOW-UP APPOINTMENTS. THEY ARE AVAILABLE SEVEN DAYS A WEEK AND WILL NAVIGATE FOR ANY PATIENT WITH A CHRONIC CONDITION. CASH AND IN-KIND DONATIONS HCMH CONTRIBUTED NEARLY $33,000 TO CHARITABLE ORGANIZATIONS IN THE COMMUNITY VIA CASH AND IN-KIND DONATIONS, INCLUDING PROGRAMS AIMED TO HELP YOUTH, HEALTH IMPROVEMENT, HEALTH EDUCATION AND HEALTH PROFESSIONS EDUCATION. BECAUSE THE NEEDS ARE GREAT AND IT WOULD BE UNREASONABLE TO ADDRESS EACH AND EVERY IDENTIFIED NEED, RESOURCES ARE FOCUSED PRIMARILY ON IDENTIFIED NEEDS WITHIN THE COMMUNITY BENEFIT PRIORITIES SET. MANY OF THESE NEEDS ARE ADDRESSED THROUGH PARTNERSHIPS AND COLLABORATIVE EFFORTS. ONE SIGNIFICANT CONTRIBUTION WAS TO THE HOOPESTON MULTI AGENCY ($5,000) TO ENHANCE THE MULTITUDE OF IMPORTANT COMMUNITY BENEFIT SERVICES THEY OFFER FOR DISABLED AND ELDERLY PATIENTS, INCLUDING RIDES THROUGHOUT HOOPESTON AND DANVILLE TO HELP MAINTAIN THEIR HEALTH AND LIFESTYLE. THE ORGANIZATION ALSO ADDRESSES TWO OTHER CRITICAL AREAS OF NEED IN VERMILION COUNTY BY PROVIDING A FREE AFTER-SCHOOL PROGRAM FOR TEENS. THIS PROGRAM PROVIDES THE PARTICIPANT WITH A MEAL AND TUTORING, HELPING KEEP YOUTH FED, HEALTHY AND IN SCHOOL. THE FINAL SERVICE PROVIDED BY THE MULTI AGENCY IS HEALTH NAVIGATION. THEY ASSIST CLIENTS IN COORDINATING CARE APPOINTMENTS, AND FINDING RESOURCES TO ASSIST THEM WITH THEIR NEEDS. HCMH ALSO SUPPORTS ALL LIONS CLUB CHAPTERS IN VERMILION COUNTY. THE LIONS CLUB IS KNOWN FOR THEIR HUMANITARIAN EFFORTS ON BEHALF OF THE DEAF AND BLIND, AND SPECIFICALLY PROVIDES EYE GLASSES FOR UNDERPRIVILEGED CHILDREN. THERE ARE ALSO SEVERAL STATEWIDE AND NATIONWIDE ORGANIZATIONS THAT HAVE REGIONAL CHAPTERS THAT RECEIVE SUPPORT FROM HCMH. THOSE INCLUDE: ROTARY OF HOOPESTON, SPECIAL OLYMPICS OF ILLINOIS AND FELLOWSHIP OF CHRISTIAN ATHLETES. EACH OF THESE ORGANIZATIONS HAS MISSION STATEMENTS OUTLINING THEIR COMMITMENT TO IMPROVING HEALTH, ACTIVITY AND WELL-BEING OF OUR YOUTH. WHILE THERE WERE A NUMBER OF ADDITIONAL NEEDS IDENTIFIED BY THE DATA AND INPUT FROM COMMUNITY LEADERS, AS A CRITICAL ACCESS HOSPITAL, HCMH DOES NOT HAVE THE RESOURCES TO ADDRESS ALL OF THEM. THE ISSUES THAT WILL NOT BE ADDRESSED IN THIS IMPLEMENTATION PLAN ARE LOWER PRIORITY BECAUSE THE NEED WAS NOT AS SIGNIFICANT; THEY ARE NOT CENTRAL TO THE HOSPITALS MISSION; AND HCMH HAS DETERMINED IT DOES NOT HAVE THE ABILITY TO MAKE A MEASURABLE IMPACT IN THOSE AREAS. HCMH WILL NOT FOCUS THIS COMMUNITY BENEFIT IMPLEMENTATION PLAN ON ADDRESSING COMMUNITY HEALTH CHALLENGES RELATED TO DISABILITIES; EXERCISE, NUTRITION AND WEIGHT; IMMUNIZATION AND INFECTIOUS DISEASES; MATERNAL, FETAL AND INFANT HEALTH; MENTAL HEALTH; OLDER ADULTS AND AGING; RESPIRATORY DISEASES OR SUBSTANCE ABUSE. PUBLICATION OF FINANCIAL ASSISTANCE POLICY (PART V, SECT B, LINE 16A THE FAP WAS WIDELY AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.CARRLE.ORG/HOOPESTON/DOCUMENTS/CHARITY-CARE-HOSPITAL- POLICY.aspx PUBLICATION OF FINANCIAL ASSISTANCE POLICY APPLICATION (PART V, SECT B, LINE 16B THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.CARLE.ORG/HOOPESTON/DOCUMENTS/CHARITY-CARE-HOSPITAL.PDF
FINANCIAL ASSISTANCE POLICY (PART V, SECT B, LINE 20E)HCMH HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE CERTAIN THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THIS INCLUDES: - A SIMPLIFIED APPLICATION FORM THAT CLEARLY EXPLAINS PATIENT RIGHTS AND HCMH'S EXPECTATIONS - INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM ON ALL BILLING STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - INFORMATION AND APPLICATION FORMS ARE READILY AVAILABLE AND ACCESSED AT WWW.CARLE.ORG/HOOPESTON - FINANCIAL ASSISTANCE APPLICATION FORMS AND BROCHURES ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS, AS WELL AS IN THE HOSPITAL'S MAIN LOBBY - MEETING WITH OUR STAFF TO KEEP THEM INFORMED ABOUT THE PROGRAM AND THE BENEFITS THAT ARE AVAILABLE TO PATIENTS - FINANCIAL ASSISTANCE REPRESENTATIVES ARE AVAILABLE AT VARIOUS COMMUNITY FORUMS - SCREENING PATIENTS THROUGH OUR VENDOR FOR KEY FINANCIAL INDICATORS TO PRESUME ELIGIBILITY OR CONTACT REGARDING OUR ASSISTANCE PROGRAMS
FINANCIAL ASSISTANCE POLICY (PART V, SECT B, LINE 22D)HCMH ESTABLISHES A STANDARDIZED FEE SCHEDULE USING A NATIONAL DATABASE OF FEE INFORMATION WHICH BLENDS THE RELATIVE VALUE OF A SERVICE WITH STATISTICAL PROFILING OF ACTUAL CHARGE DATA SPECIFIC TO THIS REGION. THIS FOLLOWS DATA USED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) TO SET MEDICARE FEES. THIS ALLOWS US TO ESTABLISH A FAIR FEE THAT REPRESENTS THE COST OF DELIVERING THE SERVICES. CHARGES FOR PATIENTS WHO APPLY AND ARE IDENTIFIED AS QUALIFIED FOR FINANCIAL ASSISTANCE ARE DISCOUNTED BASED UPON THE DISCOUNT LEVEL FOR WHICH THEY QUALIFY. DISCOUNTS FOR HCMHS FINANCIAL ASSISTANCE PROGRAM ARE EITHER 50% OR 100% BASED UPON THE APPLICANTS FEDERAL POVERTY LEVEL.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
CARLE DANVILLE ON FAIRCHILD
311 W FAIRCHILDDANVILLEIL61832RURAL HEALTH CLINIC
CARLE MATTOON ON HURST
2512 HURST DRIVEMATTOONIL61938MEDICAL CLINIC
CHARLOTTE ANN RUSSELL MEDICAL CENTER
801 E ORANGE STHOOPESTONIL60342RURAL HEALTH CLINIC
CARLE AT TUSCOLA
301 E SOUTHLINE ROADTUSCOLAIL61953RURAL HEALTH CLINIC
ROBERTS CLINIC
1490 EAST WALNUT STREET SUITE CWATSEKAIL60970RURAL HEALTH CLINIC
ROSSVILLE MEDICAL CLINIC
619 N CHICAGO STROSSVILLEIL60963RURAL HEALTH CLINIC
MILFORD CLINIC
322 CHICAGO STMILFORDIL60953RURAL HEALTH CLINIC
CISSNA PARK MEDICAL CLINIC
141 W CARFIELD AVECISSNA PARKIL60924RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H SUPPLEMENTAL INFORMATIONSCHEDULE H, PART VI 1 - REQUIRED DESCRIPTIONS FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA (PART I, LINE 3C) IT IS THE RESPONSIBILITY OF OUR PATIENTS TO REQUEST AND COMPLETE A CHARITY CARE APPLICATION. PATIENTS ARE INFORMED ABOUT CHARITY CARE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IF A PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION AND PATIENTS COVERED BY MEDICAID TITLE XIX. A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC. IS UTILIZED TO DETERMINE THOSE PATIENTS WHO MAY BE PRESUMPTIVELY QUALIFIED FOR ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE OR RECEIVE ADDITIONAL CONTACT REGARDING APPLYING FOR FINANCIAL ASSISTANCE. PATIENTS MAY APPLY FOR CHARITY CARE AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. THE MAXIMUM AMOUNT HCMH SHALL COLLECT FOR FACILITY SERVICES FROM A PATIENT IN A TWELVE MONTH PERIOD IS 25% OF THE ANNUAL PRE-TAX EARNINGS AND CASH BENEFITS FROM ALL SOURCES OF THE PATIENT IF THE PATIENT IS UNINSURED AND EARNS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL. EXPLANATION OF COSTING METHODOLOGY (PART I, LINE 7 AND PART III, LINE 2) TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER BENEFIT COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUALS FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. COMMUNITY BUILDING ACTIVITIES (PART II) MUCH OF HCMHS COMMUNITY BUILDING ACTIVITIES ARE THROUGH IN-KIND SUPPORT VIA COMMITTEES, BOARDS AND SPECIAL PROJECTS. TWO MEMBERS OF HCMH LEADERSHIP AND STAFF WERE A PART OF THE HOOPESTON COMMUNITY ALLIANCE IN 2015, A COMMITTEE DEDICATED TO THE IMPROVEMENT OF HOOPESTON. A TOTAL OF 31 HOURS OF MEETINGS AND PREPARATION WERE SPENT ON THE COMMITTEE AND VARIOUS SUB-COMMITTEES FOR THE ALLIANCE AMOUNTING TO $1,918 IN COMMUNITY BENEFIT. THE HOSPITAL CEO SERVED HIS SECOND YEAR AS A VERMILION ADVANTAGE BOARD MEMBER AMOUNTING TO $978 OF IN-KIND SUPPORT, AND THE HOOPESTON ECONOMIC DEVELOPMENT COMMITTEE HELD WEEKLY MEETINGS TO DISCUSS A NUMBER OF ISSUES THAT IMPACT THE COMMUNITY'S HEALTH AND SAFETY, AMOUNTING TO $413 OF IN-KIND SUPPORT. NEW THIS YEAR, THE DIRECTOR OF QUALITY SAT ON A BOARD FOR THE PRESERVATION OF THE HISTORIC LORRAINE THEATER IN HOOPESTON, AMOUNTING TO $902 IN SUPPORT TO THE COMMUNITY. AN ADDITIONAL $2,610 WAS ON MISCELLANEOUS IN-KIND SUPPORT, INCLUDING CHAMBER OF COMMERCE AND HOLIDAY PARTNERSHIP OPPORTUNITIES IN THE COMMUNITY. THE ADDITIONAL FUNDS CAPTURED AS COMMUNITY BUILDING ($376) WERE FOR DISASTER READINESS THOSE HOURS AND STAFF TIME SPENT ABOVE AND BEYOND NORMAL REQUIREMENTS FOR A HOSPITAL. AT HCMH, EMERGENCY PREPAREDNESS IS A PRIORITY, WITH ONE STAFF MEMBER SERVING AS THE DISASTER PREPAREDNESS COORDINATOR. THIS INDIVIDUAL SAT ON THE HOOPESTON EMERGENCY MANAGEMENT AGENCY AS A REPRESENTATIVE OF CARLE HOOPESTON, ATTENDED DISASTER MEETINGS, AND PARTICIPATED IN DRILLS. SHE ALSO CONTINUED TO PARTICIPATE IN REGULAR DISCUSSIONS WITHIN THE REGION, INCLUDING THE CARLE EMERGENCY MANAGEMENT COMMITTEE, WORKING TOGETHER TO PREPARE AND STANDING READY IF THE NEED OCCURS. BAD DEBT, MEDICARE, & COLLECTION PRACTICES (PART III, LINE 3) HCMH USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY. BAD DEBT FOOTNOTE (PART III, LINE 4) THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 28 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS. EXPLANATION OF MEDICARE COST REPORT COSTING METHODOLOGY (PART III, LINE 8) THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE DESIGNED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE INCURRING THE COST NECESSARY TO PROVIDE THESE SERVICES, ASSURING CARE TO SENIORS, A DEMOGRAPHIC THAT HAS EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. COLLECTION PRACTICES (PART III, LINE 9B) ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT TO ESTABLISH PAYMENT ARRANGEMENTS ON THE REMAINING BALANCE DUE. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE COLLECTORS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT. IF THEY ARE UNABLE TO MAKE PAYMENT ON THE REMAINING BALANCE AFTER THE FINANCIAL ASSISTANCE DISCOUNTS, THEN THE BALANCE MAY BE LISTED WITH THE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATIONS ARE MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND TO US, THEN THE ACCOUNT IS FINAL NOTICED WITH A LETTER AND SENT TO AN OUTSIDE COLLECTION AGENCY. HCMH WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE THE COLLECTION ATTORNEYS TO USE SO-CALLED BODY ATTACHMENTS. THE AGENCIES ARE AWARE OF OUR FINANCIAL ASSISTANCE PROGRAM AND HAVE BEEN ADVISED TO REFER THE PATIENTS BACK TO OUR IN-HOUSE COLLECTORS AND/OR PATIENT ACCOUNTS DEPARTMENT AT HCMH IF THEY DEEM THE PATIENT UNABLE TO PAY. WE THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT IN APPLYING FOR FINANCIAL ASSISTANCE. IF HCMH THEN DETERMINES THAT THE PATIENT MIGHT QUALIFY, WE SEND THE PATIENT A FINANCIAL ASSISTANCE APPLICATION AND PUT A HOLD ON THE ACCOUNT LISTED WITH THE AGENCY FOR AS LONG AS WE HAVE DETERMINED NECESSARY; THE AVERAGE IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED. IF THEY ARE APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY TO COLLECT ANY REMAINING BALANCE.
2 - NEEDS ASSESSMENTHCMH USED EXISTING DATA, INFORMAL DISCUSSIONS, AND A COMPREHENSIVE QUALITATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE IF EXISTING PROGRAMS ARE ON TRACK; WHAT NEEDS TO BE ADDED, DELETED OR ENHANCED; AND WHERE OUR FOCUS NEEDED TO BE PLACED IN THE FUTURE. THE CHNA INCLUDED DISCUSSIONS WITH COMMUNITY LEADERS, INCLUDING HUMAN SERVICE AGENCY ADMINISTRATORS, PUBLIC HEALTH REPRESENTATIVES AND HCMH LEADERSHIP.
3 - PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCEHCMH IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE AND AS A RESULT, OFFERS A STRONG FINANCIAL ASSISTANCE PROGRAM THAT IS BASED IN A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS AND BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITYS RESOURCES. BY DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING FINANCIAL ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO HELP. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERES ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE. HCMH HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THIS INCLUDES: - A SIMPLIFIED APPLICATION FORM THAT CLEARLY EXPLAINS PATIENT RIGHTS AND HCMHS EXPECTATIONS - INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM ON ALL BILLING STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - INFORMATION AND APPLICATION FORMS READILY AVAILABLE AND ACCESSED AT WWW.CARLE.ORG/HOOPESTON - FINANCIAL ASSISTANCE APPLICATION FORMS AND BROCHURES AVAILABLE AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS, AS WELL AS IN THE HOSPITALS MAIN LOBBY - MEETING WITH OUR OWN STAFF TO KEEP THEM INFORMED ABOUT THE PROGRAM AND WHAT BENEFITS ARE AVAILABLE TO PATIENTS - FINANCIAL ASSISTANCE REPRESENTATIVES AVAILABLE AT VARIOUS COMMUNITY FORUMS - SCREENING PATIENTS THROUGH OUR VENDOR FOR KEY FINANCIAL INDICATORS TO PRESUME ELIGIBILITY OR CONTACT REGARDING OUR ASSISTANCE PROGRAMS
4 - COMMUNITY INFORMATIONTHE SERVICE AREA OF HCMH IS DEFINED AS THE GEOGRAPHICAL BOUNDARY OF VERMILION COUNTY, ILLINOIS. WHILE SOME RESIDENTS OF SURROUNDING COUNTIES UTILIZE HCMHS SERVICES, OUR MOST RECENT CHNA TARGETED VERMILION COUNTY RESIDENTS, WHO MAKE UP THE MAJORITY OF HCMH PATIENTS. POCKETS OF EXTREME POVERTY EXIST THROUGHOUT THIS REGION, WITH RATES HIGHEST AROUND THE CITY OF DANVILLE. THE PROGRAMS WITHIN OUR COMMUNITY BENEFIT PLAN GENERALLY HAVE IMPACT UPON ALL THE TARGETED COMMUNITIES, WITH CERTAIN PROGRAMS DIRECTED AT SPECIFIC POPULATIONS.
5 - PROMOTION OF COMMUNITY HEALTHHCMH HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY AN 11-MEMBER COMMUNITY BOARD THAT SERVES ON A VOLUNTEER BASIS, WITH 7 VOTING MEMBERS AND 4 NON-VOTING STAFF MEMBERS. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE
6 - AFFILIATED HEALTH CARE SYSTEMHCMH IS A CRITICAL ACCESS HOSPITAL COMMITTED TO IMPROVING QUALITY OF LIFE IN NORTHERN VERMILION COUNTY AND THE SURROUNDING AREA. HCMH INTEGRATED WITH THE CARLE FOUNDATION IN 2012 TO PROVIDE MORE ACCESS TO PRIMARY AND SPECIALTY CARE. THOUGH HCMH FALLS UNDER THE UMBRELLA OF THE CARLE FOUNDATION, IT MAINTAINS A SEPARATE BOARD OF DIRECTORS AND SENIOR LEADERSHIP, AND CONDUCTED ITS OWN CHNA AND IMPLEMENTATION PLAN IN 2013. WHILE HCMHS CHNA AND COMMUNITY BENEFIT REPORTING IS SEPARATE FROM THE CARLE FOUNDATION HOSPITAL, IT FOLLOWS THE SAME GUIDELINES AND PRINCIPLES. HCMH STAFF ARE INVOLVED IN THE CHNA AND IMPLEMENTATION PLAN, AND SERVE ON HUMAN SERVICES AGENCY BOARDS AND COMMITTEES TO PROVIDE SUPPORT TO HELP ADDRESS IDENTIFIED COMMUNITY NEEDS IN NORTHERN VERMILION COUNTY, INCLUDING CHILDRENS HEALTH, TEEN AND ADOLESCENT HEALTH, ORAL HEALTH, CANCER AND DIABETES.
7 - STATE FILING OF COMMUNITY BENEFIT REPORTAS A CRITICAL ACCESS HOSPITAL, HCMH IS NOT RESPONSIBLE FOR FILING A STATE COMMUNITY BENEFIT REPORT.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Joseph Barkmeier MD
Trustee$0$260,805$0$58,459$0$41,525$0$75,984$0$11,938$0$448,711$0$34,418
Letha Kramer
Trustee$0$155,478$0$19,367$0$548$0$13,749$0$9,878$0$199,020$0$0
Harry Brockus
Ex-Officio Board, CEO$188,364$0$28,739$0$2,222$0$50,515$0$19,694$0$289,534$0$0$0
Dennis Hesch
Exec VP & CFO$0$621,077$0$149,692$0$224,736$0$220,069$0$22,991$0$1,238,565$0$193,630
Laurence Fallon
Exec VP-Legal Affairs & HR$0$501,989$0$119,936$0$128,289$0$170,362$0$22,333$0$942,909$0$122,184
Daniel Chase MD
Highly Comp Emp - Former$0$434,877$0$0$0$2,659$0$21,480$0$20,018$0$479,034$0$0
William McCarthy MD
Highly Comp Emp - Former$0$242,168$0$0$0$32,133$0$21,227$0$1,600$0$297,128$0$0
Albert Tanlim MD
Highly Comp Emp - Former$0$206,785$0$0$0$1,992$0$16,241$0$19,873$0$244,891$0$0
Cortney Joneikis MD MS
Highly Comp Emp - Former$0$309,585$0$25,000$0$2,537$0$21,480$0$19,322$0$377,924$0$0
Susan Berg MD
Highly Comp Emp - Former$0$233,311$0$25,000$0$8,166$0$17,983$0$9,851$0$294,311$0$0
Douglas Morton MD
Med Dir-Radiology$0$611,483$0$0$0$6,736$0$21,480$0$9,430$0$649,129$0$0
Ikechukwu Uzoaru MD
Med Dir-Lab$0$460,253$0$0$0$24,462$0$21,480$0$18,751$0$524,946$0$0
Pamela Bigler
SVP-Nursing & CNO$0$287,295$0$62,215$0$101,840$0$91,925$0$6,181$0$549,456$0$75,805
Scott Harding
VP-Facilities & Support Svcs$0$262,019$0$39,516$0$47,978$0$73,432$0$19,853$0$442,798$0$41,647
Sally Salmons MD
Med Dir-Prim Care & Ped Spec.$0$276,582$0$14,664$0$3,129$0$21,480$0$16,926$0$332,781$0$0
Dennis Price
Physician Assistant$143,928$0$375$0$17,161$0$12,082$0$4,521$0$178,067$0$0$0
Larry Whitaker Jr
Physician Assistant$126,661$0$375$0$607$0$9,876$0$23,597$0$161,116$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSUPPLEMENTAL COMPENSATION INFORMATIONFormAndLineReferenceDesc
ExplanationSCHEDULE J, PART I, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HCMH, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. SCHEDULE J, PART I, QUESTION 4B PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF HCMH, THAT ARE LISTED IN THE 990 PART VII INCLUDE JOSEPH BARKMEIER, MD, HARRY BROCKUS, DENNIS HESCH, LAURENCE FALLON, PAMELA BIGLER AND SCOTT HARDING. IN 2015, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO JOSEPH BARKMEIER, MD ($34,418), DENNIS HESCH ($193,630), LAURENCE FALLON ($122,184), PAMELA BIGLER ($75,805), AND SCOTT HARDING ($41,647). SCHEDULE J, PART I, QUESTION 7 PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
SHAUN GILLINS
FAMILY MEMB OF BOARD CHR$32,426EMPLOYMENTfalse
KIMBERLY S HOUMES
FAMILY MEMB OF TRUSTEE$90,089EMPLOYMENTfalse
HEATHER MOORE
FAMILY MEMB OF TRUSTEE$76,287EMPLOYMENTfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceRELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATIONFormAndLineReferenceDesc
ExplanationFORM 990, SCHEDULE L, PART IV, COLUMN D SHAUN GILLINS IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH RUSS LEIGH WHO SERVES AS THE CHAIR OF THE HOSPITAL'S BOARD OF DIRECTORS. KIMBERLY HOUMES IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE FOR THE HOSPITAL. HEATHER MOORE IS AN EMPLOYEE OF HCMH AND HAS A FAMILY RELATIONSHIP WITH KARLA COON WHO SERVES AS A TRUSTEE FOR THE HOSPITAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, SUPPLEMENTAL INFORMATIONFORM 990, PART VI, QUESTION 2 TRUSTEE, JOSEPH BARKMEIER, MD AND OFFICER, DENNIS HESCH HAD A BUSINESS RELATIONSHIP. FORM 990, PART VI, QUESTION 6 HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION.
FORM 990, PART VI, QUESTION 7AHOOPESTON COMMUNITY MEMORIAL HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES.
FORM 990, PART VI, QUESTION 7BHOOPESTON COMMUNITY MEMORIAL HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF INCORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $50,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED AND FOR RECOMMENDING THE CEO OF THE CORPORATION TO THE HOOPESTON BOARD OF TRUSTEES.
FORM 990, PART VI, QUESTION 11BTHE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS.
FORM 990, PART VI, QUESTION 12CTHE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, QUESTIONS 15A & 15BTHE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO OF THE CARLE FOUNDATION, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE.
FORM 990, PART VI, QUESTIONS 18 & 19THE CARLE FOUNDATION, THE SOLE MEMBER OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES.
FORM 990, PART VII, SECTION A, COLUMN BTHE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK.
FORM 990, PART XI, LINE 9PERMANANTLY RESTRICTED ASSETS INCREASED AS A RESULT OF A CHANGE IN VALUE OF THE BENEFICIAL INTEREST IN A PERPETUAL TRUST OF $5,276. TEMPORARILY RESTRICTED ASSETS INCREASED BY $2,062 RESULTING FROM CHANGES IN THE POLAND TRUST ACCOUNT WHICH IS A TEMPORARILY RESTRICTED FUND USED TO PROVIDE TUITION ASSITANCE FOR NURSING STUDENTS.
FORM 990, PART XII, LINES 2A, B, C AND PART IV, LINES 12A & 12BTHE FINANCIAL STATEMENTS FOR HOOPESTON COMMUNITY MEMORIAL HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
THE CARLE FOUNDATION HOSPITAL
611 W PARK STURBANAIL618012595371119538HOSPITAL SERVIL501(c)(3)3TCFYes (true)
THE CARLE FOUNDATION
611 W PARK STURBANAIL618012595370673465PARENT/INVMGTIL501(c)(3)11C III-FINAfalse
CARLE HEALTH CARE INCORPORATED
611 W PARK STURBANAIL618012595371140016VAR MED SVCSIL501(c)(3)9TCFYes (true)
CARLE RETIREMENT CENTERS INC
611 W PARK STURBANAIL618012595371160033RTRMT LIVINGIL501(C)(3)9TCFYes (true)
THE CARLE DEVELOPMENT FOUNDATION
611 W PARK STURBANAIL618012595371159978FUNDRAISINGIL501(c)(3)7TCFYes (true)
CARLE COMMUNITY HEALTH CORPORATION
611 W PARK STURBANAIL618012595364458371FNDN MISSIONIL501(c)(3)11a TYPE ITCDFYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
HEALTH SYSTEMS INSURANCE LIMITED
GOVERNORS SQ 2ND FL BLDG 3GRAND CAYMANCJKY1-1102INSURANCECJNAC CorpYes (true)
CARLE HOLDING COMPANY INC
HOLDING COmpanyNAC CorpYes (true)611 W PARK STURBANAIL618012595371188284IL
CARLE RISK MANAGEMENT COMPANY
RISK MANAGEMEntNAC CorpYes (true)611 W PARK STURBANAIL618012595371217973IL
EVALIDATA INC
PHYS CREDENTIalsNAC CorpYes (true)611 W PARK STURBANAIL618012595462022658IL
HEALTH ALLIANCE CONNECT INC
HEALTH CARE CoordNAC CorpYes (true)301 S VINE STURBANAIL61801464796891IL
HEALTH ALLIANCE MEDICAL PLANS INC
HEALTH COVERAgeNAC CORPYes (true)301 S VINE STURBANAIL61801371260731IL
CHA HOLDING INC
HOLDING COmpanyNAC CORPYes (true)301 S VINE STURBANAIL61801471854275IL
HEALTH ALLIANCE NORTHWEST HOLDING INC
HOLDING COmpanyNAC CORPYes (true)820 N CHELAN AVEWENATCHEEWA98801461717578WA
HEALTH ALLIANCE NORTHWEST HEALTHPLAN INC
HEALTH COVERAgeNAC CORPYes (true)820 N CHELAN AVEWENATCHEEWA98801461966323WA
HEALTH ALLIANCE MIDWEST INC
HEALTH COVERAgeNAC CORPYes (true)301 S VINE STURBANAIL61801371354502IL
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
health systems insurance limited
m$67,345book value
the carle foundation hospital
m$472,541book value
the carle foundation hospital
l$54,721book value
the carle foundation hospital
s$2,132,501book value
carle health care incorporated
m$11,910,044book value
health alliance medical plans inc
l$8,574,242book value
health alliance connect inc
l$6,693,127book value

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