St Margaret's Health-Peru: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- St Margaret's Health-Peru (EIN 36-2852553)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201601339349305560
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T16:12:28-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 N BROADWAY SUITE 600 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 631022733 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362852553 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Illinois Valley Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DIANE GARLAND | InCareOfNm |
| Business Name Control | ILLI | BusinessNameControlTxt |
| Phone | 8152233300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TOMMY HOBBS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8152233300 | PhoneNum |
| Signature | 2016-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Troy A Lindsey | PreparerPersonNm |
| PTIN | P01041237 | PTIN |
| Phone | 3142315544 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TOMMY HOBBS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,163,175 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IVCH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 710 | TotalEmployeeCnt |
| Total Volunteers | 170 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $439,388 | PYContributionsGrantsAmt |
| CY Contributions Grants | $56,272 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $83,035,966 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $79,511,873 | CYProgramServiceRevenueAmt |
| PY Investment Income | $649,191 | PYInvestmentIncomeAmt |
| CY Investment Income | $425,856 | CYInvestmentIncomeAmt |
| PY Other Revenue | $644,437 | PYOtherRevenueAmt |
| CY Other Revenue | $627,854 | CYOtherRevenueAmt |
| PY Total Revenue | $84,768,982 | PYTotalRevenueAmt |
| CY Total Revenue | $80,621,855 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $43,695 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $40,520 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,944,930 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $40,080,651 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $46,264,933 | PYOtherExpensesAmt |
| CY Other Expenses | $43,139,215 | CYOtherExpensesAmt |
| PY Total Expenses | $84,253,558 | PYTotalExpensesAmt |
| CY Total Expenses | $83,260,386 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $515,424 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,638,531 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $76,014,036 | TotalAssetsBOYAmt |
| Total Assets EOY | $76,142,677 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $39,971,042 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $46,458,665 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $36,042,994 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $29,684,012 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $68,951,442 | ExpenseAmt |
| Grant | $40,520 | GrantAmt |
| Revenue | $79,511,873 | RevenueAmt |
| Desc | ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) IS A SMALL, INTEGRATED COMMUNITY HEALTH CARE DELIVERY SYSTEM. SERVICES RANGE FROM EMPLOYED PHYSICIANS AND MID-LEVELS IN THE SPECIALTIES OF FAMILY MEDICINE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, OTORHINOLARYNGOLOY, AND SLEEP MEDICINE. IN ADDITION TO THESE PHYSICIAN PRACTICES, IVCH ALSO OFFERS A FAST CARE AND CARE TODAY CLINIC WHICH PROVIDES A LOWER-COST, CONVENIENT ALTERNATIVE TO EMERGENCY ROOM CARE. CONTRACTED PHYSICIAN SERVICES ARE PROVIDED FOR EMERGENCY MEDICINE, ANESTHESIOLOGY AND HOSPITALISTS SERVICES. INPATIENT HOSPITAL SERVICES PROVIDED BY IVCH INCLUDE MEDICAL AND SURGICAL SERVICES, ICU, OBSTETRICS, SWING BEDS, DIAGNOSTIC, REHAB AND TREATMENT SERVICES. OUTPATIENT SERVICES INCLUDE SURGERY, EMERGENCY ROOM, LABORATORY, DIAGNOSTIC IMAGING, REHAB SERVICES, PAIN MANAGEMENT, SLEEP THERAPY, WOUND MANAGEMENT, RESPIRATORY CARE, EKG, OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES. HOSPICE AND ADULT DAY CARE SERVICES ARE ALSO PROVIDED. IVCH IS A MEDICARE DEPENDENT HOSPITAL AND QUALIFIES FOR DISPROPORTIONATE SHARE PAYMENTS. IVCH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR FINANCIAL STATUS OR ABILITY TO PAY. IVCH SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNABLE TO PAY AND THOSE WHO RECEIVE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. IN FY 2015 THE COST OF FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMS PROVIDED BY IVCH WAS $6,798,890. STATISTICS: INPATIENT ADMISSIONS: 2,555 INPATIENT DAYS: 7,346 NEWBORN DELIVERIES: 464 INPATIENT SURGERIES: 735 OUTPATIENT SURGERIES: 4,628 OUTPATIENT VISITS: 91,092 EMERGENCY ROOM VISITS: 15,552 CLINIC VISITS: 71,094 | Desc |
| Total Program Service Expenses | $68,951,442 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 69 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 710 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DIANE GARLAND | PersonNm |
| Phone | 8157803500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CYNTHIA KURKOWSKI | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| DAVID J SICKLEY | ||||||||
| TREASURER | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GEORGE BUCKMAN | ||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES CLINARD | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES LOVELAND | ||||||||
| VICE PRESIDENT | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOSEPH HOGAN | ||||||||
| DIRECTOR | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| KRISTINE A PAUL | ||||||||
| PRESIDENT | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MICHAEL ROONEY OD | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD MARTUZZO | ||||||||
| SECRETARY | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WILLIAM ETZENBACH | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM VLASNIK | ||||||||
| DIRECTOR | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN DAVIS | ||||||||
| CFO | 34.0 | 6.0 | $139,992 | $0 | $36,763 | Yes (X) | ||
| TOMMY HOBBS | ||||||||
| CEO | 34.0 | 6.0 | $235,319 | $0 | $43,382 | Yes (X) | ||
| BRANDON MUSGRAVE MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $510,249 | $0 | $34,727 | Yes (X) | ||
| MARIO COTE MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $467,560 | $0 | $37,126 | Yes (X) | ||
| PETER MEIER MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $726,707 | $0 | $33,790 | Yes (X) | ||
| ROBERT MITCHELL MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $578,642 | $0 | $31,069 | Yes (X) | ||
| SCOTT MILLINGTON MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $415,993 | $0 | $33,366 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,074,462 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $250,223 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PERU EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | PHYSICIAN SERVICES | $3,282,384 |
| IVAA | |||||
| 925 WEST STREET | PERU | IL | 61354 | ANESTHESIOLOGY | $1,167,667 |
| EUGENE BECKER MD | |||||
| 14637 RIVER OAKS DRIVE | LINCONSHIRE | IL | 60069 | ANESTHESIOLOGY | $450,000 |
| DOWNSTATE SHOCKWAVE THERAPIES | |||||
| 405 BRONCO DRIVE | BLOOMINGTON | IL | 61704 | LITHOTRIPSY | $380,901 |
| LOCUMTENENSCOM | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | PHYSICIAN STAFFING | $273,290 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $56,272 | RelatedOrganizationsAmt |
| Total Contributions | $56,272 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $78,849,913 | $78,849,913 |
| EHR INCENTIVE REVENUE | 621110 | $661,960 | $661,960 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $79,511,873 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $425,856 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $425,856 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $426,499 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $541,320 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$114,821 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$114,821 | TotalRevenueColumnAmt |
| Exclusion | -$114,821 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 721000 | $272,237 | $272,237 |
| MANAGEMENT FEES | 541610 | $58,000 | $58,000 |
| TRANSPORT VEHICLE REVENUE | 900099 | $248,541 | $248,541 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,897 | TotalRevenueColumnAmt |
| Exclusion | $163,897 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $742,675 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,621,855 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,511,873 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,053,710 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,520 | TotalAmt |
| Program Services | $40,520 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455,456 | TotalAmt |
| Management And General | $455,456 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,474 | TotalAmt |
| Management And General | $25,474 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,360,139 | TotalAmt |
| Program Services | $23,296,120 | ProgramServicesAmt |
| Management And General | $5,064,019 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,314,368 | TotalAmt |
| Program Services | $1,084,456 | ProgramServicesAmt |
| Management And General | $229,912 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,966,707 | TotalAmt |
| Program Services | $6,498,058 | ProgramServicesAmt |
| Management And General | $1,468,649 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,958,507 | TotalAmt |
| Program Services | $1,586,307 | ProgramServicesAmt |
| Management And General | $372,200 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $560,795 | TotalAmt |
| Management And General | $560,795 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,651 | TotalAmt |
| Management And General | $69,651 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,685 | TotalAmt |
| Management And General | $46,685 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,565,617 | TotalAmt |
| Program Services | $5,565,617 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,921 | TotalAmt |
| Program Services | $133,727 | ProgramServicesAmt |
| Management And General | $459,194 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $702,390 | TotalAmt |
| Program Services | $338,604 | ProgramServicesAmt |
| Management And General | $363,786 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,201,254 | TotalAmt |
| Program Services | $800,836 | ProgramServicesAmt |
| Management And General | $400,418 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,846,708 | TotalAmt |
| Program Services | $1,622,665 | ProgramServicesAmt |
| Management And General | $224,043 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,084 | TotalAmt |
| Program Services | $16,294 | ProgramServicesAmt |
| Management And General | $790 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,015 | TotalAmt |
| Program Services | $118,500 | ProgramServicesAmt |
| Management And General | $14,515 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,175 | TotalAmt |
| Program Services | $486,947 | ProgramServicesAmt |
| Management And General | $114,228 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,063,823 | TotalAmt |
| Program Services | $3,285,967 | ProgramServicesAmt |
| Management And General | $777,856 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $854,786 | TotalAmt |
| Program Services | $496,980 | ProgramServicesAmt |
| Management And General | $357,806 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $12,051,161 | $11,817,139 | $234,022 |
| PURCHASED SERVICES | $7,457,747 | $5,019,072 | $2,438,675 |
| BAD DEBT EXPENSE | $4,267,911 | $4,267,911 | |
| REPAIRS & MAINTENANCE | $1,582,321 | $1,208,081 | $374,240 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,524,171 | TotalAmt |
| Program Services | $1,267,641 | ProgramServicesAmt |
| Management And General | $256,530 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,260,386 | TotalAmt |
| Program Services | $68,951,442 | ProgramServicesAmt |
| Management And General | $14,308,944 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,682,073 | BOYAmt |
| EOY | $3,420,379 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,807 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,254,591 | BOYAmt |
| EOY | $10,174,899 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,927,763 | BOYAmt |
| EOY | $2,707,034 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,130,385 | BOYAmt |
| EOY | $1,340,551 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $112,738,937 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $75,525,518 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,981,086 | BOYAmt |
| EOY | $37,213,419 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,377,346 | BOYAmt |
| EOY | $15,819,673 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $436,084 | BOYAmt |
| EOY | $405,300 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,123,901 | BOYAmt |
| EOY | $5,061,422 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,014,036 | BOYAmt |
| EOY | $76,142,677 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,190,488 | BOYAmt |
| EOY | $10,067,413 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,559,750 | BOYAmt |
| EOY | $21,430,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,210,865 | BOYAmt |
| EOY | $1,793,247 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,009,939 | BOYAmt |
| EOY | $13,168,005 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,971,042 | BOYAmt |
| EOY | $46,458,665 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,832,432 | BOYAmt |
| EOY | $28,473,430 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,210,562 | BOYAmt |
| EOY | $1,210,582 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,042,994 | BOYAmt |
| EOY | $29,684,012 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,014,036 | BOYAmt |
| EOY | $76,142,677 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,638,531 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$154,046 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$2,761,088 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$805,317 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Mailings Members | $100 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $64,004 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $64,104 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | ALLOCATED PORTION OF MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND MEDICARE DEPENDENT RURAL HOSPITAL COALITION. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,476,235 | OtherCostOrOtherBasisAmt |
| Book Value | $1,476,235 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,703,163 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,891,975 | DepreciationAmt |
| Book Value | $22,811,188 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $304,038 | OtherCostOrOtherBasisAmt |
| Depreciation | $184,042 | DepreciationAmt |
| Book Value | $119,996 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $56,831,404 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,397,794 | DepreciationAmt |
| Book Value | $12,433,610 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,424,097 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,051,707 | DepreciationAmt |
| Book Value | $372,390 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $37,213,419 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $2,042,685 |
| INTEREST IN IVCH FOUNDATION | $1,210,582 |
| OTHER ASSETS | $1,808,155 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,061,422 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION OBLIGATION | $4,965,800 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $3,903,132 |
| ESTIMATED SELF-INSURANCE COSTS | $3,912,000 |
| DUE TO AFFILIATES | $387,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $13,168,005 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $551,327 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $551,327 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00700 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,719,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,553,248 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,166,567 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,271,142 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,553,248 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,717,894 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $805,320 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $319,151 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $486,169 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,270 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,270 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $964,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $613,434 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $350,812 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,520 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $44,520 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,831,356 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $932,585 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $898,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,102,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,485,833 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,616,665 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,267,911 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $427,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $18,901,544 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,027,488 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$125,944 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS VALLEY COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.IVCH.ORG | WebsiteAddressTxt |
| State License | 0003418 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | VARIOUS PHYSICIAN CLINICS & OUTPATIENT SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS VALLEY COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | 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 |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3J | INDUSTRY DATA RELATED TO PROJECTED GROWTH IN NEED FOR VARIOUS SERVICES SPECIFIC TO THE POPULATION OF THIS AREA |
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT FOR CHNA: THE CHNA STAKEHOLDERS WORKING GROUP, COMPRISED OF MEMBERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, WAS RESPONSIBLE FOR THE CHNA PROCESS. THE STAKEHOLDER GROUP INCLUDED MEMBERS FROM : IVCH, IVCH MEDICAL GROUP, LA SALLE COUNTY HEALTH DEPT., ALTERNATIVES FOR THE OLDER ADULT, YOUTH SERVICE BUREAU, NORTH CENTRAL BEHAVIORAL HEALTH SERVICES, HYGIENIC INSTITUTE, OGLESBY PUBLIC SCHOOLS AND ILLINOIS VALLEY UNITED WAY. THE WORKING GROUP DEVELOPED A SURVEY INSTRUMENT, EVALUATED SURVEY RESPONSES, COLLECTED AND EVALUATED SECONDARY DATA, SYNTHESIZED THE PRIMARY AND SECONDARY DATA, AND IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. PRIMARY DATA FOR THIS ASSESSMENT CAME FROM TWO SOURCES, A COMMUNITY STUDY PERFORMED FOR IVCH BY LEEDE RESEARCH IN 2008 AND A SURVEY DEVELOPED, DISTRIBUTED AND ANALYZED BY THE STAKEHOLDERS WORKING GROUP SPECIFICALLY FOR THE CHNA. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | WWW.IVCH.ORG IS THE ORGANIZATION'S WEBSITE. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE UNDER THE ABOUT US TAB ON THE HOME PAGE. |
| SCHEDULE H, PART V, SECTION B, LINE 10A | WWW.IVCH.ORG UNDER THE PATIENT TAB OF THE HOME PAGE OF THE ORGANIZATION. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES A DESCRIPTION OF THE ACTIONS TAKEN TO MEET NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE AREAS OF CONCERN THAT HAVE BEEN IDENTIFIED HISTORICALLY, AND WERE FURTHER ELEVATED IN THE NEW 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, RELATE TO MENTAL HEALTH/ADDICTION SERVICES AND DENTAL CARE. REGARDING DENTAL CARE, IVCH HAS DEVELOPED A LISTING OF SERVICES AVAILABLE IN THE AREA WHICH IS PROVIDED TO PATIENTS. THE MOST SIGNIFICANT NEED IS THE MENTAL HEALTH AND ADDICTION SERVICES. IN ADDITION TO THE ALREADY IDENTIFIED NEED, A SIGNIFICANT MENTAL HEALTH AGENCY IN THE SERVICE AREA HAS GREATLY REDUCED ITS SERVICES DUE TO THE REDUCTION IN ITS GRANT FUNDING. THIS IS CURRENTLY SIGNIFICANTLY IMPACTING ACCESS TO MENTAL HEALTH CARE. INADEQUATE AVAILABILE MENTAL HEALTH INPATIENT CARE IS RESULTING IN A BACKUP OF PATIENTS IN EMERGENCY CARE. IVCH IS EXPLORING PSYCHIATRY TELEHEALTH SERVICES AS WELL AS A POTENTIAL JOINT VENTURE OF PSYCHIATRY SERVICES WITH A HOSPITAL IN THE ADJACENT SERVICE AREA. |
| SCHEDULE H, PART V, SECTION B, LINES 16 A, B, & C | WWW.IVCH.ORG LOCATED IN THE PATIENTS TAB ON THE HOME PAGE |
| SCHEDULE H, PART V, SECTION B, LINE 20E | EFFORTS ARE MADE ON EACH ACCOUNT TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE POLICY, AND WITH PATIENTS WHO DO NOT WISH TO BECOME ELIGIBLE, A REASONABLE RE-PAYMENT PLAN IS DEVELOPED THAT IS KNOWN TO THE PATIENT. |
| 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 |
|---|---|---|---|---|
| CENTER FOR PHYSICAL REHABILITATION | ||||
| 300 WALNUT ST | PERU | IL | 61354 | OUTPATIENT PHYSICAL REHABILITATION |
| IVCH WOUND & HYPERBARIC CENTER | ||||
| 1403 6TH ST | PERU | IL | 61354 | WOUND AND HYPERBARIC THERAPY |
| ILLINOIS VALLEY ADULT DAY CENTER | ||||
| 1040 SECOND ST | LA SALLE | IL | 61301 | ADULT DAY CARE |
| IVCH CARE TODAY | ||||
| 300 WALNUT ST | PERU | IL | 61354 | URGENT CARE ALTERNATIVE TO ER |
| IVCH FAST CARE | ||||
| 5307 ST ROUTE 251 | PERU | IL | 63154 | RETAIL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART III, SECTION A, LINE 2 | THE ORGANIZATION RECORDS CONTRACTUAL DISCOUNTS AT THE TIME OF THE POSTING OF THE PAYMENT FOR SERVICES FROM THIRD PARTY PAYORS. BAD DEBT IS RECORDED AT THE TIME THE ACCOUNT IS EITHER PRESUMED UNCOLLECTIBLE OR TURNED OVER TO COLLECTION. FURTHER, THE ORGANIZATION RECORDS APPROPRIATE ALLOWANCES FOR CONTRACTUAL DISCOUNTS AND BAD DEBT/CHARITY CARE ORDER TO REFLECT ACCOUNTS RECEIVABLE AT THE EXPECTED COLLECTIBLE AMOUNT. CONTRACTUAL DISCOUNTS/MEDICARE/MEDICAID: MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYORS IN EVALUATING THE REASONABLE ESTIMATE OF THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. FOR SERVICES PROVIDED TO PATIENTS THAT HAVE THIRD PARTY COVERAGE, THE CORPORATION ANALYZES THE DISCOUNT RATES FOR EACH MAJOR PAYOR. THE DIFFERENCE BETWEEN THE NEGOTIATED RATES FOR THE MEDICARE/MEDICAID STANDARD RATES ARE USED TO DETERMINE THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. SELF-PAY ACCOUNTS RECEIVABLE INCLUDE THE PATIENT RESPONSIBILITY FOR SERVICES AFTER THE THIRD PARTY COVERAGE HAS BEEN APPLIED TO THE PATIENT ACCOUNT AS WELL AS THE UNINSURED. AN ALLOWANCE FOR BAD DEBT IS ESTIMATED BASED ON PAST EXPERIENCE AS WELL AS THE AGE OF THE ACCOUNTS. THE ORGANIZATION HAS A COLLECTIONS PRACTICES POLICY THAT IS USED TO SET GUIDELINES ON THE APPROACH AND TIMELINE TO MAKE REASONABLE COLLECTION EFFORTS BEFORE ANY ACCOUNTS ARE TURNED OVER TO A COLLECTION AGENCY. THE ORGANIZATION HAD BAD DEBT EXPENSE TOTALING $4,267,911. THIS REFLECTS THE COMBINED IMPACT OF WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS, PROVISIONS RECORDED TO ESTIMATE BAD DEBT ON ACCOUNTS RECEIVABLE. DURING FISCAL 2015 THERE WERE NO CHANGES IN THE ORGANIZATION'S POLICIES OR PRACTICES. IN FISCAL 2016 THE CHARITY CARE POLICY AND COLLECTION PRACTICES POLICIES HAVE ALL BEEN UPDATED AND ARE 501(R) COMPLIANT. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | 10% OF BAD DEBT IS ASSUMED TO BE PROVIDED INCLUDE AMOUNTS WRITTEN OFF FOR PATIENTS THAT WOULD HAVE QUALIFIED FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE RATIONALE FOR THE PERCENTAGE BEING THIS IS BECAUSE OF THE SIGNIFICANT STEPS TAKEN WITH PATIENTS TO FACILITATE MEDICAID OR FINANCIAL ASSISTANCE QUALIFICATION. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 73 PERCENT AT JUNE 30, 2015. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON-PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM WORKSHEET D OF THE FY 2015 MEDICARE COST REPORT. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | WHEN A PATIENT IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE THE ACCOUNT IS PLACED ON HOLD AND NO FURTHER COLLECTION EFFORTS ARE MADE UNTIL THE REQUEST FOR ASSISTANCE HAS BEEN RESOLVED. THE APPLICATION PROCESS INCLUDES FACILITATING THE PATIENT'S APPLICATION FOR VARIOUS ASSISTANCE PROGRAMS, AND IDENTIFYING WHERE THE PATIENT FALLS IN THE DISCOUNT SCALE OF THE ORGANIZATION BASED ON INCOME LEVEL AND SIZE OF FAMILY. IF THERE IS A BALANCE REMAINING AFTER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE HAS BEEN APPLIED, A MUTUALLY AGREED UPON PAYMENT PLAN IS DEVELOPED AND THE ACCOUNT FOLLOWS THE SAME COLLECTION PROCEDURES AS ALL OTHER SELF-PAY ACCOUNTS. MONTHLY PAYMENTS ARE REQUIRED AND BALANCES ARE TYPICALLY EXPECTED TO BE PAID IN FULL WITHIN ONE YEAR. EXTENSIONS MAY BE APPROVED FOR UNEXPECTED CHANGES IN ABILITY TO MEET THE PAYMENT SCHEDULE. COLLECTION PROCEDURES INCLUDE STATEMENTS, PAST DUE NOTICES, PHONE CALLS AND IF AGREED UPON PAYMENT ARRANGEMENTS CAN NOT BE MET, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY. |
| SCHEDULE H, PART VI, LINE 2 | THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY IVCH IS BASED ON A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON-EXISTENCE OF APPROPRIATE SERVICES, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, COLLABORATION WITH COMMUNITY ORGANIZATIONS, GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS, BENCHMARKING MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT AND MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS. |
| SCHEDULE H, PART VI, LINE 3 | DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDING CONTACT INFORMATION FOR THE PATIENT FINANCIAL SERVICES DEPT. BASIC INFORMATION AND CONTACT INFORMATION IS ALSO AVAILABLE AT WWW.ICVH.ORG ON THE PATIENTS & VISITORS TAB ON THE HOME PAGE. WHEN CONTACTED BY A PATIENT, FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT TO DETERMINE ELIGIBILITY FOR CHARITY OR FINANCIAL ASSISTANCE. NOTICES ABOUT FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE REGISTRATION AREAS AND INFORMATION IS ALSO INCLUDED ON THE PATIENT STATEMENTS. THE SOCIAL SERVICES DEPARTMENT NOTIFIES EACH INPATIENT OF FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT IVCH AS WELL AS LOCAL, STATE AND FEDERAL PROGRAMS THEY MAY BE ELIGIBLE FOR. |
| SCHEDULE H, PART VI, LINE 4 | ILLINOIS VALLEY COMMUNITY HOSPITAL SERVES THE RESIDENTS OF RURAL COMMUNITIES LOCATED IN LA SALLE, BUREAU AND PUTNAM COUNTIES, IN NORTH CENTRAL ILLINOIS. THE HOSPITAL IS LOCATED NEAR THE JUNCTION OF INTERSTATES 80 AND 39 AND IS 62 MILES WEST OF JOLIET AND 64 MILES NORTH OF BLOOMINGTON. THE PRIMARY SERVICE AREA OF THE HOSPITAL HAS A POPULATION OF ABOUT 35,000. NO POPULATION GROWTH IS PROJECTED FOR THE AREA. THE LARGEST AREA EMPLOYERS ARE INVOLVED IN TRANSPORTATION, WAREHOUSING, AGRICULTURE, LIGHT INDUSTRY AND RETAIL SERVICES. THE SERVICE AREA RACE AND ETHNICITY IS COMPOSED OF 88% WHITE, 2% AFRICAN AMERICAN, 9% HISPANIC AND 1% ASIAN. ACCORDING TO THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, THE 2015 UNEMPLOYMENT RATE IN LA SALLE COUNTY WAS 8.3%, WHICH WAS HIGHER THAN THE STATE OF ILLINOIS (7.1%) AND THE UNITED STATES (6.2%). THE MEDIAN HOUSEHOLD INCOME IN LA SALLE ($49,487), BUREAU ($49,062) AND PUTNAM ($56,212) COUNTIES WERE ALL BELOW THE STATE OF ILLINOIS FIGURE OF $58,438. THE PROPORTION OF LA SALLE COUNTY RESIDENTS LIVING BELOW THE FEDERAL POVERTY LEVEL (13.2%) IS SLIGHTLY LESS THAN THE STATE AVERAGE OF 14.4%. IVCH SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE OR ABILITY TO PAY. APPROXIMATELY 63.5% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM PARTICIPATION IN THE MEDICARE AND MEDICAID PROGRAMS FOR THE YEAR ENDING JUNE 30, 2015. |
| SCHEDULE H, PART VI, LINE 5 | THE BOARD OF DIRECTORS OF IVCH IS COMPOSED OF 10 COMMUNITY MEMBERS RESIDING IN OUR SERVICE AREA. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT. IVCH MAINTAINS AN OPEN MEDICAL STAFF AND IS CONSTANTLY RECRUITING NEW PHYSICIANS TO MEET IDENTIFIED NEEDS. ALL AVAILABLE CASH FLOW GENERATED BY THE ORGANIZATION IS REINVESTED BACK INTO THE HOSPITAL THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT MEET THE NEEDS OF THE SERVICE AREA. THE COMMUNITY OUTREACH DEPARTMENT OFFERS A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMMING, INCLUDING TAI CHI CLASSES, FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS, HEMOGLOBIN A1C SCREENINGS, LIPID PROFILE SCREENINGS, HEALTHY HEART SCREENINGS, PROSTATE CANCER SCREENINGS, SMOKING CESSATION CLASSES, BABYSITTING CLINICS, CPR INSTRUCTION AND FIRST AID. |
| SCHEDULE H, PART VI, LINE 6 | NOT APPLICABLE |
| SCHEDULE H, PART VI, LINE 7 | ILLINOIS |
| SCHEDULE H, PART I, LINE 7, COLUMNF F | THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $4,267,911 REPORTED ON FORM 990, PART IX, LINE 25, HOWEVER, THIS EXPENSE HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| SCHEDULE H, PART I, LINE 7 | THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. |
| SCHEDULE H, PART I, LINE 7G | THE AMOUNTS REPORTED ON ROW 7G DO NOT CONTAIN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCH OF DIMES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 FIRST ST | AddressLine1Txt |
| City | LA SALLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 131846366 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $13,000 | CashGrantAmt |
| Purpose Of Grant | DONATION | 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 | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | IVCH GRANTS FUNDS TO OTHER ORGANIZATIONS AND COMMUNITY BENEFIT PROJECTS AROUND THEIR COMMUNITY TO IMPROVE THE HEALTH AND WELLNESS OF RESIDENTS. ALL RECIPIENTS WHO RECEIVED OVER $5,000 DURING THE YEAR ARE REPORTED ON PART II. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHEN DAVIS | ||||||||||||||
| CFO | $139,992 | $0 | $0 | $0 | $0 | $0 | $9,184 | $0 | $27,579 | $0 | $176,755 | $0 | $0 | $0 |
| TOMMY HOBBS | ||||||||||||||
| CEO | $235,319 | $0 | $0 | $0 | $0 | $0 | $15,296 | $0 | $28,086 | $0 | $278,701 | $0 | $0 | $0 |
| BRANDON MUSGRAVE MD | ||||||||||||||
| PHYSICIAN | $480,249 | $0 | $30,000 | $0 | $0 | $0 | $7,800 | $0 | $26,927 | $0 | $544,976 | $0 | $0 | $0 |
| MARIO COTE MD | ||||||||||||||
| PHYSICIAN | $206,206 | $0 | $261,354 | $0 | $0 | $0 | $7,800 | $0 | $29,326 | $0 | $504,686 | $0 | $0 | $0 |
| PETER MEIER MD | ||||||||||||||
| PHYSICIAN | $626,707 | $0 | $100,000 | $0 | $0 | $0 | $7,800 | $0 | $25,990 | $0 | $760,497 | $0 | $0 | $0 |
| ROBERT MITCHELL MD | ||||||||||||||
| PHYSICIAN | $553,642 | $0 | $25,000 | $0 | $0 | $0 | $7,800 | $0 | $23,269 | $0 | $609,711 | $0 | $0 | $0 |
| SCOTT MILLINGTON MD | ||||||||||||||
| PHYSICIAN | $415,993 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $25,566 | $0 | $449,359 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4A | STEPHEN DAVIS, FORMER CFO, WAS PAID A SEVERANCE PAYMENT OF $10,000 RELATED TO HIS SEPARATION FROM THE ORGANIZATION IN DECEMBER 2014. THE SEVERANCE PAYMENT MADE TO STEPHEN DAVIS WAS DETERMINED BY TOMMY HOBBS, CEO, AND WAS ADVISED AND APPROVED BY THE BOARD OF DIRECTORS. |
| SCHEDULE J, PART I, LINE 7 | EMPLOYED PHYSICIANS OF THE ORGANIZATION RECEIVE A BASE SALARY BASED ON THE MARKET FOR PHYSICIANS IN THEIR MEDICAL SPECIALTY. EACH PHYSICIAN HAS AN EMPLOYMENT CONTRACT WHICH MAY INCLUDE A COMPONENT OF INCENTIVE COMPENSATION. INCENTIVE COMPENSATION IS BASED ON THEIR INDIVIDUAL PROFESSIONAL PRODUCTION, PROVIDING AN OPPORTUNITY TO EARN ABOVE THE BASE SALARY LEVEL. THE BASE SALARY IS RECONCILED WITH THE PHYSICIAN'S PROFESSIONAL PRODUCTION ON A QUARTERLY AND ANNUAL BASIS. ANY AMOUNTS DUE TO THE PHYSICIANS FOR INCENTIVE COMPENSATION ARE PAID WITHIN 30 DAYS OF THE END OF THE PERIOD. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| ILLINOIS FINANCING AUTHORITY | ||||||||
| A | 861091967 | 45203HK35 | 2014-12-15 | $10,000,000 | RE-FINANCING OF EXISTING DEBT | false | false | false |
| ILLINOIS FINANCING AUTHORITY | ||||||||
| B | 861091967 | 45203HK43 | 2014-12-15 | $8,000,000 | RE-FINANCING OF EXISTING DEBT | false | false | false |
| ILLINOIS FINANCING AUTHORITY | ||||||||
| C | 861091967 | 45203HK50 | 2014-12-15 | $3,160,000 | RE-FINANCING OF EXISTING DEBT | false | false | false |
| ILLINOIS FINANCING AUTHORITY | ||||||||
| D | 861091967 | 450285255 | 2014-12-15 | $670,000 | RE-FINANCING OF EXISTING DEBT | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $0 | $0 | $10,000,000 | $0 | $0 | $10,000,000 | $0 | $0 | $0 | $0 | $0 | $0 | 2015 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $0 | $0 | $8,000,000 | $0 | $0 | $8,000,000 | $0 | $0 | $0 | $0 | $0 | $0 | 2015 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $0 | $0 | $3,160,000 | $0 | $0 | $3,160,000 | $0 | $0 | $0 | $0 | $0 | $0 | 2015 | Yes (true) | false | Yes (true) | Yes (true) |
| D | $400,000 | $0 | $670,000 | $0 | $0 | $975 | $669,025 | $0 | $0 | $0 | $0 | $0 | 2015 | Yes (true) | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | false | false | 0.01000 | 0.00000 | 0.01000 | false | false | false | Yes (true) |
| B | false | Yes (true) | false | false | 0.01000 | 0.00000 | 0.01000 | false | false | false | Yes (true) |
| C | false | Yes (true) | false | false | 0.01000 | 0.00000 | 0.01000 | false | false | false | Yes (true) |
| D | false | Yes (true) | false | false | 0.01000 | 0.00000 | 0.01000 | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | Yes (true) | false | false | Yes (true) | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| B | false | Yes (true) | false | false | Yes (true) | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| C | false | Yes (true) | false | false | Yes (true) | false | false | 0 | false | Yes (true) |
| 0 | ||||||||||
| D | false | Yes (true) | false | false | Yes (true) | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
| D | Yes (true) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DIANE DAVIS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE OF OFFICER | RelationshipDescriptionTxt |
| Transaction | $25,474 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | WILLIAM ETZENBACH, BOARD MEMBER, AND JAMES CLINARD, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S GOVERNING DOCUMENTS DURING THE YEAR: 1) RESTATEMENT OF CORPORATE PURPOSE, WITH SPECIFIC REFERENCE TO EXCLUSIVE OPERATION AS A NON-PROFIT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 2) CLARIFIED THE PROCEDURE IN THE EVENT OF CORPORATE DISSOLUTION AND 3) INCORPORATED THE CONFLICT OF INTEREST POLICY OF IVCH INTO THE PROCESS OF DECLARING AND MANAGING ANY CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION A, LINE 6 | ILLINOIS VALLEY COMMUNITY HOSPITAL IS A SUBSIDIARY OF ITS SOLE CORPORATE MEMBER, ILLINOIS VALLEY HEALTH CORP. ,INC. |
| FORM 990, PART VI, SECTION A, LINE 7A & 7B | MEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, ILLINOIS VALLEY HEALTH CORP., INC. , ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO AS IT RELATES TO THE OPERATIONS OF IVCH: APPOINT AND REMOVE DIRECTORS, RATIFY AND REMOVE OFFICERS, ADOPT, AMEND, OR REPEAL THE ARTICLES OF INCORPORATION AND/OR BY-LAWS, ADOPT A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION, APPROVE THE PURCHASE, SALE, TRANSFER, LEASE ENCUMBRANCE OF PROPERTY, APPROVE BORROWING WITH A TERM > A ONE YEAR TERM OR WHICH REQUIRES A MORTGAGE OF REAL PROPERTY, AND SELECTION OR MODIFICATION OF THE BUSINESS/LEGAL NAME OF THE ENTITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE IRS. THE FINAL VERSION OF THE FORM 990 IS E-MAILED OR HAND DELIVERED TO EACH BOARD MEMBER FOR THEIR REVIEW AND A SPECIAL BOARD MEETING IS HELD TO REVIEW AND ANSWER QUESTIONS REGARDING THE 990 PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE OFFICERS AND DIRECTORS OF IVCH ARE COVERED UNDER THE POLICY AND HAVE A DUTY TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. ALL PERSONS COVERED UNDER THE POLICY ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSE ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS. ANY TRANSACTIONS WITH COVERED PERSONS, OR ENTITIES IN WHICH A COVERED PERSON HAS ANY TYPE OF INTEREST, MUST BE AN ARM'S LENGTH TRANSACTION. THE DIRECTORS WILL REVIEW ANY TRANSACTIONS IN QUESTION AND DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PERSON MAY MAKE A PRESENTATION, BUT MUST LEAVE THE MEETING DURING DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A | AN ADHOC COMMITTEE OF THE BOARD OF DIRECTORS (INCLUDING THE BOARD PRESIDENT, CHAIRPERSON OF THE PERSONNEL COMMITTEE AND AT LEAST ONE OTHER MEMBER) CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND DETERMINE ANY CHANGE/INCREASE IN THE COMPENSATION, IF ANY, BASED UPON BENCHMARK COMPENSATION SURVEYS AND AREA NORMS. THE CEO HAS A WRITTEN EMPLOYMENT CONTRACT. RENEWAL OF THE CONTRACT OR INCREASE IN COMPENSATION MUST BE APPROVED BY A MAJORITY OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | CHANGE IN MINIMUM PENSION LIABILITY -770,651 CHANGES DUE TO FOUNDATION CONTRIBUTIONS -34,666 -------- TOTAL -805,317 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HYGIENIC INSTITUTE | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 362167742 | PRIMARY CARE | IL | 501(C)(3) | 9 | IVHC | Yes (true) |
| IVCH FOUNDATION | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 371211780 | FUNDRAISING | IL | 501(C)(3) | 11A | IVHC | Yes (true) |
| IV HEALTH CORP INC | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 371211890 | HEALTH CARE | IL | 501(C)(3) | 11B | IVHC | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALLEY REGIONAL HEALTH SERVICE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4391 VENTURE DR | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273891281 | EIN |
| Primary Activities | CANCER CARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IVCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$30,784 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $521,974 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (true) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VALLEY HEALTH ENTERPRISES | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363476877 | DME | IL | NA | C CORPORATION | Yes (true) | |||
| ILLINOIS VALLEY HEALTH SERVICES INC | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 364050682 | DORMANT | IL | NA | C CORPORATION | Yes (true) | |||
| ILLINOIS VALLEY PHO | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363978381 | PPO CONTRACTING | IL | IVCH | C CORPORATION | false | $30 | $28,632 | 0.50000 |
| IVCH GENERAL&PROFESSIONAL LIAB LOSS FUND | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 366673231 | DORMANT | IL | NA | TRUST | Yes (true) | |||
| HEALTH CARE BUILDING CORP | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363306917 | DORMANT | IL | NA | C CORPORATION | Yes (true) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| IVCH FOUNDATION | ||
| C | $56,272 | CASH |
| HYGIENIC INSTITUTE | ||
| R | $493,087 | CASH |
| HYGIENIC INSTITUTE | ||
| S | $330,000 | CASH |
| IV HEALTH CORP | ||
| E | $1,154,437 | CASH |
| VALLEY HEALTH ENTERPRISES | ||
| O | $354,021 | CASH |
| VALLEY HEALTH ENTERPRISES | ||
| Q | $68,405 | CASH |
| VALLEY HEALTH ENTERPRISES | ||
| S | $425,981 | CASH |
Comments