FURP.ORG / PUBLIC DATA EXPLORER

LAWRENCE COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
LAWRENCE COUNTY MEMORIAL HOSPITAL (EIN 80-0618988)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-16
IRS object ID
201641379349301524
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-16T08:17:52-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN430352985PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KERBER ECK & BRAECKEL LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11116 W MAIN STAddressLine1Txt
CityCARBONDALECityNm
State AbbreviationILStateAbbreviationCd
ZIP629012335ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN800618988EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAWRENCE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLAWRBusinessNameControlTxt
Phone6189431000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 WEST STATE STREETAddressLine1Txt
CityLAWRENCEVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62439ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCARL ATENPersonNm
Person TitleBOARD CHAIRPersonTitleTxt
Phone6189431000PhoneNum
Signature2016-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRENT KOCHELPreparerPersonNm
PTINP01055927PTIN
Phone6185291040PhoneNum
Preparation2016-05-16PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCARL ATENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 STATE STREETAddressLine1Txt
CityLAWRENCEVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62439ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,575,272GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LCMHOSP.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1950FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionAT LAWRENCE COUNTY MEMORIAL HOSPITAL WE OFFER COMPASSIONATE, PROFESSIONAL HEALTHCARE THAT MEETS THE HIGHEST STANDARDS OF EXCELLENCE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee174TotalEmployeeCnt
Total Volunteers37TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,518,169PYContributionsGrantsAmt
CY Contributions Grants$66,850CYContributionsGrantsAmt
PY Program Service Revenue$13,762,197PYProgramServiceRevenueAmt
CY Program Service Revenue$15,868,522CYProgramServiceRevenueAmt
PY Investment Income$26,155PYInvestmentIncomeAmt
CY Investment Income$15,765CYInvestmentIncomeAmt
PY Other Revenue$31,433PYOtherRevenueAmt
CY Other Revenue$624,135CYOtherRevenueAmt
PY Total Revenue$17,337,954PYTotalRevenueAmt
CY Total Revenue$16,575,272CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,521,431PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,972,018CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,230,270PYOtherExpensesAmt
CY Other Expenses$7,584,021CYOtherExpensesAmt
PY Total Expenses$13,751,701PYTotalExpensesAmt
CY Total Expenses$15,556,039CYTotalExpensesAmt
PY Revenues Less Expenses$3,586,253PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,019,233CYRevenuesLessExpensesAmt
Total Assets BOY$11,441,097TotalAssetsBOYAmt
Total Assets EOY$12,434,966TotalAssetsEOYAmt
Total Liabilities BOY$3,599,595TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,574,231TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,841,502NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,860,735NetAssetsOrFundBalancesEOYAmt
MissionAT LAWRENCE COUNTY MEMORIAL HOSPITAL WE OFFER COMPASSIONATE, PROFESSIONAL HEALTHCARE THAT MEETS THE HIGHEST STANDARDS OF EXCELLENCE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,297,590ExpenseAmt
Revenue$16,492,657RevenueAmt
DescTHE HOSPITPAL'S MISSION IS TO PROVIDE HIGH QUALITY CARE AND COST EFFECTIVE HEALTHCARE, WHICH INCLUDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF LAWRENCE COUNTY, IL. ALL EXPENSES RELATE TO COSTS ASSOCIATED WITH PROVIDING THESE SERVICES, AND MAINLY INCLUDE SALARY AND WAGES TO STAFF AND COST OF SUPPLIES.Desc
Total Program Service Expenses$11,297,590TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
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 EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document50IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee174EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLARRY SPOURPersonNm
Phone6189437202PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 WEST STATE STREETAddressLine1Txt
CityLAWRENCEVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62439ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CARL ATEN
BOARD CHAIR3.001.00Yes (X)Yes (X)$0$0$0
RON WALDROP
VICE CHAIR3.00Yes (X)Yes (X)$0$0$0
MATT PARGIN
TREASURER2.00Yes (X)Yes (X)$0$0$0
REBECCA NESTLEROAD
SECRETARY2.00Yes (X)Yes (X)$0$0$0
MIKE SHEPPARD
TRUSTEE2.00Yes (X)$0$0$0
STAN WILLIAMS
TRUSTEE2.00Yes (X)$0$0$0
BJ SHAFFER
TRUSTEE1.00Yes (X)$0$0$0
CURT BENSON
TRUSTEE/BEG1.00Yes (X)$0$0$0
DR GARY CARR
TRUSTEE /PHY42.00Yes (X)$224,258$0$0
DOUG FLORKOWSKI
CEO43.00Yes (X)$201,334$0$59,950
LARRY SPOUR
CFO45.00Yes (X)$104,616$0$26,991
RITA GARVEY
CNO45.00Yes (X)$87,825$0$20,703
KIM WEBER
PHARMACIST40.00$133,541$0$14,867Yes (X)
STEVEN RAMSARAN
PHYSICAN40.00$321,687$0$22,122Yes (X)
GEORGE NELSON
CRNA40.00$103,909$0$11,957Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,177,170TotalReportableCompFromOrgAmt
Total Other Compensation$156,590TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
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/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2TxtBusiness Name Line2ContractorName/BusinessName/BusinessNameLine2Txt
HEALTHCARE SERVICE CORP
25551 NETWORK PLACECHICAGOIL606731255EMPL HEALTH INS$716,988
QUORUM HEALTH RESOURCES LLC
105 CONTINENTAL PLACEBRENTWOODTN370271018CONTRACT MGT SV$683,868
MARTIN GOLDSTONE MD
3926 W TOUHY STE 369LINCOLNWOODIL60712CONTRACTED PHYS$419,580
CPSI
PO BOX 850309MOBILEAL366860309HOSP COMP SOFTW$406,6176600 WALL STREET
CARDINAL HEALTH PHARM DISTRIB
5279 COLLECTION CENTERCHICAGOIL60646PHARMACUETICALS$378,436ST LOUIS DIV
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Related Organizations$26,105RelatedOrganizationsAmt
Government Grants$40,745GovernmentGrantsAmt
Total Contributions$66,850TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Total Revenue Column$15,868,522TotalRevenueColumnAmt
Related Or Exempt Func Income$15,868,522RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,868,522TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,765TotalRevenueColumnAmt
Exclusion$15,765ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$24,796RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$24,796RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,796TotalRevenueColumnAmt
Related Or Exempt Func Income$24,796RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEANINGFULL REVENUE$463,974$463,974
CAFETERIA INCOME$95,797$95,797
OTHER REVENUE$39,568$39,568
FieldValueIRS element (for citing)
Other Revenue Total$599,339OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,575,272TotalRevenueColumnAmt
Related Or Exempt Func Income$16,492,657RelatedOrExemptFuncIncomeAmt
Exclusion$15,765ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$759,772TotalAmt
Management And General$759,772ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,793,688TotalAmt
Program Services$4,345,266ProgramServicesAmt
Management And General$1,448,422ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$102,477TotalAmt
Program Services$76,858ProgramServicesAmt
Management And General$25,619ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$875,392TotalAmt
Program Services$656,544ProgramServicesAmt
Management And General$218,848ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$440,689TotalAmt
Program Services$330,517ProgramServicesAmt
Management And General$110,172ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$204,300TotalAmt
Management And General$204,300ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$13,620TotalAmt
Management And General$13,620ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$85,021TotalAmt
Management And General$85,021ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$6,748TotalAmt
Management And General$6,748ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,637,918TotalAmt
Program Services$1,988,333ProgramServicesAmt
Management And General$649,585ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,947TotalAmt
Program Services$26,223ProgramServicesAmt
Management And General$5,724ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$280,651TotalAmt
Program Services$122,031ProgramServicesAmt
Management And General$158,620ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,389TotalAmt
Program Services$2,542ProgramServicesAmt
Management And General$847ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$763,211TotalAmt
Program Services$572,408ProgramServicesAmt
Management And General$190,803ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,479TotalAmt
Program Services$3,479ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$64,378TotalAmt
Program Services$35,571ProgramServicesAmt
Management And General$28,807ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$36,646TotalAmt
Program Services$36,646ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$883,055TotalAmt
Program Services$662,291ProgramServicesAmt
Management And General$220,764ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$198,241TotalAmt
Program Services$148,681ProgramServicesAmt
Management And General$49,560ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
UNCOLLECTABLE ACCOUNTS$998,756$998,756
MEDICAL SUPPLY$600,617$600,617
MISCELLANEOUS$324,904$243,687$81,217
DRUG EXPENSE$281,759$281,759

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$165,381TotalAmt
Program Services$165,381ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,556,039TotalAmt
Program Services$11,297,590ProgramServicesAmt
Management And General$4,258,449ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,035BOYAmt
EOY$2,164,196EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$682,025BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,135,131BOYAmt
EOY$2,789,988EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$267,373BOYAmt
EOY$289,377EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$684,056BOYAmt
EOY$118,262EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,665,846LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,592,703LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$7,671,477BOYAmt
EOY$7,073,143EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,441,097BOYAmt
EOY$12,434,966EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,219,490BOYAmt
EOY$1,312,572EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$500,000BOYAmt
EOY$261,835EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$819,912BOYAmt
EOY$618,575EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,060,193BOYAmt
EOY$1,381,249EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,599,595BOYAmt
EOY$3,574,231EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,841,502BOYAmt
EOY$8,860,735EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,841,502BOYAmt
EOY$8,860,735EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,441,097BOYAmt
EOY$12,434,966EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,019,233ReconcilationRevenueExpnssAmt
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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,150OtherCostOrOtherBasisAmt
Book Value$20,150BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,078,534OtherCostOrOtherBasisAmt
Depreciation$4,194,786DepreciationAmt
Book Value$5,883,748BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,567,162OtherCostOrOtherBasisAmt
Depreciation$5,397,917DepreciationAmt
Book Value$1,169,245BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,073,143TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
THIRD - PARTY REIMBURSEMENT$1,130,269
LINE OF CREDIT$250,980
FieldValueIRS element (for citing)
Total Liability$1,381,249TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$15,576,516TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$998,756OtherRevenueAmt
Revenue Not Reported-$998,756RevenueNotReportedAmt
Revenue Subtotal$16,575,272RevenueSubtotalAmt
Total Revenue Per Form990$16,575,272TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$14,557,283TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$998,756OtherExpensesIncludedAmt
Expenses Not Reported-$998,756ExpensesNotReportedAmt
Expenses Subtotal$15,556,039ExpensesSubtotalAmt
Total Expenses Per Form990$15,556,039TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DPROVISION FOR UNCOLLECTABLE -998,756
SCHEDULE D, PAGE 4, PART XII, LINE 2DPROVISION FOR UNCOLLECTABLE -998,756
SCHEDULE D, PAGE 4, PART XIIIMANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITION UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

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 Other1.100000000000FreeCareOtherPct
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 BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$461,703TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$461,703NetCommunityBenefitExpnsAmt
Total Expense0.02970TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,048,640TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,376,679DirectOffsettingRevenueAmt
Net Community Benefit Expns$671,961NetCommunityBenefitExpnsAmt
Total Expense0.04320TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,510,343TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,376,679DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,133,664NetCommunityBenefitExpnsAmt
Total Expense0.07290TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,510,343TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,376,679DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,133,664NetCommunityBenefitExpnsAmt
Total Expense0.07290TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$367,288BadDebtExpenseAmt
Reimbursed By Medicare$7,664,488ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,706,733CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$42,245MedicareSurplusOrShortfallAmt

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 Line1LAWRENCE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 STATE STREETAddressLine1Txt
CityLAWRENCEVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62439ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTPS://LCMHOSP.ORGWebsiteAddressTxt
State License0005769StateLicenseNum
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 Line1LAWRENCE COUNTY 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
Information GapsYes (X)InformationGapsInd
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 URLHTTPS://LCMHOSP.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care110.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPSLCMHOSPORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPSLCMHOSPORGFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesYes (true)GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 5LCMH CONTRACTED WITH QHR CONSULTING SERVICES AS IT PRETAINED TO THE PREPARATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE FIRM PERFORMS SEVERAL INDEPENDENT DATA, AND RESOLVES ANY DATA INCONSISTENCIES OR DISCREPANCIES FROM THE COMBINED OPINIONS FORMED FROM LOCAL EXPERTS. ADDITIONALLY, QHR RELIES ON SECONDARY SOURCE DATA, AND MOST SECONDARY SOURCES USE THE COUNTY AS THE SMALLEST UNIT OF ANALYSIS. FINALLY, QHR ASKED OUR LOCAL EXPERT AREA RESIDENTS TO NOTE IF THEY PRECEIVED THE PROBLEMS OR NEEDS IDENTIFIED BY SECONDARY SOURCES TO EXIST IN THEIR PORTION OF THE COUNTY. MOST DATA USED IN THE ANALYSIS IS AVAILABLE FROM PUBLIC INTERNET SOURCES. IN ADDITION, WE DEPLOYED A CHNA "ROUND 1" SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN LOCAL INPUT AS TO LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED TO CONFORM TO THE INPUT REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS. WE RECEIVED COMMUNITY INPUT FROM 19 LOCAL EXPERT ADVISORS. INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW LAWRENCE COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON IF THEY BELIEVE CERTAIN POPULATION GROUPS (OR PEOPLE WITH CERTAIN SITUATIONS) NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT. WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL GROUP OF EXPERTS, WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL STATEMENTS OF NEED, AND NEW NEEDS DID EMERGE FROM THE EXCHANGE. CONSULTATION WITH 19 LOCAL EXPERTS OCCURRED AGAIN VIA AN INTERNET-BASED SURVEY. WITH THE PRIOR STEPS IDENTIFYING POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A DELPHI METHOD, ORIGINALLY DEVELOPED AS A SYSTEMATIC, INTERACTIVE FORECASTING METHOD THAT RELIES ON A PANEL OF EXPERTS. EXPERTS ANSWER QUESTIONNAIRES IN A SERIES OF ROUNDS. AFTER EACH ROUND, WE PROVIDED AN ANONYMOUS SUMMARY OF THE EXPERTS' FORECASTS FROM THE PREVIOUS ROUND, AS WELL AS REASONS PROVIDED FOR THEIR JUDGEMENTS. THE PROCESS ENCOURAGED EXPERTS TO REVISE THEIR EARLIER ANSWERS IN LIGHT OF THE REPLIES OF OTHER MEMBERS OF THEIR PANEL. TYPICALLY, THIS PROCESS DECREASES THE RANGE OF ANSWERS AND MOVES THE EXPERT OPINIONS TOWARD A CONSENSUS "CORRECT" ANSWER. THE PROCESS STOPS WHEN WE IDENTIFY THE MOST PRESSING, HIGHEST PRIORITY, COMMUNITY NEEDS.
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 111. SMOKING/TOBACCO USE (LCMH NOW PROVIDES EDUCATION MATERIALS TO PATIENTS AND EMPLOYEES.) A. RESOURCE CONSTRAINTS (LCMH RECENTLY IS LOSING MONEY FROM OPERATIONS SO NO RESOURCES ARE AVAILABLE TO DEVOTE TO THE NEED; AND B. NEED IS ADDRESSED BY OTHER FACILITY OR ORGANIZAION. 2. COMPLIANCE BEHAVIOR/PREDISPOSING CONDITIONS A. A LACK OF IDENTIFIED EFFECTIVE INTERVENTIONS TO ADDRESS THE NEED. 3. DENTISTS A. RESOURCE CONSTRAINTS (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO THE NEED; B. LACK OF EXPERTISE OF COMPETENCY (I.E. CERTAIN PROFESSIONAL CREDENTIAL REQUIRED AND NO SUCH INDIVIDUAL IS IN AREA); AND C. NEED IS ADDRESSED BY OTHER FACILITY OR ORGANIZATION. 4. MATERNAL AND INFANT MEASURES A. RESOURCE CONSTRAINTS (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO THE NEED); 5. PRIORITY POPULATIONS A. RESOURCE CONSTRAINTS (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 6. CHOLESTEROL (HIGH) A. RESOURCE CONSTRAINTS (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 7. BLOOD PRESSURE (HIGH) A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 8. PHYSICIANS INCLUDING SPECIALITY (PHYSICANS) A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 9. POLLUTION A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 10 EMERGENCY SERVICES A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 11. ALZHEIMER'S A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 12. PREVENTABLE HOSPITALIZATION A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 13. ACCIDENTS A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 14. LIFE EXPECTANCY/PREMATURE DEATH A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 15. KIDNEY DISEASE A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 16. PALLIATIVE CARE AND HOSPICE A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 17. CHRONIC OSTEOPOROSIS A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 18. FLU-PNEUMONIA A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 19. LOW BACK PAIN (CHRONIC) A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED); 20. BLOOD POISONING A. RESOURCE CONSTRAINT (LCMH RECENTLY LOST MONEY FROM OPERATIONS SO NO RESOURCES TO DEVOTE TO NEED);
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 15ELCMH CHARGES THE SAME AMOUNT FOR ALL PATIENTS AND DISCOUNTS BASED ON FEDERAL POVERTY GUIDELINES.
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 19DLCMH USES SEARCH AMERICA WHICH MEANS THAT ADDITIONAL THIRD PARTIES ARE NOT NEEDED BEFORE MAKING REASONABLE EFFORTS REGARDING ELIGIBILITY.
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 20EOUTPATIENTS ARE NOTIFIED ON THE FIRST STATEMENT THEY RECEIVE THAT SHOWS ANY PATIENT BALANCE. LCMH ATTEMPTS TO NOTIFY ALL INPATIENTS AS PART OF THEIR STAY, BUT WITH THE AVERAGE LENGTH OF STAY OF 3 DAYS THIS IS NOT ALWAYS ACCOMPLISHED. THEY ALSO RECEIVE NOTICE ON THEIR FIRST STATEMENT OF THE FINANCIAL ASSISTANCE POLICY. ALL UNISURED PATIENTS RECEIVE A FINANCIAL ASSISTANCE APPLICATION UPON REGISTRATION.
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 22DLCMH HAS NO POLICY IN PLACE TO ADJUST NORMAL CHARGES TO A LOWER AMOUNT BEFORE FAP CHARITY IS APPLIED.
FACILITY 1, LAWRENCE COUNTY MEMORIAL HOSPITAL - PART V, LINE 24CHARGES ARE ALL AT NORMAL RATES. ANY FAP DISCOUNT IS APPLIED BASED ON NORMAL CHARGES. NO FAP-ELIGIBLE PATIENT PAID ANYTHING CLOSE TO USUAL CHARGES.

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATIONFormAndLineReferenceDesc
ExplanationCOMMUNITY BUILDING ACTIVITIES FORM 990, SCH H, PART II LAWRENCE COUNTY MEMORIAL HOSPITAL DID NOT CONDUCT ANY COMMUNITY BUILDING ACTIVITIES FOR THE YEAR ENDED 6/30/2015. BAD DEBT EXPENSE FORM 990, SCH H, PART III, LINES 2-4 ACCOUNTS ARE REPORTED AS BAD DEBT ONLY IF PATIENTS ARE NOT ELIGIBLE UNDER PRESUMPTIVE CHARITY OR DO NOT COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE IF THEY CANNOT BE QUALIFIED AS PRESUMPTIVE. BAD DEBT EXPENSES ARE ACCOUNTS FOR PATIENTS THAT HAVE NOT PAID LCMH FOR THE SERVICES PROVIDED. EVERY EFFORT IS MADE TO QUALIFY THEM AS PRESUMPTIVE IF THEY DO NOT DIRECTLY REQUEST FINANCIAL ASSISTANCE. AN ELECTRONIC RESOURCE IS USED TO QUALIFY PATIENTS AS CHARITY BEFORE THE COLLECTION PROCESS IS STARTED. THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF PAY PATIENTS WAS 69% AT JUNE 30, 2015 AND 71% AT JUNE 30, 2014. IN ADDITION, THERE WERE NO SIGNIFICANT FLUCTUATIONS IN WRITE-OFFS FROM SELF-PAY PATIENTS DURING FISCAL YEAR 2015 COMPARED TO FISCAL YEAR 2014. THE HOSPITAL PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. MEDICARE INFORMATION FORM 990, SCH H PART III LINE 8 MEDICARE AMOUNTS ARE TAKEN FROM THE AUDITED FINANCIAL STATMENTS. COLLECTION PRACTICES FORM 990, SCH H, PART III LINE 9B ANY PATIENT BALANCE THAT HAS GONE THROUGH THE IN-HOUSE COLLECTION PROCESS WILL BE SUBMITTED TO SEARCH AMERICA PRIOR TO BECOMING BAD DEBT. SEARCH AMERICA WILL YIELD BACK FEDERAL POVERTY PERCENTAGES THAT CAN BE USED TO QUALITY AS PRESUMPTIVE CHARITY WITHOUT APPLICATION BY THE PATIENT OR FAMILY. PATIENT EDUCATION OF ELGIBILITY FOR ASSISTANCE FORM 990, SCH H, PART VI, LINE 3 LCHM HAS POSTERS IN ALL REGISRATION AREAS RELATED TO ANY HOSPITAL DEPARTMENT INCLUDING OUR RURAL HEALTH CLINIC INFORMING PATIENTS THAT WE SEE ANYONE REGARDLESS OF THEIR ABILITY TO PAY AND THAT FINANCIAL ASSISTANCE IS AVALABLE TO UNINSURED AND UNDERINSURED. ALL ED PATIENTS ARE SEEN BY A PRACTITIONER PRIOR TO REQUEST FOR ANY FINANCIAL INFORMATION/INSURANCE AS REQUIRED BY EMTALA. ALL PATIENTS THAT DO NOT HAVE INSURANCE OR THAT HAVE A PATIENT BALANCE AFTER INSURANCE ARE CONTACTED BY OUR PATIENT FINANICAL SERVICES REPRESENTATIVE WHO THEN PROVIDES A FINANCIAL ASSISTANCE FORM. COMMUNITY INFORMATION FORM 990, SCH H, PART VI, LINE 4 LCMH SERVES AS A PREDOMINANTLY RURAL COUNTY IN SOUTH EASTERN ILLINOIS. THE POPULATION IS MORE ELDERLY AND LESS AFFLUENT THAN MOST COUNTIES IN THE STATE. 18.8% OF THE POPULATION HAS LESS THAN A HIGH SCHOOL DIPLOMA WITH ANOTHER 37.7% HAVING ONLY A HIGH SCHOOL EDUCATION. 22% OF THE HOUSEHOLDS REPORT INCOME OF LESS THAN 15,000. A LARGE TERTIARY HOSPITAL IS WITHIN 12 MILES OF LCMH LOCATED IN VINCENNES, IN. MANY PATIENTS WITH INSURANCE MAKE THE DRIVE LEAVING LCHM WITH A MUCH HIGHER PERCENT OF MEDICAID BUSINESS. WITH LCMH MOVEMENT TO NOT-FOR-PROFIT STATUS IN FY 2012 A MORE CONCERTED EFFORT WAS UNDERATKEN AT THE DIRECTION OF OUR BOARD TO IDENTIFY ANY PATIENT THAT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. TO BETTER SERVE THE NEED OF THESE PATIENTS, LCMH OPENED A RURAL HEALTH CLINIC STAFFED WITH PHYSICIANS AND MID-LEVEL PRACTITIONERS TO PROVIDE A PRIMARY SOURCE OF CARE THAT IS EASILY ACCESSIBLE FOR THEM. PROMOTION OF COMMINTY HEALTH FORM 990, SCH H. PART V, LINE 5 LCMH PARTICIPATES IN MANY COMMUNITY GROUPS THAT ARE DESIGNED TO IMPROVE THE HEALTH OF THE COMMUNITY. LCMH PROVIDES A MEETING LOCATION FOR ALCOHOLICS ANONYMOUS TWICE PER WEEK AS WELL AS A LOCATION FOR A LOCAL BEREAVEMENT AND SUPPORT GROUP. LCMH LEADERSHIP ALSO IS ONE OF SEVERAL BOARDS IN THE AREA TO SUPPORT ECONOMIC DEVELOPMENT AS WELL AS PROVIDE LEADERSHIP ROLES IN BOARDS THAT PROVIDE RESOURCES DURING FLOODING AND PROVIDE ACTIVE LEADERSHIP IN COMMITTEES FOR ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK PROVIDING SUPPORT TO ALL CAHS IN ILLINOIS TO HELP THEM BETTER SERVE THEIR COMMUNITIES. AFFLIATED HEALTH CARE SYSTEMS FORM 990, SCH H, PART VI LINE 6 LCMH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. STATE FILING OF COMMUNITY BENEFIT REPORT FORM 990, SCH H. PART VI, LINE 7 LCHM IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT IN ILLNOIS DUE TO THE FACT THAT THE HOSPITAL CONTAINS LESS THAN 100 BEDS. NEEDS ASSESSMENT FORM 990, SCH H. PART VI LINE 2 LCMH UTILIZED SERVICES FROM QHR TO PERFORM A COMMUNITY HEALTH NEEDS ASSESSEMENT (CHNA) AND THE REPORT WAS PROVIDED IN JUNE 2013.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
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 (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
DR GARY CARR
TRUSTEE /PHYSICAN$224,258$224,258
DOUG FLORKOWSKI
CEO$201,334$261,284$52,690$7,260
STEVEN RAMSARAN
PHYSICAN$301,494$343,809$22,122$20,193

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PAGE 1, PART I, LINE 7FormAndLineReferenceDesc
ExplanationSCHEDULE J, PART I, LINE 7 PHYSICAIN COMPENSATION PAID BASED ON ANTICIPATED VOLUME (VISITS) AND RECONCILED QUARTERLY.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
STAN WLLIAMS
FAMILY MEMBER$56,456W-2 WAGESfalse
RON WALDROP
FAMILY MEMBER$27,196W-2 WAGESfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationRON WALDROP IS A VOTING OFFICER OF THE HOSPITAL BOARD. HIS DAUGHTER IN LAW IS EMPLOYED IN THE IT DEPARTMENT. THE 2014 WAGES PAID BY LAWRENCE COUNTY MEMORIAL HOSPITAL LISTED ON HER W-2 TOTALED 27,195.20. STAN WILLIAMS IS A VOTING TRUSTEE OF THE HOSPITAL BOARD. HIS SON IN LAW IS THE DIRECTOR OF THE IT DEPARTMENT. THE 2014 WAGES PAID BY LAWRENCE COUNTY MEMORIAL HOSPITAL LISTED ON HIS W-2 TOTALED 56,455.98.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 3QUORUM HEALTH RESOURCES, LLC HAS A MANAGEMENT CONTRACT WITH THE BOARD OF LCMH SINCE MAY OF 2006. THIS CONTRACT WAS RENEWED IN 2011 FOR 6 YEARS. QUORUM HEALTH RESOURCES PROVIDES ASSISTANCE IN THE EVALUATION OF OFFICERS, PROVIDES ADMINISTRATIVE RESOURCES, CONSULTING SERVICES, CHARGE MASTER AND COMPLIANCE SERVICES. COMPENSATION OF BOARD MEMBERS FORM 990 PART VII, SECTION A DR GARY CARR IS COMPENSATED FOR BEING A PRACTICING PHYSICIAN AT LCMH. HE IS NOT COMPENSATED AS A MEMBER OF THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 11BTHE CFO AND AN INDEPENDENT ACCOUNTING FIRM REVIEWED THE FORM 990 BEFORE FILING. AN ELECTRONIC OR HARD COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS AFTER IT IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12CTRUSTEES AND DEPARTMENT LEADERS SIGN ANNUAL CONFLICT OF INTEREST POLICY STATEMENTS. ANYONE WITH A CONFLICT DOES NOT PARTICIPATE IN ANY RELATED DECISION MAKING PROCESSES. STAFF AND DEPARTMENT LEADERS HAVE THIS INCLUDED AS A PART OF THEIR ANNUAL TRAINING CONDUCTED ELECTRONICALLY THROUGH HEALTH STREAM. THE SIGNED STATEMENTS ARE REVIEWED BY THE COO AND THE CEO.
FORM 990, PAGE 6, PART VI, LINE 15AA REVIEW IS CONDUCTED ANNUALLY BY THE ENTIRE BOARD OF TRUSTEES ALONG WITH THE REGIONAL MANAGEMENT TEAM FROM QUORUM HEALTH RESOURCES. NATIONAL COMPARATIVE DATA IS PROVIDED BY QHR AS PART OF THE ANNUAL CEO EVALUATION AND WAGE ADJUSTMENT. OFFICER COMPENSATION DECISIONS ARE ALSO DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PAGE 6, PART VI, LINE 15BA REVIEW IS CONDUCTED BY THE ENTIRE BOARD OF TRUSTEES ALONG WITH THE REGIONAL MANAGEMENT TEAM FROM QUROUM HEALTH RESOURCES. NATIONAL COMPARATIVE DATA IS PROVIDED BY QHR AS PART OF THE ANNUAL CEO EVALUATION AND WAGE ADJUSTMENT. OFFICER COMPENSATION DECISIONS ARE ALSO DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PAGE 6, PART VI, LINE 18FORM 1023 HAS BEEN FILED, APPROVED AND IS AVAILAVLE TO THE PUBLIC UPON REQUEST.
FORM 990, PAGE 6, PART VI, LINE 19THE DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE ADMINISTRATIVE OFFICES.
FORM 990, PART IX, LINE 11GED PHYSICIAN SERVICES 766,830 0 0 CONTRACTED SURGEON 300,000 0 0 CONTRACTED RHC PHYSICIAN 112,948 0 0 LAUNDRY/LINEN SERVICE 0 127,057 0 CPSI - SOFTWARE 0 127,214 0 DIAGNOSTIC SHARED 156,086 0 0 NUC MED ULTRASOUND 332,011 0 0 VARIOUS OTHER SERVICES 320,458 395,314 0
FORM 990, PART XI, LINE 9PROVISION FOR UNCOLLECTABLE -998,756 PROVISION FOR UNCOLLECTABLE 998,756

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1END AND DEV FOUNDATION FOR LAWRENBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 STATE STREETAddressLine1Txt
CityLAWRENCEVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62439ZIPCd
FieldValueIRS element (for citing)
EIN376052607EIN
Primary ActivitiesFUNDRAISINPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status9PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
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 OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd