KEWANEE HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- KEWANEE HOSPITAL (EIN 36-2167767)
- Tax period
- 2013-10-01 to 2014-03-31
- Filed
- 2015-02-13
- IRS object ID
- 201510449349302516
- Schema version
- 2013v4.0
- 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 N
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-02-13T15:40:59-06:00 | ReturnTs |
| Tax Period End | 2014-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1 |
| City | GREEN BAY | City |
| State | WI | State |
| ZIP Code | 543072237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362167767 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEWANEE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KEWA | BusinessNameControlTxt |
| Phone | 3098527500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 W SOUTH ST PO BOX 747 | AddressLine1 |
| City | KEWANEE | City |
| State | IL | State |
| ZIP Code | 61443 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN M BOWSER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3098527522 | PhoneNum |
| Signature | 2015-02-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2015-02-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | JOHN M BOWSER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 W SOUTH ST PO BOX 747 | AddressLine1 |
| City | KEWANEE | City |
| State | IL | State |
| ZIP Code | 61443 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,634,186 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OSFSAINTLUKE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1902 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OPERATES A 25 BED CRITICAL ACCESS HOSPITAL PLUS RELATED HEALTH CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 252 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $89,145 | PYContributionsGrantsAmt |
| CY Contributions Grants | $33,182 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,550,846 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,786,927 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,007,997 | PYInvestmentIncomeAmt |
| CY Investment Income | $676,346 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,506,472 | PYOtherRevenueAmt |
| CY Other Revenue | $77,044 | CYOtherRevenueAmt |
| PY Total Revenue | $31,154,460 | PYTotalRevenueAmt |
| CY Total Revenue | $15,573,499 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $18,721 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $216,250 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,860,642 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,192,810 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,945,504 | PYOtherExpensesAmt |
| CY Other Expenses | $8,941,092 | CYOtherExpensesAmt |
| PY Total Expenses | $29,824,867 | PYTotalExpensesAmt |
| CY Total Expenses | $15,350,152 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,329,593 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $223,347 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $63,172,289 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,135,070 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,037,219 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH AND CARE OF THOSE WE SERVE FOCUSING ON QUALITY OF CARE REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,408,965 | ExpenseAmt |
| Grant | $216,250 | GrantAmt |
| Revenue | $13,814,777 | RevenueAmt |
| Desc | KEWANEE HOSPITAL IS A 501(C)(3) NOT-FOR-PROFIT CORPORATION LICENSED ASA 25-BED CRITICAL ACCESS HOSPITAL (CAH) LOCATED IN A RURAL COMMUNITY INILLINOIS. KEWANEE HOSPITAL STRIVES TO PROVIDE QUALITY HEALTH CARE TOALL PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP,AGE, OR ABILITY TO PAY. MANY OF THE COMMUNITY MEMBERS WOULD HAVE NOACCESS TO HEALTH CARE WITHOUT KEWANEE HOSPITAL. THE PATIENTS AND THEIRFAMILIES ABILITY TO TRAVEL 50+ MILES TO A LARGER TERTIARY CENTER ISCOMPROMISED BY A LACK OF MOBILITY, A LACK OF INCOME, AND A LACK OFTRANSPORTATION. MANY OF THE SERVICES PROVIDED BY KEWANEE HOSPITAL ARE REIMBURSED AT OR BELOW THE COST TO PROVIDE CARE. KEWANEE HOSPITAL OFFERS A WIDE VARIETY OF SERVICES INCLUDING INPATIENT ACUTE AND CRITICAL CARE, SKILLED LEVEL CARE THROUGH SWING BEDS, DIAGNOSTIC CAPABILITIES INCLUDING RADIOLOGY,LABORATORY AND CARDIOPULMONARY, INPATIENT AND OUTPATIENT REHABILITATION AND TREATMENT, INPATIENT AND OUTPATIENT SURGICAL SERVICES, AND PRIMARY CARE SERVICES THROUGH THE FAMILY HEALTH CLINIC (FHC). DURING THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014, KEWANEE HOSPITAL PROVIDED 606 DAYS OF INPATIENT CARE AND 212 DAYS OF SWING BED CARE IN THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014. KEWANEE HOSPITAL PROVIDED A WIDE SCOPE OF OUTPATIENT SERVICES WHICH PROVIDED CARE TO 17,249 OUTPATIENTS. THE EMERGENCY DEPARTMENT (ED) IS A SAFETY NET TO THE RURAL COMMUNITY OF KEWANEE AND THE SURROUNDING AREA. THE ED IS STAFFED 24/7 BY DEDICATED EMERGENCY DEPARTMENT PHYSICIANS; DURING THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014 THE ED HAD 5,099 VISITS. THE HOSPITAL OFFERS A VARIETY OF SURGICAL SERVICES INCLUDING GENERAL, ORTHOPEDIC, OPHTHALMOLOGIC, ENDOSCOPY AND GASTROENTEROLOGY. IN THE SIX-MONTH PERIOD ENDING MARCH 31, 2014 THE HOSPITAL PROVIDED A TOTAL OF 361 SURGICAL PROCEDURES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $682,314 | ExpenseAmt |
| Revenue | $986,087 | RevenueAmt |
| Desc | KEWANEE HOSPITAL STAFFS A MULTI-DISCIPLINARY OUTPATIENT FAMILY HEALTHCLINIC (FHC) WITH A COMPLIMENT OF BOTH PHYSICIAN AND MID-LEVELPROVIDERS EMPLOYED BY THE HOSPITAL. THE FHC PROVIDES AN ARRAY OFSERVICES INCLUDING PRIMARY CARE (ADULTS AND PEDIATRICS) AND SURGICALSERVICES. THE FHC IS A LICENSED RURAL HEALTH CLINIC AND PROVIDES MANYNEEDED SERVICES TO THE COMMUNITY. THE FHC IS ONE OF THE ONLY CLINICSIN THE AREA TO ACCEPT THE TREATMENT AND CARE OF CHILDREN WITH ATTENTIONDEFICIT DISORDER. THE PROVIDERS IN THE FHC HAVE PARTICIPATED INSEVERAL OUTREACH EFFORTS INCLUDING DIABETIC HEALTH, SMOKING CESSATION,MEDICATION MANAGEMENT, AND HEALTH AND NUTRITION. IN FY 2014, THE FHCPROVIDERS BROUGHT THEIR SERVICES TO THE AREA HIGH SCHOOL TO PROVIDEFREE SPORTS PHYSICALS. BECAUSE OF THE HIGH POVERTY LEVEL IN THE KEWANEE DISTRICT, MANY STUDENTS HAVE DIFFICULTY TRAVELING TO PROVIDEROFFICES FOR THEIR PHYSICALS AND MOST CANNOT PAY THE COST. KEWANEEHOSPITAL MADE THE DECISION TO OUTREACH TO THESE STUDENTS IN ORDER TOENSURE THEY CAN TAKE PART IN SPORT ACTIVITIES AND RECEIVE THEIR NEEDEDPHYSICAL EXAM.THE FHC PRACTICES THE MEDICAL HOME MODEL THROUGH THE ILLINOIS HEALTHCONNECT PROGRAM. THE NURSE PRACTITIONERS PROVIDE AFTER-HOURS CALL INORDER TO ENSURE PATIENTS HAVE THE ABILITY TO ACCESS A PROVIDERAFTER-HOURS AND ON WEEKENDS WHEN NEEDED. IN FY 2014, THE FHC PRACTITIONERSCONTINUALLY COLLABORATE WITH THE AREA SCHOOLS AND PROVIDERS OF OTHERHEALTH SERVICES IN ORDER TO PROVIDE THE BEST CARE POSSIBLE TO THE AREACOMMUNITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,091,279 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 252 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN M BOWSER CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3098527522 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 W SOUTH STREET | AddressLine1 |
| City | KEWANEE | City |
| State | IL | State |
| ZIP Code | 61443 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| PRESTON BECKER | |||||||
| FORMER CFO/TREASURER | 40.00 | Yes (X) | Yes (X) | $112,410 | $0 | $23,014 | |
| LYNN A FULTON | |||||||
| CEO | 40.00 | Yes (X) | Yes (X) | $191,677 | $0 | $34,765 | |
| MARY KAY NORTH | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GARY PHEIFFER | |||||||
| CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARK REWERTS | |||||||
| VICE CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TOM BURHORN | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DANIEL CONGREVE MD | |||||||
| TRUSTEE | 40.00 | Yes (X) | $411,637 | $0 | $35,299 | ||
| RITA HUNGATE MD | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RUSSELL MEDLEY | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK TOCHA | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE YAKLICH | |||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER JUNIS | |||||||
| CNO | 40.00 | Yes (X) | $136,779 | $0 | $11,695 | ||
| DEBRA EWING DO | |||||||
| PHYSICIAN | 40.00 | $140,469 | $0 | $6,078 | Yes (X) | ||
| AIMEE SHANE CRNA | |||||||
| CRNA | 40.00 | $168,628 | $0 | $19,654 | Yes (X) | ||
| PRIYANKA PATEL | |||||||
| PHARMACY DIRECTOR | 40.00 | $113,616 | $0 | $6,712 | Yes (X) | ||
| TAMARA HARKER | |||||||
| NURSE PRACTITIONER | 40.00 | $106,587 | $0 | $5,377 | Yes (X) | ||
| NEIL TEX | |||||||
| CRNA | 40.00 | $151,752 | $0 | $6,751 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,533,555 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $149,345 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EPPS | |||||
| 12528 SR 78 | HAVANA | IL | 62644 | ED PHYSIAN STAFFING | $1,635,598 |
| HOSPITAL CARE CONSULTANTS | |||||
| 17304 PRESTON RD | DALLAS | TX | 75252 | HOSPITALIST STAFFING | $577,365 |
| OSF SAINT FRANCIS INC | |||||
| 1420 W PIONEER PARKWAY | PEORIA | IL | 61615 | MRI SERVICES | $560,889 |
| DRINKER BIDDLE & REATH LLP | |||||
| ONE LOGAN SQUARE SUITE 2000 | PHILADELPHIA | PA | 19103 | LEGAL | $474,245 |
| METHODIST REFERENCE LABORATORY | |||||
| 221 NE GLEN OAK | PEORIA | IL | 61636 | REFERENCE LAB | $221,977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $12,000 | GovernmentGrantsAmt |
| All Other Contributions | $21,182 | AllOtherContributionsAmt |
| Total Contributions | $33,182 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $14,709,740 | $14,709,740 | |
| CAFETERIA MEALS | 621400 | $62,866 | $62,866 | |
| MASSAGE THERAPY | 621400 | $11,540 | $11,540 | |
| MEDICAL RECORDS | 621400 | $2,781 | $2,781 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,786,927 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $672,346 | TotalRevenueColumnAmt |
| Exclusion | $672,346 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $33,475 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $43,062 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$9,587 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$9,587 | TotalRevenueColumnAmt |
| Exclusion | -$9,587 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,000 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,000 | TotalRevenueColumnAmt |
| Exclusion | $4,000 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $24,672 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $17,625 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,047 | TotalRevenueColumnAmt |
| Exclusion | $7,047 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EHR REVENUE | 900099 | $38,944 | $38,944 |
| MISC OPERATING REVENUE | 900099 | $37,565 | $37,565 |
| MEDICAL STAFF | 900099 | $3,075 | $3,075 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $79,584 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,573,499 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,800,864 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $739,453 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,250 | TotalAmt |
| Program Services | $216,250 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $787,456 | TotalAmt |
| Program Services | $626,211 | ProgramServicesAmt |
| Management And General | $161,245 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,215,843 | TotalAmt |
| Program Services | $3,120,233 | ProgramServicesAmt |
| Management And General | $1,095,610 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,512 | TotalAmt |
| Program Services | $129,925 | ProgramServicesAmt |
| Management And General | $43,587 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,624 | TotalAmt |
| Program Services | $431,773 | ProgramServicesAmt |
| Management And General | $144,851 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $439,375 | TotalAmt |
| Program Services | $329,002 | ProgramServicesAmt |
| Management And General | $110,373 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,206 | TotalAmt |
| Management And General | $142,206 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,922 | TotalAmt |
| Management And General | $84,922 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,696,677 | TotalAmt |
| Program Services | $997,316 | ProgramServicesAmt |
| Management And General | $699,361 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,665 | TotalAmt |
| Management And General | $51,665 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,658 | TotalAmt |
| Program Services | $123,185 | ProgramServicesAmt |
| Management And General | $65,473 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,884 | TotalAmt |
| Program Services | $27,423 | ProgramServicesAmt |
| Management And General | $162,461 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,862 | TotalAmt |
| Program Services | $29,611 | ProgramServicesAmt |
| Management And General | $9,251 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,201 | TotalAmt |
| Program Services | $3,200 | ProgramServicesAmt |
| Management And General | $11,001 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $703,069 | TotalAmt |
| Program Services | $703,069 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,293,087 | TotalAmt |
| Program Services | $464,595 | ProgramServicesAmt |
| Management And General | $828,492 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,801 | TotalAmt |
| Program Services | $45,434 | ProgramServicesAmt |
| Management And General | $78,367 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $1,850,538 | $1,850,538 | |
| MEDICAL PROFESSIONAL FE | $1,086,539 | $1,086,539 | |
| MEDICAL SUPPLIES | $718,812 | $717,426 | $1,386 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $758,171 | TotalAmt |
| Program Services | $189,549 | ProgramServicesAmt |
| Management And General | $568,622 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,350,152 | TotalAmt |
| Program Services | $11,091,279 | ProgramServicesAmt |
| Management And General | $4,258,873 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,300,342 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,251,461 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,937 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,449,879 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,286 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $554,777 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,163,332 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,129,533 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,956,742 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,172,289 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,781,825 | BOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,163 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,305,000 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,726,082 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,135,070 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,306,051 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,062 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $677,106 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,037,219 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,172,289 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $223,347 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $697,464 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$31,958,030 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $1,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,200 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,200 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE LOBBYING EFFORTS BY KEWANEE HOSPITAL FOR THE FISCAL YEAR ENDED 3-31-14 CONSISTED OF SEVERAL LETTERS AND E-MAILS TO AREA LEGISLATORS REGARDING PENDING LEGISLATION. ANNUALLY, A PORTION OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND ILLINOIS HOSPITAL ASSOCIATION (IHA) DUES ARE ALLOCATED TO LOBBYING EFFORTS BOTH ORGANIZATIONS EXERT ON BEHALF OF HOSPITALS AT THE NATIONAL AND STATE LEVEL. ACCORDING TO THE AHA AND IHA, 23.65% AND 39% RESPECTIVELY, OF OUR DUES WENT TOWARDS LOBBYING; THIS REPRESENTS $11,200 FOR THE YEAR. PART II-B 1 (G), DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENTAL OFFICIALS, OR A LEGISLATIVE BODY: LEADERSHIP TIME SPENT WITH LEGISLATORS CONCERNING ISSUES RELATING TO PROPERTY TAX LEGISLATION. ESTIMATED COST EQUALS $1,000. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,771,264 | BeginningYearBalanceAmt |
| Contributions | $6,182 | ContributionsAmt |
| Investment Earnings Or Losses | $493,327 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $10,270,773 | OtherExpendituresAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,372,410 | BeginningYearBalanceAmt |
| Contributions | $3,596 | ContributionsAmt |
| Investment Earnings Or Losses | $1,084,245 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $688,987 | OtherExpendituresAmt |
| End Year Balance | $9,771,264 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,148,017 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,280,567 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $56,174 | OtherExpendituresAmt |
| End Year Balance | $9,372,410 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,131,640 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$552,439 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $431,184 | OtherExpendituresAmt |
| End Year Balance | $8,148,017 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,210,168 | BeginningYearBalanceAmt |
| Contributions | $892,005 | ContributionsAmt |
| Investment Earnings Or Losses | $1,241,101 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $211,634 | OtherExpendituresAmt |
| End Year Balance | $9,131,640 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,777,466 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,777,466 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,796,033 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,796,033 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,573,499 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,360,301 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $60,687 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $60,687 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,299,614 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,050,538 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,050,538 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,350,152 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENTS INCLUDED ON FORM 990 INCLUDE ASSETS SET ASIDE BY THE BOARD OF TRUSTEES FOR FUTURE CAPITAL IMPROVEMENTS, OVER WHICH THE BOARD RETAINS CONTROL AND MAY AT ITS DISCRETION SUBSEQUENTLY USE FOR OTHER PURPOSES. ENDOWMENTS ALSO INCLUDE DONOR-RESTRICTED FUNDS WHICH WILL BE USED FOR PROPERTY AND EQUIPMENT ADDITIONS, REIMBURSEMENT OF OPERATING EXPENSES, AND TO SUPPORT HEALTH CARE SERVICES. THE ENTIRE AMOUNT WAS TRANSFERRED IN THE MERGER WITH OSF HEALTHCARE SYSTEM. |
| PART X, LINE 2: | IN ORDER TO ACCOUNT FOR UNCERTAIN TAX POSITIONS, THE HOSPITAL DETERMINES WHETHER IT IS MORE LIKELY THAN NOT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITIES HAVE FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF THE SIX-MONTH PERIOD ENDED MARCH 31, 2014 AND THE YEAR ENDED SEPTEMBER 30, 2013. THE HOSPITAL'S INCOME TAX RETURNS FOR TAX YEARS 2011 AND BEYOND ARE NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | COGS ON INVENTORY SALES -17,625. NONOPERATING REVENUE INCLUDED IN FINANCIAL STATEMENT EXPENSE 6,182. BAD DEBT EXPENSE INCLUDED IN FINANCIAL STATEMENT REVENUE 1,850,538. RENT EXPENSE INCLUDED IN FORM 990 REVENUE -43,062. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | COGS ON INVENTORY SALES 17,625. RENT EXPENSE INCLUDED IN FORM 990 REVENUE 43,062. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE INCLUDED IN FINANCIAL STATEMENT REVENUE 1,850,538. GRANT EXPENSE NOT INCLUDED IN FINANCIAL STATEMENT EXPESNE 200,000. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $338,489 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $338,489 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,376,409 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,426,830 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $949,579 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07030 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,714,898 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,426,830 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,288,068 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09540 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $70,501 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $70,501 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,751 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $89,751 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,804,649 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,426,830 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,377,819 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,850,538 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,395,116 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,435,582 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$40,466 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEWANEE HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 WEST SOUTH STREET | AddressLine1 |
| City | KEWANEE | City |
| State | IL | State |
| ZIP Code | 61443 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEWANEE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION B, LINE 5D | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| KEWANEE HOSPITAL | PART V, SECTION B, LINE 3: A FOCUS GROUP COMPRISED OF HEALTHCARE PROFESSIONALS AND PARTNERS MET ON OCTOBER 18, 2012. THE GROUP INCLUDED REPRESENTATIVES OF NURSING AND REHABILITATION FACILITIES, CLINICS, AND OTHERS. THIS GROUP DISCUSSED POSITIVE DEVELOPMENTS IN THE KEWANEE HOSPITAL SERVICE AREA IN THE RECENT PAST AND A WIDE VARIETY OF HEALTH NEEDS AND HEALTH-RELATED CONCERNS IN GENERAL.A FOCUS GROUP COMPRISED OF COMMUNITY LEADERS AND GROUP REPRESENTATIVES ALSO MET ON OCTOBER 18, 2012. THE GROUP INCLUDED REPRESENTATIVES OF LOCAL EMPLOYERS, CITY DEPARTMENTS, COMMUNITY GROUPS, AND OTHERS. THIS FOCUS GROUP SESSION OPENED WITH THE IDENTIFICATION OF SEVERAL POSITIVE EVENTS THAT TOOK PLACE WITHIN THE KEWANEE HOSPITAL SERVICE AREA DURING THE PAST FIVE YEARS. THROUGH A FACILITATED IDENTIFICATION PROCESS, THE GROUP NEXT DEVELOPED A LIST OF OBSERVED OR PERCEIVED WEAKNESSES, BOTH CURRENT AND THREATENED FOR THE FUTURE, IN DELIVERY OF HEALTH CARE IN THE KEWANEE HOSPITAL SERVICE AREA. |
| KEWANEE HOSPITAL | PART V, SECTION B, LINE 5D: THE CHNA REPORT WAS PROVIDED TO THE PARTICIPANTS, MADE AVAILABLE ON THE WEBSITE (WWW.KEWANEEHOSPITAL.COM, AFTER THE MERGER, THE WEBSITE IS NOW WWW.OSFSAINTLUKE.ORG), A PORTION POSTED ON THE FACILITY BULLETIN BOARD, AND DISTRIBUTED AT LOCAL SERVICE CLUB MEETINGS. WEBSITE LOCATION OF CHNA: HTTP://WWW.OSFHEALTHCARE.ORG/ABOUT/COMMUNITY-HEALTH/. |
| KEWANEE HOSPITAL | PART V, SECTION B, LINE 10: KEWANEE HOSPITAL REVIEWS THE FOLLOWING CRITERIA TO DETERMINE FREE AND/OR DISCOUNTED CARE: INCOME LEVEL, ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNINSURED DISCOUNT, MEDICARE/MEDICAID AND STATE REGULATION. |
| KEWANEE HOSPITAL | PART V, SECTION B, LINE 11: KEWANEE HOSPITAL REVIEWS THE FOLLOWING CRITERIA TO DETERMINE FREE AND/OR DISCOUNTED CARE: INCOME LEVEL, ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNINSURED DISCOUNT, MEDICARE/MEDICAID AND STATE REGULATION. |
| KEWANEE HOSPITAL | PART V, SECTION B, LINE 20D: FOR UNINSURED, THE MAXIMUM CHARGED AMOUNT CANNOT EXCEED 25% OF ANNUAL INCOME. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEWANEE HOSPITAL FAMILY HEALTH CLINIC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1051 WEST SOUTH STREET | AddressLine1 |
| City | KEWANEE | City |
| State | IL | State |
| ZIP Code | 61443 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,850,538. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | KEWANEE HOSPITAL HAS AN OPEN MEDICAL STAFF AND WELCOMES PHYSICIANS AND MID-LEVEL PROVIDERS TO PRACTICE AND PROVIDE CARE IN THE KEWANEE COMMUNITY. THE BOARD OF TRUSTEES IS MADE UP OF COMMUNITY MEMBERS FROM THE LOCAL SERVICE AREA WHO ARE COMMITTED TO THEIR ROLE IN KEEPING QUALITY HEALTH CARE LOCAL. THE HOSPITAL PROVIDES MANY SERVICES THAT WOULD OTHERWISE BE UNAVAILABLE, PARTICULARLY TO THOSE COMMUNITY MEMBERS UNABLE TO TRAVEL FOR SERVICES OR UNABLE TO PAY. THE HOSPITAL CONTINUALLY WORKS WITH AREA STUDENTS PURSUING MEDICAL RELATED CAREERS AND PARTNERS WITH THE AREA COMMUNITY COLLEGE AND REGIONAL COLLEGES AND UNIVERSITIES TO OFFER CLINICAL AND ADMINISTRATIVE EXPERIENCES. THIS INCLUDES PRE-MED, NURSING, LAB, RADIOLOGY, CARDIOPULMONARY, FINANCE, AND ADMINISTRATION.IN ORDER TO RECRUIT AND RETAIN PHYSICIANS AND MID-LEVEL PROVIDERS TO THE RURAL COMMUNITY, KEWANEE HOSPITAL MUST OFFER COMPETITIVE EMPLOYMENT OPPORTUNITIES. EMPLOYING PHYSICIANS IS AN EXPENSIVE UNDERTAKING WHICH INCLUDES TAKING THE RISK OF PRACTICE DEVELOPMENT AND ASSUMING THE EXPENSE AND RISK FOR LIABILITY INSURANCE. CURRENTLY THE FHC PROVIDERS STRUGGLE TO ACCESS SPECIALISTS FOR THEIR PATIENTS WHEN NEEDED. THERE IS A RELUCTANCE OF OUT-OF-TOWN SPECIALISTS TO ACCEPT PATIENTS RELIANT ON MEDICAID. ILLINOIS' CURRENT MEDICAID CRISISHAS CAUSED THOSE SPECIALISTS ONCE WILLING TO TAKE NEW MEDICAID PATIENTS TO CEASE BECAUSE THEY CANNOT DETERMINE WHEN THEY WILL RECEIVE PAYMENT. THE CHILDREN UNDER THE CARE OF THE FHC ARE TURNED DOWN BY ENT'S, PSYCHIATRIST, AND OTHER NEEDED SPECIALIST BECAUSE OF THEIR RELIANCE ON MEDICAID. BECAUSE OF THE SIZE OF THE COMMUNITY, THE DEMOGRAPHICS AND THE CURRENT PHYSICIAN SHORTAGE, KEWANEE HOSPITAL IS UNABLE TO RECRUIT SPECIALISTS SUCH AS ENT, PSYCHIATRISTS, UROLOGISTS, CARDIOLOGISTS,ETC. TO THE AREA. THE FHC PROVIDERS THEREFORE HAVE TO RELY ON OUT-OF-TOWN SPECIALISTS FOR REFERRAL. THE FHC HAS STARTED A PATIENT ASSISTANCE PROGRAM THAT REACHES OUT TO ORGANIZATIONS, PROGRAMS, FOUNDATIONS, ETC. TO MATCH PATIENTS SO THEY CAN ACCESS SPECIALTY CARE, TREATMENT, OR MEDICATIONS THAT ARE NEEDED.KEWANEE HOSPITAL CONTINUES THE COMMITMENT TO THEIR MISSION OF IMPROVING THE HEALTH AND CARE OF THOSE THEY SERVE WITHIN THEIR COMMUNITIES. FY 2014 CONTINUES A FOCUS ON HEALTH EDUCATION, DISEASE MANAGEMENT, PREVENTION, AND WELLNESS. DESPITE GROWING ECONOMIC HARDSHIPS DUE TO CONTINUED DECREASE IN THE NUMBER OF COMMERCIALLY INSURED INDIVIDUALS, THE GROWTH IN PATIENTS RELIANT ON MEDICAID, AND THE INCREASE IN UNINSURED PATIENTS, THE HOSPITAL WILL CONTINUE TO PROVIDE COMMUNITY OUTREACH TO ASSIST THOSE IN NEED. THE HOSPITAL'S VALUE TO THE COMMUNITY FOR THE SIX-MONTH PERIOD ENDED MARCH 31, 2014, WAS APPROXIMATELY $1 MILLION. THE HOSPITAL IS THERE 24 HOURS A DAY, 7 DAYS A WEEK, FOR COMMUNITY MEMBERS IN THEIR TIME OF NEED-WHETHER FOR A CHILD WHO IS SICK THROUGHOUT THE NIGHT, A PARENT EXPERIENCING CHEST PAINS, A GRANDMOTHER WITH THE WARNING SIGNS OF A STROKE, OR THE VICTIMS OF A TRAUMATIC CAR ACCIDENT. KEWANEE HOSPITAL STANDS READY TO TAKE CARE OF THOSE COMMUNITY MEMBERS IN NEED AND CONTINUES TO WORK TOWARDS THEIR VISION OF SETTING THE STANDARD FOR LOCAL HEALTH CARE WITH A TEAM OF COMPASSIONATE PROFESSIONALS WHO ARE FOCUSED ON CLINICAL EXCELLENCE AND CUSTOMER SERVICE. |
| PART III, LINE 4: | BAD DEBTS WERE REPORTED ON THE FINANCIAL STATEMENTS AT GROSS CHARGES. THEN THE COST TO CHARGE RATIO WAS USED TO CONVERT THE BAD DEBT AMOUNT FROM A CHARGE BASED NUMBER TO A COST BASED NUMBER. |
| PART III, LINE 8: | 100% OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. KEWANEE HOSPITAL IS COMMITTED TO SERVING PATIENTS, REGARDLESS OF ABILITY TO PAY OR IF THE PAYMENTS TO BE RECEIVED WILL BE LESS THAN THE COST TO PROVIDE THE SERVICE, WHICH IS THE CASE FOR MEDICARE AND MEDICAID PATIENTS. THE MEDICARE ALLOWABLE COSTS ON LINE 6 PART III HAVE BEEN CALCULATED BY MULTIPLYING MEDICARE CHARGES BY THE PATIENT CARE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2. THE AMOUNT IS COMPARED TO TOTAL MEDICARE PAYMENTS RECEIVED INCLUDING DSH AND IME PAYMENTS. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT SINCE IT REFLECTS UNREIMBURSED COSTS TO THE HEALTH SYSTEM FOR PROVIDING MEDICAL SERVICES TO THE MEDICARE RESIDENTS OF THE COMMUNITY. |
| PART III, LINE 9B: | IT IS THE POLICY OF KEWANEE HOSPITAL TO EXTEND A FULL OR PARTIAL DISCOUNT FROM CHARGES TO QUALIFYING PATIENTS WHOSE CARE IS NOT COVERED BY OTHER FINANCIAL AID OR GOVERNMENT HEALTHCARE PROGRAMS. KEWANEE HOSPITAL UTILIZES A NUMBER OF METHODS FOR COMMUNICATING FINANCIAL ASSISTANCE, INCLUDING CHARITY CARE, TO PATIENTS AND THE COMMUNITY INCLUDING:A. SIGNS STATING THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED INTHE EMERGENCY DEPARTMENT, REGISTRATION AND ADMITTING AREAS AND THECASHIERS OFFICE. BROCHURES WITH INFORMATION REGARDING CHARITY CARE ARE ALSO AVAILABLE.B. NOTICE OF THE AVAILABILITY OF CHARITY CARE IS INCLUDED ON THEHOSPITALS WEB SITE.C. PATIENT FINANCIAL SERVICES STAFF IS KNOWLEDGEABLE ABOUT THE POLICY AND PROCESS.D. THE STAFFS OF THE OUTSOURCED SELF PAY BILLING SERVICE AND BAD DEBTCOLLECTION AGENCY ARE ALSO KNOWLEDGEABLE ABOUT THE POLICY AND PROCESS.E. NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON ORWITH HOSPITAL BILLING STATEMENTS TO GUARANTORS.KEWANEE HOSPITAL ATTEMPTS TO IDENTIFY UNINSURED PATIENTS ELIGIBLE FORCHARITY CARE PRIOR TO OR AT TIME OF SERVICE. FINANCIAL ASSISTANCEINFORMATION AND APPLICATIONS MAY BE OBTAINED FROM THE FINANCIALCOUNSELORS. COMPLETED APPLICATIONS AND DOCUMENTATION WILL BE REVIEWED AND PROCESSED. APPLICANTS WILL THEN RECEIVE A WRITTEN DETERMINATION OF ELIGIBILITY. |
| PART VI, LINE 2: | KEWANEE HOSPITAL CONTINUALLY STRIVES TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY SERVED AND PERFORMS ONGOING ASSESSMENTS IN ORDER TO BEST ALLOCATE THE HOSPITAL'S SCARCE RESOURCES, THE HOSPITAL EVALUATES THE NEEDS OF THE KEWANEE COMMUNITY THROUGH INTERNAL EVALUATION OF MARKET DATA, COMMUNITY DEMOGRAPHICS, CDC AND OTHER HEALTH RELATED DATA, ANALYSIS OF PATIENTS SERVED THROUGH THE HOSPITALS FAMILY HEALTH CLINIC, REVIEW OF EMERGENCY DEPARTMENT VISITS, AND COLLABORATIVE MEETINGS WITH THE AREA SCHOOL DISTRICTS AND THE COUNTY HEALTH DEPARTMENT.KEWANEE HOSPITAL WORKS WITH A NUMBER OF COMMUNITY VOLUNTEERS THROUGH THE HOSPITALS DEVELOPMENT COUNCIL. THE COMMUNITY RELATIONS COMMITTEE IS CHARGED WITH NEEDED EDUCATION FOR THE COMMUNITY AND UTILIZES THE INFORMATION GAINED AS TOPICS FOR EDUCATION. THROUGH THE ONGOING ASSESSMENT PROCESS THE HOSPITAL HAS IDENTIFIED AND PROVIDED OUTREACH INCLUDING A SUICIDE PREVENTION EDUCATIONAL SERIES FOR TEACHERS AND PARENTS, FINANCIAL WELLNESS FOR WOMEN, AND SKIN-CANCER PREVENTION.THROUGH COLLABORATION WITH KEWANEE HOSPITAL'S REGIONAL PARTNERS, INCLUDING THE HENRY COUNTY HEALTH DEPARTMENT, THE HOSPITAL IDENTIFIED DISASTER PREPAREDNESS AS A COMMUNITY NEED. AS A RURAL COMMUNITY, KEWANEE HAS FEW CITY RESOURCES. CITIZENS VIEW THE HOSPITAL AS THE MAINSTAY OR COMMUNITY CORNERSTONE AND THUS WOULD LOOK TO KEWANEE HOSPITAL IN AN EMERGENCY. THE HOSPITAL LEADERSHIP TEAM, STAFF AND PROVIDERS HAVE GONE THROUGH EDUCATION AND TRAINING ON INCIDENT COMMAND. |
| PART VI, LINE 3: | KEWANEE HOSPITAL PROVIDED NEARLY $800,000 IN CHARITY CARE TO NEEDY COMMUNITY MEMBERS IN THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014. KEWANEE HOSPITAL COMMUNICATES TO PATIENTS ABOUT THEIR FINANCIAL OBLIGATIONS THROUGHOUT THE HEALTH CARE EXPERIENCE. IT IS THE HOSPITAL'S GOAL TO ASSESS FINANCIAL NEED AS SOON AS POSSIBLE IN THE CARE PROCESS. PATIENTS SETTING UP DIAGNOSTIC TESTING THROUGH CENTRALIZED SCHEDULING DISCUSS THE PAYMENT OBLIGATIONS PRIOR TO VISITING THE HOSPITAL, ALLOWING FOR PATIENTS NEEDING ASSISTANCE TO START THE PROCESS RIGHT THEN. THE FAMILY HEALTH CLINIC (FHC) PATIENTS BENEFIT FROM HAVING FHC STAFF TALK WITH THEM ABOUT OBLIGATIONS RELATED TO PROCEDURES, DIAGNOSTICS, ETC. AND ARE OFTEN ABLE TO ACCESS FINANCIAL ASSISTANCE PRIOR TO THE PROCEDURE. KEWANEE HOSPITAL STAFF IS TRAINED TO RECOGNIZE POTENTIAL NEED AND TO PROACTIVELY DISCUSS PAYMENT ARRANGEMENTS. THE HOSPITAL PROMOTES FINANCIAL ASSISTANCE THROUGHOUT THE ORGANIZATION AND THROUGH VARIOUS PUBLICATIONS. INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS IS POSTED THROUGH:-SIGNAGE (ADMISSIONS/REGISTRATION AT MAIN ENTRANCE, EMERGENCY DEPARTMENT ADMISSIONS, ADMISSION BOOTHS).-KEWANEE HOSPITAL'S WEBSITE, WWW.KEWANEEHOSPITAL.COM (AFTER THE MERGER, THE WEBSITE IS WWW.OSFSAINTLUKE.ORG) DIRECT MAIL PIECES INCLUDING BIANNUAL NEWSLETTERS AND COMMUNITY BENEFIT REPORT-HENRY COUNTY TOURISM VIDEO/WEB-SITE LINK-RADIO PROGRAM, MONDAY MORNING TUNED-IN, WKEI-PATIENT EDUCATION THROUGHOUT THE CARE PROCESS-FINANCIAL ASSISTANCE BROCHURES AT CASHIERS WINDOW-PATIENT BILL FOR SERVICE.-IDENTIFICATION OF NEED AND EDUCATION THROUGH CENTRALIZED SCHEDULING, ADMISSIONS STAFF, FHC STAFF, CASHIERS OFFICE, FINANCIAL COUNSELORS, PROVIDERS OF SERVICES, AND OTHER STAFF AS THEY BECOME AWARE OF THE PATIENTS NEED.-ANNOUNCEMENTS AND POSTINGS AT BOOTHS AT FREE COMMUNITY EDUCATION AND OUTREACH CONDUCTED BY KEWANEE HOSPITAL. |
| PART VI, LINE 4: | KEWANEE HOSPITAL IS LOCATED IN A RURAL AREA OF NORTHERN WEST-CENTRAL ILLINOIS, ABOUT 10 MILES SOUTH OF INTERSTATE 80 AND BETWEEN THE LARGER URBAN AREAS OF PEORIA, ILLINOIS AND THE QUAD CITIES (LOCATED ABOUT 50-55 MILES FROM EACH). THE HOSPITAL SERVES THE PRIMARY MARKET AREA (POPULATION APPROXIMATELY 19,700) OF KEWANEE AND THE SURROUNDING RURAL COMMUNITIES INCLUDING GALVA AND TOULON. THE OVERALL MARKET (POPULATION APPROXIMATELY 29,000) INCLUDES THE THREE COUNTY PORTIONS OF HENRY, BUREAU, AND STARK IN RURAL ILLINOIS. THE LARGEST PERCENTAGES OF KEWANEE HOSPITALS PATIENTS ARE DERIVED FROM THE KEWANEE ZIP CODE OF 61443. THE POPULATION OF KEWANEE IS AGING AND POOR WITH THE GREATEST NUMBERS IN THE OVER 65 AND UNDER 18. IN 2012, 18% OF THE POPULATION WAS BELOW THE POVERTY LEVEL. THE KEWANEE SCHOOL DISTRICT REPORTED OVER 79% OF CHILDREN ATTENDING SCHOOL ON THE FREE AND REDUCED LUNCH PROGRAM. SUBSEQUENTLY THAT LEAVES FEW CITIZENS IN THE MIDDLE WHERE A COMMUNITY TYPICALLY SEES THE WORKING CLASS. AS A RESULT OF THE DEMOGRAPHICS, KEWANEE HOSPITAL SEES A HIGH PROPORTION OF PATIENTS RELIANT ON MEDICAID AND UNINSURED. FOLLOWING THE NATIONAL TREND, THE HIGHEST CONCENTRATION IS IN THE EMERGENCY DEPARTMENT AND THE HOSPITAL'S FAMILY HEALTH CLINIC (FHC). FOR THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014, 30% OF PATIENTS IN THE EMERGENCY DEPARTMENT WERE RELIANT ON MEDICAID WHILE 15% WERE UNINSURED. THE FAMILY HEALTH CLINIC REPORTED 37% OF PATIENTS WERE RELIANT ON MEDICAID AND 8% UNINSURED. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| IL HOSPITAL RESEARCH & EDUCATION FOUNDATION | |||||||
| 1151 E WARRENVILLE | NAPERVILLE | IL | 60566 | 237421930 | 501(C)(3) | $16,250 | TO ADDRESS THE DISPARATE AND NEGATIVE EFFECTS OF THE ILLINOIS MEDICAID PROGRAM. |
| KEWANEE AREA HEALTHCARE TRUST | |||||||
| 1051 WEST SOUTH ST | KEWANEE | IL | 61443 | 806264344 | 501(C)(3) | $200,000 | TO SUPPORT THE DELIVERY AND AVAILABILITY OF HIGH-QUALITY HEALTHCARE SERVICES WITHIN KEWANEE HOSPITAL'S SERVICE AREA PER THE AFFILIATION AGREEMENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | FOR GRANTS GIVEN TO ORGANIZATIONS, SUBSTANTIATION IS REQUIRED PRIOR TO DISBURSEMENT OF ALL FUNDS FOR SCHOLARSHIPS, ALL INDIVIDUALS MUST SIGN A SUPPORT AGREEMENT VERIFYING THEIR OBLIGATIONS AS AWARD RECIPIENTS AND THE RAMIFICATIONS IF THE AGREEMENT IS NOT MET. | 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 | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LYNN A FULTON | ||||||||||||||
| CEO | $191,677 | $0 | $0 | $0 | $0 | $0 | $10,061 | $0 | $24,704 | $0 | $226,442 | $0 | $0 | $0 |
| DANIEL CONGREVE MD | ||||||||||||||
| TRUSTEE | $411,637 | $0 | $0 | $0 | $0 | $0 | $11,100 | $0 | $24,199 | $0 | $446,936 | $0 | $0 | $0 |
| AIMEE SHANE CRNA | ||||||||||||||
| CRNA | $168,628 | $0 | $0 | $0 | $0 | $0 | $8,651 | $0 | $11,003 | $0 | $188,282 | $0 | $0 | $0 |
| NEIL TEX | ||||||||||||||
| CRNA | $151,752 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,751 | $0 | $158,503 | $0 | $0 | $0 |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | ALL ASSETS AND LIABILITIES WERE TRANSFERRED AS PART OF A MERGER DUE TO AFFILIATION. | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2014-04-01 | DistributionDt |
| Fair Market Value Of Asset | $31,958,030 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 370813229 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OSF HEALTHCARE SYSTEM | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | NORTHEAST GLEN OAK AVE | AddressLine1 |
| City | PEORIA | City |
| State | IL | State |
| ZIP Code | 61603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (1) | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | 0 | AssetsDistributedInd |
| Required To Notify AG | 0 | RequiredToNotifyAGInd |
| Attorney General Notified | 0 | AttorneyGeneralNotifiedInd |
| Liabilities Paid | 0 | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2E: | FormAndLineReferenceDesc |
| Explanation | EXPLANATION OF INVOLVEMENT: THE TRANSFER, DUE TO AFFILIATION, WAS A STATUTORY MERGER. ALL OF THE OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES CONTINUED EMPLOYMENT (OR SERVICE TO THE BOARD) AFTER AFFILIATION. THE MERGER WILL ALLOW BOTH PARTIES TO UNIFY THEIR HEALTH CARE MISSIONS AND BETTER SERVE THE COMMUNITIES SERVED BY OSF AND KEWANEE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | UROLOGY |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 FOR THE SIX-MONTH PERIOD ENDED MARCH 31, 2014 WILL BE REVIEWED AND APPROVED BY THE CFO AND CEO AND THEN IT WILL BE SENT TO OSF (WHOM THIS ORGANIZATION MERGED WITH EFFECTIVE ON APRIL 1, 2014) FOR THEIR FINAL REVIEW AND APPROVAL. AT THIS TIME, THE FORMER BOD IS NO LONGER FIDUCIALLY RESPONSIBLE FOR THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY INTERESTED PERSON WHO HAS A PERSONAL OR PRIVATE INTEREST IN A MEASURE, CONTRACT, RESOLUTION, OR OTHER TRANSACTION PRESENTED TO THE BOARD OR A COMMITTEE THEREOF FOR DELIBERATION, AUTHORIZATION, APPROVAL, OR RATIFICATION, OR ANY INTERESTED PERSON WHO REASONABLY BELIEVES SUCH AN INTEREST EXISTS IN ANOTHER PERSON, SHALL MAKE A PROMPT, FULL, AND FRANK DISCLOSURE IN WRITING OF THE PERSONAL OR PRIVATE INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. THE INTERESTED PERSON SHALL DISCLOSE THE EXISTENCE OF HIS OR HER PERSONAL OR PRIVATE INTEREST AND ALL MATERIAL FACTS, KNOWN TO HIM OR HER ABOUT THE PERSONAL OR PRIVATE INTEREST AND POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE HOSPITAL BOARD OF TRUSTEES ACTS AS THE COMPENSATION COMMITTEE FOR KEWANEE HOSPITAL. ANNUALLY THE EXECUTIVE COMMITTEE OF THE BOARD MEETS TO REVIEW AND APPROVE COMPENSATION FOR THE EXECUTIVE TEAM WHICH INCLUDES THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND CHIEF NURSING OFFICER. RESOURCE DATA FOR THIS REVIEW COMES FROM SALARY SURVEYS FROM A NUMBER OF SOURCES INCLUDING SULLIVAN COTTER, CENTRAL ILLINOIS SOCIETY FOR HEALTHCARE HUMAN RESOURCE ADMINISTRATION (CISHRA), IHA EXECUTIVE AND MANAGEMENT SALARY SURVEY, AND A 990 REVIEW THROUGH GUIDESTAR.ORG OF LOCAL AND REGIONAL ORGANIZATIONS. THE SURVEYS ARE ANALYZED BY REVIEWING APPLICABLE CUTS OF THE SURVEY INCLUDING CRITICAL ACCESS HOSPITALS, HOSPITALS WITH LIKE REVENUE, AND SIMILARLY STAFFED ORGANIZATIONS. SURVEYS ARE ALSO REVIEWED AT REGIONAL AND NATIONAL LEVELS. COMPENSATION IS PROPOSED TO THE COMMITTEE TAKING INTO CONSIDERATION THE MEDIAN RANGE OF ALL SALARY SOURCES, EDUCATION/DEGREE, TRAINING, CERTIFICATION, AND EXPERIENCE. THE COMMITTEE REVIEWS THE SALARY PROPOSAL FOR REASONABLENESS BASED ON THE DATA SOURCES. THE CHIEF EXECUTIVE OFFICER MAKES RECOMMENDATIONS FOR THE SALARIES OF THE OTHER EXECUTIVES (CFO AND CNO). |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED MEDICAL STAFF SERVICES: PROGRAM SERVICE EXPENSES 997,316. MANAGEMENT AND GENERAL EXPENSES 699,361. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,696,677. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF ASSETS DUE TO STATUTORY MERGER -31,958,030. |
| FORM 990, PART XII, LINE 2C, AUDITED FINANCIAL STATEMENTS | THE PROCESS HAS CHANGED FROM THE PRIOR YEAR. EFFECTIVE APRIL 1, 2014, THE HOSPITAL WAS MERGED INTO OSF HEALTHCARE SYSTEM (OSF), AN ILLINOIS NOT-FOR-PROFIT CORPORATION. DUE TO THE STATUTORY MERGER WITH OSF, THE COMMUNITY BOARD OF DIRECTORS NO LONGER HAD A FIDUCIARY RESPONSIBILITY, AND WAS NO LONGER A PART OF THE FINAL AUDIT PROCESS. |
| FORM 990, PART XI, LINE 9, OTHER CHANGES IN NET ASSETS | EFFECTIVE APRIL 1, 2014, THE HOSPITAL WAS MERGED INTO OSF HEALTHCARE SYSTEM (OSF), AN ILLINOIS NOT-FOR-PROFIT CORPORATION. AFTER THE MERGER, THE HOSPITAL AND OSF BECAME A SINGLE NOT-FOR-PROFIT CORPORATION WITH OSF BEING THE SURVIVING ENTITY AND THE HOSPITAL BECOMING AN OPERATING DIVISION OF OSF KNOWN AS OSF SAINT LUKE MEDICAL CENTER. THE HOSPITAL AS A SEPARATE CORPORATION CEASED TO EXIST AS OF APRIL 1, 2014, WITH ITS LAST DAY OF OPERATIONS BEING MARCH 31, 2014. AFTER THE MERGER, THE DEFINED CONTRIBUTION PLAN FOR HOSPITAL EMPLOYEES WAS FROZEN AND CONTRIBUTIONS TO THE PLAN CAN NO LONGER BE MADE. AS A RESULT OF THE MERGER, ALL ASSETS AND LIABILITIES OF THE HOSPITAL AS OF MARCH 31, 2014, WERE TRANSFERRED AND ASSUMED BY OSF. THE ILLINOIS FINANCE AUTHORITY REVENUE BONDS, SERIES 2006 ASSUMED BY OSF AND REFINANCED IN AUGUST 2014. DURING MARCH 2014, THE HOSPITAL TRANSFERRED $200,000 TO KEWANEE AREA HEALTHCARE TRUST, A NEWLY CREATED CHARITABLE TRUST AS REQUIRED BY THE MERGER OF THE HOSPITAL AND OSF. KEWANEE AREA HEALTHCARE TRUST IS A NOT-FOR-PROFIT PRIVATE FOUNDATION ESTABLISHED TO SUPPORT THE DELIVERY AND AVAILABILITY OF HIGH-QUALITY HEALTH CARE SERVICES TO THE RESIDENTS WITHIN OSF SAINT LUKE MEDICAL CENTER'S SERVICE AREA. |
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