FURP.ORG / PUBLIC DATA EXPLORER

ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (EIN 55-0809159)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-09-02
IRS object ID
201542459349300949
Schema version
2014v5.0
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)
Return2015-09-02T16:06:59-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1114 E EVERETTAddressLine1Txt
CityDIXONCityNm
State AbbreviationILStateAbbreviationCd
ZIP61021ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550809159EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlILLIBusinessNameControlTxt
Phone8158752999PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 BACKBONE ROAD EASTAddressLine1Txt
CityPRINCETONCityNm
State AbbreviationILStateAbbreviationCd
ZIP61356ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICIA SCHOUPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone8158752999PhoneNum
Signature2015-08-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTODD M ETHERIDGEPreparerPersonNm
PTINP00233050PTIN
Phone8152859300PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPATRICIA SCHOUPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 BACKBONE ROAD EASTAddressLine1Txt
CityPRINCETONCityNm
State AbbreviationILStateAbbreviationCd
ZIP61356ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,340,994GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ICAHN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTHE MISSION OF ICAHN IS TO STRENGTHEN ILLINOIS CRITICAL ACCESS HOSPITALS THROUGH COLLABORATION.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee13TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,990,625PYContributionsGrantsAmt
CY Contributions Grants$1,961,112CYContributionsGrantsAmt
PY Program Service Revenue$986,435PYProgramServiceRevenueAmt
CY Program Service Revenue$1,376,604CYProgramServiceRevenueAmt
PY Investment Income$4,330PYInvestmentIncomeAmt
CY Investment Income$3,278CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,981,390PYTotalRevenueAmt
CY Total Revenue$3,340,994CYTotalRevenueAmt
PY Grants And Similar Paid$1,295,607PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,390,274CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$872,249PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,004,327CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$757,554PYOtherExpensesAmt
CY Other Expenses$856,786CYOtherExpensesAmt
PY Total Expenses$2,925,410PYTotalExpensesAmt
CY Total Expenses$3,251,387CYTotalExpensesAmt
PY Revenues Less Expenses$55,980PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$89,607CYRevenuesLessExpensesAmt
Total Assets BOY$842,489TotalAssetsBOYAmt
Total Assets EOY$1,010,499TotalAssetsEOYAmt
Total Liabilities BOY$132,925TotalLiabilitiesBOYAmt
Total Liabilities EOY$211,328TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$709,564NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$799,171NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionICAHN IS A NOT-FOR-PROFIT 501(C)3 CORPORATION ESTABLISHED IN 2003 FOR THE PURPOSES OF SHARING RESOURCES, EDUCATION, PROMOTING EFFICIENCY AND BEST PRACTICE AND IMPROVING HEALTH CARE SERVICES FOR MEMBER CRITICAL ACCESS HOSPITALS AND THEIR RURAL COMMUNITIES. ICAHN, WITH 53 MEMBER HOSPITALS, IS AN INDEPENDENT NETWORK GOVERNED BY A NINE-MEMBER BOARD OF DIRECTORS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,596,216ExpenseAmt
Grant$1,390,274GrantAmt
Revenue$879,016RevenueAmt
DescICAHN PROVIDES TECHNICAL ASSISTANCE TO SMALL RURAL HOSPITALS1) TO HELP THEM WITH ADMINISTRATIVE PROCESSES FOR CRITICAL ACCESS HOSPITALS.2) SHARE RESOURCES WITH MEMBERS AND3) IMPLEMENT PROGRAMS TO IMPROVE QUALITY AND EFFICIENCES OF MEDICAL SERVICES PROVIDED BY RURAL HEALTH CARE FACILITIES. SERVES APPROXIMATELY 53 HOSPITALS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$120,595ExpenseAmt
Revenue$69,257RevenueAmt
DescICAHN PROVIDES QUALITY EDUCATIONAL OPPORTUNITIES TO MEMBER HOSPITALS FOCUSING ON RURAL HEALTH ISSUES AND STRATEGIES FOR SUCCESS THROUGH ONSITE MEETINGS, VIDEOCONFERENCES, AND WEB-BASED TRAINING.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$16,217ExpenseAmt
Revenue$428,331RevenueAmt
DescICAN PROVIDES INFORMATION TECHNOLOGY ASSISTANCE TO SMALL RURAL HOSPITALS ACROSS THE STATE SERVING APPROXIMATELY 53 HOSPITALS. SERVICES ARE AVAILABLE TO ALL 53 HOSPITALS AND ALL CHOSE TO UTILIZE THEM IN 2014.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$2,733,028TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee13EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMATT COMERFORDPersonNm
Phone8158752999PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 BACKBONE ROAD EASTAddressLine1Txt
CityPRINCETONCityNm
State AbbreviationILStateAbbreviationCd
ZIP61356ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
GREG STARNES
DIRECTOR0.50Yes (X)$0$0$0
TOM HUDGINS
PRESIDENT0.50Yes (X)$0$0$0Yes (X)
TRINA CASNER
SECRETARY/TREASURER0.50Yes (X)$0$0$0Yes (X)
KATHY HULL
DIRECTOR0.50Yes (X)$0$0$0
STEPHANIE HILTON-SIEBERT
DIRECTOR0.50Yes (X)$0$0$0
TRACY BAUER
DIRECTOR0.50Yes (X)$0$0$0
MARK ROSSI
PRESIDENT ELECT0.50Yes (X)$0$0$0Yes (X)
DOUG FLORKOWSKI
DIRECTOR0.50Yes (X)$0$0$0
KEN REID
DIRECTOR0.50Yes (X)$0$0$0
SUSIE CAMPBELL
PAST - DIRECTOR0.50Yes (X)$0$0$0
BRAD SOLBERG
PAST - DIRECTOR0.50Yes (X)$0$0$0
PATRICIA SCHOU
EXECUTIVE DIRECTOR40.00$194,272$0$23,752Yes (X)
RYAN MORGAN
IT CONSULTANT40.00$119,115$0$8,118Yes (X)
CURTIS ZIMMERMAN
DIRECTOR OF BUSINESS SERVICES AND DEVELOPMENT40.00$101,152$0$12,805Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$414,539TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$44,675TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HART LLCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line13001 MARKWOOD LANEAddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP62712ZIPCd
FieldValueIRS element (for citing)
ServicesCONSULTING SERVICESServicesDesc
Compensation$173,096CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Membership Dues$397,500MembershipDuesAmt
Government Grants$1,513,612GovernmentGrantsAmt
All Other Contributions$50,000AllOtherContributionsAmt
Total Contributions$1,961,112TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
IT SERVICES541519$428,331$428,331
CONSULTING REVENUE541610$117,273$117,273
IL RURAL COMMUNITY CAR900099$116,000$116,000
ICAHN RURAL RECRUITMEN900099$82,863$82,863
WORKSHOP/MEETING FEES900099$69,257$69,257

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$562,880TotalRevenueColumnAmt
Related Or Exempt Func Income$562,880RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,376,604TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,278TotalRevenueColumnAmt
Exclusion$3,278ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,340,994TotalRevenueColumnAmt
Related Or Exempt Func Income$1,376,604RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,278ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,390,274TotalAmt
Program Services$1,390,274ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$218,024TotalAmt
Program Services$152,617ProgramServicesAmt
Management And General$65,407ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$676,059TotalAmt
Program Services$473,239ProgramServicesAmt
Management And General$202,820ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$14,837TotalAmt
Program Services$10,386ProgramServicesAmt
Management And General$4,451ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$34,574TotalAmt
Program Services$24,202ProgramServicesAmt
Management And General$10,372ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$60,833TotalAmt
Program Services$42,583ProgramServicesAmt
Management And General$18,250ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$19,041TotalAmt
Management And General$19,041ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$19,055TotalAmt
Management And General$19,055ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$372,130TotalAmt
Program Services$371,791ProgramServicesAmt
Management And General$339ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$37,998TotalAmt
Program Services$22,799ProgramServicesAmt
Management And General$15,199ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$23,212TotalAmt
Program Services$13,927ProgramServicesAmt
Management And General$9,285ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$27,029TotalAmt
Program Services$16,217ProgramServicesAmt
Management And General$10,812ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$40,135TotalAmt
Program Services$24,081ProgramServicesAmt
Management And General$16,054ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$64,373TotalAmt
Program Services$38,624ProgramServicesAmt
Management And General$25,749ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$200,992TotalAmt
Program Services$120,595ProgramServicesAmt
Management And General$80,397ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$11,963TotalAmt
Program Services$7,178ProgramServicesAmt
Management And General$4,785ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$15,755TotalAmt
Program Services$9,453ProgramServicesAmt
Management And General$6,302ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEMBERSHIP DUES EXPENSE$16,725$10,035$6,690
MISCELLANEOUS EXPENSE$8,078$4,847$3,231
JOB POSTING EXPENSE$300$180$120

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,251,387TotalAmt
Program Services$2,733,028ProgramServicesAmt
Management And General$518,359ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$37,386BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$583,406BOYAmt
EOY$810,526EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$175,990BOYAmt
EOY$154,369EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$15,518BOYAmt
EOY$11,781EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$81,773LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$47,950LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,189BOYAmt
EOY$33,823EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$842,489BOYAmt
EOY$1,010,499EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,752BOYAmt
EOY$107,718EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$102,173BOYAmt
EOY$103,610EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$132,925BOYAmt
EOY$211,328EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$703,888BOYAmt
EOY$777,425EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,676BOYAmt
EOY$21,746EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$709,564BOYAmt
EOY$799,171EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$842,489BOYAmt
EOY$1,010,499EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$89,607ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,316,892CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,547,848CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,551,197CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,990,425CurrentTaxYearMinus1YearAmt
Current Tax Year$1,961,112CurrentTaxYearAmt
Total$8,367,474TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,316,892CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,547,848CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,551,197CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,990,425CurrentTaxYearMinus1YearAmt
Current Tax Year$1,961,112CurrentTaxYearAmt
Total$8,367,474TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$8,367,474PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,325CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,091CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,964CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,330CurrentTaxYearMinus1YearAmt
Current Tax Year$3,278CurrentTaxYearAmt
Total$34,988TotalAmt
FieldValueIRS element (for citing)
Total Support$8,402,462TotalSupportAmt
Gross Receipts Rltd Activities$5,555,558GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99580PublicSupportCY170Pct
Public Support PY1700.97870PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$81,773OtherCostOrOtherBasisAmt
Depreciation$47,950DepreciationAmt
Book Value$33,823BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$33,823TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationICAHN AND AHEC ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND AS SUCH, ARE NOT LIABLE FOR INCOME TAXES. IRRS AND IRCCO ARE SOLE MEMBER LIMITED LIABILITY COMPANIES AND THEREFORE ARE DISREGARDED ENTITIES FOR FEDERAL INCOME TAX PURPOSES. FOR 990 REPORTING PURPOSES IRRS'S AND IRCCO'S ACTIVITIES ARE INCLUDED IN ICAHN'S 990. ICAHN AND AHEC ARE CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS OTHER THAN A PRIVATE FOUNDATION. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES UNDER THE AUTHORITATIVE GUIDANCE ISSUED BY FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB"). THE ORGANIZATION USES A THRESHOLD OF MORE-LIKELY THAN-NOT TO BE SUSTAINED UPON EXANIMATION TO ACCOUNT FOR UNCERTAINTY INCOME TAXES. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS NOT BEEN MET. THIS GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE ORGANIZATION CONDUCTS BUSINESS SOLELY IN THE U.S. AND, AS A RESULT, FILES FEDERAL AND ILLINOIS TAX RETURNS. IN THE NORMAL COURSE OF BUSINESS THE ORGANIZATION IS SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. THE ORGANIZATION'S TAX RETURNS FOR YEARS SUBSEQUENT TO 2011 ARE OPEN, BY STATUTE, FOR REVIEW BY AUTHORITIES. HOWEVER, AT PRESENT, THERE ARE NO ONGOING INCOME TAX AUDITS OR UNRESOLVED DISPUTES WITH THE TAX AUTHORITIES THAT THE ORGANIZATION CURRENTLY FILES OR HAS FILED WITH.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (59 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
ABRAHAM LINCOLN MEMORIAL HOSPITAL
200 STALHUT DRIVELINCOLNIL62656370723793501(C)(3)$12,939N/AN/ASHIP GRANT, REHAB SERVICES GRANT
ADVOCATE EUREKA HOSPITAL
101 S MAJOR STEUREKAIL61530370662542501(C)(3)$7,939N/AN/ASHIP GRANT
CARLINVILLE AREA HOSPITAL
20733 N BROAD STREETCARLINVILLEIL62626370645239501(C)(3)$12,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT
CLAY COUNTY HOSPITAL
911 STACY BURK DRIVEFLORAIL62839376000605GOVERNMENTAL UNIT$32,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, HOSPITAL BOARD GRANT
COMMUNITY MEMORIAL HOSPITAL
400 CALDWELL STSTAUNTONIL62088370624255501(C)(3)$29,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, FINANCIAL ASSESSMENT GRANT
CRAWFORD MEMORIAL HOSPITAL
1000 NORTH ALLEN STREETROBINSONIL62454371241849GOVERNMENTAL UNIT$24,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION/MODEL POPULATION HEALTH GRANT
DR JOHN WARNER HOSPITAL
422 WEST WHITE STCLINTONIL61727376000695GOVERNMENTAL UNIT$12,939N/AN/ASHIP GRANT, TRANSITION/MODEL POPULATION HEALTH GRANT
FAIRFIELD MEMORIAL HOSPITAL
303 NW 11TH STFAIRFIELDIL62837370661202GOVERNMENTAL UNIT$32,000N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, EMS EDUCATION & EQUIPMENT GRANT
FAYETTE COUNTY HOSPITAL AND LONG TERM CARE
650 WEST TAYLOR STVANDALIAIL62471201890414GOVERNMENTAL UNIT$7,939N/AN/ASHIP GRANT
FERRELL HOSPITAL
1201 PINE STELDORADOIL62930201244058501(C)(3)$15,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT, HOSPITAL BOARD EDUCATION GRANT
FRANKLIN HOSPITAL
201 BAILEY LANEBENTONIL62812376006885GOVERNMENTAL UNIT$34,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
GENESIS MEDICAL CENTER
409 NW 9TH AVENUEALEDOIL61231454475683501(C)(3)$7,939N/AN/ASHIP GRANT
GIBSON AREA HOSPITAL & HEALTH SERVICES
1120 N MELVIN STGIBSON CITYIL60936370647938501(C)(3)$34,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
GREENVILLE REGIONAL HOSPITAL
200 HEALTHCARE DRGREENVILLEIL62246370792770501(C)(3)$7,939N/AN/ASHIP GRANT
HAMILTON MEMORIAL HOSPITAL DISTRICT
611 S MARSHALL AVENUE PO BOX 429MCLEANSBOROIL62859376019589GOVERNMENTAL UNIT$29,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, EMS EDUCATION & EQUIPMENT GRANT
HAMMOND HENRY HOSPITAL
600 NORTH COLLEGE AVENUEGENESEOIL61254366008003GOVERNMENTAL UNIT$12,939N/AN/ASHIP GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
HARDIN COUNTY GENERAL HOSPITAL
6 FERRELL ROAD BOX 2467ROSICLAREIL62982370702309501(C)(3)$27,939N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
HILLSBORO AREA HOSPITAL
1200 EAST TREMONT STHILLSBOROIL62049370661208501(C)(3)$17,939N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT, EMS EDUCATION & EQUIPMENT GRANT
HOPEDALE MEDICAL COMPLEX
107 TREMONT STHOPEDALEIL61747370808925501(C)(3)$12,939N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT
ILLINI COMMUNITY HOSPITAL
640 WEST WASHINGTON STPITTSFIELDIL62363371396010501(C)(3)$15,739N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT, EMS EDUCATION & EQUIPMENT GRANT
ILLINOIS HOSPITAL ASSOCIATION
1151 EAST WARRENVILLE ROADNAPERVILLEIL60566362352486501(C)(3)$29,500N/AN/AMEDICARE RURAL HOSPITAL FLEX PROGRAM GRANT
IROQUOIS MEMORIAL HOSPITAL
200 FAIRMANWATSEKAIL60970370673512501(C)(3)$17,939N/AN/ASHIP GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, FINANCIAL ASSESSMENT GRANT
JERSEY COMMUNITY HOSPITAL
400 MAPLE SUMMITJERSEYVILLEIL62052376013958501(C)(3)$7,939N/AN/ASHIP GRANT
KEWANEE HOSPITAL
1051 WEST SOUTH ST PO BOX 747KEWANEEIL61443362167767501(C)(3)$19,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT
KIRBY MEDICAL CENTER
1000 MEDICAL CENTER DRIVEMONTICELLOIL61856370661215501(C)(3)$11,639N/AN/ASHIP GRANT, EMS EDUCATION & EQUIPMENT GRANT
LAWRENCE COUNTY MEMORIAL HOSPITAL
2200 WEST STATE STLAWRENCEVILLEIL62439371080256GOVERNMENTAL UNIT$7,939N/AN/ASHIP GRANT
MARSHALL BROWNING HOSPITAL
900 N WASHINGTON STDUQUOINIL62832370661218501(C)(3)$12,939N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT
MASON DISTRICT HOSPITAL
615 N PROMENADE STHAVANAIL62644376017857GOVERNMENTAL UNIT$24,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT
MASSAC MEMORIAL HOSPITAL
28 CHICK ST PO BOX 850METROPOLISIL62960370857853GOVERNMENTAL UNIT$12,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT
MEMORIAL HOSPITAL CARTHAGE
1454 N COUNTY ROAD 2050 PO BOX 160CARTHAGEIL62321370662570501(C)(3)$20,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT, PREVENTION/REHAB SERVICES GRANT, HOSPITAL BOARD EDUCATION GRANT
MEMORIAL HOSPITAL CHESTER
1900 STATE STCHESTERIL62233376020801GOVERNMENTAL UNIT$7,939N/AN/ASHIP GRANT
MENDOTA COMMUNITY HOSPITAL
1401 EAST 12TH STMENDOTAIL61342362167785501(C)(3)$24,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, PREVENTION/REHAB SERVICES GRANT
MERCY HARVARD HOSPITAL
901 GRANT STREETHARVARDIL60033311551871501(C)(3)$7,939N/AN/ASHIP GRANT
MIDWEST MEDICAL CENTER
1 MEDICAL CENTER DRIVEGALENAIL61036204560540501(C)(3)$17,939N/AN/ASHIP GRANT, EMS GRANT, FINANCIAL ASSESSMENT GRANT
MORRISON COMMUNITY HOSPITAL
303 N JACKSON STMORRISONIL61270366008167GOVERNMENTAL UNIT$9,939N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT
NORTHERN ILLINOIS UNIVERSITY
148 N 3RD STDEKALBIL60115363251692GOVERNMENTAL UNIT$10,000N/AN/AFLEX GRANT
OSF HOLY FAMILY MEDICAL CENTER
1000 W HARLEM AVEMONMOUTHIL61462370813229501(C)(3)$17,911N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
OSF ST JAMES W ALBRECHT MEDICAL CENTER
2500 W REYNOLDS STPONTIACIL61764370662570501(C)(3)$12,939N/AN/ASHIP GRANT, EMS EDUCATION & EQUIPMENT GRANT
PANA COMMUNITY HOSPITAL
101 EAST NINTH STPANAIL62557376062326501(C)(3)$22,880N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT, EMS EDUCATION & EQUIPMENT GRANT, PREVENTION/REHAB SERVICES GRANT
PARIS COMMUNITY HOSPITAL
721 EAST COURT STPARISIL61944370860281501(C)(3)$32,924N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, HOSPITAL BOARD EDUCATION GRANT, EMS EDUCATION & EQUIPMENT GRANT
PERRY MEMORIAL HOSPITAL
530 PARK AVENUE EASTPRINCETONIL61356366006057GOVERNMENTAL UNIT$12,939N/AN/ASHIP GRANT, EMS EDUCATION & EQUIPMENT GRANT
PINCKNEYVILLE COMMUNITY HOSPITAL
101 NORTH WALNUT STREETPINCKNEYVILLEIL62274376006955GOVERNMENTAL UNIT$15,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT, HOSPITAL BOARD EDUCATION GRANT
RED BUD REGIONAL HOSPITAL
325 SPRING STRED BUDIL62278364443919501(C)(3)$12,739N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT
RICHLAND MEMORIAL HOSPITAL
800 EAST LOCUSTOLNEYIL62450371363001501(C)(3)$12,604N/AN/ASHIP GRANT, EMS EDUCATION & EQUIPMENT GRANT
ROCHELLE COMMUNITY HOSPITAL
900 N SECOND STROCHELLEIL61068362548549501(C)(3)$10,939N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT
SALEM TOWNSHIP HOSPITAL
1201 RICKER DRIVESALEMIL62881370925318GOVERNMENTAL UNIT$30,439N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, PREVENTION/REHAB SERVICES GRANT
SARAH D CULBERTSON MEMORIAL HOSPITAL
238 SOUTH CONGRESS AVERUSHVILLEIL62681376006672GOVERNMENTAL UNIT$19,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
SHELBY MEMORIAL HOSPITAL
200 SOUTH CEDARSHELBYVILLEIL62565370512290501(C)(3)$12,939N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT
SPARTA COMMUNITY HOSPITAL DISTRICT
818 EAST BROADWAYSPARTAIL62286376014817GOVERNMENTAL UNIT$28,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT, ILHIE WHITE SPACE GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236501(C)(3)$12,939N/AN/ASHIP GRANT, FINANCIAL ASSESSMENT GRANT
ST JOSEPH'S HOSPITAL
1515 MAIN STHIGHLANDIL62249370663568501(C)(3)$20,939N/AN/ASHIP GRANT, TRANSITION MODEL/POPULATION HEALTH GRANT, HOSPITAL BOARD EDUCATION GRANT, FINANCIAL ASSESSMENT GRANT
ST JOSEPH MEMORIAL HOSPITAL
2 SOUTH HOSPITAL DRIVEMURPHYSBOROIL62966370618939501(C)(3)$12,939N/AN/ASHIP GRANT, PREVENTION/REHAB SERVICES GRANT
TAYLORVILLE MEMORIAL HOSPITAL
201 EAST PLEASANT STTAYLORVILLEIL62568370661250501(C)(3)$7,939N/AN/ASHIP GRANT
THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
809 S MARSHFIELD AVENUECHICAGOIL60612376000511501(C)(3)$15,000N/AN/AFLEX SPECIAL PROJECTS
THOMAS H BOYD MEMORIAL HOSPITAL
800 SCHOOL STCARROLTONIL62016370673461GOVERNMENTAL UNIT$10,939N/AN/ASHIP GRANT, HOSPITAL BOARD EDUCATION GRANT
UNION COUNTY HOSPITAL
517 NORTH MAIN STANNAIL62906364431843GOVERNMENTAL UNIT$7,939N/AN/ASHIP GRANT
VALLEY WEST COMMUNITY HOSPITAL
11 E PLEASANT AVESANDWICHIL60548364244337501(C)(3)$7,939N/AN/ASHIP GRANT
WABASH GENERAL HOSPITAL
1418 COLLEGE DRMT CARMELIL62863376013625GOVERNMENTAL UNIT$11,939N/AN/ASHIP GRANT, EMS EDUCATION & EQUIPMENT GRANT
WASHINGTON COUNTY HOSPITAL
705 S GRANDNASHVILLEIL62263376020408GOVERNMENTAL UNIT$37,939N/AN/ASHIP GRANT, ILHIE WHITE SPACE GRANT, HOSPITAL BOARD EDUCATION GRANT
FieldValueIRS element (for citing)
Total501c3 Org59Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationONCE IT IS DETERMINED THAT AN INDIVIDUAL OR ORGANIZATION WILL BE RECEIVING A GRANT AWARD, THEY ARE ISSUED A TRACKING NUMBER AND ENTERED INTO THE GRANT MONITORING DATABASE. THE DATABASE INCLUDES CONTACT INFORMATION FOR THE RECIPIENT, AS WELL AS PAYMENT TERMS, DATE, CHECK NUMBER, AND PAYMENT AMOUNT. AT THE END OF THE GRANT TERM OUTLINED IN THE GRANT AGREEMENT PROVIDED TO THE RECIPIENT, A FINAL REPORT IS COMPLETED BY THE RECIPIENT AND SENT BACK TO ICAHN THROUGH THE MAIL OR ELECTRONICALLY WITH SIGNATURE. ICAHN THEN REVIEWS THE REPORT AND COMPARES IT TO THE AGREEMENT TO ENSURE GRANT FUNDS WERE SPENT AS OUTLINED. ON OCCASION, A RECIPIENT'S PROJECT WILL NEED TO CHANGE DUE TO UNFORESEEN CIRCUMSTANCES. IN THESE INSTANCES, THE GRANTEE IS INSTRUCTED TO REQUEST WRITTEN PERMISSION FROM ICAHN AUTHORIZING THE CHANGE. A COPY OF THIS CORRESPONDENCE IS PLACED IN THE RECIPIENT'S GRANT FILE DOCUMENTING THE CHANGE TO THE GRANT PROJECT. WHEN THE GRANT REPORT IS RECEIVED BY ICAHN, IT CAN THEN BE NOTED THAT THERE WAS AN AUTHORIZED CHANGE TO THE GRANT PROJECT. IN ADDITION TO THESE TRACKING PROCESSES, THE OPERATIONS COORDINATOR PERFORMS ONSITE VISITS TO GRANT RECIPIENTS OVER THE COURSE OF THE YEAR. DURING THESE VISITS, DOCUMENTATION SUCH AS INVOICES, RECEIPTS, AND FINANCIAL STATEMENTS ARE REVIEWED WITH COPIES OBTAINED, TO ENSURE GRANT FUNDS HAVE BEEN SPENT AS OUTLINED. THE OPERATIONS COORDINATOR PERFORMS ABOUT 12 ONSITE GRANT REVIEW VISITS PER YEAR.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonPATRICIA SCHOUPersonNm
TitleEXECUTIVE DIRECTORTitleTxt
Base Compensation Filing Org$194,272BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$5,795DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$17,957NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$218,024TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, PRESIDENT-ELECT, SECRETARY/TREASURER, AND IMMEDIATE PAST PRESIDENT IF THE IMMEDIATE PAST PRESIDENT REMAINS ON THE BOARD OF DIRECTORS. WHEN THE IMMEDIATE PAST PRESIDENT SERVES ON THE EXECUTIVE COMMITTEE, THE PRESIDENT SHALL NOT VOTE EXCEPT TO END A TIE VOTE. THE PRESIDENT OF THE BOARD OF DIRECTORS SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH ANY RULE AND REGULATION ESTABLISHED BY THE BOARD OF DIRECTORS OR EXPRESSED WISHES OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7AEACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHESE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THESE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS. IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT. IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER.
FORM 990, PART VI, SECTION B, LINE 15ATHE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECTUVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTORS' SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS. INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GCONSULTING, PERMITS, & OTHER: PROGRAM SERVICE EXPENSES 371,791. MANAGEMENT AND GENERAL EXPENSES 339. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 372,130.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ICAHN RURAL RECRUITMENT SERVICES LLC
245 BACKBONE RD EASTPRINCETONIL61356208045884RECRUITING SERVICES FOR MEMBER HOSPITALSIL$82,911$43,728ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK
ILLINOIS RURAL COMMUNITY CARE ORGANIZATION LLC
245 BACKBONE RD EASTPRINCETONIL61356465654316DEVELOP SYSTEMS OF CLINICAL INTEGRATION & EFFICIENCIES FOR MEMBER HOSPITALSIL$116,000$115,502ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1WESTERN ILLINOIS AREA HEALTH EDUCATION CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1245 BACKBONE ROAD EASTAddressLine1Txt
CityPRINCETONCityNm
State AbbreviationILStateAbbreviationCd
ZIP61356ZIPCd
FieldValueIRS element (for citing)
EIN262145452EIN
Primary ActivitiesIMPROVE HEALTH CARE IN UNDERSERVED AREAS OF IL THROUGH EDUC. OF PROVIDERSPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 9PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
AHEC APPLIED FOR AND RECEIVED FLEX GRANT FROM ICAHN DURING 2014
B$1,650ACTUAL DOLLAR AMOUNT
AHEC RENDERED SERVICES FOR ICAHN DURING 2014
L$1,020ACTUAL DOLLAR AMOUNT