St Mary's Hospital Streator Hospital Sisters of the 3rd Order of St Francis: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- St Mary's Hospital Streator Hospital Sisters of the 3rd Order of St Francis (EIN 36-2169181)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-12
- IRS object ID
- 201411329349302376
- Schema version
- 2012v2.3
- 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 J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-12T12:34:22-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 West Nationwide Blvd Ste 500 | AddressLine1 |
| City | Columbus | City |
| State | OH | State |
| ZIP Code | 432152568 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362169181 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL STREATOR HOSPITAL SISTERS | BusinessNameLine1 |
| Business Name Line2 | OF THE 3RD ORDER ST FRANCIS | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % KAREN CLARK | InCareOfName |
| Name Control | STMA | NameControl |
| Phone | 8156732311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SPRING STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | STREATOR | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KAREN S CLARK | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8156732311 | Phone |
| Date Signed | 2014-04-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KPMG LLP | Name |
| Phone | 6142492300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Kevin Kast | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Spring Street | AddressLine1 |
| City | Streator | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 51927900 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARYSHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1885 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | TO CONTINUE CHRIST'S HEALING MINISTRY THROUGH SERVICE TO THE SICK, THE AGED, THE POOR, AND THE TERMINALLY ILL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 543 | TotalNbrEmployees |
| Total Nbr Volunteers | 117 | TotalNbrVolunteers |
| Total Gross UBI | 173 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -102 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 65053 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2179983 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 53476524 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 48050023 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1897769 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1294440 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 551911 | OtherRevenuePriorYear |
| Other Revenue Current Year | 401490 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 55991257 | TotalRevenuePriorYear |
| Total Revenue Current Year | 51925936 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23488886 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22586970 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 31962242 | OtherExpensePriorYear |
| Other Expenses Current Year | 29777482 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 55451128 | TotalExpensesPriorYear |
| Total Expenses Current Year | 52364452 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 540129 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -438516 | RevenuesLessExpensesCY |
| Total Assets BOY | 82270710 | TotalAssetsBOY |
| Total Assets EOY | 80897923 | TotalAssetsEOY |
| Total Liabilities BOY | 39173685 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 31519535 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 43097025 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 49378388 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 36511869 | Expense |
| Grants | 0 | Grants |
| Revenue | 48049850 | Revenue |
| Description | See Schedule O - Community Benefit Report | Description |
| Total Program Service Expense | 36511869 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 37 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 543 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KAREN CLARK | NamePerson |
| Telephone Number | 8156734514 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SPRING STREET | AddressLine1 |
| City | STREATOR | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| STEVEN BROADUS | ||||||||
| CHAIR/B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| SR MARYBETH CULNAN OSF | ||||||||
| MBR. B.O.D. | 1.0 | X | 0 | 0 | 0 | 59.0 | ||
| PATRICK GIBBONS | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| SHERYL KUZMA | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| JIMMIE LANSFORD | ||||||||
| SECRETARY B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| EVERETT J SOLON | ||||||||
| VICE CHAIR/ B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| WILLIAM FRANKLIN | ||||||||
| MBR. B.O.D. | 1.0 | X | 0 | 0 | 0 | |||
| WILLIAM E EHLING MD | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| SR MAUREEN FAGAN OSF | ||||||||
| MBR. B.O.D. | 1.0 | X | 0 | 0 | 0 | |||
| JOHN FLANDERS | ||||||||
| PRESIDENT/CEO | 40.0 | X | X | 0 | 135827 | 40629 | ||
| TIMOTHY KENNEY | ||||||||
| MBR. B.O.D. | 1.0 | X | 0 | 0 | 0 | |||
| MARK WARGO MD | ||||||||
| MBR. B.O.D. | 1.0 | X | 0 | 242414 | 22167 | |||
| ANN CARR | ||||||||
| TREASURER | 0.25 | X | 0 | 272146 | 138031 | 59.75 | ||
| KEVIN KAST | ||||||||
| DIVISION CEO | 1.0 | X | 0 | 585194 | 114028 | |||
| KAREN CLARK | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | X | 172700 | 0 | 8812 | |||
| MARK DABBS | ||||||||
| COO/CNO | 40.0 | X | 197594 | 0 | 41279 | |||
| DONALD DAMRON | ||||||||
| DIR. REHAB & ORTHO | 40.0 | 105746 | 0 | 23665 | X | |||
| CATHERINE CHAPMAN | ||||||||
| DIRECTOR PHARMACY | 40.0 | 126270 | 0 | 19124 | X | |||
| JEANNE A WASHKO | ||||||||
| PHARMACIST | 40.0 | 113986 | 0 | 32092 | X | |||
| RENA A MATHESIUS | ||||||||
| PHARMACIST | 40.0 | 117485 | 0 | 16121 | X | |||
| SHERRI L SNYDER | ||||||||
| PHARMACIST | 40.0 | 98222 | 7390 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 932003 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1235581 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 463338 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Emergency Medical Experts LTD | |||||
| 1401 South Prairie Avenue | CHICAGO | IL | 60605 | Emergency MD | 1643333 |
| Anesthesia Pain Services LLC | |||||
| 1800 E Lake Shore Dr | DECATUR | IL | 62521 | Anesthesia MD | 1221630 |
| Immediate Care Experts LLC | |||||
| 1401 South Prairie Avenue | CHICAGO | IL | 60605 | Immediate Care MD | 1109861 |
| Comphealth Medical Staffing | |||||
| PO Box 972670 | DALLAS | TX | 753972670 | Staffing | 211476 |
| Executive Health Resources Inc | |||||
| PO Box 822688 | PHILADELPHIA | PA | 191822688 | Compliance Services | 210324 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 45 | NumberOfContractorsGT100K |
| Related Organizations | 66409 | RelatedOrganizations |
| Government Grants | 2113574 | GovernmentGrants |
| Total Contributions | 2179983 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 900000 | BusinessCode |
| Total Revenue Column | 48050023 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48049850 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 173 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 48050023 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 469552 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Exclusion | $469,552 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 807852 | Securities |
| Other | 19000 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1964 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 807852 | Securities |
| Other | 17036 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 824888 | TotalRevenueColumn |
| Exclusion | $824,888 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Misc Healthcare Revenue | 532000 | 345651 | $345,651 |
| Gift Shop | 453220 | 55839 | $55,839 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 401490 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 51925936 | TotalRevenueColumn |
| Related Or Exempt Function Income | 48049850 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 173 | UnrelatedBusinessRevenue |
| Exclusion | $1,695,930 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 438025 | Total |
| Management And General | 438025 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15598973 | Total |
| Program Services | 12110620 | ProgramServices |
| Management And General | 3488353 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1929923 | Total |
| Program Services | 1406678 | ProgramServices |
| Management And General | 523245 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3447799 | Total |
| Program Services | 2513024 | ProgramServices |
| Management And General | 934775 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1172250 | Total |
| Program Services | 854427 | ProgramServices |
| Management And General | 317823 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29207 | Total |
| Management And General | 29207 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21502 | Total |
| Management And General | 21502 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9479321 | Total |
| Program Services | 6531448 | ProgramServices |
| Management And General | 2947873 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 230382 | Total |
| Program Services | 52499 | ProgramServices |
| Management And General | 177883 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6480637 | Total |
| Program Services | 5924989 | ProgramServices |
| Management And General | 555648 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1048660 | Total |
| Program Services | 230696 | ProgramServices |
| Management And General | 817964 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1174147 | Total |
| Program Services | 1075577 | ProgramServices |
| Management And General | 98570 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57784 | Total |
| Program Services | 48377 | ProgramServices |
| Management And General | 9407 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67260 | Total |
| Program Services | 31746 | ProgramServices |
| Management And General | 35514 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188 | Total |
| Management And General | 188 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 154536 | Total |
| Management And General | 154536 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3446656 | Total |
| Management And General | 3446656 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3739397 | Total |
| Program Services | 3189529 | ProgramServices |
| Management And General | 549868 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372367 | Total |
| Program Services | 9694 | ProgramServices |
| Management And General | 362673 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 1815683 | 1815683 | 0 |
| MISCELLANEOUS | 1030114 | 183130 | 846984 |
| REFERRAL LAB | 526787 | 526787 | 0 |
| DUES AND SUBSCRIPTIONS | 102854 | 6965 | 95889 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52364452 | Total |
| Program Services | 36511869 | ProgramServices |
| Management And General | 15852583 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | X | InfoInScheduleOPartX |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1349 | BOY |
| EOY | 1349 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -421339 | BOY |
| EOY | -507730 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8015880 | BOY |
| EOY | 7178815 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 931503 | BOY |
| EOY | 921882 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 477871 | BOY |
| EOY | 350634 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 80414173 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 42795946 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39539392 | BOY |
| EOY | 37618227 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26661215 | BOY |
| EOY | 26969311 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43791 | BOY |
| EOY | 43794 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7021048 | BOY |
| EOY | 8321641 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82270710 | BOY |
| EOY | 80897923 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8587515 | BOY |
| EOY | 7563925 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12622783 | BOY |
| EOY | 12680045 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17963387 | BOY |
| EOY | 11275565 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39173685 | BOY |
| EOY | 31519535 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40831614 | BOY |
| EOY | 46956664 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2184308 | BOY |
| EOY | 2339264 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81103 | BOY |
| EOY | 82460 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43097025 | BOY |
| EOY | 49378388 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82270710 | BOY |
| EOY | 80897923 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -438516 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1430604 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 5289275 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $21,502 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 21502 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II B, QUESTION 1I | ReturnReference |
| Explanation | ST. MARY'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION (CHA), THE ILLINOIS HOSPITAL ASSOCIATION (IHA), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES AND PART OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FOR ITS DUES PAID. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1259924 | OtherCostOrOtherBasis |
| Book Value | 1259924 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 51577759 | OtherCostOrOtherBasis |
| Depreciation | 21929694 | Depreciation |
| Book Value | 29648065 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 976810 | OtherCostOrOtherBasis |
| Depreciation | 752786 | Depreciation |
| Book Value | 224024 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 26294997 | OtherCostOrOtherBasis |
| Depreciation | 20113466 | Depreciation |
| Book Value | 6181531 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 304683 | OtherCostOrOtherBasis |
| Book Value | 304683 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 37618227 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| VALUATION RESERVE | 3821324 |
| ASSETS WHOSE USE IS LIMITED | 2421726 |
| WORKERS COMP HS | 1277715 |
| A/R NON-PATIENT | 456686 |
| A/R FOUNDATION | 788 |
| PAY ADJUSTMENT | 1965 |
| OTHER ASSETS | 341437 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 8321641 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED BENEFIT LIABILITY | $9,418,262 |
| RETIRE OBLIGATION - ASBESTOS | $1,855,385 |
| A/R SELF INSURANCE | $1,918 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11275565 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ASC SUBTOPIC 740-10 | Identifier |
| Explanation | HSHS HAS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. AS OF JUNE 30, 2013 AND 2012, HSHS DOES NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 135. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 215. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2000 | PersonsServed |
| Total Community Benefit Expense | 2766650 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2766650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05470 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8857 | PersonsServed |
| Total Community Benefit Expense | 7479607 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3728873 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3750734 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07420 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10857 | PersonsServed |
| Total Community Benefit Expense | 10246257 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3728873 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6517384 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12890 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 16 | NumberOfActivitiesOrPrograms |
| Persons Served | 22892 | PersonsServed |
| Total Community Benefit Expense | 306026 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2296 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 303730 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00600 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 1079 | PersonsServed |
| Total Community Benefit Expense | 53508 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 53508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 41 | NumberOfActivitiesOrPrograms |
| Persons Served | 23971 | PersonsServed |
| Total Community Benefit Expense | 359534 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2296 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 357238 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 41 | NumberOfActivitiesOrPrograms |
| Persons Served | 34828 | PersonsServed |
| Total Community Benefit Expense | 10605791 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3731169 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6874622 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13600 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 289 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 289 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 289 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 289 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $620,934 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 17100814 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 24086943 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6986129 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Spring Street | AddressLine1 |
| City | Streator | City |
| State | IL | State |
| ZIP Code | 61364 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 135. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 215. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part I, line 3c | Not applicable. The organization follows federal poverty guidelines to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals. | |
| Part I, line 6a | St. Mary's Hospital prepares an annual community benefit report as a part of our annual report in booklet form distributed to the public via mail and available at St. Mary's Hospital, 111 Spring Street, Streator, IL. The annual report can also be accessed on St. Mary's website at www.stmaryshospital.org/publications. Part I, Line 7 St. Mary's Hospital uses the Lyons Software (CBISA) which follows the Catholic Health Association (CHA) guidelines on reporting charity care and certain other community benefits at cost. Lyons Software uses the hospitals audited financials for total expenses, bad debt and gross patient charges to calculate the appropriate cost to charge ratio in determining charity care and other community benefits at cost. | |
| Part I, line 7g | The hospital uses Lyons Software (CBISA) to determine subsidized services. Physician clinics were not included in the subsidized health services. | |
| Part I, line 7, column (f) | The percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 13.60%. Total amount of bad debt removed when calculating the percentages in Part I, Line 7, column (F) was $1,815,683. | |
| Part II | Community Building through community support, health improvement advocacy, and workforce development is an important part of St. Mary's Hospital's commitment to enhancing community-wide health and well-being. St. Mary's is engaged in community building by developing support groups and through coalition building with community outreach events. As part of our commitment to provide our community with the highest quality of care, St. Mary's Hospital participated in a number of health fairs providing free health screenings and educational information. In FY2013, St. Mary's colleagues donated their time to travel to several health fairs throughout the Illinois Valley, offering health education and free screenings such as bone density tests, ankle brachial index screenings, blood pressure checks and pulse ox screenings. Health fairs are just one way that our hospital educates the community and promotes early detection and disease prevention, as well as encourages a healthy lifestyle. Throughout the course of the year, St. Mary's Hospital lent our support by sponsoring a variety of events in our community. In February, St. Mary's Hospital was a corporate sponsor of Streator's Taste of the Town, a culinary auction event that raises funds for several local organizations in the community. In addition to our sponsorship, the hospital provided event volunteers. St. Mary's Hospital partners with the March of Dimes, an organization that supports research aimed at preventing birth defects, premature birth and infant mortality, to help create awareness about premature birth; the hospital also sponsored the market place tent at the March for Babies. In conjunction with Earth Day, St. Mary's Hospital hosted an electronics recycling event with multiple drop-off locations. St. Mary's collected a total of 14,269 pounds of electronic recyclables. The hospital also collected 22 pounds of unused pharmaceuticals for proper disposal and sent 471 pounds of various waste products to a local recycler for proper disposal in an effort to further protect our environment. St. Mary's also takes pride in our partnership with the Streator Area Chamber of Commerce. St. Mary's Hospital colleagues attended several Chamber events to raise money to build a better community as well as sponsored the Chamber's corporate bowling challenge, dessert auction and golf outing. St. Mary's Hospital is also a proud supporter of the American Cancer Society's Relay for Life. This year the hospital was a Gold Sponsor of Relay for Life. This event represents the hope that those lost to cancer will never be forgotten, that those who face cancer will be supported, and that one-day cancer will be eliminated. In addition to being a Gold Sponsor, the hospital supported Relay for Life by printing the event programs in-house free of charge and supplying bottled water for the night of the event. In addition to sponsorship and in kind donations, a group of St. Mary's colleagues volunteered at the event and distributed health care information and water to the walkers. St. Mary's Hospital is proud to be a sponsor of this great event - one that educates the public about the importance of cancer research and celebrates those whose lives have been affected by cancer. In January, St. Mary's coordinated and provided the venue for a cardiologist who gave a community presentation at St. Mary's Health Care-Ottawa on the importance of knowing your cholesterol numbers, how to interpret the results and how to lower the risk of cardiovascular disease. One lucky winner received a free copy of the American Heart Association's "Low-Fat, Low Cholesterol" cookbook. St. Mary's Hospital strives to promote and improve the health of the communities it serves by providing a teaching environment for nursing and technical clinical expertise for the regional workforce, recruiting and retaining the professional medical staff to meet the area need, and by providing care through a collaborative approach. Consistent with its exempt purpose, St. Mary's serves as a clinical site for students in the fields of nursing, laboratory, diagnostic imaging, physical therapy, speech and pharmacy. St. Mary's hospital is a community partner with Illinois Valley Community College to provide a clinical training site, professional oversight, and supportive entrance to the nursing field. By providing this medical education, the hospital is contributing to the regional and national workforce in a way that will continue to ensure access and high quality care for the families St. Mary's serves. St. Mary's Hospital supported fundraising efforts to provide scholarships for students who wish to go into the field of health care. Friends of St. Mary's Hospital awarded three $800 scholarships for the 2013 Chad Scoles Memorial Scholarship. The scholarship was established in memory of Chad Scoles, son of Dick Scoles, a long-term St. Mary's Hospital employee, and his wife Sally. Chad passed away in 2004 at the age of 21. The scholarship fund was created by two emergency room physicians. | |
| Part III, Line 4 | Bad debt expense of HSHS is discussed at pages 18 and 19 of the audited financial statements, a copy of which is attached to this return. | |
| Part III, Line 8 | Our total Medicare shortfall was estimated at $6,986,129. Of that amount, the hospital is considering Community Benefit reportable portion of Medicare Shortfall to be $2,959,213. Medicare Cost is calculated total to be $24,086,943, and Medicare reimbursements to be $17,100,814. The hospital removed $12,002,986 in charges that are not considered reportable on the Medicare Cost Report (Medicare Managed Care, Physician Fees, and charges reimbursed by a fee schedule), which resulted in removing $1,854,312 in Medicare reimbursements and $2,125,275 in costs related to those charges. Finally, St. Mary's also had an additional $3,755,953 in cost that is not considered reportable on the Cost Report (difference between the Medicare Cost report and the Overall Hospital cost to charge ratio). The Medicare Cost was calculated using the Cost to Charge ratio from the Medicare Cost report, while the Overall Hospital cost was calculated using all hospital charges and costs. The difference in the removal of costs and reimbursements resulted in a net difference of Community Benefit reportable Medicare Shortfall to calculated Medicare Shortfall of $4,026,916. | |
| Part III, line 9b | Prior to an account being sent to collection, the patient predictability for a 'no response' patient will be checked through Search America. "No response" for this purpose is described as no response for at least sixty (60) days, during which at least three (3) contact attempts have been made. Attempts include mailing an application, sending patient statements, and/or making telephone calls. If the result of the payment predictability comes back as low or undetermined, the Search America result is stored and retrievable through the system and the account written off to charity. If an indication of the inability to pay is apparent, the patient will be given the option to complete Illinois Public Aid - Form 450, if appropriate. The final option would then be to ask the patient to cooperate with the Christian Care determination process to determine the patient's ability to pay. Part V, Section B, line 1 St. Mary's Hospital in cooperation with Leede Research, a research firm specializing in health care information programs and tools, completed the 2012 Community Health Needs Assessment. The goal of the study was to identify population perceptions of community issues and needs that could be combined with other information for a Community Health Needs Assessment. The needs assessment report was used as a basis for the implementation strategy that outlined a plan to address selected needs which would benefit the community and general populations. The next scheduled date for a formal Community Heath Needs Assessment is the hospital's fiscal year 2015 (July 1, 2014 - June 30, 2015). | |
| Part V, Section B, Line 3 | Yes. A Community Needs Steering Committee was established in our prior fiscal year 2012 to review the results. This was a diverse group of twenty-one community leaders from LaSalle, Livingston and Marshall Counties, consisting of health care and physician leaders, political leaders, individuals with expertise in public health, and representatives of underserved, low-income and minority populations. Part V, line 5c The Community Health Needs Assessment and associated Implementation Strategy guided the hospital's efforts in FY2013. Both documents are available to the public at http://www.stmaryshospital.org on the "Check Up 2012" and "Implementation Strategy" link. | |
| Part V, SECTION B, Line 7 | St. Mary's Hospital's Board of Directors approved an implementation strategy based on the CHNA during the prior fiscal year, and the identified needs were addressed in our fiscal year FY2013. Using the data from the CHNA, the steering committee identified four priority needs for the community including: obesity, family violence, substance/alcohol abuse, and education. St. Mary's Hospital will focus on two of the four major needs - obesity and family violence - because they best match our core competencies and would offer St. Mary's Hospital the best opportunity to affect the most change. One identified need in the community not specifically addressed by St. Mary's was substance/alcohol abuse. Since St. Mary's Hospital does not have a specific substance/alcohol abuse program and is not an educational institution, the hospital collaborated with other organizations to support their efforts in these areas. Physicians and hospital colleagues refer patients as appropriate to local resources that can better support healing in this area. Substance/alcohol abuse is also served by the Streator Substance Abuse Prevention Coalition, in which a hospital chaplain actively participates. The current implementation strategy consists of an expansion of St. Mary's "Healthy You" program and the development of a community garden, both focused on reducing obesity and encouraging the community to embrace a healthier lifestyle. In addition, St. Mary's is also engaged in a process with other community organizations to assess how the hospital could support local resources already in place for domestic violence. In particular, St. Mary's is collaborating with ADV/SAS (A Domestic Violence & Sexual Assault Service) to help strengthen their medical advocate program through our hospital. | |
| Part V, section b, Line 14g | The Registration Department provides brochures to patients upon request regarding the Payment Assistance Program available to them at St. Mary's Hospital. The Christian Care brochures are also supplied in waiting and ancillary areas, as well as on the hospital's website at www.stmaryshospital.org. Information outlining the program is also available on Patient Statements and upon request. | |
| Part V, section b, Line 18e | Patient Financial Representatives conduct telephone interviews and in-person counseling sessions with patients as to program availability and potential qualification based on discussion results. Once a patient completes the self-pay questionnaire, a determination is made based on policy guidelines through an internet-based tool. If a patient fails to comply with the questions, prior to an account being sent to collection, the patient payment predictability from an outside vendor is reviewed and based on the information an account may be written off to charity. As directed by Illinois State Law, the hospital internet site lists the information regarding income guidelines for financial assistance as well as the process to apply. These guidelines are updated annually based on changes in the federal poverty guidelines. All billing statements list various payment options including a statement that reads, "Financial Assistance is available to eligible persons who meet requirements." Self-pay patient statements also include the following statement "Please contact our office to see if you qualify for the level of Uninsured Discounts or Financial Assistance." Part V, Line 20d, 21, 22 Every patient is charged the same amount. All uninsured received the uninsured discount. All other patients were discounted per their insurance plan. | |
| Needs assessment | As indicated in Part V, Section B, St. Mary's conducted a Community Health Needs Assessment in our FY2012. In prior years, St. Mary's used other methods to identify community need. For example, historic encounters are reviewed for trends and demographic information is reviewed annually during our strategic planning process. Indigent levels, educational levels, housing costs, unemployment and uninsured children are all considered in the planning process. While physician demand analysis is always an ongoing process, in the last 12 months St. Mary's also engaged an independent, third party, to assist with completing a comprehensive 'Community Physician Needs Analysis.' This information is used in conjunction with our community health needs assessment and other internal planning documents to guide the broader hospital strategic planning process. St. Mary's Hospital engages in conversations with the community to ascertain those services that are in demand and which ones are out-migrating. Those conversations are held informally and sometimes formally. As areas are identified a business plan and proforma are done to validate the need. | |
| Patient education of eligibility for assistance | The Registration Department provides brochures to patients upon request regarding the Payment Assistance Program available to them at St. Mary's Hospital. The Christian Care brochures are also supplied in waiting and ancillary areas, as well as on the hospital's website at www.stmaryshospital.org. Information outlining the program is also available on Patient Statements and upon request. St. Mary's Hospital contracts with an organization that assists patients who may be eligible for Medicaid assistance through the Illinois Department of Public Assistance. This organization works with patients to determine if they are potentially eligible, assisting in compiling the documentation necessary for application submission. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. The customer service representative, cashier, or other qualified staff member, will inform/educate the patient about financial assistance options. The Search America system is utilized after attempts made by the hospital to work out payment arrangements have failed. The Search America system accesses credit and other information allowing the hospital to see the probability of a patient being able to pay their bill. After assessing that information, the hospital makes a determination whether to grant charity care or continue collection efforts. | |
| Community Information | St. Mary's primary service area population, with 44.6% of the residents currently 45 years of age or older, is older than both the U.S. average at 39.3% and the state of Illinois average at 37.9%. According to the 2010 Census, the demographic make-up of the city of Streator is 85.2% Caucasian, 10.4% Latino, 2.5% African American, and 1.9% from other races. The number of persons living below the poverty level in the city of Streator is 14.8%, which is above the LaSalle County level of 10.8% and the Illinois state level of 12.6%. Obesity has reached epidemic proportions in Illinois - 62 percent of Illinois adults are overweight or obese. One in five children are obese, the fourth worst rate in the nation. LaSalle County exceeds the Illinois benchmark with 28% of the population obese, according to the Illinois Behavioral Risk Factor Surveillance System (IBRFSS, 2009). In addition, St. Mary's has provided charity benefits for 2,000 uninsured persons and transportation trips totaling 5,925 to underserved persons. | |
| Promotion of Community Health | St. Mary's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Mary's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 125 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Streator, Illinois and surrounding areas. The hospital is governed by a Board of Directors, the majority of whom reside in the organization's primary service area and who are neither employees nor contractors of the hospital. The Board ensures that St. Mary's is responding to community need. During our prior fiscal year 2012, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. Also consistent with its exempt purpose, St. Mary's has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Mary's reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Mary's is currently working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. St. Mary's Hospital has taken an active role in leading the Central Illinois Health Information Exchange (HIE). The primary goal of the exchange is to provide an integrated long-term aggregated health care record. The HIE is the first to become operational in Illinois. St. Mary's Hospital has been contributing information to the exchange since 2012 and membership has grown to 32 members, 16 of which are hospitals located in the region. Because of St. Mary's Hospital participation in the electronic sharing of information, there will be a positive impact on the quality of care, care coordination, improved efficiency, and reduction of health care costs. St. Mary's continues to enhance quality of care by implementing Computerized Provider Order Entry (CPOE) beginning in November 2012. Benefits of this technological advancement include advancing ability to meet quality and care integration goals, improving clinical and operational efficiencies, promoting evidence based care to provide predictable clinical outcomes, and enhancing the ability to provide clinical decision support. St. Mary's Hospital devotes significant resources to provide access for patients who cannot afford care, along with other community benefits. In fiscal year 2012, St. Mary's provided over $9.8 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. During this period, St. Mary's provided $6.5 million (at cost) in uncompensated care to patients that qualified for charity care or public assistance and over $2.9 million (at cost) in excess of Medicare payment for health care services (please see note below). St. Mary's Hospital participates in multiple government-sponsored health care programs, including Medicaid, Medicare, Champus and Tricare. NOTE: Our total Medicare shortfall was estimated at $6.86 million, and of that St. Mary's is considering Community Benefit reportable portion of Medicare Shortfall to be $2.9 million. St. Mary's calculated total Medicare Costs to be $24,086,943 and Medicare reimbursements to be $17.1 million. St. Mary's removed $12 million in charges that are not considered reportable on the Medicare Cost Report (Medicare Managed Care, Physician Fees, and charges reimbursed by a fee schedule), which resulted in removing $1.85 million in Medicare reimbursements and $2.13 million in costs related to those charges. Lastly, St. Mary's also had an additional $3.76 million in cost that is not considered reportable on the Cost Report (difference between the Medicare Cost report and Overall Hospital cost to charge ratio). The Medicare Cost was calculated using the Cost to Charge ratio from the Medicare Cost report, while the Overall Hospital cost was calculated using all hospital charges and costs. The difference in the removal of costs and reimbursements resulted in a net difference of Community Benefit reportable Medicare Shortfall to calculated Medicare Shortfall of $4.03 million. St. Mary's Hospital provides a range of community benefits which flows from its mission and long-standing commitment to the community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Mary's Hospital, and they often relieve a burden that would otherwise be carried by government. Based on the assessment of community needs, St. Mary's has focused on the following priorities: obesity and family violence. These major needs in our community best match the hospital's core competencies and would offer the best opportunity to affect the most change in the communities St. Mary's serves. These programs and activities were designed in response to our FY2012 Community Health Needs Assessment, which surfaced the following priority needs for attention from the hospital in collaboration with other community organizations: 1) Obesity a. Expand/enhance Lean To Green Program b. Develop community garden on hospital property 2) Domestic violence a. Develop a new Medical Advocate Program Expand Lean to Green Program (Identified need - Obesity) To address obesity in the communities served, St. Mary's Hospital focused on exercise, nutrition and healthy lifestyles. In FY2013, St. Mary's Hospital reintroduced a 12-week weight-loss competition previously called "Lean to Green", and a new partnership was announced with the Streator YMCA to evolve "Lean to Green" into a bigger and better community program. As part of this partnership, the program was renamed "Healthy You" - emphasizing that this is not just a weight loss program, but a more holistic program aimed at helping individuals live an all-around healthier lifestyle. Added program benefits included a pedometer to help motivate weight loss, a maintenance program to maintain weight loss year-round, and cooking classes provided by the hospital for participants to learn methods of cooking with fresh, healthy foods and new low-fat recipes. The hospital's program partner, the Streator YMCA, also provided five free aerobics classes for participants. The 2013 "Healthy You" program attracted 282 participants (66 teams), nearly double the number of participants from the previous year. The teams began with a combined weight of 59,145 pounds. A total of 191 participants completed the program losing a total of 2,491 pounds or 4.21% overall. To help individuals stay motivated and stay on track with a healthy lifestyle journey, "Healthy You" offers a maintenance component that encourages participants to weigh in on a monthly basis; approximately 50 individuals are participating in the maintenance program. Create Community Garden (Identified need - Obesity) In FY2013, many of the above activities were continued or strengthened as St. Mary's continues to focus on the priority needs identified in the FY2012 Community Health Needs Assessment process. To further support Streator's underserved population and promote healthy eating choices, a community garden was established and planted on hospital property; the garden is maintained by hospital and community volunteers. All harvest proceeds are donated to the local food pantry to provide fresh, healthy produce to those in need to further promote improved health in the community and reduction of obesity. Enhance Medical Advocate Program (Identified need - Domestic Violence) St. Mary's Hospital has engaged in a process with other community organizations to assess how the hospital could support local resources already in place for domestic violence. In particular, the hospital is collaborating with ADV/SAS (A Domestic Violence & Sexual Assault Service) to help strengthen their medical advocate progr | |
| STATE FILING OF COMMUNITY BENEFIT REPORT | IL, | 990 SCHEDULE H, PART VI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANN CARR | ||||||||||||||
| TREASURER | 0 | 193454 | 0 | 29440 | 0 | 49252 | 0 | 121170 | 0 | 17686 | 0 | 411002 | 0 | 18215 |
| KEVIN KAST | ||||||||||||||
| DIVISION CEO | 0 | 378897 | 0 | 55273 | 0 | 151024 | 0 | 90300 | 0 | 24621 | 0 | 700115 | 0 | 112204 |
| KAREN CLARK | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 159413 | 0 | 13262 | 0 | 25 | 0 | 652 | 0 | 8892 | 0 | 182244 | 0 | 0 | 0 |
| MARK DABBS | ||||||||||||||
| COO/CNO | 175504 | 0 | 21757 | 0 | 333 | 0 | 29416 | 0 | 12688 | 0 | 239698 | 0 | 0 | 0 |
| JOHN FLANDERS | ||||||||||||||
| PRESIDENT/CEO | 0 | 76610 | 0 | 0 | 0 | 59217 | 0 | 10692 | 0 | 30222 | 0 | 176741 | 0 | 0 |
| MARK WARGO MD | ||||||||||||||
| MBR. B.O.D. | 0 | 241597 | 0 | 0 | 0 | 817 | 0 | 0 | 0 | 23031 | 0 | 265445 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 1A | Country club dues are paid for John Flanders in his capacity as President of the Hospital and are only used for hospital-associated events. As such, this benefit is not treated as taxable compensation to John Flanders. Kevin Kast Schedule J, Part I, Line 4b kevin kast participated in a serp plan during the year in the amount of $157,883. | |
| ann m. carr | ann m. carr participated in a serp plan during the year in the amount of $42,817. | schedule j, part i, line 4b |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Georgene Lansford | |||
| Spouse of Director | 65131 | Employment | false |
| Jeannine Solon | |||
| Spouse of Director | 59470 | Employment | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | Identifier |
| Return Reference | FORM 990 SCHEDULE L, PART IV | ReturnReference |
| Explanation | THERE ARE TWO ST. MARY'S HOSPITAL COLLEAGUES WHO ARE SPOUSES OF DIRECTORS. ALL PERSONS LISTED ON SCHEDULE L, PART IV WERE HIRED IN ACCORDANCE WITH THE HOSPITAL HIRING POLICY AT COMPARATIVE INDUSTRY MARKET COMPENSATION. GEORGENE LANSFORD AND JEANNINE SOLON WERE HIRED PRIOR TO THEIR RESPECTIVE SPOUSES' APPOINTMENT AS BOARD MEMBERS. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Organization's mission | FORM 990 PART III, Line 1 | TO CONTINUE CHRIST'S HEALING MINISTRY THROUGH SERVICE TO THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL, REGARDLESS OF RACE, CREED, SEX, HANDICAPS, RELIGION, AGE, SEXUAL ORIENTATION, MARITAL, MILITARY DISCHARGE, OR FINANCIAL STATUS. THE VALUES OF COMPASSION, JUSTICE, REVERENCE FOR LIFE, AND INDIVIDUAL DIGNITY ARE FOSTERED. HEALTH SERVICES THAT IMPROVE OR MAINTAIN THE QUALITY OF LIFE ARE SUPPORTED. THE SISTERS, ADMINISTRATION, MEDICAL STAFF AND EMPLOYEES PRACTICE THIS MISSION BY IDENTIFYING WITH THE CORE VALUES OF THE HOSPITAL SISTERS HEALTH SYSTEM - RESPECT, CARE, COMPETENCE AND JOY. FORM 990, PART 111, LINE 4 THREE LARGEST PROGRAMS INPATIENT AND OUTPATIENT CARE SERVICES WITH DIRECT EXPENSES OF $2,911,047 INCLUDES MEDICAL SURGICAL, WOMEN'S HEALTH, AND INTENSIVE CARE ACUTE INPATIENT AND OBSERVATION PATIENT SERVICES AS WELL AS NURSERY INPATIENT CARE. THESE SERVICES PROVIDED 6,647 ACUTE PATIENT DAYS, PROVIDED SERVICES FOR 1,221 OBSERVATION PATIENTS AND 435 NURSERY DAYS. IMAGING SERVICES WITH DIRECT EXPENSES OF $3,408,690 INCLUDE ROUTING DIAGNOSTIC, ANGIOGRAPHY, ULTRASOUND, MRI, CT, AND NUCLEAR MEDICINE SERVICES. DIAGNOSTIC IMAGING CONDUCTED 19,171 IP/OP PROCEDURES; ANGIOGRAPHY CONDUCTED 450 IP/OP PROCEDURES; ULTRASOUND CONDUCTED 6,436 IP/OP PROCEDURES; MRI CONDUCTED 1,092 IP/OP PROCEDURES; CT 4,223 IP/OP PROCEDURES AND NUCLEAR MEDICINE CONDUCTED 1,354 IP/OP PROCEDURES. THE IMAGING DEPARTMENTS PROVIDE NECESSARY INPATIENT AND OUTPATIENT SERVICES TO THE COMMUNITY WE SERVE. SURGICAL SERVICES WITH DIRECT EXPENSES OF $3,303,625 INCLUDED BOTH INPATIENT AND OUTPATIENT SERVICES. SURGERY PERFORMED A TOTAL OF 2,753 SURGICAL PROCEDURES. 490 OF THOSE SERVICES WERE PROVIDED FOR INPATIENTS AND 2,263 FOR OUTPATIENTS. THE SURGERY DEPARTMENT MEETS THE NEEDS OF THE COMMUNITY BY PROVIDING BOTH EMERGENT AND ELECTIVE SURGERY ON AN INPATIENT AND OUTPATIENT BASIS. PROGRAM SERVICE ACCOMPLISHMENTS - FORM 990 PART III, LINE 4A THE COMMUNITY BENEFIT CONTRIBUTION OF ST. MARY'S HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1: QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT MISSION, HOW THE MISSION IS TRANSLATED INTO A PROACTIVE APPROACH DESIGNED TO MEET COMMUNITY HEALTH NEEDS, HOW THE HOSPITAL MEETS TAX-EXEMPT REQUIREMENTS, AND A DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT HIGHLIGHT THE HOSPITAL'S IMPACT ON COMMUNITY HEALTH. SECTION 2: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT CONTRIBUTION IN FINANCIAL TERMS PRESENTING THE AMOUNT OF CHARITY CARE, THE UNPAID SHORTFALL FROM GOVERNMENT HEALTH CARE FOR THE INDIGENT, AND THE NET EXPENSE OF COMMUNITY BENEFIT SERVICES. SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1. ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT- ST. MARY'S HOSPITAL MISSION IS TO CONTINUE CHRIST'S HEALING MINISTRY THROUGH SERVICE TO THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL REGARDLESS OF RACE, CREED, SEX, HANDICAPS, AGE, RELIGION, SEXUAL ORIENTATION, MARITAL, MILITARY-DISCHARGE OR FINANCIAL STATUS. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF ST. MARY'S HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. A. ST. MARY'S HOSPITAL IS LOCATED IN STREATOR, ILLINOIS AND SERVES A PRIMARY SERVICE AREA OF APPROXIMATELY 113,921 RESIDENTS; WITH A SECONDARY SERVICE AREA OF APPROXIMATELY 90,254 RESIDENTS. ST. MARY'S HOSPITAL HAS BEEN DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL MEETING THE CRITERIA OF AT LEAST 60 PERCENT OF INPATIENT DAYS OR DISCHARGES COVERED BY MEDICARE. THIS GREATER DEPENDENCE ON MEDICARE MAKES THE HOSPITAL MORE FINANCIALLY VULNERABLE TO PROSPECTIVE PAYMENT. ST. MARY'S HOSPITAL HAS IDENTIFIED TRANSPORTATION AS A NEED OF OUR SERVICE AREA. THE INCREASE IN THE ELDERLY POPULATION WHO ARE STILL IN THEIR HOMES AND DO NOT HAVE TRANSPORTATION TO OBTAIN MEDICAL NEEDS HAS INCREASED IN THIS SERVICE AREA. THE HOSPITAL HAS PROVIDED TRANSPORTATION BENEFITS TO 5,925 UNDERSERVED PERSONS AND IS WORKING IN CONJUNCTION WITH THE INTERAGENCY COORDINATING COMMITTEE ON TRANSPORTATION FOR LASALLE COUNTY TO ADDRESS THIS GROWING NEED. ST. MARY'S HOSPITAL'S BOARD OF DIRECTORS APPROVED AN IMPLEMENTATION STRATEGY BASED ON THE CHNA DURING THE PRIOR FISCAL YEAR, AND THE IDENTIFIED NEEDS WERE ADDRESSED IN OUR FISCAL YEAR FY2013. USING THE DATA FROM THE CHNA, THE STEERING COMMITTEE IDENTIFIED FOUR PRIORITY NEEDS FOR THE COMMUNITY INCLUDING: OBESITY, FAMILY VIOLENCE, SUBSTANCE/ALCOHOL ABUSE, AND EDUCATION. ST. MARY'S HOSPITAL WILL FOCUS ON TWO OF THE FOUR MAJOR NEEDS - OBESITY AND FAMILY VIOLENCE - BECAUSE THEY BEST MATCH OUR CORE COMPETENCIES AND WOULD OFFER ST. MARY'S HOSPITAL THE BEST OPPORTUNITY TO AFFECT THE MOST CHANGE. ONE IDENTIFIED NEED IN THE COMMUNITY NOT SPECIFICALLY ADDRESSED BY ST. MARY'S WAS SUBSTANCE/ALCOHOL ABUSE. SINCE ST. MARY'S HOSPITAL DOES NOT HAVE A SPECIFIC SUBSTANCE/ALCOHOL ABUSE PROGRAM AND IS NOT AN EDUCATIONAL INSTITUTION, THE HOSPITAL COLLABORATED WITH OTHER ORGANIZATIONS TO SUPPORT THEIR EFFORTS IN THESE AREAS. PHYSICIANS AND HOSPITAL COLLEAGUES REFER PATIENTS AS APPROPRIATE TO LOCAL RESOURCES THAT CAN BETTER SUPPORT HEALING IN THIS AREA. SUBSTANCE/ALCOHOL ABUSE IS ALSO SERVED BY THE STREATOR SUBSTANCE ABUSE PREVENTION COALITION, IN WHICH A HOSPITAL CHAPLAIN ACTIVELY PARTICIPATES. THE CURRENT IMPLEMENTATION STRATEGY CONSISTS OF AN EXPANSION OF ST. MARY'S "HEALTHY YOU" PROGRAM AND THE DEVELOPMENT OF A COMMUNITY GARDEN, BOTH FOCUSED ON REDUCING OBESITY AND ENCOURAGING THE COMMUNITY TO EMBRACE A HEALTHIER LIFESTYLE. IN ADDITION, ST. MARY'S IS ALSO ENGAGED IN A PROCESS WITH OTHER COMMUNITY ORGANIZATIONS TO ASSESS HOW THE HOSPITAL COULD SUPPORT LOCAL RESOURCES ALREADY IN PLACE FOR DOMESTIC VIOLENCE. IN PARTICULAR, ST. MARY'S IS COLLABORATING WITH ADV/SAS (A DOMESTIC VIOLENCE & SEXUAL ASSAULT SERVICE) TO HELP STRENGTHEN THEIR MEDICAL ADVOCATE PROGRAM THROUGH OUR HOSPITAL. TO ADDRESS OBESITY IN THE COMMUNITIES SERVED, ST. MARY'S HOSPITAL FOCUSED ON EXERCISE, NUTRITION AND HEALTHY LIFESTYLES. IN FY2013, ST. MARY'S HOSPITAL REINTRODUCED A 12-WEEK WEIGHT-LOSS COMPETITION PREVIOUSLY CALLED "LEAN TO GREEN", AND A NEW PARTNERSHIP WAS ANNOUNCED WITH THE STREATOR YMCA TO EVOLVE "LEAN TO GREEN" INTO A BIGGER AND BETTER COMMUNITY PROGRAM. AS PART OF THIS PARTNERSHIP, THE PROGRAM WAS RENAMED "HEALTHY YOU" - EMPHASIZING THAT THIS IS NOT JUST A WEIGHT LOSS PROGRAM, BUT A MORE HOLISTIC PROGRAM AIMED AT HELPING INDIVIDUALS LIVE AN ALL-AROUND HEALTHIER LIFESTYLE. ADDED PROGRAM BENEFITS INCLUDED A PEDOMETER TO HELP MOTIVATE WEIGHT LOSS, A MAINTENANCE PROGRAM TO MAINTAIN WEIGHT LOSS YEAR-ROUND, AND COOKING CLASSES PROVIDED BY THE HOSPITAL FOR PARTICIPANTS TO LEARN METHODS OF COOKING WITH FRESH, HEALTHY FOODS AND NEW LOW-FAT RECIPES. THE HOSPITAL'S PROGRAM PARTNER, THE STREATOR YMCA, ALSO PROVIDED FIVE FREE AEROBICS CLASSES FOR PARTICIPANTS. THE 2013 "HEALTHY YOU" PROGRAM ATTRACTED 282 PARTICIPANTS (66 TEAMS), NEARLY DOUBLE THE NUMBER OF PARTICIPANTS FROM THE PREVIOUS YEAR. THE TEAMS BEGAN WITH A COMBINED WEIGHT OF 59,145 POUNDS. A TOTAL OF 191 PARTICIPANTS COMPLETED THE PROGRAM LOSING A TOTAL OF 2,491 POUNDS OR 4.21% OVERALL. TO HELP INDIVIDUALS STAY MOTIVATED AND STAY ON TRACK WITH A HEALTHY LIFESTYLE JOURNEY, "HEALTHY YOU" OFFERS A MAINTENANCE COMPONENT THAT ENCOURAGES PARTICIPANTS TO WEIGH IN ON A MONTHLY BASIS; APPROXIMATELY 50 INDIVIDUALS ARE PARTICIPATING IN THE MAINTENANCE PROGRAM. ST. MARY'S HOSTED AN ELECTRONIC RECYCLING AND USED MEDICAL EQUIPMENT DRIVE OPEN TO ALL COLLEAGUES AND THE COMMUNITY IN HONOR OF EARTH DAY. VINTAGE TECH RECYCLERS, INC. AS ON SITE WITH A TRUCK COLLECTING VARIOUS ELECTRONIC ITEMS TO BE RECYCLED AND THE USED MEDICAL EQUIPMENT WAS DONATED TO HSHS MISSION OUTREACH IN SPRINGFIELD, ILLINOIS. BECAUSE OF OUR EVENT, WE WERE ABLE TO RECYCLE 14,269 POUNDS OF ELECTRONICS THAT OTHERWISE WOULD END UP IN OUR LANDFILLS. IN ADDITION TO THE ELECTRONICS RECYCLING DRIVE, ST. MARY'S PHARMACY SET UP A MEDICATION DISPOSAL DRIVE TO HELP PRESERVE OUR WATER SUPPLY. THE PHARMACY COLLECTED 22 POUNDS OF EXPIRED OR UNWANTED MEDICATIONS THAT INDIVIDUALS WISHED TO SAFELY DISCARD. |
| B. THE REGISTRATION DEPARTMENT PROVIDES BROCHURES TO PATIENTS UPON REQUEST | B. THE REGISTRATION DEPARTMENT PROVIDES BROCHURES TO PATIENTS UPON REQUEST REGARDING THE PAYMENT ASSISTANCE PROGRAM AVAILABLE TO THEM AT ST. MARY'S HOSPITAL. THE CHRISTIAN CARE BROCHURES ARE ALSO SUPPLIED IN WAITING AND ANCILLARY AREAS, AS WELL AS ON THE HOSPITAL'S WEBSITE AT WWW.STMARYSHOSPITAL.ORG. INFORMATION OUTLINING THE PROGRAM IS ALSO AVAILABLE ON PATIENT STATEMENTS AND UPON REQUEST. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION- ST. MARY'S HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ST. MARY'S HOSPITAL SERVES AS A CLINICAL SITE FOR STUDENTS IN THE FIELDS OF NURSING, LABORATORY, DIAGNOSTIC IMAGING, PHYSICAL THERAPY, SPEECH AND PHARMACY. ST. MARY'S HOSPITAL PARTICIPATES IN THE GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS FOR MEDICAID, MEDICARE, CHAMPUS AND TRICARE. 3. IN FY2013, MANY OF THE ABOVE ACTIVITIES WERE CONTINUED OR STRENGTHENED AS ST. MARY'S CONTINUES TO FOCUS ON THE PRIORITY NEEDS IDENTIFIED IN THE FY2012 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. TO FURTHER SUPPORT STREATOR'S UNDERSERVED POPULATION AND PROMOTE HEALTHY EATING CHOICES, A COMMUNITY GARDEN WAS ESTABLISHED AND PLANTED ON HOSPITAL PROPERTY; THE GARDEN IS MAINTAINED BY HOSPITAL AND COMMUNITY VOLUNTEERS. ALL HARVEST PROCEEDS ARE DONATED TO THE LOCAL FOOD PANTRY TO PROVIDE FRESH, HEALTHY PRODUCE TO THOSE IN NEED TO FURTHER PROMOTE IMPROVED HEALTH IN THE COMMUNITY AND REDUCTION OF OBESITY. ST. MARY'S HOSPITAL IS AWARE OF THE NEED IN THE COMMUNITY FOR TRANSPORTATION TO AND FROM MEDICAL SERVICES. IN AN EFFORT TO ALLEVIATE THIS NEED, THE HOSPITAL PROVIDES A MEDICAL TRANSPORTATION PROGRAM WHICH INCLUDES FREE VAN SERVICE TO MEDICAL APPOINTMENTS FOR PATIENTS WITH SPECIAL NEEDS AND NO MEANS OF TRANSPORTATION. THIS SERVICE INCLUDES TRANSPORTATION TO PHYSICIAN OFFICE AND ALL OUTPATIENT SERVICES AFFILIATED WITH ST. MARY'S HOSPITAL. TRANSPORTATION IS MADE WITH THE PARTICIPANTS SAFETY IN MIND WITH A QUALIFIED STAFF TO ASSIST INDIVIDUALS WITH BOARDING AND DISEMBARKING IN VANS MAINTAINED TO ILLINOIS DEPARTMENT OF TRANSPORTATION STANDARDS. ST. MARY'S HOSPITAL HAS ENGAGED IN A PROCESS WITH OTHER COMMUNITY ORGANIZATIONS TO ASSESS HOW THE HOSPITAL COULD SUPPORT LOCAL RESOURCES ALREADY IN PLACE FOR DOMESTIC VIOLENCE. IN PARTICULAR, THE HOSPITAL IS COLLABORATING WITH ADV/SAS (A DOMESTIC VIOLENCE & SEXUAL ASSAULT SERVICE) TO HELP STRENGTHEN THEIR MEDICAL ADVOCATE PROGRAM THROUGHOUT LASALLE AND LIVINGSTON COUNTIES. MEDICAL ADVOCATES PROVIDE SUPPORT AND INFORMATION TO SURVIVORS OF DOMESTIC OR SEXUAL VIOLENCE, ADVOCATE FOR THE VICTIM WITH THE MEDICAL STAFF AND LAW ENFORCEMENT PERSONNEL, EXPLAIN THE MEDICAL EVIDENCE COLLECTION AND CRIMINAL JUSTICE PROCEDURES, AND ARRANGE TRANSPORTATION AND SHELTER IF THE VICTIM WISHES. IN FY2013, ALL HOSPITAL EMERGENCY DEPARTMENT COLLEAGUES RECEIVED ADDITIONAL TRAINING ON DOMESTIC VIOLENCE RESOURCES WITHIN THE COMMUNITY AND THE TOOLS TO MAKE REFERRALS FOR THESE PATIENTS AS APPROPRIATE. IN ADDITION, ST. MARY'S HOSPITAL COLLEAGUES PROUDLY SERVE ON THE ILLINOIS HEALTHCARES COALITION (IHC), A LOCAL SITE OF A STATEWIDE HEALTH INITIATIVE ADDRESSING DOMESTIC VIOLENCE, INTIMATE PARTNER VIOLENCE, SEXUAL ASSAULT/VIOLENCE AND ELDER ABUSE, AS A PUBLIC HEALTH CONCERN. ADV/SAS IS A PARTNER IN THIS COALITION.. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION- ST. MARY'S HOSPITAL CHRISTIAN CARE POLICY, REQUEST FOR FINANCIAL ASSISTANCE, FINANCIAL ELIGIBILITY CRITERIA TABLE AND COMMUNITY BENEFITS REPORT IS ATTACHED. SECTION 2 - QUANTIFIABLE COMMUNITY BENEFIT THE FINANCIAL INFORMATION IN THIS REPORT WAS PREPARED IN ACCORDANCE WITH THE CATHOLIC HEALTH ASSOCIATION'S (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. THESE GUIDELINES RECOMMEND THE FOLLOWING: "REPORT CHARITY CARE AT COST, NOT CHARGES. "DO NOT INCLUDE BAD DEBT, CONTRACTUAL ALLOWANCES, AND QUICK PAY DISCOUNTS AS PART OF CHARITY CARE EXPENSE. "DO NOT COUNT MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. "REPORT THE NET EXPENSE FOR COMMUNITY BENEFIT SERVICES, I.E., THE TOTAL COMMUNITY BENEFIT EXPENSE MINUS ANY ASSOCIATED REVENUE FROM PATIENTS, PAYERS, AND OTHER EXTERNAL SOURCES. THE CHA REPORTING GUIDELINES REFLECT A CONSERVATIVE APPROACH TO REPORTING QUANTIFIABLE COMMUNITY BENEFIT. THE GOAL OF THE REPORTING GUIDELINES IS TO PRODUCE COMMUNITY BENEFIT FINANCIAL REPORTS THAT REFLECT TRUE COSTS AND THAT DESCRIBE COMMUNITY BENEFIT ACTIVITIES THAT INCREASE ACCESS TO HEALTH CARE AND IMPROVE COMMUNITY HEALTH. CATEGORY A, COMMUNTIY HEALTH IMPROVEMENT SERVICES- EDUCATION, CLINICAL, AND SUPPORT SERVICES WERE PROVIDED TO 22,892 PEOPLE, AT A COST OF $301,522, FOR A TOTAL BENEFIT AMOUNT OF $299,226. A1 - COMMUNITY HEALTH EDUCATION: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS, SERVED 22,554 PERSONS AT A COST OF $90,890, WITH OFFSETTING REVENUES OF $275 FOR A TOTAL BENEFIT AMOUNT OF $90,615. A2 - COMMUNITY BASED CLINICAL SERVICES: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS SERVED 55 PERSONS AT A COST OF $54,928, WITH NO OFFSETTING REVENUES FOR A TOTAL BENEFIT AMOUNT OF $54,928. A3 - HEALTH CARE SUPPORT SERVICES: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS SERVED 283 PERSONS AT A COST OF $152,152 WITH OFFSETTING REVENUES OF $2,021 FOR A TOTAL BENEFIT AMOUNT OF $150,131. CATEGORY B- NO ACTIVITY CATEGORY C- NO ACTIVITY CATEGORY E, FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALED $53,508 SERVING 1,079 PEOPLE. E1 - CASH DONATIONS TOTALED $7,718. E3 - IN-KIND DONANTIONS: IN-KIND DONATIONS SERVED 1,079 PERSONS AT A COST OF $45,790 WITH NO OFFSETTING REVENUES FOR A TOTAL BENEFIT AMOUNT OF $45,790. CATEGORY F - COMMUNITY BUILDING ACTIVITIES, INCLUDED SUPPORT SYSTEM ENHANCEMENTS AT A COST OF $289. CATEGORY G- COMMUNITY BENEFIT OPERATIONS INCLUDES EXPENSES RELATED TO TRACKING, RECORDING, AND REPORTING COMMUNITY BENEFIT FOR A TOTAL BENEFIT OF $4,504. A TOTAL OF 42 COMMUNITY BENEFIT ACTIVITIES WERE COMPLETED, AT A COST OF $359,823 WITH OFFSETTING REVENUES OF $2,296 FOR A TOTAL BENEFIT AMOUNT OF $357,527. TOTAL NUMBER OF PERSONS SERVED WAS 23,971. CHARITY CARE SERVED 2,000 PERSONS AT A COST OF $2,766,650. THIS IS IN ADDITION TO THE 42 ACTIVITIES MENTIONED ABOVE AT A BENEFIT OF $357,527. BOTH PROVIDED A TOTAL COMBINED BENEFIT AMOUNT OF $3,124,177. TAX EXEMPT BONDS FORM 990, PART IV, QUESTION 4 ST. MARY'S - STREATOR HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. Changes to By-Laws Form 990, Part VI, Line 4 Section 2.3(g) - This is a new section giving the Members authority over the incurrence of debt above a limit set by the Members. This section makes explicit what was implied in Section 2.3(f) and clarifies that the authority extends also to debt secured by other than real estate. Section 3.2 - The added language to this section clarifies the position of the President as Board member. Section 4.8 - This revision gives the board the ability to use electronic voting technology. The Board members are not likely to use this ability frequently. Section 4.9 - This revision broadens the use of Telecommunications to any Board Committees. Section 5.5 - This revision clarifies the role of the Executive Committee in financial transactions with physicians (as per HSHS policy). Section 5.7 - The underlined is an addition to the Quality Care Committee. Most Local Systems will not be using a combined Quality Care Committee, but it is available to them should they desire to do so. Article 7 Medical Staff - Revisions are made to address recent Joint Commission changes to Medical Staff accreditation standards. RIGHTS OF MEMBERS TO ELECT GOVERNING BODY FORM 990 PART VI, LINES 6 & 7A THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL STREATOR (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. | |
| MEMBER RESERVED POWERS | FORM 990 PART VI, LINE 7B | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL STREATOR (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO FROM TIME TO TIME ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. |
| FORM 990 REVIEW PROCESS | FORM 990 PART VI, LINE 11b | THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990 PART VI, LINE 12C | THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY- SYSTEM OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. |
| WHISTLEBLOWER POLICY | FORM 990 PART VI, LINE 13 | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| COMPENSATION PROCESS | FORM 990 PART VI, LINE 15 | THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES (IHS), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. JOINT VENTURES FORM 990, PART VI, LINE 16B HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. MARY'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. MARY'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. MARY'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. |
| DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990 PART VI, LINE 19 | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| POOLED INVESTMENT ACCOUNT | FORM 990 PART X, LINE 11 | THE HOSPITALS CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM (HSHS). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 124, "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. |
| Other changes in net assets | Form 990, Part XI, Line 9 | CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 691,621 TEMPORARILY RESTRICTED NET INCOME (9,000) PERMANENTLY RESTRICED NET INCOME 1,357 RECOGNITION OF CHANGES IN PENSION FUNDED STATUS 6,714,215 TRANSFER TO/FROM AFFILIATES (1,796,721) LOSS ON EARLY EXTINGUISHMENT OF DEBT (141,042) SWAP PAYMENTS (170,905) ROUNDING (250) ----------- 5,289,275 =========== |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Kiara Clinical Integration Network LLC | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 261417684 | Healthcare | IL | 0 | 0 | HSSI |
| PHYSICIANS CLINICAL INTEGRATION NETWORK | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 311668647 | Healthcare | IL | 0 | 0 | KCIN |
| Springfield Health Partners LLC | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 371364419 | Healthcare | IL | HSHS MG | ||
Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL SISTERS HEALTH SYSTEM | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371058692 | HEALTHCARE | IL | 501(C)(3) | 11A | NA | false |
| HOSPITAL SISTERS SERVICES INC | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163402 | HEALTHCARE | IL | 501(C)(3) | 11A | HSHS | false |
| HOSPITAL SISTERS OF ST FRANCIS FDTN | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(C)(3) | 11A | HSHS | false |
| HSHS HEALTH CARE PLAN TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371137724 | HEALTHCARE | IL | 501(C)(9) | N/A | HSHS | false |
| ST ANTHONY'S HOSPITAL | ||||||||||
| 503 N MAPLE STREET | EFFINGHAM | IL | 62401 | 370661233 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST ELIZABTH'S HOSPITAL | ||||||||||
| 211 SOUTH THIRD STREET | BELLEVILLE | IL | 62220 | 370663567 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST FRANCIS HOSPITAL | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST JOHN'S HOSPITAL | ||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 370661238 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 9515 HOLY CROSS LANE | BREESE | IL | 62230 | 371208459 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 1515 MAIN STREET | HIGHLAND | IL | 62249 | 370663568 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 390810545 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | false |
| ST MARY'S HOSPITAL | ||||||||||
| 1800 E LAKE SHORE DRIVE | DECATUR | IL | 62521 | 370661244 | HEALTHCARE | IL | 501(C)(3) | 3 | HSSI | false |
| SACRED HEART HOSPITAL | ||||||||||
| 900 WEST CLAIREMONT AVE | EAU CLAIRE | WI | 54701 | 390807060 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | false |
| ST MARY'S MEDICAL CENTER | ||||||||||
| 1726 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | false |
| ST NICHOLAS HOSPITAL | ||||||||||
| 3100 SUPERIOR AVENUE | SHEBOYGAN | WI | 53081 | 390808480 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | false |
| ST VINCENT HOSPITAL | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 390817529 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | false |
| Hospital Sisters Healthcare West Inc | ||||||||||
| 2661 COUNTY HIGHWAY I | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | WI | 501(C)(3) | 11A | HSSI | false |
| HSHS SELF INSURANCE TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371120626 | INSURANCE | IL | 501(C)(3) | 11A | HSHS | false |
| HSHS Medical Group Inc | ||||||||||
| 3215 Executive Park Drive | SPRINGFIELD | IL | 62703 | 263956318 | HEALTHCARE | IL | 501(C)(3) | 11A | HSSI | false |
| HSHS Wisconsin Medical Group Inc | ||||||||||
| 3215 Executive Park Drive | springfield | IL | 62703 | 264515959 | HEALTHCARE | WI | 501(C)(3) | 11A | HSSI | false |
| Orange Cross Ambulance Inc | ||||||||||
| 919 ASHLAND AVENUE | SHEBOYGAN | WI | 53081 | 391860942 | HEALTHCARE | WI | 501(C)(3) | 9 | ST NICHOLAS | false |
| WISCONSIN UPPER PENINSULA ONCOLOGY MGMT | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 391677100 | HEALTHCARE | WI | 501(C)(3) | 3 | ST VINCENT | false |
| UNITY LIMITED PARTNERSHIP | ||||||||||
| 2366 OAK RIDGE CIRCLE | DE PERE | WI | 54115 | 391750729 | HEALTHCARE | WI | 501(C)(3) | 9 | HSSI | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Memorial and St Elizabeth's Healthcare | ||||||||||||||
| 4000 North Illinois Street | Swansea | IL | 62226 | 371312961 | HealthCare | IL | St Elizabeth's | related | 0 | 0 | false | $0 | false | 0.00000 |
| Prairie Heart Institute - Carbondale | ||||||||||||||
| 800 East Carpenter Street | Springfield | IL | 62769 | 371321197 | HealthCare | IL | St John's | related | 0 | 0 | false | $0 | false | 0.00000 |
| Northeast Wisconsin Radiation Therapy Se | ||||||||||||||
| 1821 S Webster Avenue STE 300 | Green Bay | WI | 543079047 | 263749065 | HealthCare | WI | HSSI | related | 0 | 0 | false | $0 | false | 0.00000 |
| Pain Center of Wisconsin | ||||||||||||||
| 4131 W Loomis Road STE 300 | Greenfield | WI | 53221 | 263155343 | HealthCare | WI | St Vincent | related | 0 | 0 | false | $0 | false | 0.00000 |
| Prevea Ventures LLC | ||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 203775127 | HealthCare | WI | HSSI | related | 0 | 0 | false | $0 | false | 0.00000 |
| Surgery Center of Sheboygan LLC | ||||||||||||||
| 3141 Saemann Avenue | Sheboygan | WI | 53081 | 260822209 | Healthcare | WI | St Nicholas | related | 0 | 0 | false | $0 | false | 0.00000 |
| Carpenter Street Hotel LLC | ||||||||||||||
| 525 North Sixth Street | Springfield | IL | 62702 | 364128127 | Hotel | IL | LaSante Inc | related | 0 | 0 | false | $0 | false | 0.00000 |
| Springfield Urgent Care Real Estate LLC | ||||||||||||||
| PO Box 19456 | Springfield | IL | 627949456 | 030413258 | Rent. Real Es | IL | LaSante Inc | related | 0 | 0 | false | $0 | false | 0.00000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kiara Inc | |||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 371163401 | HealthCare | IL | HSHS | C Corp | 0 | 0 | 0.00000 | false | |||||
| LaSante Wisconsin Inc | |||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 391572196 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | false | |||||
| LaSante Inc | |||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 371163400 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | false | |||||
| Prairie Cardiovascular | |||||||||||||||||
| 619 East Mason STE 4P57 | Springfield | IL | 62701 | 371071858 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | false | |||||
| Prevea Health Services | |||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 391839351 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | false | |||||
| Prevea Clinic Inc | |||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 391839349 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | false | |||||
| Prevea Health Network | |||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 392000537 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | false | |||||
| RENAISSANCE QUALITY INSURANCE | |||||||||||||||||
| 980669953 | Insurance | HSSI | C Corp | 0 | 0 | 0.00000 | false | PO Box 1159 | Grand Caymans | CJ | KY1-1102 | CJ | |||||
| OJV INC | |||||||||||||||||
| 4936 Laverna Rd | Springfield | IL | 62707 | 460873384 | Healthcare | IL | LaSante | C Corp | 0 | 0 | false | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | true | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | transactions with related organizations | Identifier |
| Return Reference | schedule r, part v, line 2 | ReturnReference |
| Explanation | The transactions reported on line 1 and not specifically identified on line 2 are between related 501(c)(3) public charities. accordingly they are not reported in this section. | Explanation |
Comments