ST ANTHONYS MEMORIAL HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ST ANTHONYS MEMORIAL HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD (EIN 37-0661233)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-12
- IRS object ID
- 201411329349302591
- 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 | 2014-05-12T14:23:26-05:00 | 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 | 370661233 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ANTHONY'S MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DAVE STORM | InCareOfName |
| Name Control | STAN | NameControl |
| Phone | 2173472121 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 N MAPLE STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | EFFINGHAM | City |
| State | IL | State |
| ZIP Code | 624012099 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID STORM | Name |
| Title | CFO | Title |
| Phone | 2173472121 | Phone |
| Date Signed | 2014-04-04 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Theresa Rutherford | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 N maple street | AddressLine1 |
| City | Effingham | City |
| State | IL | State |
| ZIP Code | 62401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 133702762 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | stanthonyshospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | TO PARTICIPATE IN THE HEALTHCARE MINISTRY OF THE CHURCH BY COMMITTING OUR RESOURCES TO PROVIDE A FAMILY-CENTERED APPROACH IN MEETING THE HEALTHCARE NEEDS OF ALL PEOPLE IN THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 943 | TotalNbrEmployees |
| Total Nbr Volunteers | 361 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 464433 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2920965 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 118536477 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 118705496 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 11900865 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9285620 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1588414 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2302434 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 132490189 | TotalRevenuePriorYear |
| Total Revenue Current Year | 133214515 | 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 | 45409794 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 46521330 | 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 | 57350579 | OtherExpensePriorYear |
| Other Expenses Current Year | 59638449 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 102760373 | TotalExpensesPriorYear |
| Total Expenses Current Year | 106159779 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 29729816 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 27054736 | RevenuesLessExpensesCY |
| Total Assets BOY | 315621580 | TotalAssetsBOY |
| Total Assets EOY | 347216009 | TotalAssetsEOY |
| Total Liabilities BOY | 63478378 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 58407758 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 252143202 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 288808251 | 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 | 74159405 | Expense |
| Grants | 0 | Grants |
| Revenue | 118705496 | Revenue |
| Description | SEE SCHEDULE O - PROGRAM SERVICE ACCOMPLISHMENTS | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 74159405 | 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 | false | 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 | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | 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 | 107 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 943 | 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 | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | 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 | false | 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 | DAVE STORM | NamePerson |
| Telephone Number | 2173471333 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 N MAPLE STREET | AddressLine1 |
| City | EFFINGHAM | City |
| State | IL | State |
| ZIP Code | 624012099 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (26 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 | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| Daniel J Woods | |||||||||
| Former President/CEO | 40.0 | X | X | 0 | 451844 | 15520 | |||
| Mark Reifsteck | |||||||||
| Interim President | 35.0 | X | X | 0 | 495721 | 98441 | 25.0 | ||
| John Kingery | |||||||||
| chairperson | 1.0 | X | X | ||||||
| Tom Wegman | |||||||||
| board member | 1.0 | X | |||||||
| Rick Chambers | |||||||||
| Vice Chairperson | 1.0 | X | X | ||||||
| Dot Behrns | |||||||||
| board member | 1.0 | X | |||||||
| Tom Henderson | |||||||||
| secretary | 1.0 | X | X | ||||||
| Dean Keller | |||||||||
| board member | 1.0 | X | |||||||
| Sister Ritamary Brown OSF | |||||||||
| board member | 1.0 | X | |||||||
| Sister Marybeth Culnan OSF | |||||||||
| board member | 1.0 | X | 59.0 | ||||||
| Timothy Gray MD | |||||||||
| board member | 1.0 | X | |||||||
| DAVID A STORM | |||||||||
| CFO | 40.0 | X | 187981 | 0 | 37137 | ||||
| Ann M Carr | |||||||||
| Treasurer | 0.25 | X | 0 | 272146 | 138031 | 59.75 | |||
| Johnny Watkins | |||||||||
| Division CFO | 35.0 | X | 0 | 274329 | 45867 | 25.0 | |||
| ROBERT W ESKER | |||||||||
| ASSISTANT ADMINISTRATOR | 40.0 | 233454 | 0 | 96732 | X | ||||
| MARY C FINLEY | |||||||||
| DIRECTOR, QUALITY MANAGEMENT | 40.0 | 114458 | 32232 | X | |||||
| KAL KEITEL | |||||||||
| DIRECTOR, PEOPLE SERVICES | 40.0 | 124925 | 23152 | X | |||||
| JODY A PUCKETT | |||||||||
| DIRECTOR, FACILITY SERVICES | 40.0 | 93023 | 28107 | X | |||||
| ANNETTE D SCHNABEL | |||||||||
| DIRECTOR, BUSINESS PLANNING | 40.0 | 104452 | 23444 | X | |||||
| KELLY M SAGER | |||||||||
| DIRECTOR, NURSING | 40.0 | 80595 | 13849 | X | |||||
| JULIE L FENOGLIO | |||||||||
| DIRECTOR, NURSING | 40.0 | 153171 | 0 | 9990 | X | ||||
| BRIAN G WATSON | |||||||||
| CRNA | 40.0 | 197220 | 0 | 26737 | X | ||||
| LINDA C SHARPLESS | |||||||||
| CRNA | 40.0 | 180504 | 0 | 37573 | X | ||||
| ALICE K BEARY | |||||||||
| CRNA | 40.0 | 178916 | 0 | 34244 | X | ||||
| LARRY J CARROLL | |||||||||
| CRNA | 40.0 | 177834 | 0 | 36623 | X | ||||
| ROBERT S BRYANT | |||||||||
| CRNA | 40.0 | 173222 | 0 | 21914 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1999755 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1494040 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 719593 | TotalOtherCompensation |
| Number Individuals GT100 K | 26 | 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 |
|---|---|---|---|---|---|
| PRAIRIE CARDIOVASCULAR | |||||
| PO BOX 19420 | SPRINGFIELD | IL | 62794 | PHYSICIAN SERVICES | 3487194 |
| CENTRAL ILLINOIS ANESTHESIA | |||||
| 1800 E LAKE SHORE DR | DECATUR | IL | 62521 | ANESTHESIA SERVICES | 1492830 |
| CROSSROADS EMERGENCY PHYSICIANS | |||||
| PO BOX 793 | TRAVERSE CITY | MI | 496850793 | EMERGENCY SERVICES | 456804 |
| EXECUTIVE HEALTH RESOURCES | |||||
| 112 W KENTUCKY AVE BOX 684 | PO BOX | PA | 191822688 | SURVEY SERVICES | 419345 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| PO BOX 793 | PO BOX | OH | 452636981 | WOUND CARE SERVICES | 417751 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Related Organizations | 275000 | RelatedOrganizations |
| Government Grants | 2645965 | GovernmentGrants |
| Total Contributions | 2920965 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 118705496 | TotalRevenueColumn |
| Related Or Exempt Function Income | 118705496 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 118705496 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3365697 | TotalRevenueColumn |
| Exclusion | $3,365,697 | 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 |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 694936 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 488247 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 206689 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 206689 | TotalRevenueColumn |
| Exclusion | $206,689 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5910279 | Securities |
| Other | 9644 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5910279 | Securities |
| Other | 9644 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5919923 | TotalRevenueColumn |
| Exclusion | $5,919,923 | 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 (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| ANESTHESIA LEASE INCOME | 900099 | 1805016 | $1,805,016 |
| MEDICAL RECORDS | 900099 | 69336 | $69,336 |
| AUXILIARY GIFT SHOP | 453220 | 43533 | $43,533 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 177860 | TotalRevenueColumn |
| Exclusion | $177,860 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2095745 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 133214515 | TotalRevenueColumn |
| Related Or Exempt Function Income | 118705496 | RelatedOrExemptFunctionIncome |
| Exclusion | $11,588,054 | 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 | 1320354 | Total |
| Management And General | 1320354 | 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 | 31170730 | Total |
| Program Services | 23091826 | ProgramServices |
| Management And General | 8078904 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2924933 | Total |
| Program Services | 2078787 | ProgramServices |
| Management And General | 846146 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8843103 | Total |
| Program Services | 6284906 | ProgramServices |
| Management And General | 2558197 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2262210 | Total |
| Program Services | 1607781 | ProgramServices |
| Management And General | 654429 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5627707 | Total |
| Management And General | 5627707 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245644 | Total |
| Management And General | 245644 | 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 | 27924 | Total |
| Management And General | 27924 | 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 | 525693 | Total |
| Management And General | 525693 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5267392 | Total |
| Program Services | 5267392 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17703745 | Total |
| Program Services | 17227915 | ProgramServices |
| Management And General | 475830 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1333608 | Total |
| Program Services | 947812 | ProgramServices |
| Management And General | 385796 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1491019 | Total |
| Program Services | 20058 | ProgramServices |
| Management And General | 1470961 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81561 | Total |
| Program Services | 75301 | ProgramServices |
| Management And General | 6260 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109746 | Total |
| Program Services | 45611 | ProgramServices |
| Management And General | 64135 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326678 | Total |
| Management And General | 326678 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6021540 | Total |
| Program Services | 3177544 | ProgramServices |
| Management And General | 2843996 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 816330 | Total |
| Program Services | 580176 | ProgramServices |
| Management And General | 236154 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MAINTENANCE & REPAIRS | 11546432 | 5484248 | 6062184 |
| MEDICAID TAX ASSESSMENT | 2109769 | 2109769 | |
| LEASE/RENTALS | 1039855 | 846402 | 193453 |
| PROVISION FOR BAD DEBT | 5239000 | 5239000 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124806 | Total |
| Program Services | 74877 | ProgramServices |
| Management And General | 49929 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106159779 | Total |
| Program Services | 74159405 | ProgramServices |
| Management And General | 32000374 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9184852 | BOY |
| EOY | 5921801 | 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 | 17953602 | BOY |
| EOY | 18340258 | 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 | 5389291 | BOY |
| EOY | 4788025 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1388087 | BOY |
| EOY | 1249064 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 152121890 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 92081772 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56717908 | BOY |
| EOY | 60040118 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224055734 | BOY |
| EOY | 256447040 | 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 | 0 | BOY |
| EOY | 0 | 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 | 932106 | BOY |
| EOY | 429703 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315621580 | BOY |
| EOY | 347216009 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8017303 | BOY |
| EOY | 10173416 | 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 | 25864502 | BOY |
| EOY | 25981833 | 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 | 3771355 | BOY |
| EOY | 3409946 | 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 | 25825218 | BOY |
| EOY | 18842563 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63478378 | BOY |
| EOY | 58407758 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 249919789 | BOY |
| EOY | 286715447 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2111195 | BOY |
| EOY | 1980586 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112218 | BOY |
| EOY | 112218 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 252143202 | BOY |
| EOY | 288808251 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315621580 | BOY |
| EOY | 347216009 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 27054736 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 9865203 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -254890 | 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 |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
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 | |
| 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 | $27,924 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 27924 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
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. ANTHONY'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM 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) |
|---|---|---|
| Investment Cost Or Other Basis | 582602 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 2444026 | OtherCostOrOtherBasis |
| Book Value | 3026628 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 5549881 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 57340471 | OtherCostOrOtherBasis |
| Depreciation | 23916688 | Depreciation |
| Book Value | 38973664 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 70648 | OtherCostOrOtherBasis |
| Depreciation | 62430 | Depreciation |
| Book Value | 8218 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 68203758 | OtherCostOrOtherBasis |
| Depreciation | 53099157 | Depreciation |
| Book Value | 15104601 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17930504 | OtherCostOrOtherBasis |
| Depreciation | 15003497 | Depreciation |
| Book Value | 2927007 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 60040118 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION BENEFIT LIABILITY | $9,468,612 |
| BLUE CROSS SETTLEMENT | $7,587,000 |
| SETTLEMENT-HSHS BC (EMP) | $800,000 |
| RETIRE OBLIGATION-ASBESTOS | $686,757 |
| WORKERS COMP ACCRUED LIABILITY | $300,194 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 18842563 | 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 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, ACCOUNTING IN INTERIM PERIODS AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2013 AND 2012, HSHS DOES NOT HAVE A 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 | 175. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1711 | PersonsServed |
| Total Community Benefit Expense | 2185475 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2185475 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 21166 | PersonsServed |
| Total Community Benefit Expense | 13128699 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8049228 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5079471 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 22877 | PersonsServed |
| Total Community Benefit Expense | 15314174 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8049228 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7264946 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07200 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 50 | NumberOfActivitiesOrPrograms |
| Persons Served | 7707 | PersonsServed |
| Total Community Benefit Expense | 344800 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 344620 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 132 | PersonsServed |
| Total Community Benefit Expense | 274349 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 274349 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 2493 | PersonsServed |
| Total Community Benefit Expense | 93385 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6848 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 86537 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 61 | NumberOfActivitiesOrPrograms |
| Persons Served | 10332 | PersonsServed |
| Total Community Benefit Expense | 712534 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7028 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 705506 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00700 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 61 | NumberOfActivitiesOrPrograms |
| Persons Served | 33209 | PersonsServed |
| Total Community Benefit Expense | 16026708 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8056256 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7970452 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07900 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 30 | PersonsServed |
| Total Community Building Expense | 563 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 563 | NetCommunityBuildingExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 802 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 802 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 85 | PersonsServed |
| Total Community Building Expense | 15049 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15049 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 115 | PersonsServed |
| Total Community Building Expense | 16414 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 16414 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $5,239,000 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 45982014 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 50612869 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4630855 | 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 ANTHONY'S MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 503 N MAPLE STREET | AddressLine1 |
| City | EFFINGHAM | City |
| State | IL | State |
| ZIP Code | 62401 | 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 ANTHONY'S MEMORIAL 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 |
| Information Gaps | X | InformationGaps |
| 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 |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 175. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 400. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| 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 |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| 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. St. Anthony's Memorial Hospital utilizes FPG as the basis to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals. St. Anthony's provides charity care to uninsured patients who have income less than 175% of the FPG and provides discounted care prorated up to 400% of the FPG. | |
| PART I, LINE 6A | The hospital's community benefit report is contained within its Annual Report, which can be accessed at www.stanthonyshospital.org. | |
| PART I, LINE 7 | The Cost to Charge Ratio costing methodology, utilizing the Lyon's CBISA software, was used to calculate the amounts reported in the table at hospital cost. PART I, LINE 7(f) THE PERCENT OF CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST AS A PERCENT OF TOTAL EXPENSES LESS BAD DEBT IS 7.90%. THE PERCENT OF CHARITY BAD DEBT AS A PERCENT OF TOTAL EXPENSESLESS BAD DEBT IS 4.93%. THE AMOUNT OF BAD DEBT EXPENSE REMOVED WHEN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN (F) WAS $5,239,000. | |
| PART II | St. Anthony's Memorial Hospital's crucial role in emergency situations is the reason that the City of Effingham has requested hospital representation on the City of Effingham Emergency Preparedness Committee. Deb Murbarger, ICU and Emergency Services supervisor, and Dennis Baker, Plant Services manager, serve on the City's Emergency Preparedness Committee, which meets regularly to develop and revise the City's Emergency Operations Plan and to prepare for any disaster or emergency situation that might arise. Other community members of this committee represent the Effingham City Police and Fire Departments, emergency dispatch, area schools, Effingham County Coroner, City Engineer and other city departments. It is important to St. Anthony's to assist the younger generation to discover where their gifts and interests lie in order to determine the best career for themselves. By partnering with the Eastern Illinois Education for Employment System and Lake Land College in offering the Health Occupations, St. Anthony's helps students from area schools in their career exploration. St. Anthony's contributes staff time, supplies and other costs associated with offering this course to area students. Another way St. Anthony's helps in building the community for the future is through facilitating opportunities for students to job shadow at the hospital. By linking interested students with a hospital colleague to job shadow for a day or more, the students gain real insight into the career they are considering, helping them determine if that is the right career path for them. Over the past year, St. Anthony's provided job shadowing opportunities for 85 students. St. Anthony's also works to build their community and the surrounding area is through our colleagues' participation on various agencies and organizations' Board of Directors to advance the health and welfare of area residents. The United Way of Effingham County requests representation by the hospital on their Board of Directors. Ross Richardson, Guest Services manager, serves on the United Way Board of Directors. Ross offers his time working on the Board and in the community on United Way activities, as well as providing other costs associated with his service on the Board. A hospital representative also serves on the Heartland Human Services Board of Directors. Heartland Human Services is a nonprofit organization that uses a comprehensive approach to address the mental health and substance abuse issues of their clients. Heartland Human Services requests representation by the hospital on their Board of Directors. Over the past year, Teri Phillips, Health Information manager, then Terriann Tharp, Community Relations and Marketing manager, offered their time and other costs associated with their service on the Board. St. Anthony's is an active participant in Alliance for a Healthier Effingham County, an endeavor to improve the health of all citizens in Effingham County. St. Anthony's assists the Alliance by preparing materials, newsletters and flyers about healthy topics. In addition, the Alliance sponsors a quarterly Community Breakfast where healthy, self-improvement topics are addressed. St. Anthony's assists in the publicity, materials preparation, and presentations for the breakfast meeting. St. Anthony's is actively involved in all Alliance activities and supports this health improvement endeavor by offering staff time and other costs. | |
| PART III, LINE 4 | THE AMOUNT REPORTED ON LINE 2 IS THE HOSPITAL COST OF THE TOTAL CHARGES WRITTEN OFF TO BAD DEBT DURING THE FISCAL YEAR. THE COST TO CHARGE RATIO COSTING METHODOLOGY, UTILIZING THE LYON'S CBISA SOFTWARE WAS USED TO CALCULATE HE AMOUNT REPORTED. THE AMOUNT REPORTED ON LINE 3 IS THE HOSPITAL COST OF ACCOUNTS THAT WERE WRITTEN OFF TO BAD DEBT BUT WERE LATER PROVIDED FINANCIAL ASSISTANCE. THIS AMOUNT HAS BEEN RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY AND IS REPORTED AS COMMUNITY BENEFIT COST ON LINE 7A OF THE SCHEDULE H FORM 990. THE RATIONALE FOR INCLUDING THIS COST AS COMMUNITY BENEFIT, IS THAT IF THE PATIENT HAD RESPONDED AND COMPLETED THE FINANCIAL ASSISTANCE APPLICATION MORE TIMELY, THE ACCOUNT WOULD HAVE BEEN PROVIDED ASSISTANCE EARLIER IN THE REVENUE CYCLE AND THE ACCOUNT WOULD HAVE BEEN ADJUSTED TO CHARITY RATHER THAN SENT TO COLLECTIONS. 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 | The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. The hospital Medicare shortfall at cost for fiscal year 2013 was $4,630,855. | |
| PART III, LINE 9B | Debt Collection Policy - Any patient accounts that are sent to a collection agency have an opportunity to complete a financial application for Charity/Christian Care. If an account meets the qualifications for financial assistance, St. Anthony's notifies the collection agency to make it a Christian Care adjustment. At the end of every month, the collection agency provides a list of patients, accounts, and amounts that should be reclassified as Charity Care. As a result, a journal entry is prepared to transfer these amounts from bad debt to Charity Care. | |
| PART V, section b, LINE 3 | St. Anthony's took into account input from persons who represent the community by working in partnership with members of The Alliance for a Healthier Effingham County in Effingham County and the Jasper County Steering Committee in Jasper County, to conduct the FY2012 Community Health Needs Assessment (CHNA). Professional Research Consultants (PRC), a nationally-recognized health care consulting firm with extensive experience in conducting Community Health Needs Assessments, was chosen to conduct the survey. The assessment process utilized by PRC included three components. The first component and main survey instrument was a telephone survey containing questions utilized in surveys conducted by the Centers for Disease Control and Prevention (CDC) and the Behavioral Risk Factor Surveillance System (BRFSS). The second component was the use of research data (i.e. Healthy People 2020, Illinois Risk Factor Data, Illinois Department of Public Health, US Census Bureau) that allows for trending and comparison in order to benchmark data at the state and national levels. As the final component, St. Anthony's organized community focus groups with community representatives acting as facilitators for the groups. The study area for the CHNA encompassed each of the residential zip codes within Effingham and Jasper counties. To ensure the best representation of the population surveyed, a telephone interview was conducted and included residents ages 18 and older. The survey in Effingham County included 1,000 residents and the survey for Jasper County included 400 residents, for a total of 1,400 residents. Once the telephone interviews were completed, they were weighted in proportion to the actual population distribution of each respective county in order to accurately represent the total area as a whole. In August and September 2011, St. Anthony's organized six community focus groups with community representatives acting as facilitators for the groups. Emphasis was placed on focus group participants from members of the public from key groups including area senior citizens, Hispanics and the underinsured/uninsured populations. Focus group candidates were contacted by advertising flyers and through contact with area agencies. A total of forty-four people attended at least one of the sessions. The facilitator led each group discussion with questions about access to healthcare services, chronic disease conditions, modifiable health risk behaviors, and the needs of special populations. Participants were also asked what they consider the top five health needs in the community. After completion of the "Healthy Community 2011" assessment, St. Anthony's worked in partnership with members of The Alliance for a Healthier Effingham County in Effingham County and the Jasper County Steering Committee in Jasper County to review the assessment data, identify priorities, develop goals, and create action plans. The following describes those persons who participated in the FY2012 Community Health Needs Assessment and the special need areas they represented: o Schools (superintendent, principal) - low-income, minority o Public Health (administrator) - medically underserved, low-income, minority, chronic disease o Nurses (nurse practitioner, retired nurse) - medically underserved, low-income, minority, chronic disease o Business leaders o Civic Leaders (Mayor, civic board chairpersons, Chamber of Commerce) o Physicians (dentist, chiropractor) - medically underserved, low-income, minority, chronic disease o Area community agencies (mental health, Catholic Charities, Extension Center, social services) - medically underserved, low-income, minority, chronic disease Additionally, PRC, in tandem with steering committee members, presented the findings from the assessment at community meetings. During the meetings, input from community members was welcomed and those in attendance were encouraged to get involved by volunteering to serve on one of the future task force teams. | |
| PART V, section b, LINE 5C | The assessment findings were presented at community meetings held in both Effingham and Jasper counties. News releases were distributed to local news media following the community presentations and the entire survey, including graphical data and identified priorities, has been made available on the hospital's Web site: http://www.stanthonyshospital.org/Community/health-assessment-2011.aspx The community needs assessment report, which is a companion document to the aforementioned survey, is also available at http://www.stanthonyshospital.org/PDF/SAE%20CHNA%206-28-12.pdf. | |
| PART V, section b, LINE 7 | At their May 2012 meeting, St. Anthony's Memorial Hospital's Board of Directors, which includes representatives from its service area, reviewed and approved the Community Benefit Implementation Strategy for addressing priorities identified in the FY2012 Community Health Needs Assessment. This implementation strategy was executed in our fiscal year 2013. St. Anthony's Implementation Strategy focuses on priorities identified by the study and the populations exhibiting the greatest need within these priority areas. For each of the four areas of opportunity, selected by the steering committees, St. Anthony's worked with the steering committees and community partners to: o Form project teams to further assess the identified priorities. o Identify current and/or additional resources needed to address the priority. o Develop goals, strategies and action plans for project implementation. o Develop detailed work plans and provide project status updates to the steering committees and to the community through local media and the hospital Web site. o Build support for the project in the community and among other agencies. o Continue current programs that address identified community needs. The following is a list of the identified priorities to be addressed in FY2013, which is a subset of the needs identified in the FY2012 CHNA: Access to Health Care Services (Prescription Coverage and Hours of Operation, Transportation, Urgent Care Facilities) For the past decade, St. Anthony's Memorial Hospital has assisted Effingham Catholic Charities by co-sponsoring their Prescription Assistance Program. Catholic Charities' staff works with clients who need prescription medication but may not be able to afford them because they are uninsured or underinsured. St. Anthony's provides assistance to Catholic Charities to help pay for the costs incurred by the program. Rather than establishing their own prescription assistance and duplicating efforts, St. Anthony's partners with Catholic Charities who hAVE an excellent program in place to assist those in need of prescription medication. A Hispanic focus group held in conjunction with the CHNA indicated one barrier they encounter in obtaining health care services was lack of forms in Spanish to apply for financial assistance. St. Anthony's developed a Spanish version of the Charity Care application and this form is distributed as needed to the Hispanic population. St. Anthony's monthly blood pressure program was enhanced to provide better access to low-income populations. Monthly screenings locations include Effingham, Altamont, Dieterich, Newton and Clay City. The screening locations were evaluated to determine access to the underserved. This led to the addition of two new locations including Effingham Catholic Charities and Golden Circle Nutrition. The steering committees in both Effingham and Jasper counties have developed a task force to address barriers to health care access identified in the survey. As the leader in health care for the region, St. Anthony's continues to lead this project team to explore ways to increase residents' access to health care services. In addition, the hospital's five-year strategic plan identified a potential need for an urgent care facility which is currently being evaluated by hospital leadership. Nutrition and Weight Status Alliance members, including the hospital, continue to promote the importance of daily physical activity and encourage support of TREC (Trail Recreation Effingham County) which is establishing walking trails for the health and enjoyment of all residents. The first two phases of the trail opened in 2010, and the third phase of construction began in 2011. St. Anthony's hosted a trail clean-up day in June 2012, with colleagues from St. Anthony's joining other community members to help clear debris from the sides of the trails and trim branches away from the trail. Effingham area school children receive free lunches during the summer months of June and July thanks to the collaborative efforts of members of the Alliance for a Healthier Effingham County. The Summer Lunch for Kids program, which began in 2006, provides a free meal along with games that educate children about nutrition and the importance of physical activity. St. Anthony's Food and Nutrition staff and student interns volunteer their time to help with the program, teaching children about nutrition through fun games and activities. The Nutrition and Fitness task force created a program to encourage people who do not normally exercise to participate in a "Couch to 5K Run/Walk." Fitness days were held leading up to the 5K Run/Walk to encourage people to start an exercise program. Thirty-three percent of participants who completed a race survey indicated this was their first 5K and they plan to continue exercising. The Nutrition and Fitness task force, formed after the 2005 CHNA, continues to evaluate programs to promote healthy nutrition and weight for community members. This task force is currently adding new members and will continue to develop programs that address the priority of nutrition, physical activity, and weight loss. Mental Health & Mental Disorders (Seeking Professional Help) Improving access to professionals who treat mental health issues and mental disorders has been identified as a priority for both Effingham and Jasper counties. A task force team has been developed and is chaired by the executive director of the local mental health facility. Additional community members also serve on this team. St. Anthony's collaborates with this task force to assist in addressing this priority. St. Anthony's worked with a local behavioral health care provider to identify opportunities and a target audience for additional education regarding depression and reducing the stigma associated with seeking services. To address the stigma related to seeking professional mental health services, an ad campaign with real-life testimonials was developed and appears in the monthly health editions of local newspapers. The ads include a call to action including phone number and website to locating area services. Injury & Violence Prevention (Child Abuse Offenses) - Effingham Only St. Anthony's worked with the Jasper county school district to provide bike helmets free of charge and educational information to students in grades 1 through 3 at a Bike Safety Rodeo. School representatives, including a school resource officer, were on hand to teach the children riding skills and educate them on bicycle safety. St. Anthony's continues to provide Safe Sitter classes to teach 11 to 13 year old babysitters how to handle crisIs, how to keep their charges secure, and how to nurture and guide a young child. In short, Safe Sitter babysitters help children stay safe and sound while their parents are away (ref. www.safesitter.org). The Alliance for a Healthier Effingham County identified child abuse offenses as a priority. A task force team made up of representatives from health care organizations and social service agencies has been formed to address the number of child abuse offenses reported in Effingham County. Education developed by this task force will be integrated into the curriculum for St. Anthony's Safe Sitter classes. The following priorities were also identified as areas of opportunity by PRC. St. Anthony's addresses these needs on an ongoing basis through services and/or programs that currently exist. The development of separate task force teams is not being planned for these areas. Heart Disease and Stroke (Stroke Deaths, Cholesterol Screenings) St. Anthony's offers numerous community health education and screening programs free of charge to area residents. These programs provide needed access to health care services for the underserved and preventative health services for the community. Programs offered range from monthly blood pressure screenings in area communities to large health fairs offering numerous preventive testing, such as blood pressure, total cholesterol and blood glucose testing. Prairie Heart Institute at St. Anthony's offers a Heart Failure Program to help people living daily with Congestive Heart Failure. The program empowers patients to improve their quality of life by making educated decisions about their treatment. In addition, Prairie Heart Institute received a telehealth grant which allowed St. Anthony's Heart Failure nurses to distribute electronic home scales to patients who qualified for the program. The scales are provided free of charge and measure the patient's daily weight and symptoms, and transmit key data to nurses for evaluation. This program offers immediate access to Heart Failure nurses and the specialists at Prairie Heart Institute at St. Anthony's for patients in need of urgent medical assistance. Maternal, Child & Infant Health (Infant Mortality, Mothers who Smoke during Pregnancy) St. Anthony's currently provides prenatal education classes to expectant parents free of char | |
| PART V, section b, LINE 20D | All uninsured patients are eligible for a 10% discount. If the patient provides St. Anthony's Memorial Hospital with their household income, the patient may be eligible for additional discounts. Patients with household income greater than 400% of the federal poverty level qualify for a 10% discount of billed charges. Patients with household income less than 400% of the federal poverty level qualify for a 20% discount, which was calculated based on HSHS Policy F27. The discount is the greater of 75% of the HSHS employee plan discount amount or 25 to 60% of the average Medicare discount rate. Additional discounts are available based on the State of Illinois Uninsured Patient Act. This Act allows for a 50% discount for uninsured patients when household income is less than 300% of the federal poverty level. We ask each patient to fill out a form in order to determine their eligibility under the Illinois Uninsured Act. If the patient fails to fill out the form, financial counselors will seek to determine patient eligibility by seeking appropriate information in the Search America program. We also review the patients' accounts to ensure they are not charged more than 25% of their annual gross income. Once the charges for a self-pay balance exceed 25% of the patients' annual gross income, the remaining balance is adjusted off to Christian Care. | |
| NEEDS ASSESSMENT | The FY2012 Community Health Needs Assessment and associated implementation strategy guided our efforts in FY2013. In prior years, St. Anthony's used a similar approach to identify community need. Since 2005, St. Anthony's Memorial Hospital has been involved in needs assessments conducted by the hospital and several other organizations. Health care needs identified by community members involved in a grassroots effort to improve quality of life for Effingham County identified health care needs that paralleled those identified by "Checkup 2005" community needs assessment. Members of Vision 2020 eventually joined the "Checkup 2005" committee to form the Alliance for a Healthier Effingham County that continues today. St. Anthony's has a number of representatives on the Alliance, including the hospital's current chairperson of its Board of Directors, Director of Quality Support, and the Community Relations and Marketing manager. In addition to St. Anthony's involvement, the Alliance membership is comprised of representatives from the county health department, physicians' offices, dental offices, Catholic Charities and other social service agencies, community businesses, and area media. The "Checkup 2005" initiatives included achievements such as a summer lunch program for children, awareness/promotion campaign focusing on women's wellness and the availability of the Illinois Breast & Cervical Cancer program, and a TREC initiative to establish walking trails to increase health and activity levels of all community residents. Members of the Alliance continue to monitor needs assessments to determine priorities that should continue to be addressed and to include new health priorities. Needs identified through these various assessments led to the development of the Alliance's Goals for 2012. These include: . Continue to focus on exercise, nutrition, and healthy lifestyles . Continue to raise awareness and improve access to affordable health care, dental care and mental health professionals . Continue to raise awareness and improve access to mental health treatment for youth and families including treatment programs for suicide & depression and drug & alcohol abuse. . Develop strategies that create awareness and provide resources to reduce child abuse offenses. In 2011, a steering committee similar to the Alliance was formed in Jasper County to address health care needs identified in that county. In addition to representatives from St. Anthony's, this committee includes representatives from other health care organizations, area schools, government, community organizations, business and local community members. Members of the Jasper County Steering Committee identified health care needs similar to those in Effingham County. These include: . Focus on exercise, nutrition, and healthy lifestyles . Raise awareness and improve access to affordable health care, dental care and mental health professionals . Raise awareness and improve access to mental health treatment for youth and families including treatment programs for suicide & depression and drug & alcohol abuse. | |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | St. Anthony's informs patients about financial assistance programs in various ways. Patients receive a patient guide, which explains that hospital staff will assist patients in filing claims for governmental programs. The Patient Guide also explains St. Anthony's Christian Care Financial Assistance program and how to apply for assistance. Brochures about the Christian Care Financial Assistance Program are also located in waiting rooms throughout St. Anthony's campus. For patients who visit St. Anthony's emergency room, each patient is visited bedside by a hospital staff member who provides them with a brochure about the Christian Care Financial Assistance Program if they are self-pay or if they express concern about the hospital bill. The brochures are available in English and Spanish. During registration, the hospital also provides uninsured or underinsured patients with information about the Cardinal Health eRecovery Pharmaceutical Program, which offers medication assistance for medications received during the hospital visit. There is signage about financial assistance in all of the hospital registration areas. In addition, every hospital billing statement includes information about the availability of financial assistance. In St. Anthony's Business Office, when staff members receive calls from people expressing problems with being able to pay their hospital bills, they share information with them about the availability of government programs and the Christian Care Financial Assistance Program. All patients with a self-pay portion greater than $1000 are mailed a copy of the financial assistance application form. St. Anthony's Web site also explains that hospital staff can assist patients who have financial concerns, offer phone numbers to call for assistance, and provides information on the Christian Care Financial Assistance Program. | |
| COMMUNITY INFORMATION | Effingham is located in central Illinois at the crossroads of two major interstate systems. Effingham has a population of over 12,000 people with an economy comprised of various businesses from agriculture, printing, and manufacturing plants to health care and tourism. St. Anthony's Memorial Hospital's service area is Effingham and Jasper Counties along with portions of the counties of Clark, Clay, Crawford, Cumberland, Fayette, Marion, Richland, and Shelby, serving a population of over 250,000 people. According to the 2012 estimates of the U.S. Census, the demographic make-up of Effingham County is 96.7% white (non-Hispanic), 1.8% of Hispanic or Latino origin, and 0.9% other. The demographic make-up of Jasper County is 97.6% white (non-Hispanic), 1.0% of Hispanic or Latino origin, and 0.8% other. In 2010, the percentage of people living below poverty level in Effingham County was 10.7% and Jasper County was 7.6%. The Community Health Needs Assessment (CHNA) indicated that 13.5% of adults ages 18-64 in the total area surveyed have health insurance coverage through a government-sponsored program (e.g., Medicaid, Medicare, military benefits). Additionally 8.7% of the adults surveyed have no insurance coverage for health care expenses. The population segments most likely to be without health care insurance coverage were men and residents living at lower incomes. Among adults with diagnosed depression, only 64.8% acknowledge they have sought professional help for a mental or emotional problem. This is much lower than the national findings of 82% and fails to satisfy the Healthy People 2020 target of 75.1% or higher. Additionally, based on self-reported heights and weights in the CHNA, only 30.3% of adults in the total area are at a healthy weight. This fails to satisfy the Healthy People 2020 target of 33.9% or higher. This number has not changed significantly since the 2005 CHNA. | |
| PROMOTION OF COMMUNITY HEALTH | St. Anthony's Memorial 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. Anthony's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 135 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 Effingham 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 (nor family members thereof). The Board ensures that St. Anthony's is responding to community need. During the last year, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. St. Anthony's also has a Hospital Advisory Council comprised of community leaders who serve as liaisons between the hospital and its publics by advising on matters of community health care service and its effective delivery. Community leaders also serve on the Friends of St. Anthony's Board of Directors, which ensure the continuing growth, stability and future of health care in the region, by accepting and acknowledging charitable contributions to the hospital. St. Anthony's Auxiliary Executive Committee is a board of volunteers who direct the Auxiliary volunteer program which promotes and advances the welfare of the hospital through services for patients and their families, and fundraising for hospital needs. Also consistent with its exempt purpose, St. Anthony'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. Anthony'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. Anthony'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. For example, St. Anthony's has worked with various area medical practices whose medical records were still on paper with adopting electronic medical records (EMRs) in their offices. Having access to an EMR assists caregivers with increased information by patients and other health care providers, enables the practice of evidence-based medicine, and improves patient safety and quality of care. For those medical office that already have EMRs, St. Anthony's is working on determining software to help medical practices' EMR interface with the hospital's EMR to help improve communication, efficiency, and patient safety. St. Anthony's also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2013, St. Anthony's provided over $7.9 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. Additionally, during this period, St. Anthony's provided $1.6 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance and over $4.6 million (at cost) in excess of Medicare payment for health services. Responding to Community Need St. Anthony's provides a range of community benefits that flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Anthony's, and they often relieve a burden that would otherwise be carried by government. Several of these programs and activities are designed to respond to our FY2012 Community Health Needs Assessment, which surfaced the following priority needs for attention from the hospital in collaboration with other community organizations: o Develop strategies that improve access to and awareness of needed health services to improve the health status of the community. o To improve nutrition and increase physical activity thereby decreasing obesity among individuals residing in Effingham County. Increase the number of people who seek professional help for a mental or emotional problem. o Develop strategies that create awareness and provide resources to reduce child abuse offenses. Identified Priority: Affordable Health Care for Uninsured and Underinsured Patients o Catholic Charities Prescription Assistance For the past decade, St. Anthony's Memorial Hospital has assisted Effingham Catholic Charities by co-sponsoring their Prescription Assistance Program. This is one of the ongoing programs that St. Anthony's has supported based on the health priorities established by the Alliance following Checkup 2005. St. Anthony's and Catholic Charities believe that no one should be without prescribed medications because they cannot afford to pay for them. Catholic Charities' staff members work with clients who need prescription medication but may not be able to afford them because they are uninsured or underinsured. St. Anthony's provides assistance to Catholic Charities to help pay for the costs incurred by the program. Rather than establishing their own prescription assistance and duplicating efforts, St. Anthony's partners with Catholic Charities who has an excellent program in place to assist those in need of prescription medication. Catholic Charities is grateful for the assistance, given the number of clients they help each month through the program. In Fiscal Year 2013, Catholic Charities was able to help 283 people receive the prescription medications they need, thanks to the support of St. Anthony's Memorial Hospital. Without the assistance that St. Anthony's provides, Catholic Charities might not be able to continue to provide prescription medication assistance to those in need. Currently, members of the Alliance continue to monitor needs assessments to determine priorities that should continue to be addressed and to include new health priorities. Needs identified through these various assessments led to the development of the Alliance's Goals for 2012. These include: . Continue to focus on exercise, nutrition, and healthy lifestyles . Continue to raise awareness and improve access to affordable health care, dental care and mental health professionals . Continue to raise awareness and improve access to mental health treatment for youth and families including treatment programs for suicide & depression and drug & alcohol abuse. . Develop strategies that create awareness and provide resources to reduce child abuse offenses. o Exercise, Nutrition, and Healthy Lifestyles The Nutrition and Fitness task force created a program to encourage people who do not normally exercise to participate in a "Couch to 5K Run/Walk." Fitness days were held leading up to the 5K Run/Walk to encourage people to start an exercise program. Thirty-three percent of participants who completed a race survey indicated this was their first 5K and they plan to continue exercising. o Access to Health Care Services A Hispanic focus group held in conjunction with the CHNA indicated one barrier they encounter in obtaining healthcare services was lack of forms in Spanish to apply for financial assistance. St. Anthony's developed a Spanish version of the Charity Care application and this form is distributed as needed to the Hispanic population. St. Anthony's monthly blood pressure program was enhanced to provide better access to low-income populations. Monthly screenings locations include Effingham, Altamont, Dieterich, Newton and Clay City. The screening locations were evaluated to determine access to the underserved. This led to the addition of two new locations including Effingham Catholic Charities and Golden Circle Nutrition. o Awareness of Mental Health & Mental Disorders (Seeking Professional Help) St. Anthony's worked with a local behavioral health care provider to identify opportunities and a target audien | |
| AFFILIATED HEALTH CARE SYSTEM | St. Anthony's Memorial Hospital in Effingham, Illinois is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The Mission of HSHS is "to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry." We live our Mission by providing holistic healing to all who seek our care, as well as through Community Benefit. Working collaboratively with others in the communities we serve, our Community Benefit initiatives are strategically and successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. In FY2013, our 13 hospitals responded to needs identified in each of their Community Health Needs Assessments (CHNAs) completed in FY2012. The information gathered from these assessments was used to develop new and enhance existing Community Benefit programs and services that best addressed community needs. Included among the many priority needs identified in our CHNAs were chronic disease prevention and management, obesity, adequate food and nutrition, mental health, and access to health care services. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. Across HSHS, we collectively provided $185.6 million in Community Benefit (or 10.2% of total hospital expenses) in FY2013. Included in this amount was $45.9 million provided for Financial Assistance (i.e. Charity Care) and $104.2 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $152.3 million. HSHS hospitals also recorded $107.1 million in uncollectible accounts. In addition to the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the United States is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2013, we made significant progress with this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care at the right time in the right setting often involve partnering with others to achieve this goal. Across our two-state System, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. From 2006 to 2009, the United States saw a 16% increase in individuals seeking dental care at hospital emergency rooms. With the support of St. Mary's Hospital Medical Center and St. Vincent Hospital in Green Bay, Wisconsin, the NEW Dental Clinic on the campus of Northeast Wisconsin Technical College expanded in FY2013 and was able to accommodate up to 6,000 visits. The clinic provides dental services to low-income and uninsured persons including the homeless in Brown County. St. Francis Hospital in Litchfield, Illinois partnered with Lewis & Clark Community College to bring their mobile health unit to the Litchfield area; the unit provides dental exams and screenings, x-rays and dental hygiene to those in need. In western Wisconsin, St. Joseph's Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,672 patient visits, an 11% increase from the prior year. With more than 166 individuals volunteering, the clinic provided more than 6,751 hours (including 753 provider hours and 675 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthony's Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthony's helped underwrite the cost of prescription medications for more than 280 residents. In southwest Illinois, St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive an intensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, in collaboration with the Illinois Department of Insurance, St. Joseph's Hospital participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Financial Assistance (i.e. Charity Care) program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our financial assistance policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our Mission to embody Christ's healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In partnership with the Sangamon County Health Department (SCHD) and local farmers, St. John's Hospital in Springfield, Illinois took a lead role in bringing a Farmers Market to the east side of Springfield. The East Side Farmers Market addresses three community needs: childhood obesity, childhood poverty (26% of children in Sangamon County live in poverty vs. 18% in the state) and providing fresh produce to persons living in a known "food desert." WIC Cooking Classes are also offered in tandem with the East Side Farmers Market to teach participants how to prepare fresh produce. The Farmers Market and cooking classes are hosted at the SCHD. St. Mary's Hospital in Streator, Illinois teamed up with the Streator YMCA to offer a 12 week weight loss program - Healthy You - to motivate 282 participants (nearly double the participants from last year) to lose weight and maintain a healthy lifestyle. The program included aerobics classes, cooking classes, and a maintenance program to encourage participants to weigh in monthly. A total of 191 participants | |
| STATE FILING OF COMMUNITY BENEFIT REPORT | IL, | 990 SCHEDULE H, PART VI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| 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 | true | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Daniel J Woods | ||||||||||||||
| Former President/CEO | 0 | 189286 | 0 | 37559 | 0 | 224999 | 0 | 0 | 0 | 16252 | 0 | 468096 | 0 | 55468 |
| Mark Reifsteck | ||||||||||||||
| Interim President | 0 | 397174 | 0 | 66854 | 0 | 31693 | 0 | 74658 | 0 | 30647 | 0 | 601026 | 0 | 0 |
| ROBERT W ESKER | ||||||||||||||
| ASSISTANT ADMINISTRATOR | 173561 | 0 | 14220 | 0 | 45673 | 0 | 78353 | 0 | 19162 | 0 | 330969 | 0 | 0 | 0 |
| DAVID A STORM | ||||||||||||||
| CFO | 173302 | 0 | 13899 | 0 | 780 | 0 | 18857 | 0 | 19074 | 0 | 225912 | 0 | 0 | 0 |
| JULIE L FENOGLIO | ||||||||||||||
| DIRECTOR, NURSING | 137981 | 0 | 9301 | 0 | 5889 | 0 | 9990 | 0 | 645 | 0 | 163806 | 0 | 0 | 0 |
| Ann M Carr | ||||||||||||||
| Treasurer | 0 | 193454 | 0 | 29440 | 0 | 49252 | 0 | 121170 | 0 | 17686 | 0 | 411002 | 0 | 18215 |
| BRIAN G WATSON | ||||||||||||||
| CRNA | 192407 | 0 | 4423 | 0 | 390 | 0 | 10895 | 0 | 16621 | 0 | 224736 | 0 | 0 | 0 |
| LINDA C SHARPLESS | ||||||||||||||
| CRNA | 173191 | 0 | 6923 | 0 | 390 | 0 | 28598 | 0 | 9716 | 0 | 218818 | 0 | 0 | 0 |
| ALICE K BEARY | ||||||||||||||
| CRNA | 171501 | 0 | 6635 | 0 | 780 | 0 | 16306 | 0 | 18603 | 0 | 213825 | 0 | 0 | 0 |
| LARRY J CARROLL | ||||||||||||||
| CRNA | 173021 | 0 | 4423 | 0 | 390 | 0 | 28665 | 0 | 8699 | 0 | 215198 | 0 | 0 | 0 |
| ROBERT S BRYANT | ||||||||||||||
| CRNA | 168409 | 0 | 4423 | 0 | 390 | 0 | 12658 | 0 | 9997 | 0 | 195877 | 0 | 0 | 0 |
| Johnny Watkins | ||||||||||||||
| Division CFO | 0 | 242237 | 0 | 31702 | 0 | 390 | 0 | 36688 | 0 | 10141 | 0 | 321158 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| TAX INDEMNIFICATION AND GROSS-UP PAYMENTS | SCHEDULE J, PART I, LINE 1A | TAX GROSS-UPS WERE PAID BY HSHS TO ANN CARR FOR $11 DURING THE YEAR. THE FAIR VALUE OF THIS WAS INCLUDED IN HER ANNUAL REPORTED INCOME. DANIEL WOODS' SEVERANCE PACKAGE SCHEDULE J, PART I, LINE 4A DANIEL WOODS RECEIVED A SEVERANCE PACKAGE DURING THE YEAR IN THE AMOUNT OF $75,963 FOR HIS SERVICES AS President/CEO OF ST ANTHONY'S MEMORIAL HOSPITAL. |
| MARK REIFSTECK | schedule j, part i, line 4b | Mark Reifsteck participated in a serp plan during the year in the amount of $48,937. |
| ann m. carr | schedule j, part i, line 4b | ann m. carr participated in a serp plan during the year in the amount of $42,817. |
| DANIEL WOODS | SCHEDULE J, PART I, LINE 4B | DANIEL WOODS PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $55,468. |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Relationship With OrganizationRelationshipWithOrganization | Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|---|
| Julie Fenoglio | |||||||
| Chief Nursing Offic. | Second Mortgage | X | $66,000 | 66000 | false | true | true |
| Julie Fenoglio | |||||||
| Chief Nursing Offic. | Note and Mortgage | X | $185,592 | 194951 | false | true | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 260951 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Organization's Mission | FORM 990, PAGE 2, PART III, LINE 1 | THE MISSION OF ST ANTHONY'S MEMORIAL HOSPITAL IS TO PARTICIPATE IN THE HEALTHCARE MINISTRY OF THE CHURCH. WE COMMIT OUR VALUABLE RESOURCES TO PROVIDE A FAMILY-CENTERED APPROACH IN MEETING THE HEALTHCARE NEEDS OF ALL PEOPLE IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY, AND TO FOSTER THE VALUES OF RESPECT, CARE, COMPETENCE, AND JOY. |
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PAGE 2, PART III, LINE 4A | ST. ANTHONY'S MEMORIAL HOSPITAL, EFFINGHAM OF THE HOSPITAL SISTERS HEALTH SYSTEM PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED,SEX, NATIONAL ORIGIN, HANDICAP, AGE, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL TO THE CONTINUED OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE NECESSARY MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH THE BEST QUALITY HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. INHERENT TO OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF COMMUNITY SUPPORT ACTIVITIES. DURING FISCAL YEAR 2013, ST. ANTHONY'S MEMORIAL HOSPITAL PROVIDED SERVICES TO 6,143 INPATIENTS UTILIZING 23,571 ADULT AND PEDIATRIC DAYS OF CARE. IN ADDITION, ST. ANTHONY'S MEMORIAL HOSPITAL PROVIDED SERVICES TO 104,828 OUTPATIENTS. ST. ANTHONY'S MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE TO THE POOR AT FREE OR REDUCED COST THROUGH OUR CHRISTIAN CARE PROGRAM. CHARITY CARE PROVIDED AT COST WAS $2,185,475. IN ADDITION, THE HOSPITAL PARTICIPATES IN THE ILLINOIS MEDICAID PROGRAM, WHICH REIMBURSES THE HOSPITAL AT RATES SUBSTANTIALLY BELOW THE COST OF PROVIDING THE SERVICES. FULFILLING OUR MISSION TO THE COMMUNITY, SERVICES WERE PROVIDED TO MEDICAID INPATIENTS UTILIZING 1,746 DAYS OF CARE. THE UNPAID COST OF MEDICAID WAS $5,079,471 OTHER BENEFITS INCLUDED IN-KIND DONATIONS IN THE AMOUNT OF $86,537. ST. ANTHONY'S MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE TO MEMBERS OF THE BROADER COMMUNITY THROUGH OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE, PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN, AND THROUGH EDUCATIONAL PROGRAMS AT NO COST. THE UNPAID AND UNREIMBURSED COST OF PARTICIPATING IN THE MEDICARE PROGRAM WAS $4,630,855 DURING FISCAL YEAR 2013. |
| TAX EXEMPT BONDS | FORM 990, PART IV, LINE 24 | ST ANTHONY'S MEMORIAL HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS PARENT CORPORATION, HOSPITAL SISTERS SERVICES, INC. ("HSSI"). AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. |
| RIGHTS OF MEMBERS TO ELECT GOVERNING BODY | FORM 990, PART VI, LINE 6 & 7A | THE SENIOR GOVERNING BODY OF ST. ANTHONY'S HOSPITAL (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH 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. 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. |
| MEMBER RESERVED POWERS | FORM 990, PART VI, LINE 7B | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. ANTHONY'S HOSPITAL (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 USED SINCE JANUARY 2009 TO ESTABLISH THE PRACTICE OF MANAGING 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 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 16 HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. ANTHONY'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. ANTHONY HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. ANTHONY 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 | INVESTMENTS IN SECURITIES AND RELATED INVESTMENT INCOME THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS" INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE 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 OR FUND BALANCES | FORM 990, PART XI, LINE 9 | CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS/SWAP (4,143,645) PAYMENTS TRANSFERS FROM AFFILIATES (2,990,150) temporarily restricted net income (268,000) RECOGNITION OF CHANGES IN PENSION FUNDED STATUS 7,386,525 LOSS ON EARLY EXTINGUISHMENT OF DEBT (239,288) OTHER (332) ------------- TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES: (254,890) ============= |
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 | 61707 | 261417684 | HEALTHCARE | IL | 0 | 0 | HSSI |
| PHYSICIAN CLINICAL INTEGRATION NETWORK L | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 61707 | 371668647 | HEALTHCARE | IL | 0 | 0 | KCIN |
| SPRINGFIELD HEALTH PARTNERS LLC | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 61707 | 371364419 | HEALTHCARE | IL | 0 | 0 | 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 OF ST FRANCIS FDTN | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(C)(3) | 11A | HSHS | false |
| 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 |
| HSHS HEALTH CARE PLAN TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371137724 | HEALTHCARE | IL | 501(C)(9) | N/A | HSHS | false |
| HOSPITAL SISTERS HEALTHCARE - WEST INC | ||||||||||
| 2661 COUNTY HIGHWAY I | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | WI | 501(C)(3) | 11A | HSSI | false |
| SACRED HEART HOSPITAL | ||||||||||
| 900 WEST CLAIREMONT AVENUE | EAU CLAIRE | WI | 54701 | 390807060 | 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 ELIZABETH'S HOSPITAL | ||||||||||
| 211 SOUTH THIRD STREET | BELLEVILLE | IL | 62220 | 370663567 | 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 FRANCIS HOSPITAL | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | 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 |
| ST MARY'S HOSPITAL | ||||||||||
| 111 SPRING STREET | STREATOR | IL | 61364 | 362169181 | HEALTHCARE | IL | 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 |
| ST MARY'S HOSPITAL MEDICAL CENTER | ||||||||||
| 1726 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(C)(3) | 3 | HSSI | 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 |
| HSHS SELF INSURANCE TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371120626 | INSURANCE | IL | 501(C)(3) | 11A | HSHS | false |
| ORANGE CROSS AMBULANCE INC | ||||||||||
| 919 ASHLAND AVE | SHEBOYGAN | WI | 53081 | 391860942 | HEALTHCARE | WI | 501(C)(3) | 9 | ST NICHOLAS | false |
| WISCONSIN UPPER PEN ONC MNGMT SERVICES | ||||||||||
| 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 (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEMORIAL AND ST ELIZABETH'S HEALTHCARE | |||||||||||||
| 4000 NORTH ILLINOIS STREET | SWANSEA | IL | 62226 | 371312961 | HEALTHCARE | IL | ST ELIZABETH'S | false | $0 | false | |||
| PRAIRIE HEART INSUTUTE - CARBONDALE LLC | |||||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 371321197 | HEALTHCARE | IL | ST JOHN'S | false | $0 | false | |||
| NORTHEAST WISCONSIN RADIATION THERAPY SE | |||||||||||||
| 1821 S WEBSTER AVENUE STE 300 | GREEN BAY | WI | 543079047 | 263749065 | HEALTHCARE | WI | HSSI | false | $0 | false | |||
| PAIN CENTER OF WISCONSIN | |||||||||||||
| 4131 W LOOMIS ROAD STE 300 | GREENFIELD | WI | 53221 | 263155343 | HEALTHCARE | WI | ST VINCENT | false | $0 | false | |||
| SURGERY CENTER OF SHEBOYGAN LLC | |||||||||||||
| 3141 SAEMANN AVE | SHEBOYGAN | WI | 53081 | 260822209 | HEALTHCARE | WI | ST NICHOLAS | false | $0 | false | |||
| PREVEA VENTURES LLC | |||||||||||||
| 2710 EXECUTIVE DR | GREEN BAY | WI | 54304 | 203775127 | HEALTHCARE | WI | HSSI | false | $0 | false | |||
| CARPENTER STREET HOTEL LLC | |||||||||||||
| 525 NORTH SIXTH STREET | SPRINGFIELD | IL | 62702 | 364128127 | HOTEL | IL | LASANTE INC | false | $0 | false | |||
| SPRINGFIELD URGENT CARE REAL ESTATE LLC | |||||||||||||
| PO BOX 19456 | SPRINGFIELD | IL | 627949456 | 030413258 | RENT. REAL ES | IL | LASANTE INC | false | $0 | false | |||
| PRAIRIE HEART INSTITUTE MANAGEMENT LLC | |||||||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 261417684 | Medical | IL | HSHS | false | $0 | false | Related | 0 | 0 |
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 | Controlled OrgControlledOrg | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KIARA INC | ||||||||||||
| 4936 LAVERNA RD | SPRINGFIELD | IL | 62707 | 371163401 | HEALTHCARE | IL | HSHS | C CORP | 0 | 0 | false | |
| LASANTE WISCONSIN INC | ||||||||||||
| 4936 LAVERNA RD | SPRINGFIELD | IL | 62707 | 391572196 | HEALTHCARE | IL | KIARA INC | C CORP | 0 | 0 | false | |
| LASANTE INC | ||||||||||||
| 4936 LAVERNA RD | SPRINGFIELD | IL | 62707 | 371163400 | HEALTHCARE | IL | KIARA INC | C CORP | 0 | 0 | false | |
| PRAIRIE CARDIOVASCULAR | ||||||||||||
| 619 EAST MASON STE 4P57 | SPRINGFIELD | IL | 62701 | 371071858 | HEALTHCARE | IL | KIARA INC | C CORP | 0 | 0 | false | |
| PREVEA HEALTH SERVICES | ||||||||||||
| 2710 EXECUTIVE DR | GREEN BAY | WI | 54304 | 391839351 | HEALTHCARE | WI | HSSI | C CORP | 0 | 0 | false | |
| PREVEA CLINIC INC | ||||||||||||
| 2710 EXECUTIVE DR | GREEN BAY | WI | 54304 | 391839349 | HEALTHCARE | WI | HSSI | C CORP | 0 | 0 | false | |
| PREVEA HEALTH NETWORK | ||||||||||||
| 2710 EXECUTIVE DR | GREEN BAY | WI | 54304 | 392000537 | HEALTHCARE | WI | HSSI | C CORP | 0 | 0 | false | |
| RENAISSANCE QUALITY INSURANCE | ||||||||||||
| 980669953 | INSURANCE | HSSI | C CORP | 0 | 0 | false | CJ | |||||
| OJV INC | ||||||||||||
| 4936 LAVERNA RD | SPRINGFIELD | IL | 62707 | 460873384 | HEALTHCARE | IL | LASANTE INC | 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 | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ENTITIES | Identifier |
| Return Reference | schedule r, part v, line 2 | ReturnReference |
| Explanation | THE TRANSACTIONS REPORTED IN QUESTION 1 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REPORTED IN THIS SECTION. | Explanation |
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