HOPEDALE MEDICAL FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: HOPEDALE MEDICAL FOUNDATION (EIN 37-0808925)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-14
IRS object ID: 201421349349301597
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-14T09:17:21-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	420714325	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MCGLADREY LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	201 N HARRISON STREET SUITE 300	AddressLine1
City	DAVENPORT	City
State	IA	State
ZIP Code	528011999	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	370808925	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	THE HOPEDALE MEDICAL FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HOPE	NameControl
Phone	3094494298	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 267	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ALFRED N ROSSI MD	Name
Title	PRESIDENT	Title
Phone	3094494298	Phone
Date Signed	2014-05-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JOHN J ROMANO	Name
PTIN	P00227323	PTIN
Phone	5638884000	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	HOPEDALE MEDICAL COMPLEX	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	ALFRED N ROSSI MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 267	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	23997541	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.HOPEDALEMC.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1961	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	MAINTAIN A MEDICAL COMPLEX THAT INCLUDES AN ACUTE CARE HOSPITAL AND HEALTH CARE FACILITY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	8	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	434	TotalNbrEmployees
Total Nbr Volunteers	35	TotalNbrVolunteers
Total Gross UBI	616160	TotalGrossUBI
Net Unrelated Business Txbl Income	-304838	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	71741	ContributionsGrantsPriorYear
Contributions Grants Current Year	128049	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	20842325	ProgramServiceRevenuePriorYear
Program Service Revenue CY	18994402	ProgramServiceRevenueCY
Investment Income Prior Year	66414	InvestmentIncomePriorYear
Investment Income Current Year	76914	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2685490	OtherRevenuePriorYear
Other Revenue Current Year	3081022	OtherRevenueCurrentYear
Total Revenue Prior Year	23665970	TotalRevenuePriorYear
Total Revenue Current Year	22280387	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	28493	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	23013	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	12727614	SalariesEtcPriorYear
Salaries Etc Current Year	12544896	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	19520	TotalFundrsngExpCurrentYear
Other Expense Prior Year	9715076	OtherExpensePriorYear
Other Expenses Current Year	8624525	OtherExpensesCurrentYear
Total Expenses Prior Year	22471183	TotalExpensesPriorYear
Total Expenses Current Year	21192434	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1194787	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1087953	RevenuesLessExpensesCY
Total Assets BOY	22996627	TotalAssetsBOY
Total Assets EOY	31326718	TotalAssetsEOY
Total Liabilities BOY	8151910	TotalLiabilitiesBOY
Total Liabilities EOY	15343732	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	14844717	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	15982986	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE HOPEDALE MEDICAL FOUNDATION IS A NON-PROFIT, CHARITABLE CORPORATION COMMITTED TO EXCELLENCE IN PROMOTING GOOD HEALTH AND WELLNESS TO ALL, AND SERVING THE HEALTHCARE NEEDS OF THE SICK AND ELDERLY, 24 HOURS A DAY, 7 DAYS A WEEK, WITHOUT DISCRIMINATION AND REGARDLESS OF ONE'S ABILITY TO PAY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	15729237	Expense
Grants	23013	Grants
Revenue	16371165	Revenue
Description	THE HOPEDALE MEDICAL COMPLEX IS OWNED AND OPERATED BY THE NOT-FOR-PROFIT CHARITABLE CORPORATION KNOWN AS THE HOPEDALE MEDICAL FOUNDATION. THE HOPEDALE MEDICAL COMPLEX STARTED AS A 20-BED HOSPITAL IN 1955 IN HOPEDALE, ILLINOIS AND HAS EXPANDED OVER THE YEARS TO OFFER A CONTINUUM OF CARE SERVICES, INCLUDING A 25-BED ACUTE CARE HOSPITAL, NURSING HOME, INDEPENDENT AND ASSISTED LIVING FACILITY AS WELL AS A WELLNESS CENTER.THE HOPEDALE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND OFFERS VIRTUALLY THE SAME SERVICES AS A LARGER, URBAN HOSPITAL, INCLUDING 24 HOUR EMERGENCY ROOM, ICU, GENERAL AND ADVANCED VASCULAR SURGERY, ORTHOPEDIC SURGERY, PLASTIC/RECONSTRUCTIVE SURGERY, OPEN MRI AND CT SCANNER. THE HOPEDALE MEDICAL COMPLEX ALSO OFFERS PHYSICIAN SERVICES THROUGH FOUR SATELLITE OFFICES IN ATLANTA, MANITO, MACINAW AND DELAVAN.HOPEDALE WELLNESS CENTER HAS AN INDOOR GYM, WALKING TRACK, THREE THERAPY POOLS, DAY CARE, PHYSICAL THERAPY DEPARTMENT AND CONFERENCE ROOM FOR THEIR MEMBERS TO USE. THE WELLNESS CENTER ALSO OFFERS CLUB MEMBERSHIPS TO THE RESIDENTS OF HOPEDALE AND SURROUNDING AREAS. PRESENTLY, THE WELLNESS CENTER HAS APPROXIMATELY 1,000 MEMBERS WHO ENROLLED IN VARIOUS PROGRAMS AND ACTIVITIES. A SPORTS MEDICINE PROGRAM HAS ALSO BEEN DEVELOPED FOR LOCAL SCHOOL DISTRICTS AND SPORTS TEAMS THAT THE COMPLEX SERVES TO IMPROVE CONDITIONING OF ATHLETES AND TO REDUCE SPORTS INJURIES. THE COST TO OPERATE THE WELLNESS CENTER IS MORE THAN THE REVENUE THAT IS DERIVED FROM THE HEALTH MEMBERSHIPS WITH THE DIFFERENCE REPRESENTING A BENEFIT TO THE RESIDENTS AND THE COMMUNITY.SERVICE AREATHE HOPEDALE MEDICAL COMPLEX SERVES THE MEDICAL NEEDS OF THE LOCAL CITIZENS WITHIN A 50 MILE RADIUS OF HOPEDALE, ILLINOIS. THE HOPEDALE MEDICAL COMPLEX OPERATES FOUR SATELLITE PHYSICIAN OFFICES IN ADDITION TO A PHYSICIAN'S OFFICE LOCATED ON THE MAIN CAMPUS FOR THE CONVENIENCE OF OUR PATIENTS WITHIN OUR SERVICES AREA.HOSPITAL STAFFTHE HOPEDALE MEDICAL COMPLEX HAS A DEDICATED STAFF OF TRAINED HEALTH PROFESSIONALS THAT HAVE JOINED TOGEATHER AS A TEAM TO PROVIDE THE BEST POSSIBLE HEALTH CARE FOR THE PATIENTS AND RESIDENTS OF OUR COMMUNITY.FINANCIAL ASSISTANCE PROGRAMSTHE HOPEDALE MEDICAL COMPLEX HAS POLICIES IN PLACE TO ENSURE THAT NECESSARY HEALTH SERVICES ARE NOT DENIED BASED ON ABILITY TO PAY AND THAT ALL PATIENTS ARE TREATED FAIRLY AND EQUITABLY, AND WITH RESPECT AND COMPASSION. HOPEDALE MEDICAL COMPLEX ASSISTS PERSONS WITHOUT INSURANCE COVERAGE BY WAIVING ALL OR PART OF THE CHARGES FOR SERVICES IT PROVIDES. SIGNS ARE POSTED IN THE ADMITTING AREAS SO THAT HOSPITAL POLICIES ARE CLEARLY COMMUNICATED TO PATIENTS AND PROSPECTIVE PATIENTS.EMERGENCY SERVICESTHE HOPEDALE MEDICAL COMPLEX OPERATES AN EMERGENCY ROOM THAT IS OPEN 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY ROOM PROVIDES SERVICE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY AND DENIES SERVICE TO NO ONE.COMMUNITY LEADERSHOPEDALE MEDICAL FOUNDATION'S BOARD OF DIRECTORS IS COMPOSED OF VARIOUS LEADERS FROM THE COMMUNITY. THE DIRECTOR'S REPRESENT DIVERSE BACKGROUNDS AND INDUSTRIES WITHIN THE COMMUNITY.MEDICAL STAFFTHE MEDICAL STAFF AT HOPEDALE MEDICAL CENTER IS OPEN AND OFFERS PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE AREA.UNCOMPENSATED CARETHE HOPEDALE MEDICAL COMPLEX PARTICIPATES IN MEDICARE, MEDICAID, CHAMPUS, TRICARE AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. THE CONTRACTED AMOUNT FOR THE ABOVE SERVICES EXCEPT MEDICARE IS OFTEN LESS THAN THE ACTUAL COST OF THE SERVICES, WITH THE DIFFERENCE REPRESENTING A BENEFIT TO THE PATIENT AND THE COMMUNITY.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1816134	Expense
Revenue	3207207	Revenue
Description	HOPEDALE NURSING HOME IS A 52-BED LICENSED FACILITY OFFERING 24-HOUR NURSING CARE. IT IS PHYSICALLY LOCATED ON CAMPUS AND CONNECTED TO THE HOSPITAL FOR THE CONVENIENCE OF OUR RESIDENTS AND THEIR FAMILIES.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	847234	Expense
Revenue	1360931	Revenue
Description	HOPEDALE COMMONS IS A 67-BED INDEPENDENT AND ASSISTED LIVING FACILITY. IT IS ALSO LOCATED ON CAMPUS AND IS LOCATED NEAR THE HOSPITAL FOR THE CONVENIENCE OF OUR RESIDENTS AND THEIR FAMILIES.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Description	OTHER COMMUNITY ACTIVITIES -ANNUAL 5K RUN/WALKEACH JULY 4TH, THE HOPEDALE WELLNESS CENTER SPONSORS A 5K RUN/WALK OPEN TO ALL RESIDENTS OF THE COMMUNITY. AWARDS ARE GIVEN TO DIFFERENT WINNERS OF VARIOUS AGE GROUPS OF RUNNERS AND WALKERS.DIETICIAN HEALTHY EATING SEMINARSTHE HOPEDALE MEDICAL FOUNDATION DIETICIAN HOLDS VARIOUS SEMINARS ANNUALLY TO HELP RESIDENTS OF THE COMMUNITY AND EMPLOYEES TO EAT A HEALTHIER DIET. VARIOUS RECIPES ARE GIVEN TO PARTICIPANTS WHICH ENCOURAGE HEALTHIER DIETS.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	18392605	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	1	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	78	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	434	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	8	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DWIGHT JOHNSON	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3094494362	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	107 TREMONT STREET	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
ALFRED N ROSSI MD
CHAIRMAN/CHIEF EXECUTIVE OFFICER HMF	2.00	X	X	62721	0	0
MATTHEW B ROSSI MD
SECRETARY/TREASURER	2.00	X	X	52418	0	18722
MICHAEL J MCLAUGHLIN
DIRECTOR	2.00	X		334760	0	0
ROLAND RICH
DIRECTOR	2.00	X		0	0	0
TOM HIESER
DIRECTOR	2.00	X		0	0	0
RAY SLACK
DIRECTOR	2.00	X		0	0	0
JARIE SLACK
DIRECTOR	2.00	X		0	0	0
DONALD OSWALD
DIRECTOR	2.00	X		12264	0	0
MARK F ROSSI
CHIEF OPERATING OFFICER	40.00		X	208894	0	6630
JOHN ZANON
DIRECTOR OF RETAIL PHARMAC	40.00			126200	0	26177	X
WENDY MOBLEY
DIRCTOR OF HOSPITAL PHARMACY	40.00			114491	0	7897	X
LAWRENCE KLOC
FORMER CHIEF FINANCIAL OFFICER	40.00			100563	0	25408		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1012311	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	84834	TotalOtherCompensation
Number Individuals GT100 K	5	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
EMERGENCY PHYSICIAN STAFFING SOLUTIONS
12528 SR 78	HAVANA	IL	62644	STAFFING AGENCY	903838
TRI-COUNTY ANESTHESIA SC
PO BOX 267	HOPEDALE	IL	61747	ANESTHESIA SERVICES	405400
MICHAEL J MCLAUGHLIN
2 DEEPWOOD ROAD	BARRINGTON HILLS	IL	60010	CONSULTING SERVICES	334760
PEARL TECHNOLOGY
1200 E GLEN AVE	PEORIA HEIGHTS	IL	61616	IT SERVICES	293904
FIDELITY ON CALL
9006 N INDUSTRIAL ROAD	PEORIA	IL	61615	STAFFING AGENCY	190838

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K
Government Grants	60733	GovernmentGrants
All Other Contributions	67316	AllOtherContributions
Total Contributions	128049	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE	621110	14492943	14492943
NURSING HOME	623000	3207207	3207207
ASSISTED AND INDEPENDENT	623000	1360931	1360931
WELLNESS CENTER	713940	367525	367525
MASSAGE THERAPY	621110	74105		74105

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-508309	TotalRevenueColumn
Related Or Exempt Function Income	-508309	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	18994402	TotalProgramServiceRevenue

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	71214	TotalRevenueColumn
Exclusion	$71,214	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	294969	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	294969	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	294969	TotalRevenueColumn
Exclusion	$294,969	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	5700	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	5700	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	5700	TotalRevenueColumn
Exclusion	$5,700	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	4277990	GrossSalesOfInventory
Cost Of Goods Sold	1717154	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2560836	TotalRevenueColumn
Related Or Exempt Function Income	2018781	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	542055	UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CHILD CARE	624410	131970	$131,970
CAFETERIA INCOME	722210	93022	$93,022
MISCELLANEOUS	900099	225		225

Field	Value	IRS element (for citing)
Total Other Revenue	225217	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	22280387	TotalRevenueColumn
Related Or Exempt Function Income	20939303	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	616160	UnrelatedBusinessRevenue
Exclusion	$596,875	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	8720	Total
Program Services	8720	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	14293	Total
Program Services	14293	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	842925	Total
Program Services	545139	ProgramServices
Management And General	297786	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	309544	Total
Program Services	209807	ProgramServices
Management And General	99737	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	9514034	Total
Program Services	8735109	ProgramServices
Management And General	778925	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	135179	Total
Program Services	117193	ProgramServices
Management And General	17986	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1065296	Total
Program Services	1037627	ProgramServices
Management And General	27669	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	677918	Total
Program Services	596360	ProgramServices
Management And General	81558	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	10134	Total
Management And General	10134	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	124007	Total
Management And General	124007	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	8555	Total
Program Services	8555	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	943603	Total
Program Services	540486	ProgramServices
Management And General	396500	ManagementAndGeneral
Fundraising	6617	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	155384	Total
Program Services	22944	ProgramServices
Management And General	128531	ManagementAndGeneral
Fundraising	3909	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2834691	Total
Program Services	2652857	ProgramServices
Management And General	175460	ManagementAndGeneral
Fundraising	6374	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	829	Total
Management And General	829	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	731200	Total
Program Services	635905	ProgramServices
Management And General	95295	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	52966	Total
Program Services	35535	ProgramServices
Management And General	14811	ManagementAndGeneral
Fundraising	2620	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	261021	Total
Program Services	233795	ProgramServices
Management And General	27226	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	997726	Total
Program Services	957292	ProgramServices
Management And General	40434	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	116110	Total
Program Services	18530	ProgramServices
Management And General	97580	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
SERVICES	1353122	1030767	322355
MEDICAID TAXES	378794	378794
REPAIRS & MAINTENANCE	328089	284603	43486
DIRECTORSHIP EXPENSE	150000	150000

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	178294	Total
Program Services	178294	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	21192434	Total
Program Services	18392605	ProgramServices
Management And General	2780309	ManagementAndGeneral
Fundraising	19520	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	5676769	BOY
EOY	8085784	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	961983	BOY
EOY	5275218	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	288289	BOY
EOY	109016	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2598206	BOY
EOY	2596798	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	36495	BOY
EOY	36495	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	101236	BOY
EOY	85788	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	778416	BOY
EOY	797037	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	115051	BOY
EOY	73273	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	34017235	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	22905151	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	10486241	BOY
EOY	11112084	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	902449	BOY
EOY	1848970	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1051492	BOY
EOY	1306255	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	22996627	BOY
EOY	31326718	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2401222	BOY
EOY	1912696	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	388192	BOY
EOY	373504	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	3675000	BOY
EOY	10835208	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1687496	BOY
EOY	2222324	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	8151910	BOY
EOY	15343732	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	13593001	BOY
EOY	14664885	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1251716	BOY
EOY	1318101	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14844717	BOY
EOY	15982986	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	22996627	BOY
EOY	31326718	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	1087953	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-5178	ReconciliationUnrealizedInvest
Reconcilation Other Changes	55494	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$8,555	OtherActivitiesAmount
Total Lobbying Expenditures IIB	8555	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	PART II-B, LINE 1I, OTHER LOBBYING ACTIVITIES: LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: $8,555 OF MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	1	AgentTrusteeEtc
Beginning Balance	2624	BeginningBalance
Additions During Year	0	AdditionsDuringYear
Distributions During Year	1383	DistributionsDuringYear
Ending Balance	1241	EndingBalance
Included On FS	0	IncludedOnFS

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	701461	OtherCostOrOtherBasis
Book Value	701461	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13935444	OtherCostOrOtherBasis
Depreciation	7698399	Depreciation
Book Value	6237045	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	16583042	OtherCostOrOtherBasis
Depreciation	14666104	Depreciation
Book Value	1916938	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2797288	OtherCostOrOtherBasis
Depreciation	540648	Depreciation
Book Value	2256640	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	11112084	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
ACCRETION LIABILITY	$247,841
CAPITALIZED LEASE OBLIGATIONS	$127,975
ESTIMATED THIRD PARTY PAYOR SETTLEMENT	$1,770,292
INTEREST RATE SWAP AGREEMENT	$76,216

Field	Value	IRS element (for citing)
Total Of Amounts	2222324	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART IV, LINE 1B:	SOME NURSING HOME PATIENTS HOLD SMALL AMOUNTS OF FUNDS ON DEPOSIT WITH THE ORGANIZATION FOR INCIDENTALS AND LOW VALUE SERVICES, SUCH AS HAIR-CUTS. THE ORGANIZATION DOES NOT RECORD THE AMOUNTS AS ASSETS OF THE ORGANIZATION.
PART X, LINE 2:	THE HEALTH ASSOCIATION AND ITS TWO NOT-FOR-PROFIT SUBSIDIARIES HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HEALTH ASSOCIATION AND ITS TWO NOT-FOR-PROFIT SUBSIDIARIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. AS PRIVATE FOUNDATIONS, THE HEALTH ASSOCIATION AND ONE OF ITS SUBSIDIARIES, PRAIRIE HEALTH SERVICES, INC, ARE REQUIRED TO DISTRIBUTE A MINIMUM PERCENTAGE OF THE FAIR MARKET VALUE OF THEIR INVESTMENT ASSETS ANNUALLY. HRES IS A FOR-PROFIT CORPORATION SUBJECT TO APPLICABLE FEDERAL AND ILLINOIS TAXES ON INCOME. HRES COMPUTES DEFERRED INCOME TAXES UNDER THE LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND NET OPERATING LOSS AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASES. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE LIKELY THAN NOT THAT SOME OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN TAX LAWS AND RATES ON THE DATE OF ENACTMENT. THE TAXABLE INCOME OF HRES AND ITS RELATED CURRENT AND DEFERRED INCOME TAXES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT, THEREFORE, SEPARATELY PRESENTED. THE HEALTH ASSOCIATION AND PRAIRIE HEALTH SERVICES, INC, FILE FORM 990-PF (RETURN OF PRIVATE FOUNDATION) ANNUALLY. HOPEDALE MEDICAL FOUNDATION FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). AN EXCISE TAX OF 2% IS IMPOSED ON NET INVESTMENT INCOME OF ALL DOMESTIC TAX-EXEMPT PRIVATE FOUNDATIONS FOR EACH TAX YEAR, AND IS REPORTED ON FORM 990-PF. UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE DIFFERENCE BETWEEN THE BENEFIT OF A TAX POSITION RECORDED FOR FINANCIAL STATEMENT PURPOSES AND THE AMOUNT REFLECTED ON A TAX RETURN IS RECORDED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2013 AND 2012, THERE WERE NO UNCERTAIN TAX BENEFITS RELATED TO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990-PF, 990, 990-T, AND 1120 FILED BY THE HEALTH ASSOCIATION AND ITS SUBSIDIARIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. GENERALLY, FORMS 990-PF, 990, 990-T, AND 1120 FILED BY THE HEALTH ASSOCIATION AND ITS SUBSIDIARIES ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED JUNE 30, 2009 AND PRIOR.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	300.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	764357	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	764357	NetCommunityBenefitExpense
Percent Of Total Expense	0.03610	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	866118	TotalCommunityBenefitExpense
Direct Offsetting Revenue	617597	DirectOffsettingRevenue
Net Community Benefit Expense	248521	NetCommunityBenefitExpense
Percent Of Total Expense	0.01170	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	150012	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	150012	NetCommunityBenefitExpense
Percent Of Total Expense	0.00710	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1780487	TotalCommunityBenefitExpense
Direct Offsetting Revenue	617597	DirectOffsettingRevenue
Net Community Benefit Expense	1162890	NetCommunityBenefitExpense
Percent Of Total Expense	0.05490	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	669685	TotalCommunityBenefitExpense
Direct Offsetting Revenue	501753	DirectOffsettingRevenue
Net Community Benefit Expense	167932	NetCommunityBenefitExpense
Percent Of Total Expense	0.00790	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1691	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1691	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	671376	TotalCommunityBenefitExpense
Direct Offsetting Revenue	501753	DirectOffsettingRevenue
Net Community Benefit Expense	169623	NetCommunityBenefitExpense
Percent Of Total Expense	0.00800	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2451863	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1119350	DirectOffsettingRevenue
Net Community Benefit Expense	1332513	NetCommunityBenefitExpense
Percent Of Total Expense	0.06290	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$508,309	BadDebtExpenseAmount
Amount Attributable To	267000	AmountAttributableTo
Amount Reimbursed By Medicare	6268689	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	6227653	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	41036	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	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	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	HOPEDALE MEDICAL FOUNDATION	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	107 TREMONT STREET	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.HOPEDALEMC.COM	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
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	HOPEDALE MEDICAL COMPLEX	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	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	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	1	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	300.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	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	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Medicare Rate	X	MedicareRate
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	8	NumberOfOtherFacilities

Other Facilities OtherFacilities (8 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
HOPEDALE NURSING HOME
111 TREMONT STREET	HOPEDALE	IL	61747	NURSING HOME
HOPEDALE COMMONS
211 221 SW RAILROAD STREET	HOPEDALE	IL	61747	ASSISTED AND INDEPENDENT LIVING
HOPEDLAE WELLNESS CENTER
107 TREMONT STREET	HOPEDALE	IL	61747	WELLNESS & FITNESS CENTER
MEDICAL ARTS PHYSICIAN BUILDING
107 TREMONT STREET	HOPEDALE	IL	61747	OUTPATIENT PHYSICIAN CLINIC
DELAVAN DOCTOR'S OFFICE
115 EAST 4TH STREET	DELAVAN	IL	61734	OUTPATIENT PHYSICIAN CLINIC
ATLANTA DOCTOR'S OFFICE
108 SW ARCH STREET	ATLANTA	IL	61723	OUTPATIENT PHYSICIAN CLINIC
MACKINAW DOCTOR'S OFFICE
407 S ORCHARD STREET	MACKINAW	IL	61755	OUTPATIENT PHYSICIAN CLINIC
MANITO DOCTOR'S OFFICE
101 E MASON	MANITO	IL	61546	OUTPATIENT PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

ExplanationExplanation	Return ReferenceReturnReference	IdentifierIdentifier
PART I, LINE 3C: NOT APPLICABLE
PART I, LINE 6A: NOT APPLICABLE
PART I, LINE 7: THE ORGANIZATION CALCULATED THE COST AMOUNTS NOTED IN PART I, LINE 7 BY UTILIZING ITS CURRENT COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS REPORTED ON, INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, MEDICAID, UNINSURED, AND MEDICARE.
PART I, LINE 7G: NOT APPLICABLE
PART I, L7 COL(F): NO BAD DEBT EXPENSE WAS INCLUDED IN THE DENOMINATOR BECAUSE BAD DEBT WAS REPORTED IN LINE 2F OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 11.57%, AND THE PERCENTAGE INCREASES TO 40.96% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNTY BENEFIT EXPENSE.
PART II: NOT APPLICABLE
BAD DEBT IS REPORTED AT THE FULL-ESTABLISHED CHARGE FROM THE MOST RECENT AUDITED FINANCIAL REPORT. ANY RECOVERIES ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.	PART III, LINE 2:
THE ORGANIZATION USED A COST TO CHARGE RATIO TO DETERMINE THE COST AMOUNT OF THE BAD DEBT EXPENSE. WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, AS PROVIDED IN THE IRS INSTRUCTIONS WAS USED TO DETERMINE THE APPROPRIATE RATIO.	PART III, LINE 3:
PART III, LINE 4: THE TEXT FROM THE FOOTNOTE TO HOPEDALE RURAL HEALTH ASSOCIATION, INC.'S FINANCIAL STATEMENT IS AS FOLLOWS: PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING ACCOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. THE ORGANIZATION DOES NOT CHARGE INTEREST ON PATIENT RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYORS' AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. AS A SERVICE TO THE PATIENT, THE ORGANIZATION BILLS THIRD-PARTY PAYORS DIRECTLY AND THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED.
PART III, LINE 8: THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. ROUTINE AND ICU COSTS ARE DETERMINED BASED ON AN AVERAGE COST PER DAY MULTIPLIED BY THE NUMBER OF MEDICARE ALLOWABLE DAYS. MEDICARE ANCILLARY COSTS ARE DETERMINED BY THE RATIO OF DEPARTMENT COSTS TO DEPARTMENT CHARGES THEN THE RESULTING % IS APPLIED TO MEDICARE ALLOWABLE CHARGES. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.
PART III, LINE 9B: THE ORGANIZATION APPLIES THE FOLLOWING PROCESSES AND PROCEDURES IN ITS COLLECTION PRACTICES FOR THOSE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE POLICY:THE DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT IS THE INABILITY TO PAY VERSUS THE UNWILLINGNESS OF THE PERSON TO PAY THEIR ACCOUNT. THOSE WITH LOW INCOMES OR WITH CATASTROPHIC MEDICAL BILLS MAY BE MEDICALLY INDIGENT EVEN THOUGH THEY ARE ABLE TO MEET BASIC LIVING EXPENSES. HOPEDALE MEDICAL COMPLEX WILL NOT DENY SERVICES TO ANY PATIENT DUE TO RACE, COLOR, RELIGION, GENDER, ANCESTRY, SEXUAL ORIENTATION, FINANCIAL CLASS OR NATIONAL ORIGIN.HOPEDALE MEDICAL FOUNDATION IS COMMITTED, TO THE EXTENT RESOURCES ALLOW, TO PROVIDING QUALITY HEALTHCARE TO ITS PATIENTS AND RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY.THE HOPEDALE MEDICAL FOUNDATION FINANCIAL ASSISTANCE PROGRAM ALLOWS FOR FREE OR REDUCED MEDICAL SERVICES TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT CARE; HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY FOR PART OF THE BILL AND ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID); AND MEET THE INCOME AND ASSETS ELIGIBILITY CRITERIA.FINANCIAL ASSISTANCE IS AVAILABLE FOR NECESSARY HOSPITAL AND PHYSICIAN CHARGES ONLY.ELIGIBILITY DETERMINATION:FINANCIAL ASSISTANCE FORMS AND INSTRUCTIONS SHALL BE FURNISHED TO PATIENTS WHEN FINANCIAL ASSISTANCE IS REQUESTED, WHEN NEED IS INDICATED, OR WHEN FINANCIAL SCREENING INDICATES POTENTIAL NEED, IN THE CASE OF PATIENTS WITHOUT HEALTH INSURANCE. ALL APPLICATIONS SHOULD BE FOLLOWED BY DOCUMENTATION TO VERIFY INCOME AMOUNTS INDICATED ON THE APPLICATION FORM. ALL INFORMATION RECEIVED RELATING TO THE APPLICATION WILL BE KEPT CONFIDENTIAL AND USED TO VERIFY FINANCIAL NEEDS. STEPS USED BY HOPEDALE MEDICAL FOUNDATION TO DETERMINE AND VERIFY FINANCIAL ASSISTANCE:1) HOSPITAL IDENTIFIES ANY UNINSURED, UNDERINSURED, OR SELF-PAY PATIENTS.2) PATIENT COMPLETES APPLICATION/FINANCIAL STATEMENT THAT INCLUDES INCOME, ASSETS, AND LIABILITIES.3) FINANCIAL COUNSELOR INTERVIEWS PATIENT TO ASSESS THE PATIENT'S ABILITY TO PAY IN FULL; ABILITY TO PAY REASONABLE MONTHLY INSTALLMENTS; AND QUALIFICATION FOR FINANCIAL ASSISTANCE.4) HOSPITAL MAKES INITIAL DETREMINATION BASED UPON APPLICATION AND ANY ORAL INFORMATION PROVIDED BY PATIENT. PATIENT SIGNS APPLICATION CONFIRMING ACCURACY OF INFORMATION PROVIDED.5) PATIENT SUPPLIES DOCUMENTATION OF RESOURCES AND OUTSTANDING OBLIGATIONS WITHIN 30 DAYS FROM DATE OF APPLICATION.6) HOSPITAL MAKES FINAL DETERMINATION REGARDING ELIGIBILITY FOR FINANCIAL ASSISTANCE.7) HOSPITAL SENDS NOTIFICATION LETTER TO THE PATIENT AND/OR FAMILY WITH THE DECISION. NOTICE WILL INCLUDE INSTRUCTIONS FOR ESTABLISHING A PAYMENT PLAN, IF NEEDED, AND REASON FOR DENIAL, IF APPLICABLE.
WWW.HOPEDALEMC.COM	PART V, SECTION B, LINE 5A:
PART V, SECTION B, LINE 3: HOPEDALE MEDICAL FOUNDATION CREATED THE FOLLOWING FOCUS GROUPS TO GATHER INPUT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT:1) A FOCUS GROUP MADE UP OF HEALTH PROFESSIONALS AND PARTNERS MET ON NOVEMBER 29, 2011. THE GROUP INCLUDED A DOCTOR, A HOSPICE SERVICE PROVIDER, A REPRESENTATIVE OF THE LOCAL HEALTH DEPARTMENT, AND A REPRESENTATIVE OF AN AMBULANCE SERVICE.2) A FOCUS GROUP MADE UP OF COMMUNITY LEADERS AND ELECTED OFFICIALS MET ON NOVEMBER 29, 2011. THE GROUP INCLUDED REPRESENTATIVES OF LOCAL FINANCIAL INSTITUTIONS, LEGAL SERVICES, A COMMUNITY IMPROVEMENT GROUP AND INDIVIDUAL COMMUNITY LEADERS.3) A FOCUS GROUP MADE UP OF COMMUNITY LEADERS AND ELECTED OFFICIALS MET ON NOVEMBER 30, 2011. THE GROUP INCLUDED THE COUNTY BOARD CHAIRMAN, SCHOOL OFFICIALS, RELIGIOUS LEADERS, A MAYOR, POLICE CHIEFS, AND TOWNSHIP SUPERVISORS.		HOPEDALE MEDICAL COMPLEX
PART VI, LINE 2: SERVICES OFFERED BY THE FOUNDATION INCLUDE MEDICAL/SURGICAL, SWING BED, CRITICAL CARE, OUTPATIENT SURGICAL SERVICES AND A SIGNIFICANT NUMBER OF OTHER ANCILLARY SERVICES NECESSARY TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL ALSO OFFERS 24-HOUR EMERGENCY ROOM SERVICES, LABORATORY AND DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND OUTPATIENT/AMBULATORY PROCEDURES. ALTHOUGH CARE IS RENDERED TO ALL TO THE EXTENT POSSIBLE, MIDDLE AGED TO GERIATRIC PATIENT CARE COMPOSES BOTH THE PRIMARY AND SECONDARY SERVICE AREAS AND OUR PATIENT DEMOGRAPHICS.
PART VI, LINE 3: SIGNS AND BROCHURES ARE LOCATED IN THE REGISTRATION AND MOST OTHER ENTRANCE AREAS. STAFF IN THE ADMISSIONS AND PATIENT REGISTRATION AREA ARE TRAINED TO RECOMMEND THAT PATIENTS MEET OUR PATIENT FINANCIAL COUNSELOR FOR AN APPLICATION AND TO DISCUSS BILLING AND COLLECTION PROCEDURES.
PART VI, LINE 4: SIXTY-FIVE PERCENT OF ADMISSIONS COME FROM 9 CENSUS TRACTS SURROUNDING THE HOSPITAL, THE PRIMARY SERVICE AREA. AN ADDITIONAL EIGHTEEN PERCENT COME FROM 8 CENSUS TRACTS, THE SECONDARY SERVICE AREA, FURTHER, BUT CONTIGUOUS TO THE PRIMARY SERVICE AREA. THE TOTAL SERVICE AREA POPULATION IS 134,000. THE AGES 45-65 COMPOSE 26.5% AND AGE 65+ COMPOSES 15.5% OF THE AREA POPULATION.
PART VI, LINE 5: THE FOUNDATION MAINTAINS A WELLNESS CENTER WHICH HAS THERAPY AND EXERCISE POOLS, WEIGHT ROOM AND GYMNASIUM AREAS, A LAP TRACK, EXERCISE MACHINES AND MEETING ROOMS. WEIGHT-LOSS, NUTRITION COUNSELING, AND CHRONIC CONDITION MANAGEMENT SESSIONS ARE HELD IN THE MEETING ROOMS, AS WELL AS COMMUNITY ORGANIZATION MEETINGS. BLOOD DRIVES ARE REGULARLY SCHEDULED.
PART VI, LINE 6: NOT APPLICABLE
IL	PART VI, LINE 7	REPORTS FILED WITH STATES

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS FOR STUDENTS ENTERING FIELDS OF HEALTHCARE & AG	TypeOfGrant
Number Of Recipients	29	NumberOfRecipients
Amount Of Cash Grant	14293	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: IN KEEPING WITH THE SUPPORT OF EDUCATION OF THE YOUTH IN THE AREA COMMUNITIES, AND ENCOURAGING THEM TO ENTER THE IMPORTANT FIELDS OF HEALTHCARE AND AGRICULTURE, HOPEDALE MEDICAL FOUNDATION AWARDS SCHOLARSHIPS TO HIGH SCHOOL STUDENTS AND COLLEGE FRESHMAN. HOPEDALE MEDICAL FOUNDATION REQUIRES AN APPLICATION FROM STUDENTS FROM QUALIFYING SCHOOLS IN THE LOCAL AREA. SCHOLARSHIPS ARE AWARDED BY AN INDEPENDENT JUDGE BASED ON RECOMMENDATIONS, ACT SCORES, STUDENT NARRATIVE, AND CLASS RANKING. SCHOLARSHIP MONEY IS SENT DIRECTLY TO THE RECIPIENT'S SCHOOL TO ENSURE THE MONEY IS USED TOWARDS TUITION.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 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
MICHAEL J MCLAUGHLIN
DIRECTOR	0	0	0	0	334760	0	0	0	0	0	334760	0	0	0
MARK F ROSSI
CHIEF OPERATING OFFICER	208894	0	0	0	0	0	450	0	6180	0	215524	0	0	0
JOHN ZANON
DIRECTOR OF RETAIL PHARMAC	126200	0	0	0	0	0	3786	0	22391	0	152377	0	0	0
LAWRENCE KLOC
FORMER CHIEF FINANCIAL OFFICER	100563	0	0	0	0	0	3017	0	22391	0	125971	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
VILLAGE OF HOPEDALE
A	376002155	2012-10-16	10000000	CAPITAL IMPROVEMENTS - REFUNDING REVENUE BONDS	0	0	0
VILLAGE OF HOPEDALE
B	376002155	2012-10-31	1000000	CAPITAL IMPROVEMENT REVENUE BONDS	0	0	0
VILLAGE OF HOPEDALE
C	376002155	2012-10-31	2900000	CAPITAL IMPROVEMENT REVENUE BONDS	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Amount UnspentAmountUnspent	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	210630	10000000	199143	329540	4201692	5269626	2014	1	1	1
B	21063	1000000	63812	110876		825312	2014	0	1	1
C		2900000				2900000	2014	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0	0	1
B	0	0	0	0	0	0	1
C	0	0	0	0	0	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
HEARTLAND BANK
A	0	1	0	0	1	1	20.000000000000	0	0	0	0	1
HEARTLAND BANK
B	0	1	0	0	1	1	20.000000000000	0	0	0	0	1
(no name)
C	0	1	0	0	1	0				0	0	1

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	1
B	1
C	1

Schedule L IRS990ScheduleL

Loan Table LoanTable (3 entries)

Relationship With OrganizationRelationshipWithOrganization	Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
MATTHEW B ROSSI MD
SEE BELOW IN PART V	PHYSICIAN RENT RECEIVABLE	X	$36,495	36495	0	1	1
AARON ROSSI
SEE BELOW IN PART V	LOAN TO SUPPORT COMPLETION OF MEDICAL SCHOOL	X	$50,000	50000	0	1	1
PHILLIP ROSSI MD
SEE BELOW IN PART V	PHYSICIAN RENT RECEIVABLE	X	$35,788	35788	0	1	1

Field	Value	IRS element (for citing)
Total Balance Due	122283	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
PHILLIP ROSSI MD
SEE BELOW IN PART V	74448	PHILLIP ROSSI, M.D. RECEIVES COMPENSATION FROM THE HOPEDALE MEDICAL FOUNDATION FOR HIS SERVICES IN THE EMERGENCY ROOM.	0
TRI-COUNTY ANESTHESIA SC
SEE BELOW IN PART V	405400	TRI-COUNTY ANESTHESIA PROVIDES ANESTHESIA SERVICES TO HOPEDALE MEDICAL FOUNDATION.	0
LISA MCLAUGHLIN
SEE BELOW IN PART V	43700	LISA MCLAUGHLIN RECEIVES COMPENSATION FROM THE HOPEDALE MEDICAL FOUNDATION AS A PHARMACY DIRECTOR.	0
CYNTHIA NOREUIL
SEE BELOW IN PART V	56355	CYNTHIA NOREUIL RECEIVES COMPENSATION FROM THE HOPEDALE MEDICAL FOUNDATION AS THE DIRECTOR OF ASSISTED AND INDEPENDENT LIVING.	0
LARRY NOREUIL
SEE BELOW IN PART V	53480	LARRY NOREUIL RECEIVES COMPENSATION AS AN EMPLOYEE OF THE HOPEDALE MEDICAL FOUNDATION.	0
PEGGIE ROSSI
SEE BELOW IN PART V	41511	PEGGIE ROSSI RECEIVES COMPENSATION AS AN EMPLOYEE OF THE HOPEDALE MEDICAL FOUNDATION.	0
LORAYNE ROSSI
SEE BELOW IN PART V	25080	LORAYNE ROSSI RECEIVES MAINTENANCE PAYMENTS FROM THE HOPEDALE MEDICAL FOUNDATION.	0
PHILLIP NOREUIL
SEE BELOW IN PART V	35626	PHILLIP NOREUIL RECEIVES COMPENSATION AS AN EMPLOYEE OF THE HOPEDALE MEDICAL FOUNDATION.	0
MICHAEL J MCLAUGHLIN
SEE BELOW IN PART V	334760	MICHAEL MCLAUGHLIN RECEIVES COMPENSATION AS AN INDEPENDENT CONTRACTOR FOR CONSULTING SERVICES PROVIDED TO THE HOPEDALE MEDICAL FOUNDATION.	0

Form990 Schedule L Part V Form990ScheduleLPartV (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
FORM 990, SCHEDULE L, PART II	RELATIONSHIP WITH ORGANIZATION:	MATTHEW B. ROSSI, M.D. IS THE SECRETARY AND TREASURER OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.AARON ROSSI IS THE SON OF LARRY ROSSI, M.D. LARRY ROSSI, M.D. IS THE BROTHER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS. LARRY ROSSI, M.D. IS ALSO THE OWNER OF TRI-COUNTY ANESTHESIA, S.C., AN ORGANIZATION THAT PROVIDES SERVICES TO THE HOPEDALE MEDICAL FOUNDATION AND IS REPORTED IN PART VII, SECTION B AND SCHEDULE L, PART VI.PHILLIP ROSSI, M.D. IS THE BROTHER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - PHILLIP ROSSI, M.D.	PHILLIP ROSSI, M.D. IS THE BROTHER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - TRI-COUNTY ANESTHESIA, S.C.	LARRY ROSSI, M.D. IS THE BROTHER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS. LARRY ROSSI, M.D. IS THE OWNER OF TRI-COUNTY ANESTHESIA, S.C.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - LISA MCLAUGHLIN	LISA MCLAUGHLIN IS THE SISTER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS. LISA MCLAUGHLIN'S HUSBAND, MICHAEL J. MCLAUGHLIN, IS ALSO A MEMBER OF THE BOARD OF DIRECTORS.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - CYNTHIA, LARRY, AND PHILLIP NOREUIL	CYNTHIA NOREUIL IS THE SISTER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS. LARRY NOREUILL IS CYNTHIA NOREUIL'S HUSBAND, AND PHILLIP NOREUIL IS HER SON.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - PEGGIE ROSSI	PEGGY ROSSI IS THE WIFE OF ALFRED N. ROSSI, M.D., OFFICER OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - LORAYNE ROSSI	LORAYNE ROSSI IS THE MOTHER TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.
FORM 990, SCHEDULE L, PART IV, COLUMN B:	DESCRIPTION OF RELATIONSHIP - MICHAEL J. MCLAUGHLIN	MICHAEL J. MCLAUGHLIN IS THE BROTHER-IN-LAW TO MARK, ALFRED, AND MATTHEW ROSSI, ALL OFFICERS OF THE HOPEDALE MEDICAL FOUNDATION BOARD OF DIRECTORS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	ALFRED ROSSI, DIRECTOR, MATTHEW ROSSI, DIRECTOR, MIKE MCLAUGHLIN, DIRECTOR, AND MARK F. ROSSI, COO ALL HAVE A FAMILY RELATIONSHIP. SEE FURTHER DESCRIPTION REGARDING FAMILY RELATIONSHIPS ON SCH L, PART V. RAY SLACK AND JARIE SLACK HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF HOPEDALE MEDICAL FOUNDATION IS HOPEDALE RURAL HEALTH ASSOCIATION, INC., AN ILLINOIS NOT FOR PROFIT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	DIRECTORS SHALL BE APPOINTED TO THE BOARD BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER FROM AMONG THOSE PERSONS NOMINATED BY THE NOMINATING COMMITTEE OF THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER OF HOPEDALE MEDICAL FOUNDATION, HOPEDALE RURAL HEALTH ASSOCIATION, INC., HAS THE FOLLOWING RIGHTS AND POWERS: A. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS OF THE FOUNDATION; B. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR, VICE CHAIR, PRESIDENT AND OTHER OFFICERS OF THE FOUNDATION; C. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, THE AUDITORS OF THE FOUNDATION; D. TO APPROVE ANY CHANGES TO THE GOVERNANCE DOCUMENTS OF THE FOUNDATION; E. TO APPROVE THE MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, CORPORATE REORGANIZATION OR DISSOLUTION OF THE FOUNDATION; F. TO APPROVE THE CREATION OF NEW SUBSIDIARIES OR AFFILIATES BY THE FOUNDATION; G. TO APPROVE THE STRATEGIC AND FINANCIAL PLANS AND THE CAPITAL AND OPERATING BUDGETS OF THE FOUNDATION; H. TO APPROVE DEBT INCURRED BY THE FOUNDATION IN EXCESS OF $500,000; I. TO APPROVE THE PURCHASE, SALE, LEASE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF ASSETS IN EXCESS OF $150,000; J. TO APPROVE ALL NON-BUDGETED DEBT OR TRANSFERS OF ASSETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE SOLE MEMBER; K. TO APPROVE THE MANAGED CARE POLICY OF THE FOUNDATION; AND L. TO APPROVE THE FILING OF THE BANKRUPTCY BY THE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11	THE ORGANIZATION'S CONTROLLER REVIEWS THE FORM 990 WITH EXTERNAL ACCOUNTANTS. THE BOARD IS THEN PROVIDED A FINAL COPY OF THE FORM 990 BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL CORPORATE OFFICERS, AGENTS AND EMPLOYEES OF THE FOUNDATION, INCLUDING INDEPENDENT CONTRACTORS, PROVIDERS OF SERVICES AND MATERIALS. AN ANNUAL DISCLOSURE STATEMENT IS COMPLETED BY ALL PERSONS TO WHOM THE CONFLICT OF INTEREST POLICY APPLIES TO ASSIST THEM IN CONSIDERING ALL REAL AND APPARENT CONFLICTS OR DUALITIES IN CONNECTION WITH THE FOUNDATION'S ACTIVITIES. DISCLOSURE IS ALSO REQUIRED WHENEVER CONFLICTS ARISE. THE WRITTEN DISCLOSURE NOTICES OF CONFLICTS ARE FILED WITH THE PRESIDENT OF THE FOUNDATION OR ANY OTHER PERSON DESIGNATED BY THE PRESIDENT. ALL DISCLOSURE NOTICES ARE NOTED FOR RECORD IN THE MINUTES OF A MEETING OF THE BOARD OF DIRECTORS. WHEN OFFICERS, DIRECTORS, EMPLOYEES OR AGENTS BELIEVE THEY HAVE A REAL OR APPARENT CONFLICT, THEY ABSTAIN FROM MAKING MOTIONS, VOTING, EXECUTING AGREEMENT OR TAKING ANY OTHER SIMILAR DIRECT ACTION ON BEHALF OF THE FOUNDATION. THEY ARE NOT PRECLUDED FROM DEBATE OR OTHER SIMILAR INVOLVEMENT ON BEHALF OF THE FOUNDATION. ANY VIOLATION OF THE DUTY OF THE DISCLOSURE BY DIRECTORS OR OFFICERS OF THE FOUNDATION IS GROUNDS FOR REMOVAL FROM THE OFFICE.
FORM 990, PART VI, SECTION B, LINE 15A	THE COO'S COMPENSATION IS REVEIWED AND APPROVED BY THE COMPENSATION COMMITTEE. THE MEMBERS OF THE ENTIRE GOVERNING BODY MAKE UP THE COMPENSATION COMMITTEE. THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO GATHER COMPARABILITY DATA AND PROVIDE ADDITIONAL ANALYSIS. THE COMPENSATION COMMITTEE DOCUMENTS ITS DELIBERATIONS IN THE GOVERNING BOARD MINUTES AND ESTABLISHES A WRITTEN CONTRACT. THIS PROCESS TAKES PLACE ANNUALLY. THE HR DIRECTOR OVERSEES THE SALARY PROGRAM FOR ALL OTHER EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VII	THE BOARD OF DIRECTORS ARE NOT COMPENSATED FOR THEIR SERVICES AS THE BOARD OF DIRECTORS. COMPENSATION REPORTED TO BOARD MEMBERS ON PART VII IS RELATED TO COMPENSATION FOR SERVICES AS EMPLOYEES AND ER PHYSICIANS. AVERAGE HOURS PER WEEK REPORTED FOR EACH BOARD MEMBER IS AN ESTIMATE OF TIME SPENT SOLELY ON BOARD OF DIRECTOR DUTIES.	VOLUNTEER BOARD OF DIRECTORS:
FORM 990, PART XI, LINE 9:	ASSETS TRANSFERRED FROM PRAIRIE HEALTH SERVICES, INC UPON MERGER 55,494.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:	THERE WERE NO CHANGES IN THE PROCESS DURING THE YEAR.	FINANCIAL STATEMENTS AUDIT OVERSIGHT:
FORM 990, PART I, LINE 6:	VOLUNTEERS CONTRIBUTE BY WORKING IN THE GIFT SHOP, TRANSPORTING PATIENTS AND RESIDENTS OF THE COMPLEX TO/FROM APPOINTMENTS AND ASSIST WITH RESIDENT ACTIVITIES IN THE NURSING HOME AND ASSISTED LIVING FACILITY.	VOLUNTEERS:
FORM 990, PART VII, SECTION A, LINE 1A & SCHEDULE J, PART II, LINE 1	MICHAEL J. MCLAUGHLIN RECEIVED COMPENSATION FROM THE HOPEDALE MEDICAL FOUNDATION FOR CONSULTING SERVICES PROVIDED TO THE ORGANIZATION. THIS COMPENSATION IS REPORTED TO HIM ON IRS FORM 1099-MISC, AND THE AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION ON FORM 990, PART VII, SECTION A, LINE 1, COLUMN D AND SCHEDULE J, PART II, LINE 1, COLUMN B(III).	EXPLANATION OF COMPENSATION - MICHAEL J. MCLAUGHLIN

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	MISS MONA'S LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	107 TREMONT STREET	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Field	Value	IRS element (for citing)
Primary Activities	DAY CARE	PrimaryActivities
Legal Domicile State	IL	LegalDomicileState
Total Income	131970	TotalIncome
EOY Assets	28976	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HOPEDALE REAL ESTATE SERVICES INC	BusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (2 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	Direct Controlling Entity NADirectControllingEntityNA
PRAIRIE HEALTH SERVICES INC
PO BOX 267	HOPEDALE	IL	61747	371390103	PROMOTE PUBLIC HEALTH AND WELFARE	IL	501(C)(3)	PF	HOPEDALE RURAL HEALTH ASSOCIATION INC	1
HOPEDALE RURAL ASOCIATION INC
PO BOX 267	HOPEDALE	IL	61747	391930105	SUPPORT HEALTHCARE, EDUCATION AND RESEARCH	IL	501(C)(3)	PF		0	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	HOPEDALE REAL ESTATE SERVICES INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	107 TREMONT STREET	AddressLine1
City	HOPEDALE	City
State	IL	State
ZIP Code	61747	ZIPCode

Field	Value	IRS element (for citing)
EIN	371406582	EIN
Primary Activity	PROPERTY RENTAL	PrimaryActivity
Legal Domicile State	IL	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C	TypeOfEntity
Controlled Org	1	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
HOPEDALE REAL ESTATE SERVICES INC
B	60000	FAIR MARKET VALUE
HOPEDALE RURAL HEALTH ASSOCIATION INC
S	15916601	FAIR MARKET VALUE
PRAIRIE HELATH SERVICES INC
S	55494	FAIR MARKET VALUE

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Return Reference	PART V, LINE 2:	ReturnReference
Explanation	EFFECTIVE JUNE 25, 2013, HOPEDALE RURAL HEALTH ASSOCIATION, INC. (HEALTH ASSOCIATION) AND PRAIRIE HEALTH SERVICES, INC. (PHS) EACH MERGED INTO THE HOPEDALE MEDICAL FOUNDATION (FOUNDATION) AND THEN THE HEALTH ASSOCIATION AND PHS DISSOLVED, AT WHICH TIME HOPEDALE REAL ESTATE SERVICES, INC. (HRES) BECAME A WHOLLY-OWNED SUBSIDIARY OF THE FOUNDATION. AS OF JUNE 30, 2013, THE ORGANIZATION CONSISTS OF THE FOUNDATION AND ITS WHOLLY-OWNED SUBSIDIARY, HRES.	Explanation