2014-08-13T09:45:07-07:00 2013-09-30 Gray Hunter Stenn LLP 500 Maine Street Quincy IL 62301 990 2012-10-01 370661183 BLESSING HOSPITAL BLES 2172231200 1005 BROADWAY QUINCY IL 62301 MAUREEN KAHN 2014-08-13 true STEPHEN C KOESTER CPA P00342386 2172220304 2012 2015-11-30 17:44:51Z 410068489 false false X www.blessinghealthsystem.org X 1875 IL Blessing Hospital's mission is to provide high quality, accessible health care showing compassion and respect to those we serve. 14 9 2711 801 1299297 -487556 5379936 7812497 294475665 305258022 3199876 4261487 9738053 8923758 312793530 326255764 1467722 2040637 0 139042142 145307757 0 0 138158415 137329435 278668279 284677829 34125251 41577935 363145586 382927402 214615775 181540921 148529811 201386481 Blessing Hospital's mission is to provide high quality, accessible health care showing compassion and respect to those we serve. false false 225040705 2040637 326890828 SINCE IT WAS FOUNDED IN 1875, Blessing Hospital HAS PROVIDED quality health care services to ALL patients regardless of race, sex, national origin, age or ability to pay. In serving all members of its community, Blessing Hospital CONTINUES THIS TRADITION BY PROVIDING free/subsidized care, care to persons covered by governmental programs at less than full charges, and community health/education/wellness programs. For fiscal year 2013, the cost of charity care provided was $8,097,468. Medicare and Medicaid shortfalls were $38,645,122 and $2,076,264, respectively. Blessing Hospital serviced 13,322 inpatients and 65,925 emergency department patients. Outpatient services included 327,402 laboratory exams and 80,477 radiology procedures.Blessing Hospital provided ADDITIONAL benefits of $10,137,436 to the community DURING FISCAL YEAR 2013 as follows:Health Professionals Education SIU Residency Program $2,835,946 Blessing-Rieman College of Nursing $1,707,602 NURSING EDUCATIONAL PreceptorS $ 711,549 SCHOOL OF RADIOLOGIC TECHNOLOGY $ 250,447 SCHOOL OF MEDICAL LABORATORY TECHNICIANS $ 96,962 SUB Total Health Professionals education $5,602,506Community Health Improvement Services COMMUNITY OUTREACH CLINIC $ 831,258 SIU PATIENT CENTERED MEDICAL HOME $ 213,750 ADAMS COUNTY HEALTH DEPARTMENT DENTAL PROGRAM $ 70,000 Health Screenings/Tests $ 39,063 Educational Programs $ 63,703 Patient Transportation $ 52,729 CHARITY PHARMACY PRESCRIPTIONS $ 16,862 Medical Supplies/Services for Patients $ 48,826 MEDICAL INTERPRETING SERVICES $ 4,985 SUB Total community health improvement serviceS $1,408,681Subsidized Health Services Home Healthcare SERVICES $1,229,800 CARE COORDINATION $1,053,136 HOSPICE $ 182,277 BLESSING FAST CARE $ 300,854 SUB TOTAL SUBSIDIZED HEALTH SERVICES $2,766,067In-Kind Contributions/Donations Donations/Sponsorships $ 143,393 MEETING SPACE $ 77,064 Adams County Ambulance Service $ 70,775 COMMUNITY OUTREACH CLINIC $ 68,950 SUB Total in-kind contributions/donations $ 360,182 225040705 true true false false false false false false false true true true false true true false true true false false false false false false false false true true true true true true false false false false false false false false false true false false false false false true false false false false true 182 0 true 2711 true true false false false false false false 0 false false false false false false false false false false X 14 9 false true false false true true true true true false true true true true true true true true true true true true IL X TIMOTHY MOORE 2172238400 BROADWAY AT 11TH PO BOX 7005 QUINCY IL 62305 HARRY RUTH MD 1.00 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4000 CATAMARAN CT QUINCY IL 62301 PATHOLOGY SERVICES 2328703 QUINCY ANESTHESIA ASSOCIATES PC BROADWAY AT 11TH QUINCY IL 62301 ANESTHESIA SERVICES 8322431 DELOITTE CONSULTING LLP PO BOX 7247-6447 PHILADELPHIA PA 191706447 CONSULTING SERVICES 2996343 CHRISTNER INC PO BOX 790379 ST LOUIS MO 63179 ENGINEERING SERVICES 1875923 ALLSCRIPTS HEALTHCARE PO BOX 8538-0133 PHILADELPHIA PA 191710133 INFORMATION TECHNLGY 2195174 50 5151114 1236696 1424687 7812497 PHYSICAL THERAPY 621400 371581 371581 PATIENT REVENUE 621110 776194891 776194891 LESS: CONTRACT ALLOW 621110 -443396401 -443396401 LESS: CHARITY CARE 621110 -31262535 -31262535 COLLEGE OF NURSING 611600 3350486 3350486 305258022 1774399 1774399 0 0 1019450 1019450 1019450 1019450 85664749 83177661 2487088 2487088 2487088 0 0 1934361 635064 1299297 1299297 SALE OF FOOD 722210 1412433 1412433 OTHER 900099 2825783 2825783 CHILD CARE CENTER 624410 1482188 1482188 884607 884607 6605011 326255764 304394624 1299297 12749346 1705372 1705372 335265 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2235047 9043688 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1844729 -36194 1808535 560920 60036 1223773 1844729 568392 -5502 1970 560920 555077 14824 1509 568392 80883 15464 555077 555077 0.93850 0.06150 false true true 12869734 12869734 141448769 90118719 51330050 6558947 4640555 1918392 174775235 109541458 65233777 131351953 28424253 OTHER RECEIVABLES 4821704 INTEREST RECEIVABLE 155106 INTEREST IN NET ASSETS OF FOUNDATION 4602273 INSURANCE RECOVERY RECEIVABLE 2192951 GOODWILL 9332371 21104405 PREMIUM ON LONG TERM DEBT 556905 OTHER LONG TERM LIABILITY 6863928 MOB III BUILD OUT 1967081 MOB CARDIO REHAB LEASE 118427 MOB BLOOD DRAW LEASE 112950 MAMMOGRAPHY FURNITURE LEASE 26552 HILL-ROM LEASE 129447 ESTIMATED 3RD-PARTY PAYOR SETTLEMENTS 9695878 DEFERRED COMPENSATION 4865933 DA VINCI ROBOT LEASE 538528 CATH LAB 1 192075 ADVANCES AND DEFERRED REVENUE 2213793 ACCRUED SALARIES & WAGES 16903776 ACCRUED PENSION COSTS 29461602 ACCRUED PAYROLL TAXES 536378 ACCRUED INTEREST 657529 74840782 294422204 -20361208 -20361208 314783412 11472352 11472352 326255764 263811781 2331072 2331072 261480709 461387 22735733 23197120 284677829 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S BAD DEBT REDUCTION OF REVENUE ON F/S $22735733 Part XII, Line 2d Part XII, Line 2d: Other expenses and losses per audited F/S LIABILITY CLAIMS RPTD ON SEPARATE 990 $1696008 COGS INCLUDED IN EXPENSES ON F/S $635064 Part XI, Line 4b Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S COGS INCLUDED IN EXPENSES ON F/S $635064 TEMPORARILY RESTRICTED CONTRIBUTIONS $6575801 PERMANENTLY RESRTICTED CONTRIBUTIONS $0 INVESTMENT INCOME $1774399 REALIZED GAINS ON SECURITIES AND ASSETS $2487088 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. ENDOWMENT FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT AND OPERATIONS OF BLESSING HOSPITAL. true true X true X 250.000000000 true X true true false false true true 8097468 8097468 0.03090 39074467 36998203 2076264 0.00790 47171935 36998203 10173732 0.03880 1408681 5991 1402690 0.00540 5602506 5602506 0.02140 15519660 12753593 2766067 0.01050 360182 360182 0.00140 22891029 12759584 10131445 0.03870 70062964 49757787 20305177 0.07750 80928 80928 0.00030 80928 80928 0.00030 true 22735733 1061759 89707277 98564946 -8857669 X true false LINCOLN LAND HEALTH EXCHNGE INFORMATION EXCHANGE 0.27000 ADVANCE LLC PHYSICAL THERAPY SERVICES 0.17000 2 2 BLESSING HOSPITAL AT 14TH ST

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PHARMACY WITHIN RURAL HEALTH CLINIC EAST ADAMS COUNTY RURAL HEALTH CLINIC

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RURAL HEALTH CLINIC BLESSING HOSPICE - PIKE COUNTY

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FULL HOSPICE PROGRAM IN ILLINOIS BLESSING HOSPICE & PALLIATIVE CARE

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HOME HEALTH AGENCY IN MISSOURI BLESSING HOME CARE

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HOME HEALTH AGENCY IN ILLINOIS BLESSING AMBULATORY SURGERY CENTER

1118 HAMPSHIRE STREET QUINCY IL 62301

AMBULATORY SURGICAL TREATMENT CENTER Part VI - Additional Information BLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PRESENTED TO THE COMMUNITY AS A SUPPLEMENT IN THE QUINCY HERALD-WHIG ONCE A YEAR. IT IS ALSO PLACED IN LITERATURE RACKS AROUND THE HOSPITAL CAMPUS. ILLINOIS IS THE ONLY STATE IN WHICH THE COMMUNITY BENEFIT REPORT IS PUBLISHED. Part V - Explanation of Number of Facility Type BLESSING HOSPITAL OPERATES NO FACILITIES OTHER THAN THE LOCATIONS LISTED IN PART V. Part VI - States Where Community Benefit Report Filed IL Part VI - Affilated Health Care System Roles and Promotion Blessing Corporate Services, Inc. is the parent organization of a group of related organizations and provides overall direction to all entities within the structure. During the year ended September 30, 2005, Blessing Corporate Services, Inc. began operating a division comprised of practicing physicians. The Group is related through Board control. The following is a brief description of each member of the Group.Organization - Blessing Hospital (Hospital), located in Quincy, Illinois, is a not-for-profit acute care hospital. The Hospital provides inpatient, outpatient and emergency care services for residents of Western Illinois and Northeastern Missouri. The Hospital was incorporated in Illinois in 1875.Organization - The Blessing Foundation, Inc. serves Blessing Corporate Services and its affiliated entities by providing financial support for services and programs promoting the improvement and availability of healthcare services within the general community.Organization - Denman Services, Inc. (a taxable corporation) engages primarily in the business of selling and renting medical equipment and operating a commercial laundry. Denman Services, Inc. is a wholly owned subsidiary of Blessing Corporate Services, Inc.Organization - BlessingCare Corporation dba Illini Community Hospital and Subsidiary, located in Pittsfield, Illinois, is a not-for-profit acute care hospital. The Hospital provides inpatient, outpatient and emergency care services for residents of Western Illinois. The Hospital was incorporated on January 20, 2000. For financial reporting purposes, the Hospital's financial information is consolidated with West Central Illinois Therapy & Sports Medicine, LLC. The Hospital has a 51% partnership interest in West Central Illinois Therapy & Sports Medicine, LLC, and the outside investor's 49% interest in the partnership is included as a minority interest. THIS PARTNERSHIP WAS DISSOLVED IN FY2013.Organization - Illini Health Services, LLC conducts a pharmacy business in Pittsfield, Illinois. The Pharmacy is owned ninety-five percent (95%) by Denman Services, Inc. and five percent (5%) by BlessingCare Corporation dba Illini Community Hospital. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose Blessing Hospital offers a wide range of specialty services important to promoting the health and well-being of Adams County and the surrounding area. Included in these are the Cancer Center, the Heart and Vascular Center, the Breast Center, psychiatric services, and Hospice and Home Care programs. Surplus funds generated from these operations, as well as the operations of all other Blessing Hospital Services, are used to fund capital expenditures and the expansion of health care service lines to the community we serve. Blessing Hospital operates an emergency room available to all regardless of the ability to pay. The financial assistance policy of Blessing Hospital enables patients to have access to area resources to assist them with payment of medical expenses. Blessing Hospital operates the Blessing-Rieman College of Nursing, which offers a Bachelor of Science in Nursing degree and a Master of Science in Nursing degree, along with other programs. The college has a 100 year history in the community and is currently accredited by the Higher Learning Commission.Blessing Hospital is the largest employer in the area with 2,277 employees. Of significant importance are the volunteers who serve the Hospital. In Fiscal Year 2013, Blessing Hospital had 801 active volunteers who served for a total of 74,301 hours. In addition to the volunteers actively working in the hospital, Blessing's Board of Trustees is comprised of volunteers that include business leaders, physicians, and other community leaders. Part VI - Community Building Activities IN PARTNERSHIP WITH THE ALLIANCE FOR BUILDING COMMUNITY, BLESSING HOSPITAL PROVIDES FUNDS TO PAY FOR THE POSITION OF THE DIRECTOR OF COMMUNITY IMPACT, A KEY INDIVIDUAL IN THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. Part VI - Community Information For 137 years, Blessing Hospital has served the health care needs of the people of west central Illinois, northeast Missouri and southeast Iowa. Approximately 227,000 people live within a 50 mile radius of Blessing Hospital. The Hospital's primary market area covers six counties-four in west central Illinois (Adams, Brown, Hancock and Pike) and two in northeast Missouri (Marion and Lewis). The region's economy is heavily agricultural, with a mix of approximately 100 manufacturers in addition to commercial/retail business making up the rest of the local economy. Blessing Hospital is the largest employer in its region. Quincy, ILLINOIS - the city in which the main Blessing Hospital campus is located - is the hub of non-farm employment and retail trade in the market area. THE PERCENTAGE OF TOTAL POPULATION IN POVERTY IN BLESSING'S PRIMARY MARKET AREA COUNTIES ARE: PIKE, IL - 16.1%; ADAMS, IL - 12.4%; BROWN, IL - 16.3%; AND HANCOCK, IL - 13.1%. IN MISSOURI, LEWIS - 16.1% AND MARION - 17.5%.ACROSS THE SIX COUNTIES IN BLESSING'S PRIMARY MARKET AREA, THE AVERAGE ADULT OBESITY IS FIVE PERCENT HIGHER THAN THE NATIONAL AVERAGE. THE PERCENTAGE OF CHILDREN LIVING IN POVERTY RANGED FROM 16% TO 25% ACROSS THE PRIMARY MARKET AREA AND THE AVERAGE PERCENTAGE OF PEOPLE 65 YEARS AND OLDER IS NEARLY FIVE PERCENT HIGHER THAN THE ILLINOIS AVERAGE AND ONE AND A HALF TIMES HIGHER THAN THE MISSOURI AVERAGE. Part VI - Patient Education of Eligibility for Assistance All Blessing Hospital self-pay inpatients are contacted by a Financial Account Specialist (FAS) within 24 hours of admission. The patient is screened for government programs or eligibility for participation in our Community Outreach Clinic or Access Health Adams County. Outpatients are contacted once the patient's condition has been stabilized and are screened in the same manner as inpatients. If a FAS is not available to meet with a patient at an appropriate time, the patient is given contact information and asked to call if assistance is needed. Part VI - Needs Assessment Blessing Hospital HAS workED in partnership with the community public health department, the local United Way agency and other area agencies in conducting a needs assessment. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN MAY 2012. Number of Hospital Faciltiy - 1 Part V, Line 14g - Other Means Hospital Facility Publicized the Policy THE BILLING INVOICE INCLUDES A STATEMENT INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHO TO CONTACT IN THE ORGANIZATION. Number of Hospital Faciltiy - 1 Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why THE FOLLOWING NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA WERE NOT ADDRESSED BY BLESSING HOSPITAL BECAUSE THEY ARE BEING ADDRESSED BY OTHER PARTNER ORGANIZATIONS:1) SUBSTANCE ABUSE2) NUTRITION & WEIGHT STATUS AND PHYSICAL ACTIVITY3) MATERNAL, INFANT & CHILD HEALTH4) ENVIRONMENTAL HEALTH Number of Hospital Faciltiy - 1 Part V, Line 1j - Description of Other Needs Assessment OTHER INFORMATION DESCRIBED IN BLESSING HOSPITAL'S CHNA REPORT IS AS FOLLOWS:1) THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING & PARTNERSHIPS) TO GUIDE COMMUNITY PLANNING EFFORTS.2) THE RELATIONSHIP OF THE ALLIANCE FOR BUILDING COMMUNITY TO OTHER EFFORTS TO CREATE THE ADAMS COUNTY PLAN.3) THE ALIGNMENT OF BLESSING HOSPITAL WITH THE ALLIANCE FOR BUILDING COMMUNITY TO PROVIDE REPRESENTATION AND RESOURCES TO CONTINUE THE EFFORTS OF IDENTIFYING SPECIFIC OBJECTIVES TOWARD WHICH OUR COMMUNITY WILL WORK IN THE COMING YEARS.4) PLANS FOR LEADERSHIP & SOLUTIONS OF CURRENT AND FUTURE COMMUNITY HEALTH NEEDS. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Collection practices are not pursued if a completed financial assistance application has been returned and approved. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The hospital uses a cost-to-charge ratio to calculate cost amounts. This ratio is computed using Blessing Hospital's as-filed Medicare cost report. These costs and charges are adjusted to account for items not reimbursed through the cost report such as provider-based physician services. IRS Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospital's states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating medicare patients is a community benefit. Part III, Line 4 - Bad Debt Expense SEE NOTE (3) ON PAGES 11 AND 12 OF THE HOSPITAL'S ATTACHED FINANCIAL STATEMENTS. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit A number of patients are truly unable to pay for their medical expenditures but do not complete the process required to apply for financial assistance. THE HOSPITAL USES FINANCIAL AND OTHER INFORMATION OF SUCH PATIENTS OTHERWISE AVAILABLE TO THE HOSPITAL TO IDENTIFY THOSE patients THAT would qualify for charity care if they completed the paperwork. THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES THE PERCENTAGE OF THE BAD DEBT EXPENSE THAT IS EVENTUALLY REVERSED DUE TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE. THE HOSPITAL APPLIES THAT PERCENTAGE TO THE BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE THAT WILL BE FOUND TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. The bad debt expense associated with SUCH PATIENTS' ACCOUNTS ARE treated as community benefit. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Bad debt expense is calculated on the net patient account balance after the balance has been reduced for any payments received or discounts/adjustments that are known. Patients qualifying for financial assistance are recognized as charity care accounts when sufficient information is received to determine their eligibility. Prior to this point, an allowance for doubtful accounts is calculated on uninsured accounts. This allowance is reversed if the account is determined to qualify for financial assistance. Part I, Line 7g - Costs Associated With Physicans Clinics BLESSING HOSPITAL DOES NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. Part I, Line 7, Column F - Explanation of Bad Debt Expense BAD DEBT EXPENSE OF $22,735,733 IS SUBTRACTED FROM TOTAL EXPENSES OF $284,677,829 REPORTED ON LINE 25, COLUMN A OF FORM 990, PART IX,FOR A NET TOTAL EXPENSE OF $261,942,096. Part I, Line 7 - Explanation of Costing Methodology WHEN POSSIBLE, CALCULATIONS OF DIRECT AND INDIRECT COSTS ASSOCIATED WITH THE SERVICES PROVIDED ARE REPORTED. IF NOT AVAILABLE, A COST-TO-CHARGE RATIO IS USED TO CALCULATE THE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES. Part I, Line 6a - Related Organization Community Benefit Report BLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PREPARED BY BLESSING HOSPITAL, NOT A RELATED ORGANIZATION. true SIU SCHOOL OF MEDICINE PO BOX 19607 327 W CALHOUN STREET SPRINGFIELD IL 62794 376005961 1705372 0 BOOK MEDICAL EDUCATION & RESEARCH AT SIU 1 0 GRANTS TO STUDENTS AT BLESSING-RIEMAN COLLEGE OF NURSING 128 335265 BOOK Additional Supplemental Information PART I, LINE 2SIU SCHOOL OF MEDICINESIU PROVIDES THE HOSPITAL BOARD OF TRUSTEES WITH AN ANNUAL UPDATE REGARDING THEIR USE OF THE GRANT FUNDS PROVIDED TO THEIR PROGRAM.Blessing-Rieman College of NursingBlessing-Rieman College of Nursing requires a financial aid application upon admittance, has academic performance and financial need criteria, and has a selection committee that awards grants. The College monitors and reviews the recipients individually on a semester basis for satisfactory academic progress and good standing. X X X X false true false false false false false false false false TIMOTHY A MOORE 151273 41103 33698 69006 14871 309951 THOMAS A CLIATT DO 326957 212642 26844 41565 18682 626690 STUART L PYATT DO 337753 318104 20626 47485 19616 743584 RICHARD A SAALBORN DO 510960 106094 27020 61740 14076 719890 PATRICK M GERVELER 268164 81817 39091 44614 15129 448815 MAUREEN A KAHN 340887 107398 24549 54716 14780 542330 JILL MASON 186860 42934 7794 136901 7593 382082 JAMES B KASE MD 543919 27000 11578 4940 18682 606119 GEORGE E LIESMANN 161146 10000 3193 5955 180294 B BRADFORD BILLINGS 435328 345933 40179 462674 14428 1298542 193647 ANTONY S WOLLASTON MD 339562 205649 19965 4403 18682 588261 ABBY REICH MD 170032 5258 1825 15129 192244 C CITY OF QUINCY ADAMS CNTY 376000378 2012-08-01 30000000 SCHEDULE O false false false B CITY OF QUINCY ADAMS CNTY 376000378 2012-08-01 32785000 SCHEDULE O false false false A CITY OF QUINCY ADAMS CNTY 376000378 748476BN7 2007-05-03 48850181 SCHEDULE O false false false C 2845000 164582 2676914 3504 false false false true B 32785000 164582 32620418 2012 true false true true A 13175000 48853595 570296 48853595 2009 true true true true C false false false false false true false true B false false false false false true false true A false false false false false 0.02900 0.02900 true false true C false true false false false false false true B false false true false false false false true A false false true false false false false true C true B true A true Supplemental Information Part VI PART II, LINE 3, BOND C - PROCEEDS ARE BEING DRAWN AS CONSTRUCTION PROGRESSES AND THUS TOTAL PROCEEDS DIFFER FROM THE ISSUE PRICE. KLINGNER AND ASSOCIATES SEE PART V 137305 ENGINEERING SERVICES false BOARD TRUSTEE, MICHAEL KLINGNER, IS PRESIDENT OF ENTITY WITH WHICH BUSINESS TRANSACTIONS WERE CONDUCTED. SCHEDULE K, PART II, LINE 12 - OTHER UNSPENT PROCEEDS OTHER UNSPENT PROCEEDS ARE IN THE ADVANCE FUND. SCHEDULE K, PART I, (f) DESC. OF PURPOSE A - USED TO (i) CURRENTLY REFUND ALL OF THE OUTSTANDING CITY OF QUINCY, ADAMS COUNTY, ILLINOIS REVENUE BONDS, SERIES 1993 (BLESSING HOSPITAL)(THE "SERIES 1993 BONDS"), (ii) ADVANCE REFUND ALL OF THE OUTSTANDING ILLINOIS HEALTH FACILITIES AUTHORITY REVENUE BONDS, SERIES 1999A (BLESSING HOSPITAL)(THE "SERIES 1999A BONDS") AND (iii) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2007 BONDS AND THE REFUNDING OF THE SERIES 1993 BONDS AND THE SERIES 1999A BONDS.B - USED TO (i) REFUND THE OUTSTANDING VARIABLE RATE DEMAND REVENUE REFUNDING BONDS, SERIES 2008 (BLESSING HOSPITAL)(THE "SERIES 2008 BONDS")AND(ii) REFUND THE OUTSTANDING ADJUSTABLE RATE DEMAND REVENUE BONDS, SERIES 2004 (BLESSING HOSPITAL PROJECT)(THE "SERIES 2004 BONDS").C - TO REIMBURSE FOR THE COSTS OF THE PROJECT AND TO PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2012B BONDS. THE PROJECT CONSISTS OF THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF AN APPROXIMATELY 172,755 SQUARE FOOT PATIENT CARE ADDITION LOCATED ON THE MAIN CAMPUS AT BROADWAY AND 11TH STREETS IN QUINCY, ILLINOIS. Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases TRANSFERS TO SITF = -$11650000 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Decreases TRANSFERS TO AFFILIATES = -$13042828 Form 990, Part XI, Line 9 Other Changes In Net Assets Or Fund Balances - Other Increases DECREASE IN MINIMUM PENSION LIABILITY = $33736516 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available These forms are located in the corporate administrative offices and are available upon request for public inspection. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees TIMOTHY A. MOORE - CAO AND secretary of blessing hospital - No compensation IS RECEIVED FOR POSITION as Secretary OF BLESSING HOSPITAL. ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.JILL K. MASON - cno OF BLESSING HOSPITAL - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.GEORGE E. LIESMAN - CMO OF BLESSING HOSPITAL - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL. Form 990, Part VI, Line 15a Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management MAUREEN A. KAHN - president and ceo of blessing hospital - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE NO CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING. Form 990, Part VI, Line 11b Form 990, Part VI, Line 11b: Form 990 Review Process FOLLOWING MANAGEMENT AND LEGAL REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders BLESSING CORPORATE SERVICES SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO (b)appoint the corporation's president and nominate all candidates to serveas directors of Quincy Health Care Management, Inc., (c) approveexpressly all amendments to the corporation's articles of incorporationand bylaws before they may become effective, (d) approve long-term debt,long-range plans and capital and operating budgets, (e) approve thepurchase and sale of real and personal property and contracts enteredinto by the corporation, not expressly made part of an approved budget,the reasonable value of which exceeds an amount set forth in the bylawsof the member, (f) approval of material investment decisions,including without limitation establishment and modification ofinvestment policies, engagement and removal of investment managers andadvisors, and changes in investment allocations not permitted by anexisting investment policy, (g) approval of the parameters for terms of employment of physicians, including physician compensation plans, and any material variances from such parameters for individual physicians, (h) approval of the selection of auditors and legal counsel, (i) approval of charity care and community benefits-related policies, (j) approval of the formation of subsidiary entities and/or joint ventures, (k) approval of the filing of a petition in bankruptcy, making and assignment for the benefit of creditors, or applying for protection under any insolvency laws, (l) approval of the participation in any merger, combination, consolidation, liquidation, dissolution or other corporate or business entity restructuring, and (m) the power to compel the corporation to enforce and/or perform any contractual obligation. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body BLESSING CORPORATE SERVICES SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO (A) Appoint and/or remove all the trustees of the corporation. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder BLESSING CORPORATE SERVICES, INC. IS THE SOLE VOTING MEMBER OF BLESSING HOSPITAL. Form 990, Part VI, Line 3 Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company 1) BLESSING CORPORATE SERVICES PROVIDES GENERAL MANAGEMENT SERVICES.2) NATIONAL HEALING PROVIDES MANAGEMENT SERVICES FOR THE WOUND CARE DEPARTMENT WHICH INCLUDES HYPERBARIC SERVICES.3) QUINCY MEDICAL GROUP PROVIDES MANAGEMENT OF THE SURGERY CENTER OF QUINCY.4) ARAMARK PROVIDES MANAGEMENT OF FOOD SERVICES AND STERILE PROCESSING.5) BRIDGE HOME CARE PARTNERS PROVIDES MANAGEMENT OF BLESSING'S HOME CARE SERVICES. BLESSING AFFILIATES INC BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 371128708 CURRENTLY INACTIVE IL 501(C)(3) 9 BCS INC false BLESSING VOLUNTEERS IN PARTNERSHIP BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 237160187 PROVIDE SUPPORT FOR BLESSING HOSPITAL IL 501(C)(3) 11B NA false BLESSINGCARE CORPORATION - MISSOURI 1005 BROADWAY QUINCY IL 62301 431371818 CURRENTLY INACTIVE MO 501(C)(3) 3 BCS INC false BLESSING HOSPITAL SELF-INSURANCE PLAN BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 371045366 PROVIDE SUPPORT FOR MEDICAL LIABILITY CLAIMS IL 501(C)(3) 11A BCS INC false BLESSINGCARE CORP DBA ILLINI COMM HOSP 640 WEST WASHINGTON PITTSFIELD IL 62363 371396010 PROVIDE HEALTHCARE IL 501(C)(3) 3 BCS INC false THE BLESSING FOUNDATION BROADWAY AT 11TH POBOX 7005 QUINCY IL 623057005 371128705 FUNDRAISING & GRANT-MAKING IL 501(C)(3) 11B BCS INC false BLESSING CORPORATE SERVICES BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 371128706 PROVIDE DIRECTION AND CONTROL TO ENTITIES IL 501(C)(3) 9 BCS INC false ILLINI HEALTH SERVICES LLC PO BOX 40 QUINCY IL 623060040 470901851 PHARMACY IL DENMAN N/A false false DENMAN SERVICES INC BROADWAY AT 14TH STREET QUINCY IL 62306 371132117 MED. EQUIP. IL BCS INC C CORP false false true true false false false false false false true true true true true true true true true false