MARSHALL BROWNING HOSPITAL ASSOCIATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MARSHALL BROWNING HOSPITAL ASSOCIATION (EIN 37-0661218)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2014-12-19
- IRS object ID
- 201423539349300417
- Schema version
- 2013v3.1
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-12-19T10:16:02-06:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 430352985 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KERBER ECK & BRAECKEL LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1116 W MAIN ST | AddressLine1 |
| City | CARBONDALE | City |
| State | IL | State |
| ZIP Code | 629012335 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370661218 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL BROWNING HOSPITAL | BusinessNameLine1 |
| Business Name Line2 | ASSOCIATION | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARS | BusinessNameControlTxt |
| Phone | 6185422146 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 N WASHINGTON ST PO BOX 192 | AddressLine1 |
| City | DU QUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDWIN GAST | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6185422146 | PhoneNum |
| Signature | 2014-12-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID SCHNAKE | PreparerPersonNm |
| PTIN | P00112012 | PTIN |
| Phone | 6185291040 | PhoneNum |
| Preparation | 2014-12-19 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EDWIN GAST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 N WASHINGTON ST PO BOX 192 | AddressLine1 |
| City | DU QUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,851,674 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MARSHALLBROWNINGHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1919 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 231 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $258,331 | PYContributionsGrantsAmt |
| CY Contributions Grants | $78,630 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,927,184 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,610,353 | CYProgramServiceRevenueAmt |
| PY Investment Income | $359,625 | PYInvestmentIncomeAmt |
| CY Investment Income | $630,141 | CYInvestmentIncomeAmt |
| PY Other Revenue | $901,500 | PYOtherRevenueAmt |
| CY Other Revenue | $526,901 | CYOtherRevenueAmt |
| PY Total Revenue | $19,446,640 | PYTotalRevenueAmt |
| CY Total Revenue | $18,846,025 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,161,701 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,272,461 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,196,889 | PYOtherExpensesAmt |
| CY Other Expenses | $9,704,293 | CYOtherExpensesAmt |
| PY Total Expenses | $18,362,590 | PYTotalExpensesAmt |
| CY Total Expenses | $18,980,754 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,084,050 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$134,729 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,963,186 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,378,946 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,673,376 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,644,725 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,289,810 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,734,221 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $18,980,754 | ExpenseAmt |
| Grant | $4,000 | GrantAmt |
| Revenue | $18,846,025 | RevenueAmt |
| Desc | AS A NON-FOR-PROFIT COMMUNITY HOSPITAL, MARSHALL BROWNING HOSPITAL IS A CHARITABLE ORGANIZATION THAT EXISTS TO ADVANCE THE HEALTH OF THE RESIDENTS OF DUQUOIN AND THE SURROUNDING COMMUNITIES. MARSHALL BROWNING HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MARSHALL BROWNING HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THIS CORPORATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, ARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. MARSHALL BROWNING HOSPITAL RECORDED 2,596 PATIENT DAYS. 1,973 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 112 CONSISTED OF MEDICAID DAYS. DURING FY 2014 THE HOSPITAL ADMITTED 553 PATIENTS AND DISCHARGED 552. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 93,433 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,531 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. FINANCIAL ASSISTANCE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2014 THIS AMOUNTED TO 336,000 AT COST. MARSHALL BROWNING HOSPITAL OFFERS VARIOUS PROGRAMS AND SERVICES THAT SUPPORT THE HEALTH OF OUR COMMUNITY. HERE ARE A FEW EXAMPLES: AS PART OF OUR MISSION, THE HOSPITAL ANNUALLY PROVIDES ATHLETIC TRAINING SERVICES TO DUQUOIN HIGH SCHOOL ATHLETES. SERVICES ARE PROVIDED AT PRACTICES AS WELL AS AT SCHOOL SPORTING EVENTS AT NO COST TO THE SCHOOL. THE HOSPITAL ALSO PROVIDES RANDOM DRUG TESTING SERVICES AT COST-ONLY TO THE LOCAL HIGH SCHOOL. HOSPITIAL MANAGERS ARE FREQUENTLY GUEST SPEAKERS AT SCHOOLS ON VARIOUS HEALTH TOPICS AND HEALTHCARE CAREERS. HIGH SCHOOL STUDENTS PARTCIPATE IN JOB SHADOWING AND COOPERATIVE EDUCATION PROGRAMS AT THE HOSPITAL. MARSHALL BROWNING HOSPITAL ANNUALLY PROVIDES TWO SPORTS PHYSICAL CLININCS TO AREA JUNIOR HIGH AND HIGH SCHOOL STUDENTS AT A COST OF 10. THE FEE IS THEN RETURNED TO THE SCHOOLS. THE HOSPITAL ALSO SERVES AS A CLINICAL SITE FOR JOHN A. LOGAN COLLEGE NURSING STUDENTS. MARSHALL BROWNING HOSPITAL PROVIDES A VARIETY OF COMMUNITY SERVICES TO CITIZENS AND EMPLOYEES FOR WHICH WE RECEIVE NO REIMBURSEMENT SUCH AS HEALTH FAIRS, FIRST AID STATIONS, AND CLASSES FOR AUTOMATIC ELECTRONIC DEFIBULATOR'S (AED) AND BASIC LIFE SUPPORT (BLS). ADDITIONALLY, COLLEAGUES FROM MBH REACH HUNDREDS OF PEOPLE WITH PRESENTATIONS ON A WIDE VARIETY OF TOPICS INCLUDING HEART HEALTH, NUTRITION, ASTHMA, DIABETES, ALZHEIMER'S DISEASE, SLEEP APNEA, HEALTHLY GRIEVING, ARTHRITUS, BREAST CANCER, EXCERCISE AND DIET, SMOKING CESSATION, PNEUMONIA VACCINE, CIRCUIT BREAKER, AND IL CARE RX TO NAME A FEW. THE HOSPITAL ANNUALLY PROVIDES A FOUR-YEAR 1,000 SCHOLARSHIP TO A LOCAL HIGH SCHOOL SENIOR ENTERING THE HEALTHCARE FIELD. WE ALSO SPONSER A 5K RUN/WALK, GOLF TOURNAMENT, SPEAKERS FOR CAMPING CONVENTIONS AND SCREENINGS FOR LOCAL MANUFACTURING COMPANIES. THE HOSPITAL HOSTS SIX AMERICAN RED CROSS BLOOD DRIVES EACH YEAR. MBH EMPLOYEES CONTINUE TO GROW THEIR TRADITION OF SUPPORTING THE COMMUNITY THROUGH PARTICIPATION IN A VARIETY OF FUNDRAISING WALKS FOR AMERICAN HEART ASSOCAITION AND AMERICAN CANCER SOCIETY. THEY ALSO FREQUENTLY RAISE FUNDS FOR THE LOCAL FOOD PANTRY AND HUMANE SHELTER. | Desc |
| Total Program Service Expenses | $18,980,754 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 231 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL BROWNING HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6185422146 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 N WASHINGTON ST | AddressLine1 |
| Address Line2 | PO BOX 192 | AddressLine2 |
| City | DU QUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| RICHARD ZIMMERMANDC | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES GENISIO JR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK MACLIN | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAN EAVES | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN ENGELHARDT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG FURRY MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD K HAINES | |||||||
| VICE-PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DON HOFFMAN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRAD GALLI RPH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID SEARBY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHY WEST | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EDWIN GAST | |||||||
| CEO | 40.00 | $146,167 | $0 | $13,222 | Yes (X) | ||
| LAURIE KELLERMAN | |||||||
| CNO | 40.00 | $90,270 | $0 | $11,031 | Yes (X) | ||
| BRICE HARSY | |||||||
| CFO | 40.00 | $66,094 | $0 | $9,437 | Yes (X) | ||
| TERRENCE HALL | |||||||
| PHYSICIAN | 40.00 | $274,202 | $0 | $16,523 | Yes (X) | ||
| GLADSTONE TUCKER | |||||||
| PHYSICIAN | 40.00 | $241,545 | $0 | $1,879 | Yes (X) | ||
| BETH BIGHAM | |||||||
| PHYSICIAN | 40.00 | $154,711 | $0 | $4,751 | Yes (X) | ||
| ALAN MORRIS | |||||||
| PHARMACIST | 40.00 | $126,916 | $0 | $12,003 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,099,905 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $68,846 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ACUTE CARE INC | |||||
| 1609 N ANKENY BLVD STE 200 | ANKENY | IA | 50023 | HOSPITALIST SRV | $1,453,045 |
| ST LOUIS UNIVERSITY | |||||
| 1402 S GRAND BLVD | ST LOUIS | MO | 63104 | PHYSICIAN SERVI | $168,000 |
| NUMED INC | |||||
| PO BOX 1098 | DENTON | TX | 76202 | NUCLEAR MEDICIN | $145,848 |
| BRIGHAM ANESTHESIA SOUTH LLC | |||||
| 35 ALBANY ROAD SUITE C | CARBONDALE | IL | 62903 | ANESTHESIA | $129,415 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 272162140 | LAB SERVICES | $108,429 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $47,096 | GovernmentGrantsAmt |
| All Other Contributions | $31,534 | AllOtherContributionsAmt |
| Total Contributions | $78,630 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INPATIENT & OUTPATIENT SVC | Desc |
| Total Revenue Column | $17,610,353 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,610,353 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,610,353 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $622,465 | TotalRevenueColumnAmt |
| Exclusion | $622,465 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,676 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,676 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,676 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,676 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $19,922 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $5,649 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,273 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| INDEPENDENT LIVING RENT | $274,735 | $274,735 |
| DR HALL-SHARED EXP | $80,874 | $80,874 |
| PHARMACY | $58,698 | $58,698 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,321 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $98,321 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $512,628 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,846,025 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,130,657 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $622,465 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,221 | TotalAmt |
| Program Services | $336,221 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,806,624 | TotalAmt |
| Program Services | $6,806,624 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,186 | TotalAmt |
| Program Services | $125,186 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,503,282 | TotalAmt |
| Program Services | $1,503,282 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,148 | TotalAmt |
| Program Services | $501,148 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,750 | TotalAmt |
| Program Services | $43,750 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,146 | TotalAmt |
| Program Services | $771,146 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,093 | TotalAmt |
| Program Services | $73,093 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,227 | TotalAmt |
| Program Services | $278,227 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,958 | TotalAmt |
| Program Services | $282,958 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,746 | TotalAmt |
| Program Services | $75,746 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $620,821 | TotalAmt |
| Program Services | $620,821 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $998,940 | TotalAmt |
| Program Services | $998,940 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,533 | TotalAmt |
| Program Services | $262,533 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT | $1,863,055 | $1,863,055 |
| PHYSICIANS' FEES | $1,798,896 | $1,798,896 |
| MEDICAL SUPPLIES | $712,982 | $712,982 |
| DRUGS | $660,361 | $660,361 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,261,785 | TotalAmt |
| Program Services | $1,261,785 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,980,754 | TotalAmt |
| Program Services | $18,980,754 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,067 | BOYAmt |
| EOY | $246,894 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,582,725 | BOYAmt |
| EOY | $3,308,167 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $429,703 | BOYAmt |
| EOY | $484,173 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,253 | BOYAmt |
| EOY | $268,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,179,767 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,515,552 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,175,770 | BOYAmt |
| EOY | $10,664,215 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,637,934 | BOYAmt |
| EOY | $7,612,493 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,000 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,357,734 | BOYAmt |
| EOY | $794,611 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,963,186 | BOYAmt |
| EOY | $23,378,946 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,495,003 | BOYAmt |
| EOY | $1,217,046 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,775 | BOYAmt |
| EOY | $34,107 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,252,889 | BOYAmt |
| EOY | $8,929,399 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,866,709 | BOYAmt |
| EOY | $3,464,173 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,673,376 | BOYAmt |
| EOY | $13,644,725 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,289,810 | BOYAmt |
| EOY | $9,734,221 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,289,810 | BOYAmt |
| EOY | $9,734,221 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,963,186 | BOYAmt |
| EOY | $23,378,946 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$134,729 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $528,187 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $50,953 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $48,400 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $3,114 | OtherCostOrOtherBasisAmt |
| Book Value | $51,514 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,405,330 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,024,256 | DepreciationAmt |
| Book Value | $4,381,074 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,212,116 | OtherCostOrOtherBasisAmt |
| Depreciation | $726,001 | DepreciationAmt |
| Book Value | $486,115 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,393,968 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,765,295 | DepreciationAmt |
| Book Value | $5,628,673 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $116,839 | OtherCostOrOtherBasisAmt |
| Book Value | $116,839 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,664,215 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| L-T OBLIGATION-CAPITAL LEASES | $1,281,631 |
| INTEREST RATE SWAP CONTRACTS | $1,081,439 |
| ACCUMULATED BENEFIT OBLIGATION | $635,346 |
| CURRENT OBLIG-CAPITAL LEASES | $340,255 |
| THIRD PARTY REIMBURSEMENT PROGRAMS | $75,502 |
| ESTIMATED MED MALPRACTICE CLAIMS | $50,000 |
| CURRENT ACCUM BENEFIT OBLIGATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,464,173 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2014 OR 2013. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $19,922 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $19,922 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $5,649 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $19,922 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $19,922 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,649 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $5,649 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $14,273 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $336,325 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $336,325 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01770 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,943,134 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,094,395 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $848,739 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04470 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,279,459 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,094,395 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,185,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $325,786 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $325,786 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01720 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $325,786 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $325,786 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01720 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,605,245 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,094,395 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,510,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07960 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $938,048 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $187,610 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,782,494 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,002,229 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$219,735 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL BROWNING HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 900 N WASHINGTON ST | AddressLine1 |
| City | DUQUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | OUTPATIENT PHYSICIAN CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL BROWNING HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MARSHALLBROWNINGHOSPITAL.COM | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | false | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, MARSHALL BROWNING HOSPITAL - PART V, LINE 3 | SEVERAL MBH STAFF ACTIVELY PARTICIPATE IN THE PERRY COUNTY HEALTHY COMMUNITY COALITION, A GRASSROOTS ORGANIZATION WHOSE MEMBERS FOSTER COLLABORATION AND LEVERAGE THEIR COLLECTIVE RESOURCES TO IMPROVE THE OVERALL HEALTH AND WELL-BEING OF PERRY COUNTY RESIDENTS. INPUT FROM MEMBERS INCLUDES HEALTH AND WELLNESS IN ALL ITS VARIOUS ASPECTS INCLUDING PHYSICAL, SPIRITUAL, OCCUPATIONAL, SOCIAL, INTELLECTUAL, EMOTIONAL, ENVIRONMENTAL, FINANCIAL, MENTAL AND MEDICAL. IT SHARES RESOURCES WITH A NETWORK OF OTHER AREA COALITIONS SUCH AS CONNECT SI ON LOCAL AND REGIONAL PROGRAMS AND THROUGH THE DELTA REGIONAL AUTHORITY. MEMBERSHIP INCLUDES REPRESENTATIVES FROM MARSHALL BROWNING HOSPITAL, PINCKNEYVILLE COMMUNITY HOSPITAL, FIRE DEPARTMENT, POLICE DEPARTMENT, CHILD ADVOCACY CENTER, DISTRICT 300 SCHOOL DISTRICT, PERRY COUNTY COUNSELING CENTER, STATE OF ILLINOIS DIETITIAN, DOC ZS FITNESS AND CHIROPRACTIC,AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN RED CROSS,PERRY COUNTY HEALTH DEPARTMENT, FIVE STAR INDUSTRIES,AND SOUTHERN ILLINOIS HEALTHCARE. |
| FACILITY 1, MARSHALL BROWNING HOSPITAL - PART V, LINE 5C | COPIES ARE ALSO LOCATED IN EACH OF THE HOSPITAL'S WAITING ROOMS AND ARE AVAILABLE UPON REQUEST. |
| FACILITY 1, MARSHALL BROWNING HOSPITAL - PART V, LINE 7 | THE HOSPITAL IS CONTINUALLY WORKING TO MEET THE NEEDS IDENTIFIED THROUGH COMMUNITY EDUCATION PROGRAMS, HEALTH SCREENINGS, AND OTHER EVENTS. THE HOSPITAL IS NOT ABLE TO MEET EVERY NEED SUCH AS MENTAL ILLNESS AND SUBSTANCE ABUSE DISORDERS BECAUSE THEY DO NOT HAVE THOSE SERVICES AVAILABLE. |
| FACILITY 1, MARSHALL BROWNING HOSPITAL - PART V, LINE 20D | THE HOSPITAL OFFERS A 10% DISCOUNT IF PAID IF FULL WITHIN 7 DAYS OF THE FIRST BILLING STATEMENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARSHALL BROWNING HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CLINIC | AddressLine1 |
| Address Line2 | 900 N WASHINGTON STREET | AddressLine2 |
| City | DUQUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE MARSHALL BROWNING HOSPITAL ASSOCIATION (THE ASSOCIATION) USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE ASSOCIATION CALCULATED BAD DEBT EXPENSE AT COST USING THE COST TO CHARGE RATIO AS CALCULATED USING WORSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AS OUTLINED IN SCHEDULE H, PART III, LINE 9B. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. BASED ON THE ASSOCIATION'S EXPEREINCE WITH ALL ITS PATIENTS, THEY ESTIMATE THAT IT IS LIKELY THAT UP TO 20% OF THE PATIENTS ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR FINANCIAL OR OTHER ASSISTANCE BUT CHOOSE NOT TO APPLY. THEREFORE, 20% OF THE BAD DEBT EXPENSE WAS INCLUDED ON PART III, LINE 3 AT COST. THE FOLLOWING DESCRIPTION OF BAD DEBT EXPENSE (UNCOMPENSATED CARE)IS INCLUDED IN THE COMMUNITY BENEFIT NOTE TO THE ASSOCIATIONS AUDITED FINANCIAL STATEMENTS: THE HOSPITAL ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FOR PATIENTS WHICH IS NOT INCLUDED ABOVE, BUT IS REPORTED ON THE STATEMENT OF OPERATIONS AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANY OF THOSE PATIENTS ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE. DURING THE YEAR ENDED JUNE 30, 2014, THE HOSPITAL REPORTED BAD DEBT EXPENSE; AT COST, OF 938,000. |
| PART III, LINE 8 - MEDICARE EXPLANATION | FISCAL YEAR 2014 MEDICARE COST REPORT WAS USED TO DETERMINE THE UNPAID COST OF MEDICARE. UNPAID COST OF MEDICARE REPRESENTS THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT 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 9B - COLLECTION PRACTICES EXPLANATION | THE MARSHALL BROWNING HOSPITAL ASSOCIATION APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH FINANCIAL ASSISTANCE ELIGIBLE AND NON-FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. THE PROCEDURES FOR COLLECTION ON PATIENT ACCOUNTS ARE AS FOLLOWS: IT IS THE RESPONSIBILITY OF THE CREDIT AND COLLECTION MANAGER WITHIN THE PATIENT ACCOUNTS OFFICE, TO SECURE PAYMENT ARRANGEMENTS FOR ALL ACCOUNTS ON WHICH INSURANCE BENEFITS ARE NOT AVAILABLE, OR IF BENEFITS HAVE BEEN APPLIED AND A BALANCE IS DUE FROM THE PATIENT. 1.CREDIT AND COLLECTION MANAGER: A.CREDIT AND COLLECTION MANAGER REVIEWS ALL ADMISSION FOLDERS FOR INSURANCE INFORMATION OR ABILITY TO PAY (MONDAY - SATURDAY). B.CREDIT AND COLLECTION MANAGER CHECKS WITH RN ON THE PATIENT UNIT REGARDING THE PATIENT'S CONDITION OR FAMILY WHEREABOUTS (IF PATIENT IS A MINOR OR UNABLE PHYSICALLY OR MENTALLY TO MAKE A FINANCIAL DECISION). C.AFTER AN INTERVIEW WITH PATIENT OR FAMILY, CREDIT AND COLLECTION MANAGER DETERMINES APPROPRIATE PAYMENT ARRANGEMENT WITH THE BEST INTERESTS OF THE PATIENT AND THE HOSPITAL IN MIND. D.CREDIT AND COLLECTION MANAGER DETERMINES IF PATIENT'S NEEDS WOULD BE BETTER SERVED BY DEPARTMENT OF PUBLIC AID ASSISTANCE E.IF IT IS DETERMINED THAT THE PATIENT'S NEEDS WOULD BE BETTER SERVED THROUGH DPA THEN THE PATIENT CARE COORDINATOR'S OFFICE IS NOTIFIED FOR COMPLETION OF DPA APPLICATION. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | MARSHALL BROWNING HOSPITAL HAS A COMMUNITY BENEFITS TEAM WHICH IS COMPRISED OF HOSPITAL EMPLOYEES FROM VARIOUS DEPARTMENTS AS WELL AS COMMUNITY MEMBERS INCLUDING THE ADMINISTRATOR OF THE PERRY COUNTY HEALTH DEPARTMENT. MARSHALL BROWNING HOSPITAL IS ALSO AN ACTIVE PARTICIPANT IN THE PERRY COUNTY HEALTHY COMMUNITY COALITION AND HOSTS COALITION MEETINGS ON A MONTHLY BASIS. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED TO IDENTIFY THE MOST IMPORTANT HEALTH ISSUES IN PERRY COUNTY, PARTICULARLY FOR VULNERABLE AND UNDER-REPRESENTED POPULATIONS, TO ENSURE THAT PROGRAMS AND SERVICES CLOSELY MATCH THE PRIORITIES AND NEEDS OF THE COMMUNITY, AND TO STRATEGICALLY ADDRESS THOSE NEEDS TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. MARSHALL BROWNING HOSPITAL CONDUCTED A CHNA FOR 2013. THE ASSESSMENT WAS DONE USING MANY SOURCES INCLUDING A BROAD REPRESENTATION OF THE COMMUNITY THROUGH THE PERRY COUNTY HEALTHY COMMUNITY COALITION AND AN INTERNAL TEAM CONSISTING OF THE PERRY COUNTY HEALTH DEPARTMENT ADMINISTRATOR, PASTOR OF LIBERTY CHURCH, SCHOOL NURSE, DIRECTOR OF FIVE STAR INDUSTRIES, MARSHALL BROWNING HOSPITAL BOARD MEMBER, HOSPITAL ER DIRECTOR, HOSPITAL CFO, HOSPITAL CHIEF NURSE EXECUTIVE, HOSPITAL DIRECTOR OF SENIOR INDEPENDENT LIVING FACILITY, HOSPITAL CEO AND HOSPITAL DIRECTOR OF MARKETING. MARSHALL BROWNING HOSPITAL WAS ASSISTED BY THE COMMUNITY BENEFITS DEPARTMENT OF SOUTHERN ILLINOIS HEALTHCARE AS A SOURCE OF INFORMATION SINCE BOTH FACILITIES SERVE THE RESIDENTS OF PERRY COUNTY. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE PROVIDED IN THE FOLLOWING MEDIUMS: - HOSPITAL BROCHURE - HOSPITAL WEBSITE - POSTED IN ADMITTING - PATIENTS ARE CONTACTED BY A PATIENT ACCOUNTS REPRESENTATIVE DURING AND AFTER THEIR HOSPITAL STAY REGARDING ELIGIBILITY FOR ASSISTANCE |
| PART VI, LINE 4 - COMMUNITY INFORMATION | PERRY COUNTY IS A RURAL AREA WITH AN ESTIMATED POPULATION OF 22,350. THE AVERAGE HOUSEHOLD INCOME (ACCORDING TO US CENSUS BUREAU IN 2010) WAS 40,696. THERE WERE 22.64% OF CHILDREN IN THE COUNTY LIVING IN POVERTY IN 2011 WHICH IS CONSIDERABLY HIGHER THAN 17.68% OVERALL IN ILLINOIS. PINKNEYVILLE COMMUNITY HOSPITAL, LOCATED 12 MILES AWAY, ALSO SERVES THE HEALTHCARE NEEDS OF PERRY COUNTY RESIDENTS. MARSHALL BROWNING HOSPITAL PRIMARILY SERVES RESIDENTS OF PERRY COUNTY. HOWEVER A SMALL PORTION OF SURROUNDING COMMUNITIES IS SERVED AND INCLUDES THE FOLLOWING ZIP CODES: 62832(DUQUOIN); 62888 (TAMAROA); 62274 (PINCKNEYVILLE); 62932 (ELKVILLE); 62927(DOWELL); 62884 (SESSER); AND 62865 (MULKEYTOWN). PERRY COUNTY HAD A POPULATION OF 22,350 IN THE YEAR 2010 WHICH IS A DECREASE OF 3.2% FROM 2000. AGE DISTRIBUTION OF POPULATION IN PERRY COUNTY IN YEAR 2010 (US CENSUS BUREAU) INCLUDED: AGE 0-4 (1,152), AGE 5-17 (3,376), AGE 18-24 (2,476), 25 -34(2,966), 35-44 (3,124), 45-54 (3,212), AGE 55-64 (2,661) AND OVER 65 (3,521). |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | MARSHALL BROWNING HOSPITAL PROVIDES ACTIVITIES AND SERVICES FOR WHICH NO PATIENT BILL EXISTS. THESE SERVICES ARE NOT EXPECTED TO BE FINANCIALLY SELF-SUPPORTING, ALTHOUGH SOME MAY BE SUPPORTED BY OUTSIDE GRANTS OR FUNDING. SOME EXAMPLES INCLUDE FREE OR LOW-COST CLINICS SUCH AS THE SPORTS PHYSICAL CLINIC WHEREBY THE FEES ARE ONLY 10 AND DONATED BACK TO THE STUDENT'S SCHOOL. ALL PHYSICIANS AND STAFF DONATE THEIR TIME TO THE CLINICS. THE HOSPITAL PROVIDES THE SALARY OF OUR ATHLETIC TRAINER TO ATTEND ALL PRACTICES AND BALLGAMES FOR ATHLETIC TRAINING SERVICES TO DU QUOIN HIGH SCHOOL ATHLETES AND PROVIDES A FREE SPORTS INJURY CLINIC EACH SATURDAY MORNING THROUGHOUT THE FALL SEASON. THE HOSPITAL ESTABLISHED A COUMADIN CLINIC WHICH IS AN ANTICOAGULATION CLINIC HELD EACH WEDNESDAY. THE CLINIC PROVIDES ONE-ON-ONE CARE TO ASSIST PATIENTS WITH THE CONTROL OF THEIR ANTICOAGULATION THERAPY, SPECIFICALLY COUMADIN (GENERIC WARFARIN). PATIENTS ARE GIVEN EDUCATION AND DIETARY INSTRUCTION AND KNOW THEIR RESULTS AND DOSAGE FOR THE WEEK FOLLOWING EACH APPOINTMENT. THIS IS A COLLABORATIVE PRACTICE WITH NO BILLING CODES FOR THE CONSULTATION OF THE PHARMACIST OR LAB DIRECTOR WHO PROVIDE THE INSTRUCTION FOR THE PATIENTS. THIS SERVICE IS DONATED BACK TO THE COMMUNITY. THE CLINIC IS HIGHLY SUCCESSFUL AND RESULTS IN THE AVOIDANCE OF ER VISITS AND ADMISSIONS TO THE HOSPITAL. MARSHALL BROWNING HOSPITAL OFFERS A MONTHLY "SECOND ACT" LUNCHEON PROGRAM FOR INDIVIDUALS AGE 50 AND OLDER WITH A PHYSICIAN OR OTHER HEALTHCARE PROVIDER PRESENTING A HEALTHCARE PROGRAM. THE HOSPITAL PROVIDES A HEALTH FAIR FOR EATON'S B-LINE BUSINESS (MANUFACTURING PLANT) EMPLOYEES EACH YEAR AND OFFERS FREE HEALTH SCREENINGS AT THE COMMUNITY'S ANNUAL HOME AND GARDEN SHOW. COMMUNITY MEMBERS ARE GIVEN FREE COLON CANCER SCREENING KITS AND PROVIDE THE TESTING AT NO CHARGE DURING COLON CANCER AWARENESS MONTH. THE HOSPITAL HOSTS MANY FREE EDUCATIONAL PROGRAMS TO THE COMMUNITY THROUGHOUT THE YEAR ON TOPICS SUCH AS DIABETES, CERVICAL AND OVARIAN CANCER, SLEEP APNEA, PROSTATE CANCER, SKIN CANCER, HEART DISEASE, HIGH BLOOD PRESSURE, ALZHEIMER'S DISEASE, GRIEF, EXERCISE AND DIET, COPD, ANEMIA, EYE DISEASES, FIRST AID/CPR/AED CLASSES, CHANGES IN LAWS FOR SENIORS AND PROVIDES SPEAKERS FOR VARIOUS COMMUNITY ORGANIZATIONS. THE HOSPITAL PROVIDES FREE SPACE EVERY OTHER MONTH FOR WEIGHT LOSS PROGRAMS PRESENTED BY A BARIATRIC SURGEON AT HERRIN HOSPITAL. THE HOSPITAL EMPLOYS AN INDIVIDUAL WHO IS A CERTIFIED SHIP COUNSELOR FOR FREE COUNSELING TO SENIORS. MARSHALL BROWNING PROVIDES CLINICAL ROTATIONS AND INTERNSHIPS FOR MEDICAL STUDENTS AND A VARIETY OF COLLEGE STUDENTS ENTERING THE HEALTHCARE FIELD. MARSHALL BROWNING HOSPITAL OFFERS A FOUR-YEAR 1,000 SCHOLARSHIP TO A HIGH SCHOOL SENIOR EACH YEAR ENTERING THE HEALTHCARE FIELD. THE HOSPITAL HOSTS SIX COMMUNITY BLOOD DRIVES PER YEAR. THE COMMUNITY IS OFFERED A REDUCED RATE MAMMOGRAM EACH YEAR IN OCTOBER DURING BREAST CANCER AWARENESS MONTH. THE HOSPITAL CONDUCTS A 5K RUN/WALK EACH YEAR TO PROMOTE EXERCISE AND FITNESS. THE HOSPITAL PROVIDES DRUG TESTING FOR HIGH SCHOOL ATHLETES AT COST. THE HOSPITAL PROVIDES A FIRST AID STATION AT THE LOCAL CONSERVATION FAIR FOR AREA SCHOOL CHILDREN. THE HOSPITAL DONATES EACH YEAR TO THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, DU QUOIN YOUTH CLUB, DU QUOIN FOOD PANTRY AND VARIOUS OTHER NEEDS IN THE COMMUNITY. THE HOSPITAL OFFERS A SENIOR INDEPENDENT LIVING FACILITY ON ITS CAMPUS THAT IS OFFERED AS A BREAK-EVEN SERVICE AND HAS NEVER BEEN OPERATED AS A FOR-PROFIT ENTITY. MARSHALL BROWNING HOSPITAL PROVIDES OVERHEAD AND SPACE FOR COMMUNITY MEETINGS. THE HOSPITAL PROVIDES EDUCATIONAL PROGRAMS FREE OF CHARGE TO CAMPERS UTILIZING THE DU QUOIN STATE FAIRGROUNDS FOR CAMPING CONVENTIONS. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | MARSHALL BROWNING HOSPITAL IS AFFILIATED WITH SOUTHERN ILLINOIS HEALTHCARE TO ENHANCE SERVICES FOR THE RESIDENTS OF PERRY COUNTY. IT IS NOT A MERGER OR ACQUISITION BUT IS A PARTNERSHIP TO PROVIDE EDUCATIONAL, ADMINISTRATIVE AND CLINICAL OPPORTUNITIES FOR HEALTHCARE STAFF, DEVELOP LINKAGES AMONG HEALTHCARE PROVIDERS, PROVIDE BETTER COORDINATION OF CARE AND SERVICES AND EXPAND THE POOL OF SPECIALISTS. SINCE THE AFFILIATION, MARSHALL BROWNING HOSPITAL HAS EXPANDED THE NUMBER OF SPECIALISTS OFFERING CLINICS AT THE HOSPITAL, BEGAN OFFERING SECOND ACT COMMUNITY EDUCATION PROGRAMS, COLLABORATED ON THE CHNA, ESTABLISHED DIGITAL MAMMOGRAPHY SERVICES, INITIATED A LEAN DAILY MANAGEMENT PROGRAM, OFFER UROLOGIC SURGICAL PROCEDURES, ESTABLISHED A MORE EFFICIENT EMAIL SYSTEM AND COLLABORATION ON IMPLEMENTING ELECTRONIC HEALTH RECORD. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| EDWIN GAST | ||||
| CEO | $146,167 | $4,440 | $8,782 | $159,389 |
| TERRENCE HALL | ||||
| PHYSICIAN | $274,202 | $8,280 | $8,243 | $290,725 |
| GLADSTONE TUCKER | ||||
| PHYSICIAN | $241,545 | $1,879 | $243,424 | |
| BETH BIGHAM | ||||
| PHYSICIAN | $154,711 | $4,751 | $159,462 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS ARE PART OF THE HOSPITAL AUXILIARY WHO RUN FUNDRAISERS ON BEHALF OF THE HOSPITAL AND OPERATE THE GIFT SHOP. |
| FORM 990, PAGE 2, PART III, LINE 4A | HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. MARSHALL BROWNING HOSPITAL RECORDED 2,596 PATIENT DAYS. 1,973 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 112 CONSISTED OF MEDICAID DAYS. DURING FY 2014 THE HOSPITAL ADMITTED 553 PATIENTS AND DISCHARGED 552. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 93,433 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,531 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. FINANCIAL ASSISTANCE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2014 THIS AMOUNTED TO 336,000 AT COST. MARSHALL BROWNING HOSPITAL OFFERS VARIOUS PROGRAMS AND SERVICES THAT SUPPORT THE HEALTH OF OUR COMMUNITY. HERE ARE A FEW EXAMPLES: AS PART OF OUR MISSION, THE HOSPITAL ANNUALLY PROVIDES ATHLETIC TRAINING SERVICES TO DUQUOIN HIGH SCHOOL ATHLETES. SERVICES ARE PROVIDED AT PRACTICES AS WELL AS AT SCHOOL SPORTING EVENTS AT NO COST TO THE SCHOOL. THE HOSPITAL ALSO PROVIDES RANDOM DRUG TESTING SERVICES AT COST-ONLY TO THE LOCAL HIGH SCHOOL. HOSPITIAL MANAGERS ARE FREQUENTLY GUEST SPEAKERS AT SCHOOLS ON VARIOUS HEALTH TOPICS AND HEALTHCARE CAREERS. HIGH SCHOOL STUDENTS PARTCIPATE IN JOB SHADOWING AND COOPERATIVE EDUCATION PROGRAMS AT THE HOSPITAL. MARSHALL BROWNING HOSPITAL ANNUALLY PROVIDES TWO SPORTS PHYSICAL CLININCS TO AREA JUNIOR HIGH AND HIGH SCHOOL STUDENTS AT A COST OF 10. THE FEE IS THEN RETURNED TO THE SCHOOLS. THE HOSPITAL ALSO SERVES AS A CLINICAL SITE FOR JOHN A. LOGAN COLLEGE NURSING STUDENTS. MARSHALL BROWNING HOSPITAL PROVIDES A VARIETY OF COMMUNITY SERVICES TO CITIZENS AND EMPLOYEES FOR WHICH WE RECEIVE NO REIMBURSEMENT SUCH AS HEALTH FAIRS, FIRST AID STATIONS, AND CLASSES FOR AUTOMATIC ELECTRONIC DEFIBULATOR'S (AED) AND BASIC LIFE SUPPORT (BLS). ADDITIONALLY, COLLEAGUES FROM MBH REACH HUNDREDS OF PEOPLE WITH PRESENTATIONS ON A WIDE VARIETY OF TOPICS INCLUDING HEART HEALTH, NUTRITION, ASTHMA, DIABETES, ALZHEIMER'S DISEASE, SLEEP APNEA, HEALTHLY GRIEVING, ARTHRITUS, BREAST CANCER, EXCERCISE AND DIET, SMOKING CESSATION, PNEUMONIA VACCINE, CIRCUIT BREAKER, AND IL CARE RX TO NAME A FEW. THE HOSPITAL ANNUALLY PROVIDES A FOUR-YEAR 1,000 SCHOLARSHIP TO A LOCAL HIGH SCHOOL SENIOR ENTERING THE HEALTHCARE FIELD. WE ALSO SPONSER A 5K RUN/WALK, GOLF TOURNAMENT, SPEAKERS FOR CAMPING CONVENTIONS AND SCREENINGS FOR LOCAL MANUFACTURING COMPANIES. THE HOSPITAL HOSTS SIX AMERICAN RED CROSS BLOOD DRIVES EACH YEAR. MBH EMPLOYEES CONTINUE TO GROW THEIR TRADITION OF SUPPORTING THE COMMUNITY THROUGH PARTICIPATION IN A VARIETY OF FUNDRAISING WALKS FOR AMERICAN HEART ASSOCAITION AND AMERICAN CANCER SOCIETY. THEY ALSO FREQUENTLY RAISE FUNDS FOR THE LOCAL FOOD PANTRY AND HUMANE SHELTER. |
| FORM 990, PAGE 6, PART VI, LINE 11B | ALL BOARD MEMBERS ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW AND COMMENT BEFORE IT IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO'S SALARY IS DETERMINED BY THE BOARD OF DIRECTOR'S IN WHICH THEY REVIEW MARKET WAGE DATA FOR COMPARABILITY. |
| FORM 990, PAGE 6, PART VI, LINE 15B | ALL OTHER OFFICERS AND EMPLOYEES ARE APPROVED BY THE CEO THROUGH THE HOSPITAL'S NORMAL WAGE AND SALARY POLICY. ALL EMPLOYEES WAGES ARE COMPARED TO MARKET RATES IN THE HEALTHCARE INDUSTRY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | COPIES OF THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS, AND THE FEDERAL FORM 990 TAX RETURN ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATIVE OFFICE. |
| FORM 990, PART XI, LINE 9 | NET UNREALIZED LOSS 0 |
| FORM 990, PART XI, LINE 9 | GAIN ON HEDGING ACTIVITY 50,953 |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DUQUOIN CLINIC INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 WEST MAIN ST | AddressLine1 |
| Address Line2 | PO BOX 192 | AddressLine2 |
| City | DUQUOIN | City |
| State | IL | State |
| ZIP Code | 62832 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C CORP | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | Yes (true) | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DUQUOIN CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | F | TransactionTypeTxt |
| Involved | $245,090 | InvolvedAmt |
| Method Of Amount Determination | DISTRIBUTION FROM SALE | MethodOfAmountDeterminationTxt |