St Mary's Hospital Streator Hospital Sisters of the 3rd Order of St Francis: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- St Mary's Hospital Streator Hospital Sisters of the 3rd Order of St Francis (EIN 36-2169181)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201301349349305180
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T15:10:58-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 West Nationwide Blvd Ste 500 | AddressLine1 |
| City | Columbus | City |
| State | OH | State |
| ZIP Code | 432152568 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362169181 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARY'S HOSPITAL STREATOR HOSPITAL SISTERS | BusinessNameLine1 |
| Business Name Line2 | OF THE 3RD ORDER ST FRANCIS | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % KAREN CLARK | InCareOfName |
| Name Control | STMA | NameControl |
| Phone | 8156732311 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SPRING STREET | AddressLine1 |
| City | STREATOR | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Karen S Clark | Name |
| Title | Chief Financial Officer | Title |
| Date Signed | 2013-05-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KPMG LLP | Name |
| Phone | 6142492300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | kevin kast | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Spring Street | AddressLine1 |
| City | Streator | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 56008977 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARYSHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1885 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | TO CONTINUE CHRIST'S HEALING MINISTRY THROUGH SERVICE TO THE SICK, THE AGED, THE POOR, AND THE TERMINALLY ILL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 619 | TotalNbrEmployees |
| Total Nbr Volunteers | 119 | TotalNbrVolunteers |
| Total Gross UBI | 16 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -156 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 95740 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 65053 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 56252478 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 53476524 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2288999 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1897769 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 774533 | OtherRevenuePriorYear |
| Other Revenue Current Year | 551911 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 59411750 | TotalRevenuePriorYear |
| Total Revenue Current Year | 55991257 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 28746450 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 23488886 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 34367167 | OtherExpensePriorYear |
| Other Expenses Current Year | 31962242 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 63113617 | TotalExpensesPriorYear |
| Total Expenses Current Year | 55451128 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3701867 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 540129 | RevenuesLessExpensesCY |
| Total Assets BOY | 89062226 | TotalAssetsBOY |
| Total Assets EOY | 82270710 | TotalAssetsEOY |
| Total Liabilities BOY | 35116998 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 39173685 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 53945228 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 43097025 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 39676266 | Expense |
| Revenue | 53476524 | Revenue |
| Description | See Schedule O - Community Benefit Report | Description |
| Total Program Service Expense | 39676266 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | true | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 28 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 619 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KAREN CLARK | NamePerson |
| Telephone Number | 8156734514 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 SPRING STREET | AddressLine1 |
| City | STREATOR | City |
| State | IL | State |
| ZIP Code | 613643332 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| MARK WARGO MD | ||||||||
| SECRETARY/MBR. B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| STEVEN BROADUS | ||||||||
| CHAIRPERSON, B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| WILLIAM E EHLING MD | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| PATRICK GIBBONS | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| SR MARYbeth CULNAN OSF | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| SHERYL KUZMA | ||||||||
| MBR. BOARD OF DIRECTORS | 1.0 | X | 0 | 0 | 0 | |||
| JIMMIE LANSFORD | ||||||||
| secretary, B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| EVERETT J SOLON | ||||||||
| vice chair, B.O.D. | 1.0 | X | X | 0 | 0 | 0 | ||
| JOANNE FENTON | ||||||||
| PRESIDENT/CEO | 40.0 | X | X | 0 | 211185 | 36241 | ||
| Sr Maureen Fagan OSF | ||||||||
| MBR. Board of Directors | 1.0 | X | 0 | 0 | 0 | |||
| William Franklin | ||||||||
| Mbr. board of directors | 1.0 | X | 0 | 0 | 0 | |||
| ANN CARR | ||||||||
| TREASURER | 0.25 | X | 0 | 225813 | 215561 | |||
| KEVIN KAST | ||||||||
| Division CEO | 1.0 | X | 0 | 403490 | 180530 | |||
| KAREN CLARK | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | X | 154117 | 0 | 134821 | |||
| KIMBERLY LANDERS | ||||||||
| DIR. PAT. CARE SERVICES | 40.0 | X | 132217 | 0 | 111422 | |||
| PARVEEN CHAND | ||||||||
| CHIEF OPERATING OFFICER | 40.0 | X | 154789 | 0 | 19349 | |||
| CATHERINE CHAPMAN | ||||||||
| Director Pharmacy | 40.0 | 123913 | 0 | 44999 | X | |||
| Jeanne A Washko | ||||||||
| Pharmacist | 40.0 | 114271 | 0 | 124611 | X | |||
| RENA A MATHESIUS | ||||||||
| PHARMACIST | 40.0 | 122030 | 0 | 21357 | X | |||
| LARRY JONES | ||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 153856 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 955193 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 840488 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 888891 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Emergency Medical Experts LTD | |||||
| 1401 South Prairie Avenue | CHICAGO | IL | 60605 | Emergency MD | 1652889 |
| Anesthesia Pain Services LLC | |||||
| 1800 E Lake Shore Dr | DECATUR | IL | 62521 | Anesthesia MD | 1235228 |
| Immediate Care Experts LLC | |||||
| 1401 South Prairie Avenue | CHICAGO | IL | 60605 | Immediate Care MD | 1115587 |
| TGC LLC | |||||
| PO Box 130 | HIGHLAND | MD | 20777 | Consulting | 184689 |
| Executive Health Resources Inc | |||||
| PO Box 822688 | PHILADELPHIA | PA | 191822688 | Compliance Services | 160133 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 43 | NumberOfContractorsGT100K |
| Related Organizations | 65053 | RelatedOrganizations |
| Total Contributions | 65053 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 53476524 | TotalRevenueColumn |
| Related Or Exempt Function Income | 53476508 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 16 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 53476524 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 638313 | TotalRevenueColumn |
| Exclusion | $638,313 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1264221 | Securities |
| Other | 12955 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 17720 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1264221 | Securities |
| Other | -4765 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1259456 | TotalRevenueColumn |
| Exclusion | $1,259,456 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISC. HEALTHCARE REVENUE | 532000 | 501487 | $501,487 |
| GIFT SHOP | 453220 | 50424 | $50,424 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 551911 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55991257 | TotalRevenueColumn |
| Related Or Exempt Function Income | 53476508 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 16 | UnrelatedBusinessRevenue |
| Exclusion | $2,449,680 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 449375 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 449375 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16600787 | Total |
| Program Services | 12852694 | ProgramServices |
| Management And General | 3748093 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1269576 | Total |
| Program Services | 982934 | ProgramServices |
| Management And General | 286642 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3888402 | Total |
| Program Services | 3010486 | ProgramServices |
| Management And General | 877916 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1280746 | Total |
| Program Services | 991582 | ProgramServices |
| Management And General | 289164 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281280 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 281280 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10667291 | Total |
| Program Services | 7718604 | ProgramServices |
| Management And General | 2948687 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 245109 | Total |
| Program Services | 47727 | ProgramServices |
| Management And General | 197382 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6987257 | Total |
| Program Services | 6354234 | ProgramServices |
| Management And General | 633023 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 290373 | Total |
| Program Services | 78247 | ProgramServices |
| Management And General | 212126 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1142101 | Total |
| Program Services | 1047470 | ProgramServices |
| Management And General | 94631 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75103 | Total |
| Program Services | 61365 | ProgramServices |
| Management And General | 13738 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40276 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 40276 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241131 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 241131 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3477600 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 3477600 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4524318 | Total |
| Program Services | 3988585 | ProgramServices |
| Management And General | 535733 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 379778 | Total |
| Program Services | 9039 | ProgramServices |
| Management And General | 370739 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 1678013 | 1678013 | 0 |
| MISCELLANEOUS | 1158985 | 191496 | 967489 |
| REFERRAL LAB | 662687 | 662687 | 0 |
| DUES AND SUBSCRIPTIONS | 110940 | 1103 | 109837 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55451128 | Total |
| Program Services | 39676266 | ProgramServices |
| Management And General | 15774862 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1424 | BOY |
| EOY | 1349 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 499962 | BOY |
| EOY | -421339 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7544058 | BOY |
| EOY | 8015880 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1440093 | BOY |
| EOY | 931503 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 518462 | BOY |
| EOY | 477871 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 79772850 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 40233458 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42792432 | BOY |
| EOY | 39539392 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28971877 | BOY |
| EOY | 26661215 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76000 | BOY |
| EOY | 43791 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7217918 | BOY |
| EOY | 7021048 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89062226 | BOY |
| EOY | 82270710 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10793726 | BOY |
| EOY | 8587515 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12917783 | BOY |
| EOY | 12622783 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11405489 | BOY |
| EOY | 17963387 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35116998 | BOY |
| EOY | 39173685 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51726068 | BOY |
| EOY | 40831614 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2152138 | BOY |
| EOY | 2184308 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 67022 | BOY |
| EOY | 81103 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53945228 | BOY |
| EOY | 43097025 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89062226 | BOY |
| EOY | 82270710 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 540129 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -11388332 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $17,862 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 17862 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | Schedule C, Part II, Question 1i | ReturnReference |
| Explanation | St. Mary's Hospital ("The Hospital") is a member of the Catholic Health Association ("CHA"), The Illinois Hospital Association ("IHA"), The National Association for Home Care and Hospice, and the American Hospital Association ("AHA"). As a member of these organizations, the hospital pays dues and part of these dues are attributable to lobbying fees paid by the organizations. The amount listed above is the amount attributable to the hospital for its dues paid. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1234827 | OtherCostOrOtherBasis |
| Book Value | 1234827 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 51627392 | OtherCostOrOtherBasis |
| Depreciation | 20539555 | Depreciation |
| Book Value | 31087837 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 979977 | OtherCostOrOtherBasis |
| Depreciation | 708522 | Depreciation |
| Book Value | 271455 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25685221 | OtherCostOrOtherBasis |
| Depreciation | 18985381 | Depreciation |
| Book Value | 6699840 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 245433 | OtherCostOrOtherBasis |
| Book Value | 245433 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 39539392 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| VALUATION RESERVE | 2585000 |
| ASSETS WHOSE USE IS LIMITED | 2265412 |
| WORKERS COMP HS | 1273092 |
| A/R NON-PATIENT | 445764 |
| A/R FOUNDATION | 13196 |
| PAY ADJUSTMENT | 1965 |
| OTHER ASSETS | 436619 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 7021048 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED BENEFIT LIABILITY | $16,132,477 |
| RETIRE OBLIGATION - ASBESTOS | $1,829,143 |
| A/R SELF INSURANCE | $1,767 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 17963387 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ASC SUBTOPIC 740-10 | Identifier |
| Explanation | The Obligated Group adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109. ASC Subtopic 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, the Obligated Group must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods, and requires increased disclosures. As of June 30, 2012 and 2011, the Obligated Group does not have a liability for unrecognized tax benefits. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 135. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 215. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2344 | PersonsServed |
| Total Community Benefit Expense | 2788181 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2788181 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05190 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9545 | PersonsServed |
| Total Community Benefit Expense | 7142036 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3480057 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3661979 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06810 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11889 | PersonsServed |
| Total Community Benefit Expense | 9930217 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3480057 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6450160 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12000 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 17 | NumberOfActivitiesOrPrograms |
| Persons Served | 26183 | PersonsServed |
| Total Community Benefit Expense | 300600 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3355 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 297245 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00550 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 39 | PersonsServed |
| Total Community Benefit Expense | 20044 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 18 | PersonsServed |
| Total Community Benefit Expense | 45963 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 39080 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 18 | NumberOfActivitiesOrPrograms |
| Persons Served | 5447 | PersonsServed |
| Total Community Benefit Expense | 67763 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 67763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 39 | NumberOfActivitiesOrPrograms |
| Persons Served | 31687 | PersonsServed |
| Total Community Benefit Expense | 434370 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 42435 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 391935 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 39 | NumberOfActivitiesOrPrograms |
| Persons Served | 43576 | PersonsServed |
| Total Community Benefit Expense | 10364587 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3522492 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6842095 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12730 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 500 | PersonsServed |
| Total Community Building Expense | 2533 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 2533 | NetCommunityBuildingExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 662 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 662 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 500 | PersonsServed |
| Total Community Building Expense | 3195 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 3195 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $598,619 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 19952471 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23902113 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3949642 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Spring Street | AddressLine1 |
| City | Streator | City |
| State | IL | State |
| ZIP Code | 61364 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mary's Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 135. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 215. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Part I, line 3c | Not applicable as the organization does follow federal poverty guidelines to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals. | |
| Part I, line 6a | SMS does prepare an annual community benefit report in booklet form distributed to the public via mail and is available upon request at St. Mary's Hospital, 111 Spring Street, Streator, IL. | |
| Part I, line 7g | The Adult Day program and Supportive Care program are subsidized services offered at St. Mary's Hospital. The hospital uses Lyons Software ("CBISA") to determine subsidized services. Physician clinics were not included in the subsidized health services. | |
| Part I, line 7, column (f) | The percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 12.73%. The amount of bad debt removed when calculating the percentages in Part I, Line 7, column (F) was $1,678,013. | |
| Part I, line 7 | SMS uses the Lyons Software (CBISA) which follows the CHA guidelines on reporting Christian care and certain other community benefits at cost. Lyons Software uses the hospital's audited financials for total expenses, bad debt and gross patient charges to calculate the appropriate cost to charge ratio in determining charity care and other community benefits at cost. | |
| Part II | Community building through community support, health improvement advocacy, and workforce development is an important part of St. Mary's commitment to enhancing community-wide health and well-being. St. Mary's is engaged in the community by developing support groups and through coalition building with community outreach events. As part of our commitment to provide our community with the highest quality of care, St. Mary's Hospital participated in a number of health fairs providing free health screenings and educational information. This year St. Mary's colleagues donated their time to travel to several health fairs throughout the Illinois Valley, offering health education and free screenings such as bone density tests, ankle brachial index screenings, blood pressure checks and pulse ox screenings. These health fairs are just one way that our hospital can educate the community and promote early detection and disease prevention, as well as encouraging a healthy lifestyle. Throughout the course of the year St. Mary's Hospital lends our support by sponsoring a variety of events in our community. In February, St. Mary's Hospital was a corporate sponsor of Streator's Taste of Town, a culinary auction event that raises funds for several local organizations in the community. Aside from our sponsorship, our hospital provided volunteers to assist during the event. St. Mary's Hospital partners with the March of Dimes, an organization that supports research aimed at preventing birth defects, premature birth and infant mortality, to help create awareness about premature births. St. Mary's also sponsored the market place tent at the March for Babies. St. Mary's also takes pride in our partnership with the Streator Area Chamber of Commerce. We attend several of their events that raise money to help build a better community. Some of the annual Chamber events that we participate in include their corporate bowling challenge, dessert auction and golf outing. St. Mary's Hospital is a proud supporter of the American Cancer Society's relay for life. This year the hospital was a $3,000 gold sponsor of Relay for Life. This event represents the hope that those lost to cancer will never be forgotten, that those who face cancer will be supported, and that one-day cancer will be eliminated. In addition to being a gold sponsor, the hospital was able to assist Relay for Life by printing the event programs in-house free of charge, as well as supplying the bottles of water for the night of the event. Beyond our hospital efforts, we also had a group of St. Mary's colleagues who volunteered at the event and distributed health care information and water to the walkers. St. Mary's Hospital is proud to be a sponsor of this great event - one that educates the public about the importance of cancer research and celebrates those whose lives have been affected by cancer. In January, cardiologist Riyaz Nomani, MD gave a presentation to the community at St. Mary's Health Care-Ottawa on the importance of knowing your cholesterol numbers. He educated the group on why they should know their numbers, how to interpret their results and how to lower their risk of cardiovascular disease. One lucky winner received a free copy of the American Heart Association's "Low-Fat, Low Cholesterol" cookbook. St. Mary's Hospital strives to promote and improve the health of the communities it serves by providing a teaching environment for nursing and technical clinical expertise for the regional workforce, recruiting and retaining the professional medical staff to meet the area need, and by providing care through a collaborative approach. Consistent with its exempt purpose, St. Mary's serves as a clinical site for students in the fields of nursing, laboratory, diagnostic imaging, physical therapy, speech and pharmacy. St. Mary's hospital is a community partner with Illinois Valley Community College to provide a clinical training site, professional oversight, and supportive entrance to the nursing field. By providing this medical education, the hospital is contributing to the regional and national workforce in a way that will continue to ensure access and high quality care for the families we serve. St. Mary's hospital supports those students who wish to make a difference in the lives of others by going into the field of health care. Friends of St. Mary's Hospital awarded two $1,000 scholarships for the 2012 Chad Scoles Memorial Scholarship. The scholarship was established in memory of Chad Scoles, son of Dick Scoles, a long-term St. Mary's Hospital employee, and his wife Sally. Chad passed away in 2004 at the age of 21. The scholarship fund was created by two emergency room physicians, Dr. William Sullivan and Dr. Ted Patras. | |
| Part III, Line 4 | Since the hospital implemented the Search America process, a much closer representation of the true community benefit is reflected. Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors that do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 301% of the federal poverty level, the appropriate discount according to the established criteria will be applied. That amount of money not collected from those Self-pay patients who are not eligible for charity care is calculated as bad debt. | |
| Part III, Line 8 | The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. The hospital Medicare shortfall at cost for fiscal year 2012 was $7,388,641. | |
| Part III, line 9b | EVERY EFFORT IS MADE PRIOR TO, DURING AND AFTER PROVISION OF MEDICAL SERVICES TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR CHARITY/COMMUNITY CARE AND TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION AND PROVIDING ADEQUATE DOCUMENTATION. IF THE PATIENT QUALIFIED FOR CHARITY/COMMUNITY CARE FOR THE FULL BALANCE OF THEIR ACCOUNT, THE ENTIRE AMOUNT IS WRITTEN OFF TO CHARITY/COMMUNITY CARE AND HENCE NO DEBT COLLECTION IS PURSUED. IF THE PATIENT QUALIFIED FOR CHARITY/COMMUNITY CARE FOR A PORTION OF THEIR ACCOUNT BALANCE, THAT PORTION IS WRITTEN OFF TO CHARITY/COMMUNITY CARE, WITH THE PATIENT BEING RESPONSIBLE FOR THE REMAINDER OF THE BALANCE. ADDITIONALLY, REASONABLE EFFORT WILL BE MADE TO OBTAIN THIRD-PARTY OR GOVERNMENT PAYER REIMBURSEMENT ON BEHALF OF THE PATIENT. IF THOSE EFFORTS ARE NOT FRUITFUL, AN OFFER WILL BE EXTENDED TO THE PATIENT TO MAKE INSTALLMENT PAYMENTS ON THEIR BALANCE. ONLY AT SUCH POINT THAT THE PATIENT DEFAULTS ON INSTALLMENT PAYMENTS OR REFUSES TO COOPERATE WITH THE HOSPITALS EFFORTS TO BE REIMBURSED WILL THE ACCOUNT BE SENT TO COLLECTIONS. FOR ADDITIONAL INFORMATION, SEE RESPONSE TO QUESTION VI, 3. | |
| Part V, Section B, Line 3 | St. Mary's Hospital in cooperation with Leede Research, a research firm specializing in health care information programs and tools, completed the 2012 Community Needs Assessment survey process. The goal of the study was to identify population perceptions of community issues and needs that could be combined with other information for a Community Health Needs Assessment. The needs assessment report was used as a basis for the implementation strategy that outlines a plan to address selected needs which would benefit the community and general populations. A Community Needs Steering Committee was established to review the results of the survey and other data. This was a diverse group of twenty-one community leaders from LaSalle, Livingston and Marshall Counties, consisting of health care and physician leaders, political leaders, individuals with expertise in public health, and representatives of underserved, low-income and minority populations. | |
| Part V, SECTION B, Line 7 | The St. Mary's Hospital Board of Directors approved an implementation strategy based on the CHNA during the reporting year (FY2012); however, the identified needs are being addressed in the current year (FY2013). Using the data from the CHNA, the steering committee identified four priority areas for the community: obesity, family violence, substance abuse/alcohol, and education. St. Mary's Hospital will focus on two of the four major needs - obesity and family violence - because they best match our core competencies and would offer us the best opportunity to affect the most change. Since St. Mary's Hospital does not have a specific substance/alcohol abuse program and is not an educational institution, we will collaborate with other organizations to support their efforts in these areas. The implementation strategy consists of plans to expand St. Mary's Hospital Lean 2 Green program and also develop community gardens, both aimed at reducing obesity and focusing the community on a healthier lifestyle. In addition, St. Mary's Hospital is currently engaging in a process with other community organizations to assess how the hospital could support local resources already in place for domestic violence. | |
| Part V, section b, Line 13g | Brochures giving notice of the hospitals Christian Care Policy will be available to the public in the Emergency Department, Collection and Registration areas. Information outlining the program is also available on patient statements and upon request. Patient statements shall include but not be limited to the following: Request that the patient inform the hospital if the patient has health insurance coverage, Medicare, Medicaid or other insurance. | |
| Part V, section b, Line 19d | WE ASK EACH PATIENT TO FILL OUT A FORM IN ORDER TO DETERMINE THEIR ELIGIBILITY UNDER THE ILLINOIS UNINSURED ACT. IF THE PATIENT FAILS TO FILL OUT THE FORM, FINANCIAL COUNSELORS WILL SEEK TO DETERMINE PATIENT ELIGIBILITY BY SEEKING APPROPRIATE INFORMATION IN THE SEARCH AMERICA PROGRAM. WE ALSO REVIEW THE PATIENTS' ACCOUNTS TO ENSURE THEY ARE NOT CHARGED MORE THAN 25% OF THEIR ANNUAL GROSS INCOME. ONCE THE CHARGES FOR A SELF-PAY BALANCE EXCEED 25% OF THE PATIENTS' ANNUAL GROSS INCOME, THE REMAINING BALANCE IS ADJUSTED OFF TO CHRISTIAN CARE. | |
| Needs assessment | The Community Health Needs and associated implementation strategy will be used to guide our efforts in FY2013 and is available at http://www.stmaryshospital.org on the Check Up 2012 and Implementation Strategy link. For prior years, we used other methods to identify community need. For example, historic encounters are reviewed for trends and demographic information is reviewed annually during our strategic planning process. Indigent levels, educational levels, housing costs, unemployment and uninsured children are all considered in the planning process. Physician demand analysis is ongoing. SMS engages in conversations with the community to ascertain those services that are in demand and which ones are out-migrating. Those conversations are held informally and sometimes formally. As areas are identified a business plan and proforma are done to validate the need. | |
| Patient education of eligibility for assistance | The Registration Department provides brochures to patients upon registration regarding the Payment Assistance Program available to them at St. Mary's Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient contact numbers for several agencies are listed in the brochure, as well as information about how to read and understand the billing information on payment assistance, billing procedures and explanation of Medicare forms are available on the organization's web site. The organization has a representative on site to assist patients who may be eligible for Medicaid assistance through the Illinois Department of Public Assistance. They work with patients to determine if they may be eligible, and if so, assist in pulling together the necessary application for submission. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care. The Search America is now being utilized after failed attempts made by the hospital to work out payment arrangements. That system accesses credit and other information and allows us to see the probability of a patient being able to pay their bill. After assessing that information, the hospital makes a determination whether to grant charity or continue collection efforts. | |
| Community Information | According to the 2010 Census, the demographic make-up of the city of Streator is 85.2% White, 10.4% Latino, 2.5% African American, and 1.9% from other races. The number of persons below poverty level for the city of Streator is 14.8%, which is above the LaSalle County level of 10.8% and the Illinois state level of 12.6%. In addition, St. Mary's has provided charity benefits for 2,344 uninsured persons and transportation benefits to 238 underserved persons. | |
| Promotion of Community Health | St. Mary's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Mary's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 125 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged St. Mary's is a small, rural hospital with 68 staffed beds. Because of the hospital's purpose and tradition, it is organized to promote the health of Streator, Illinois and surrounding areas. The hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Mary's is responding to community need. During the last year, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. Also consistent with its exempt purpose, St. Mary's has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Mary's reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Mary's is currently working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. Affordable healthcare for uninsured and underinsured patients St. Mary's Hospital devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2012, St. Mary's provided over $14.2 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, St. Mary's provided $6.4 million (at cost) in uncompensated care to patients that qualified for charity care or public assistance and over $7.3 million (at cost) in excess of Medicare payment for health care services. St. Mary's Hospital participates in multiple government-sponsored health care programs, including Medicaid, Medicare, Champus and Tricare. The range of benefits provided by St. Mary's flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Mary's, and they often relieve a burden that would otherwise be carried by government. To further improve the health status of the community and/or access for underserved populations, St. Mary's offered free educational nutritional programs throughout the year. St. Mary's clinical dietitian taught a series of educational nutrition programs designed to help people take better care of themselves and to better manage their cholesterol and diabetes. This included a free cholesterol screening and educational program for the community at St. Mary's Health Care - Ottawa, on how to incorporate Therapeutic Lifestyle Changes (TLC). TLC is a set of tools that helps participants get results. Participants of the program received an easy-to-read booklet designed to help make the lifestyle changes that will lower blood cholesterol and reduce the risk for heart disease. In addition, St. Mary's clinical dietitian gave tips on how to follow the TLC diet, increase physical activity and manage weight for those who have a cholesterol level above normal. During Diabetes Awareness Month, St. Mary's Hospital offered a free holiday diabetes education program, led again by the registered dietitian. The topic was Dining with Diabetes-Holiday survival skills to help you manage your diabetes. Participants enjoyed food samples and took home some healthy holiday recipes. As a way to show thanks and appreciation to local Veterans, St. Mary's Hospital offered a series of free health screenings for anyone who had or was currently serving our military. The screenings that were provided were able to help determine if one might be at risk for developing heart disease, diabetes, osteoporosis, vascular disease and/or chronic obstructive pulmonary disease. The screenings offered included a Heart Smart cholesterol and glucose screening, Bone Density screening, Ankle-Brachial Index screening, Pulse Oximetry screening and a Body Mass Index screening. Other Community Benefits Based on the assessment of community needs described under #2 above, St. Mary's has focused on the following priorities: obesity and family violence. These major needs in our community best match the hospital's core competencies and would offer the best opportunity to affect the most change in the communities we serve. To target obesity in the communities served, St. Mary's Hospital focused on exercise, nutrition and healthy lifestyles. Every January, St. Mary's Hospital offers their Lean to Green (L2G) program, designed to help St. Mary's colleagues and community members realize that healthy eating and fitness are year round activities. In the style of the popular television show, "The Biggest Loser", L2G is designed to be a fun and exciting way to encourage hospital colleagues and community members to achieve and maintain a healthy lifestyle with weight loss as the motivator. Lean to Green also serves as a maintenance program for those who don't need to lose weight but would still like to improve their overall fitness. This year we had 116 participants complete the 12-week weight loss program and those participants lost a total of 1,995 pounds or 5.14 percent of their original body weight. In conjunction with the Lean to Green program, St. Mary's Hospital offered weekly handouts related to nutrition and exercise. In the coming year, these activities will be modified or supplemented to focus on the priority needs identified by the FY2012 community health needs assessment process. Another area of focus for St. Mary's is environment sustainability. St. Mary's hosted an electronic recycling and used medical equipment drive open to all colleagues and the community in honor of earth day. Vintage Tech Recyclers, Inc. as on site with a truck collecting various electronic items to be recycled and the used medical equipment was donated to HSHS Mission Outreach in Springfield, Illinois. Because of our event, we were able to recycle 38,397 pounds of electronics that otherwise would end up in our landfills. In addition to the electronics recycling drive, St. Mary's Pharmacy set up a medication disposal drive to help preserve our water supply. The pharmacy collected 95.4 pounds of expired or unwanted medications that individuals wished to safely discard. St. Mary's is committed to facilitating access for populations with special needs. Transportation options in Streator are severely limited. Not only is there no public transportation system, there is not even a taxi company. This leaves many people, especially the elderly or disabled, at the mercy of others' kindness. St. Mary's Hospital recognized this as a very serious problem and responded with the medical transportation program. The program established in 1994, provides free transportation to needy patients, particularly those with disabilities, who had no other way of getting to and from their medical appointments. The program provides transportation to seniors, children, expectant mothers and individuals with special needs. Transportation is made with the participant's safety in mind with a qualified staff to assist individuals with boarding and disembarking in vans maintained to Illinois Department of Transportation Standards. Enhancing the Health of Our Community In the coming year, many of the above activities will be continued or strengthened as St. Mary's begins to focus on the priority needs identified during the FY1012 Community Health Needs Assessment process. As outlined in a board-approved "implementation strategy," in addition to expansion of St. Mary's Lean 2 Green program t | |
| Affiliated health care system | St. Mary's Hospital Streator is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and more than 2,000 physician partners across Illinois and Wisconsin. The Mission of HSHS is to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry. We live our Mission by healing those who seek our care, as well as through our Community Benefit initiatives. Working collaboratively with others in the 12 communities we serve, our Community Benefit efforts are successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. Across HSHS, we collectively provided $174.2 million in Community Benefits (or 9.7% of total hospital expenses) in FY2012. Included in this amount was $43.1 million provided for Charity Care and $97.9 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $168.4 million. HSHS hospitals also recorded $106.6 million in uncollectible accounts. Beyond the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing do, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the U.S. is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2012, we made significant progress with this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for the individual. Our efforts to ensure residents in the communities we serve receive the right care at the right time often involve partnering with others to achieve this goal. Across our two-state system, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. In western Wisconsin, St. Joseph's Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,216 patient visits, a 25% increase from the prior year. With more than 150 individuals volunteering, the clinic provided over 6,500 hours (including 700 physician hours and 1,500 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In northeastern Wisconsin, St. Vincent Hospital in Green Bay supports patient care for the uninsured at the NEW Community Clinic by paying a nurse's salary and offering free and discounted laboratory and radiology services. More than 70% of patients who use the clinic report the care they received helped keep them out of the Emergency Department. St. Nicholas Hospital in Sheboygan proactively reaches out to local Hmong and Hispanic organizations to ensure these populations can participate in free screenings and health education programs. Through this ongoing outreach initiative, St. Nicholas engaged more than 350 people last year, and in many cases was able to identify critical health conditions early and provide appropriate follow-up care. A Woman's Place at St. Mary's Hospital Medical Center in Green Bay reaches out to Hispanic neighbors to provide health and wellness education, health screenings, resources and referral services. Last year A Woman's Place touched the lives of more than 7,000 women through health screenings, educational events, classes and its resource center. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthony's Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthony's helped underwrite the cost of prescription medications for more than 430 residents. In southwest Illinois, St. Joseph's Hospital in Highland recognized many rural residents did not have a reliable means of transportation and partnered with generous individuals in the community to offer a free transportation service. The "Friends' Van," fully supported by the Friends of St. Joseph's Hospital, provides free rides to medical, dental and other personal appointments within a 20-mile radius of Highland. In FY2012, the Friends Van transported 2,050 individuals for a total of 12,561 miles. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Charity Care program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Charity Care programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our charity care policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our mission to embody Christ's healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. To address metabolic disease management, St. Francis Hospital in Litchfield, Illinois, partners with Montgomery County Health Department to provide screening for diabetes and renal disease. St. Francis Hospital teams up with Macoupin County Health Department to provide Diabetes Self-Management classes. St. Joseph's Hospital in Breese, Illinois coordinates several community education seminars and health fairs on cardiovascular disease and healthy eating each year. Over 3,000 residents participated in these health events last year. Recognizing the importance of proper food and nutrition to overall health, St. John's Hospital in Springfield initiated the Destination Dinner program which teaches families how to cook healthy, from-scratch meals, and eat together as a family. Families meet quarterly to learn new cooking skills. They also learn how to prepare a meal for a family of four on a budget of $8.00. In addition to raising awareness about how to eat healthy on a limited budget, the program brings families together around the dinner table, which research shows promotes healthy relationships, increased academic performance and decreased risk for substance abuse and risky sexual behavior. Sacred Heart Hospital in Eau Claire, Wisconsin addressed the need for access to mental health services for children and adolescents by opening an outpatient behavioral health clinic. Sacred Heart has also adopted screening tools for behavioral and mental health risk factors for use at affiliated clinics. The goal is to better identify mental health issues and provide earlier intervention. Sacred Heart Hospital is also working with the Chippewa Valley Free Clinic (CVFC) to develop expanded provider coverage for CVFC patients who require mental health services. St. | |
| STATE FILING OF COMMUNITY BENEFIT REPORT | IL, | 990 SCHEDULE H, PART VI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOANNE FENTON | |||||||||||||
| 0 | 170753 | 0 | 0 | 0 | 40432 | 0 | 23600 | 0 | 13241 | 0 | 248026 | 0 | 0 |
| ANN CARR | |||||||||||||
| 0 | 180382 | 0 | 0 | 0 | 45431 | 0 | 197622 | 0 | 18652 | 0 | 442087 | 0 | 15440 |
| KEVIN KAST | |||||||||||||
| 0 | 368854 | 0 | 0 | 0 | 34636 | 0 | 158181 | 0 | 23169 | 0 | 584840 | 0 | 40460 |
| KAREN CLARK | |||||||||||||
| 154092 | 0 | 0 | 0 | 25 | 0 | 126238 | 0 | 9196 | 0 | 289551 | 0 | 0 | 0 |
| KIMBERLY LANDERS | |||||||||||||
| 98099 | 0 | 7319 | 0 | 26799 | 0 | 98431 | 0 | 13395 | 0 | 244043 | 0 | 0 | 0 |
| LARRY JONES | |||||||||||||
| 0 | 0 | 0 | 0 | 153856 | 0 | 0 | 0 | 0 | 0 | 153856 | 0 | 0 | 0 |
| PARVEEN CHAND | |||||||||||||
| 154494 | 0 | 0 | 0 | 295 | 0 | 0 | 0 | 19998 | 0 | 174787 | 0 | 0 | 0 |
| CATHERINE CHAPMAN | |||||||||||||
| 123353 | 0 | 0 | 0 | 560 | 0 | 38470 | 0 | 7061 | 0 | 169444 | 0 | 0 | 0 |
| Jeanne A Washko | |||||||||||||
| 113639 | 0 | 168 | 0 | 464 | 0 | 105997 | 0 | 19100 | 0 | 239368 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| severance payment | Schedule J, Part I, Line 4a | Larry Jones received a severance payment in the amount of $152,231 during the tax year. This amount has been included in Larry's reportable compensation on Schedule J and Form 990, Part VII. |
| joanne fenton | Schedule J, Part I, Line 4b | joanne fenton participated in a serp plan during the year in the amount of $23,600. |
| kevin kast | Schedule J, Part I, Line 4b | kevin kast participated in a serp plan during the year in the amount of $79,410. |
| ann m. carr | schedule j, part i, line 4b | ann m. carr participated in a serp plan during the year in the amount of $33,655. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Georgene Lansford | |||
| Spouse of Director | 93220 | Employment | false |
| Kara Hughes | |||
| Sister of Officer | 60981 | Employment | false |
| Jeannine Solon | |||
| Spouse of Director | 53941 | Employment | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS | Identifier |
| Return Reference | FORM 990 SCHEDULE L, PART IV | ReturnReference |
| Explanation | THERE ARE TWO ST. MARY'S HOSPITAL COLLEAGUES WHO ARE SPOUSES OF OFFICERS. ONE EMPLOYEE IS THE SISTER OF A DIRECTOR. ALL PERSONS LISTED ON SCHEDULE L, PART IV WERE HIRED IN ACCORDANCE WITH THE HOSPITAL HIRING POLICY AT COMPARATIVE INDUSTRY MARKET COMPENSATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Organization's mission | FORM 990 PART III, Line 1 | To continue Christ's healing ministry through service to the sick, the aged, the poor and the terminally ill, regardless of race, creed, sex, handicaps, religion, age, sexual orientation, marital, military discharge, or financial status. The values of compassion, justice, reverence for life, and individual dignity are fostered. Health services that improve or maintain the quality of life are supported. The Sisters, Administration, Medical Staff and employees practice this mission by identifying with the core values of the Hospital Sisters Health System - Respect, Care, Competence and Joy. FORM 990, PART III, LINE 3 ST. MARY'S HOSPITAL DISCONTINUED ITS SKILLED NURSING UNIT ON AUGUST, 2011 AND DISCONTINUED ITS ADULT DAY PROGRAM ON SEPTEMBER 30, 2011. FORM 990, PART 111, LINE 4 THREE LARGEST PROGRAMS INPATIENT AND OUTPATIENT CARE SERVICES WITH DIRECT EXPENSES OF $3,164,558 INCLUDES MEDICAL SURGICAL, WOMEN'S HEALTH, AND INTENSIVE CARE ACUTE INPATIENT AND OBSERVATION PATIENT SERVICES AS WELL AS NURSERY INPATIENT CARE. THESE SERVICES PROVIDED 7,782 ACUTE PATIENT DAYS, PROVIDED SERVICES FOR 1,320 OBSERVATION PATIENTS AND 421 NURSERY DAYS. IMAGING SERVICES WITH DIRECT EXPENSES OF $3,818,048 INCLUDE ROUTING DIAGNOSTIC, ANGIOGRAPHY, ULTRASOUND, MRI, CT, AND NUCLEAR MEDICINE SERVICES. DIAGNOSTIC IMAGING CONDUCTED 19,975 IP/OP PROCEDURES; ANGIOGRAPHY CONDUCTED 1,932 IP/OP PROCEDURES; ULTRASOUND CONDUCTED 7,303 IP/OP PROCEDURES; MRI CONDUCTED 1,347 IP/OP PROCEDURES; CT 4,499 IP/OP PROCEDURES AND NUCLEAR MEDICINE CONDUTED 1,348 IP/OP PROCEDURES. THE IMAGING DEPARTMENTS PROVIDE NECESSARY INPATIENT AND OUTPATIENT SERVICES TO THE COMMUNITY WE SERVE. SURGICAL SERVICES WITH DIRECT EXPENSES OF $3,588,156 INCLUDED BOTH INPATIENT AND OUTPATIENT SERVICES. SURGERY PERFORMED A TOTAL OF 3,201 SURGICAL PROCEDUDRES. 582 OF THOSE SERVICES WERE PROVIDED FOR INPATIENTS AND 2,619 FOR OUTPATIENTS. THE SURGERY DEPARTMENT MEETS THE NEEDS OF THE COMMUNITY BY PROVIDING BOTH EMERGENT AND ELECTIVE SURGERY ON AN INPATIENT AND OUTPATIENT BASIS. PROGRAM SERVICE ACCOMPLISHMENTS - FORM 990 PART III, LINE 4A THE COMMUNITY BENEFIT CONTRIBUTION OF ST. MARY'S HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1: QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT MISSION, HOW THE MISSION IS TRANSLATED INTO A PROACTIVE APPROACH DESIGNED TO MEET COMMUNITY HEALTH NEEDS, HOW THE HOSPITAL MEETS TAX-EXEMPT REQUIREMENTS, AND A DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT HIGHLIGHT THE HOSPITAL'S IMPACT ON COMMUNITY HEALTH. SECTION 2: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT CONTRIBUTION IN FINANCIAL TERMS PRESENTING THE AMOUNT OF CHARITY CARE, THE UNPAID SHORTFALL FROM GOVERNMENT HEALTH CARE FOR THE INDIGENT, AND THE NET EXPENSE OF COMMUNITY BENEFIT SERVICES. SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT 1.ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT- ST. MARY'S HOSPITAL MISSION IS TO CONTINUE CHRIST'S HEALING MINISTRY THROUGH SERVICE TO THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL REGARDLESS OF RACE, CREED, SEX, HANDICAPS, AGE, RELIGION, SEXUAL ORIENTATION, MARITAL, MILITARY-DISCHARGE OR FINANCIAL STATUS. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF ST. MARY'S HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. A. ST. MARY'S HOSPITAL IS LOCATED IN STREATOR ILLINOIS AND SERVES A PRIMARY SERVICE AREA OF APPROXIMATELY 113,921 RESIDENTS; WITH A SECONDARY SERVICE AREA OF APPROXIMATELY 90,254 RESIDENTS. ST. MARY'S HOSPITAL HAS BEEN DESIGNATED AS A MEDICARE DEPENDENT HOSPITAL MEETING THE CRITERIA OF AT LEAST 60 PERCENT OF INPATIENT DAYS OR DISCHARGES COVERED BY MEDICARE. THIS GREATER DEPENDENCE ON MEDICARE MAKES THE HOSPITAL MORE FINANCIALLY VULNERABLE TO PROSPECTIVE PAYMENT. ST. MARY'S HOSPITAL HAS IDENTIFIED TRANSPORTATION AS A NEED OF OUR SERVICE AREA. THE INCREASE IN THE ELDERLY POPULATION WHO ARE STILL IN THEIR HOMES AND DO NOT HAVE TRANSPORTATION TO OBTAIN MEDICAL NEEDS HAS INCREASED IN THIS SERVICE AREA. THE HOSPITAL HAS PROVIDED TRANSPORTATION BENEFITS TO 238 UNDERSERVED PERSONS AND IS WORKING IN CONJUNCTION WITH THE INTERAGENCY COORDINATING COMMITTEE ON TRANSPORTATION FOR LASALLE COUNTY TO ADDRESS THIS GROWING NEED. BASED ON THE ASSESSMENT OF COMMUNITY NEEDS, ST. MARY'S HAS FOCUSED ON THE FOLLOWING PRIORITIES: OBESITY AND FAMILY VIOLENCE. THESE MAJOR NEEDS IN OUR COMMUNITY BEST MATCH THE HOSPITAL'S CORE COMPETENCIES AND WOULD OFFER THE BEST OPPORTUNITY TO AFFECT THE MOST CHANGE IN THE COMMUNITIES WE SERVE. TO TARGET OBESITY IN THE COMMUNITIES SERVED, ST. MARY'S HOSPITAL FOCUSED ON EXERCISE, NUTRITION AND HEALTHY LIFESTYLES. EVERY JANUARY, ST. MARY'S HOSPITAL OFFERS THEIR LEAN TO GREEN (L2G) PROGRAM, DESIGNED TO HELP ST. MARY'S COLLEAGUES AND COMMUNITY MEMBERS REALIZE THAT HEALTHY EATING AND FITNESS ARE YEAR ROUND ACTIVITIES. IN THE STYLE OF THE POPULAR TELEVISION SHOW, "THE BIGGEST LOSER", L2G IS DESIGNED TO BE A FUN AND EXCITING WAY TO ENCOURAGE HOSPITAL COLLEAGUES AND COMMUNITY MEMBERS TO ACHIEVE AND MAINTAIN A HEALTHY LIFESTYLE WITH WEIGHT LOSS AS THE MOTIVATOR. LEAN TO GREEN ALSO SERVES AS A MAINTENANCE PROGRAM FOR THOSE WHO DON'T NEED TO LOSE WEIGHT BUT WOULD STILL LIKE TO IMPROVE THEIR OVERALL FITNESS. THIS YEAR WE HAD 116 PARTICIPANTS COMPLETE THE 12-WEEK WEIGHT LOSS PROGRAM AND THOSE PARTICIPANTS LOST A TOTAL OF 1,995 POUNDS OR 5.14 PERCENT OF THEIR ORIGINAL BODY WEIGHT. IN CONJUNCTION WITH THE LEAN TO GREEN PROGRAM, ST. MARY'S HOSPITAL OFFERED WEEKLY HANDOUTS RELATED TO NUTRITION AND EXERCISE. ST. MARY'S HOSTED AN ELECTRONIC RECYCLING AND USED MEDICAL EQUIPMENT DRIVE OPEN TO ALL COLLEAGUES AND THE COMMUNITY IN HONOR OF EARTH DAY. VINTAGE TECH RECYCLERS, INC. AS ON SITE WITH A TRUCK COLLECTING VARIOUS ELECTRONIC ITEMS TO BE RECYCLED AND THE USED MEDICAL EQUIPMENT WAS DONATED TO HSHS MISSION OUTREACH IN SPRINGFIELD, ILLINOIS. BECAUSE OF OUR EVENT, WE WERE ABLE TO RECYCLE 38,397 POUNDS OF ELECTRONICS THAT OTHERWISE WOULD END UP IN OUR LANDFILLS. IN ADDITION TO THE ELECTRONICS RECYCLING DRIVE, ST. MARY'S PHARMACY SET UP A MEDICATION DISPOSAL DRIVE TO HELP PRESERVE OUR WATER SUPPLY. THE PHARMACY COLLECTED 95.4 POUNDS OF EXPIRED OR UNWANTED MEDICATIONS THAT INDIVIDUALS WISHED TO SAFELY DISCARD. B. ST. MARY'S HOSPITAL HAS A CHARITY PROGRAM IN PLACE TO OFFER FINANCIAL ASSISTANCE TO PERSONS WITHOUT THE ABILITY TO PAY FOR NECESSARY MEDICAL TREATMENT. ST. MARY'S PROVIDES BROCHURES IN THE EMERGENCY DEPARTMENT, PATIENT REGISTRATION DEPARTMENT AND FROM THE PATIENT FINANCIAL REPRESENTATIVES GIVING NOTICE OF THE HOSPITAL'S CHARITY ASSISTANCE POLICY. INFORMATION OUTLINING THE PROGRAM IS ALSO AVAILABLE ON PATIENT STATEMENTS AND UPON REQUEST. 2. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION- ST. MARY'S HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24 HOURS TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. ST. MARY'S HOSPITAL SERVES AS A CLINICAL SITE FOR STUDENTS IN THE FIELDS OF NURSING, LABORATORY, DIAGNOSTIC IMAGING, PHYSICAL THERAPY, SPEECH AND PHARMACY. ST. MARY'S HOSPITAL PARTICIPATES IN THE GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS FOR MEDICAID, MEDICARE, CHAMPUS AND TRICARE. 3. DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS- ST. MARY'S HOSPITAL OPERATES AN ADULT DAY PROGRAM WHICH PROVIDES MEALS, TRANSPORTATION, AND SOCIAL STIMULATION FOR SENIORS WHO LIVE AT HOME BUT DO NOT HAVE A CARETAKER AVAILABLE DURING THE DAY. THE ADULT DAY CENTER IS FOR ADULTS WHO ARE MINIMALLY PHYSICALLY IMPAIRED, SOCIALLY ISOLATED OR DISABLED. THE PROGRAM PROVIDES DAILY ACTIVITIES WHICH MAY INCLUDE MUSIC, ART, CRAFTS AND EXERCISE PROVIDED BY PROFESSIONALLY TRAINED AND QUALIFIED INDIVIDUALS. NO PARTICIPANT IS REFUSED SERVICE BECAUSE OF AN INABILITY TO PAY. ST. MARY'S HOSPITAL IS AWARE OF THE NEED IN THE COMMUNITY FOR TRANSPORTATION TO AND FROM MEDICAL SERVICES. IN AN EFFORT TO ALLEVIATE THIS NEED, THE HOSPITAL PROVIDES A MEDICAL TRANSPORTATION PROGRAM WHICH INCLUDES FREE VAN SERVICE TO MEDICAL APPOINTMENTS FOR PATIENTS WITH SPECIAL NEEDS AND NO MEANS OF TRANSPORTATION. THIS SERVICE INCLUDES TRANSPORTATION TO PHYSICIAN OFFICE AND ALL OUTPATIENT SERVICES AFFILIATED WITH ST. MARY'S HOSPITAL. TRANSPORTATION IS MADE WITH THE PARTICIPANTS SAFETY IN MIND WITH A QUALIFIED STAFF TO ASSIST INDIVIDUALS WITH BOARDING AND DISEMBARKING IN VANS MAINTAINED TO ILLINOIS DEPARTMENT OF TRANSPORTATION STANDARDS. |
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED | FORM 990 PART III, | ST. MARY'S HOSPITAL HAS RECOGNIZED THE NEED FOR COMPREHENSIVE MANAGEMENT OF THE PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF PATIENTS WITH COMPLICATED OR SERIOUS ILLNESSES. IN RESPONSE TO THIS NEED, THE HOSPITAL OFFERS THE SERVICES OF THE SUPPORTIVE CARE TEAM. THIS TEAM UTILIZES A TEAM OF PROFESSIONALS AS A CONSULT WITH THE PRIMARY PHYSICIAN. A PHYSICIAN, NURSE, SOCIAL WORKER, AND CHAPLAIN AIM TO RELIEVE SUFFERING AND IMPROVE QUALITY OF LIFE, REGARDLESS OF THE PROGNOSIS AND TREATMENT. THE PRIMARY FOCUS OF CARE IS TO IDENTIFY PATIENT AND FAMILY GOALS AND MANAGE SYMPTOMS FOR A BETTER QUALITY OF LIFE. THIS SERVICE IS OFFERED FREE OF CHARGE AND OFFERS COORDINATION OF CARE BASED ON PATIENT AND FAMILY GOALS, TIME INTENSIVE PATIENT-FAMILY COMMUNICATION INCLUDING DIFFICULT DECISION MAKING, EXPERTISE IN SYMPTOM MANAGEMENT SUCH AS PAIN, ANXIETY, NAUSEA, DIFFICULTY BREATHING, APPETITE LOSS, BOWEL PATTERNS, EMOTIONAL DISTRESS AND SLEEP DISTURBANCES AND A HIGH LEVEL PATIENT AND FAMILY SATISFACTION WITH THEIR PHYSICIAN, HEALTH CARE TEAM AND HOSPITAL. 4. LINKS TO ADDITIONAL COMMUNITY BENEFIT INFORMATION- ST. MARY'S HOSPITAL CHRISTIAN CARE POLICY, REQUEST FOR FINANCIAL ASSISTANCE, FINANCIAL ELIGIBILITY CRITERIA TABLE AND COMMUNITY BENEFITS REPORT IS ATTACHED. SECTION 2 - QUANTIFIABLE COMMUNITY BENEFIT THE FINANCIAL INFORMATION IN THIS REPORT WAS PREPARED IN ACCORDANCE WITH THE CATHOLIC HEALTH ASSOCIATION'S (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. THESE GUIDELINES RECOMMEND THE FOLLOWING: "REPORT CHARITY CARE AT COST, NOT CHARGES. "DO NOT INCLUDE BAD DEBT, CONTRACTUAL ALLOWANCES, AND QUICK PAY DISCOUNTS AS PART OF CHARITY CARE EXPENSE. "DO NOT COUNT MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. "REPORT THE NET EXPENSE FOR COMMUNITY BENEFIT SERVICES, I.E., THE TOTAL COMMUNITY BENEFIT EXPENSE MINUS ANY ASSOCIATED REVENUE FROM PATIENTS, PAYERS, AND OTHER EXTERNAL SOURCES. THE CHA REPORTING GUIDELINES REFLECT A CONSERVATIVE APPROACH TO REPORTING QUANTIFIABLE COMMUNITY BENEFIT. THE GOAL OF THE REPORTING GUIDELINES IS TO PRODUCE COMMUNITY BENEFIT FINANCIAL REPORTS THAT REFLECT TRUE COSTS AND THAT DESCRIBE COMMUNITY BENEFIT ACTIVITIES THAT INCREASE ACCESS TO HEALTH CARE AND IMPROVE COMMUNITY HEALTH. CATEGORY A, COMMUNTIY HEALTH IMPROVEMENT SERVICES- EDUCATION, CLINICAL, AND SUPPORT SERVICES WERE PROVIDED TO 26,183 PEOPLE, AT A COST OF 300,600, FOR A TOTAL BENEFIT AMOUNT OF 297,245. A1 - COMMUNITY HEALTH EDUCATION: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS, SERVED 24,366 PERSONS AT A COST OF 91,430. THERE WERE NO OFFSETTING REVENUES FOR A TOTAL BENEFIT AMOUNT OF 90,132. A2 - COMMUNITY BASED CLINICAL SERVICES: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS SERVED 1,534 PERSONS AT A COST OF 67,675, WITH NO OFFSETTING REVENUES FOR A TOTAL BENEFIT AMOUNT OF 67,675. A3 - HEALTH CARE SUPPORT SERVICES: COMMUNITY HEALTH EDUCATION BENEFIT PROGRAMS SERVED 283 PERSONS AT A COST OF 300,600 WITH OFFSETTING REVENUES OF 1,995 FOR A TOTAL BENEFIT AMOUNT OF 297,245. CATEGORY B, COMMUNTIY HEALTH IMPROVEMENT SERVICES- 20,044 IN SCHOLARSHIPS AND FUNDING FOR EDUCATION WAS PROVIDED. CATEGORY C, LOW OR NEGATIVE MARGIN PROGRAMS SERVED 18 PEOPLE AT A COST OF 45,963, WITH OFFSETTING REVENUES OF 237,859 FOR A TOTAL BENEFIT AMOUNT OF 6,883. CATEGORY E, FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALED 67,763 SERVING 5,447 PEOPLE. E1 - CASH DONATIONS TOTALED 5500. E3 - IN-KIND DONANTIONS: IN-KIND DONATIONS SERVED 5,447 PERSONS AT A COST OF 62,263 WITH NO OFFSETTING REVENUES FOR A TOTAL BENEFIT AMOUNT OF 62,263. CATEGORY F - COMMUNITY BUILDING ACTIVITIES, INCLUDED SUPPORT SYSTEM ENHANCEMENTS AT A COST OF 3,195. A TOTAL OF 43 COMMUNITY BENEFIT ACTIVITIES WERE COMPLETED, AT A COST OF 437,565 WITH OFFSETTING REVENUES OF 42,435 FOR A TOTAL BENEFIT AMOUNT OF 395,130. TAX EXEMPT BONDS FORM 990, PART IV, QUESTION 4 ST. MARY'S - STREATOR HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. |
| RIGHTS OF MEMBERS TO ELECT GOVERNING BODY | FORM 990 PART VI, LINES 6 & 7A | THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL STREATOR (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. |
| MEMBER RESERVED POWERS | FORM 990 PART VI, LINE 7B | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL STREATOR (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO FROM TIME TO TIME ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. |
| FORM 990 REVIEW PROCESS | FORM 990 PART VI, LINE 11b | THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL preparation and REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990 PART VI, LINE 12C | THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWERS ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. |
| WHISTLEBLOWER POLICY | FORM 990 PART VI, LINE 13 | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| COMPENSATION PROCESS | FORM 990 PART VI, LINE 15 | THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES (IHS), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. |
| DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990 PART VI, LINE 19 | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| POOLED INVESTMENT ACCOUNT | FORM 990 PART X, LINE 11 | St. Mary's Hospital's cash reserves ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM (HSHS). PARTICIPATION IN THE POOLED INVESTMENT FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 124, "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. |
| Other changes in net assets | Form 990, Part XI, Line 5 | UNREALIZED LOSS (2,287,250) NET ASSETS REALISED FORM RESTRICTION - PP&E 27,483 TEMPORARILY RESTRICTED NET INCOME (32,882) PERMANENTLY RESTRICTED NET INCOME 14,081 RECOGNITION OF CHANGES IN PENSION FUNDED STATUS (6,507,053) PROCEEDS FROM RESTRICTED GRANT USED TO ACQUIRE EQUIPMENT 195,290 TRANSFER TO/FROM AFFILIATES (2,798,001) ------------- TOTAL (11,388,332) ============= |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:SR. MARYbeth CULNAN, OSF TITLE:MBR. BOARD OF DIRECTORS HOURS:59 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ANN CARR TITLE:TREASURER HOURS:60 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Springfield Health Partners LLC | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 371364419 | Healthcare | IL | 0 | 0 | hshs mg |
| Kiara Clinical Integration Network LLC | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 261417684 | Healthcare | IL | 0 | 0 | HSSI |
| PHYSICIANS CLINICAL INTEGRATION NETWORK | |||||||||
| 4936 Laverna Road | Springfield | IL | 62707 | 311668647 | Healthcare | IL | 0 | 0 | KCIN |
Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL SISTERS HEALTH SYSTEM | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371058692 | HEALTHCARE | IL | 501(c)(3) | 11A | NA | false |
| HOSPITAL SISTERS SERVICES INC | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163402 | HEALTHCARE | IL | 501(c)(3) | 11A | NA | false |
| HOSPITAL SISTERS OF ST FRANCIS FDTN | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(c)(3) | 11A | NA | false |
| HSHS HEALTH CARE PLAN TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371137724 | HEALTHCARE | IL | 501(c)(9) | N/A | NA | false |
| ST ANTHONY'S HOSPITAL | ||||||||||
| 503 N MAPLE STREET | EFFINGHAM | IL | 62401 | 370661233 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST ELIZABTH'S HOSPITAL | ||||||||||
| 211 SOUTH THIRD STREET | BELLEVILLE | IL | 62220 | 370663567 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST FRANCIS HOSPITAL | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST JOHN'S HOSPITAL | ||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 370661238 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 9515 HOLY CROSS LANE | BREESE | IL | 62230 | 371208459 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 1515 MAIN STREET | HIGHLAND | IL | 62249 | 370663568 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| ST JOSEPH'S HOSPITAL | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 390810545 | HEALTHCARE | WI | 501(c)(3) | 3 | NA | false |
| ST MARY'S HOSPITAL | ||||||||||
| 1800 E LAKE SHORE DRIVE | DECATUR | IL | 62521 | 370661244 | HEALTHCARE | IL | 501(c)(3) | 3 | NA | false |
| SACRED HEART HOSPITAL | ||||||||||
| 900 WEST CLAIREMONT AVE | EAU CLAIRE | WI | 54701 | 390807060 | HEALTHCARE | WI | 501(c)(3) | 3 | NA | false |
| ST MARY'S MEDICAL CENTER | ||||||||||
| 1726 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(c)(3) | 3 | NA | false |
| ST NICHOLAS HOSPITAL | ||||||||||
| 3100 SUPERIOR AVENUE | SHEBOYGAN | WI | 53081 | 390808480 | HEALTHCARE | WI | 501(c)(3) | 3 | NA | false |
| ST VINCENT HOSPITAL | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 390817529 | HEALTHCARE | WI | 501(c)(3) | 3 | NA | false |
| Hospital Sisters Healthcare West Inc | ||||||||||
| 2661 COUNTY HIGHWAY I | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | WI | 501(c)(3) | 11A | NA | false |
| HSHS SELF INSURANCE TRUST FUND | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371120626 | INSURANCE | IL | 501(c)(3) | 11A | NA | false |
| HSHS Medical Group Inc | ||||||||||
| 3215 Executive Park Drive | SPRINGFIELD | IL | 62703 | 263956318 | HEALTHCARE | IL | 501(c)(3) | 11A | NA | false |
| HSHS Wisconsin Medical Group Inc | ||||||||||
| 3215 Executive Park Drive | springfield | IL | 62703 | 264515959 | HEALTHCARE | WI | 501(c)(3) | 11A | NA | false |
| Orange Cross Ambulance Inc | ||||||||||
| 919 ASHLAND AVENUE | SHEBOYGAN | WI | 53081 | 391860942 | HEALTHCARE | WI | 501(c)(3) | 9 | ST NICHOLAS | false |
| WISCONSIN UPPER PENINSULA ONCOLOGY MGMT | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 391677100 | HEALTHCARE | WI | 501(c)(3) | 3 | ST VINCENT | false |
| UNITY LIMITED PARTNERSHIP | ||||||||||
| 2366 OAK RIDGE CIRCLE | DE PERE | WI | 54115 | 391750729 | HEALTHCARE | WI | 501(c)(3) | 9 | HSSI | false |
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Memorial and St Elizabeth's Healthcare | ||||||||||||||
| 4000 North Illinois Street | Swansea | IL | 62226 | 371312961 | HealthCare | IL | St Elizabeth's | related | 0 | 0 | false | $0 | false | 0.00000 |
| Prairie Heart Institute - Carbondale | ||||||||||||||
| 800 East Carpenter Street | Springfield | IL | 62769 | 371321197 | HealthCare | IL | St John's | related | 0 | 0 | false | $0 | false | 0.00000 |
| Northeast Wisconsin Radiation Therapy Se | ||||||||||||||
| 1821 S Webster Avenue STE 300 | Green Bay | WI | 543079047 | 263749065 | HealthCare | WI | HSSI | related | 0 | 0 | false | $0 | false | 0.00000 |
| Pain Center of Wisconsin | ||||||||||||||
| 4131 W Loomis Road STE 300 | Greenfield | WI | 53221 | 263155343 | HealthCare | WI | St Vincent | related | 0 | 0 | false | $0 | false | 0.00000 |
| Prevea Ventures LLC | ||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 203775127 | HealthCare | WI | HSSI | related | 0 | 0 | false | $0 | false | 0.00000 |
| Surgery Center of Sheboygan LLC | ||||||||||||||
| 3141 Saemann Avenue | Sheboygan | WI | 53081 | 260822209 | Healthcare | WI | St Nicholas | related | 0 | 0 | false | $0 | false | 0.00000 |
| Carpenter Street Hotel LLC | ||||||||||||||
| 525 North Sixth Street | Springfield | IL | 62702 | 364128127 | Hotel | IL | LaSante Inc | related | 0 | 0 | false | $0 | false | 0.00000 |
| Springfield Urgent Care Real Estate LLC | ||||||||||||||
| PO Box 19456 | Springfield | IL | 627949456 | 030413258 | Rent. Real Es | IL | LaSante Inc | related | 0 | 0 | false | $0 | false | 0.00000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kiara Inc | ||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 371163401 | HealthCare | IL | HSHS | C Corp | 0 | 0 | 0.00000 | |||||
| LaSante Wisconsin Inc | ||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 391572196 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |||||
| LaSante Inc | ||||||||||||||||
| 4936 Laverna ROAd | Springfield | IL | 62707 | 371163400 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |||||
| Prairie Cardiovascular | ||||||||||||||||
| 619 East Mason STE 4P57 | Springfield | IL | 62701 | 371071858 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |||||
| Prevea Health Services | ||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 391839351 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |||||
| Prevea Clinic Inc | ||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 391839349 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |||||
| Prevea Health Network | ||||||||||||||||
| 2710 EXECUTIVE DRIVE | Green Bay | WI | 54304 | 392000537 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |||||
| RENAISSANCE QUALITY INSURANCE | ||||||||||||||||
| 980669953 | Insurance | HSSI | C Corp | 0 | 0 | 0.00000 | PO Box 1159 | Grand Caymans | CJ | KY1-1102 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | true | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRARIE CARDIOVASCULAR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | I | TransactionType |
| Amount Involved | 19092 | AmountInvolved |
| Method Of Amt Determination | fmv | MethodOfAmtDetermination |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | transactions with related organizations | Identifier |
| Return Reference | schedule r, part v, line 2 | ReturnReference |
| Explanation | The transactions reported on line 1 and not specifically identified on line 2 are between related 501(c)(3) public charities. accordingly they are not reported in this section. | Explanation |
Comments