GIBSON AREA HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- GIBSON AREA HOSPITAL (EIN 37-0647938)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-12
- IRS object ID
- 201302249349301930
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-12T14:26:30-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371335003 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ECK SCHAFER & PUNKE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East Adams Street | AddressLine1 |
| City | Springfield | City |
| State | IL | State |
| ZIP Code | 627011624 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370647938 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gibson Community Hospital Association | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GIBS | NameControl |
| Phone | 2177844251 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1120 North Melvin | AddressLine1 |
| City | Gibson City | City |
| State | IL | State |
| ZIP Code | 60936 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rob Schmitt | Name |
| Title | CEO | Title |
| Phone | 2177844251 | Phone |
| Date Signed | 2013-08-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brent Leach | Name |
| PTIN | P00331592 | PTIN |
| Phone | 2175251111 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Rob Schmitt | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1120 North Melvin | AddressLine1 |
| City | Gibson City | City |
| State | IL | State |
| ZIP Code | 60936 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 62594819 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | http://www.gibsonhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | Health care and related services | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 593 | TotalNbrEmployees |
| Total Nbr Volunteers | 248 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 13304 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1268416 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 53714155 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 59258212 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 62935 | InvestmentIncomePriorYear |
| Investment Income Current Year | 46971 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1901333 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1959437 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 55691727 | TotalRevenuePriorYear |
| Total Revenue Current Year | 62533036 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 20000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 15000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 31286379 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 33607604 | 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 | 23720257 | OtherExpensePriorYear |
| Other Expenses Current Year | 27199013 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 55026636 | TotalExpensesPriorYear |
| Total Expenses Current Year | 60821617 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 665091 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1711419 | RevenuesLessExpensesCY |
| Total Assets BOY | 32573458 | TotalAssetsBOY |
| Total Assets EOY | 37311266 | TotalAssetsEOY |
| Total Liabilities BOY | 16784389 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 19771366 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15789069 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17539900 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide personalized, professional services to the residents of the communities we serve. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 51698374 | Expense |
| Grants | 15000 | Grants |
| Revenue | 61217649 | Revenue |
| Description | The organization provides for inpatient and outpatient health care along with long-term care for members of the community and surrounding areas. | Description |
| Total Program Service Expense | 51698374 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 58 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 593 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rob Schmitt | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2177844251 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1120 North Melvin | AddressLine1 |
| City | Gibson City | City |
| State | IL | State |
| ZIP Code | 60936 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 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 |
|---|---|---|---|---|---|---|---|
| Jim Hood | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Margo Martin | |||||||
| Vice-President | 1.00 | X | X | 0 | 0 | 0 | |
| Tracy Epps | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Ellen Lee | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Carl Hudson Jr | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Steve Kelly | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| David J Hagan MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Marty Nuss | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Mark Spangler MD | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Nancy Krumwiede | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| John Leonard | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Michael Young | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Kathy Bennett | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Ted Swanson | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Rob Schmitt | |||||||
| CEO | 40.00 | X | 129541 | 0 | 7798 | ||
| John Jacobson | |||||||
| CFO | 40.00 | X | 147938 | 0 | 12716 | ||
| Richard Foellner DO | |||||||
| Physician | 40.00 | 516834 | 0 | 19301 | X | ||
| William Price MD | |||||||
| Physician | 40.00 | 600000 | 0 | 25941 | X | ||
| Benjamin Brewer MD | |||||||
| Physician | 40.00 | 351265 | 0 | 19301 | X | ||
| Katherine Austman MD | |||||||
| Physician | 40.00 | 244707 | 0 | 9373 | X | ||
| Jeremy Henrichs | |||||||
| Physician | 40.00 | 236182 | 0 | 7080 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2226467 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 101510 | TotalOtherCompensation |
| Number Individuals GT100 K | 34 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Cardinal Health Pharmacy Management | |||||
| 1330 Enclave Parkway | Houston | TX | 77077 | Pharmacy Management | 1992730 |
| All Inclusive Medical Services | |||||
| Orland Park Illinois | Orland Park | IL | 60462 | ER Hospitalist Physicians | 1578472 |
| Gary W Kerber MD | |||||
| 1002 S Busey Ave | Urbana | IL | 61801 | Radiologist | 395106 |
| CPSI | |||||
| 6600 Wall St | Mobile | AL | 36695 | Computer Services | 227114 |
| Helvey & Associates INC | |||||
| 1029 E Center St | Warsaw | IN | 46580 | Collection Agency | 203245 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| All Other Contributions | 1268416 | AllOtherContributions |
| Total Contributions | 1268416 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 59258212 | TotalRevenueColumn |
| Related Or Exempt Function Income | 59258212 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 59258212 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45278 | TotalRevenueColumn |
| Exclusion | $45,278 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 63476 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 61783 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1693 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1693 | TotalRevenueColumn |
| Exclusion | $1,693 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Miscellaneous | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 1959437 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1959437 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1959437 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 62533036 | TotalRevenueColumn |
| Related Or Exempt Function Income | 61217649 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $46,971 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Program Services | 15000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 424962 | Total |
| Program Services | 361218 | ProgramServices |
| Management And General | 63744 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26135686 | Total |
| Program Services | 22215333 | ProgramServices |
| Management And General | 3920353 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7046956 | Total |
| Program Services | 5989913 | ProgramServices |
| Management And General | 1057043 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2990151 | Total |
| Program Services | 2541628 | ProgramServices |
| Management And General | 448523 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 312967 | Total |
| Program Services | 266022 | ProgramServices |
| Management And General | 46945 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497692 | Total |
| Program Services | 423038 | ProgramServices |
| Management And General | 74654 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2130223 | Total |
| Program Services | 1810690 | ProgramServices |
| Management And General | 319533 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1010038 | Total |
| Program Services | 858532 | ProgramServices |
| Management And General | 151506 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Supplies | 7034032 | 5978927 | 1055105 |
| Purchased Services | 5297535 | 4502905 | 794630 |
| Bad Debts | 2848413 | 2421151 | 427262 |
| Other | 1687393 | 1432033 | 255360 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3390569 | Total |
| Program Services | 2881984 | ProgramServices |
| Management And General | 508585 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60821617 | Total |
| Program Services | 51698374 | ProgramServices |
| Management And General | 9123243 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 325507 | BOY |
| EOY | 563131 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9629945 | BOY |
| EOY | 12778149 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 655914 | BOY |
| EOY | 666772 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 637336 | BOY |
| EOY | 452265 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 45150175 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26122910 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18915930 | BOY |
| EOY | 19027265 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1459437 | BOY |
| EOY | 2641625 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 322950 | BOY |
| EOY | 305123 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 626439 | BOY |
| EOY | 876936 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32573458 | BOY |
| EOY | 37311266 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5289976 | BOY |
| EOY | 7650656 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11494413 | BOY |
| EOY | 11342337 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 778373 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16784389 | BOY |
| EOY | 19771366 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15695416 | BOY |
| EOY | 17417369 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93653 | BOY |
| EOY | 122531 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15789069 | BOY |
| EOY | 17539900 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32573458 | BOY |
| EOY | 37311266 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1711419 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 39412 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 344036 | OtherCostOrOtherBasis |
| Book Value | 344036 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 24318831 | OtherCostOrOtherBasis |
| Depreciation | 12493120 | Depreciation |
| Book Value | 11825711 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19141967 | OtherCostOrOtherBasis |
| Depreciation | 12858984 | Depreciation |
| Book Value | 6282983 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1345341 | OtherCostOrOtherBasis |
| Depreciation | 770806 | Depreciation |
| Book Value | 574535 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 19027265 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Investments | Description |
| Book Value | 2641625 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 2641625 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital lease payable | $223,320 |
| Estimated Third pary Settlements | $555,053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 778373 | TotalOfAmounts |
| Total Revenue | 62533036 | TotalRevenue |
| Total Expenses | 60821617 | TotalExpenses |
| Excess Or Deficit For Year | 1711419 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 15360 | NetUnrealizedGLOnInvestments |
| Other | $24,052 | OtherAmount |
| Total Adjustments | 39412 | TotalAdjustments |
| Excess Or Deficit Per FS | 1750831 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 62548396 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 15360 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 15360 | RevenueNotRptdF990 |
| Revenue Subtotal | 62533036 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 62533036 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 60821617 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 60821617 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 60821617 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | GAHHS follows accounting principles generally accepted in the United States of America related to the accounting for uncertainty in income taxes which sets a minimum threshold for financial statement recognition of the benefit of a tax position taken or expected to be taken in a tax return. Tax positions for the open tax years as of September 30, 2012 were reviewed, and it was determined that no provision for uncertain tax positions is required. GAHHSs information and income tax returns for years subsequent to fiscal year 2009 are open, by statute, for review by authorities. |
| Part XI, Line 8 - Other Adjustments: | Loss on Extinguishment of Debt 0. Transfer of Net Assets from Gibson Area Hospital Foundation #36-4311943 24,052. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1146601 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 481638 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 664963 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01090 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6751092 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4303865 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2447227 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7897693 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4785503 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3112190 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05110 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3593 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3593 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11935282 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6539028 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5396254 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08870 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 192326 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 192326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12131201 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6539028 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5592173 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09200 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20028894 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11324531 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8704363 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14310 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,303,466 | BadDebtExpenseAmount |
| Amount Attributable To | 65173 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 15390973 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23442049 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8051076 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 12 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (12 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| Gibson Community Hospital | ||||||||
| 1 | 1120 North Melvin | Gibson City | IL | 60936 | X | X | X | Long-term care |
| Paxton Clinic | ||||||||
| 2 | 227 N Market | Paxton | IL | 60957 | Physician clinic | |||
| Onarga Clinic | ||||||||
| 3 | 109 N Chestnut | Onarga | IL | 60955 | Physician clinic | |||
| Family Healthcare of Hoopeston | ||||||||
| 4 | 837 E Orange | Hoopeston | IL | 60942 | Physician clinic | |||
| Family Health Care of Farmer City | ||||||||
| 5 | 1230 S George Rock Dr | Farmer City | IL | 61842 | Physician clinic | |||
| Prairie Family Medicine and Obstetrics | ||||||||
| 6 | 122 E Wabash | Forrest | IL | 60936 | Physician clinic | |||
| Gibson Area Hospital Orthopedics | ||||||||
| 7 | 10 Doctors Park | Gibson City | IL | 60936 | Physician clinic | |||
| Gibson Area Ambulance Service | ||||||||
| 8 | 1120 North Melvin | Gibson City | IL | 60936 | Ambulance service | |||
| Gibson Area Hospital Surgery Clinic | ||||||||
| 9 | 1 Doctors Park | Gibson City | IL | 60936 | Physician clinic | |||
| Family Health Care of Fairbury | ||||||||
| 10 | 401 S Clay Street | Fairbury | IL | 61739 | Physician clinic | |||
| Family Health Care of Gibson City | ||||||||
| 11 | 7 Doctors Park | Gibson City | IL | 60936 | Physician clinic | |||
| Gibson Cosmetology | ||||||||
| 12 | 1117 N Melvin Street | Gibson City | IL | 60936 | ||||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Not Required | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 0 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 0 | IncludesPublicityMeasures |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: Cost to charge ratio was obtained using Cost Accounting System. This system does address all patient segments. It is an overall cost to charge ratio for the hospital. | ||
| Part III, Line 4: Cost methodology for numbers in 2, and 3: 2 - actual bad debt expenses recorded in FY 2011 times 53.7% cost to charge ratio. 3 - 5% of total bad debt expense. Patient Financial Services works towards getting charity eligible patients qualified several times during the collection process. Ultimately, unpaid patient accounts are turned over to agencies that try to collect the patient balance due, but patients accounts are never turned over to a credit reporting agency. | ||
| Part III, Line 8: Part of the shortfall will be settled on the Cost Report. Also filed Cost Report will be reviwed by intermediary, and will be settled according to Medicare Guidelines. | ||
| Part III, Line 9b: To the extent patients qualify for charity and financial assistance, no further collection efforts are taken on those balances qualified. No patient balances are credit reportable. | ||
| Part VI, Line 2: The hospital is currently working on a community needs assessment outlined by CMS guidelines. | ||
| Part VI, Line 3: Charity care/financial assistance is posted on the hospital website. It is also discussed during the pre-registration process for all self pay and patients with a high deductible. Informational packets are distributed from each registration area [including ED] for self pay & high deductible. The informational packets have a application, cover letter about the program, and contact info on who/where to call for more info or assistance. Each self pay patient is contacted by Financial Healthcare Resources to discuss the government programs they may be eligible for and/or charity care. Charity care is also offered on the first statement that the patient receives. | ||
| Part VI, Line 4: The hospital is located Ford County, IL. The hospital also has clinics in Livingston, DeWitt, and Iroquois counties, as well as serving Vermillion County. The hospital and clinics serve areas that are all considered rural; small towns and farmland. Of the counties listed above, as of 2008, percentage of persons below poverty level: Ford, 9.8%; Livingston 11.4%; DeWitt 10.2%; Iroquois 10.8%; Vermillion 14.6%; State level is 12.2% . Median Income, 2008: Ford, $51,313; Livingston, $50,972, DeWitt, $47,645; Iroquois, $46,529; Vermillion $41,292; State level is $56,230. Percent of population enrolled with HFS for benefits as of 2009: Ford, 18.8%; Livingston, 17.2%; DeWitt 18.7%; Iroquois 19.6%; Vermillion 27.1%. Closest hospital facilities are 30 miles to the southeast in Champaign/Urbana (Carle, Provena), and 35 miles to the west in Bloomington/Normal (OSF, Advocate/BroMenn). | ||
| Part VI, Line 5: The entire Board of Directors is comprised of persons who reside in our primary service area, as do the Administrative Staff of the hospital. All of the physicians in the community have privileges at the hospital. The organization has also recruited and placed physicians in other rural communities, that also have privileges at the hospital. The hospital runs and maintains EMS services to several rural communities, which the organization runs at a loss every year. Any surplus funds are used to improve medical equipment, purchase needed supplies and pharmaceuticals, recruit providers for needed services, pay for staff to attend educational workshops, and other needed items and services for the betterment of the community. No excess of revenue over expenses are used to pay any shareholders or investors. This organization does not have either of the latter. | ||
| Part VI, Line 6: Gibson Hospital is not part of an affiliated healthcare system. | ||
| IL | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Telecare | |||||||
| 215 E 3rd St | Gibson City | IL | 60936 | 237353001 | 501(c)3 | 10000 | Community Benefit |
| Community Economic Development Foundation | |||||||
| 402 N Sangamon Ave | Gibson City | IL | 60936 | 371336454 | 501(c)3 | 5000 | Community Benefit |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: Grants are made to 501 (c)(3) organizations to provide community benefit. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John Jacobson | |||||||||||||
| 147938 | 0 | 0 | 0 | 0 | 0 | 9915 | 0 | 2801 | 0 | 160654 | 0 | 0 | 0 |
| Richard Foellner DO | |||||||||||||
| 484808 | 0 | 32026 | 0 | 0 | 0 | 16500 | 0 | 2801 | 0 | 536135 | 0 | 0 | 0 |
| William Price MD | |||||||||||||
| 600000 | 0 | 0 | 0 | 0 | 0 | 22749 | 0 | 3192 | 0 | 625941 | 0 | 0 | 0 |
| Benjamin Brewer MD | |||||||||||||
| 278500 | 0 | 72765 | 0 | 0 | 0 | 16500 | 0 | 2801 | 0 | 370566 | 0 | 0 | 0 |
| Katherine Austman MD | |||||||||||||
| 166292 | 0 | 78415 | 0 | 0 | 0 | 6572 | 0 | 2801 | 0 | 254080 | 0 | 0 | 0 |
| Jeremy Henrichs | |||||||||||||
| 177000 | 0 | 59182 | 0 | 0 | 0 | 7080 | 0 | 0 | 0 | 243262 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The City of Gibson City | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 376000811 | IssuerEIN |
| Date Issued | 2010-12-01 | DateIssued |
| Issue Price | 11720000 | IssuePrice |
| Description Of Purpose | Refinancing of prior bonds, costs associated with facility renovation | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 387576 | AmountRetired |
| Total Proceeds | 13306062 | TotalProceeds |
| Amount In Reserve Fund | 858896 | AmountInReserveFund |
| Capitalized Interest | 77708 | CapitalizedInterest |
| Refunding Escrow | 11398979 | RefundingEscrow |
| Issuance Costs From Proceeds | 281280 | IssuanceCostsFromProceeds |
| Capital Expenditures | 689199 | CapitalExpenditures |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 0 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Post Issuance Compliance Procdrs | 0 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Mark Spangler MD | NamePerson |
| Purpose Of Loan | Start-up costs for his practice | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $345,000 | OriginalPrincipalAmount |
| Balance Due | 94029 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 94029 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Mark Spangler MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Current board member of the Organization | Relationship |
| Amount Of Transaction | 131578 | AmountOfTransaction |
| Description Of Transaction | Pays the Organization a monthly fee for management services for his office. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Mark Spangler has a outstanding loan with the Hospital. | |
| Form 990, Part VI, Section A, line 3 | The hospital is in a contract with a managment company but the CEO remains employed by the hospital. | |
| Form 990, Part VI, Section A, line 6 | The Hospital has association members. These members are any individual who contributed $100 or more to the Hospital during the fiscal year and Life Members - Being those who have contributed a sum of One Thousand ($1,000) dollars or more to further the objectives of the Hospital. | |
| Form 990, Part VI, Section A, line 7a | The Association's members are allowed to vote annually at the member meeting. | |
| Form 990, Part VI, Section A, line 7b | At the annual meeting, the members are asked to vote on the approval of the Board of Directors acting on the member's behalf. | |
| Form 990, Part VI, Section B, line 11 | Form 990 is prepared by our independent accountants and provided to the governing body prior to filing. Form 990 is reviewed in detail by the Controller and CFO. | |
| Form 990, Part VI, Section B, line 12c | Yearly conflict of interest agreements are signed by board members. There is also a quarterly compliance review of these agreeements. | |
| Form 990, Part VI, Section B, line 15 | Top management and key employees' compensation is determined based on a review of current market comparables, experience level, and competitive compensation packages. The CEO is responsible for all compensation negotiations. | |
| Form 990, Part VI, Section C, line 19 | All documents are available to the public upon request. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 15,360. Loss on Extinguishment of Debt 0. Transfer of Net Assets from Gibson Area Hospital Foundation #36-4311943 24,052. Total to Form 990, Part XI, Line 5: 39,412. | Changes in Net Assets or Fund Balances: |
| Form 990, Part IV, Line 12 | The Hospital received an unqualified GAAP opinion on financial statements that were combined with the Gibson Area Hospital Foundation. | Explanation on audited financial statements |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Gibson Area Hospital Foundation | ||||||||||
| 1120 N Melvin | Gibson City | IL | 60936 | 364311943 | Support of the Hospital | IL | 501(c)3 | 509(a)2 | N/A | 0 |
| Gibson Community Hospital Auxiliary | ||||||||||
| 1120 N Melvin | Gibson City | IL | 60936 | 371150282 | Scholarships, Giftshop, Gala Fundraiser | IL | 501(c)3 | 509(a)2 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |