HOPEDALE MEDICAL FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: HOPEDALE MEDICAL FOUNDATION (EIN 37-0808925)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-14
IRS object ID: 201311349349302311
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 I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-14T10:33:06-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	420714325	EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

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

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	370808925	EIN

Name Name

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

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

US Address USAddress

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

Officer Officer

Field	Value	IRS element (for citing)
Name	ALFRED N ROSSI MD	Name
Title	PRESIDENT	Title
Phone	3094494298	Phone
Date Signed	2013-05-09	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

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

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

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

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

Address Principal Officer US AddressPrincipalOfficerUS

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

Field	Value	IRS element (for citing)
Gross Receipts	25411113	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.HOPEDALEMC.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1961	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	MAINTAIN A MEDICAL COMPLEX THAT INCLUDES AN ACUTE CARE HOSPITAL AND HEALTH CARE FACILITY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	8	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	443	TotalNbrEmployees
Total Nbr Volunteers	35	TotalNbrVolunteers
Total Gross UBI	129560	TotalGrossUBI
Net Unrelated Business Txbl Income	-30070	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	755989	ContributionsGrantsPriorYear
Contributions Grants Current Year	71741	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	19423183	ProgramServiceRevenuePriorYear
Program Service Revenue CY	20842325	ProgramServiceRevenueCY
Investment Income Prior Year	99277	InvestmentIncomePriorYear
Investment Income Current Year	66414	InvestmentIncomeCurrentYear
Other Revenue Prior Year	3079291	OtherRevenuePriorYear
Other Revenue Current Year	2685490	OtherRevenueCurrentYear
Total Revenue Prior Year	23357740	TotalRevenuePriorYear
Total Revenue Current Year	23665970	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	30721	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	28493	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	11701562	SalariesEtcPriorYear
Salaries Etc Current Year	12727614	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	31420	TotalFundrsngExpCurrentYear
Other Expense Prior Year	9764168	OtherExpensePriorYear
Other Expenses Current Year	9715076	OtherExpensesCurrentYear
Total Expenses Prior Year	21496451	TotalExpensesPriorYear
Total Expenses Current Year	22471183	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1861289	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1194787	RevenuesLessExpensesCY
Total Assets BOY	22894079	TotalAssetsBOY
Total Assets EOY	22996627	TotalAssetsEOY
Total Liabilities BOY	9224768	TotalLiabilitiesBOY
Total Liabilities EOY	8151910	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	13669311	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	14844717	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE HOPEDALE MEDICAL FOUNDATION IS A NON-PROFIT, CHARITABLE CORPORATION COMMITTED TO EXCELLENCE IN PROMOTING GOOD HEALTH AND WELLNESS TO ALL, AND SERVING THE HEALTHCARE NEEDS OF THE SICK AND ELDERLY, 24 HOURS A DAY, 7 DAYS A WEEK, WITHOUT DISCRIMINATION AND REGARDLESS OF ONE'S ABILITY TO PAY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	16152116	Expense
Grants	28493	Grants
Revenue	18504991	Revenue
Description	THE HOPEDALE MEDICAL COMPLEX IS OWNED AND OPERATED BY THE NOT-FOR-PROFIT CHARITABLE CORPORATION KNOWN AS THE HOPEDALE MEDICAL FOUNDATION. THE HOPEDALE MEDICAL COMPLEX STARTED AS A 20-BED HOSPITAL IN 1955 IN HOPEDALE, ILLINOIS AND HAS EXPANDED OVER THE YEARS TO OFFER A CONTINUUM OF CARE SERVICES, INCLUDING A 25-BED ACUTE CARE HOSPITAL, NURSING HOME, INDEPENDENT AND ASSISTED LIVING FACILITY AS WELL AS A WELLNESS CENTER.THE HOPEDALE HOSPITAL IS A CRITICAL ACCESS HOSPITAL AND OFFERS VIRTUALLY THE SAME SERVICES AS A LARGER, URBAN HOSPITAL, INCLUDING 24 HOUR EMERGENCY ROOM, ICU, GENERAL AND ADVANCED VASCULAR SURGERY, ORTHOPEDIC SURGERY, PLASTIC/RECONSTRUCTIVE SURGERY, OPEN MRI AND CT SCANNER. THE HOPEDALE MEDICAL COMPLEX ALSO OFFERS PHYSICIAN SERVICES THROUGH FOUR SATELLITE OFFICES IN ATLANTA, MANITO, MACINAW AND DELAVAN.HOPEDALE WELLNESS CENTER HAS AN INDOOR GYM, WALKING TRACK, THREE THERAPY POOLS, DAY CARE, PHYSICAL THERAPY DEPARTMENT AND CONFERENCE ROOM FOR THEIR MEMBERS TO USE. THE WELLNESS CENTER ALSO OFFERS CLUB MEMBERSHIPS TO THE RESIDENTS OF HOPEDALE AND SURROUNDING AREAS. PRESENTLY, THE WELLNESS CENTER HAS APPROXIMATELY 1,000 MEMBERS WHO ENROLLED IN VARIOUS PROGRAMS AND ACTIVITIES. A SPORTS MEDICINE PROGRAM HAS ALSO BEEN DEVELOPED FOR LOCAL SCHOOL DISTRICTS AND SPORTS TEAMS THAT THE COMPLEX SERVES TO IMPROVE CONDITIONING OF ATHLETES AND TO REDUCE SPORTS INJURIES. THE COST TO OPERATE THE WELLNESS CENTER IS MORE THAN THE REVENUE THAT IS DERIVED FROM THE HEALTH MEMBERSHIPS WITH THE DIFFERENCE REPRESENTING A BENEFIT TO THE RESIDENTS AND THE COMMUNITY.SERVICE AREATHE HOPEDALE MEDICAL COMPLEX SERVES THE MEDICAL NEEDS OF THE LOCAL CITIZENS WITHIN A 50 MILE RADIUS OF HOPEDALE, ILLINOIS. THE HOPEDALE MEDICAL COMPLEX OPERATES FOUR SATELLITE PHYSICIAN OFFICES IN ADDITION TO A PHYSICIAN'S OFFICE LOCATED ON THE MAIN CAMPUS FOR THE CONVENIENCE OF OUR PATIENTS WITHIN OUR SERVICES AREA.HOSPITAL STAFFTHE HOPEDALE MEDICAL COMPLEX HAS A DEDICATED STAFF OF TRAINED HEALTH PROFESSIONALS THAT HAVE JOINED TOGEATHER AS A TEAM TO PROVIDE THE BEST POSSIBLE HEALTH CARE FOR THE PATIENTS AND RESIDENTS OF OUR COMMUNITY.FINANCIAL ASSISTANCE PROGRAMSTHE HOPEDALE MEDICAL COMPLEX HAS POLICIES IN PLACE TO ENSURE THAT NECESSARY HEALTH SERVICES ARE NOT DENIED BASED ON ABILITY TO PAY AND THAT ALL PATIENTS ARE TREATED FAIRLY AND EQUITABLY, AND WITH RESPECT AND COMPASSION. HOPEDALE MEDICAL COMPLEX ASSISTS PERSONS WITHOUT INSURANCE COVERAGE BY WAIVING ALL OR PART OF THE CHARGES FOR SERVICES IT PROVIDES. SIGNS ARE POSTED IN THE ADMITTING AREAS SO THAT HOSPITAL POLICIES ARE CLEARLY COMMUNICATED TO PATIENTS AND PROSPECTIVE PATIENTS.EMERGENCY SERVICESTHE HOPEDALE MEDICAL COMPLEX OPERATES AN EMERGENCY ROOM THAT IS OPEN 24 HOURS A DAY, 365 DAYS A YEAR. THE EMERGENCY ROOM PROVIDES SERVICE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY AND DENIES SERVICE TO NO ONE.COMMUNITY LEADERSHOPEDALE MEDICAL FOUNDATION'S BOARD OF DIRECTORS IS COMPOSED OF VARIOUS LEADERS FROM THE COMMUNITY. THE DIRECTOR'S REPRESENT DIVERSE BACKGROUNDS AND INDUSTRIES WITHIN THE COMMUNITY.MEDICAL STAFFTHE MEDICAL STAFF AT HOPEDALE MEDICAL CENTER IS OPEN AND OFFERS PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE AREA.UNCOMPENSATED CARETHE HOPEDALE MEDICAL COMPLEX PARTICIPATES IN MEDICARE, MEDICAID, CHAMPUS, TRICARE AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS. THE CONTRACTED AMOUNT FOR THE ABOVE SERVICES EXCEPT MEDICARE IS OFTEN LESS THAN THE ACTUAL COST OF THE SERVICES, WITH THE DIFFERENCE REPRESENTING A BENEFIT TO THE PATIENT AND THE COMMUNITY.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	1758698	Expense
Revenue	2669385	Revenue
Description	HOPEDALE NURSING HOME IS A 74-BED LICENSED FACILITY OFFERING 24-HOUR NURSING CARE. IT IS PHYSICALLY LOCATED ON CAMPUS AND CONNECTED TO THE HOSPITAL FOR THE CONVENIENCE OF OUR RESIDENTS AND THEIR FAMILIES.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1374500	Expense
Revenue	1613775	Revenue
Description	HOPEDALE COMMONS IS A 67-BED INDEPENDENT AND ASSISTED LIVING FACILITY. IT IS ALSO LOCATED ON CAMPUS AND IS LOCATED NEAR THE HOSPITAL FOR THE CONVENIENCE OF OUR RESIDENTS AND THEIR FAMILIES.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Description	OTHER COMMUNITY ACTIVITIES -HEALTH FAIR AT WELLNESS CENTERTHE HMC WELLNESS FAIR (FIT FAIR) ACCOMPLISHES THE GOAL OF EDUCATING THE COMMUNITY ABOUT HEALTH. AREA CITIZENS ARE EXPOSED TO THE MOST CURRENT HEALTH INSURANCE AS WELL AS EDUCATION ON IMPORTANT LIFESTYLE CHOICES. THE EVENT REACHES BETWEEN 200 AND 500 INDIVIDUALS EACH YEAR. EVENT INCLUDES SPEAKERS, BOOTHS, SCREENINGS, RAFFLES, CHILDREN'S INFLATABLES, LIFE FLIGHT HELICOPTER DISPLAY, AND THE CHILDREN'S TRIATHALON. SCHOLARSHIP AWARD WINNERS ARE ANNOUNCED.GO RED FOR WOMENGO RED FOR WOMEN ACCOMPLISHES THE GOAL OF EDUCATING THE COMMUNITY ABOUT WOMEN'S HEALTH. THE INFORMATION FOCUSES ON HEART HEALTH WITH THE ADDITION OF OTHER CURRENT WOMEN'S HEALTH TOPICS. ANNUALLY, BETWEEN 100 AND 200 WOMEN ATTEND. THE EVENT INCLUDES SPEAKERS, DEMONSTRATIONS, FOOD AND RAFFLES.ANNUAL 5K RUN/WALKEACH JULY 4TH, THE HOPEDALE WELLNESS CENTER SPONSORS A 5K RUN/WALK OPEN TO ALL RESIDENTS OF THE COMMUNITY. AWARDS ARE GIVEN TO DIFFERENT WINNERS OF VARIOUS AGE GROUPS OF RUNNERS AND WALKERS.DIETICIAN HEALTHY EATING SEMINARSTHE HOPEDALE MEDICAL FOUNDATION DIETICIAN HOLDS VARIOUS SEMINARS ANNUALLY TO HELP RESIDENTS OF THE COMMUNITY AND EMPLOYEES TO EAT A HEALTHIER DIET. VARIOUS RECIPES ARE GIVEN TO PARTICIPANTS WHICH ENCOURAGE HEALTHIER DIETS.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	19285314	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	1	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	78	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	443	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	8	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	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	DWIGHT JOHNSON	BusinessNameLine1

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

Address US AddressUS

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

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

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
ALFRED N ROSSI MD
CHAIRMAN/CEO	2.00	X	X	83068	0	0
MATTHEW B ROSSI MD
SECRETARY	2.00	X	X	81534	0	16375
MICHAEL J MCLAUGHLIN
DIRECTOR	2.00	X		243134	0	0
ROLAND RICH
DIRECTOR	2.00	X		0	0	0
TOM HIESER
DIRECTOR	2.00	X		0	0	0
RAY SLACK
DIRECTOR	2.00	X		0	0	0
JARIE SLACK
DIRECTOR	2.00	X		0	0	0
DONALD OSWALD
DIRECTOR	2.00	X		12264	0	0
MARK F ROSSI
CHIEF OPERATING OFFICER	40.00		X	211594	0	5645
LAWRENCE KLOC
CHIEF FINANCIAL OFFICER	40.00		X	109614	0	18262
JOHN ZANON
DIRECTOR OF RETAIL PHARMACY	40.00			137556	0	17650	X
WENDY MOBLEY
DIRECTOR OF HOSPITAL PHARMACY	40.00			119643	0	5121	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	998407	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	63053	TotalOtherCompensation
Number Individuals GT100 K	5	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
EMERGENCY PHYSICIAN STAFFING SOLUTIONS
12528 SR 78	HAVANA	IL	62644	STAFFING AGENCY	818659
E-CODE SOLUTIONS LLC
994 EAST ASH	CANTON	IL	61520	CONSULTING	351167
MICHAEL J MCLAUGHLIN
2 DEEPWOOD ROAD	BARRINGTON HILLS	IL	60010	CONSULTING	243134
NUCLEAR DIAGNOSTICS INC
18158 COUNTRY CLUB ROAD	GIRARD	IL	62640	MEDICAL TESTING SERVICES	177494
TRI COUNTY ANESTHESIA SC
627 S MAIN ST	CREVE COEUR	IL	61610	STAFFING AGENCY	165200

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	9	NumberOfContractorsGT100K
Government Grants	29389	GovernmentGrants
All Other Contributions	42352	AllOtherContributions
Total Contributions	71741	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENU	621110	16101986	16101986
NURSING HOME	623000	2669385	2669385
ASSISTED AND INDEPENDE	623000	1613775	1613775
WELLNESS CENTER	713940	377595	377595
MASSAGE THERAPY	621110	79584		79584

Field	Value	IRS element (for citing)
Total Program Service Revenue	20842325	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	66339	TotalRevenueColumn
Exclusion	$66,339	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	372781	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	372781	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	372781	TotalRevenueColumn
Exclusion	$372,781	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	75	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	75	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	75	TotalRevenueColumn
Exclusion	$75	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	3763779	GrossSalesOfInventory
Cost Of Goods Sold	1745143	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2018636	TotalRevenueColumn
Related Or Exempt Function Income	1968660	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	49976	UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CHILD CARE	624410	148309	$148,309
CAFETERIA INCOME	722210	89014	$89,014
MISCELLANEOUS	900099	56750		56750

Field	Value	IRS element (for citing)
Total Other Revenue	294073	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	23665970	TotalRevenueColumn
Related Or Exempt Function Income	22788151	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	129560	UnrelatedBusinessRevenue
Exclusion	$676,518	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	18073	Total
Program Services	18073	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	10420	Total
Program Services	10420	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	975839	Total
Program Services	630724	ProgramServices
Management And General	345115	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	311556	Total
Program Services	235617	ProgramServices
Management And General	75939	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	9332321	Total
Program Services	8221141	ProgramServices
Management And General	1111180	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	127577	Total
Program Services	113138	ProgramServices
Management And General	14439	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1314893	Total
Program Services	1293279	ProgramServices
Management And General	21614	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	665428	Total
Program Services	590380	ProgramServices
Management And General	75048	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	48956	Total
Management And General	48956	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	143711	Total
Management And General	143711	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	6628	Total
Program Services	6628	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	855012	Total
Program Services	728575	ProgramServices
Management And General	116262	ManagementAndGeneral
Fundraising	10175	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	173335	Total
Program Services	32190	ProgramServices
Management And General	141145	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2566972	Total
Program Services	2373151	ProgramServices
Management And General	174031	ManagementAndGeneral
Fundraising	19790	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	6926	Total
Management And General	6926	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	783677	Total
Program Services	688313	ProgramServices
Management And General	95364	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	31070	Total
Program Services	25647	ProgramServices
Management And General	3968	ManagementAndGeneral
Fundraising	1455	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	90703	Total
Program Services	76668	ProgramServices
Management And General	14035	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	971398	Total
Program Services	934657	ProgramServices
Management And General	36741	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	132691	Total
Program Services	16815	ProgramServices
Management And General	115876	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBT EXPENSE	1449340	1449340
SERVICES	1430478	1102169	328309
REPAIRS & MAINTENANCE	415815	358807	57008
MEDICAID TAXES	320281	91499	228782

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	288083	Total
Program Services	288083	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	22471183	Total
Program Services	19285314	ProgramServices
Management And General	3154449	ManagementAndGeneral
Fundraising	31420	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2555	BOY
EOY	5676769	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	5807895	BOY
EOY	961983	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	453831	BOY
EOY	288289	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2806496	BOY
EOY	2598206	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	54589	BOY
EOY	36495	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	76139	BOY
EOY	101236	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	49311	BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	813119	BOY
EOY	778416	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	273715	BOY
EOY	115051	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	32609472	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	22123231	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	10694570	BOY
EOY	10486241	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	905979	BOY
EOY	902449	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	955880	BOY
EOY	1051492	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	22894079	BOY
EOY	22996627	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2023039	BOY
EOY	2401222	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	370998	BOY
EOY	388192	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	4275000	BOY
EOY	3675000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	479040	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2076691	BOY
EOY	1687496	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	9224768	BOY
EOY	8151910	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	12459726	BOY
EOY	13593001	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1209585	BOY
EOY	1251716	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	13669311	BOY
EOY	14844717	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	22894079	BOY
EOY	22996627	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	1194787	ReconcilationRevenueExpenses
Reconcilation Other Changes	-19380	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
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 B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$6,628	OtherActivitiesAmount
Total Lobbying Expenditures IIB	6628	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	PART II-B, LINE 1I, OTHER LOBBYING ACTIVITIES: LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: $6,628 OF MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	1	AgentTrusteeEtc
Beginning Balance	2656	BeginningBalance
Additions During Year	2500	AdditionsDuringYear
Distributions During Year	2532	DistributionsDuringYear
Ending Balance	2624	EndingBalance
Included On FS	0	IncludedOnFS

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	663463	OtherCostOrOtherBasis
Book Value	663463	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	13635451	OtherCostOrOtherBasis
Depreciation	7307759	Depreciation
Book Value	6327692	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	15846042	OtherCostOrOtherBasis
Depreciation	14376634	Depreciation
Book Value	1469408	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2464516	OtherCostOrOtherBasis
Depreciation	438838	Depreciation
Book Value	2025678	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	10486241	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
ACCRUED PROFESSIONAL LIABILITY	$25,000
ACCRETION LIABILITY	$241,580
CAPITALIZED LEASE OBLIGATIONS	$76,293
ESTIMATED THIRD PARTY PAYOR SETTLEMENT	$1,344,623

Field	Value	IRS element (for citing)
Total Of Amounts	1687496	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART IV, LINE 1B:	SOME NURSING HOME PATIENTS HOLD SMALL AMOUNTS OF FUNDS ON DEPOSIT WITH THE ORGANIZATION FOR INCIDENTALS AND LOW VALUE SERVICES, SUCH AS HAIR-CUTS. THE ORGANIZATION DOES NOT RECORD THE AMOUNTS AS ASSETS OF THE ORGANIZATION.
PART X:	THE HEALTH ASSOCIATION AND ITS TWO NOT-FOR-PROFIT SUBSIDIARIES HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HEALTH ASSOCIATION AND ITS TWO NOT-FOR-PROFIT SUBSIDIARIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. AS PRIVATE FOUNDATIONS, THE HEALTH ASSOCIATION AND ONE OF ITS SUBSIDIARIES, PRAIRIE HEALTH SERVICES, INC, ARE REQUIRED TO DISTRIBUTE A MINIMUM PERCENTAGE OF THE FAIR MARKET VALUE OF THEIR INVESTMENT ASSETS ANNUALLY. HRES IS A FOR-PROFIT CORPORATION SUBJECT TO APPLICABLE FEDERAL AND ILLINOIS TAXES ON INCOME. HRES COMPUTES DEFERRED INCOME TAXES UNDER THE LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND NET OPERATING LOSS AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASES. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE LIKELY THAN NOT THAT SOME OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN TAX LAWS AND RATES ON THE DATE OF ENACTMENT. THE TAXABLE INCOME OF HRES AND ITS RELATED CURRENT AND DEFERRED INCOME TAXES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT, THEREFORE, SEPARATELY PRESENTED. THE HEALTH ASSOCIATION AND PRAIRIE HEALTH SERVICES, INC, FILE FORM 990-PF (RETURN OF PRIVATE FOUNDATION) ANNUALLY. HOPEDALE MEDICAL FOUNDATION FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). AN EXCISE TAX OF 2% IS IMPOSED ON NET INVESTMENT INCOME OF ALL DOMESTIC TAX-EXEMPT PRIVATE FOUNDATIONS FOR EACH TAX YEAR, AND IS REPORTED ON FORM 990-PF. UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE DIFFERENCE BETWEEN THE BENEFIT OF A TAX POSITION RECORDED FOR FINANCIAL STATEMENT PURPOSES AND THE AMOUNT REFLECTED ON A TAX RETURN IS RECORDED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2012 AND 2011, THERE WERE NO UNCERTAIN TAX BENEFITS RELATED TO UNCERTAIN TAX POSITIONS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990-PF, 990, 990-T, AND 1120 FILED BY THE HEALTH ASSOCIATION AND ITS SUBSIDIARIES ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. GENERALLY, FORMS 990-PF, 990, 990-T, AND 1120 FILED BY THE HEALTH ASSOCIATION AND ITS SUBSIDIARIES ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED JUNE 30, 2008 AND PRIOR.	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule H IRS990ScheduleH

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

Other Percentage OtherPercentage

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

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

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	938431	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	938431	NetCommunityBenefitExpense
Percent Of Total Expense	0.04460	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1073506	TotalCommunityBenefitExpense
Direct Offsetting Revenue	517597	DirectOffsettingRevenue
Net Community Benefit Expense	555909	NetCommunityBenefitExpense
Percent Of Total Expense	0.02640	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	91499	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	91499	NetCommunityBenefitExpense
Percent Of Total Expense	0.00440	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2103436	TotalCommunityBenefitExpense
Direct Offsetting Revenue	517597	DirectOffsettingRevenue
Net Community Benefit Expense	1585839	NetCommunityBenefitExpense
Percent Of Total Expense	0.07540	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	696212	TotalCommunityBenefitExpense
Direct Offsetting Revenue	451178	DirectOffsettingRevenue
Net Community Benefit Expense	245034	NetCommunityBenefitExpense
Percent Of Total Expense	0.01170	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6263	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	6263	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

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

Research Research

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

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	19375	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8955	DirectOffsettingRevenue
Net Community Benefit Expense	10420	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	721850	TotalCommunityBenefitExpense
Direct Offsetting Revenue	460133	DirectOffsettingRevenue
Net Community Benefit Expense	261717	NetCommunityBenefitExpense
Percent Of Total Expense	0.01250	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2825286	TotalCommunityBenefitExpense
Direct Offsetting Revenue	977730	DirectOffsettingRevenue
Net Community Benefit Expense	1847556	NetCommunityBenefitExpense
Percent Of Total Expense	0.08790	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$800,905	BadDebtExpenseAmount
Amount Attributable To	440498	AmountAttributableTo
Amount Reimbursed By Medicare	7223664	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	7560667	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-337003	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	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

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

Address Address

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

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	600.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Medicare Rate	X	MedicareRate
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

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

Other Facilities OtherFacilities (8 entries)

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: NOT APPLICABLE
PART I, LINE 6A: NOT APPLICABLE
PART I, LINE 7: THE ORGANIZATION CALCULATED THE COST AMOUNTS NOTED IN PART I, LINE 7 BY UTILIZING ITS CURRENT COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS REPORTED ON, INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, MEDICAID, UNINSURED, AND MEDICARE.
PART I, LINE 7G: NOT APPLICABLE
PART I, L7 COL(F): $1,449,340 OF BAD DEBT EXPENSE IS SUBTRACTED FOR PURPOSES OF COMPUTING THE PERCENTAGE IN PART I, LINE 7K, COLUMN F. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES, LESS BAD DEBT, IS 13.44%, AND THE PERCENTAGE INCREASES TO 49.41% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNTY BENEFIT EXPENSE.
PART II: NOT APPLICABLE
PART III, LINE 4: I. THE ORGANIZATION USED A COST TO CHARGE RATIO TO DETERMINE THE COST AMOUNT OF THE BAD DEBT EXPENSE. WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, AS PROVIDED IN THE IRS INSTRUCTIONS WAS USED TO DETERMINE THE APPROPRIATE RATIO.II. THE TEXT FROM THE FOOTNOTE TO HOPEDALE RURAL HEALTH ASSOCIATION, INC.'S FINANCIAL STATEMENT IS AS FOLLOWS: PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING ACCOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. THE ORGANIZATION DOES NOT CHARGE INTEREST ON PATIENT RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYORS' AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. AS A SERVICE TO THE PATIENT, THE ORGANIZATION BILLS THIRD-PARTY PAYORS DIRECTLY AND THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED.
PART III, LINE 8: THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. ROUTINE AND ICU COSTS ARE DETERMINED BASED ON AN AVERAGE COST PER DAY MULTIPLIED BY THE NUMBER OF MEDICARE ALLOWABLE DAYS. MEDICARE ANCILLARY COSTS ARE DETERMINED BY THE RATIO OF DEPARTMENT COSTS TO DEPARTMENT CHARGES THEN THE RESULTING % IS APPLIED TO MEDICARE ALLOWABLE CHARGES. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.
PART III, LINE 9B: THE ORGANIZATION APPLIES THE FOLLOWING PROCESSES AND PROCEDURES IN ITS COLLECTION PRACTICES FOR THOSE WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE:POLICY:THE DISTINCTION BETWEEN CHARITY CARE AND BAD DEBT IS THE INABILITY TO PAY VERSUS THE UNWILLINGNESS OF THE PERSON TO PAY THEIR ACCOUNT. THOSE WITH LOW INCOMES OR WITH CATASTROPHIC MEDICAL BILLS MAY BE MEDICALLY INDIGENT EVEN THOUGH THEY ARE ABLE TO MEET BASIC LIVING EXPENSES. HOPEDALE MEDICAL COMPLEX WILL NOT DENY SERVICES TO ANY PATIENT DUE TO RACE, COLOR, RELIGION, GENDER, ANCESTRY, SEXUAL ORIENTATION, FINANCIAL CLASS OR NATIONAL ORIGIN.HOPEDALE MEDICAL FOUNDATION IS COMMITTED, TO THE EXTENT RESOURCES ALLOW, TO PROVIDING QUALITY HEALTHCARE TO ITS PATIENTS AND RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY.THE HOPEDALE MEDICAL FOUNDATION FINANCIAL ASSISTANCE PROGRAM ALLOWS FOR FREE OR REDUCED MEDICAL SERVICES TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT CARE; HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY FOR PART OF THE BILL AND ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID); AND MEET THE INCOME AND ASSETS ELIGIBILITY CRITERIA.FINANCIAL ASSISTANCE IS AVAILABLE FOR NECESSARY HOSPITAL AND PHYSICIAN CHARGES ONLY.ELIGIBILITY DETERMINATION:FINANCIAL ASSISTANCE FORMS AND INSTRUCTIONS SHALL BE FURNISHED TO PATIENTS WHEN FINANCIAL ASSISTANCE IS REQUESTED, WHEN NEED IS INDICATED, OR WHEN FINANCIAL SCREENING INDICATES POTENTIAL NEED, IN THE CASE OF PATIENTS WITHOUT HEALTH INSURANCE. ALL APPLICATIONS SHOULD BE FOLLOWED BY DOCUMENTATION TO VERIFY INCOME AMOUNTS INDICATED ON THE APPLICATION FORM. ALL INFORMATION RECEIVED RELATING TO THE APPLICATION WILL BE KEPT CONFIDENTIAL AND USED TO VERIFY FINANCIAL NEEDS. STEPS USED BY HOPEDALE MEDICAL FOUNDATION TO DETERMINE AND VERIFY FINANCIAL ASSISTANCE:1) HOSPITAL IDENTIFIES ANY UNINSURED, UNDERINSURED, OR SELF-PAY PATIENTS.2) PATIENT COMPLETES APPLICATION/FINANCIAL STATEMENT THAT INCLUDES INCOME, ASSETS, AND LIABILITIES.3) FINANCIAL COUNSELOR INTERVIEWS PATIENT TO ASSESS THE PATIENT'S ABILITY TO PAY IN FULL; ABILITY TO PAY REASONABLE MONTHLY INSTALLMENTS; AND QUALIFICATION FOR FINANCIAL ASSISTANCE.4) HOSPITAL MAKES INITIAL DETREMINATION BASED UPON APPLICATION AND ANY ORAL INFORMATION PROVIDED BY PATIENT. PATIENT SIGNS APPLICATION CONFIRMING ACCURACY OF INFORMATION PROVIDED.5) PATIENT SUPPLIES DOCUMENTATION OF RESOURCES AND OUTSTANDING OBLIGATIONS WITHIN 30 DAYS FROM DATE OF APPLICATION.6) HOSPITAL MAKES FINAL DETERMINATION REGARDING ELIGIBILITY FOR FINANCIAL ASSISTANCE.7) HOSPITAL SENDS NOTIFICATION LETTER TO THE PATIENT AND/OR FAMILY WITH THE DECISION. NOTICE WILL INCLUDE INSTRUCTIONS FOR ESTABLISHING A PAYMENT PLAN, IF NEEDED, AND REASON FOR DENIAL, IF APPLICABLE.
PART VI, LINE 2: SERVICES OFFERED BY THE FOUNDATION INCLUDE MEDICAL/SURGICAL, SWING BED, CRITICAL CARE, OUTPATIENT SURGICAL SERVICES AND A SIGNIFICANT NUMBER OF OTHER ANCILLARY SERVICES NECESSARY TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL ALSO OFFERS 24-HOUR EMERGENCY ROOM SERVICES, LABORATORY AND DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND OUTPATIENT/AMBULATORY PROCEDURES. ALTHOUGH CARE IS RENDERED TO ALL TO THE EXTENT POSSIBLE, MIDDLE AGED TO GERIATRIC PATIENT CARE COMPOSES BOTH THE PRIMARY AND SECONDARY SERVICE AREAS AND OUR PATIENT DEMOGRAPHICS.
PART VI, LINE 3: SIGNS AND BROCHURES ARE LOCATED IN THE REGISTRATION AND MOST OTHER ENTRANCE AREAS. STAFF IN THE ADMISSIONS AND PATIENT REGISTRATION AREA ARE TRAINED TO RECOMMEND THAT PATIENTS MEET OUR PATIENT FINANCIAL COUNSELOR FOR AN APPLICATION AND TO DISCUSS BILLING AND COLLECTION PROCEDURES.
PART VI, LINE 4: SIXTY-FIVE PERCENT OF ADMISSIONS COME FROM 9 CENSUS TRACTS SURROUNDING THE HOSPITAL, THE PRIMARY SERVICE AREA. AN ADDITIONAL EIGHTEEN PERCENT COME FROM 8 CENSUS TRACTS, THE SECONDARY SERVICE AREA, FURTHER, BUT CONTIGUOUS TO THE PRIMARY SERVICE AREA. THE TOTAL SERVICE AREA POPULATION IS 134,000. THE AGES 45-65 COMPOSE 26.5% AND AGE 65+ COMPOSES 15.5% OF THE AREA POPULATION.
PART VI, LINE 5: THE FOUNDATION MAINTAINS A WELLNESS CENTER WHICH HAS THERAPY AND EXCERCISE POOLS, WEIGHT ROOM AND GYMNASIUM AREAS, A LAP TRACK, EXERCISE MACHINES AND MEETING ROOMS. WEIGHT-LOSS, NUTRITION COUNSELING, AND CHRONIC CONDITION MANAGEMENT SESSIONS ARE HELD IN THE MEETING ROOMS, AS WELL AS COMMUNITY ORGANIZATION MEETINGS. BLOOD DRIVES ARE REGULARLY SCHEDULED.
PART VI, LINE 6: NOT APPLICABLE
IL	REPORTS FILED WITH STATES	PART VI, LINE 7
THE FOUNDATION IS LOCATED IN THE MIDDLE OF CENTRAL ILLINOIS; PRACTICALLY ALL PATIENTS ARE FROM THE SURROUNDING COMMUNITIES. ANNUAL HOSPITAL QUESTIONNAIRES ARE SENT TO THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH WHICH INCLUDE A REVIEW OF COMMUNITY BENEFIT ACTIVITIES.		SCHEDULE H, PART VI, LINE 7:

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained
No Grant More Than5000	X	NoGrantMoreThan5000

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	SCHOLARSHIPS FOR STUDENTS ENTERING FIELDS OF HEALTHCARE & AG	TypeOfGrant
Number Of Recipients	34	NumberOfRecipients
Amount Of Cash Grant	10420	AmountOfCashGrant
Amount Of Non Cash Assistance	0	AmountOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

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

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (3 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
MICHAEL J MCLAUGHLIN
0	0	0	0	243134	0	0	0	0	0	243134	0	0	0
MARK F ROSSI
211594	0	0	0	0	0	0	0	5645	0	217239	0	0	0
JOHN ZANON
137556	0	0	0	0	0	0	0	17650	0	155206	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	VILLAGE OF HOPEDALE ILLINOIS VARIABLE RATE DEMAND REVENUE BONDS SERIES 09	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	376002155	IssuerEIN
CUSIP Number	43950QAA0	CUSIPNumber
Date Issued	2009-09-23	DateIssued
Issue Price	5500000	IssuePrice
Description Of Purpose	REFINANCE 1998 BONDS AND CONSTRUCTION COSTS	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)
Total Proceeds	5500000	TotalProceeds
Refunding Escrow	4150580	RefundingEscrow
Issuance Costs From Proceeds	110000	IssuanceCostsFromProceeds
Capital Expenditures	1239420	CapitalExpenditures
Year Of Subst Completion	2011	YearOfSubstCompletion
Current Refunding	1	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	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
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00600	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00600	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	1	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	1	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 (5 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
DR JOSEPH ROSSI
LOAN TO REPAY RURAL IMSE PROGRAM	X	$32,118	13406	0	1	1
DR MATT ROSSI
PHYSICIAN RENT RECEIVABLE	X	$36,495	36495	0	1	1
DR LARRY ROSSI
PHYSICIAN RENT RECEIVABLE	X	$2,042	2042	0	1	1
AARON ROSSI
LOAN TO SUPPORT COMPLETION OF MEDICAL SCHOOL	X	$50,000	50000	0	1	1
DR PHIL ROSSI
PHYSICIAN RENT RECEIVABLE	X	$35,788	35788	0	1	1

Field	Value	IRS element (for citing)
Total Balance Due	137731	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (11 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
DR PHILLIP ROSSI
FAMILY RELATIONSHIP	78287	COMPENSATION	0
(no name)
FAMILY RELATIONSHIP			0
DR LARRY ROSSI
FAMILY RELATIONSHIP	420150	ANESTHESIA SERVICES	0
LISA MCLAUGHLIN
FAMILY RELATIONSHIP	48309	COMPENSATION	0
(no name)
			0
CYNTHIA NOREUIL
FAMILY RELATIONSHIP	48957	COMPENSATION	0
LARRY NOREUIL
FAMILY RELATIONSHIP	33368	COMPENSATION	0
PEGGIE ROSSI
FAMILY RELATIONSHIP	21195	COMPENSATION	0
LORAYNE ROSSI
FAMILY RELATIONSHIP	13420	PAYMENT FOR REAL ESTATE, ETC.	0
PHILLIP NOREUIL
FAMILY RELATIONSHIP	18714	COMPENSATION	0
LAURA MURRAY
FAMILY RELATIONSHIP	1350	COMPENSATION	0

Form990 Schedule L Part V Form990ScheduleLPartV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SCHEDULE L, PAGE 2, PART IV	EXPLANATION OF TRANSACTIONS	HOPEDALE MEDICAL FOUNDATION PROVIDES A BUILDING AND SERVICES (NURSING, SECRETARIAL AND OTHER SERVICES) FOR PRIVATE PHYSICIANS, SOME OF WHOM ARE DIRECTORS AND OFFICERS OF THE FOUNDATION. THE FACILITY AND SERVICES ARE PROVIDED IN EXCHANGE FOR ER SERVICES PROVIDED FOR THE FOUNDATION BY THE PHYSICIANS. THE EXCHANGE IS BELIEVED TO BE IN THE ORDINARY COURSE OF HOSPITAL BUSINESS AND IS BELIEVED TO BE AT ARM'S LENGTH.THE VALUE OF THE ER SERVICES PROVIDED BY DIRECTORS AND OFFICERS AND THEIR FAMILY MEMBERS IN EXCHANGE FOR USE OF BUILDING SPACE AND SERVICES ARE AS FOLLOWS:DR. PHILLIP ROSSI $52,861 DR. MATTHEW ROSSI $68,169DR. ALFRED ROSSI $86,068
SCHEDULE L, PART II	LOANS TO INTERESTED PERSONS:	HOPEDALE MEDICAL FOUNDATION EXTENDS CREDIT TO DOCTORS, INCLUDING THOSE DOCTORS THAT ARE ON AND RELATED TO THE BOARD OF DIRECTORS. CREDIT IS FOR RENT THAT IS DUE TO THE HOSPITAL, TO SUPPORT A NEW CLINIC IN A NEARBY COMMUNITY AND TO SUPPORT COMPLETION OF MEDICAL SCHOOL. BELIEVED TO BE IN THE ORDINARY CORUSE OF HOSPITAL BUSINESS AND PROVIDED AT ARMS LENGTH.
SCHEDULE L	DESCRIPTION OF FAMILY RELATIONSHIPS:	LAWRENCE ROSSI WAS THE FOUNDER OF THE HOPEDALE MEDICAL FOUNDATION. HIS WIFE IS LORAYNE ROSSI. ALFRED ROSSI, LARRY ROSSI, MATT ROSSI, PHILLIP ROSSI, MARK ROSSI, CYNTHIA NOREUIL, LISA MCLAUGHLIN, AND LAURA MURRAY ARE CHILDREN OF LAWRENCE AND LORAYNE ROSSI. SPOUSES OF THE ABOVE ARE PEGGIE ROSSI, LARRY NOREUIL AND MICHAEL MCLAUGHLIN. GRANDCHILDREN OF LAWRENCE AND LORAYNE ARE AARON ROSSI AND PHILLIP NOREUIL.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	ALFRED ROSSI, DIRECTOR, MATTHEW ROSSI, DIRECTOR, MIKE MCLAUGHLIN, DIRECTOR, AND MARK F. ROSSI, COO ALL HAVE A FAMILY RELATIONSHIP. SEE FURTHER DESCRIPTION REGARDING FAMILY RELATIONSHIPS ON SCH L, PART V. RAY SLACK AND JARIE SLACK HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF HOPEDALE MEDICAL FOUNDATION IS HOPEDALE RURAL HEALTH ASSOCIATION, INC., AN ILLINOIS NOT FOR PROFIT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	DIRECTORS SHALL BE APPOINTED TO THE BOARD BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER FROM AMONG THOSE PERSONS NOMINATED BY THE NOMINATING COMMITTEE OF THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER OF HOPEDALE MEDICAL FOUNDATION, HOPEDALE RURAL HEALTH ASSOCIATION, INC., HAS THE FOLLOWING RIGHTS AND POWERS: A. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, MEMBERS OF THE BOARD OF DIRECTORS OF THE FOUNDATION; B. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR, VICE CHAIR, PRESIDENT AND OTHER OFFICERS OF THE FOUNDATION; C. TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, THE AUDITORS OF THE FOUNDATION; D. TO APPROVE ANY CHANGES TO THE GOVERNANCE DOCUMENTS OF THE FOUNDATION; E. TO APPROVE THE MERGER, CONSOLIDATION, CHANGE IN CORPORATE MEMBERSHIP, CORPORATE REORGANIZATION OR DISSOLUTION OF THE FOUNDATION; F. TO APPROVE THE CREATION OF NEW SUBSIDIARIES OR AFFILIATES BY THE FOUNDATION; G. TO APPROVE THE STRATEGIC AND FINANCIAL PLANS AND THE CAPITAL AND OPERATING BUDGETS OF THE FOUNDATION; H. TO APPROVE DEBT INCURRED BY THE FOUNDATION IN EXCESS OF $500,000; I. TO APPROVE THE PURCHASE, SALE, LEASE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF ASSETS IN EXCESS OF $150,000; J. TO APPROVE ALL NON-BUDGETED DEBT OR TRANSFERS OF ASSETS IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE SOLE MEMBER; K. TO APPROVE THE MANAGED CARE POLICY OF THE FOUNDATION; AND L. TO APPROVE THE FILING OF THE BANKRUPTCY BY THE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11	THE ORGANIZATION'S CFO AND CONTROLLER REVIEW THE FORM 990 WITH EXTERNAL ACCOUNTANTS. THE BOARD IS THEN PROVIDED A FINAL COPY OF THE FORM 990 BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL CORPORATE OFFICERS, AGENTS AND EMPLOYEES OF THE FOUNDATION, INCLUDING INDEPENDENT CONTRACTORS, PROVIDERS OF SERVICES AND MATERIALS. AN ANNUAL DISCLOSURE STATEMENT IS COMPLETED BY ALL PERSONS TO WHOM THE CONFLICT OF INTEREST POLICY APPLIES TO ASSIST THEM IN CONSIDERING ALL REAL AND APPARENT CONFLICTS OR DUALITIES IN CONNECTION WITH THE FOUNDATION'S ACTIVITIES. DISCLOSURE IS ALSO REQUIRED WHENEVER CONFLICTS ARISE. THE WRITTEN DISCLOSURE NOTICES OF CONFLICTS ARE FILED WITH THE PRESIDENT OF THE FOUNDATION OR ANY OTHER PERSON DESIGNATED BY THE PRESIDENT. ALL DISCLOSURE NOTICES ARE NOTED FOR RECORD IN THE MINUTES OF A MEETING OF THE BOARD OF DIRECTORS. WHEN OFFICERS, DIRECTORS, EMPLOYEES OR AGENTS BELIEVE THEY HAVE A REAL OR APPARENT CONFLICT, THEY ABSTAIN FROM MAKING MOTIONS, VOTING, EXECUTING AGREEMENT OR TAKING ANY OTHER SIMILAR DIRECT ACTION ON BEHALF OF THE FOUNDATION. THEY ARE NOT PRECLUDED FROM DEBATE OR OTHER SIMILAR INVOLVEMENT ON BEHALF OF THE FOUNDATION. ANY VIOLATION OF THE DUTY OF THE DISCLOSURE BY DIRECTORS OR OFFICERS OF THE FOUNDATION IS GROUNDS FOR REMOVAL FROM THE OFFICE.
FORM 990, PART VI, SECTION B, LINE 15	THE COO'S COMPENSATION IS REVEIWED AND APPROVED BY THE COMPENSATION COMMITTEE. THE MEMBERS OF THE ENTIRE GOVERNING BODY MAKE UP THE COMPENSATION COMMITTEE. THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO GATHER COMPARABILITY DATA AND PROVIDE ADDITIONAL ANALYSIS. THE COMPENSATION COMMITTEE DOCUMENTS ITS DELIBERATIONS IN THE GOVERNING BOARD MINUTES AND ESTABLISHES A WRITTEN CONTRACT. THIS PROCESS TAKES PLACE ANNUALLY. THE CFO'S COMPENSATION IS REVIEWED AND APPROVED BY THE CHAIRMAN OF THE BOARD, THE COO, AND THE HR DIRECTOR. THE HR DIRECTOR OVERSEES THE SALARY PROGRAM FOR ALL OTHER EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VII	THE BOARD OF DIRECTORS ARE NOT COMPENSATED FOR THEIR SERVICES AS THE BOARD OF DIRECTORS. COMPENSATION REPORTED TO BOARD MEMBERS ON PART VII IS RELATED TO COMPENSATION FOR SERVICES AS EMPLOYEES AND ER PHYSICIANS. AVERAGE HOURS PER WEEK REPORTED FOR EACH BOARD MEMBER IS AN ESTIMATE OF TIME SPENT SOLELY ON BOARD OF DIRECTOR DUTIES.	VOLUNTEER BOARD OF DIRECTORS:
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -19,380.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:	THERE WERE NO CHANGES IN THE PROCESS DURING THE YEAR.	FINANCIAL STATEMENTS AUDIT OVERSIGHT:
FORM 990, PART I, LINE 6:	VOLUNTEERS CONTRIBUTE BY WORKING IN THE GIFT SHOP, TRANSPORTING PATIENTS AND RESIDENTS OF THE COMPLEX TO/FROM APPOINTMENTS AND ASSIST WITH RESIDENT ACTIVITIES IN THE NURSING HOME AND ASSISTED LIVING FACILITY.	VOLUNTEERS:
FORM 990, PART VII, SECTION A, LINE 1A & SCHEDULE J, PART II, LINE 1	MICHAEL J. MCLAUGHLIN RECEIVED COMPENSATION FROM THE HOPEDALE MEDICAL FOUNDATION FOR CONSULTING SERVICES PROVIDED TO THE ORGANIZATION. THIS COMPENSATION IS REPORTED TO HIM ON IRS FORM 1099-MISC, AND THE AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION ON FORM 990, PART VII, SECTION A, LINE 1, COLUMN D AND SCHEDULE J, PART II, LINE 1, COLUMN B(III).	EXPLANATION OF COMPENSATION - MICHAEL J. MCLAUGHLIN

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

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

Address US AddressUS

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

Field	Value	IRS element (for citing)
Primary Activities	DAY CARE	PrimaryActivities
Legal Domicile State	IL	LegalDomicileState
Total Income	148309	TotalIncome
EOY Assets	69397	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
PRAIRIE HEALTH SERVICES INC
PO BOX 267	HOPEDALE	IL	61747	371390103	PROMOTE PUBLIC HEALTH AND WELFARE	IL	501(C)(3)	PF	HOPEDALE RURAL HEALTH ASSOCIATION INC	1
HOPEDALE RURAL ASOCIATION INC
PO BOX 267	HOPEDALE	IL	61747	391930105	SUPPORT HEALTHCARE, EDUCATION AND RESEARCH	IL	501(C)(3)	PF		0	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

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

Address US AddressUS

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

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

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	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

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

Field	Value	IRS element (for citing)
Transaction Type	Q	TransactionType
Amount Involved	91031	AmountInvolved
Method Of Amt Determination	FAIR MARKET VALUE	MethodOfAmtDetermination