HOOPESTON COMMUNITY MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HOOPESTON COMMUNITY MEMORIAL HOSPITAL (EIN 36-3637465)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-03-08
- IRS object ID
- 201330679349300013
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-03-08T11:14:31-06:00 | 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 | 363637465 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOOPESTON COMMUNITY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOOP | NameControl |
| Phone | 2172835531 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 E ORANGE STREET | AddressLine1 |
| City | HOOPESTON | City |
| State | IL | State |
| ZIP Code | 60942 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RUSS LEIGH | Name |
| Title | PRESIDENT | Title |
| Phone | 2172835531 | Phone |
| Date Signed | 2013-03-06 | 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 | RUSS LEIGH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 E ORANGE STREET | AddressLine1 |
| City | HOOPESTON | City |
| State | IL | State |
| ZIP Code | 60942 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 25669561 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HOOPESTONHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1962 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE ACUTE AND SKILLED NURSING CARE FOR RESIDENTS OF HOOPESTON AND THE SURROUNDING AREAS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 306 | TotalNbrEmployees |
| Total Nbr Volunteers | 21 | TotalNbrVolunteers |
| Total Gross UBI | 21344 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -10480 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 104672 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 433358 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24553662 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25194607 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 84055 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3203 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 63142 | OtherRevenuePriorYear |
| Other Revenue Current Year | 34316 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 24805531 | TotalRevenuePriorYear |
| Total Revenue Current Year | 25665484 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11117034 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11969713 | 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 | 12888426 | OtherExpensePriorYear |
| Other Expenses Current Year | 14697938 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24005460 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26667651 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 800071 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1002167 | RevenuesLessExpensesCY |
| Total Assets BOY | 20060737 | TotalAssetsBOY |
| Total Assets EOY | 31585792 | TotalAssetsEOY |
| Total Liabilities BOY | 13723855 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 26259893 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6336882 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5325899 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE ACUTE AND SKILLED NURSING CARE FOR RESIDENTS OF HOOPESTON AND THE SURROUNDING AREAS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 21004213 | Expense |
| Revenue | 25194607 | Revenue |
| Description | PROVIDE ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES AND LONG TERM HEALTH CARE SERVICES | Description |
| Total Program Service Expense | 21004213 | 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 | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 1 | EscrowAccount |
| On Behalf Of Issuer | 1 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | 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 | 0 | DisregardedEntity |
| Related Entity | 0 | 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 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 306 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KEN FOZDAR CONTROLLER | NamePerson |
| Telephone Number | 2172838487 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 701 E ORANGE | AddressLine1 |
| City | HOOPESTON | City |
| State | IL | State |
| ZIP Code | 60942 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 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 |
|---|---|---|---|---|---|---|---|
| RUSS LEIGH | |||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| RICHARD READ | |||||||
| VICE-PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| LYNN GALLOWAY | |||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| KARLA COON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| LONI GRESS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TODD HARRIS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| GREG LANE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ED LAYDEN JR | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| HANK HORNBECK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| ANGELA TOTHEROH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JAY COLBERT MD | |||||||
| PHYSICIAN | 40.00 | 258001 | 0 | 0 | X | ||
| CHASE DANIEL | |||||||
| PHYSICIAN | 20.00 | 329508 | 0 | 0 | X | ||
| DENNIS PRICE | |||||||
| PHYSICIAN ASST | 40.00 | 151269 | 0 | 0 | X | ||
| WILLIAM MCCARTHY | |||||||
| PHYSICIAN | 40.00 | 263053 | 0 | 0 | X | ||
| DENNIS BIRKY | |||||||
| PHYSICIAN | 40.00 | 120100 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1121931 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | 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 |
|---|---|---|---|---|---|
| HEALTH ALLIANCE MEDICAL PLANS | |||||
| 1677 RELIABLE PKWY | CHICAGO | IL | 60686 | HEALTH INSURANCE | 1466632 |
| CARLE HOSPITAL FOUNDATION | |||||
| 611 W PARK STREET | URBANA | IL | 61801 | PROFESSIONAL SERVICES | 1213864 |
| HOOPESTON ER MEDICAL SPECIALISTS | |||||
| 6948 WINDSOR AVE | BERWYN | IL | 60402 | ER & HOSPITALIST DOCTORS | 1038000 |
| QUORUM HEALTH RESOURCES | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | CONSULTING/MANAGEMENT | 535264 |
| SIGHTPATH MEDICAL | |||||
| 5775 W OLD SHAKOPEE ROAD SUITE 90 | BLOOMINGTON | MN | 55437 | CATARACT SERVICES | 430060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 30 | NumberOfContractorsGT100K |
| Fundraising Events | 17238 | FundraisingEvents |
| All Other Contributions | 416120 | AllOtherContributions |
| Total Contributions | 433358 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICES | 621990 | 24562724 | 24562724 |
| OTHER | 900099 | 631883 | 631883 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25194607 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3203 | TotalRevenueColumn |
| Exclusion | $3,203 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 8444 | 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 | 8444 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8444 | TotalRevenueColumn |
| Exclusion | $8,444 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 2160 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 17238 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 4077 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1917 | TotalRevenueColumn |
| Exclusion | -$1,917 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAFETERIA | Description |
| Business Code | 722320 | BusinessCode |
| Total Revenue Column | 27789 | TotalRevenueColumn |
| Unrelated Business Revenue | 21344 | UnrelatedBusinessRevenue |
| Exclusion | $6,445 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 27789 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25665484 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25194607 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 21344 | UnrelatedBusinessRevenue |
| Exclusion | $16,175 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9806935 | Total |
| Program Services | 8325888 | ProgramServices |
| Management And General | 1481047 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61966 | Total |
| Program Services | 49437 | ProgramServices |
| Management And General | 12529 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1423685 | Total |
| Program Services | 1161290 | ProgramServices |
| Management And General | 262395 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 677127 | Total |
| Program Services | 570240 | ProgramServices |
| Management And General | 106887 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 412654 | Total |
| Management And General | 412654 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287960 | Total |
| Management And General | 287960 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104169 | Total |
| Management And General | 104169 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2635780 | Total |
| Program Services | 2635780 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186347 | Total |
| Program Services | 162741 | ProgramServices |
| Management And General | 23606 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2519632 | Total |
| Program Services | 1226778 | ProgramServices |
| Management And General | 1292854 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 650159 | Total |
| Program Services | 501476 | ProgramServices |
| Management And General | 148683 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163372 | Total |
| Program Services | 114180 | ProgramServices |
| Management And General | 49192 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50503 | Total |
| Program Services | 24471 | ProgramServices |
| Management And General | 26032 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 621789 | Total |
| Program Services | 519882 | ProgramServices |
| Management And General | 101907 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 858914 | Total |
| Program Services | 675192 | ProgramServices |
| Management And General | 183722 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 504060 | Total |
| Program Services | 497986 | ProgramServices |
| Management And General | 6074 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DRUGS AND OTHER SUPPLIE | 2425236 | 2200223 | 225013 |
| BAD DEBTS | 1839611 | 1839611 | |
| PURCHASED SERVICES/PROF | 1437752 | 499038 | 938714 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26667651 | Total |
| Program Services | 21004213 | ProgramServices |
| Management And General | 5663438 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 817551 | BOY |
| EOY | 128541 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2631148 | BOY |
| EOY | 4148360 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 245659 | BOY |
| EOY | 255780 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 153488 | BOY |
| EOY | 333676 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30582801 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8371309 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11706082 | BOY |
| EOY | 22211492 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 539925 | BOY |
| EOY | 563832 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 90000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3966884 | BOY |
| EOY | 3854111 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20060737 | BOY |
| EOY | 31585792 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3383515 | BOY |
| EOY | 5679500 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9851548 | BOY |
| EOY | 20437825 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 488792 | BOY |
| EOY | 142568 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13723855 | BOY |
| EOY | 26259893 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2771484 | BOY |
| EOY | 1762142 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3565398 | BOY |
| EOY | 3563757 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6336882 | BOY |
| EOY | 5325899 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20060737 | BOY |
| EOY | 31585792 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1002167 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -8816 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| 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 | 297500 | OtherCostOrOtherBasis |
| Book Value | 297500 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13503787 | OtherCostOrOtherBasis |
| Depreciation | 4539722 | Depreciation |
| Book Value | 8964065 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 831030 | OtherCostOrOtherBasis |
| Depreciation | 199653 | Depreciation |
| Book Value | 631377 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8339001 | OtherCostOrOtherBasis |
| Depreciation | 3631934 | Depreciation |
| Book Value | 4707067 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7611483 | OtherCostOrOtherBasis |
| Book Value | 7611483 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22211492 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BENEFICIAL INTEREST IN PERPETUAL TRUST | 3563757 |
| DEFERRED FINANCING COSTS | 290354 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3854111 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSET RETIREMENT OBLIGATION | Description |
| Amount | $142,568 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 142568 | TotalOfAmounts |
| Total Revenue | 25665484 | TotalRevenue |
| Total Expenses | 26667651 | TotalExpenses |
| Excess Or Deficit For Year | -1002167 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -7175 | NetUnrealizedGLOnInvestments |
| Other | -$1,641 | OtherAmount |
| Total Adjustments | -8816 | TotalAdjustments |
| Excess Or Deficit Per FS | -1010983 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 25662386 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -7175 | NetUnrealizedGainsInvestments |
| Other Revenues | 4077 | OtherRevenues |
| Revenue Not Rptd F990 | -3098 | RevenueNotRptdF990 |
| Revenue Subtotal | 25665484 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 25665484 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 26671728 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 4077 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 4077 | ExpensesNotRptdF990 |
| Expenses Subtotal | 26667651 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 26667651 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE CENTER FOLLOWS ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA 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. THE CENTERS INFORMATION INCOME TAX RETURNS FOR YEARS SUBSEQUENT TO FISCAL YEAR 2009 ARE OPEN, BY STATUTE, FOR REVIEW BY AUTHORITIES. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN VALUATION OF PERMANENTLY RESTRICTED NET ASSET -1,641. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT FUNDRAISING EXPENSES NETTED WITH FUNDRAISING REVENUE 4,077. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT FUNDRAISING EXPENSES NETTED WITH FUNDRAISING REVENUE 4,077. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 19398 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 17238 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 2160 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 2226 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 1851 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 19398 | GrossReceiptsTotal |
| Charitable Contributions Total | 17238 | CharitableContributionsTotal |
| Gross Revenue Total Events | 2160 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 2226 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 1851 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 4077 | DirectExpenseSummaryEvents |
| Net Income Summary | -1917 | NetIncomeSummary |
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 | 125.000000000000 | 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 | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 846 | PersonsServed |
| Total Community Benefit Expense | 958017 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 958017 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 846 | PersonsServed |
| Total Community Benefit Expense | 958017 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 958017 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03680 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 250 | PersonsServed |
| Total Community Benefit Expense | 9220 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7044 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 250 | PersonsServed |
| Total Community Benefit Expense | 9220 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7044 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1096 | PersonsServed |
| Total Community Benefit Expense | 967237 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7044 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 960193 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03690 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $661,022 | BadDebtExpenseAmount |
| Amount Attributable To | 650564 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5264295 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5457199 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -192904 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 QUORUM HEALTH RESOURCES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | MANAGEMENT AND CONSULTING | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.00000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.00000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (10 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| HOOPESTON COMMUNITY MEMORIAL HOSPITAL | |||||||||
| 1 | 701 E ORANGE | HOOPESTON | IL | 60942 | X | X | X | X | |
| HOOPESTON COM MEMORIAL NURSING HOM | |||||||||
| 2 | 701 E ORANGE | HOOPESTON | IL | 60942 | LONG TERM CARE/NURSING HOME | ||||
| COUNTRY TERRACE INDEPENDENT LIVING APART | |||||||||
| 3 | 705 E ORANGE | HOOPESTON | IL | 60942 | SENIOR INDEPENDENT LIVING APTS | ||||
| BRIDGEWAY CLINIC | |||||||||
| 4 | 843 E ORANGE | HOOPESTON | IL | 60942 | MEDICAL CLINIC | ||||
| HOOPESTON BUSINESS OFFICE | |||||||||
| 5 | 847 E ORANGE | HOOPESTON | IL | 60942 | ACCTING, BO, HR, IT | ||||
| ROSSVILLE MEDICAL CENTER | |||||||||
| 6 | 619 N CHICAGO | HOOPESTON | IL | 60942 | MEDICAL CLINIC | ||||
| CISSNA PARK MEDICAL CLINIC | |||||||||
| 7 | 141 W GARFIELD | HOOPESTON | IL | 60942 | MEDICAL CLINIC | ||||
| HOOPESTON AMBULANCE SERVICES | |||||||||
| 8 | 413 E MAIN | HOOPESTON | IL | 60942 | AMBULANCE SERVICES | ||||
| CHARLOTTE ANN RUSSELL MEDICAL CENTER | |||||||||
| 9 | 801 E ORANGE | HOOPESTON | IL | 60942 | MEDICAL CLINIC | ||||
| ROBERTS CLINIC | |||||||||
| 10 | 845 SOUTH 4TH STREET | WATSEKA | IL | 60970 | MEDICAL CLINIC | ||||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOOPESTON COMMUNITY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 125.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Other Reason | X | OtherReason |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 661022. | |
| PART II: THE HOSPITAL'S BUILDING PROGRAM WILL ENHANCE THE HEALTHCARE OF THE COMMUNITY BY PROVIDING EASIER ACCESS TO SERVICES AND A GREATER NUMBER OF SERVICES TO BE PROVIDED LOCALLY:1. NEW CLINIC IN ROSSVILLE, IL WAS OPENED IN NOVEMBER 2011 2. NEW EMERGENCY ROOM WAS OPENED IN SEPTEMBER 20123. NEW SURGERY SUITE WAS OPENED IN SEPTEMBER 20124. NEW CLINIC IN WATSEKA, IL WAS OPENED IN JUNE 20125. REPLACEMENT NURSING HOME FACILITY TO BE COMPLETE IN OCTOBER 20126. NEW CLINIC IN MILFORD, IL TO BE COMPLETE IN DECEMBER 2012 | |
| PART V, SECTION B, LINE 13G: CHARITY CARE APPLICATIONS ARE OFFERED TO PATIENTS AT THE TIME OF REGISTRATION. A COMMUNICATION SHEET INCLUDING A BRIEF DESCRIPTION AND CONTACT INFORMATION IS AVAILABLE AT REGISTRATION AND ALSO SENT WITH THE FIRST STATEMENT. FINANCIAL ASSISTANCE CONTACT INFORMATION IS PRINTED ON THE STATEMENTS. CHARITY CARE IS ON OUR WEBSITE WITH CONTACT INFORMATION. CHARITY CARE IS OFFERED TO PATIENTS WHO EXPRESS FINANCIAL HARDSHIP AND TO THOSE THAT WE ASSUME ARE GOING THROUGH A FINANCIAL HARDSHIP. | HOOPESTON COMMUNITY MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 18D: HOOPESTON COMMUNITY MEMORIAL HOSPITAL FOLLOWS EMTALA LAWS. | HOOPESTON COMMUNITY MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 19D: THE HOSPITAL USES A DISCOUNT EQUAL TO THE HIGHEST NEGOTIATED COMMERCIAL OUT-PATIENT INSURANCE RATE. | HOOPESTON COMMUNITY MEMORIAL HOSPITAL |
| PART VI, LINE 2: HOOPESTON REGIONAL HEALTH CENTER ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS THROUGH A PUBLICLY ADVERTISED STATE OF THE HOSPITAL MEETING, WHERE COMMUNITY RESIDENTS ARE SURVEYED UPON ENTRY CONCERNING THE MOST SIGNIFICANT HEALTH CONCERNS THEY MAY HAVE IN OUR COMMUNITY TODAY. THROUGH THESE ASSESSMENTS THE HOSPITAL HAS INITIATED THE FOLLOWING PROGRAMS OVER THE PAST 3 YEARS:1. NURSE DOING HEAD CHECKS IN THE LOCAL SCHOOL SYSTEM. WE PROVIDE THIS SERVICE FOR FREE.2. VISION AND HEARING TESTING FOR ALL SCHOOLS IN THE REGION. WE PROVIDE THIS SERVICE FOR FREE.3. ATHLETIC TRAINER TO CARE FOR STUDENT ATHLETES, SPECIALIZING IN CONCUSSION CARE. WE PROVIDE THIS SERVICE FOR FREE.4. AFTER HOURS CARE PROGRAM. WE HAVE EXPANDED OUR CLINIC HOURS UNTIL 8PM DURING THE WEEK AND 9AM TO 5PM ON SATURDAY AND SUNDAY.5. HIRED A GENERAL SURGEON, 3 PHYSICIANS AND 4 PHYSICIAN ASSISTANTS FOR OUR COMMUNITY.6. FREE DIABETES EDUCATION FROM OUR REGISTERED DIETICIAN. CLASSROOM AND INDIVIDUAL COUNSELING ARE OFFERED.7. FUTURE PROGRAM DEVELOPMENTS WILL INCLUDE AGING AND OBESITY.8. CONTRACTED 2 ADDITIONAL CARDIOLOGISTS FOR OUR COMMUNITY.WE PERFORM A FORMAL 3RD PARTY ASSESSMENT ONCE EVERY THREE YEARS. CHNA WAS COMPLETED IN 2012. ALL SURVEYS AND ASSESSMENTS ARE DISCUSSED AT OUR ANNUAL STRATEGIC PLANNING SESSIONS WITH THE COMMUNITY BOARD OF DIRECTORS EACH SEPTEMBER. | |
| PART VI, LINE 3: PATIENTS ARE EDUCATED ON THE FINANCIAL ASSISTANCE POLICIES AND AVAILABILITY IN THE FOLLOWING WAYS;1. SIGNS ARE POSTED AT ALL AREAS OF PATIENT REGISTRATION FOR SERVICES.2. DISCUSS WITH PATIENTS EXPRESSING DIFFICULTY OR NEED. WE THEN HELP DETERMINE IF THEY ARE AVAILABLE FOR STATE MEDICAID OR IF THEY QUALIFY FOR CHARITY CARE UNDER OUR POLICY. IF SO, WE ASSIST THEM WITH THE APPLICATION PROCESS. | |
| PART VI, LINE 4: HOOPESTON REGIONAL HEALTH CENTER SERVES A ZIP CODE WITH 5,400 PEOPLE IN A RURAL ENVIRONMENT. A VAST MAJORITY OF THE PEOPLE LIVING IN THIS AREA ARE OF A WHITE RACE. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2011 WAS $37,276. IN 2011, 24.3% OF THE POPULATION HAD AN INCOME BELOW THE POVERTY LINE. | |
| PART VI, LINE 5: THE HOSPITAL FURTHERS HEALTH IN THE COMMUNITY BY:1. PROVIDING CHILDREN'S ACTIVITIES THROUGHOUT THE YEAR FREE OF CHARGE, IE; MOVIES, PONY RIDES, AND FIREWORKS,2. MAINTAINING AN OPEN MEDICAL STAFF TO ENCOURAGE PHYSICIAN MEMBERSHIP IN OUR ORGANIZATION AND PROVIDE CHOICE FOR LOCAL PATIENTS,3. 10 MEMBER COMMUNITY BOARD SERVES ON A VOLUNTEER BASIS. |
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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAY COLBERT MD | |||||||||||||
| 258001 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 258001 | 0 | 0 | 0 |
| CHASE DANIEL | |||||||||||||
| 329508 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 329508 | 0 | 0 | 0 |
| DENNIS PRICE | |||||||||||||
| 151269 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 151269 | 0 | 0 | 0 |
| WILLIAM MCCARTHY | |||||||||||||
| 263053 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 263053 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FARM CREDIT SERVICES OF ILLINOIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 371270645 | IssuerEIN |
| Date Issued | 2011-08-02 | DateIssued |
| Issue Price | 7450000 | IssuePrice |
| Description Of Purpose | REFINANCING OF PRIOR BONDS | 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 | 203158 | AmountRetired |
| Total Proceeds | 7450000 | TotalProceeds |
| Amount In Reserve Fund | 500000 | AmountInReserveFund |
| Refunding Escrow | 6930095 | RefundingEscrow |
| Issuance Costs From Proceeds | 19905 | IssuanceCostsFromProceeds |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | 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
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DICK READ | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD MEMBER | Relationship |
| Amount Of Transaction | 31752 | AmountOfTransaction |
| Description Of Transaction | MAINTENANCE AND VEHICLE PURCHASE | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TWO BOARD MEMBERS, KARLA COON AND ANGELA TOTHEROH, ARE STEP-MOTHER AND STEP-DAUGHTER. | |
| FORM 990, PART VI, SECTION A, LINE 3 | THE CEO OF THE ORGANIZATION IS EMPLOYED BY QUORUM HEALTH RESOURCES. THE ORGANIZATION NEGOTIATED A MANAGEMENT CONTRACT WITH THAT FIRM. | |
| 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, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST DISCLOSURE FORMS ARE ANNUALLY COMPLETED BY EMPLOYEES AND BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO OF THE ORGANIZATION IS EMPLOYED BY QUORUM HEALTH RESOURCES. THE ORGANIZATION NEGOTIATED A MANAGEMENT CONTRACT WITH THAT FIRM. THERE IS CURRENTLY NO CFO. | |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -7,175. CHANGE IN VALUATION OF PERMANENTLY RESTRICTED NET ASSET -1,641. TOTAL TO FORM 990, PART XI, LINE 5: -8,816. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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