HILLSBORO AREA HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HILLSBORO AREA HOSPITAL INC (EIN 37-0661208)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-01-29
IRS object ID
201340299349300934
Schema version
2011v1.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-01-29T14:25:05-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN430352985EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KERBER ECK & BRAECKEL LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE MEMORIAL DRIVE STE 950AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63102ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370661208EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHILLNameControl
Phone2175326111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1
CityHILLSBOROCity
StateILState
ZIP Code62049ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameREX BROWNName
TitlePRESIDENT & CEOTitle
Phone2175326111Phone
Date Signed2013-01-18DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBRENT E MCCLURE CPAName
PTINP00234013PTIN
Phone3142316232Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonREX BROWNNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1
CityHILLSBOROCity
StateILState
ZIP Code62049ZIPCode
FieldValueIRS element (for citing)
Gross Receipts19646273GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HILLSBOROHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionOPERATION OF HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) AND ASSISTED LIVING FACILITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees253TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year73748ContributionsGrantsPriorYear
Contributions Grants Current Year62329ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19071802ProgramServiceRevenuePriorYear
Program Service Revenue CY19302125ProgramServiceRevenueCY
Investment Income Prior Year214164InvestmentIncomePriorYear
Investment Income Current Year192093InvestmentIncomeCurrentYear
Other Revenue Prior Year90430OtherRevenuePriorYear
Other Revenue Current Year85252OtherRevenueCurrentYear
Total Revenue Prior Year19450144TotalRevenuePriorYear
Total Revenue Current Year19641799TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8155610SalariesEtcPriorYear
Salaries Etc Current Year8162640SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9981456OtherExpensePriorYear
Other Expenses Current Year10301105OtherExpensesCurrentYear
Total Expenses Prior Year18137066TotalExpensesPriorYear
Total Expenses Current Year18463745TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1313078RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1178054RevenuesLessExpensesCY
Total Assets BOY27641801TotalAssetsBOY
Total Assets EOY28185143TotalAssetsEOY
Total Liabilities BOY8839945TotalLiabilitiesBOY
Total Liabilities EOY8548195TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY18801856NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19636948NetAssetsOrFundBalancesEOY
Mission DescriptionTO POSITIVELY AFFECT THE HEALTH AND WELFARE OF THE COMMUNITIES WE SERVE THROUGH THE OPERATION OF A HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) AND AN ASSISTED LIVING FACILITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13651477Expense
Revenue19346779Revenue
DescriptionOPERATION OF A 25 BED CRITICAL ACCESS HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) WITH AN ASSISTED LIVING FACILITY. 1,179 ACUTE DAYS, 1,383 SWING BED DAYS, 15,607 OUTPATIENT VISITS AND 13,299 ASSISTED LIVING RESIDENT DAYS PROVIDED IN FY 2012. HILLSBORO AREA HOSPITAL ALSO PROVIDES $885,851 IN CHARITY CARE AND $1,450,585 IN OTHER COMMUNITY BENEFITS, NOT INCLUDING BAD DEBT.Description
Total Program Service Expense13651477TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109627NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees253NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TERRI CARROLL CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2175324187TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1
CityHILLSBOROCity
StateILState
ZIP Code62049ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
BILL BRINK
DIRECTOR1.00X000
TODD DEAN
TREASURER1.00X000X
TOM GOODING
CHAIRMAN1.00X000X
BARBARA HEWITT
VICE CHAIRMAN1.00X000X
BARBARA MULCH
DIRECTOR1.00X000
PATRICIA WHITWORTH
DIRECTOR1.00X000
PATRICIA CLARKE
SECRETARY1.00X000X
BRIAN KNODLE
DIRECTOR1.00X000
MICHELLE ONDREY
DIRECTOR1.00X000
DAVE IMLER
DIRECTOR1.00X000
REX BROWN
CEO40.00000X
TERRI CARROLL
CFO40.00000X
CHRISTOPHER WHITTEN
DIR REHAB SV40.0011890804570X
FieldValueIRS element (for citing)
Total Reportable Comp From Org118908TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation4570TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS EMERGENCY PHYSICIANSBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 793AddressLine1
CityTRAVERSE CITYCity
StateMIState
ZIP Code49685ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesER COVERAGEDescriptionOfServices
Compensation1293618Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants60329GovernmentGrants
All Other Contributions2000AllOtherContributions
Total Contributions62329TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE REVENUDescription
Business Code900099BusinessCode
Total Revenue Column19302125TotalRevenueColumn
Related Or Exempt Function Income19302125RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue19302125TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column181083TotalRevenueColumn
Exclusion$181,083ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real4107Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real4107Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column4107TotalRevenueColumn
Exclusion$4,107ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other15484Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other4474Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other11010Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column11010TotalRevenueColumn
Exclusion$11,010ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA90009936491$36,491
OTHER INCOME9000993631536315
MEDICAL RECORDS90009955885588

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2751TotalRevenueColumn
Related Or Exempt Function Income2751RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue81145TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column19641799TotalRevenueColumn
Related Or Exempt Function Income19346779RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$232,691ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6069032Total
Program Services5310570ProgramServices
Management And General758462ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total132515Total
Program Services115954ProgramServices
Management And General16561ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1497089Total
Program Services1309994ProgramServices
Management And General187095ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total464004Total
Program Services406016ProgramServices
Management And General57988ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total621293Total
Management And General621293ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total72756Total
Program Services9986ProgramServices
Management And General62770ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total54756Total
Management And General54756ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total7442Total
Management And General7442ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1551258Total
Program Services1257391ProgramServices
Management And General293867ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total35948Total
Management And General35948ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total141818Total
Program Services50671ProgramServices
Management And General91147ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total478922Total
Program Services436010ProgramServices
Management And General42912ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total46204Total
Program Services30340ProgramServices
Management And General15864ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total330250Total
Program Services217963ProgramServices
Management And General112287ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1033408Total
Program Services692183ProgramServices
Management And General341225ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total154781Total
Program Services31060ProgramServices
Management And General123721ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
BAD DEBT16804341680434
PHYSICIAN'S FEES16038411603841
SUPPLIES1399899254141374485
EQUIPMENT RENTAL AND MA409887723409164

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total678208Total
Program Services395849ProgramServices
Management And General282359ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18463745Total
Program Services13651477ProgramServices
Management And General4812268ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY584396BOY
EOY656465EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8918092BOY
EOY8316495EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2090384BOY
EOY2744121EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY352581BOY
EOY320672EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY324533BOY
EOY250821EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis25882838LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec11960345LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY13397808BOY
EOY13922493EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1366080BOY
EOY1391348EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY607927BOY
EOY582728EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY27641801BOY
EOY28185143EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1694168BOY
EOY1606318EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY7012396BOY
EOY6803324EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY133381BOY
EOY138553EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8839945BOY
EOY8548195EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY17739998BOY
EOY18408004EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY776858BOY
EOY943944EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY285000BOY
EOY285000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18801856BOY
EOY19636948EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27641801BOY
EOY28185143EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1178054ReconcilationRevenueExpenses
Reconcilation Other Changes-342962ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$7,442OtherActivitiesAmount
Total Lobbying Expenditures IIB7442TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationA PORTION OF THE DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE CLASSIFIED AS BEING FOR LOBBYING.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance429495BeginningOfYearBalance
Investment Earnings Or Losses1960InvestmentEarningsOrLosses
End Of Year Balance431455EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance425202BeginningOfYearBalance
Investment Earnings Or Losses4293InvestmentEarningsOrLosses
End Of Year Balance429495EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance420360BeginningOfYearBalance
Investment Earnings Or Losses4842InvestmentEarningsOrLosses
End Of Year Balance425202EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance406863BeginningOfYearBalance
Investment Earnings Or Losses13497InvestmentEarningsOrLosses
End Of Year Balance420360EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.66060PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.33940TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis237676OtherCostOrOtherBasis
Book Value237676BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis15207526OtherCostOrOtherBasis
Depreciation5854646Depreciation
Book Value9352880BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1580567OtherCostOrOtherBasis
Depreciation596695Depreciation
Book Value983872BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7760036OtherCostOrOtherBasis
Depreciation5509004Depreciation
Book Value2251032BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1097033OtherCostOrOtherBasis
Book Value1097033BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13922493TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionASSET RETIREMENT OBLIGATIONDescription
Amount$138,553Amount
FieldValueIRS element (for citing)
Total Of Amounts138553TotalOfAmounts
Total Revenue19641799TotalRevenue
Total Expenses18463745TotalExpenses
Excess Or Deficit For Year1178054ExcessOrDeficitForYear
Net Unrealized GL On Investments-755NetUnrealizedGLOnInvestments
Other-$342,207OtherAmount
Total Adjustments-342962TotalAdjustments
Excess Or Deficit Per FS835092ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt19644616TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-755NetUnrealizedGainsInvestments
Other Revenues3572OtherRevenues
Revenue Not Rptd F9902817RevenueNotRptdF990
Revenue Subtotal19641799RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99019641799TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18463745TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal18463745ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99018463745TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:PERMANENTLY RESTRICTED ENDOWMENT FUND INTEREST IS TO BE USED FOR THE HOSPITAL'S BUILDING AND MAINTENANCE.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF STATE LAW. HOWEVER, THE HOSPITAL WOULD BE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES FEDERAL INFORMATION RETURNS. THE STATUTES OF LIMITATIONS FOR INFORMATION RETURNS FILED FOR THE YEARS ENDED JUNE 30, 2009 THROUGH 2012 HAVE NOT EXPIRED AND THEREFORE ARE SUBJECT TO EXAMINATION. THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS CODIFICATION (ASC) SECTION 740-10. ASC SECTION 740-10 CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM STANDARD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL HAS NOT TAKEN ANY UNCERTAIN TAX POSITIONS THAT SHOULD BE ACCOUNTED FOR UNDER ASC SECTION 740-10.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 3,572. CONTRIBUTIONS IN EXCESS OF NET ASSETS RELEASED FROM RESTRICTIONS 154,221. TRANSFER TO HILLSBORO AREA HEALTH SYSTEM NFP -500,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: -342,207.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 3,572.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent0FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available0ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense459375TotalCommunityBenefitExpense
Net Community Benefit Expense459375NetCommunityBenefitExpense
Percent Of Total Expense0.02740PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2484763TotalCommunityBenefitExpense
Direct Offsetting Revenue1333844DirectOffsettingRevenue
Net Community Benefit Expense1150919NetCommunityBenefitExpense
Percent Of Total Expense0.06860PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense2944138TotalCommunityBenefitExpense
Direct Offsetting Revenue1333844DirectOffsettingRevenue
Net Community Benefit Expense1610294NetCommunityBenefitExpense
Percent Of Total Expense0.09600PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense39477TotalCommunityBenefitExpense
Direct Offsetting Revenue9144DirectOffsettingRevenue
Net Community Benefit Expense30333NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2452822TotalCommunityBenefitExpense
Direct Offsetting Revenue2187583DirectOffsettingRevenue
Net Community Benefit Expense265239NetCommunityBenefitExpense
Percent Of Total Expense0.01580PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense153666TotalCommunityBenefitExpense
Net Community Benefit Expense153666NetCommunityBenefitExpense
Percent Of Total Expense0.00920PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2645965TotalCommunityBenefitExpense
Direct Offsetting Revenue2196727DirectOffsettingRevenue
Net Community Benefit Expense449238NetCommunityBenefitExpense
Percent Of Total Expense0.02680PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5590103TotalCommunityBenefitExpense
Direct Offsetting Revenue3530571DirectOffsettingRevenue
Net Community Benefit Expense2059532NetCommunityBenefitExpense
Percent Of Total Expense0.12280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$871,473BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11200 EAST TREMONT STREETAddressLine1
CityHILLSBOROCity
StateILState
ZIP Code62049ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HILLSBORO AREA HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Other FactorsXOtherFactors
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
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 $ 1680434.
PART III, LINE 3: THE HOSPITAL BELIEVES THAT THE COMMUNITY BENEFIT OBTAINED FROM ITS CHARITY CARE IS UNDERSTATED DUE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT DO NOT APPLY OR PROVIDE INCOMPLETE INFORMATION. SOME CARE PROVIDED TO PATIENTS IS NOT CLASSIFIED AS CHARITY CARE DUE TO PATIENTS MISSING DOCUMENTATION THAT PROVES THEY QUALIFY FOR CHARITY CARE. THE HOSPITAL'S BAD DEBT DOES INCLUDE AMOUNTS THAT COULD BE CLASSIFIED AS CHARITY CARE IF THE PATIENTS WOULD APPLY OR PROVIDE THE APPROPRIATE INFORMATION TO COMPLETE THE CHARITY CARE APPLICATION.
PART III, LINE 4: TEXT OF FOOTNOTE FROM THE FINANCIAL STATEMENTSTHE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AS DETERMINED BY THE HOSPITAL'S CRITERIA FOR FINANCIAL ASSISTANCE.IN SOME CASES, THE HOSPITAL DOES NOT RECEIVE THE AMOUNT BILLED FOR PATIENT SERVICES EVEN THOUGH IT DID NOT RECEIVE INFORMATION NECESSARY TO DETERMINE IF THE PATIENTS MET THE CRITERIA FOR FINANCIAL ASSISTANCE. BAD DEBTS EXPENSE IS THE ESTIMATED AMOUNT OF PATIENT REVENUE THAT THE HOSPITAL WILL NOT COLLECT.THE COSTING METHODOLOGY USED WAS THE RATIO OF PATIENT CARE COST-TO-CHARGES. NO BAD DEBT AMOUNTS WERE INCLUDED IN COMMUNITY BENEFIT.
PART III, LINE 9B: ALL COLLECTION EFFORTS WILL CEASE IMMEDIATELY ON AMOUNTS APPROVED FOR SPECIAL FINANCIAL CONSIDERATIONS.
PART V, SECTION B, LINE 11H: NUMBER OF DEPENDENTS.HILLSBORO AREA HOSPITAL
PART V, SECTION B, LINE 17E: A MINIMUM OF 2 STATEMENTS AND 2 LETTERS ARE SENT PRIOR TO SENDING THE ACCOUNT TO COLLECTIONS, EACH NOTING HOW TO CONTACT THE HOSPITAL FOR FINANCIAL ASSISTANCE.HILLSBORO AREA HOSPITAL
PART V, SECTION B, LINE 21: IF A PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE, NO DISCOUNT IS APPLIED PER HOSPITAL POLICY, SO GROSS CHARGES ARE BILLED TO THOSE PATIENTS.HILLSBORO AREA HOSPITAL
PART VI, LINE 2: HILLSBORO AREA HOSPITAL CONDUCTS A NEEDS ASSESSMENT DURING ITS STRATEGIC PLANNING AND LONG RANGE BUDGETING PROCESS. THIS PROCESS INCLUDES OBTAINING AND ANALYZING VARIOUS DATA AND MARKET DEMOGRAPHICS. THE DATA IS THEN SUPPLEMENTED WITH VIEWS AND CONCERNS FROM OUR COMMUNITY BOARD MEMBERS, OTHER COMMUNITY OUTREACH RELATIONSHIPS AND OTHER COMMON ORGANIZATIONS.
PART VI, LINE 3: UNINSURED PATIENTS AND PERSONS WHO SEEK AND / OR OBTAIN SERVICES FROM THE HOSPITAL, ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE VIA SIGNAGE THROUGHOUT THE PATIENT ACCESS AREAS OF THE FACILITY, BROCHURES, ADMISSION PACKETS, DISCLOSURE ON THE PATIENT BILL, IN PERSON AND TELEPHONE ASSISTED CUSTOMER SERVICE, AS WELL AS INFORMATION SUCH AS THE GUIDELINES AND APPLICATION BEING PREDOMINATELY POSTED ON THE HOSPITAL WEBSITE.
PART VI, LINE 4: THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF PATIENTS IN THE CITY OF HILLSBORO AND THE SURROUNDING AREAS. THE HOSPITAL IS THE LEADING HEALTHCARE PROVIDER FOR THE MONTGOMERY COUNTY ILLINOIS COMMUNITY. THESE COMMUNITIES ARE MEDICALLY VULNERABLE AND HAVE A LARGE INDIGENT POPULATION.
PART VI, LINE 5: DESIGNATED AS A CRITICAL ACCESS HOSPITAL, THE HOSPITAL USES ANY LIMITED SURPLUS FUNDS TO FURTHER ITS EXEMPT PURPOSE BY PROVIDING PROGRAMS AND ACCESS AS NOTED IN FORM 990, PART III, LINE 1 AND 4A AND CONTINUED ON SCHEDULE O. THE BOARD OF DIRECTORS IS MADE UP OF VOLUNTEER COMMUNITY LEADERS WITHIN ITS PRIMARY SERVICE AREA THAT ARE APPROVED BY THE MEMBER ORGANIZATION.
PART VI, LINE 6: THE HOSPITAL IS PART OF A CRITICAL ACCESS NETWORK THAT INCLUDES HILLSBORO AREA HEALTH SYSTEM NFP, ITS SOLE CORPORATE MEMBER, WHICH PROVIDES HEALTH AND SUPPORTIVE SERVICES TO THE COMMUNITIES THEY SERVE.THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ACTIVITIES AND SERVICES THAT MEET UNMET COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, HEALTH FAIRS AND EVENTS, HEALTH SCREENINGS AND ASSESSMENTS, SPACE FOR DAYCARE PROGRAMS OFFERED BY THE LOCAL SCHOOL SYSTEM, SUPPORT FOR VITAL COMMUNITY SERVICES, TRAUMA CARE, AND VARIOUS COMMUNITY EDUCATIONAL SERVICES. HILLSBORO AREA HOSPITAL RECEIVED LEED CERTIFICATION FOR THE BUILDING ADDITION COMPLETED IN JULY 2010. THE ENVIRONMENTAL BENEFITS OF LEED INCLUDE: REDUCTION OF WASTE SENT TO LANDFILLS, CONSERVATION OF ENERGY AND WATER, REDUCTION OF HARMFUL GREENHOUSE GASES, AND A HEALTHIER AND SAFER PLACE FOR EMPLOYEES, PATIENTS, AND THE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE CHAMBER OF COMMERCE AND PARTNERS WITH THE MONTGOMERY COUNTY ECONOMIC DEVELOPMENT CORPORATION TO OBTAIN GRANTS AND EXPAND THE SERVICES NEEDED IN THE COMMUNITY. THE HOSPITAL PROVIDES THE USE OF SPACE AT NO CHARGE TO THE HILLSBORO COMMUNITY SCHOOL DISTRICT FOR A DAYCARE FACILITY. FOR MANY YEARS, UNTIL MAY 2010, THE HOSPITAL PROVIDED CLASSROOM SPACE, FREE OF CHARGE, FOR LINCOLN LAND COMMUNITY COLLEGE TO USE FOR NURSING INSTRUCTION. THE HOSPITAL ALSO PROVIDES GRAND ADVANTAGE SENIOR EXERCISE CLASSES TO THE SENIORS IN THE AREA AT NO CHARGE, AND PROVIDES THE DIAMOND CLUB TO SENIORS FOR ASSISTANCE WITH THE UNDERSTANDING AND ORGANIZATION OF MEDICAL BILLS AND INSURANCE. HOSPITAL EMPLOYEES ALSO SHARE THEIR EXPERTISE THROUGH COMMUNITY SPEAKING AT LOCAL ORGANIZATIONS AND EVENTS. SEVERAL MONETARY DONATIONS ARE MADE BY THE HOSPITAL THROUGHOUT THE YEAR TO OTHER NON-PROFIT ORGANIZATIONS. AN AUTOMATIC BLOOD PRESSURE MACHINE IS LOCATED IN THE HOSPITAL LOBBY WHERE THE COMMUNITY MEMBERS CAN USE IT FREE OF CHARGE, AND THE HOSPITAL PROVIDES A BOOTH AT THE LOCAL COMMUNITY FAIR EACH YEAR WHERE EMPLOYEES TAKE BLOOD PRESSURES AND PROVIDE HEALTH INFORMATION TO THE PUBLIC.THE HOSPITAL RECEIVED A USDA DISTANCE LEARNING & TELEMEDICINE GRANT TO EXPAND CERTIFIED NURSING ASSISTANT INSTRUCTION TO HIGH SCHOOL STUDENTS IN OUR COMMUNITY. IN COMBINATION WITH THE HOSPITAL'S MATCHING FUNDS, VIDEO CONFERENCING EQUIPMENT WAS PURCHASED AND PLACED IN 4 COMMUNITY HIGH SCHOOLS SO THAT THE STUDENTS CAN REMAIN IN THEIR OWN CLASSROOMS INSTEAD OF BEING TRANSPORTED TO THE HOSPITAL'S CAMPUS FOR CNA INSTRUCTION. IN ADDITION, THE HOSPITAL PROVIDES THE USE OF SPACE ON OUR CAMPUS FOR THE CLASSES FREE OF CHARGE, SO THE COMBINATION OF FREE SPACE USAGE AND REDUCED TRANSPORTATION COSTS PROVIDES GREAT BENEFITS FOR THIS STATE-APPROVED PROGRAM. THE HOSPITAL ALSO HAS THE HILLSBORO AREA HOSPITAL JUNIOR BOARD WHICH IS COMPRISED OF STUDENT VOLUNTEERS AGES 9-16. THE JUNIOR BOARD MEMBERS LEARN HOW ORGANIZATIONS WORK, DEVELOP LEADERSHIP SKILLS, AND PLAN AND EXECUTE COMMUNITY IMPROVEMENT ACTIVITIES WITH THE HELP OF HOSPITAL STAFF MEMBERS.THE HOSPITAL ALSO PARTICIPATED IN THE COLORECTAL CANCER SCREENING INITIATIVE, HELPED COORDINATE APPOINTMENTS FOR OTHER CANCER SCREENS IN COORDINATION WITH THE MONTGOMERY COUNTY CANCER ASSOCIATION, AND PROVIDED PRODUCE PLANTS TO COMMUNITY MEMBERS TO PROMOTE HEALTHIER EATING HABITS AND FOOD SUSTAINABILITY. FURTHERMORE, THE HOSPITAL HAS BEEN RECOGNIZED AS HILLSBORO'S BUSINESS OF THE YEAR FOR ITS POSITIVE ECONOMIC AND CIVIC IMPACT AND ITS OVERWHELMING SUPPORT OF THE COMMUNITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
REX BROWN
000000000000
TERRI CARROLL
000000000000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationHEALTHTECH MANAGEMENT SERVICES, FORMERLY BRIM HEALTHCARE, INC., WAS PAID $614,279 FOR MANAGEMENT SERVICES. REX BROWN, CEO AND TERRI CARROLL, CFO ARE EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF HILLSBORO MONTGOMERY COUNTY ILLINOISBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN376001658IssuerEIN
Date Issued2008-09-30DateIssued
Issue Price7220000IssuePrice
Description Of PurposeCAPITAL IMPROVEMENT PROJECT - EXPANSION CONSTRUCTIONDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired416676AmountRetired
Total Proceeds7220000TotalProceeds
Issuance Costs From Proceeds83500IssuanceCostsFromProceeds
Capital Expenditures6862436CapitalExpenditures
Amount Unspent274064AmountUnspent
Year Of Subst Completion2010YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3HILLSBORO AREA HOSPITAL DELEGATED CONTROL OVER MANAGEMENT TO HEALTHTECH MANAGEMENT SERVICES, FORMERLY BRIM HEALTHCARE, INC. - CEO & CFO ARE EMPLOYED BY HEALTHTECH MANAGEMENT SERVICES. THE CEO & CFO ARE UNDER THE SUPERVISION OF HEALTHTECH MANAGEMENT SERVICES.
FORM 990, PART VI, SECTION A, LINE 6HILLSBORO AREA HEALTH SYSTEM NFP, A NOT FOR PROFIT CORPORATION IS THE SOLE CORPORATE MEMBER OF HILLSBORO AREA HOSPITAL, INC. THE HOSPITAL ALSO HAS INDIVIDUAL MEMBERS. THERE ARE TWO CLASSES OF INDIVIDUAL MEMBERS. ANNUAL(REGULAR) AND LIFE MEMBERS MAKE UP THE CLASSES OF INDIVIDUAL MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7AONLY THE INDIVIDUAL MEMBERS CAN ELECT MEMBERS TO THE GOVERNING BODY. THE VOTING OF DIRECTORS TO THE BOARD ONLY OCCURS IN OCTOBER. IN ADDITION, THE SOLE CORPORATE MEMBER MUST APPROVE ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE CORPORATE MEMBER, HILLSBORO AREA HEALTH SYSTEM NFP, APPROVES ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR TO THE BYLAWS OF THE CORPORATION AND APPROVES HOSPITAL BOARD MEMBERS ELECTED. THE ONLY VOTING RIGHT OF THE INDIVIDUAL MEMBERS IS THE RIGHT TO ELECT DIRECTORS. IN ADDITION, HILLSBORO AREA HEALTH SYSTEM NFP MUST APPROVE SUCH ITEMS AS BUDGETS, STRATEGIC PLANS, LARGE UNBUDGETED CAPITAL EXPENDITURES, LAND SALES, ETC.
FORM 990, PART VI, SECTION B, LINE 11THE CFO REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE 990 TO EACH MEMBER OF THE BOARD FOR REVIEW. THE BOARD THEN VOTES ON THE APPROVAL OF THE 990 AS IT IS OR CONTINGENT UPON CHANGES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CEMPLOYEES COMPLETE AND SIGN AN ANNUAL DISCLOSURE STATEMENT AND THE BOARD OF DIRECTORS COMPLETE AND SIGN A CONFLICT OF INTEREST FORM ANNUALLY. THE BOARD REVIEWS THE DISCLOSURES AND TAKES APPROPRIATE ACTION TO RESOLVE ANY ISSUES.
FORM 990, PART VI, SECTION B, LINE 15A PERFORMANCE EVALUATION IS COMPLETED AND DISCUSSED IN EXECUTIVE SESSION BY THE BOARD OF DIRECTORS FOR EXECUTIVE EMPLOYEES. THE PROCESS FOR DETERMINING COMPENSATION INCLUDES REVIEWS OF SALARY RANGES FOR THE POSITIONS PER VARIOUS DATABASES AND/OR MATERIAL AVAILABLE. THE DELIBERATION AND DECISION BY THE BOARD OF DIRECTORS IS DOCUMENTED IN THE EXECUTIVE SESSION BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -755. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 3,572. CONTRIBUTIONS IN EXCESS OF NET ASSETS RELEASED FROM RESTRICTIONS 154,221. TRANSFER TO HILLSBORO AREA HEALTH SYSTEM NFP -500,000. TOTAL TO FORM 990, PART XI, LINE 5: -342,962.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HILLSBORO AREA HEALTH SYSTEM NFP
1200 EAST TREMONTHILLSBOROIL62049364539688MANAGEMENT AND OVERSIGHT OF HEALTH CARE SYSTEMIL501(C)3LINE 11C, III-FI0
HILLSBORO AREA HEALTH FOUNDATION
1200 EAST TREMONTHILLSBOROIL62049371247796PROVIDE SUPPORT FOR HILLSBORO AREA HOSPITALIL501(C)3LINE 70HILLSBORO AREA HEALTH SYSTEM NFP
HILLSBORO AREA HEALTH SERVICES INC
1210 EAST TREMONTHILLSBOROIL62049371240643ESTABLISH AND OPERATE FACILITIES FOR WELLBEING OF PERSONS IN AREAIL501(C)3LINE 90HILLSBORO AREA HEALTH SYSTEM NFP
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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