ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-1208459)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201341349349305179
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T15:09:08-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 West Nationwide Blvd Ste 500 | AddressLine1 |
| City | Columbus | City |
| State | OH | State |
| ZIP Code | 432152568 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371208459 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH'S HOSPITAL - HOSPITAL | BusinessNameLine1 |
| Business Name Line2 | SISTERS - THIRD ORDER OF ST FRANCIS | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % JOHN JEFFRIES | InCareOfName |
| Name Control | STJO | NameControl |
| Phone | 6185264511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE PO BOX 99 | AddressLine1 |
| City | BREESE | City |
| State | IL | State |
| ZIP Code | 622300099 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN JEFFRIES | Name |
| Title | CFO | Title |
| Date Signed | 2013-05-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KPMG LLP | Name |
| Phone | 6142492300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARK KLOSTERMAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE | AddressLine1 |
| City | BREESE | City |
| State | IL | State |
| ZIP Code | 622300099 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 54973608 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.stjoebreese.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1987 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION OF ST. JOSEPH'S HOSPITAL IS TO MINISTER TO THOSE IN NEED AS EXEMPLIFIED BY THE GOSPEL OF CHRIST. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 385 | TotalNbrEmployees |
| Total Nbr Volunteers | 500 | TotalNbrVolunteers |
| Total Gross UBI | 99004 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -12887 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 127059 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 82828 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 47700323 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 49961505 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4596800 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4096112 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 173885 | OtherRevenuePriorYear |
| Other Revenue Current Year | 90912 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 52598067 | TotalRevenuePriorYear |
| Total Revenue Current Year | 54231357 | 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 | 20218101 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22198546 | 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 | 24798921 | OtherExpensePriorYear |
| Other Expenses Current Year | 22512303 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 45017022 | TotalExpensesPriorYear |
| Total Expenses Current Year | 44710849 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7581045 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 9520508 | RevenuesLessExpensesCY |
| Total Assets BOY | 106137770 | TotalAssetsBOY |
| Total Assets EOY | 114057880 | TotalAssetsEOY |
| Total Liabilities BOY | 22242023 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 28770236 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 83895747 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 85287644 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSION OF ST. JOSEPH'S HOSPITAL IS TO MINISTER TO THOSE IN NEED AS EXEMPLIFIED BY THE GOSPEL OF CHRIST. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 37365960 | Expense |
| Revenue | 49961505 | Revenue |
| Description | SEE SCHEDULE O - PROGRAM SERVICE ACCOMPLISHMENTS | Description |
| Total Program Service Expense | 37365960 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 51 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 385 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN JEFFRIES | NamePerson |
| Telephone Number | 6185265312 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 HOLY CROSS LANE | AddressLine1 |
| City | BREESE | City |
| State | IL | State |
| ZIP Code | 622300099 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Key EmployeeKeyEmployee | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Jonathan Osborn MD | ||||||||
| Secretary | 40.0 | X | X | 363433 | 28669 | |||
| Mark Klosterman | ||||||||
| President, CEO | 40.0 | X | 234912 | 75118 | X | |||
| Carson Hempen | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Elaine Behrmann | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Erin Gagen MD | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Janice Wiegmann PH D | ||||||||
| Director | 1.0 | X | 0 | 0 | ||||
| Paul Strieker | ||||||||
| Vice- Chair Person | 1.0 | X | 0 | 0 | X | 0 | ||
| John Hudspeth | ||||||||
| Chairperson | 1.0 | X | 0 | 0 | X | 0 | ||
| Sr Marybeth Culnan | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| George Kruse | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Sr Kenneth Wildt | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Johnny Watkins | ||||||||
| Division CFO | 8.4 | 253946 | 60364 | X | 0 | |||
| Ann M Carr | ||||||||
| Treasurer | 0.25 | 225812 | 215561 | X | 0 | |||
| Mark Reifsteck | ||||||||
| Division CEO | 8.4 | 392603 | 214175 | X | 0 | |||
| John Jeffries | ||||||||
| CFO | 40.0 | 0 | 12141 | X | 105374 | |||
| Andrea Linders | ||||||||
| Director of Pharmacy | 40.0 | 0 | 7320 | X | 116866 | |||
| William Deters | ||||||||
| Pharmacist | 40.0 | 0 | 13882 | X | 105973 | |||
| James Burke | ||||||||
| Division VP of Legal Services | 8.4 | 192773 | 45402 | X | ||||
| Paulette Evans | ||||||||
| CNO | 40.0 | 0 | 0 | 135785 | X | |||
| Jene Bieri | ||||||||
| Director of Prof. Services | 40.0 | 0 | 12006 | 109980 | X | |||
| Jan Robert | ||||||||
| Director of Quality Management | 40.0 | 0 | 13882 | 110717 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 684695 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1663479 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 698520 | TotalOtherCompensation |
| Number Individuals GT100 K | 16 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MIDWEST EMERGENCY DEPT SERV | |||||
| 320 EAST HIGHWAY 50 | OFALLON | IL | 62269 | ER COVERAGE | 2020459 |
| CLINTON COUNTY ANESTHESIOLOGY | |||||
| 1320 PINEWOOD | BREESE | IL | 62230 | Anesthesia physician | 945914 |
| PREMIERCARE INC | |||||
| 13810 CHAMPION FOREST DR | HOUSTON | TX | 77069 | CONSULTING SERVICES | 234942 |
| COMPETITIVE EDGE SPORTS MEDICINE | |||||
| 14160 JAMESTOWN RD | BREESE | IL | 62230 | SPORTS MED PHYSICIAN | 191935 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Related Organizations | 82828 | RelatedOrganizations |
| Total Contributions | 82828 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 49961505 | TotalRevenueColumn |
| Related Or Exempt Function Income | 49961505 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 49961505 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1418311 | TotalRevenueColumn |
| Exclusion | $1,418,311 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 764 | TotalRevenueColumn |
| Exclusion | $764 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 378149 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 742251 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -364102 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -364102 | TotalRevenueColumn |
| Exclusion | -$364,102 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2661503 | Securities |
| Other | 15534 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2661503 | Securities |
| Other | 15534 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2677037 | TotalRevenueColumn |
| Exclusion | $2,677,037 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| REVENUE CAFETERIA | 900099 | 5269 | $5,269 | ||
| EXERCISE PROGRAMS | 900099 | 110006 | 11002 | 99004 | |
| LIFELINE SUBSCRIBERS | 900099 | 44906 | 44906 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 294833 | TotalRevenueColumn |
| Related Or Exempt Function Income | 294833 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 455014 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54231357 | TotalRevenueColumn |
| Related Or Exempt Function Income | 50312246 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 99004 | UnrelatedBusinessRevenue |
| Exclusion | $3,737,279 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241159 | Total |
| Management And General | 241159 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15989017 | Total |
| Program Services | 13584293 | ProgramServices |
| Management And General | 2404724 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1141386 | Total |
| Program Services | 955315 | ProgramServices |
| Management And General | 186071 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3891163 | Total |
| Program Services | 3256817 | ProgramServices |
| Management And General | 634346 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935821 | Total |
| Program Services | 783261 | ProgramServices |
| Management And General | 152560 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3121950 | Total |
| Program Services | 2613002 | ProgramServices |
| Management And General | 508948 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103181 | Total |
| Program Services | 86360 | ProgramServices |
| Management And General | 16821 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24917 | Total |
| Program Services | 20855 | ProgramServices |
| Management And General | 4062 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 260039 | Total |
| Program Services | 217647 | ProgramServices |
| Management And General | 42392 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4006721 | Total |
| Program Services | 3353536 | ProgramServices |
| Management And General | 653185 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1006733 | Total |
| Program Services | 842613 | ProgramServices |
| Management And General | 164120 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52608 | Total |
| Program Services | 44032 | ProgramServices |
| Management And General | 8576 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262079 | Total |
| Program Services | 219354 | ProgramServices |
| Management And General | 42725 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2974769 | Total |
| Program Services | 2489815 | ProgramServices |
| Management And General | 484954 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2986599 | Total |
| Program Services | 2499716 | ProgramServices |
| Management And General | 486883 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 292479 | Total |
| Program Services | 244798 | ProgramServices |
| Management And General | 47681 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 3153997 | 2639825 | 514172 |
| PURCHASED SERVICES | 1826117 | 1528419 | 297698 |
| MAINTENANCE REPAIRS & SERVICES | 1075875 | 900482 | 175393 |
| PROVIDER TAX | 686808 | 574843 | 111965 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 677431 | Total |
| Program Services | 510977 | ProgramServices |
| Management And General | 166454 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44710849 | Total |
| Program Services | 37365960 | ProgramServices |
| Management And General | 7344889 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1309759 | BOY |
| EOY | 3324475 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6436735 | BOY |
| EOY | 7592234 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 595496 | BOY |
| EOY | 613789 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 297718 | BOY |
| EOY | 207495 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 58272857 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 34622889 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23578063 | BOY |
| EOY | 23649968 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73773157 | BOY |
| EOY | 78531675 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146842 | BOY |
| EOY | 138244 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106137770 | BOY |
| EOY | 114057880 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3384824 | BOY |
| EOY | 6116758 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11250000 | BOY |
| EOY | 10940000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7607199 | BOY |
| EOY | 11713478 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22242023 | BOY |
| EOY | 28770236 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82325136 | BOY |
| EOY | 83739672 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1570611 | BOY |
| EOY | 1547972 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83895747 | BOY |
| EOY | 85287644 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106137770 | BOY |
| EOY | 114057880 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 9520508 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -8128611 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $14,541 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 14541 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of other lobbying activities | Identifier |
| Return Reference | Schedule C, Part II-B, Question 1i | ReturnReference |
| Explanation | ST. JOSEPH'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, with PART OF THESE DUES being ATTRIBUTABLE TO LOBBYING FEES. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1454337 | OtherCostOrOtherBasis |
| Book Value | 1454337 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17516170 | OtherCostOrOtherBasis |
| Depreciation | 7521860 | Depreciation |
| Book Value | 9994310 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 163480 | OtherCostOrOtherBasis |
| Depreciation | 88578 | Depreciation |
| Book Value | 74902 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34046065 | OtherCostOrOtherBasis |
| Depreciation | 24771872 | Depreciation |
| Book Value | 9274193 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5092805 | OtherCostOrOtherBasis |
| Depreciation | 2240579 | Depreciation |
| Book Value | 2852226 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 23649968 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED BENEFIT LIABILITY | $7,683,061 |
| RETIREMENT OBLIGATION-ASBESTOS | $2,429,694 |
| RATE SWAP AGREEMENTS | $1,334,123 |
| EST. WORK COMP SELF INS. LIAB. | $266,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11713478 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADOPTION OF SUBTOPIC ASC 740-10 | Identifier |
| Explanation | ON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2012 AND 2011, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 278501 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 278501 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00670 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4653338 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3558051 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1095287 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02640 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4931839 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3558051 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1373788 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03310 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 462382 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 462382 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01110 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 462382 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 462382 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01110 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5394221 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3558051 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1836170 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04420 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,153,997 | BadDebtExpenseAmount |
| Amount Attributable To | 315400 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11336771 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13209888 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1873117 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9515 Holy Cross Lane | AddressLine1 |
| City | Breese | City |
| State | IL | State |
| ZIP Code | 62230 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Joseph's Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 11 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 150. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| PART I - LINE 3C | Not applicable as the organization does follow FPG to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals. | |
| PART I - LINE 6A | The hospital's community benefit report can be accessed by contacting Barb Strieker at 9515 Holy Cross Lane, Breese, IL 62230; By phone: (618) 526-5302. | |
| PART I - LINE 7G | THE HOSPITAL DOES NOT HAVE ANY SUBSIDIZED HEALTH SERVICES. | |
| PART I - LINE 7, COLUMN (F) | THE PERCENT OF CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST AS A PERCENT OF TOTAL EXPENSES LESS BAD DEBT IS 4.42%. The amount of bad debt expense removed when calculating the percentages in part I, Line 7 Column (F) was $3,153,997. | |
| PART I - LINE 7 | In this section, the total community benefit expenses are calculated using a cost to charge ratio from the hospital's audited financial statements. Additional Medicaid expense $686,808 is for the IDPH tax assessment. The offsetting revenue is the actual payments received from IDPH for access payments. | CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS |
| Part II | Primary care physicians are the foundation of the health care system as they are the patient's first point of access and manage their ongoing care. Access to primary care physicians is a concern for many residents in Clinton County. Located in a Health Professional Shortage Area (HPSA), physician recruitment is a top priority of St. Joseph's Hospital, Breese. Current assessment of primary care providers indicates an additional two primary care physicians are needed to serve the population. Resources expended in this area cover expenses for the recruitment of primary care providers. One family medicine provider was added during this 12-month period. Through additional recruitment efforts during the year, a family medicine physician and pediatrician committed to joining the local medical staff in the upcoming year. | |
| PART III, Line 4 | THE HOSPITAL STRONGLY BELIEVES THAT ITS CHARITY CARE, AND THE RELATED COMMUNITY BENEFIT OBTAINED FROM SUCH CARE, IS UNDERSTATED BECAUSE OF THOSE PATIENTS THAT POTENTIALLY QUALIFY FOR CHARITY CARE BUT DO NOT WISH TO APPLY FOR IT. IN ADDITION, SOME CARE IS NOT CLASSIFIED AS CHARITY DUE TO MISSING DOCUMENTATION ON PATIENT RESOURCES. THUS, THE HOSPITAL'S BAD DEBT may INCLUDE A PORTION THAT COULD BE CLASSIFIED AS CHARITY CARE IF APPLICATION FOR SUCH CARE WAS SOUGHT AND/OR COMPLETED. During the year, the hospital implemented processes to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying. At time of registration, self-pay patients are completing a documentation form that is assisting in the determination of which patients may qualify for assistance. Search America was also implemented, which accesses credit information that is used to determine the probability of a patient being able to pay for hospital services. This is improving abilities to provide a more accurate reporting of charity care services provided by the hospital. The hospital computes the cost of bad debt by applying the ratio of patient care cost to charges to the total charges written off as bad debt expense. The patient care cost is determined by adjusting the total annual operating expense by the cost of nonpatient-care activities, bad debt expenses, Medicaid provider taxes, and community benefit expense. The adjusted operating cost is then divided by the total gross patient charges to calculate the ratio of patient care cost to charges. | |
| PART III, Line 8 | The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. The hospital Medicare shortfall at cost for fiscal year 2012 was $4,940,207. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by adjusting the total annual operating expense by the cost of nonpatient-care activities, bad debt expenses, Medicaid provider taxes, and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall. | |
| PART III, LINE 9B | Specific policies are written for uninsured patient's discounts and charity/Christian care. The policies outline eligibility criteria and processes to follow for making adjustments to patient bills. For additional information, see response to Schedule H, Part VI, question 3. | |
| PART V, SECTION B LINE 3 | During the health needs assessment process, there were several methods the hospital utilized to gain input from the community. The Chief Nursing Officer is a member of the Clinton County Health Advisory Committee, which completed a significant part of the assessment through their IPlan (a standardized process for Illinois Public Health Departments). Other members of that committee include representatives from health care and senior services, as well as local businesses and community members. An outside company, Leede Research, was engaged to complete telephone interviews with residents throughout the service area. Approximately 300 households were contacted in the survey which was targeted to the broad community and also included residents who are uninsured, low-income, and those with chronic disease. To gain deeper insight, three focus groups were also conducted. Principals from area schools, members of the local clergy, and representatives of the minority Hispanic population were invited to participate. Through these discussions, more detailed information was obtained on the needs of youth, seniors, and some of the most vulnerable in the Hispanic community. | |
| Part V, Section B Line 4 | St. Joseph's Hospital is the sole hospital in the Clinton County area. There were no other hospital facilities included. | |
| Part V, Section B, Line 7 | During the reporting year, FY2012, St. Joseph's Hospital did continue with initiatives developed to address the priorities established by the Clinton County Health Advisory Committee. The group utilized the 2006 - 2011 IPLAN, which indicated the three leading causes of mortality in Clinton County, which are heart disease, malignant neoplasm (lung, breast, colo-rectal) and coronary heart disease. Services and programs to address these areas were considered during the annual budget process and carried out during the reporting year. The most recent Needs Assessment was completed in the spring of fiscal year FY2012. Priorities identified--diabetes, cancer, and women's health programs--were considered during the hospital's strategic planning and budgeting process, and an Implementation Strategy developed. In May, the Board of Directors approved the Implementation Strategy, which will be initiated in the next reporting year, fiscal year 2013. A prioritization process was adopted for the establishment of priorities during the needs assessment process. The process is more fully defined in THE NEEDS ASSESSMENT SECTION OF THIS PART VI. PART V, SECTION B, LINE 19D THE HOSPITAL DETERMINES THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE BY USING A SLIDING SCALE BASED ON FEDERAL POVERTY LEVELS. | |
| Needs Assessment | Several components were considered in the assessment process to plan for activities in FY2013: A. IPLAN: In August of 2011, Clinton County's Community Health Advisory Committee completed a thorough assessment of health care needs in the county. The committee is organized by the Clinton County Health Department. On behalf of St. Joseph's Hospital, Chief Nursing Officer Paulette Evans was a member of the committee. In addition to general health factors, chronic and infectious diseases as well as maternal and child health indicators were reviewed. Access to health care was also evaluated. Local physicians were surveyed and further information about chronic diseases specific to the senior population was obtained from area nursing homes. B. Telephone Interviews: St. Joseph's Hospital engaged the services of Leede Research to complete telephone interviews in the service area. Leede Research is a marketing research firm specializing in healthcare information programs and tools. Providing an opportunity to gather primary data, this component of the assessment was completed in conjunction with six other hospitals in the Hospital Sisters Health System. The questionnaire was designed by Leede Research with input from each local facility. St. Joseph's Hospital also consulted with September McAdoo, MPA, MA, of the Clinton County Health Department. Questions in the survey identified the resident's self-perception of their health and basic health habits. Information was also gathered on unmet needs in the community. The survey was targeted to the broad community and also included residents who are uninsured, low-income, and those with chronic disease. C. Focus Groups: To gain deeper insight, three focus groups were also conducted. Principals from area schools, members of the local clergy, and representatives of the minority Hispanic population were invited to participate. Janet Nix, HSHS Director of Learning and trained facilitator, conducted the focus groups. The groups were asked to identify what they perceived as the highest health care needs, barriers to healthy living, suggestions and advice for improvements. Through these discussions, more detailed information was obtained on the needs of youth, seniors, and some of the most vulnerable in the Hispanic community. D. Statistical Data: A vast amount of statistical data is available in the IPLAN. Additional information was obtained from the Center for Disease Control's Behavioral Risk Factor Surveillance System (BRFSS) and BRFSS data available on the Illinois Department of Public Health website. Most data found was collected in the previous two to six year time period. More recent data was not available. Data collected was compared as applicable with indicators publicized on Healthy People 2020, a site maintained by the United States Department of Health and Human Services. Internal data including the top DRG and primary diagnosis of inpatients at St. Joseph's Hospital during financial year 2011 was also utilized. Community Health Needs Assessment Process Assessing the health needs of the community began with the work of the Clinton County Health Advisory Committee. This 18-member committee is organized by the Clinton County Health Department and chaired by Michael McMillan, MPA, LEHP, Public Health Administrator. In addition to St. Joseph's Hospital Chief Nursing Officer, Paulette Evans, members of the committee include representatives from health care and senior services, as well as local businesses and community members. Their research was completed and assembled into a Community Health Plan (IPLAN) in August of 2011. Building on this core assessment and plan provided by the Clinton County Health Advisory Committee, St. Joseph's Hospital had an opportunity to further explore needs. In November of 2011, the System Office of the Hospital Sisters Health System contracted with Leede Research to complete telephone interviews in the local markets. The community was further engaged through the focus groups, which were held in February. Information gained through the additional assessment was shared with the Clinton County Health Department to further their work with the Clinton County Health Advisory Committee. St. Joseph's Hospital also formed an internal community benefit team consisting of St. Joseph's Hospital colleagues. In addition to the facility's cooperative efforts with the Clinton County Health Advisory Committee, the group reviewed all information gathered. Health Needs Identified Below are the health needs identified through all four components of the community assessment process. These are in alphabetical order. Access & Affordability of Health Care Alcohol Abuse/Underage drinking Alzheimer's * Cancer * Diabetes Food Choices & Exercise Habits Contributing to Unhealthy Lifestyle Heart Disease * Obesity/Nutrition * Respiratory Disease - Including Asthma & Pneumonia Transportation for Health Care Services Women's Health Programs - Including Maternal Health *Denotes areas identified as priorities of focus by the Clinton County Health Advisory Committee. Prioritization Process Three methods of prioritization were considered by the Community Benefit Team. The prioritization matrix model was determined as the most effective. Definitions of Criteria for Scoring Health Needs in the Prioritization Matrix: A. Community Impact: Size of issue; costs associated with not doing something; severity of condition; impact on quality of life B. Ability to Impact: Known strategies to make a difference; adequate resources available C. Community Readiness: Community ready to address health priority D. Gap in the Community: Is there a gap in community efforts to address the health priority? E. Mission: Is the issue one that falls within the hospital's overall mission? Each member of the Community Benefit Team ranked the health need identified in the five categories. A scale of 0 to 3 was used with 0 having no significance and 3 being the highest ranking. Prioritized Community Health Needs to Address Following the prioritization process, below are the top three health issues identified for St. Joseph's Hospital, Breese: Cancer -The assessment process completed by the Clinton County Advisory Committee identified cancer as one of their main areas of focus. Deaths due to cancer in Clinton County are two of the first five causes. In addition to early detection, unhealthy behaviors such as smoking, obesity, and lack of exercise contribute to the cause of this disease. Diabetes - Through telephone interviews, focus groups, and health data, the prevalence of diabetes was noted. Diabetes was also identified as one of the main diseases affecting the Hispanic population. Individuals with diabetes have an increased risk of heart disease, which is the leading cause of mortality in Clinton County. Initiatives specific to the causes of diabetes will further compliment initiatives coordinated by the Clinton County Advisory Committee that address heart disease and obesity/nutrition. Women's Health Programs - Due to the discontinuance of obstetrical services at three hospitals located in the immediate area, St. Joseph's Hospital serves the population of Clinton County as well as the four surrounding counties. Opportunities to improve birth outcomes and infant and child health exist before, during, and after pregnancy. Receiving early and adequate prenatal care, identifying health risks, promoting healthy behaviors and proper nutrition will be the center of developments in this area. These three health needs along with initiatives developed in response to previous and ongoing issues identified were used to develop the implementation strategy. They will be used to guide our efforts in FY2013. For prior years, we have utilized the work of the Clinton County Advisory Health Advisory Board and statistical data. | |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: | As part of the Mission of St. Joseph's Hospital, "to minister to those in need as exemplified by the Gospel of Christ," the hospital has established several financial assistance programs to help patients and families who are unable to pay for the services they have received from the hospital. These programs are: A. Uninsured Christian Care is for those uninsured individuals whose family income falls below 600% of the Federal Poverty Guidelines (FPG) with assistance available on a sliding scale basis. B. Uninsured Discount Program is for those uninsured individuals whose family income is in excess of 600% of the Federal Poverty Guidelines (FPG). C. Traditional Christian Care is for those individuals whose gross income falls below 200% of the Federal Poverty Guidelines (FPG). In mid-June of the reporting period this amount was increased to 250% below FPG. To determine a person's eligibility in a hospital sponsored Financial Assistance Program, the hospital has established a financial eligibility scale. Eligibility requirements are based upon Federal Poverty Guidelines (FPG) published by the Federal Government according to the applicant's family size and family income. In the absence of supporting documentation to verify family size and income level, presumptive eligibility processes have been put in place in order to provide financial assistance to a larger population. St. Joseph's Hospital informs patients about financial assistance programs in various ways. Patients receive a Christian Care brochure at the time of registration, which explains St. Joseph's Christian Care Financial Assistance program and how to apply for assistance. Signage is located at each registration desk which directs patients to the Business Office. In the event of a language barrier, an interpreter is provided to assist patients with completing application. Brochures about the Christian Care Financial Assistance program are also available in registration areas at St. Joseph's Hospital and St. Joseph's Priority Care. Inpatients are provided information about the availability of financial assistance by the Social Services Department. Information is also available on the facility's web-site. For patients who visit St. Joseph's emergency room, each patient can obtain a brochure about the Christian Care Financial Assistance Program if they are self-pay or if they express concern about the hospital bill. | |
| Community Information | Clinton County includes nine small communities ranging in population from 1,000 to 7,500 and rural areas. Based on the U.S. Census Bureau's 2010 information, the population of the entire county has grown by 6.3% over the past 10 years. The median age is 39 years of age with 14.5% of the population over the age of 65 compared to 12.5% over the age of 65 in the state of Illinois. Cultural diversity is increasing with growth seen in the Hispanic population. According to the Bureau's 2010 information, 20% of residents in the community work in the health care and social assistance sector and 17% retail. This is followed by 11% in construction and 10% manufacturing. Several grain and livestock farm operations are also located throughout the rural areas of the county. Current unemployment rate is 7.9%. Median household income has risen to $55,278, which is near the median household income for Illinois of $55,735. Persons living below the poverty level are 7.8% of the population, an increase of 1.4% since the last 2000 census. | |
| Promotion of Community Health | St. Joseph's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Joseph's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 115 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Breese and surrounding areas. The hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Joseph's Hospital is responding to community need. During the last year, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. In addition, St. Joseph's Hospital receives community support and guidance through the Advisory Board and Friends of St. Joseph's. Both Boards meet quarterly and provide feedback from the community on additional services or improvements needed. St. Joseph's Hospital is blessed with a strong volunteer program. Volunteers are active in many hospital departments on a daily basis and donate many more hours throughout the year to hospital-sponsored community programs. Also consistent with its exempt purpose, St. Joseph's Hospital has an open Medical Staff with privileges available to all qualified physicians in the area. The hospital operates an emergency department that is open 24 hours every day to all persons regardless of their ability to pay. St. Joseph's Priority Care office is located in Carlyle, a community approximately 10 miles east of Breese. A permanent structure was built in 2011. The walk-in clinic is open 7 a.m. to 7 p.m. each day including weekends and on holidays from 8 a.m. to 5 p.m. During the hours the clinic is open, a physician is available to treat patients. St. Joseph's Hospital also maintains medical offices in the outlying communities of Germantown, Trenton, and Greenville, which are utilized by local primary care providers. As a not-for-profit hospital, St. Joseph's reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. St. Joseph's Hospital continues to work with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients get well and stay well. Computerized physician order entry is being implemented in stages throughout the System. At St. Joseph's Hospital, providers began electronically entering orders in June. Also during the year, approximately 200 personal computers were replaced to enhance compatibility with Meditech, the facilities electronic health record. Resources also were devoted to quality initiatives focused on Sepsis and congestive heart failure. Significant assessment and planning were completed in the development of processes to decrease mortality rates in patients with Sepsis. In collaboration with the System Office and colleagues from hospitals within the division, screening tools, order sets, and protocols were put in place to aid in the early diagnosis, treatment and management of these patients. Improving the quality of life for patients with congestive heart failure (CHF) is the main focus of "Project Red" (Re-Engineered Discharge). The program is designed to better prepare CHF patients for the management of their chronic disease upon discharge from the hospital. With one out of four patients with CHF readmitted within 30 days after discharge, education was provided to patients and their caregivers to increase their involvement in self-care following discharge. This project developed into a community-wide initiative with training also provided to staff members from nursing homes, assisted living facilities, home health agencies, and Meals on Wheels sites about the disease process, treatment and management of CHF. Family medicine physician, Erin Gagen, M.D., was the medical champion for Project RED and one of the primary educators at the nursing homes. Other colleagues involved in the training were nursing staff, a pharmacist and dietician. St. Joseph's Hospital also partnered with Kaskaskia College to provide an educational opportunity for registered nurses and licensed practical nurses on the assessment of the patient. A community program was also held in September for heart failure awareness. Health screenings were conducted along with a cooking demonstration. Education was presented by Dr. Gagen, and a cardiology nurse practitioner. The readmission rate for CHF patients at St. Joseph's Hospital, Breese, decreased from 15% in FY2011 to 4% in FY2012. Responding to Community Need St. Joseph's also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2012, St. Joseph's Hospital provided over $1.5 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. The range of benefits provided by St. Joseph's Hospital flow from our mission and long-standing commitment to the community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Joseph's and they often relieve a burden that would otherwise be carried by government. Based on community need, St. Joseph's focused on the following main priorities for FY2012: 1) Education and low-cost screenings for chronic diseases including Heart Disease & Cancer and 2) Programs and services for expectant mothers and care of infants and children. Over 21 educational initiatives and support groups were held during the reporting period. Priority: Chronic Disease Education & Low-Cost Screenings During the month of February, St. Joseph's Hospital partnered with two other hospitals in the Hospital Sisters Southern Illinois Division - St. Joseph's Hospital, Highland, and St. Elizabeth's Hospital, Belleville to promote heart health awareness. Through community education initiatives, education on cardiovascular disease and healthy eating as well as lifestyle choices was provided. One program during the month was specifically geared towards women was a "Women's Heart Health Fair". With approximately 200 individuals attending, physicians from the area geared their information specific to the risks of heart disease in women. Ten health fairs were held during the year. Area residents have come to rely on the fairs for low-cost screenings and free health information. Over 3,000 residents participated in the fairs that were held in Breese and three surrounding communities. Diabetic educators have noted an increase in the number of patients they are seeing on an outpatient basis. Recognizing the need to improve the community's and individuals' knowledge about this disease, resources have been expended in this area. Support group meetings are held throughout the year. In addition to the participants' ability to learn from each other, an educational topic specific to diabetes was covered each month. Education about the disease and the importance of healthy eating was also provided to area school children in the 4th, 5th and 6th grades. With the prevalence of diabetes among the Hispanic community, St. Joseph's Hospital partnered with the Diocese of Belleville Office of Hispanic Ministry and offered education and free blood sugar finger sticks at an employment site and at a community school after a Mass conducted in Spanish. Educational materials were provided in Spanish. Attendance at all programs provided by the diabetic educators throughout the year has reached over 550. Since 2007, St. Joseph's Hospital has hosted an annual visit by the National Kidney Foundation of Illinois' KidneyMobile. Area residents are able to take advantage of the screenings provided to identify high blood sugar and high blood pressure - known precursors of kidney disease. This year of the 122 screened, 114 or 94 percent had abnormal results. Follow-up included referral to primary physicians. F | |
| Affiliated Health Care System | St. Joseph's Hospital- breese is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and more than 2,000 physician partners across Illinois and Wisconsin. The Mission of HSHS is to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry. We live our Mission by healing those who seek our care, as well as through our Community Benefit initiatives. Working collaboratively with others in the 12 communities we serve, our Community Benefit efforts are successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. Across HSHS, we collectively provided $174.2 million in Community Benefits (or 9.7% of total hospital expenses) in FY2012. Included in this amount was $43.1 million provided for Charity Care and $97.9 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $168.4 million. HSHS hospitals also recorded $106.6 million in uncollectible accounts. Beyond the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing do, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the U.S. is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2012, we made significant progress with this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for the individual. Our efforts to ensure residents in the communities we serve receive the right care at the right time often involve partnering with others to achieve this goal. Across our two-state system, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. In western Wisconsin, St. Joseph's Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,216 patient visits, a 25% increase from the prior year. With more than 150 individuals volunteering, the clinic provided over 6,500 hours (including 700 physician hours and 1,500 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In northeastern Wisconsin, St. Vincent Hospital in Green Bay supports patient care for the uninsured at the NEW Community Clinic by paying a nurse's salary and offering free and discounted laboratory and radiology services. More than 70% of patients who use the clinic report the care they received helped keep them out of the Emergency Department. St. Nicholas Hospital in Sheboygan proactively reaches out to local Hmong and Hispanic organizations to ensure these populations can participate in free screenings and health education programs. Through this ongoing outreach initiative, St. Nicholas engaged more than 350 people last year, and in many cases was able to identify critical health conditions early and provide appropriate follow-up care. A Woman's Place at St. Mary's Hospital Medical Center in Green Bay reaches out to Hispanic neighbors to provide health and wellness education, health screenings, resources and referral services. Last year A Woman's Place touched the lives of more than 7,000 women through health screenings, educational events, classes and its resource center. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthony's Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthony's helped underwrite the cost of prescription medications for more than 430 residents. In southwest Illinois, St. Joseph's Hospital in Highland recognized many rural residents did not have a reliable means of transportation and partnered with generous individuals in the community to offer a free transportation service. The "Friends' Van," fully supported by the Friends of St. Joseph's Hospital, provides free rides to medical, dental and other personal appointments within a 20-mile radius of Highland. In FY2012, the Friends Van transported 2,050 individuals for a total of 12,561 miles. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Charity Care program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Charity Care programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our charity care policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our mission to embody Christ's healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. To address metabolic disease management, St. Francis Hospital in Litchfield, Illinois, partners with Montgomery County Health Department to provide screening for diabetes and renal disease. St. Francis Hospital teams up with Macoupin County Health Department to provide Diabetes Self-Management classes. St. Joseph's Hospital in Breese, Illinois coordinates several community education seminars and health fairs on cardiovascular disease and healthy eating each year. Over 3,000 residents participated in these health events last year. Recognizing the importance of proper food and nutrition to overall health, St. John's Hospital in Springfield initiated the Destination Dinner program which teaches families how to cook healthy, from-scratch meals, and eat together as a family. Families meet quarterly to learn new cooking skills. They also learn how to prepare a meal for a family of four on a budget of $8.00. In addition to raising awareness about how to eat healthy on a limited budget, the program brings families together around the dinner table, which research shows promotes healthy relationships, increased academic performance and decreased risk for substance abuse and risky sexual behavior. Sacred Heart Hospital in Eau Claire, Wisconsin addressed the need for access to mental health services for children and adolescents by opening an outpatient behavioral health clinic. Sacred Heart has also adopted screening tools for behavioral and mental health risk factors for use at affiliated clinics. The goal is to better identify mental health issues and provide earlier intervention. Sacred Heart Hospital is also working with the Chippewa Valley Free Clinic (CVFC) to develop expanded provider coverage for CVFC patients who require mental health services. St. | |
| STATE FILING OF COMMUNITY BENEFIT REPORT | IL, | 990 SCHEDULE H, PART VI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jonathan Osborn MD | ||||||||||||
| 363397 | 0 | 36 | 0 | 29489 | 392922 | 0 | ||||||
| Mark Klosterman | ||||||||||||
| 191099 | 0 | 43813 | 54125 | 21813 | 310850 | 14887 | ||||||
| Johnny Watkins | ||||||||||||
| 242446 | 11500 | 0 | 51651 | 9602 | 315199 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Ann M Carr | ||||||||||||
| 180382 | 0 | 45430 | 197622 | 18652 | 442086 | 15440 | 0 | 0 | 0 | 0 | 0 | 0 |
| Mark Reifsteck | ||||||||||||
| 368111 | 0 | 24492 | 186986 | 33979 | 613568 | 41500 | 0 | 0 | 0 | 0 | 0 | 0 |
| James Burke | ||||||||||||
| 192773 | 0 | 0 | 19472 | 26774 | 239019 | 0 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ANN M. CARR | SCHEDULE J, PART I, LINE 4B | ANN CARR PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $33,655. |
| MARK KLOSTERMAN | SCHEDULE J, PART I, LINE 4B | MARK KLOSTERMAN PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $21,013. |
| MARK REIFSTICK | SCHEDULE J, PART I, LINE 4B | MARK REIFSTICK PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $39,360. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| STATEMENT OF PROGRAM SERVICE ACOMPLISHMENTS | FORM 990, PAGE 2, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | ST. JOSEPH'S HOSPITAL, BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS PROVIDES QUALITY HEALTHCARE SERVICES REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, RELIGION, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS ESSENTIAL TO THE CONTINUED OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS ARE ABLE TO AFFORD REQUIRED MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH THE BEST QUALITY HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. INHERENT IN OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF COMMUNITY SUPPORT ACTIVITIES. IN OUR TAX YEAR BEGINNING JULY 1, 2011 AND ENDING JUNE 30, 2012, ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 1,528 INPATIENTS UTILIZING 4,129 DAYS OF CARE. IN ADDITION, ST. JOSEPH'S HOSPITAL, BREESE PROVIDED SERVICES TO 94,521 OUTPATIENTS. ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO THE POOR AT NO COST THROUGH OUR CHRISTIAN CARE PROGRAM. IN ADDITION, THE HOSPITAL PARTICIPATES IN THE ILLINOIS MEDICAID PROGRAM, WHICH REIMBURSES THE HOSPITAL AT RATES SUBSTANTIALLY BELOW THE COST OF PROVIDING THE SERVICES. FULFILLING OUR MISSION TO THE COMMUNITY, SERVICES WERE PROVIDED TO 281 MEDICAID INPATIENTS UTILIZING 664 DAYS OF CARE. THE COST OF PROVIDING SERVICES TO MEDICAID PATIENTS EXCEEDED REIMBURSEMENT UNDER THE STATE OF ILLINOIS MEDICAID PROGRAM BY $1,095,287. THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE TO THE POOR IS $1,373,788. ST. JOSEPH'S HOSPITAL, BREESE PROVIDES QUALITY MEDICAL CARE TO MEMBERS OF THE BROADER COMMUNITY THROUGH PARTICIPATION IN THE MEDICARE PROGRAM AND THROUGH EDUCATIONAL PROGRAMS AND ACTIVITIES AT A REDUCED PRICE, OR AT NO COST. ST. JOSEPH'S HOSPITAL, BREESE PROVIDED MEDICAL SERVICES TO 632 MEDICARE INPATIENTS UTILIZING 2,000 DAYS OF CARE. THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS EXCEEDED REIMBURSEMENT UNDER THE FEDERAL MEDICARE PROGRAM BY $11,336,771. THE TOTAL UNREIMBURSED VALUE OF PROVIDING CARE AND SERVICES TO THE BROADER COMMUNITY IS $462,382. |
| TAX EXEMPT BONDS | FORM 990, PART IV, LINE 24 | ST JOSEPH'S HOSPITAL, BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. |
| RIGHTS OF MEMBERS TO ELECT GOVERNING BODY | FORM 990, PART VI, LINE 6 & 7A | THE SENIOR GOVERNING BODY OF ST. JOSEPH'S HOSPITAL BREESE (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT. |
| MEMBER RESERVED POWERS | FORM 990, PART VI, LINE 7B | RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. JOSEPH'S HOSPITAL BREESE (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY, OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, LINE 11B | THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, LINE 12C | THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN used SINCE JANUARY, 2010 TO establish the practice of managing CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS, AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE, AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. |
| WHISTLEBLOWER POLICY | FORM 990, PART VI, LINE 13 | PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. |
| POLICIES COMPENSTION PROCESS | FORM 990, PART VI, LINE 15 | THE COMPENSATION COMMITTEE ("COMMITTEE") IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. |
| DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990, PART VI, LINE 19 | BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. |
| POOLED INVESTMENT ACCOUNT | FORM 990, PAGE 11, PART X, LINE 11 | ST. JOSEPH'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES that are publicly traded. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS. |
| Other Change in Net Assets | Form 990, Part XI, Line 5 | Change in Pension Fund Status (3,284,000) Transfer from Affiliates (1,486,000) Unrealized Gains (3,520,783) increase in temporarily restricted net assets (245,000) contributions from foundation (82,828) ========== TOTAL (8,128,611) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Sr. Marybeth Culnan TITLE:Director HOURS:59 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Johnny Watkins TITLE:Division CFO HOURS:52 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Ann M Carr TITLE:Treasurer HOURS:60 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:Mark Reifsteck TITLE:Division CEO HOURS:52 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:James Burke TITLE:Division VP of Legal Services HOURS:52 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Springfield Health Partners LLC | |||||||||
| 4936 Laverna Road | springfield | IL | 62707 | 371364419 | healthcare | IL | 0 | 0 | hshs mg |
| KIARA Clinical Integration Network | |||||||||
| 4936 laverna rd | springfield | IL | 62707 | 261417684 | HealthCare | IL | 0 | 0 | Kiara Inc |
| Physician Clinical Integration Network L | |||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371668647 | health care | IL | 0 | 0 | KCIN |
Form990 Schedule R Part II Form990ScheduleRPartII (24 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Hospital Sisters Health System | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371058692 | HEALTHCARE | IL | 501(C)(3) | 11A | NA | false |
| HSHS Self Insurance Trust Fund | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371120626 | INSURANCE | IL | 501(C)(3) | 11A | NA | false |
| Hospital Sisters of St Francis FDTN | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371186514 | HEALTHCARE | IL | 501(C)(3) | 11A | NA | false |
| HSHS Health Care Trust Fund | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371137724 | HEALTHCARE | IL | 501(C)(9) | N/A | NA | false |
| Hospital Sisters Healthcare West Inc | ||||||||||
| 2661 COUNTY HIGHWAY I | CHIPPEWA FALLS | WI | 54729 | 510157933 | HEALTHCARE | IL | 501(C)(3) | 11A | NA | false |
| HOSPITAL SISTERS SERVICES INC | ||||||||||
| 4936 LAVERNA ROAD | SPRINGFIELD | IL | 62707 | 371163402 | HEALTHCARE | IL | 501(C)(3) | 11A | NA | false |
| SACRED HEART HOSPITAL | ||||||||||
| 900 WEST CLAIREMONT AVENUE | EAU CLAIRE | WI | 54701 | 390807060 | HEALTHCARE | WI | 501(C)(3) | 3 | NA | false |
| St Anthony's Hospital | ||||||||||
| 503 N MAPLE STREET | EFFINGHAM | IL | 62401 | 370661233 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Elizabeth's Hospital | ||||||||||
| 211 SOUTH THIRD STREET | BELLEVILLE | IL | 62220 | 370663567 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Francis Hospital | ||||||||||
| 1215 FRANCISCAN DRIVE | LITCHFIELD | IL | 62056 | 370661236 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St John's Hospital | ||||||||||
| 800 EAST CARPENTER STREET | SPRINGFIELD | IL | 62769 | 370661238 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Joseph's Hospital | ||||||||||
| 2661 COUNTY HIGHWAY 1 | CHIPPEWA FALLS | WI | 54729 | 390810545 | HEALTHCARE | WI | 501(C)(3) | 3 | NA | false |
| St Joseph's Hospital | ||||||||||
| 1515 MAIN STREET | HIGHLAND | IL | 62249 | 370663568 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Mary's Hospital | ||||||||||
| 1800 E LAKE SHORE DRIVE | DECATUR | IL | 62521 | 370661244 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Mary's Hospital | ||||||||||
| 111 SPRING STREET | STREATOR | IL | 61364 | 362169181 | HEALTHCARE | IL | 501(C)(3) | 3 | NA | false |
| St Mary's HOSPITAL Medical Center | ||||||||||
| 1726 SHAWANO AVENUE | GREEN BAY | WI | 54303 | 390818682 | HEALTHCARE | WI | 501(C)(3) | 3 | NA | false |
| St Nicholas Hospital | ||||||||||
| 3100 SUPERIOR AVENUE | SHEBOYGAN | WI | 53081 | 390808480 | HEALTHCARE | WI | 501(C)(3) | 3 | NA | false |
| St Vincent Hospital | ||||||||||
| 835 S VAN BUREN | GREEN BAY | WI | 54301 | 390817529 | HEALTHCARE | WI | 501(C)(3) | 3 | NA | false |
| HSHS MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 263956318 | HEALTHCARE | IL | 501(C)(3) | 11a | na | false |
| HSHS WISCONSIN MEDICAL GROUP INC | ||||||||||
| 3215 EXECUTIVE PARK DRIVE | SPRINGFIELD | IL | 62703 | 264515959 | HEALTHCARE | WI | 501(C)(3) | 11A | NA | false |
| Orange Cross Ambulance Inc | ||||||||||
| 919 Ashland Ave | Sheboygan | WI | 53081 | 391860942 | Healthcare | WI | 501(C)(3) | 9 | St Nicholas | false |
| Wisconsin Upper Pen Onc Mngmt Services | ||||||||||
| 835 S Van Buren | Green Bay | WI | 54301 | 391677100 | Healthcare | WI | 501(C)(3) | 3 | St Vincent | false |
| Unity Limited Partnership | ||||||||||
| 2366 Oak Ridge Circle | De Pere | WI | 54115 | 391750729 | Healthcare | WI | 501(C)(3) | 9 | HSSI | false |
| Kiara Clinical Integration Network | ||||||||||
| 4936 Laverna Road | SPRINGFIELD | IL | 62707 | HEALTH CARE | IL | 501(C)(3) | NONE | HSSI | true | |
Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | Code VCodeVAmount | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Memorial and St Elizabeth's Healthcare | ||||||||||||||
| 4000 North Illinois Street | Swansea | IL | 62226 | 371312961 | HealthCare | IL | St Elizabeth's | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Prairie Heart Institute - Carbondale | ||||||||||||||
| 800 East Carpenter Street | Springfield | IL | 62769 | 371321197 | HealthCare | IL | St John's | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Northeast Wisconsin Radiation Therapy Se | ||||||||||||||
| 1821 S Webster Avenue STE 300 | Green Bay | WI | 543079047 | 263749065 | HealthCare | WI | HSSI | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Pain Center of Wisconsin | ||||||||||||||
| 4131 W Loomis Road STE 300 | Greenfield | WI | 53221 | 263155343 | HealthCare | WI | St Vincent | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Surgery Center of Sheboygan LLC | ||||||||||||||
| 3141 Saemann Ave | Sheboygan | WI | 53081 | 260822209 | HealthCare | WI | St Nicholas | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Prevea Ventures LLC | ||||||||||||||
| 2710 EXECUTIVE DR | Green Bay | WI | 54304 | 203775127 | HealthCare | WI | HSSI | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Carpenter Street Hotel LLC | ||||||||||||||
| 525 North Sixth Street | springfield | IL | 62702 | 364128127 | hotel | IL | lasante inc | NONE | 0 | 0 | false | $0 | false | 0.00000 |
| Springfield Urgent Care Real Estate LLC | ||||||||||||||
| PO Box 19456 | springfield | IL | 627949456 | 030413258 | rent. real es | IL | lasante inc | NONE | 0 | 0 | false | $0 | false | 0.00000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kiara Inc | ||||||||||||
| 4936 Laverna Rd | Springfield | IL | 62707 | 371163401 | HealthCare | IL | HSHS | C Corp | 0 | 0 | 0.00000 | |
| LaSante Wisconsin Inc | ||||||||||||
| 4936 Laverna Rd | Springfield | IL | 62707 | 391572196 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |
| LaSante Inc | ||||||||||||
| 4936 Laverna Rd | Springfield | IL | 62707 | 371163400 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |
| Prairie Cardiovascular | ||||||||||||
| 619 East Mason STE 4P57 | Springfield | IL | 62701 | 371071858 | HealthCare | IL | Kiara Inc | C Corp | 0 | 0 | 0.00000 | |
| Prevea Health Services | ||||||||||||
| 2710 EXECUTIVE DR | Green Bay | WI | 54304 | 391839351 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |
| Prevea Clinic Inc | ||||||||||||
| 2710 EXECUTIVE DR | Green Bay | WI | 54304 | 391839349 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |
| Prevea Health Network | ||||||||||||
| 2710 EXECUTIVE DR | Green Bay | WI | 54304 | 392000537 | HealthCare | WI | HSSI | C Corp | 0 | 0 | 0.00000 | |
| RENAISSANCE QUALITY INSURANCE | ||||||||||||
| 980669953 | INSURANCE | HSSI | C CORP | 0 | 0 | 0.00000 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ENTITIES | Identifier |
| Return Reference | FORM 990, SCHEDULE R, PART V, LINE 2 | ReturnReference |
| Explanation | THE TRANSACTIONS REPORTED IN QUESTION 1 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REPORTED IN THIS SECTION. | Explanation |
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