MIDWEST MEDICAL CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MIDWEST MEDICAL CENTER (EIN 20-4560540)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-13
- IRS object ID
- 201202269349301000
- Schema version
- 2010v3.4
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-13T09:48:35-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3703 OAKWOOD HILLS PARKWAY | AddressLine1 |
| City | EAU CLAIRE | City |
| State | WI | State |
| ZIP Code | 54701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204560540 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDW | NameControl |
| Phone | 8157771340 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1 |
| City | GALENA | City |
| State | IL | State |
| ZIP Code | 61036 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TRACY BAUER | Name |
| Title | CEO | Title |
| Phone | 8157771340 | Phone |
| Date Signed | 2012-08-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL M TRACZEK CPA | Name |
| Phone | 7158323407 | Phone |
| Date Prepared | 2012-08-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TRACY BAUER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1 |
| City | GALENA | City |
| State | IL | State |
| ZIP Code | 61036 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16808383 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GALENAHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CITY OF GALENA, ILLINOIS AND THE SURROUNDING AREA REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 220 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 30000 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -10119 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 110444 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 46282 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15100968 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16616417 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -11482 | InvestmentIncomePriorYear |
| Investment Income Current Year | 104222 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -46272 | OtherRevenuePriorYear |
| Other Revenue Current Year | -67469 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15153658 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16699452 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 18598 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 28543 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6418846 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6902999 | 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 | 11805301 | OtherExpensePriorYear |
| Other Expenses Current Year | 11683326 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18242745 | TotalExpensesPriorYear |
| Total Expenses Current Year | 18614868 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3089087 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1915416 | RevenuesLessExpensesCY |
| Total Assets BOY | 48728971 | TotalAssetsBOY |
| Total Assets EOY | 48041559 | TotalAssetsEOY |
| Total Liabilities BOY | 48320163 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 49548167 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 408808 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1506608 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12118672 | Expense |
| Grants | 15336 | Grants |
| Revenue | 12155663 | Revenue |
| Description | MIDWEST MEDICAL CENTER OWNS AND OPERATES A 25-BED CRITICAL ACCESS HOSPITAL, AND LEADS IN THE DELIVERY OF HEALTHCARE SERVICES TO ITS REGION WITH OVER 200 ASSOCIATES, INCLUDING 17 PHYSICIANS AND ONE MID-LEVEL PRACTITIONER, WHICH COORDINATE PATIENT CARE AS AN INTEGRATED UNIT. THE HOSPITAL AND ITS ASSOCIATES WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE. THE ACCOMPLISHMENTS WHICH FOLLOW ARE ATTRIBUTABLE TO THE HOSPITAL AND ALL OF ITS DEPARTMENTS AS A WHOLE.REQUIREMENTS OF THE IRS COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT ORGANIZATIONS ARE A KEY COMPONENT TO THE HOSPITAL'S LARGER CHARITABLE MISSION OF IMPROVING HEALTH AND QUALITY OF LIFE. SPECIFICALLLY, THE ORGANIZATION IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS, WHICH INCLUDES COMMUNITY LEADERS, CONSUMER REPRESENTATIVES, AND BUSINESS AND CLINICAL HEALTHCARE EXPERTS. THE BOARD OF DIRECTORS IS COMMITTED TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES TO ENSURE THE HOSPITAL CONTINUES TO OPERATE SOLELY FOR THE BENEFIT OF THE COMMUNITY. DURING THE YEAR, THE BOARD WORKED WITH MANAGEMENT TO OVERSEE CRITICAL FUNCTIONS OF THE ORGANIZATION. FOR EXAMPLE:-THE COMPLIANCE COMMITTEE OF THE BOARD WAS ASSIGNED RESPONSIBILITY FOR OVERSIGHT OF THE CORPORATE COMPLIANCE PLAN AND FOR OVERSIGHT OF DEFINED COMPONENTS OF THE HOSPITAL'S INTERNAL CONTROL FUNCTIONS.-POLICIES CURRENTLY EXIST THAT REGULATE DOCUMENT RETENTION/DESTRUCTION AND WHISTLEBLOWER PROTECTION.-POLICIES ON CONFIDENTIALITY OF PATIENT AND CORPORATE INFORMATION ARE REVIEWED ANNUALLY AS A COMPONENT OF MANDATORY EDUCATION, AND A CONFIDENTIALITY STATEMENT IS SIGNED ANNUALLY BY ALL EMPLOYEES AND BOARD MEMBERS.-THE HOSPITAL'S CODE OF ETHICS/CODE OF CONDUCT IS PUBLISHED IN THE EMPLOYEE AND PHYSICIAN HANDBOOKS AND INCLUDED IN THE GENERAL ORIENTATION OF ALL NEW EMPLOYEES AND VOLUNTEERS.THE HOSPITAL ALSO MAKES MEDICAL CARE ACCESSIBLE TO THE ENTIRE REGION IT SERVES. THE HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM AND PROVIDES EMERGENCY CARE REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAD OVER 3,800 EMERGENCY CENTER VISITS DURING FISCAL YEAR 2011. THE HOSPITAL PROVIDES CLINICAL AND ANCILLARY SERVICES REQUIRED TO SUPPORT THE EMERGENCY CENTER INCLUDING DIAGNOSTIC TESTING SUCH AS LABORATORY, RADIOLOGY, CT SCANNING, AND MRI SCANNING SERVICES. FULL-TIME ON-SITE EMERGENCY MEDICAL PHYSICIANS ARE PROVIDED THROUGH AN ARRANGEMENT WITH THE UNIVERSITY OF ILLINOIS-CHICAGO PHYSICIANS.IN ADDITION, MIDWEST MEDICAL CENTER PROVIDES NON-EMERGENCY SERVICES TO THE REGION IT SERVES. IT MAKES THESE SERVICES ACCESSIBLE TO THE REGION THROUGH PARTICIPATION IN GOVENMENT PROGRAMS LIKE MEDICARE AND MEDICAID AND BY OFFERING ASSISTANCE THROUGH THE HOSPITAL'S CHARITY CARE PROGRAM.THE HOSPITAL'S CHARITY CARE POLICY PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE HOSPITAL'S CHARITY CARE POLICY IS DESIGNED TO ENSURE THAT THE ENTIRE REGION IS SERVED BY THE HOSPITAL AND HAS ACCESS TO NEEDED HEALTHCARE SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS OVERSEES THE SERVICES DELIVERED UNDER THE HOSPITAL'S CHARITY CARE POLICY, INCLUDING ASSESSING HEALTH NEEDS OF THE REGION, APPROVING ELIGIBILITY CRITERIA, AND MONITORING THE EFFECTIVENESS OF THE PROGRAM IN PROVIDING REGIONAL ACCESS TO MEDICAL CARE.ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE CHARITY CARE POLICY IS BASED ON INCOME LEVELS AND FAMILY SIZE. GENERALLY, INDIVIDUALS EARNING INCOME OF UP TO 300% OF THE FEDERAL POVERTY INCOME GUIDELINES ARE ELIGIBLE FOR VARYING LEVELS OF DISCOUNTS, INCLUDING FULL DISCOUNTS FOR CERTAIN INCOME LEVELS. IN ADDITION, AN AUTOMATIC DISCOUNT OF CHARGES IS PROVIDED TO ANY PATIENT THAT IS DETERMINED TO NOT HAVE INSURANCE OF ANY TYPE. APPLICATIONS FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY DESIGNATED HOSPITAL PATIENT REGISTRATION AREA OR BY CALLING THE HOSPITAL'S BUSINESS OFFICE.THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE PROVIDED UNDER THE CHARITY CARE PROGRAM. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE HOSPITAL REDUCED CHARGES TO PATIENTS UNDER THE CHARITY CARE PROGRAM FOR THE YEAR ENDED 2011 BY APPROXIMATELY $173,000. (SEE ADDITIONAL INFORMATION REGARDING THE COST OF PROVIDING CHARITY CARE IN SCHEDULE H TO THE FORM 990.)THE HOSPITAL TAKES ITS MISSION TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE IT SERVES A STEP FURTHER BY REACHING OUT TO MEET THE BROAD HEALTH NEEDS OF THE REGION IT SERVES. THE HOSPITAL STRIVES TO IDENTIFY THE NEEDS OF THE REGION BEYOND BASIC HEALTHCARE, AND THEN RESPONDS TO THEM BY AIMING TO MAKE A POSITIVE, LIFE-ENHANCING DIFFERENCE IN THE REGION. THE HOSPITAL TAKES A STRATEGIC, REGIONAL NEEDS BASED APPROACH TO DELIVERING BENEFITS TO THE REGION. THE HOSPITAL HAS RESPONSIBILITY FOR LEADING THE ORGANIZATION TO ACHIEVE THESE OBJECTIVES:1. COLLABORATE WITH COMMUNITIES TO IDENTIFY UNMET COMMUNITY HEALTH NEEDS AND UNDERSERVED POPULATIONS.2. ADDRESS UNDERSERVED POPULATIONS AND UNMET NEEDS.3. IMPLEMENT, COORDINATE, AND PROVIDE STRATEGIC MANAGEMENT OF THE HOSPITAL'S COMMUNITY BENEFIT EFFORTS.4. IMPROVE THE HEALTH OF THE COMMUNITIES.THIS POSITION LINKS ALL COMMUNITY BENEFITS ACTIVITIES UNDER ONE MANAGEMENT UMBRELLA WITH A CONSISTENT CONTACT POINT. ORGANIZATIONAL FOCUS ON COMMUNITY BENEFIT HAS BEEN ELEVATED BY STRENGTHENING INFRASTRUCTURE TO SUPPORT AND COMMUNICATE COMMUNITY BENEFIT WORK.THE HOSPITAL DEMONSTRATES ITS COMMITMENT TO PROVIDING COMMUNITY BENEFIT THROUGH THE FOLLOWING SPECIFIC ACCOMPLISHMENTS:THE ORGANIZATION IS A NON-PROFIT CORPORATION PROVIDING HEALTHCARE AND RESIDENTIAL SERVICES IN GALENA, ILLINOIS AND NEIGHBORING COMMUNITIES. ALL OF THESE SERVICES ARE OFFERED UNDER THE MISSION OF THE ORGANIZATION, WHICH STATES THAT "MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE." IN FISCAL YEAR 2011 THE HOSPITAL PROVIDED 632 ACUTE INPATIENT DAYS, 1,087 SWING BED DAYS, 3,859 EMERGENCY ROOM VISITS, 5,510 RADIOLOGY SERVICES, 88,093 LABORATORY TESTS, 7,701 PHYSICAL THERAPY TREATMENTS, AND 242 SURGICAL PROCEDURES AMONG MANY OF THE PATIENT SERVICES PROVIDED DURING THE YEAR. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3019365 | Expense |
| Revenue | 3303146 | Revenue |
| Description | MIDWEST MEDICAL CENTER RECOGNIZES THAT THE AGING AND DISABLED POPULATION OF PATIENTS ARE OFTEN AN UNDERSERVED DEMOGRAPHIC OF THE POPULATION AND TO MEET THE HEALTHCARE NEEDS OF THESE PATIENTS THE ORGANIZATION OPERATES THE GALENA-STAUSS SENIOR CARE COMMUNITY. THIS SENIOR CARE CAMPUS PROVIDES SENIOR CARE SERVICES THROUGH ITS 57-BED LONG-TERM CARE FACILITY, AN ASSISTED LIVING FACILITY, AS WELL AS ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS PROVIDED 18,184 DAYS OF SKILLED NURSING AND INTERMEDICARE NURSING HOME CARE DAYS IN ADDITION TO THE ASSISTED LIVING AND ADULT DAY CARE SERVICES. THE SENIOR CARE CAMPUS OFFERS SKILLED NURSING TO RESIDENTS AND PATIENTS IN BOTH SHORT TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED. THE SENIOR CARE CAMPUS OPERATES IN CONJUNCTION WITH THE MIDWEST MEDICAL CENTER HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN MIDWEST MEDICAL CENTER'S CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW COST CARE TO THE COMMUNITY. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2166622 | Expense |
| Revenue | 1127608 | Revenue |
| Description | MIDWEST MEDICAL CENTER ALSO OPERATES A PHYSICIAN CLINIC KNOWN AS THE MIDWEST HEALTH CLINIC. A TOTAL OF 8,652 CLINIC VISITS WERE PROVIDED DURING FISCAL YEAR 2011. THE CARE IN THE MIDWEST HEALTH CLINIC IS COORDINATED WITH THE CARE OF MIDWEST MEDICAL CENTER'S HOSPITAL IN AN EFFORT TO CONTINUE TO PROVIDE LOW COST AND HIGH QUALITY PATIENT CARE FOR THE RESIDENTS OF GALENA, ILLINOIS AND THE SURROUNDING AREAS. THE HEALTH CLINIC OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC TO MIDWEST MEDICAL CENTER'S HOSPITAL AND THE PRACTICE IS MADE UP OF THREE FAMILY PRACTICE PHYSICIANS, AN INTERNAL MEDICINE PHYSICIAN, AND ONE MID-LEVEL PRACTITIONER. ADDITIONAL SERVICES ARE ALSO PROVIDED IN THE CLINIC BY OUTREACH DOCTORS THAT PROVIDE SERVICES ON A LIMITED BASIS IN THE AREAS OF ORTHOPEDIC SURGERY, GENERAL SURGERY, PODIATRY, AND PLASTIC SURGERY.THE CLINIC PROVIDERS ALSO ENGAGE IN MANY ACTIVITIES WHICH PROMOTE THE WELL-BEING OF THE COMMUNITY AND PROVIDE HEALTH EDUCATION TO THE COMMUNITY. AN EXAMPLE OF THESE SERVICES IS DR. WELLS, WHO IS ON STAFF AT THE UNIVERSITY OF ILLINOIS ROCKFORD MEDICAL SCHOOL AND PROVIDES EDUCATIONAL EXPERIENCES AND TRAINING TO MEDICAL STUDENTS AT THE MIDWEST HEALTH CLINIC FOR THOSE STUDENTS INTERESTED IN LEARNING ABOUT RURAL MEDICINE. ANOTHER EXAMPLE IS DR. MATT GULLONE, WHO SPECIALIZES IN SPORTS MEDICINE AND PROVIDES FREE CARE TO LOCAL ATHLETES DURING SPORTING EVENTS. DR. BETH GULLONE AND PEG DITTMAR, ANP, ALSO PROVIDE BREAST CANCER EDUCATION TO SEVERAL GROUPS WITHIN JO DAVIESS COUNTY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 17304659 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 220 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRACY BAUER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8157771340 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1 |
| City | GALENA | City |
| State | IL | State |
| ZIP Code | 61036 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| DENNIS BLANCHARD | ||||||||
| CHAIR (THROUGH 6/30/11) | 2.00 | X | X | 0 | 0 | 0 | ||
| JOHN COOKE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| CHERYL FARRUGGIA | ||||||||
| VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| DALE HENZE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| HELEN KILGORE | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| BOB MILLER | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| BILL MORDEN | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| FRANK WAITES | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| VINCE TOEPFER | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| CAROL WRABL | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| ROY CLINGMAN | ||||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| MARY ROONEY-SHEAHEN RN | ||||||||
| CEO (THROUGH 6/30/11) / CHAIR | 40.00 | X | X | 141054 | 0 | 0 | ||
| TRACY BAUER | ||||||||
| CEO / CFO AND COO (THROUGH 6/30/11) | 50.00 | X | 131806 | 0 | 10065 | |||
| JENNIFER STEINES | ||||||||
| CONTROLLER (EFFECTIVE 7/11/11) | 50.00 | X | 0 | 0 | 0 | |||
| DEBRA HOPPMAN | ||||||||
| CNO | 50.00 | 121486 | 0 | 1339 | X | |||
| MICHAEL WELLS MD | ||||||||
| FAMILY PHYSICIAN | 36.00 | 165192 | 0 | 10463 | X | |||
| ELIZABETH GULLONE MD | ||||||||
| FAMILY PHYSICIAN | 36.00 | 165686 | 0 | 7878 | X | |||
| MATTHEW GULLONE MD | ||||||||
| FAMILY PHYSICIAN | 36.00 | 185558 | 0 | 6064 | X | |||
| K JEFF HILL | ||||||||
| FORMER CEO (THROUGH 12/31/08) | 40.00 | 181091 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1091873 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 35809 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MERCY RADIOLOGISTS OF DUBUQUE | |||||
| 250 MERCY DRIVE | DUBUQUE | IA | 52001 | RADIOLOGY PHYSICIAN SERVICES | 219470 |
| MICHAEL GREEN MD | |||||
| 1340 W NEWPORT | CHICAGO | IL | 60657 | ER PHYSICIAN COVERAGE | 212945 |
| HINSHAW & CULBERTSON LLP | |||||
| 2729 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | LEGAL SERVICES | 196823 |
| ELIZABETH NEALE MD SC | |||||
| 1145 VOLTZ ROAD | NORTHBROOK | IL | 60062 | ER PHYSICIAN COVERAGE | 195126 |
| JOSEPH COLLA MD | |||||
| 41 EAST 8TH STREET APT 3304 | CHICAGO | IL | 60605 | ER PHYSICIAN COVERAGE | 153045 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Government Grants | 43309 | GovernmentGrants |
| All Other Contributions | 2973 | AllOtherContributions |
| Total Contributions | 46282 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| HOSPITAL PATIENT REVEN | 621990 | 11814696 | 11814696 | |
| SENIOR CARE REVENUE | 623000 | 3303146 | 3303146 | |
| CLINIC REVENUE | 621110 | 1157608 | 1127608 | 30000 |
| CAFETERIA REVENUE | 621990 | 212463 | 212463 | |
| FITNESS CENTER REVENUE | 621990 | 128504 | 128504 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16616417 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 107925 | TotalRevenueColumn |
| Exclusion | $107,925 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 5493 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 83947 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -78454 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -78454 | TotalRevenueColumn |
| Exclusion | -$78,454 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13796 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 17499 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -3703 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -3703 | TotalRevenueColumn |
| Exclusion | -$3,703 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 18470 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 420 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 7485 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10985 | TotalRevenueColumn |
| Exclusion | $10,985 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16699452 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16586417 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 30000 | UnrelatedBusinessRevenue |
| Exclusion | $36,753 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13207 | Total |
| Program Services | 13207 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15336 | Total |
| Program Services | 15336 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 292889 | Total |
| Management And General | 292889 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5463722 | Total |
| Program Services | 5259686 | ProgramServices |
| Management And General | 204036 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112882 | Total |
| Program Services | 108672 | ProgramServices |
| Management And General | 4210 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 645201 | Total |
| Program Services | 621135 | ProgramServices |
| Management And General | 24066 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 388305 | Total |
| Program Services | 356021 | ProgramServices |
| Management And General | 32284 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1274229 | Total |
| Program Services | 1274229 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3460027 | Total |
| Program Services | 2707303 | ProgramServices |
| Management And General | 752724 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3591165 | Total |
| Program Services | 3591165 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54 | Total |
| Program Services | 54 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2662978 | Total |
| Program Services | 2662978 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207726 | Total |
| Program Services | 207726 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROVISION FOR BAD DEBT | Description |
| Total | 487147 | Total |
| Program Services | 487147 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18614868 | Total |
| Program Services | 17304659 | ProgramServices |
| Management And General | 1310209 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 437856 | BOY |
| EOY | 1629875 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1891856 | BOY |
| EOY | 2576105 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 393941 | BOY |
| EOY | 341932 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 274512 | BOY |
| EOY | 285077 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34435 | BOY |
| EOY | 4465 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 52274781 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 17040430 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37810925 | BOY |
| EOY | 35234351 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6999113 | BOY |
| EOY | 7113730 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15736 | BOY |
| EOY | 9496 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 870597 | BOY |
| EOY | 846528 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48728971 | BOY |
| EOY | 48041559 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2590885 | BOY |
| EOY | 2638117 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94278 | BOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45485000 | BOY |
| EOY | 45485000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150000 | BOY |
| EOY | 1425050 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48320163 | BOY |
| EOY | 49548167 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1058855 | BOY |
| EOY | -2962977 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1269014 | BOY |
| EOY | 1257720 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198649 | BOY |
| EOY | 198649 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 408808 | BOY |
| EOY | -1506608 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48728971 | BOY |
| EOY | 48041559 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1915416 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $6,105 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6105 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | MIDWEST MEDICAL CENTER PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE ORGANIZATIONS RECOGNIZE THAT A PORTION OF THE ACTIVITIES CONDUCTED BY BOTH IHA AND ICAHN ARE FUNDED IN CONJUNCTION WITH THE TOTAL ANNUAL DUES PAID. MIDWEST MEDICAL CENTER ESTIMATED THAT APPROXIMATELY $6,105 OUT OF THE TOTAL DUES PAID TO IHA AND ICAHN WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 345853 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 439 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3585 | GrantsOrScholarships |
| End Of Year Balance | 342707 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 354096 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1314 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 9557 | GrantsOrScholarships |
| End Of Year Balance | 345853 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 349405 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 6191 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1500 | GrantsOrScholarships |
| End Of Year Balance | 354096 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.57960 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.42040 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 559916 | OtherCostOrOtherBasis |
| Book Value | 559916 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 42642160 | OtherCostOrOtherBasis |
| Depreciation | 10999626 | Depreciation |
| Book Value | 31642534 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9036552 | OtherCostOrOtherBasis |
| Depreciation | 6040804 | Depreciation |
| Book Value | 2995748 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36153 | OtherCostOrOtherBasis |
| Book Value | 36153 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 35234351 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| BOARD DESIGNATED INVESTMENTS FOR CAP. IMPROVEMENTS | 1029007 | C |
| UNDER BOND AGREEMENT-RESERVE FUNDS | 3420408 | F |
| UNDER BOND AGREEMENT-PRINCIPAL/INTEREST FUNDS | 1535498 | F |
| DONOR RESTRICTED-MEDICAL SCHOLARSHIPS | 1128817 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 7113730 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAMS | $1,335,000 |
| SECURITY DEPOSITS HELD | $90,050 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1425050 | TotalOfAmounts |
| Total Revenue | 16699452 | TotalRevenue |
| Total Expenses | 18614868 | TotalExpenses |
| Excess Or Deficit For Year | -1915416 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -1915416 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16676937 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 7485 | OtherRevenues |
| Revenue Not Rptd F990 | 7485 | RevenueNotRptdF990 |
| Revenue Subtotal | 16669452 | RevenueSubtotal |
| Other Revenues Not Included | 30000 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 30000 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16699452 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 18577017 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 7485 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 7485 | ExpensesNotRptdF990 |
| Expenses Subtotal | 18569532 | ExpensesSubtotal |
| Other Expenses Not Included | 45336 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 45336 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 18614868 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE EARNINGS DERIVED FROM THE ENDOWMENT FUNDS ARE TO BE USED FOR SCHOLARSHIPS RELATED TO FIELDS IN THE MEDICAL PROFESSION. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE MEDICAL CENTER IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE MEDICAL CENTER IS ALSO EXEMPT FROM STATE INCOME TAXES PURSUANT TO SIMILAR STATE OF ILLINOIS TAX LAWS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE MEDICAL CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE MEDICAL CENTER IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES WHICH THE INTERNAL REVENUE SERVICE CONSIDERS UNRELATED TO THE MEDICAL CENTER'S EXEMPT PURPOSE AND, THEREFORE, TAXABLE. THESE ACTIVITIES, HOWEVER, ARE ANTICIPATED TO ANNUALLY RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES. THE MEDICAL CENTER DOES NOT PRESENTLY ANTICIPATE THAT A TAX BENEFIT FROM THESE NET OPERATING LOSSES WILL BE REALIZED IN THE FUTURE. ACCORDINGLY, ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. NO DEFERRED TAX ASSETS AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL AND TAX BASES OF REPORTING THE MEDICAL CENTER'S ASSETS AND LIABILITIES. THE MEDICAL CENTER'S POLICY IS TO RECOGNIZE INTEREST AND ANY PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. AS OF AND FOR THE YEARS ENDING SEPTEMBER 30, 2011 AND 2010, THERE WAS NO INCOME TAX EXPENSE, TAX PENALTIES, OR INTEREST RELATED TO TAX PENALTIES RECORDED BY THE MEDICAL CENTER IN THE FINANCIAL STATEMENTS. THE MEDICAL CENTER RECORDED NO ASSETS OR LIABILITIES FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2011 OR 2010. FEDERAL RETURNS FOR THE TAX YEARS SEPTEMBER 30, 2008, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES FOR GOLF OUTING INCLUDED IN EXPENSES ON F/S 7,485. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CLINIC PHYSICIAN CONTRACT SERVICE REVENUE NET AGAINST EXPENSE ON F/S 30,000. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES FOR GOLF OUTING INCLUDED IN EXPENSES ON F/S 7,485. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | LOANS FORGIVEN FROM SCHOLARSHIP FUNDS 15,336. CLINIC PHYSICIAN CONTRACT SERVICE REVENUE NET AGAINST EXPENSE ON F/S 30,000. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 18890 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 420 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 18470 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 1425 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 2640 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 1275 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 2145 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 18890 | GrossReceiptsTotal |
| Charitable Contributions Total | 420 | CharitableContributionsTotal |
| Gross Revenue Total Events | 18470 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 1425 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 2640 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 1275 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 2145 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 7485 | DirectExpenseSummaryEvents |
| Net Income Summary | 10985 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 158347 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 158347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00870 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3346964 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1332267 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2014697 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11110 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3505311 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1332267 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2173044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11980 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5517737 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3457198 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2060539 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11370 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13207 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13207 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5530944 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3457198 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2073746 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11440 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9036255 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4789465 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4246790 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.23420 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $446,046 | BadDebtExpenseAmount |
| Amount Attributable To | 223023 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6968870 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6973237 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4367 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MEDICAL CENTER DRIVE | AddressLine1 |
| City | GALENA | City |
| State | IL | State |
| ZIP Code | 61036 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | PROVIDER BASED RURAL HEALTH CLINIC | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDWEST MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GALENA-STAUSS SENIOR CARE CAMPUS | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 215 SUMMIT STREET | AddressLine1 |
| City | GALENA | City |
| State | IL | State |
| ZIP Code | 61036 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | SKILLED NURSING FACILITY, ASSISTED LIVING, AND ADULT DAY CARE | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: MIDWEST MEDICAL CENTER PRIMARILY USES FEDERAL POVERTY GUIDELINES TO ESTABLISH CHARITY OR DISCOUNTED CARE TO THOSE IN NEED OF CARE IN THE COMMUNITY, HOWEVER THERE ARE OTHER CONSIDERATIONS GIVEN TO PATIENTS TO AVOID HAVING PATIENTS BE IN FINANCIAL DISTRESS DUE TO CONCERNS OVER THEIR MEDICAL BILLS. BELOW ARE THE GENERAL GUIDELINES AS DEFINED IN MIDWEST MEDICAL CENTER'S CHARITY CARE POLICY WHICH ARE FOLLOWED BY THE ORGANIZATION:PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD WILL BE ELIGIBLE FOR 100% CHARITY CARE.PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME GREATER THAN 150%, BUT EQUAL TO OR LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD, WILL BE ELIGIBLE FOR PARTIAL FINANCIAL ASSISTANCE.PATIENT ACCOUNT GUARANTORS WITH INSUFFICIENT ASSETS TO PAY THE AMOUNT DUE, AND WHO DO NOT QUALIFY FOR CHARITY CARE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES, WILL BE ELIGIBLE FOR A CATASTROPHIC CHARITY ADJUSTMENT WHEN THE TOTAL AMOUNT DUE TO MIDWEST MEDICAL CENTER EQUALS AT LEAST 20% OF THE DEBTOR'S ADJUSTED GROSS INCOME. CATASTROPHIC CHARITY IS AN EIGHTY PERCENT (80%) ADJUSTMENT OFF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES. |
| PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICES REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. (THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G ON THE FIRST PAGE OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE ORGANIZATION.) |
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT MIDWEST MEDICAL CENTER INCLUDES THE OPERATION OF SEVERAL DEPARTMENTS. THESE DEPARTMENTS AND SERVICES INCLUDE: THE ADULTS AND PEDIATRICS HOSPITAL INPATIENT UNIT, EMERGENCY ROOM, ASSISTED LIVING SERVICES, AND ADULT DAY CARE PROGRAMS. A MAJORITY OF THESE DEPARTMENTS ARE OPERATED, OR ARE KEPT AT MINIMAL STAFFING LEVELS, IN ORDER TO PROVIDE ACCESS TO THE EMERGENCY ROOM OR EMERGENCY INPATIENT CARE OR CRITICAL CARE SERVICES WHICH SUPPLEMENT OTHER SERVICES AT THE HOSPITAL OR ARE BASED ON NEEDS IN THE COMMUNITY. THE EMERGENCY ROOM AND INPATIENT UNIT ARE STAFFED 24 HOURS PER DAY TO PROVIDE NEEDED ACCESS TO EMERGENCY CARE IN THE GALENA, ILLINOIS COMMUNITY OR AS REQUIRED BY REGULATIONS TO BE ON-CALL AND AVAILABLE TO PROVIDE ACCESS TO EMERGENCY INPATIENT CARE AS A PART OF OPERATING A HOSPITAL IN THE STATE OF ILLINOIS. THE INPATIENT UNIT ALSO PROVIDES CARE TO OVERNIGHT OBSERVATION PATIENTS WHICH ARE KEPT FOR OBSERVATION IN FOLLOW UP CARE FROM THE EMERGENCY ROOM AS WELL AS PROVIDING A SIGNIFICANT NUMBER OF SWING BED SERVICES. IN THE PAST, THERE WAS NO MEDICARE CERTIFIED NURSING HOME IN THE CITY OF GALENA, ILLINOIS OR IN THE IMMEDIATE SURROUNDING AREA AND AS OF FISCAL YEAR 2011 THERE ARE ONLY 5 MEDICARE CERTIFIED SKILLED NURSING BEDS IN JO DAVIESS COUNTY, ILLINOIS TO PROVIDE CARE TO SKILLED NURSING PATIENTS, SO THE HOSPITAL PARTICIPATS IN THE MEDICAL RURAL HOSPITAL SWING BED PROGRAM IN ORDER TO PROVIDE SKILLED NURSING CARE IN AVAILABLE BEDS IN THE HOSPITAL INPATIENT UNIT. THE ASSISTED LIVING AND ADULT DAY CARE PROGRAMS ARE ALSO CONSIDERED TO BE AN IMPORTANT SERVICE IN THE COMMUNITY AND THESE PROGRAMS OPERATE IN CONJUNCTION WITH THE SENIOR CARE CAMPUS OPERATED BY THE MEDICAL CENTER TO PROVIDE A CONTINUUM OF CARE TO RESIDENTS OF THE COMMUNITY. NURSING STAFF IS AVAILABLE 24 HOURS PER DAY TO RESIDENTS OF THE ASSISTED LIVING AND THE BUILDING IS CONSTRUCTED TO PROVIDE A SAFE ENVIRONMENT. THE ADULT DAY CARE SERVICES ARE PROVIDED AS ANOTHER OPTION TO COMMUNITY MEMBERS WHO WISH TO CARE FOR FAMILY MEMBERS AT HOME BUT NEED ASSISTANCE DURING THE DAY TIME WHILE THEY MAY WORK OR HAVE OTHER RESPONSIBILITIES. THE MEDICAL CENTER RECOGNIZES THAT THIS IS AN IMPORTANT SERVICE SO THIS OPERATION IS SUPPLEMENTED BY THE HOSPITAL. IT IS THE GOAL OF MIDWEST MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. |
| PART I, L7 COL(F): THE COSTING METHOD AND CALCULATIONS USED ON FORM 990 ARE BASED ON TOTAL OPERATING EXPENSES EXCLUDING BAD DEBT EXPENSE. THE COMMUNITY BENEFIT EXPENSE PERCENTAGES ARE CALCULATED BY DIVIDING THE COMMUNITY BENEFIT EXPENSE FOR EACH CATEGORY OF COMMUNITY SERVICES PROVIDED BY MIDWEST MEDICAL CENTER REPORTED IN THE TABLE ON LINE 7 PART I OF THE SCHEDULE H BY THE TOTAL OPERATING EXPENSES OF THE HOSPITAL LESS THE PROVISION FOR BAD DEBTS OF $487,147. |
| PART II: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. MIDWEST MEDICAL CENTER PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. MIDWEST MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. |
| PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE ORGANIZATION HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE ORGANIZATION PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE AND THE HOSPITAL HAS REFLECTED AN ESTIMATED AMOUNT OF THESE ADDITIONAL BAD DEBTS IN PART III OF SCHEDULE H OF THE 990.THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES LESS PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE ORGANIZATION. THE ORGANIZATION ALSO RECOGNIZES THAT IT PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE ORGANIZATION. |
| PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, RADIOLOGY PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT MIDWEST MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2011, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THE MEDICAL CENTER ALSO SUFFERS A LARGER MEDICARE LOSS NOTED ON THE FORM 990 THAN MANY OTHER CRITICAL ACCESS HOSPITALS DUE TO A REGULATION WHICH AFFECTS LAB REIMBURSEMENT FOR CRITICAL ACCESS HOSPITALS. DUE TO THIS REGULATION, THE HOSPITAL DOES NOT RECEIVE THE FULL COST OF PROVIDING LAB SERVICES TO MEDICARE BENEFICIARIES.WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: UNDER THE ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, MIDWEST MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S BUSINESS OFFICE OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. |
| PART VI, LINE 2: MIDWEST MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH MIDWEST MEDICAL CENTER'S MISSION IN THE COMMUNITY. MIDWEST MEDICAL CENTER ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND IT'S PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. |
| PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH THE ORGANIZATION'S BUSINESS OFFICE EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. A HOSPITAL REPRESENTATIVE WILL EXPLAIN THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE ILLINOIS PUBLIC AID PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. |
| PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR MIDWEST MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE HOSPITAL. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | NOTES RECEIVABLE FOR SCHOLARSHIPS FORGIVEN | TypeOfGrant |
| Amount Of Non Cash Assistance | 15336 | AmountOfNonCashAssistance |
| Method Of Valuation | CURRENT NOTE RECEIVABLE BALANCE | MethodOfValuation |
| Description Of Non Cash Assistance | FORGIVENESS OF NOTES RECEIVABLE IS GOVERNED BY THE HOSPITAL'S MEDICAL EDUCATION SCHOLARSHIP PROGRAM AND FORGIVENESS IS GRANTED IF INDIVIDUALS FULFILL FUTURE SERVICE REQUIREMENTS WITH MIDWEST MEDICAL CENTER IN HEALTH PROFESSIONAL RELATED FIELDS. THE HOSPITAL TRACKS THIS INFORMATION ANNUALLY AND AWARDS THE FORGIVENESS BASED ON THE COMPLETION OF THE REQUIRED CRITERIA OF THE PROGRAM. | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: MIDWEST MEDICAL CENTER TRACKS THE GRANTS PROVIDED THROUGH THE USE OF NOTES RECEIVABLE AS THE SCHOLARSHIP PROGRAMS ARE INTENDED TO SUPPLEMENT AND BE A FORM OF STUDENT LOANS FOR MEMBERS OF THE COMMUNITY PURSUING ADDIITIONAL EDUCATION IN HEALTH RELATED FIELDS. PRIOR TO APPROVING A NOTE TO A PERSEPCTIVE STUDENT, AN APPLICATION IS REVIEWED FOR APPROVAL BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER TO ENSURE THAT ALL BACKGROUND INFORMATION ON THE CANDIDATE WAS PROVIDED. AFTER REVIEW BY THE CHIEF FINANCIAL OFFICER, THIS INFORMATION IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. EACH STUDENT MUST SIGN A PROMISSORY NOTE WITH MIDWEST MEDICAL CENTER THAT THEY COMMIT TO COMPLETE THE EDUCATIONAL PROGRAM AND THAT UPON GRADUATION THEY WILL PERFORM SERVICES FOR MIDWEST MEDICAL CENTER (PENDING AN AVAILABLE POSITION IN THE ORGANIZATION AT THE TIME) OR THEY WILL REPAY THE NOTE WITH INTEREST. (THE REPAYMENT TERMS ENSURE THAT THE ENDOWED AND DONATED FUNDS ARE AVAILABLE IN FUTURE YEARS TO OTHER MEMBERS OF THE COMMUNITY OR THAT SERVICES ARE RETURNED TO THE COMMUNITY THROUGH SERVICE TO THE MEDICAL CENTER.) SERVICES PERFORMED AT MIDWEST MEDICAL CENTER RESULT IN FORGIVENESS OF NOTES RECEIVABLE AMOUNTS BASED ON HOURS WORKED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL WELLS MD | |||||||||||||
| 159669 | 0 | 5523 | 0 | 0 | 0 | 0 | 0 | 10463 | 0 | 175655 | 0 | 0 | 0 |
| ELIZABETH GULLONE MD | |||||||||||||
| 165686 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7878 | 0 | 173564 | 0 | 0 | 0 |
| MATTHEW GULLONE MD | |||||||||||||
| 185558 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6064 | 0 | 191622 | 0 | 0 | 0 |
| K JEFF HILL | |||||||||||||
| 0 | 0 | 0 | 0 | 181091 | 0 | 0 | 0 | 0 | 0 | 181091 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 4A | PART I, LINE 4A: K. JEFF HILL RECEIVED A SEVERANCE PAYMENT OF $181,091. |
| PART I, LINE 5 | SOME PHYSICIANS, UNDER THE TERMS OF THEIR CONTRACTUAL AGREEMENT WITH MIDWEST MEDICAL CENTER, RECEIVE ADDITIONAL COMPENSATION IF A HIGH VOLUME OF PATIENTS ARE PROVIDED SERVICES BY THE PHYSICIAN IN AN EMPLOYMENT YEAR. THE FOLLOWING PHYSICIANS HAVE SUCH CONTRACTUAL TERMS: MICHAEL WELLS, MD; ELIZABETH GULLONE, MD; MATTHEW GULLONE, MD. DURING FISCAL YEAR 2011, DR. WELLS ACHIEVED THESE GOALS AND WAS PAID AN ADDITIONAL AMOUNT BASED ON PATIENT VOLUMES AS NOTED IN THE INCENTIVE PAYMENT COLUMN ON PAGE 2 OF SCHEDULE J OF THE 990. THESE AMOUNTS ARE NOT ACCRUED BASED ON REVENUES OF THE ORGANIZATION BUT BASED ON PATIENT STATISTICS AND ACUITY OF PATIENTS PROVIDED SERVICES. |
| PART I, LINE 7 | SEE ADDITIONAL COMMENTS ABOVE REGARDING PHYSICIANS THAT RECEIVE ADDITIONAL COMPENSATION IF A HIGH VOLUME OF PATIENTS ARE PROVIDED SERVICES BY THE PHYSICIAN IN AN EMPLOYMENT YEAR. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS FINANCE AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 861091967 | IssuerEIN |
| CUSIP Number | 45200BJ66 | CUSIPNumber |
| Date Issued | 2006-10-01 | DateIssued |
| Issue Price | 45485000 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF NEW HOSPITAL FACILITY | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 45485000 | TotalProceeds |
| Amount In Reserve Fund | 3420238 | AmountInReserveFund |
| Issuance Costs From Proceeds | 909700 | IssuanceCostsFromProceeds |
| Capital Expenditures | 41155062 | CapitalExpenditures |
| Year Of Subst Completion | 2007 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| PAMELA SMITH | |||
| FAMILY MEMBER OF TRACY BAUER, OFFICER OF ORGANIZATION | 37040 | EMPLOYMENT | 0 |
| PATRICIA BAUER | |||
| FAMILY MEMBER OF TRACY BAUER, OFFICER OF ORGANIZATION | 19116 | EMPLOYMENT | 0 |
| CONNIE TRAVIS | |||
| FAMILY MEMBER OF TRACY BAUER, OFFICER OF ORGANIZATION | 15504 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | THE SENIOR CARE CAMPUS CERTIFIED FIVE OF ITS BEDS AS A SKILLED NURSING FACILITY DISTINCT PART UNIT TO ALSO PROVIDE EXTENDED SKILLED NURSING SERVICES IN THE NURSING HOME SETTING. THERAPISTS AND OTHER ANCILLARY SERVICE PROFESSIONALS ARE AVAILABLE FROM MIDWEST MEDICAL CENTER'S HOSPITAL TO SUPPORT PATIENTS IN THIS PROGRAM AS WELL. THIS UNIT IS THE ONLY MEDICARE CERTIFIED SKILLED NURSING FACILITY WITHIN JO DAVIES COUNTY ILLINOIS. DURING FISCAL YEAR 2011, THE MEDICAL CENTER ALSO EXPANDED SERVICES IN THE MIDWEST HEALTH CLINIC, WHICH IS LOCATED WITHIN MIDWEST MEDICAL CENTER. DR. CIHAK JOINED THE PRACTICE AT THE MIDWEST HEALTH CLINIC. DR. CIHAK HAS EXTENSIVE EXPERIENCE IN INTERNAL MEDICINE AND WILL BE ABLE TO PROVIDE THIS SERVICE AS A DEDICATED INTERNAL MEDICINE PHYSICIAN WAS NOT PREVIOUSLY AVAILABLE IN THE GALENA COMMUNITY WITHOUT PATIENTS HAVING TO TRAVEL OUT OF TOWN FOR THESE SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER PREVIOUSLY ISSUED TAX-EXEMPT BONDS THROUGH THE ILLINOIS FINANCE AUTHORITY TO FINANCE THE CONSTRUCTION OF A REPLACEMENT HOSPITAL. UNDER THE TERMS OF THE BOND AGREEMENTS, THE ORGANIZATION IS LIMITED AS TO ISSUING NEW DEBT, PURCHASING SIGNIFICANT CAPITAL ASSETS, DISPOSING OF SIGNIFICANT ASSETS, AND/OR SETTING UP NEW CORPORATIONS OR SUBSTAINTIALLY RESTRUCTURING THE CURRENT ORGANIZATION WITHOUT FIRST OBTAINING APPROVAL OF THE BOND TRUSTEES. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BOARD OF DIRECTORS RECEIVED A COPY OF THE FINAL 990 FOR REVIEW AND APPROVAL THROUGH POSITING TO AN ELECTRONIC SECURE WEBSITE BY MANAGEMENT OF MIDWEST MEDICAL CENTER PRIOR TO ITS SUBMISSION TO THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | SINCE MIDWEST MEDICAL CENTER IS PART OF A SMALL COMMUNITY, CONFLICTS OF INTEREST ARE GENERALLY KNOWN. THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUAL DISCLOSURE STATEMENTS. THESE ARE KEPT ON FILE AT THE HOSPITAL AND ALL MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING MANAGEMENT WHICH ATTEND MEETINGS, ARE TOLD OF THE CONFLICTS. ANY MEMBERS WITH KNOWN CONFLICTS ABSTAIN FROM VOTING ON THESE CONFLICTS DURING MEETINGS AND ENGAGE IN ONLY LIMITED DISCUSSIONS ON THESE TOPICS. THE BOARD AND MANAGEMENT HOLD EACH OTHER ACCOUNTABLE THROUGH OBSERVATION AND ENFORCEMENT OF THE POLICY DURING MEETINGS AND AT ORGANIZATION FUNCTIONS. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS EVALUATIONS FOR THESE INDIVIDUALS, COMPARES DATA TO COMPETITIVE MARKET DATA OBTAINED FROM SALARY SURVEYS, AND CONSULTS WITH OUTSIDE ORGANIZATIONS AS NEEDED IN REVIEWING CONTRACTS. LEGAL AND OUTSIDE VALUATION SERVICES ARE OBTAINED IN ENSURING THE KEY EMPLOYEES, EXECUTIVES, AND PHYSICIANS SALARIES ARE IN LINE WITH REASONABLE AND PRUDENT BUYER CONCEPTS AS WELL. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR SELECTION OF AN INDEPENDENT ACCOUNTANT, AND THE CEO OVERSEES THE AUDIT PROCESS. THE BOARD CHAIR TAKES TIME ANNUALLY TO MEET PRIVATELY WITH THE INDEPENDENT ACCOUNTANT WITHOUT MANAGEMENT PRESENT AND THE ENTIRE BOARD IS ALSO GIVEN THIS OPPORTUNITY DURING THE IN PERSON PRESENTATION OF THE AUDIT RESULTS BY THE INDEPENEDNT ACCOUNTANT. NO CHANGES IN THE OVERSIGHT OR SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE OCCURRED IN THE PAST YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| MIDWEST REGIONAL HEALTH FOUNDATION | ||||||||||
| ONE MEDICAL CENTER DRIVE | GALENA | IL | 61036 | 204560639 | FUNDRAISING | IL | 501(C)3 | 11 TYPE I | N/A | 0 |
| MIDWEST REGIONAL HEALTH SYSTEM | ||||||||||
| ONE MEDICAL CENTER DRIVE | GALENA | IL | 61036 | 204560381 | SUPPORTING | IL | 501(C)3 | 11 TYPE III | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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