2012-11-15T12:28:24-06:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 371119538 Carle Foundation Hospital % DENNIS HESCH EXEC VP & CFO CARL 2173833311 611 WEST PARK URBANA IL 61801 DENNIS P HESCH 2012-11-14 3176817000 2011 2016-02-24 21:20:13Z Dennis Hesch Exec VP CFO 611 W Park St Urbana IL 61801 460665972 false X www.carle.org X 1982 IL CARLE FOUNDATION HOSPITAL'S MISSION IS TO SERVE PEOPLE THROUGH HIGH QUALITY CARE, MEDICAL RESEARCH AND EDUCATION. HEALTH CARE SERVICES ARE PROVIDED TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY. 7 2 2397 865 2930169 -352672 3809583 7314083 224646088 415262724 21935 6498279 4467256 5505704 232944862 434580790 1000520 3822286 0 0 62526289 124148856 0 0 0 113848410 198600549 177375219 326571691 55569643 108009099 188401461 238294492 79895767 71315039 108505694 166979453 X Section 1. GENERAL PURPOSES. The corporation is organized and shall be exclusively operated as a not-for-profit corporation for charitable, benevolent, scientific and educational purposes within the meaning of Section 501c(3) of the Internal Revenue code of 1986, as amended, or the corresponding provisions of any future United States Internal Revenue Law (the "Code"). The main mission statement is: We serve people through high quality care, medical research and education. And, in furtherance of such charitable purposes, the corporation shall engage in the activities described in Section 2 of this statement. Section 2. SPECIFIC PURPOSES. The corporation's purposes shall include, but not be limited to, the following: (a)to provide and to assist in providing facilities for the rendering of comprehensive health care services on an inpatient or other basis through the operation of one or more hospitals, by providing services to providers of health care services and through all other appropr false false 284779340 2470638 417165389 Serving people through high quality medical care Carle Foundation Hospital is an Illinois not-for-profit Corporation established for the purpose of operating the Carle Foundation's 325-licensed bed hospital and related facilities and, conducting patient care related activities of the Foundation. The hospital, a level one trauma center, offers a full range of inpatient and outpatient diagnostic and therapeutic services for medical, surgical, obstetrical and gynecological patients. The hospital provides various ancillary support services to both inpatients and outpatients such as autopsy, blood bank, emergency services, respiratory therapy, operating room, occupational therapy, pastoral counseling, social services, pharmacy and physical therapy. Carle Foundation Hospital's mission is to serve people through high quality care, medical research and education. We make sure those who need care, get care, whether or not they can pay. Through our Community Care Discount Program for hospital services and our partnerships with area health agencies, access to dental, vision and general healthcare has been improved for those who are struggling financially. As the second tenet in our mission, research gives us tomorrow's answers, today. In collaboration with the University of Illinois scientists and the Carle Physician Group physicians, we are turning the latest medical knowledge into practical applications for the bedside. We are now conducting more than 126 active studies relating to cancer, gastro-intestinal disease, cardiovascular disease and more. Educational programs for both our professionals and the community ensure everyone is better prepared. For the community, we offer a myriad of opportunities like babysitting certification and new dad courses, along with free CPR and first aid classes. For our professionals, we have continuing education courses, three levels of management training classes and courses for physician leaders. Carle Foundation Hospital's continued success is rooted in our ability to adapt to a changing healthcare environment, plan diligently for our future and maintain a commitment to our patients and community. Not-for-Profit hospitals have a long standing practice of providing support, donations and services to their communities. This stems not from economic opportunity, but rather from a responsibility to address and improve the health of all the people they serve. At Carle Foundation Hospital, we also believe that we have an obligation to generously give back to our community in exchange for our tax exemption. All of these factors lead to Carle Foundation Hospital being a champion of access to healthcare and a pillar of community support. For the twelve months ended December 31, 2011 (CY11), the Carle Foundation's total community benefit was $55,193,287. Community benefit programs are based on assessed needs and designed to improve the health of those who live and work in our area, with a focus on serving those less fortunate. Areas of Community Benefit include: hospital services that operate at a loss, cash and in-kind donations, translational research, community education, community-building activities and workforce development. Another role of the Community Benefit is to step in where government falls short. As State and Federal budgets get tighter, funding for important health-related services rarely cover costs and, at a minimum, is usually slow in coming. That is most clearly evidenced by the hospital's unpaid costs of Medicare and Medicaid in the amount of $3,741,423 included in the Community Benefit total above. Carle Foundation Hospital strives to eliminate barriers that keep area residents from receiving the care they need. Carle Foundation Hospital's Community Care Discount Program is one of the most generous charity care discount programs in the country. We want to make sure that the people who qualify know about their options. Our advertising throughout the region is targeted to reach people who qualify so they are aware financial assistance is available. As a not-for-profit hospital, it is our obligation to reach out to those who cannot afford healthcare. Summary: Total Community Benefit = $55,193,287 less Medicaid "revenue" of $2,719,742, less Medicare shortfall of $3,741,423, less Community Building Activities of $235,917 = $48,496,171. 15753168 0 0 The Carle Community Care Discount Program (Charity Care) As a tax-exempt organization, Carle provides care to patients regardless of their ability to pay for that care or source of payment. We also recognize that some patients need help to pay their bills. Carle Foundation Hospital's Community Care Discount Program (charity care) provides discounts or free care to those who need it. The most recent revision of September 1, 2011, is focused primarily on providing greater clarity around covered services, based on our experiences and feedback following the inclusion of outpatient services.) An additional policy reflects our compliance with the Illinois Hospital Uninsured Patient Discount Act, established in 2009, it was last revised in January 2012. Our Community Care Discount Program is continually evaluated and managed as needed to meet the needs of our community. Evaluation involves input from administrative leaders, Patient Accounts staff, local consumer advocacy groups, and patients. For the twelve months ended December 31, 2011 (CFY11), charity care totaled $15,753,168 and served 6,295 people. 9285568 1366648 0 Research and Education initiatives Carle Foundation Hospital is actively involved in Research and Education Initiatives. The overall purpose of the Research Program is helping to discover new diagnostic and treatment technologies and methods that will improve the delivery and/or quality of healthcare. The Research Program is done in conjunction with area physicians and scientists, The University of Illinois and entrepreneurial companies. Carle Foundation Hospital's efforts in research and education have steadily grown in recent years with strategic emphasis now placed on Translational Research with The University of Illinois. In November 2010, University of Illinois researchers began to move into the Carle Biomedical Research Center, enjoying state-of-the-art laboratory facilities on our Urbana Medical Campus. As of December 2011, the Carle Research Institute had 126 active, with another 21 pending research studies underway. Of the total of 147 studies, the breakdown of studies into various areas was 23 translational, 30 investigator-initiated, 29 nursing, 17 clinical trials, and 37 residency program and student research studies. Carle physicians and University of Illinois scientists frequently collaborate on research projects within the Carle Research Institute. Besides patient and community education, significant resources are expended on the education and training of medical students, physician residents, nurses, allied health professionals and the general healthcare workforce. Through a variety of activities including significant donations, scholarship programs, and physician, nurse, and allied health education, more than $9.2 million was invested in programs that address community-wide workforce issues, strengthening the training and availability of professionals to care for our healthcare needs now and in the near and distant future. -Graduate Medical Education programs. Maintaining a geriatric fellowship and three medical residency programs, and serving as a clinical site for a fourth. There are 31 residents practicing on Carle's campus at any point in time. -Continuing Medical Education programs for regional providers who are not members of the Carle Foundation Hospital medical staff. This includes Carle Foundation Day, which is an event for providers held at the Forum. There are multiple presentations, speakers and displays which count toward required continuing medical education credit for physicians in the region who attend. -Support of the University of Illinois College of Medicine at Urbana-Champaign, with monies earmarked for the MD/PhD program. 0 0 0 309818076 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 254 0 true 2397 true true true false false false false false false false false false X 7 2 true false false false true true true true true false false true true true true true true false false false IL X X DENNIS HESCH EXEC VP CFO 2173268231 611 WEST PARK ST Urbana IL 61801 X Phillip Blankenburg 0.5 X X 0 0 0 Donna Greene 0.5 X X 0 0 0 Cora E Musial Phd MD 35.0 X X 0 204938 35754 Mathew Gibb MD 11.0 X 0 888290 32727 J Michael Martin 0.5 X 0 0 0 Marty Smith 1.0 X 0 0 0 Paul Tender MD 10.0 X 0 493822 29294 David Ikenberry Phd 0.2 X 0 0 0 E Phillips Knox 0.6 X 0 0 0 James C Leonard MD 11.0 X X 0 1040335 246421 R Bruce Wellman MD 19.0 X X 0 805580 226995 John Snyder 15.0 X 0 640038 160811 Dennis Hesch 16.0 X 0 510086 139104 Philip Kubow 13.5 X 0 408185 95490 Pamela Bigler 25.0 X 0 288538 66917 Lynne Barnes 20.0 X 0 260271 57268 Mark Berlin 20.0 X 0 234340 74664 Dawn Walden 19.0 X 0 230023 50809 Stephanie Beever 20.0 X 0 246557 70001 Diane Wasson term 2911 40.0 X 207152 0 2978 Gregory Puszkiewicz term 7111 40.0 X 204070 0 22232 Vijay Bavda 40.0 X 175984 0 27318 Cynthia Gordon 40.0 X 174174 0 24054 Linda Fred 24.0 X 165054 0 32778 Robert Tonkinson 0.0 X 0 309933 0 926434 6560936 1395615 54 true true false PNC BANK NATIONAL ASSOCIATION PO BOX 931034 CLEVELAND OH 44193 EQUIPMENT LEASING 2111797 REGIONAL HEALTH RESOURCE CENTER 1408 WEST UNIVERSITY AVENUE URBANA IL 61801 BLOOD SERVICES 1405067 AMERICAN MOBILE NURSES HEALTHCARE I 2735 COLLECTION CENTER DRIVE CHICAGO IL 60693 STAFFING 791868 QUEST DIAGNOSTICS PO BOX 12989 CHICAGO IL 60693 TESTING SERVICES 722804 ASD SPECIALTY HEALTHCARE INC ASD HEALTHCARE PO BOX 848104 DALLAS TX 75284 PHARMACEUTICALS 600489 33 3346075 3519679 448329 7314083 Net Patient Care 621110 413153806 413153806 Net Patient Care - ASC 621110 2108918 2108918 415262724 323608 323608 0 0 5455983 4034052 1421931 1421931 1421931 9183591 3008920 6174671 6174671 107169 6067502 0 0 20443279 19042210 1401069 1401069 Internal Management Fees 900099 800015 800015 INCOME TAX REFUNDS 900099 312720 312720 HOSPICE HOMECARE SERVICES ROOM AND BOARD 900099 350711 350711 1219258 439219 780039 2682704 434580790 417165389 2930169 7171149 3822286 3822286 0 0 0 0 0 98632198 94795563 3836635 4868322 4706220 162102 13512534 12783784 728750 7135802 6864817 270985 0 205001 197943 7058 360087 341516 18571 308598 308598 0 0 18091383 17083247 1008136 85158 85158 9684794 7423847 2260947 4291643 3960609 331034 0 20441303 18469335 1971968 689282 659520 29762 0 461297 453101 8196 131839 57178 74661 0 5876648 5175162 701486 21255 17342 3913 Internal Management Fees 64305997 60275744 4030253 Taxes 10171640 9649634 522006 Patient Care Supplies 62954855 62295748 659107 All other expenses 519769 391724 128045 326571691 309818076 16753615 0 112000 124000 0 0 0 0 76045181 86175599 0 0 0 0 0 0 8130434 6391661 4549292 1739894 70818713 28336432 42270824 42482281 0 0 0 0 0 0 0 0 57293730 101381057 188401461 238294492 23119172 20492866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56776595 50822173 79895767 71315039 X 108505694 166979453 0 0 0 0 108505694 166979453 188401461 238294492 X 108009099 -49535340 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 271741 false true 36857 308598 Description of other Lobbying activites Schedule C, Part II-B, Line (G) The Hospital has contract professionals to provide consulting services for the hospital. As a portion of the contractors' duties, the contractors interact with governmental officials on behalf of the Hospital. Schedule C, Part II-B, line (i) $28,969 - portion of Illinois Hospital Association (IHA) dues attributed to lobbying. $7,888 - portion of American Hospital Association (AHA) dues attributed to lobbying. 485000 485000 7716311 2275595 5440716 1973548 1432398 541150 56888063 23556168 33331895 3755791 1072271 2683520 42482281 Inter-Company receivable 97270338 Other receivables 4110719 101381057 0 Estimated Third Party Settlements 22043503 Compensation and paid leave accrual 25458911 EST LIAB FOR SELF INSURED LOSSES 3317188 Other long term liabilities 2571 50822173 SUPPLEMENTAL INFORMATION Sch D, Part X, line 2 The Foundation adopted the guidance for accounting for uncertainty in income taxes on July 1, 2007. This guidance clarifies the accounting for uncertainty in income taxes recognized in an organization's financial statement. The guidance prescribes a more-likely-than-not recognition threshold and measurement attribute for financial statement recognition of a tax position taken or expected to be taken. Amounts requiring recognition under tax accounting guidance is reflected as a liability for uncertain tax benefits along with any associated interest and penalties that would be payable to the taxing authorities upon examination. There are no uncertain tax benefits identified or recorded as a liability as of December 31, 2011. true true X true X true X true true true false true true 15753168 0 15753168 0.04890 44441634 47161376 -2719742 0.00840 6051719 0 6051719 0.01880 66246521 47161376 19085145 0.05930 535174 0 535174 0.00170 7383115 0 7383115 0.02290 7571993 0 7571993 0.02350 9285568 0 9285568 0.02880 4635176 0 4635176 0.01440 29411026 0 29411026 0.09130 95657547 47161376 48496171 0.15060 12568 12568 0.00000 53620 53620 0.00020 44076 44076 0.00010 3942 3942 0.00000 0 0 0.00000 1299 1299 0.00000 5446 5446 0.00000 108336 108336 0.00030 6664 6664 0.00000 235951 235951 0.00060 true 6051719 3025860 88826779 91596930 -2770151 X true true 1 1 THE CARLE FOUNDATION HOSPITAL

611 W PARK STREET URBANA IL 61801

X X X X X THE CARLE FOUNDATION HOSPITAL 1 true true 200. true 400. true X X X X X X true true X X X X X X X true false true X false false 4 CARLE THERAPY SERVICE

810 W ANTHONY DR URBANA IL 61801

THERAPY SERVICES CARLE RX EXPRESS

602 W UNIVERSITY URBANA IL 61801

PHARMACEUTICAL SERVICES Carle SurgiCenter - Danville

2300 North Vermilion St Danville IL 61832

GENERAL MEDICAL & SURGICAL Carle SurgiCenter - Champaign

1702 South Mattis Ave Champaign IL 61821

GENERAL MEDICAL & SURGICAL 1. REQUIRED DESCRIPTIONS PART I, LINE 7B During the 12 months ending 12/31/2011 there were circumstances which contributed to IPA costs being fully reimbursed. A market based revenue rate increase was effective January 1, 2011. Meaningful use grant revenue for electronic health records was netted against costs. The organization has implemented a cost containment program. Due to the revenue rate increase, meaningful use grant revenue and cost containment program the cost to charge ratio decreased. The IPA pending accounts receivable which were historically identified as IPA were reclassified to the current payor resulting in a decrease in the IPA reserve and an increase in calculated reimbursement. Explanation of Costing Methodology (Part I, line 7 and Part III, line 4) To compute and convert charity care, unreimbursed Medicaid, means-tested programs and bad debt charges to cost; a consistent GAAP (Generally Accepted Accounting Principles) based cost-to-charge ratio was used across all payers. Although the methodology was similar to Worksheet #2, for simplicity purposes certain immaterial values were omitted. Other benefits costs were reported at the actual expense incurred. Patients' receivable payments were recorded at time of receipt and related discounts were also recorded at actual amounts at the time of payment receipt. A separate GAAP based provision for estimated bad debts and discounts was recognized for accounts in process and pending adjudication and payment. The estimated portion was based on historical trends and adjusted to actual in future periods when the account's adjudication and payment occur. Accounts determined to be eligible for charity care were processed immediately for charity care discount with no collection effort. For accounts with insufficient information and documentation to determine charity care eligibility, the hospital consulted with a variety of alternative sources to help determine an individual's financial means (or lack of means) to pay. Based on related trends, the hospital further developed a general estimate of charity care which continued to reside within bad debts. Explanation of Medicare Cost Report Costing Methodology (Part III,line 8) The numerator (total expense) and denominator (total gross charges) of the simple ratio of patient care cost to charges is adjusted by eliminating non-patient care that generates other revenue, bad debt expense, Medicaid and other provider taxes and the total cost of community benefit activities and programs. Also, any gross patient charges for programs not relying on the ratio are eliminated from both the numerator and denominator of the ratio. These adjustments are designed to eliminate "double counting" of community benefit expenses. The resultant ratio aligns with Schedule H requirements. While the Medicare shortfall is not included in the form 990 community benefit reportable number, the cost of unreimbursed Medicare charges for CY11 was $3,741,423 (calculated using the stated method). As an Illinois-based hospital, we are required to report community benefits provided to the Office of the Attorney General by the Community Benefit Act of 2003. For that report, Illinois law defines governmental-sponsored indigent health care as the unreimbursed cost of Medicare, Medicaid and other Federal, State or local indigent care programs. To reduce public confusion caused by variations in our reports, for consistency, we have included the Medicare shortfall in all of our community benefit related reports. However, we do believe this is a community benefit because, as a hospital, we are stepping up to carry the burden of the government, assuring care to seniors, where 14.2% are 60 years of age or older in Champaign County alone. According to Family Service of Champaign County, in 2010, those 85 and older - the fastest growing demographic in the county - have experienced increasing costs over the past decade while living on fixed incomes determined 20 years ago. In CY 2011, 22.91% of Carle Foundation Hospital's patients were Medicare recipients. In CY 2011, inpatient Medicare cases that had a secondary plan code of Medicaid comprised 20% of total Medicare inpatient cases. Outpatient Medicare cases that had a secondary plan code of Medicaid comprised 15.50% of total Medicare outpatient cases. (Patients with Medicare Advantage as the primary payer are not included in these figures.) Debt collection practices (Part III-line 9b, Part V-B-19d) It is the responsibility of our patients to request and complete a Community Care Discount Program (CCDP) application. They are informed about Community Care on multiple occasions throughout the collection process. If a patient does not request or complete and return the application, then the balance is deemed his or her responsibility to pay. We presume eligibility for traditional Medicaid for homeless patients (based on current area shelters or Social Worker verification). Patients may apply for the CCDP at any time, including before care is received. Out of pocket medical expenses are limited to 40% of the patient's annual gross income if the patient is uninsured or underinsured and earns at or below 400% of the Federal Poverty Level. Once all applicable discounts have been applied, we make every attempt to work with the patient to set up payment arrangements on the remaining balance due. The current minimum is 5% or $25.00 a month. If they cannot meet these guidelines, our in-house collectors work with them to set up a temporary/short term payment arrangement until they can make the minimum payment. If they are unable to make payment on the remaining balance after the CCDP discounts, then the balance may be listed with the collection agency. When the account is still in-house, the minimum notifications are one collection letter, one phone call and monthly itemized statements. If a patient does not respond to us, then the account is final noticed (additional letter) and sent to the agency. Carle will not file collection suit liens on a primary residence, nor do we allow the collection attorneys to use "body attachments." The agencies are aware of our Community Care Discount Program and have been advised to refer the patients back to Carle if they deem the patient is unable to pay. We then make one more attempt to work with the patient to see if help is available. If Carle then determines that the patient might qualify, we send the patient a CCDP application and put a hold on the account listed with the agency for as long as we have determined necessary; the average is 60 days. If the patient is then approved for charity care, the balance is adjusted and then the account is closed. If they are approved for less than 100%, the adjustments are reported to the agency and the balance is left with the agency for collection. Text of the Community Benefit and Charity Care footnote in the Carle Foundation Hospital's Financial Statements (Part III, line 4) Carle Foundation Hospital is committed to providing quality health care to all, regardless of their ability to pay. Under the Foundation's charity care policy, patients meeting certain criteria receive care without charge or with a significant reduction in charges. Because the Foundation does not pursue collection of amounts identified as charity care, they are not reported in net patient service revenues. Charges forgone, based on established rates, totaled $96.5 million for the twelve months ended December 31, 2011. The forgone charges represent 5.6% of the gross patient service revenue. Management believes that the difference between the costs to provide care and the amounts actually received from the Medicaid program, including the net amounts received from the Hospital Assessment Program, should be considered charity care. Using the overall ratio of cost to charges, the costs exceed the reimbursement for the Foundation by $23.6 million for the twelve months ended December 31, 2011. This amount comprises 1.1% of gross patient service revenue. In addition to providing direct charity health services, Carle Foundation Hospital periodically conducts a comprehensive community needs assessment including active partnering with various community service organizations. The assessment helps identify areas of under-served and under-insured populations and further helps promote a common and joint approach to responding to identified community needs. The Hospital is a key financial supporter to the Frances Nelson Health Center, a federally qualified community health center, and also financially supports other health and educational service access for eligible at-risk populations. The Hospital plays a vital role in Champaign County's emergency preparedness and home land security initiatives. These are in addition to numerous other community health and wellness programs identified by the community needs assessment. 2. NEEDS ASSESSMENT Carle Foundation Hospital used existing data, informal discussions, and comprehensive qualitative community health needs assessment (CHNA) to determine if existing programs are on track; what needs to be added, deleted or enhanced; and where our focus needed to be placed in the future. This year the CHNA not only included secondary research (noted below), but also four focus groups conducted by an independent research firm, to query community leaders, human service agency administrators, and Carle Foundation Hospital leadership. These focus groups were conducted in Champaign, Vermilion, and Coles counties. Data was also drawn from these sources and used to affirm and re-shape our Community Benefit Plan for 2011 through 2013 as needed: * Robert Wood Johnson County Health Rankings, Feb. 2010 * County QuickFacts from the U.S. Census Bureau for Champaign, Coles & Vemilion counties * Hunger in America Study with participation by the Eastern Illinois Foodbank, Feb. 2010 * Current and future workforce shortage statistics * The Affordable Care Act: Opportunities for the Aging Network; A presentation by ECI Area n Aging, 2010 * Current statewide health reports * Poverty trends in Vermilion County, IL, August 2008 * Coles County Health Department IPLAN 2010-2015 * Homeland Security initiatives * Input from CU Public Health and Human service agencies (on-going) * A Senior Needs Assessment Focus Group, commissioned by Carle Foundation Hospital, September 2007. * Oral Health in Champaign-Urbana, IL, a review prepared by the CU Public Health District * Unanticipated opportunities or challenges in the local markets with respect to community health and wellness offerings. * Champaign County regularly conducts disaster preparedness committee meetings to plan for and practice community wide disaster preparedness. Taking these sources into account, the Community Benefit Plan is written to be aligned with the long-term strategic plan of the Hospital. Current community benefit priorities include: *Access to healthcare, which encompasses The Carle Community Discount Program (charity care) *Childhood obesity *Children-at-risk *Communications to foster outreach and collaboration *Maintenance of existing Carle community benefit programs. In every way, these activities and programs meet established community benefit criteria-but moreso, in every way contribute to a significantly healthier community. In 2011, our Community Benefit Plan, reflected the first year of a three-year plan and primarily addressed needs identified in the Champaign-Urbana area within the scope of the determined Plan priorities. It also included community building activities, as well as research and education initiatives-all of which were reviewed and confirmed through the annual budgeting process. 3.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Carle is acutely aware of the need for access to care, making that a mainstay of our community benefit program, with a strong charity care program that is based in a philosophy of doing the right thing for their community and patients and balanced by a careful stewardship of the community's resources. By focusing on determining the financial status of patients up-front, we have been able to pinpoint those needing financial assistance early in the process, minimizing bad debt and optimizing our ability to help them. Staff is also diligent in following up with patients during hospitalization and after discharge if there's any reason to believe the patient could benefit from charity care. Carle Foundation Hospital has made a concerted, continuous effort to be sure that people have access to information that will help them with their medical bills. These include: *Advertising to promote awareness of the Community Care Discount Program. This past year, we used radio, bus panels and outdoor billboards to advertise this service. We continued a presence in appropriate special event program booklets as well as utilizing messages on our onsite digital displays, static displays throughout the hospital, clinics and web sites. *Billing envelopes that carry this message prominently on the outside of the envelope: Need help with your medical bill? Call 888-479-0008. *All billing statements have messaging on the back of the statements regarding the availability of the CCPD. *Community Care application forms and brochures available at all inpatient and outpatient registration points, as well as in the Hospital's main lobby. These forms have also been translated into Spanish. *A simplified application form. *Packets including application forms, instructions and a checklist that are distributed to area free clinics and FQHCs. *Information and application forms are easily found and accessed at www.carle.org. *Staff at Frances Nelson Health Center, the local FQHC and free clinics have a supply of application forms and have been trained to assist their patients in completing them. *Informational meetings are held with local legislators to help assist constituents with healthcare needs, including financial assistance. *All collection letters indicate the availability of the Community Care program. *Hospital admission packets contain information regarding Community Care. *We meet with our own staff to keep them informed about the program and what benefits are available to patients. *Community Care representatives are available at various community events. 4. COMMUNITY INFORMATION Targeted populations include the uninsured and underinsured, and children at risk-from conception through childhood. Carle's service area is generally defined as east central Illinois, including all or parts of more than 25 counties in east central Illinois and western Indiana. For the 2011 plan, research and remedies are directed towards community health issues identified in Champaign, Coles and Vermilion counties, with the primary focus being on Champaign County. These areas represent our headquarters and two other counties where Carle has a thriving presence. Our reach extends from these three counties-also identified in this report as Champaign-Urbana (Champaign County), Mattoon-Charleston (Coles County) and Danville (Vermilion County) areas into 14 adjoining, rural Illinois counties. These areas comprise nearly 50% of the Carle service area's population of about 1.2 million residents. And the three core counties represent about 25% of the total service area population. Pockets of extreme poverty exist throughout this region. The programs within our community benefit plan generally have impact upon all of these targeted communities, with certain programs directed at specific communities and populations. Generally, targeted populations include the uninsured and underinsured, and children-at-risk-from conception through childhood. In 2011, a greater proportion of our resources were spent in Champaign County, where the largest population in our service area resides and where our community benefit program has long been established. Carle Foundation Hospital serves as the region's only Level I Trauma Center and maintains a 42-bed Level III Neonatal Intensive Care Unit, comprised of 25 NICU and 17 step-down beds. As provider of the region's Level III perinatal services, Carle provides care to patients who live throughout the area extending from Kankakee to the southern-most tip of Illinois, and spanning from as far west as Decatur into western Indiana. For the purposes of our Community Care Discount Program, coverage encompasses this entire region-40 counties in Illinois and Indiana. Qualifying trauma patients, regardless of their place of residency, are covered for their trauma care, hospitalization, and follow-up care. 5.PROMOTION OF COMMUNITY HEALTH Carle Foundation Hospital has an open medical staff and is governed by a community board. Surplus funds are reinvested into the organization for technology replacement and advancement, building renovation or construction, clinical service expansion and quality improvement. Surplus funds are also invested into our communities to meet identified health needs which contribute to the overall well-being of the residents of the communities we serve. Because the needs are great and varied and it would be unreasonable to address each and every identified need, we set priorities and use our resources to focus primarily on identified needs within the community benefit priorities set. Many of these needs are addressed through partnerships and collaborative efforts. Our progress is shown below and presented with the respective community benefit priority: Community Benefit Priority: -Additional Access to Care Programming Financial and leadership support of community programs has been central to providing access to primary, dental, preventive, and mental health services. Carle has identified and sought ways to initiate and expand healthcare services for the underinsured and uninsured by working collaboratively with community organizations and leaders. A. Free Clinic Support Champaign County Christian Health Center - $59,000 As the lead funder of the Champaign County Christian Health Center, Carle helps the free health clinic fulfill its mission to provide quality, holistic care at no cost to as many people as possible during hours limited only by the availability of volunteer healthcare providers and the energy of three part-time paid administrative staff. They provide primary care, dental and mental health services, with 1,044 patient visits and 498 new patients served in CY 11. A significant number of the volunteer medical staff is Carle physicians, nurses and techs who have personally chosen to serve their community through the Champaign County Christian Health Center. Carle has continued to cover the facility's rent-$40,000 per year-as well as provide substantial support for operations. Since this clinic's inception in 2003, Carle has provided nearly $324,000 to help maintain this small clinic that provides huge benefits to people who are underinsured or uninsured. Avicenna Carle also supports the activities of Avicenna, a local Muslim-based clinic that provides free care to all. Avicenna currently uses the Christian Health Center space on weekends. Carle also works with them so they can access specialty care as well as lab results for their patients. B. Frances Nelson Health Center - $95,608 We also continued to financially support and provide leadership to Frances Nelson Health Center, a Federally Qualified Health Center. *In 2005, in concert with a community effort, Carle Foundation Hospital purchased a former furniture store in Champaign, renovated it for $1.2 million, provided free rent for three years and continued to support the operations of the facility: The Hospital continues to pay utilities and operating costs associated with the facility's maintenance, cleaning and security, which totaled $58,331 in CY11. As always, some of the more expensive medications were provided. This year, the facility required improvements due to wear and tear, bringing the total to $80,274. Carle also pays the property taxes. *Carle's All About Baby staff regularly provides prenatal, breastfeeding and newborn care education at the clinic. They also offered a teen pregnancy program. Cost of these programs totaled $14,333. *Carle Family Medicine residents provide obstetrical care. C. Community Dental Initiative for Adults and Children Frances Nelson Dental Center - $102,175 Carle Foundation Hospital made a significant contribution towards renovation of space within the Frances Nelson Health Center facility for a newly-opened community dental center that's making access to adult and senior dental services a reality, having opened in October 2011. Meanwhile, we continue to provide leadership and support to this community dental initiative headed by United Way of Champaign County. Carle leadership played an important role on the Community Dental Initiative Coalition, with their time valued at $1,858. And Carle covered some of the costs associated the public open house-$317-as well. SmileHealthy for Mobile Dental Care - $26,808 Prior to the opening of the Dental Center within Frances Nelson Health Center, an interim, mobile service was housed on the Urbana Carle Medical Campus, serving uninsured adults, as well as children. Cost to provide the space was $26,808. D. Providing Access to Care through Subsidized Services Over the years, multiple Carle initiatives have provided additional access to care. Because these services continue to meet an enormous need, these programs have been maintained, even though several of them operate at a loss: AirLife; HomeMeds, a medication management program for seniors; free health screenings; Low Vision Center; Neonatal Intensive Care Unit; Patient Advisory Nurse, ECHO (Expanding Children's Hearing Opportunities-Pediatric Hearing Services); free and discounted prenatal and family education; free sports injury evaluations and discounted Sports Medicine coverage at local and area school sporting events; Carle's Community Parish Nurse Program; and the Carle Breastfeeding Clinic. *The Community Parish Nurse Program-designed to train nurses from local and regional churches to educate congregants and to advocate for their healthcare interests. Tuition costs are minimal. In 2011, 18 RNs completed our training program. This program is one of the largest in the nation, with 454 total nurses trained to provide service to 223 congregations in 31 counties and three states. Altogether, they logged over 7,000 hours of volunteer services to their congregations. *The Carle Breastfeeding Clinic -the certified lactation specialists with Carle's Breastfeeding Clinic have been helping thousands of women successfully breastfeed and manage challenges along the way since 1997. This service is free and available to any nursing mother, regardless of where they receive care. Located at Carle Foundation Hospital, and now at clinics in Champaign and Urbana, the Breastfeeding Clinic operates a 24/7 pager service where breastfeeding mothers can call in with questions or concerns around-the-clock. During Carle's fiscal year 2011 there were 7,060 visits to the hospital-based, urban clinic, including 2,644 walk-ins. Staff also responded to 2,463 call requests for assistance. At the two Carle regional outpatient facilities, they had 475 visits during their first month opening. Community Benefit Priority: -Children-at-Risk Child Safety Programs and other Activities (some also involving adults) which focus on reducing unintentional injury and accidental deaths. *Playing It Safe-in its 15th year of bringing together public safety and other safety-minded organizations and agencies to teach children and their families how to prevent unintentional injuries, this free safety fair-co-sponsored with Safe Kids Champaign County-involved more than 50 interactive displays, stage presentations and points of interest. Attendance was remarkably high with more than 1,800 children and parents present. *Center for Rural Health and Farm Safety-the Center for Rural Health and Farm Safety at Carle accomplished a record-setting year during its 20th anniversary year, 2011. Carle formed the Center after recognizing the need to provide education on agricultural safety and health to both children and adults in the farming community. All programs remain free to those in Carle's service area. -Of the nearly 5,000 people trained in 2011, more than 3,500 were children. Last year, the Center reached more than 2,000 youth in surrounding rural communities through 31 school programs-the highest number ever achieved annually in Carle history. In addition, 995 children were reached at Progressive Ag Safety Days, coordinated by Carle and hosted in Vermilion, Piatt and Ford Counties. -The Center also certified more than 600 adults (14 years and older) in CPR and first aid last year. -Five emergency responder training courses included Agricultural Emergency Response classes as well as tractor rollover and grain entrapment sessions and involved 89 participants. *An innovative program-Emergency Action Tubes-was launched in 2010 to protect farmsteads and aid emergency responders. The Center placed sealed plastic cylinders with detailed farm info and maps on an additional 31 farms in 2011, bringing the number of protected farmsteads to 39. *Interpersonal Violence Program-provides community education with a focus on reducing domestic violence as well as training for Sexual Assault Nurse Examiners (SANE) and others who treat rape and abuse victims. Carle has nine SANE nurses in the Emergency Department, assisting approximately 115 adult/adolescent and pediatric sexual assault patients this year. *Carle PROMOTION OF COMMUNITY HEALTH (CONTD) Community Benefit Priority: -Childhood Obesity The newest addition to our community benefit plan is an effort to join the fight against childhood obesity, first by joining with schools which have shown an interest in helping their students and families to live a healthier lifestyle through better nutrition and physical activity. During CY 11, Carle donated $2,500 to each school to boost their existing programs. Late in 2011, we began an initiative, at the request of the schools, to provide a customized, monthly health and wellness-related article featuring Carle expertise. These articles were provided to each school monthly for distribution in their PTA newsletters. In Champaign County, we partnered with Booker T. Washington STEM Academy (BTW), a Champaign School. In collaboration with the Champaign-Urbana Public Health Department, we teamed with a parent-teacher committee to create a plan which complemented what the school's leadership had already put into place. The multi-faceted program was kicked off in the spring of 2011 with baseline testing-BMI assessments and a food quiz. We also connected BTW's leadership with the principal of Northeast Elementary Magnet School in Danville, our partnership school in Vermilion County. Northeast has been recognized for its health and wellness program with a gold award from the Healthy Generations, a national organization headed by former President Bill Clinton. In Vermilion County, we continued our partnership with Northeast Elementary Magnet School. Our progress is reported later on in this report where we focus on community benefit provided to Vermilion and Coles counties. Community Benefit Priority: -Communications to Foster Outreach and Collaboration Carle has been active in facilitating community engagement and collaboration to connect, update, and expand existing databases and technology currently available to assist agencies, social workers, clergy, healthcare providers, and family members with referrals for their clients, patients and loved ones. *www.HelpSource.org-taking a leadership role in its development more than 11 years ago, we have continued to support HelpSource.org and provide guidance to the maintenance and promotion of this on-line directory of human services resources in east central Illinois. *Created the Community Communications Coalition (C-3) to convene area leaders in human service agencies to discuss how existing resources could be enhanced to include more information, reach more people and to incorporate social media technology. *Continued following updates on the status of 2-1-1- in Illinois and our region, and began considering the impact on activities of the Communications Coalition as well as HelpSource. Community Benefit Priority: -Carle Community Benefit Programs Maintained There are a host of other programs identified in earlier years that have been clearly answering the needs of our community which Carle continues to stand behind, support, and monitor to meet our obligation as a not-for-profit charitable organization. Besides maintaining the Carle Community Care Discount Program and serving Medicaid and Medicare patients, even though government reimbursement is typically below our costs, we continue to focus on the additional major categories of existing, identified health needs that Carle has consistently addressed over the years: Subsidized health services, initiated and maintained to improve the health of the community *AirLife *Carle Breastfeeding Clinic *Carle Community Parish Nurse Program *Carle Low Vision Center *ECHO (Expanding Children's Hearing Opportunities-Pediatric Hearing Services) *Carle Auditory Oral School *Home health services *Neonatal Intensive Care Unit *Patient Advisory Nurse *Pulmonary Rehabilitation Funding programs and shortages This represents a significant portion of our financial, in-kind, and leadership support of health and human service organizations with similar/compatible missions. *The new Stephens Family YMCA in Champaign County was the recipient of an 11-acre land transfer valued at $1,704,401 for construction of this modern, replacement facility which includes Larkin's Place, a recreational area dedicated to the health, wellness and fitness needs of children with all levels of abilities. Included in the donation value was approximately $200,000 in costs related to engineering, permit and water retention at the site. *Seventy-six additional community organizations received support. Some of those are: - Alzheimer's Association - American Diabetes Association - Arthritis Foundation - Camp Kesem (for children who have a parent with cancer) - Champaign County CASA - Champaign County YMCA - Coles County Council on Aging - Coles County Crisis Response Team - Community Elements - Cunningham Children's Home - Danville Rescue Mission - Developmental Services Center - Eastern Illinois Food Bank - Faith in Action - Faith United Methodist Church Christmas Meal Program - Make a Wish Foundation - Muscular Dystrophy Association - United Way-$158,105 *$138,177: Carle's corporate campaign contribution was $115,000 plus an additional $8,558 in fundraising. Campaign expenses and staff time are also included. *$4,558: Carle's corporate contribution to Stuff the Bus, a one-day event where supplies are gathered for distribution to clients through various human service agencies. *$15,370: Miscellaneous contributions throughout the year for various purposes. Health professions education/workforce development Through a variety of activities including significant donations, scholarship programs, and physician, nurse, and allied health education, more than $7.3 million was invested in programs that address community-wide workforce issues, strengthening the training and availability of professionals to care for our communities' healthcare needs now and in the near and distant future. In CY 11, the most significant contributions went towards these programs: *Graduate Medical Education programs. Maintaining a geriatric fellowship and five medical residency programs, including a general surgery residency program, and serving as a clinical site for a sixth. There were 31 residents practicing on Carle's campus in CY 11. *Continuing Medical Education programs for regional providers who are not members of the Carle Foundation Hospital medical staff, including Carle Foundation Day. *Support of the University of Illinois College of Medicine at Urbana-Champaign, with monies earmarked for the MD/PhD program. Research Carle Foundation Hospital is actively involved in research and education initiatives. The overall purpose of the research program is helping to discover new diagnostic and treatment modalities that will improve the delivery and/or quality of health care. The research program is predominantly in conjunction with Carle physicians and University of Illinois scientists, and entrepreneurial companies. Emphasis has been on continuing to create an infrastructure for a robust research program, including: *Setting up a research component of the electronic medical record system that allows for the identification of patients involved in research and assures that billing for the research is accurate and in alignment with all regulatory requirements. *Implementing a central clinical trials management system for optimal tracking of studies and subjects, and As of December 2011, the Carle Research Institute had 126 active research studies, with another 21 research studies pending. Of the total of 147 studies, the breakdown of studies into various areas was 23 translational, 30 investigator-initiated, 29 nursing, 17 clinical trials, and 37 residency program and student research studies. Reaching out to Vermilion and Coles Counties While the focus of the first year (2011) of our three-year plan is primarily on community benefits geared towards Champaign County (donations excluded), here are some of the ways we extended community benefit activities to the residents of Vermilion and Coles County: Access to Care: In Vermilion County: *We began collaborative talks with Provena United Samaritan Hospital in Danville to reduce the number of low birth weight babies born at Provena USMC to 2008 levels In Coles County: *We continued to provide Board leadership to the Coles County Community Health Center and also made a $5,000 annual pledge with a three-year commitment, beginning in 2012. *We are taking steps to strengthen mental health services for adults and children in Coles County. Last year we began to explore having additional mental health providers at our clinic, in the same building as the referring physicians-for a more private venue-and with crisis-sensitive access for the patient. We gave consideration to hiring a masters-prepared social worker at Carle Foundation Physician Services -Mattoon to be on site and immediately intervene with patients with mental health issues, but we put that position on hold. We also maintain a presence on the LifeLinks board. C SCHEDULE H, PART V- B, LINE 19 STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI IL, true YMCA 2501 Fields South Dr Champaign IL 61822 370673564 501c3 1704401 Building site University of Illinois 506 S Mathews Ave Urbana IL 61801 376000511 501c3 1309908 Scholarships & Sponsorships United Way of Champaign County 404 W Church St Champaign IL 61820 370662519 501c3 211640 Campaign Parkland College Foundation 2400 West Bradley Ave Champaign IL 61821 370892090 501c3 163000 Scholarships & Sponsorships Champaign County Christian Health PO Box 1400 Champaign IL 61824 562421584 501c3 79220 OPERATIONS AND FACILITIES Land of Lincoln Legal Assistance Fndn 302 SOUTH FIRST ST Champaign IL 61820 370958448 501c3 30000 Volunteer Stipend Vermilion County Advantage 28 W Norht St Danville IL 61832 370238000 501c3 17110 Membership, program support Smile Healthy PO Box 154 Champaign IL 61824 141880824 501c3 10000 CENTER ASSISTANCE Don Moyer Boys & Girls Club 201 East Park St Champaign IL 61820 370906638 501c3 9450 Boys and girls program support Mahomet Area Youth Club 601 E Franklin St Mahomet IL 61853 810615577 501c3 8000 Program support 11 Form 990, Schedule I Description of Organization's Procedures for Monitoring the Use of Grants The majority of the requests for funding are to The Carle Foundation or its affiliates located in the communities we serve. Any charitable organization wishing to request funds is asked to submit their request in writing. Emailed requests are acceptable. The request must include a description of the purpose of the contribution and other relevant information such as requestors name, amount of the request, etc. The requests are reviewed, evaluated, and administered by the public relations director, seeking additional information from the requestor, as needed, and input from any appropriate Carle administrator or director. A set of established guidelines drive these decisions, and most are made to improve healthcare/access to healthcare or are in line with our role as a corporate citizen. Assessed need is a common criteria. In the case of most donations of $5,000 or more, such as to colleges and universities or community clinics, written agreements are in place and we have regular, casual contact with those organizations, oftentimes through a Carle contact person to assure that the donations are being used as agreed upon. Records are maintained either in administration or public relations. true false false false false false false false false Cora E Musial Phd MD 0 185965 0 0 0 18973 0 31336 0 4418 0 240692 0 0 Mathew Gibb MD 0 785511 0 0 0 102779 0 28756 0 3971 0 921017 0 0 Paul Tender MD 0 436180 0 0 0 57642 0 19051 0 10243 0 523116 0 0 James C Leonard MD 0 811190 0 165375 0 63770 0 229762 0 16659 0 1286756 0 0 R Bruce Wellman MD 0 664501 0 116375 0 24704 0 216931 0 10064 0 1032575 0 0 John Snyder 0 517644 0 76197 0 46197 0 142807 0 18004 0 800849 0 0 Dennis Hesch 0 420264 0 62125 0 27697 0 120254 0 18850 0 649190 0 0 Philip Kubow 0 319403 0 37333 0 51449 0 79214 0 16276 0 503675 0 17401 Pamela Bigler 0 244781 0 22750 0 21007 0 62783 0 4134 0 355455 0 0 Lynne Barnes 0 232635 0 20125 0 7511 0 55228 0 2040 0 317539 0 0 Stephanie Beever 0 226358 0 17561 0 2638 0 52693 0 17308 0 316558 0 0 Mark Berlin 0 196419 0 18812 0 19109 0 55161 0 19503 0 309004 0 0 Dawn Walden 0 223334 0 0 0 6689 0 33905 0 16904 0 280832 0 0 Diane Wasson term 2911 21803 0 8825 0 176524 0 1020 0 1958 0 210130 0 0 0 Gregory Puszkiewicz term 7111 84003 0 9500 0 110567 0 9374 0 12858 0 226302 0 0 0 Vijay Bavda 174991 0 324 0 669 0 13418 0 13900 0 203302 0 0 0 Cynthia Gordon 173779 0 294 0 101 0 13979 0 10075 0 198228 0 0 0 Robert Tonkinson 0 6220 0 0 0 303713 0 0 0 0 0 309933 0 122321 Linda Fred 151181 0 11173 0 2700 0 13109 0 19669 0 197832 0 0 0 Supplemental Compensation Information FORM 990, SCHEDULE J, PART 1, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF THE CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. FORM 990, SCHEDULE J, PART 1, QUESTION 4A THE FOLLOWING THREE EMPLOYEES RECEIVED THE NOTED AMOUNT OF SEVERANCE PAY DURING CALENDAR YEAR 2011; ROBERT TONKINSON- $209,809, DIANE WASSON- $156,816 AND GREGORY PUSZKIEWICZ- $79,630. FORM 990, SUPPLEMENTAL INFORMATION FORM 990, PART VI, QUESTION 2 TRUSTEES E. PHILLIPS KNOX AND DAVID IKENBERRY HAD A BUSINESS RELATIONSHIP FORM 990, PART VI, QUESTION 6 CARLE FOUNDATION HOSPITAL HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. FORM 990, PART VI, QUESTION 7A CARLE FOUNDATION HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PART VI, QUESTION 7B CARLE FOUNDATION HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH IT'S BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF THE CORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $100,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; AND THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED. FORM 990, PART VI, QUESTION 11 THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY BY POSTING TO THE ORGANIZATION'S DIRECTOR COMMUNICATION PORTAL. ALSO BEFORE FILING, THE GOVERNING MEMBERS RECEIVED NOTIFICATION THAT THE FORM 990 WAS POSTED AND AVAILABLE FOR THEIR REVIEW. AS NECESSARY, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. FORM 990, PART VI, QUESTION 12C THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS RELATED TO THEIR CONFLICTS. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH CONFLICTS OF INTEREST. FORM 990, PART VI, QUESTION 15A & 15B Carle Foundation Hospital does not compensate its officers and key employees. These individuals are compensated by The Carle Foundation. THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS REVIEW INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. FORM 990, PART VI, QUESTION 19 THE CARLE FOUNDATION, THE PARENT COMPANY OF CARLE FOUNDATION HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. A COMMUNITY BENEFIT REPORT IS ALSO PUBLISHED AND DISTRIBUTED ANNUALLY TO THE COMMUNITY. QUARTERLY FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. PART VII, SECTION A, COLUMN B THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK. FORM 990, PART XI, LINE 5 THE CARLE FOUNDATION HOSPITAL SETTLED VARIOUS INTERCOMPANY RECEIVABLE/PAYABLE BALANCES THROUGH EQUAL OFFSETTING EQUITY TRANSFERS. THE INTERCOMPANY RECEIVABLE/PAYABLE BALANCE RESULTED FROM THE NORMAL COURSE OF OPERATIONS AND WERE PRIMARILY ATTRIBUTABLE TO CENTRALIZED CASH MANAGEMENT AND DISBURSEMENT ACTIVITIES. THESE INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS HELPED PROVIDE SUPPLEMENTAL FUNDING FOR CERTAIN RELATED ORGANIZATIONS TO FURTHER THEIR EXEMPT PURPOSES. Equity transfers (to)/from affiliates (49,567,000) Rounding (403) Net income - CRIMCO 32,063 Net other changes in net assets or fund balances (47,535,340) FORM 990, PART XII, #2A,B,C AND PART IV, LINE 12,12A THE FINANCIAL STATEMENTS FOR CARLE FOUNDATION HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION DOES HAVE AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. FORM 5471 FILING REQUIREMENTS CARLE FOUNDATION HOSPITAL (CFH) EIN 37-1119538 FORM 5471 FILING REQUIREMENTS HAVE BEEN SATISFIED. CFH CONSTRUCTIVELY OWNED A CONTROLLED FOREIGN CORPORATION IN 2011 THROUGH ITS PARENT THE CARLE FOUNDATION EIN 37-0673465. PURSUANT TO IRS SECTION 6038, THE 2011 CONTROLLED FOREIGN CORPORATION FILING REQUIREMENT OF CFH WAS FULFILLED ON THE 2011 FORM 5471 FILED ON ITS BEHALF BY THE CARLE FOUNDATION. RETURN WITH WHICH THE REQUIRED INFORMATION WAS FILED: THE CARLE FOUNDATION 2011 FORM 990-T EIN 37-0673465 611 WEST PARK URBANA, IL 61801 THE 2011 FORM 5471 WAS FILED WITH THE CARLE FOUNDATION 2011 FORM 990-T. IRS SERVICE CENTER WHERE THE RETURN WAS FILED - OGDEN, UTAH. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Phillip Blankenburg TITLE:Chairman of Board HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Donna Greene TITLE:Vice Chairman of Board HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Cora E. Musial, Phd MD TITLE:Secretary of Board HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mathew Gibb, MD TITLE:Trustee HOURS:29 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Michael Martin TITLE:Trustee HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Marty Smith TITLE:Immediate Past Chair HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Paul Tender, MD TITLE:Trustee HOURS:30 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David Ikenberry, Phd TITLE:Trustee (through 9/15/11) HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:E. Phillips Knox TITLE:Trustee (through 9/15/11) HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James C. Leonard, MD TITLE:ex-officio, President/CEO HOURS:29 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:R. Bruce Wellman, MD TITLE:ex-offico, Trustee HOURS:21 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John Snyder TITLE:EXEC VP, COO HOURS:25 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dennis Hesch TITLE:Exec VP & CFO HOURS:24 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Philip Kubow TITLE:SVP Human Resources HOURS:22 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Pamela Bigler TITLE:Chief Nursing Officer HOURS:15 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lynne Barnes TITLE:VP Hospital Operations HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mark Berlin TITLE:VP-Surgical Spec HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dawn Walden TITLE:VP-Revenue Cycle Ops HOURS:21 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Stephanie Beever TITLE:VP Strat Devl & Diag Svces HOURS:20 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Linda Fred TITLE:Inpt Pharm Director HOURS:16 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Tonkinson TITLE:SVP & CFO-former HOURS: The Carle Foundation 611 W Park St Urbana IL 61801 370673465 Parent/Invest IL 501(c)(3) 11b Type II na false Carle Development Foundation 611 W Park St Urbana IL 61801 371159978 Fundraising IL 501(c)(3) 7 TCF true Carle Health Care Incorporated 611 W Park St Urbana IL 61801 371140016 Var svcs IL 501(c)(3) 9 TCF true Carle Retirement Centers Inc 611 W Park St Urbana IL 61801 371160033 RTRMT LIVING IL 501(c)(3) 9 TCF true Carle Community Health Corp 611 W Park St Urbana IL 61801 364458371 FDN MISSION IL 501(c)(3) 11a, Type I TCDF true Health Systems Insurance LIMITED GOVERNORS SQ 2ND FL BLDG 3 Grand Cayman CJ KY1-1102 Insurance CJ na C-CORP Carle Holding Company Inc 611 W Park St Urbana IL 61801 371188284 HOLDING COMPANY IL tcf C-CORP Carle Risk Management Co 611 W Park St Urbana IL 61801 371217973 Risk management IL tcf c-corp 31628 54571 1.00000 false false true false false false false false true true true true false false true true false false Carle Community Health Care c 2618160 COST Carle Development c 449575 COST Carle Health Care Incorporated k 861687 COST Carle Health Care Incorporated l 8794559 COST Carle Health Care Incorporated p 67554 COST Schedule R, Supplemental Information SCHEDULE R, PART II CARLE HEALTH CARE INCORPORATED PRIMARY ACTIVITY: EMERGENCY TRANSPORT, DAY CARE, PHYSICIAN SERVICES.