HOOPESTON COMMUNITY MEMORIAL HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: HOOPESTON COMMUNITY MEMORIAL HOSPITAL (EIN 36-3637465)
Tax period: 2010-10-01 to 2011-09-30
Filed: 2012-07-30
IRS object ID: 201222129349300907
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 D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-07-30T14:13:10-05:00	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	ECK SCHAFER & PUNKE LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	600 East Adams Street	AddressLine1
City	Springfield	City
State	IL	State
ZIP Code	627011624	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	363637465	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HOOPESTON COMMUNITY MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HOOP	NameControl
Phone	2172835531	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 E ORANGE STREET	AddressLine1
City	HOOPESTON	City
State	IL	State
ZIP Code	60942	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RUSS LEIGH	Name
Title	PRESIDENT	Title
Phone	2172835531	Phone
Date Signed	2012-07-20	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Brent Leach	Name
Phone	2175251111	Phone

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	RUSS LEIGH	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	701 E ORANGE STREET	AddressLine1
City	HOOPESTON	City
State	IL	State
ZIP Code	60942	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	24805531	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.hoopestonhospital.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1962	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	PROVIDE ACUTE AND SKILLED NURSING CARE FOR RESIDENTS OF HOOPESTON AND THE SURROUNDING AREAS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	306	TotalNbrEmployees
Total Nbr Volunteers	15	TotalNbrVolunteers
Total Gross UBI	25673	TotalGrossUBI
Net Unrelated Business Txbl Income	2993	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1005	ContributionsGrantsPriorYear
Contributions Grants Current Year	104672	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	21077296	ProgramServiceRevenuePriorYear
Program Service Revenue CY	24553662	ProgramServiceRevenueCY
Investment Income Prior Year	110256	InvestmentIncomePriorYear
Investment Income Current Year	84055	InvestmentIncomeCurrentYear
Other Revenue Prior Year	86386	OtherRevenuePriorYear
Other Revenue Current Year	63142	OtherRevenueCurrentYear
Total Revenue Prior Year	21274943	TotalRevenuePriorYear
Total Revenue Current Year	24805531	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	9918245	SalariesEtcPriorYear
Salaries Etc Current Year	11117034	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	11304574	OtherExpensePriorYear
Other Expenses Current Year	12888426	OtherExpensesCurrentYear
Total Expenses Prior Year	21222819	TotalExpensesPriorYear
Total Expenses Current Year	24005460	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	52124	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	800071	RevenuesLessExpensesCY
Total Assets BOY	17546086	TotalAssetsBOY
Total Assets EOY	20060737	TotalAssetsEOY
Total Liabilities BOY	11684286	TotalLiabilitiesBOY
Total Liabilities EOY	13723855	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	5861800	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	6336882	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE ACUTE AND SKILLED NURSING CARE FOR RESIDENTS OF HOOPESTON AND THE SURROUNDING AREAS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	19265948	Expense
Revenue	24553662	Revenue
Description	PROVIDE ACUTE INPATIENT AND OUTPATIENT HEALTHCARE SERVICES AND LONG TERM HEALTH CARE SERVICES	Description
Total Program Service Expense	19265948	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	1	EscrowAccount
On Behalf Of Issuer	1	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	20	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	306	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	KEN FOZDAR CONTROLLER	NamePerson
Telephone Number	2172838487	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	701 E ORANGE	AddressLine1
City	HOOPESTON	City
State	IL	State
ZIP Code	60942	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
RUSS LEIGH
PRESIDENT	1.00	X	X	0	0	0
RICHARD READ
VICE-PRESIDENT	1.00	X	X	0	0	0
LYNN GALLOWAY
SECRETARY/TREASURER	1.00	X	X	0	0	0
KARLA COON
DIRECTOR	1.00	X		0	0	0
LONI GRESS
DIRECTOR	1.00	X		0	0	0
TODD HARRIS
DIRECTOR	1.00	X		0	0	0
GREG LANE
DIRECTOR	1.00	X		0	0	0
ED LAYDEN JR
DIRECTOR	1.00	X		0	0	0
DAVE MCFADDEN
DIRECTOR	1.00	X		0	0	0
HANK HORNBECK
DIRECTOR	1.00	X		0	0	0
ANGELA TOTHEROH
DIRECTOR	1.00	X		0	0	0
JAY COLBERT MD
PHYSICIAN	40.00			274237	0	0	X
CHASE DANIEL
PHYSICIAN	20.00			162098	0	0	X
DENNIS PRICE
PHYSICIAN ASST	40.00			143206	0	0	X
WILLIAM MCCARTHY
PHYSICIAN	40.00			163885	0	0	X
DENNIS BIRKY
PHYSICIAN	40.00			148040	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	891466	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	5	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
CARLE FOUNDATION HOSPITAL
610 W PARK STREET	URBANA	IL	61801	PROFESSIONAL SERVICES	1586548
HEALTH ALLIANCE MEDICAL PLANS
301 S VINE	URBANA	IL	61801	HEALTH INSURANCE	1329113
HOOPESTON ER MEDICAL SPECIALISTS
6948 Windsor Ave	BERWYN	IL	60402	ER & HOSPITALIST DOCTORS	1038000
WRIGHT MEDICAL TECHNOLOGY
PO BOX 503842	ST LOUIS	MO	63150	MEDICAL/SURGICAL SUPPLIES	699573
SIGHTPATH MEDICAL
5775 W OLD SHAKOPEE ROAD SUITE 90	BLOOMINGTON	MN	55437	MEDICAL/SURGICAL SUPPLIES	523077

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	26	NumberOfContractorsGT100K
All Other Contributions	104672	AllOtherContributions
Total Contributions	104672	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES	621990	23918176	23918176
OTHER	900099	635486	635486

Field	Value	IRS element (for citing)
Total Program Service Revenue	24553662	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	84055	TotalRevenueColumn
Exclusion	$84,055	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	10564	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	10564	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	10564	TotalRevenueColumn
Exclusion	$10,564	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	CAFETERIA	Description
Business Code	722320	BusinessCode
Total Revenue Column	52578	TotalRevenueColumn
Unrelated Business Revenue	25673	UnrelatedBusinessRevenue
Exclusion	$26,905	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	52578	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	24805531	TotalRevenueColumn
Related Or Exempt Function Income	24553662	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	25673	UnrelatedBusinessRevenue
Exclusion	$121,524	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	9158883	Total
Program Services	7488745	ProgramServices
Management And General	1670138	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	60471	Total
Program Services	45467	ProgramServices
Management And General	15004	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1262354	Total
Program Services	985039	ProgramServices
Management And General	277315	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	635326	Total
Program Services	515960	ProgramServices
Management And General	119366	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	373056	Total
Management And General	373056	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	144080	Total
Management And General	144080	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	68056	Total
Management And General	68056	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2381721	Total
Program Services	2364670	ProgramServices
Management And General	17051	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	164421	Total
Program Services	138719	ProgramServices
Management And General	25702	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1867932	Total
Program Services	1026120	ProgramServices
Management And General	841812	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	239426	Total
Management And General	239426	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	123230	Total
Program Services	86568	ProgramServices
Management And General	36662	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	56507	Total
Program Services	49578	ProgramServices
Management And General	6929	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	566015	Total
Program Services	459426	ProgramServices
Management And General	106589	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	792870	Total
Program Services	636155	ProgramServices
Management And General	156715	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	452502	Total
Program Services	447589	ProgramServices
Management And General	4913	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
DRUGS AND OTHER SUPPLIE	2761476	2608024	153452
BAD DEBTS	1931978	1931978
PURCHASED SERVICES/PROF	965156	481910	483246

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	24005460	Total
Program Services	19265948	ProgramServices
Management And General	4739512	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
EOY	817551	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2190787	BOY
EOY	2631148	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	232022	BOY
EOY	245659	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	53597	BOY
EOY	153488	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	19227843	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	7521761	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	9161303	BOY
EOY	11706082	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1678639	BOY
EOY	539925	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	4229738	BOY
EOY	3966884	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	17546086	BOY
EOY	20060737	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2880764	BOY
EOY	3383515	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	8551776	BOY
EOY	9851548	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	251746	BOY
EOY	488792	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	11684286	BOY
EOY	13723855	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2314936	BOY
EOY	2771484	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3546864	BOY
EOY	3565398	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5861800	BOY
EOY	6336882	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	17546086	BOY
EOY	20060737	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	800071	ReconcilationRevenueExpenses
Reconcilation Other Changes	-324989	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	295000	OtherCostOrOtherBasis
Book Value	295000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	10431604	OtherCostOrOtherBasis
Depreciation	4090622	Depreciation
Book Value	6340982	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	264490	OtherCostOrOtherBasis
Depreciation	168835	Depreciation
Book Value	95655	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4569031	OtherCostOrOtherBasis
Depreciation	3262304	Depreciation
Book Value	1306727	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3667718	OtherCostOrOtherBasis
Book Value	3667718	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	11706082	TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
BENEFICIAL INTEREST IN PERPETUAL TRUST	3565398
DEFERRED FINANCING COSTS	291486
ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS	110000

Field	Value	IRS element (for citing)
Total Book Value Other Assets	3966884	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
ASSET RETIREMENT OBLIGATION	$135,779
ESTIMATED AMOUNTS DUE TO THIRD-PARTY PAYERS	$353,013

Field	Value	IRS element (for citing)
Total Of Amounts	488792	TotalOfAmounts
Total Revenue	24805531	TotalRevenue
Total Expenses	24005460	TotalExpenses
Excess Or Deficit For Year	800071	ExcessOrDeficitForYear
Net Unrealized GL On Investments	3353	NetUnrealizedGLOnInvestments
Other	-$328,342	OtherAmount
Total Adjustments	-324989	TotalAdjustments
Excess Or Deficit Per FS	475082	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	24808884	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	3353	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	3353	RevenueNotRptdF990
Revenue Subtotal	24805531	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	24805531	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	24352336	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	346876	OtherExpensesIncluded
Expenses Not Rptd F990	346876	ExpensesNotRptdF990
Expenses Subtotal	24005460	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	24005460	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:	Part X:	The Center follows accounting principles generally accepted in the United States of America related to the accounting for uncertainty in income taxes which sets a minimum threshold for financial statement recognition of the benefit of a tax position taken or expected to be taken in a tax return. Tax positions for the open tax years as of September 30, 2011 were reviewed, and it was determined that no provision for uncertain tax positions is required. The Centers information and income tax returns for years subsequent to fiscal year 2007 are open, by statute, for review by authorities.
Part XI, Line 8 - Other Adjustments:		CHANGE IN VALUATION OF PERMANENTLY RESTRICTED NET ASSET BOND REFINANCING
Part XIII, Line 2d - Other Adjustments:		Bond Refinancing 346,876.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	125.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	753	PersonsServed
Total Community Benefit Expense	689742	TotalCommunityBenefitExpense
Net Community Benefit Expense	689742	NetCommunityBenefitExpense
Percent Of Total Expense	0.02980	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	753	PersonsServed
Total Community Benefit Expense	689742	TotalCommunityBenefitExpense
Net Community Benefit Expense	689742	NetCommunityBenefitExpense
Percent Of Total Expense	0.02980	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Persons Served	1500	PersonsServed
Total Community Benefit Expense	31891	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3626	DirectOffsettingRevenue
Net Community Benefit Expense	28265	NetCommunityBenefitExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Persons Served	1500	PersonsServed
Total Community Benefit Expense	31891	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3626	DirectOffsettingRevenue
Net Community Benefit Expense	28265	NetCommunityBenefitExpense
Percent Of Total Expense	0.00120	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Persons Served	2253	PersonsServed
Total Community Benefit Expense	721633	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3626	DirectOffsettingRevenue
Net Community Benefit Expense	718007	NetCommunityBenefitExpense
Percent Of Total Expense	0.03100	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$837,791	BadDebtExpenseAmount
Amount Attributable To	524444	AmountAttributableTo
Amount Reimbursed By Medicare	5612436	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	5769009	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-156573	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 Quorum Health Resources	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	Management and Consulting	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.00000	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.00000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (9 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Critical Access HospitalCriticalAccessHospital	Er24 HoursEr24Hours	OtherOther
HOOPESTON COMMUNITY MEMORIAL HOSPITAL
1	701 E ORANGE	HOOPESTON	IL	60942	X	X	X	X
HOOPESTON COM MEMORIAL NURSING HOM
2	701 E ORANGE	HOOPESTON	IL	60942					LONG TERM CARE/NURSING HOME
COUNTRY TERRACE INDEPENDENT LIVING APART
3	705 E ORANGE	HOOPESTON	IL	60942					SENIOR INDEPENDENT LIVING APTS
BRIDGEWAY CLINIC
4	843 E ORANGE	HOOPESTON	IL	60942					MEDICAL CLINIC
HOOPESTON BUSINESS OFFICE
5	847 E ORANGE	HOOPESTON	IL	60942					ACCTING, BO, HR, IT
ROSSVILLE MEDICAL CENTER
6	619 N CHICAGO	HOOPESTON	IL	60942					MEDICAL CLINIC
CISSNA PARK MEDICAL CLINIC
7	141 W GARFIELD	HOOPESTON	IL	60942					MEDICAL CLINIC
HOOPESTON AMBULANCE SERVICES
8	413 E MAIN	HOOPESTON	IL	60942					AMBULANCE SERVICES
CHARLOTTE ANN RUSSELL MEDICAL CENTER
9	801 E ORANGE	HOOPESTON	IL	60942					MEDICAL CLINIC

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	HOOPESTON COMMUNITY MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Needs Assessment Conducted	09	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	1	AllNeedsAddressed
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	125.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Lawsuit	X	PermitLawsuit
Collection Activities	1	CollectionActivities
Report To Credit Agency	X	ReportToCreditAgency
Lawsuit	X	Lawsuit
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	0	NondiscrimEmergencyCarePolicy
Other Reason	X	OtherReason
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

ExplanationExplanation	IdentifierIdentifier
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 837791.
Part II: The hospital's building program will enhance the healthcare of the community by providing easier access to services and a greater number of services to be provided locally:1. New Emergency Room to be complete in 20122. New Surgery Suite to be complete in 20123. New Clinic in Rossville, IL was opened in November 20114. Replacement Nursing Home facility to be complete in 2012
Part V, Section B, Line 13g: CHARITY CARE APPLICATIONS ARE OFFERED TO PATIENTS AT THE TIME OF REGISTRATION. A COMMUNICATION SHEET INCLUDING A BRIEF DESCRIPTION AND CONTACT INFORMATION IS AVAILABLE AT REGISTRATION AND ALSO SENT WITH THE FIRST STATEMENT. FINANCIAL ASSISTANCE CONTACT INFORMATION IS PRINTED ON THE STATEMENTS. CHARITY CARE IS ON OUR WEBSITE WITH CONTACT INFORMATION. CHARITY CARE IS OFFERED TO PATIENTS WHO EXPRESS FINANCIAL HARDSHIP AND TO THOSE THAT WE ASSUME ARE GOING THROUGH A FINANCIAL HARDSHIP.	HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Part V, Section B, Line 18d: HOOPESTON COMMUNITY MEMORIAL HOSPITAL FOLLOWS EMTALA LAWS.	HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Part V, Section B, Line 19d: THE HOSPITAL USES A DISCOUNT EQUAL TO THE HIGHEST NEGOTIATED COMMERCIAL OUT-PATIENT INSURANCE RATE.	HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Part VI, Line 2: Hoopeston Regional Health Center assesses community needs on an annual basis through a publicly advertised state of the hospital meeting, where community residents are surveyed upon entry concerning the most significant health concerns they may have in our community today. Through these assessments the hospital has initiated the following programs over the past 2 years:1. Nurse doing head checks in the local school system. We provide this service for free.2. Vision and hearing testing for all schools in the region. We provide this service for free.3. Athletic trainer to care for student athletes, specializing in concussion care. We provide this service for free.4. After hours care program. We have expanded our clinic hours until 8pm during the week and 9am to 5pm on Saturday and Sunday.5. Hired a general surgeon, a physician and 2 physician assistants for our community.6. Free diabetes education from our Registered Dietician. Classroom and individual counseling are offered.7. Future program developments will include aging and obesity.8. Contracted 2 additional Cardiologists for our community.9. Recruitment of a dentist to start in summer 2013.We perform a formal 3rd party assessment once every three years and will be completed again in 2012. All surveys and assessments are discussed at our annual strategic planning sessions with the community board of directors each September.
Part VI, Line 3: Patients are educated on the financial assistance policies and availability in the following ways;1. Signs are posted at all areas of patient registration for services.2. Once a bill reaches 45 days past due, our internal financial staff calls and discusses needs with the individual. We then help determine if they are available for state Medicaid or if they qualify for charity care under our policy. If so, we assist them with the application process.
Part VI, Line 4: Hoopeston Regional Health Center serves a zip code with 5,300 people in a rural environment. A vast majority of the people living in this area are of a white race. The estimated median household income in 2010 was $38,167. In 2010, 18.3% of the population had an income below the poverty line.
Part VI, Line 6: The hospital furthers health in the community by:1. Providing children's activities throughout the year free of charge, ie; movies, pony rides, and fireworks,2. Maintaining an open medical staff to encourage physician membership in our organization and provide choice for local patients,3. 10 member community board serves on a volunteer basis.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JAY COLBERT MD
274237	0	0	0	0	0	0	0	0	0	274237	0	0	0
CHASE DANIEL
162098	0	0	0	0	0	0	0	0	0	162098	0	0	0
WILLIAM MCCARTHY
163885	0	0	0	0	0	0	0	0	0	163885	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Farm Credit Services of Illinois	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	371270645	IssuerEIN
Date Issued	2011-08-02	DateIssued
Issue Price	7450000	IssuePrice
Description Of Purpose	Refinancing of prior bonds	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	7265000	AmountRetired
Total Proceeds	7450000	TotalProceeds
Amount In Reserve Fund	500000	AmountInReserveFund
Refunding Escrow	6930095	RefundingEscrow
Issuance Costs From Proceeds	19905	IssuanceCostsFromProceeds
Current Refunding	1	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	0	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Post Issuance Compliance Procdrs	0	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Exception To Rebate	0	ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	DICK READ	NamePerson

Field	Value	IRS element (for citing)
Relationship	BOARD MEMBER	Relationship
Amount Of Transaction	28113	AmountOfTransaction
Description Of Transaction	VAN, AMBULANCE AND AUTO REPAIRS	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Form 990, Part VI, Section A, line 2	Two board members, Karla Coon and Angela Totheroh, are step-mother and step-daughter.
Form 990, Part VI, Section A, line 3	The CEO of the organization is employed by Quorum Health Resources. The organization negotiated a management contract with that Firm.
Form 990, Part VI, Section B, line 11	Form 990 is prepared by our independent accountants and provided to the governing body prior to filing.
	Conflict of interest disclosure forms are annually completed by employees and board members.	Form 990, Part VI, Section B, line 12c
	The CEO of the organization is employed by Quorum Health Resources. The organization negotiated a management contract with that Firm. There is currently no CFO.	Form 990, Part VI, Section B, line 15
	All documents available upon request.	Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:	Net unrealized gains on investments: 3,353. CHANGE IN VALUATION OF PERMANENTLY RESTRICTED NET ASSET 18,534. BOND REFINANCING -346,876. Total to Form 990, Part XI, Line 5: -324,989.	Form 990, Part XI, line 5: