FURP.ORG / PUBLIC DATA EXPLORER

ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDE (EIN 37-0661244)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201101339349300325
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-13T07:42:19-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370661244EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSPITAL SISTERS OF THE THIRDBusinessNameLine1
Business Name Line2ORDER OF ST FRANCISBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSTMANameControl
Phone2174642966Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 E LAKE SHORE DRIVEAddressLine1
CityDECATURCity
StateILState
ZIP Code62521ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKevin F KastName
TitleChief Executive OfficerTitle
Phone2174642966Phone
Date Signed2011-05-09DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKPMG LLPName
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1ORDER OF ST FRANCISBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer Personkevin f kastNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11800 E LAKE SHORE DRIVEAddressLine1
CityDECATURCity
StateILState
ZIP Code62521ZIPCode
FieldValueIRS element (for citing)
Gross Receipts135795542GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteWWW.STMARYSDECATUR.COMWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other Description501(C) (3)TypeOfOrgOtherDescription
Year Formation1878YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTo participate in the health care ministry of the church and provide a family-centered approach in meeting the community's health care needs regardless of ability to pay.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees1423TotalNbrEmployees
Total Nbr Volunteers210TotalNbrVolunteers
Total Gross UBI165955TotalGrossUBI
Contributions Grants Prior Year2771025ContributionsGrantsPriorYear
Contributions Grants Current Year3287686ContributionsGrantsCurrentYear
Program Service Revenue Prior Year116177780ProgramServiceRevenuePriorYear
Program Service Revenue CY126707304ProgramServiceRevenueCY
Investment Income Prior Year-2877476InvestmentIncomePriorYear
Investment Income Current Year1516301InvestmentIncomeCurrentYear
Other Revenue Prior Year2806460OtherRevenuePriorYear
Other Revenue Current Year2071531OtherRevenueCurrentYear
Total Revenue Prior Year118877789TotalRevenuePriorYear
Total Revenue Current Year133582822TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year55724620SalariesEtcPriorYear
Salaries Etc Current Year57514189SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year65876901OtherExpensePriorYear
Other Expenses Current Year78895901OtherExpensesCurrentYear
Total Expenses Prior Year121601521TotalExpensesPriorYear
Total Expenses Current Year136410090TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2723732RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2827268RevenuesLessExpensesCY
Total Assets BOY148736612TotalAssetsBOY
Total Assets EOY149184672TotalAssetsEOY
Total Liabilities BOY66112922TotalLiabilitiesBOY
Total Liabilities EOY83481117TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY82623690NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY65703555NetAssetsOrFundBalancesEOY
Mission DescriptionTo participate in the health care ministry of the church and provide a family-centered approach in meeting the community's health care needs regardless of ability to pay.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense103882598Expense
Revenue126707304Revenue
DescriptionSEE SCHEDULE O - Statement of Program Service AccomplishmentsDescription
Total Program Service Expense103882598TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109665NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1423NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddresstrueOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonREBECCA COLKERNamePerson
Telephone Number2174642970TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11800 E LAKE SHORE DRIVEAddressLine1
CityDECATURCity
StateILState
ZIP Code62521ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
SR HELEN MARIE PLUMMER OSF
BOARD MEMBER1.0X000
SR MARYBETH CULNAN OSF
BOARD MEMBER1.0X000
KEVIN KAST
CHIEF EXECUTIVE Officer40.0X0427770141108X
JOHN SKEFFINGTON
SECRETARY1.0X000X
KEVIN BREHENY
CHAIRPERSON1.0X000X
JOHN J WHITE
BOARD MEMBER1.0X000
JON ROBINSON
VICE-CHAIRPERSON1.0X000X
MARK CHEVIRON
BOARD MEMBER1.0X000
PAT DAWSON
BOARD MEMBER1.0X000
Fr JOE MOLLOY
BOARD MEMBER1.0X000
BOB WIESEMANN
BOARD MEMBER1.0X000
THERESA J RUTHERFORD
COO/CNO40.0185661047335X
ANN CARR
TREASURER1.00153448117382X
ADAM CUMBO
FORMER CFO1.018110008842X
Becky Colker
Chief Financial Officer40.010699903197X
GORDON CHU MD
NEUROSURGEON40.0589801039932X
NAEEMUDDIN JATOI MD
PHYSICIAN40.0286195051963X
JOHN BRITT MD
PHYSICIAN40.0624586017246X
Beth A McCoy
CRNA40.0237051084220X
Roberta McBride
CRNA40.02326570214700X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2444050TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs581218TotalReportableCompFrmRltdOrgs
Total Other Compensation725925TotalOtherCompensation
Number Individuals GT100 K47NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Central Illinois Emergency Physicia
75 Remittance Drive Suite 1707ChicagoIL60675Emergency Physicians996022
Pencek Terrence MD
1750 E Lake Shore Drive Suite LL2DecaturIL62521PHYSICIANS725000
Urologic Surgery Assoc SC
1700 E Lake Shore DriveDecaturIL62521PHYSICIANS431028
Rehab Care Group Inc
PO Box 502096St LouisMO63150Rehab Management548180
John C Kefalas MD SC
1770 E Lake Shore DriveDecaturIL62521PHYSICIANS490205
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Related Organizations3287686RelatedOrganizations
Total Contributions3287686TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column126707304TotalRevenueColumn
Related Or Exempt Function Income126707304RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue126707304TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1415791TotalRevenueColumn
Exclusion$1,415,791ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1346563Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2167630Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-821067Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-821067TotalRevenueColumn
Exclusion-$821,067ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities142100Securities
Other3500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other45090Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities142100Securities
Other-41590Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column100510TotalRevenueColumn
Exclusion$100,510ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERA/CAFE722210590320$590,320
OUTSIDE LAUNDRY8123005240852408
REFERENCE LAB621500113547113547

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2136323TotalRevenueColumn
Exclusion$2,136,323ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2892598TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column133582822TotalRevenueColumn
Related Or Exempt Function Income126707304RelatedOrExemptFunctionIncome
Unrelated Business Revenue165955UnrelatedBusinessRevenue
Exclusion$3,421,877ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total420634Total
Program Services0ProgramServices
Management And General420634ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41890690Total
Program Services37295773ProgramServices
Management And General4594917ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1582622Total
Program Services1582622ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10570115Total
Program Services10493029ProgramServices
Management And General77086ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3050128Total
Program Services3050128ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4767658Total
Program Services358349ProgramServices
Management And General4409309ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total466754Total
Program Services13923ProgramServices
Management And General452831ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total197644Total
Management And General197644ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total26090Total
Management And General26090ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16552128Total
Program Services13921663ProgramServices
Management And General2630465ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1070216Total
Program Services76775ProgramServices
Management And General993441ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total640535Total
Program Services423197ProgramServices
Management And General217338ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total70314Total
Management And General70314ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1918204Total
Program Services1688111ProgramServices
Management And General230093ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total120757Total
Program Services78449ProgramServices
Management And General42308ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total5236705Total
Program Services12867ProgramServices
Management And General5223838ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6862728Total
Program Services30859ProgramServices
Management And General6831869ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1425026Total
Program Services186431ProgramServices
Management And General1238595ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES170732471706194411303
BAD DEBTS16927495169274950
MEDICAID TAX ASSESSMENT38179443817944
OTHER17224566809831041473

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total136410090Total
Program Services103882598ProgramServices
Management And General32527492ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY285988BOY
EOY285989EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3553393BOY
EOY5435395EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27124006BOY
EOY21239368EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2489706BOY
EOY2867210EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1666695BOY
EOY935278EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis167832699LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec111435301LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57518193BOY
EOY56397398EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY55224371BOY
EOY60035556EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY874260BOY
EOY1988478EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY148736612BOY
EOY149184672EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15825048BOY
EOY19128795EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY29797BOY
EOY26608EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30286267BOY
EOY29633909EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY19971810BOY
EOY34691805EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY66112922BOY
EOY83481117EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY73152690BOY
EOY53104217EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8240000BOY
EOY11369452EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1231000BOY
EOY1229886EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY82623690BOY
EOY65703555EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY148736612BOY
EOY149184672EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$62,090OtherActivitiesAmount
Total Lobbying Expenditures IIB62090TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF OTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II B, QUESTION 11ReturnReference
ExplanationST. MARY'S HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION (CHA), THE ILLINOIS HEALTH ASSOCIATION (IHA), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION (AHA). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES. A PART OF THESE DUES IS ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. OF THE AMOUNT LISTED ABOVE, $26,090 IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. The Hospital also engaged the services of Curry & Associates, LLC ("Curry") and Bolen, Robinson, & Ellis, LLP ("Bolen") to perform lobbying activities on its behalf. The hospital paid a $3,000 monthly retainer fee to Bolen. Bolen would then pay this to curry for lobbying services. Of the amount listed above, $36,000 is attributable to these services.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3295160OtherCostOrOtherBasis
Book Value3295160BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis28775635InvestmentCostOrOtherBasis
Other Cost Or Other Basis49110856OtherCostOrOtherBasis
Depreciation47195639Depreciation
Book Value30690852BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis13970420InvestmentCostOrOtherBasis
Other Cost Or Other Basis67292978OtherCostOrOtherBasis
Depreciation61479277Depreciation
Book Value19784121BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis150012InvestmentCostOrOtherBasis
Other Cost Or Other Basis5237638OtherCostOrOtherBasis
Depreciation2760385Depreciation
Book Value2627265BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings56397398TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ESTIMATED SELF INSURANCE LIABILITY$6,006,363
RETIRE OBLIGATION - ASBESTOS$1,574,159
ACCRUED BENEFIT LIABILITY$25,200,283
DERIVATIVE INSTRUMENTS$1,911,000
FieldValueIRS element (for citing)
Total Of Amounts34691805TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC SUBTOPIC 740-10Identifier
ExplanationOn July 1, 2007, the Obligated Group adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109. ASC Subtopic 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, the Obligated Group must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of June 30, 2010 and 2009, the Obligated Group does not have a liability for unrecognized tax benefits.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served2357PersonsServed
Total Community Benefit Expense1652631TotalCommunityBenefitExpense
Net Community Benefit Expense1652631NetCommunityBenefitExpense
Percent Of Total Expense0.01380PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1PersonsServed
Total Community Benefit Expense10628575TotalCommunityBenefitExpense
Net Community Benefit Expense10628575NetCommunityBenefitExpense
Percent Of Total Expense0.08900PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served3322PersonsServed
Total Community Benefit Expense519358TotalCommunityBenefitExpense
Direct Offsetting Revenue412028DirectOffsettingRevenue
Net Community Benefit Expense107330NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served5680PersonsServed
Total Community Benefit Expense12800564TotalCommunityBenefitExpense
Direct Offsetting Revenue412028DirectOffsettingRevenue
Net Community Benefit Expense12388536NetCommunityBenefitExpense
Percent Of Total Expense0.10370PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs445NumberOfActivitiesOrPrograms
Persons Served14891PersonsServed
Total Community Benefit Expense499335TotalCommunityBenefitExpense
Direct Offsetting Revenue1857DirectOffsettingRevenue
Net Community Benefit Expense497478NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served2125PersonsServed
Total Community Benefit Expense276660TotalCommunityBenefitExpense
Direct Offsetting Revenue13863DirectOffsettingRevenue
Net Community Benefit Expense262797NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served36532PersonsServed
Total Community Benefit Expense85215371TotalCommunityBenefitExpense
Direct Offsetting Revenue82305714DirectOffsettingRevenue
Net Community Benefit Expense2909657NetCommunityBenefitExpense
Percent Of Total Expense0.02500PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served21724PersonsServed
Total Community Benefit Expense1474387TotalCommunityBenefitExpense
Direct Offsetting Revenue1134119DirectOffsettingRevenue
Net Community Benefit Expense340268NetCommunityBenefitExpense
Percent Of Total Expense0.00300PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs459NumberOfActivitiesOrPrograms
Persons Served75272PersonsServed
Total Community Benefit Expense87465753TotalCommunityBenefitExpense
Direct Offsetting Revenue83455553DirectOffsettingRevenue
Net Community Benefit Expense4010200NetCommunityBenefitExpense
Percent Of Total Expense0.03440PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs462NumberOfActivitiesOrPrograms
Persons Served80952PersonsServed
Total Community Benefit Expense100266317TotalCommunityBenefitExpense
Direct Offsetting Revenue83867581DirectOffsettingRevenue
Net Community Benefit Expense16398736NetCommunityBenefitExpense
Percent Of Total Expense0.13810PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1486PersonsServed
Total Community Building Expense94992TotalCommunityBuildingExpense
Direct Offsetting Revenue33579DirectOffsettingRevenue
Net Community Building Expense61413NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1486PersonsServed
Total Community Building Expense94992TotalCommunityBuildingExpense
Direct Offsetting Revenue33579DirectOffsettingRevenue
Net Community Building Expense61413NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,652,506BadDebtExpenseAmount
Amount Attributable To42033AmountAttributableTo
Amount Reimbursed By Medicare30384520AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare51690260CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-21305740MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST MARY'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11700 E LAKE SHORE DRAddressLine1
CityDECATURCity
StateILState
ZIP Code62521ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaNot applicable as the organization does follow Federal Poverty Guidelines to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals.IncomeBasedCriteria
Annual Community Benefit ExplnTHE ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE STATE OF ILLINOIS' ATTORNEY GENERAL'S OFFICE. IN ADDITION, EVERY THREE YEARS, THE ORGANIZATION PARTICIPATES WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO ASSESS COMMUNITY NEEDS. STARTING FISCAL YEAR ENDING 6/30/2011, A MORE DETAILED COMMUNITY BENEFIT REPORT WILL BE COMPLETED ON AN ANNUAL BASIS.AnnualCommunityBenefitExpln
Costing Method UsedCosting methodology for amounts reported in table: The common method for estimating the true economic cost of medical services is to adjust the charges through the use of cost-to-charge ratios. Cost-to-charge ratios convert charges for medical services to their true economic costs. Applying cost-to-charge ratios to medical service charges produces average estimates of true costs. The Cost/Charge Ratio represents total hospital operating costs divided by total gross billed charges. The exception to the costing methodology described in the preceding paragraph is for the amount for subsidized services on line 7g, for which a costing information system was utilized. More accurate allocations of direct costs are available through the use of that system, and were applied for the subsidized health services. a. For FY2010, total charity care cost was $4,208,789 as reported on the income statement. The net community benefit cost, after applying the cost-to-charge ratio of 39.3%, was $1,652,631. b. For FY2010, unpaid cost of Medicaid was $23,202,799. The net community benefit cost, after applying the cost-to-charge ratio of 39.3%, was $9,110,857. Actual cost is the net of revenue (charges) minus expenses. Actual cost can be traced directly to (or identified with) a specific cost center or cost object such as a department, process, or product. The following other benefits are calculated using actual costs from the income statement. c. For FY2010, unreimbursed cost from other means tested government programs realized revenue of $412,028 and expenses of $519,358. The net community benefit expense was $107,330. d. Total of lines 7a through 7c. e. For FY2010, community health improvement services and benefit operations realized revenue of $1,857 and expenses of $499,335. The net community benefit expense was $497,478. f. For FY2010, health professions education realized revenues of $13,863 and expenses of $276,660. The net community benefit expense was $262,797. i. For FY2010, cash and in-kind contributions realized revenues of $875,786 and expenses of $1,184,075. The net community benefit expense was $308,289. Actual cash contributions of $169,877 are included and consist of charitable contributions made to organizations in the community. j. Total of lines 7e through 7i. k. Total of lines 7d and 7j. k. Total of lines 7d and 7j.CostingMethodUsed
Subsidized Health Services ExplnThe organization provides numerous clinical services despite the fact those services yield a net financial loss to the organization. Subsidized health services provided by the organization include the service lines of emergency services, obstetrics/nursery, observation, and behavioral health.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnThe percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 13.5 %.PercentOfTotalExpenseExpln
Bad Debt FootnoteThe footnote text related to bad debt expense from the audited financial statements reads as follows: "The Obligated Group also provides a significant amount of uncompensated care for patients, which is not included above, but is reported in the consolidated statements of operations as a provision for uncollectible accounts. Many of those patients are uninsured or underinsured, but did not apply for, or qualify for, charity care." Please note that reference is made to the "Obligated Group", of which this organization is a member. The organization strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients that potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity due to missing documentation on patient resources. Thus, the organization's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. The organization is in the process of implementing processes, procedures, and systems to more effectively determine charity care that will reduce a patient's documentation requirements when applying for charity care. This will provide a more accurate reporting of charity care services provided by the organization. Actual bad debt expense was $16,927,495 as reported on the income statement. After applying the cost-to-charge ratio of 39.3%, the total cost of bad debt was $6,652,506. The amount of bad debt expense attributable to patients eligible under the organization's charity care policy was $106,954. After applying the cost-to-charge ratio of 39.3%, the total cost of bad debt was $42,033. Bad debt costs attributable to charity represents the bad debt cost of services provided to charity care patients that were identified initially as eligible for charity care. A system report was created on patient accounts written off to bad debt and a second report was created that showed accounts with charity adjustments during fiscal year ended June 30, 2010. Identical patient accounts from each type of report were identified in order to determine which "charity" accounts were finally written off to bad debts at some point thereafter. The organization's cost to charge ratio was applied to the bad debt amounts identified to arrive at an estimated bad debt cost.BadDebtFootnote
Shortfall As Community BenefitThe organization continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the organization to respond to community need, the organization's management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the organization to the health and well being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so. The organization serves thousands of persons covered by Medicare. Like Medicaid, Medicare funding does not cover the actual cost of delivering hospital services to people enrolled in the program. In the fiscal year ended June 30, 2010, the organization had to make up the $21.3 million difference between what Medicare paid and the actual cost of services to Medicare beneficiaries.ShortfallAsCommunityBenefit
Debt Collection PolicyThe organization has a policy on account resolution that outlines the procedures to be followed in collecting balances on outstanding patient bills. Besides addressing the procedures and follow-up for accounts covered by insurance or governmental programs, the policy discusses situations where the patient may be eligible for financial assistance through our charity care program. If a patient is deemed eligible, reference is made to the organization's charity care policy. Even with the best intentions, patients cannot always meet their responsibility to pay for the care they receive. For a number of reasons, from the loss of a job to temporary hardships, this leaves the organization to cover the unpaid balance or even the entire bill, an expense for the organization referred to as "bad debt". In the fiscal year ended June 30, 2010, bad debt expense was almost $17 million with no outside source of funding to help compensate for the expense. The cost, after applying the cost to charge ratio, was $6.6 million. This is a growing problem. Bad debt accounted for 5% of our total costs in the fiscal year ended June 30, 2010 and constituted a significant contribution to the community.DebtCollectionPolicy
Number Of Facility Type ExplnThe organization does not have any healthcare facilities that are not registered as a healthcare facility under State law.NumberOfFacilityTypeExpln
Needs AssessmentAn integral part of the mission of St. Mary's Hospital is the commitment to meet the health care needs of all in the community, regardless of ability to pay. The organization's service to the community would not be possible without the shared leadership and active engagement of our community partners. Together, we assess the health care needs of the community, identify health priorities, and work to create viable solutions to fulfill the growing health-related needs and challenges in our community. In the past, the organization collaborated with United Way, other non-profit organizations, and local community groups in the community in conducting a community health needs assessment survey, which was conducted every four years. The results were evaluated for unmet and underserved healthcare needs and utilized for determining whether programs should be added, expanded, or in some cases, scaled back so resources can be allocated to areas of greater need. The assessment helped us develop strategies for improving community health. Currently, the organization is participating in a community needs assessment in partnership with Macon County Health Department. The assessment began in calendar year 2010, and the list of needs is being evaluated and prioritized as of the filing date of this return. The organization is one of thirteen hospitals under a parent organization, Hospital Sisters Health System, Inc. The parent organization has formed a team that is currently developing suggested guidelines for each hospital's local needs assessment for implementation during the year ended June 30, 2012. In the meantime, our organization is continuing to participate with other community organizations through the Macon County Health Department efforts. Three Advisory Councils assist the organization in identifying community health care needs and organizations for involvement. These councils are comprised of members of the community representing area businesses, clergy, education, and non-profit organizations, as well as patients. The focus of these groups is two-way communication between the hospital and the community. The St. Mary's Hospital Advisory Council advises the hospital on a wide range of strategies, including unmet needs in the community. The Oncology Advisory Council advises St. Mary's specifically about cancer-related needs and services, and is comprised entirely of cancer survivors. The Rehabilitation Advisory Council likewise advises specifically about rehabilitative-related needs and services. Additional efforts to engage and seek input from the community include the formation of a Strategic Planning Committee during the year ended June 30, 2010. Community leaders were selected and invited to participate as a member of this committee, along with representatives from the organization's management team, Board of Directors, and medical staff. This committee developed a five year strategic plan for the organization. Involvement from the community leaders insured the community has a voice in the healthcare services being offered and also those identified as needs for enhancement or development. One of the activities reviewed by the committee in establishing plans was a community survey regarding healthcare in our service area. This committee will remain intact and meets on a regular basis to review progress and adjust plans as necessary to meet the needs of our community. Input is obtained from the patients we serve through patient satisfaction surveys. Input provided through some of these surveys was taken into consideration in the development of the hospital's master facility plan, which has resulted in a current major Emergency Room capital project. The hospital Board of Directors is community-based and maintains a good pulse on the community we serve. They provide valuable input on an ongoing basis on the community's healthcare needs. The System (parent organization) revised the process for selecting the hospital Board of Directors from a System-dominated board to a community-focused board in 2008.NeedsAssessment
Patient Education AssistanceThe Registration Department provides brochures to patients upon registration regarding the payment assistance programs available to them at St. Mary's Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. Contact numbers for several agencies are listed in the brochure, as well as information about how to read and understand the bill. The organization has a representative on site to assist patients who may be eligible for Medicaid assistance through the Illinois Department of Public Aid. They work with patients to determine if they may be eligible, and if so, assist in pulling together the necessary application for submission. Patients are also provided a Fair Billing Act Notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. The organization's website provides information to patients and their families about the hospital's billing practices. The charity application is available online, as well as contact information for various government programs and hospital contacts. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's Charity Care program. The letter provides direct contact information to begin the application process for Charity Care.PatientEducationAssistance
Community InformationThe organization's primary service area is Macon County, Illinois, with surrounding counties comprising much of the secondary and tertiary service area. The population of Macon County in 2009 was estimated at 108,000, which represented a decrease of 5.7% since 2000. The median household income, as reported in 2008, was $45,664. The poverty rate for the same period was 13.5%. Primary, secondary and tertiary service area demographic information is used to identify ages and incomes of each segment. The only growing population in each service area is age 64+. The aging population will have an impact on the development of future services at the organization. The racial makeup of the county in 2009 was 82% White, 15% African American, with other races comprising the remaining 3%. Macon County has experienced high unemployment rates the past few years, but improvement was reported by the end of calendar year 2010. The unemployment rate (not seasonally adjusted) as of December 2010 was 10.4%, down from a rate of 12.6% in December 2009. Macon County has 580 square miles in land area and a population density of 186.6 per square mile. The town of Decatur, which is where St. Mary's Hospital is located, is the county seat and also the largest city in Macon County. In 2008 manufacturing was the largest of twenty major sectors, representing 22.6% of all jobs in the county. Health care and social assistance comprised the next largest sector, representing 13.8%.CommunityInformation
Community Building ActivitiesThe Lake Shore Connection program is focused on individuals age 55 and over. Participants in the program can obtain courtesy transportation to and from health related appointments. The organization offers participants free quarterly health screenings, discounts on monthly lunch and learn programs, and other resources to assist participants in staying productive, healthy, and independent well into the future. We touched the lives of 1,496 participating senior citizens through this community program.CommunityBuildingActivities
Other InformationSt. Mary's Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Mary's is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 130 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. St. Mary's hospital remains committed to serving the health care needs of the community, regardless of ability to pay. Because of the hospital's purpose and tradition, it is organized to promote the health of Decatur and surrounding areas. The hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Mary's is responding to community need as described under #2 above. As a not-for-profit hospital, St. Mary's reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, train clinicians, and support initiatives designed to promote health for all. For example, St. Mary's is working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. St. Mary's devotes significant resources to access for patients who cannot afford care, along with other community benefits. In the fiscal year ended June 30, 2010, the organization provided $16.4 million in Community Benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, the organization provided $6.4 million (at cost) in uncompensated care to patients that did not qualify for charity care or public assistance and $21.3 million (at cost) in excess of Medicare payment for health care services. The range of benefits provided by St. Mary's Hospital flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Mary's Hospital, and they often relieve a burden that would otherwise be carried by government. Some of the notable examples of how the organization contributes to the wellness, prevention, and improving the health of the community include: a) The Prenatal Clinic: The prenatal clinic serves uninsured and underinsured mothers. It provides both prenatal and postnatal care. Each year, the clinic cares for approximately 250 women and babies, with an estimated 3,500 visits. The clinic is unique in that each woman has her own physician, ensuring comprehensive and consistent prenatal care. In addition, community resources are invited to participate in the clinic, giving patients full exposure to options available to them. b) Power to End Stroke: St. Mary's partners with the American Heart Association's Power to End Stroke program. This program raises awareness in the African-American community about the risk factors and prevalence of stroke. Community awareness events are held as part of this program. c) Adult Day Care: The organization operates an adult day care program for adults unable to totally care for themselves and who do not have home assistance during the day. d) Collaborative Post-Acute Care Initiative: The organization formed a community collaborative with post-acute care providers during the fiscal year ended June 30, 2010 to address the needs of patients needing care after their acute hospital stay. Participants include assisted living facilities, critical access hospitals, supported living facilities, and nursing homes. This initiative will continue to develop into the upcoming year. e) Educational Support: Employees often serve as speakers at schools in our service areas, community events, etc. St. Mary's and its staff support the programs of Project Success in working to help children succeed in school by collaborating with local agencies, schools and other businesses in the community (example is the school supply distribution program). Staff members provide training to the local paramedics, first responder groups, and fire departments. Additionally, area organizations receive CPR training through the hospital's EMS Department. f) AthletiCare Program: The organization provides athletic training services to the surrounding community athletes. This includes recreational athletes participating in community events, such as the Rodney T. Miller Lakeside Triathlon and the Shoreline Classic 5k/15k race. The hospital provides athletic training services to various area junior and senior high schools for injury management and prevention of selected athletic programs. Athletic trainers employed by the hospital serve as experts on physical exercise for the community and provide informational presentations several times a year. They also provide instruction for new athletes to begin training in a safe and successful manner with the Decatur Tri-Gators, a local USAT triathlon club. g) Lake Shore Connection: This is a program focused on individuals age 55 and over. Participants in the program can obtain courtesy transportation to and from health related appointments, free quarterly health screenings, discounts on monthly lunch and learn programs, and other resources to assist participants in staying productive, healthy, and independent well into the future. h) Ambassadors for Christ Ministries/Stop the Violence Outreach Health Fairs: These outreach health fairs bring much needed education, testing and care to the high risk inner-city community population. The goal is that awareness, prevention and care for those who are at risk will provide the necessary treatment and ultimately save lives. Ambassadors for Christ Ministries is collaborating with organizations, including St. Mary's, to provide a team of health care providers, social service agencies and private individuals to address health issues such as HIV, AIDS, breast cancer, prostate cancer, high blood pressure, diabetes, heart disease, and high cholesterol. i) Items Donated: The organization routinely donates food to local food pantries. Other donations to nonprofit causes include equipment and medical supplies. Additionally, our staff contributes their time in volunteering to assist these organizations in their valuable community efforts. j) Community Health Fairs: St. Mary's maintains partnerships with many organizations in the community to promote health and wellness. The hospital participates in numerous community health fairs, including 35 community health screenings held during the fiscal year ending June 30, 2010. In addition to the health fairs, the organization collaborates with members of the medical staff to provide sessions on important health education topics to members of the community. Sessions conducted during the year ended June 30, 2010 included several topics, such as shoulder pain, orthopedic injuries, prostate screenings, reconstructive surgery, electrophysiology, healthy eating and cooking, and stroke. The organization's support groups offer patients and their families, and members of the community the opportunity to learn more about their health and have their voices heard. A number of benefits are associated with participating in programs offered. For example, participating in support groups can decrease psychological distress and elevate a participant's mood. Participants can exchange information and experience emotional connections through their interaction and participation. Employees, volunteers, Board members and medical staff participate in charitable activities in the community that reflect the hospital's commitment to the underserved. They contribute both financial support and their time to worthy non-profit health-related organizations in the community, including the American Heart Association, American Cancer Society, American Red Cross, Easter Seals, and the Diabetes Association. They participate with organizations such as United Way to assist in worthwhile community needs. Time and expertise is also provided to various organizations by serving on their Boards or related committees - examples include the organOtherInformation
Affiliated Health Care SystemSt. Mary's Hospital is an affiliate of Hospital Sisters Health System. The foundational mission principles of Hospital Sisters Health System (HSHS) embody the belief that every life is a sacred gift and every human being is a unity of body, mind and spirit. Our health care ministry calls on us to foster healing, serve with compassion, and promote wellness for all persons, with special attention to our neighbors who are sick, poor, underserved, and most vulnerable. These principles have made it possible for HSHS to provide high quality, cost-effective and compassionate health care for millions of people in Illinois and Wisconsin. Our health care ministry consists of 13 hospitals and numerous physician partners committed to continuing the healing ministry of Jesus Christ. Beyond functioning as a primary source for health care in the 12 primary communities we serve, HSHS also provides a wide array of Community Benefits that expand residents' access to health care, enhance their overall health status, and further medical education. In the Fiscal Year that ended June 30, 2010, HSHS hospitals provided $152.2 million in Community Benefits (or 8.5% of total expenses), an increase of $28 million from FY 2009. Of this amount, $32.3 million was provided for charity care and $89.2 million was the amount of unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals provided $159.3 million in health care services primarily to the elderly beneficiaries of the Medicare program in excess of governmental and managed care contract payments. HSHS hospitals also recorded $95 million in uncollectible accounts. HSHS is committed to sustaining and strengthening the health of our communities by continually reinvesting any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services. These ongoing enhancements ensure that our hospitals can continue to provide high quality, compassionate care to our patients. During Fiscal Year 2010, HSHS continued to pursue a Care Integration strategy designed to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by the system investments in information technology, this strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. The Care Integration strategy includes, among other efforts, three "Medical Home" pilot projects, the coordination of care for cardiac patients living in rural communities through the use of telemedicine, and development of a "clinical integration network" that will help independent physicians improve quality and the patient experience by benchmarking their care against best practices. HSHS also placed a special emphasis on investing in interoperable health information technologies and robust health information exchanges. We recognize that our investments in information technology will have a positive impact on the quality, safety and efficiency of health care. These investments also ensure that the patient is at the center of a high quality, highly integrated, compassionate health care delivery system. Expanding access to health care At the heart of our health care ministry is the commitment to care for every patient who seeks our help. Because not all patients have health insurance, HSHS hospitals have generous Charity Care program guidelines that cover 100% of hospital charges for individuals and families whose earnings are at or below 150% of the federal poverty level and 50% of hospital charges for individuals and families whose earnings are at or below 250% of the federal poverty level. Under these guidelines a family of four without health insurance that has an annual household income of $33,075 or less is eligible for a 100% discount on their hospital bill, and a family of four without health insurance that has an annual household income of $55,125 or less is eligible for a 50% discount on their hospital bill. HSHS Charity Care programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Hospitals have created a simple two page form for those wishing to apply for Charity Care and assign counselors to visit with inpatients who are uninsured to let them know about our charity care policies and provide assistance filling out applications for financial assistance or enrollment in publicly funded health care programs. The gratitude of the people who have benefitted from our Charity Care program (sometimes referred to as Christian Care) is reflected in some of the thank you letters sent to St. Anthony's Memorial Hospital in Effingham, IL. Comments included: "When I opened your letter today and read that you gave me a 100% Christian Care adjustment, I gasped and started crying. I am so grateful. I count this as an unexpected miracle from God working through people willing to show his love to others." - D.K. The King will reply, "I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me." - Matthew 25:40. "We just want to take a moment to express our deepest gratitude! Your generosity has eased our minds, hearts & pocket book!! Thank you, Thank you, Thank you! God Bless You All! I pray someday I will be able to help someone in such a generous way! You have no idea what a relief this is for us! Thank You seems too simple of words!" - S.L. and C.S. "I want to say at all those who have made it possible to help us pay my hospital bills - Thank You! I don't have words to thank you for all the worry that you have taken away. A thousand "thanks." May God bless you." - L.B. (translated by N.R. and W.R.) "My husband K. and I would like to express our deepest gratitude for your assistance with his medical bill from the hospital. We cannot thank you enough for the help and how this eased a financial burden that we faced. Keeping this gift in mind, we will strive to help others who are in need in whatever way we can to 'Pay it forward.' Thank you and bless you all!" - K.S. and L.S. Our Charity Care programs are only one aspect of our commitment to increasing access to health care services in Illinois and Wisconsin. In many of our communities, HSHS collaborates with Federally Qualified Health Centers (FQHCs) to provide greater access to health care services for low-income residents. For example, St. Elizabeth's Hospital in Belleville, IL hosts a FQHC primary care clinic adjacent to its Emergency Department and St. John's Hospital in Springfield, IL coordinates specialty physician referrals with the local FQHC and provides free health care to its clients. HSHS hospitals work collaboratively in their communities to support the various social services that together make up the fabric of the health care safety net. Sacred Heart Hospital in Eau Claire, WI provides leadership, staff support and laboratory and radiology services for the Chippewa Valley Free Clinic. During FY2010 Sacred Heart's Lab performed 676 tests for patients from the clinic St. Mary's Hospital Medical Center in Green Bay, WI supports a Women's Place, which provides health care services and referrals for men and women in the Latino community. "Because of language barriers, erratic work schedules and the lack of insurance and transportation, many in the Latino community aren't able to access our health system," explains Program Director Carol Ponce. "I feel it is important to overcome those barriers and build bridges for people in the Latino community to access health care and other services that contribute to their well-being. Our programs not only bring health care to the Latino community but joy and connection to other people from Mexico, Honduras, Nicaragua, Peru and Puerto Rico." In rural Illinois, Prairie Heart Institute of Illinois (PHII), a physician group affiliated with HSHS, is bringing a higher level of cardiovascular care to patients in their communities through extensive collaboration with local hospitals and physicians. Through regularly scheduled clinics and sharing of protocols and best practices, rural hospitals across central and southern Illinois can more rapidly and accurately identify heart attack patients and speed treatment to minimize damage to the heart muscle. Meanwhile, access to clinical trials provides opportunities for patients in rural areas to have access to drugs and treatments available only through PHII. "The result of this unique commitment is that regardless of where a patient lives, they will have access to care designed to detect heart disease earlier. We can also offer previously unavailable life-saving techniques and drugs and ensure a return to a quality of life," explains Jim Zito, PHII CEO. The benefits of this type of collaboration are many, including the stAffiliatedHealthCareSystem
Reports Filed With StatesILReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN KAST
03521970533930221800100813214201887521420547458040681
THERESA J RUTHERFORD
1849280007330302470178180233726000
ANN CARR
0131424000220240104209013649027130600
GORDON CHU MD
55620703300005940174060233070630514000
NAEEMUDDIN JATOI MD
27084101470006540299370228070338939000
JOHN BRITT MD
5744510500000135000178770642463000
ADAM CUMBO
131128000499720-131490224430190394000
Beth A McCoy
2312390528405280587490293450325145000
Roberta McBride
22639105284098201973590180950448111000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE PAYMENTSSCHEDULE J, PART I, LINE 4AADAM CUMBO RECEIVED $49,670 OF SEVERANCE FOR THE 2009 TAX YEAR.
Deceased Board MemberSchedule J, Part IIIJohn J. White, who was a board member during fiscal year 2009, has since passed away in January 2010.

Schedule L IRS990ScheduleL

Loan Table LoanTable (3 entries)

Loan To OrganizationLoanToOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Surgical Specialists
of Central
Illinois SC
X$362,509293014truefalsetrue
FieldValueIRS element (for citing)
Total Balance Due293014TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Bolen Robinson Ellis
Board Member345680legal servicesfalse
Surgical Specialist of Decatur
Board Member402265leases office spacefalse
JL HUBBARD INSURANCE AND BONDS
BOARD MEMBER12903PURCHASED BONDSfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PAGE 3 PART IIIFORM 990 - GENERAL EXPLANATION ATTACHMENT STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PAGE 3 PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ST. MARY'S HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF ST. MARY'S HOSPITAL, IT IS RECONGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE NECESSARY MEDICAL SERVICES. INHERENT TO OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE COMMUNITY EDUCATION PROGRAMS, WELLNESS PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. DURING FICAL YEAR 2010, ST. MARY'S HOSPITAL PROVIDED 37,100 ADULT AND PEDIATRIC DAYS OF CARE AND 137,175 OUTPATIENT VISITS DURING THE SAME TIME PERIOD. ST. MARY'S HOSPITAL PROVIDES BOTH BENEFITS TO THE POOR AND TO THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED ON THE FORM OF TRADITIONAL CHARITY CARE FOR THOSE WHO CANNOT AFFORD TO PAY, UNPAID COSTS FO PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF, NONBILLED SERVICES FOR THE POOR AND MANY IN-KIND DONATIONS. THE TOTAL VALUES OF THESE UNREIMBURSED BENEFITS FOR THE POOR WERE $12,388,536 IN FISCAL YEAR 2010. ST. MARY'S HOSPITAL PROVIDES NUMEROUS BENEFITS TO THE BROADER COMMUNITY. THIS IS CARRIED OUT THROUGH OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE, AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN TOTALED $17,953,697 DURING FISCAL YEAR 2010. ALL OTHER NONBILLED SERVICES PROVIDED TO THE COMMUNITY AND SERVICES PROVIDED AT LOW OR NEGATIVE MARGINS TOTALED $898,687 FOR THE YEAR ENDED 6/30/2010. BELOW ARE SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: THROUGH THE OPERATION OF ITS PRENATAL CLINIC, THE HOSPITAL PROVIDES BOTH PRE AND POST NATAL CARE TO THE POOR. THE HOSPITAL ROUTINELY DONATES FOOD TO LOCAL FOOD PANTRIES. OBSOLETE EQUIPMENT IS ALSO OCCASIONALLY DONATED TO LOCAL AGENCIES. PROVIDE TRAINING TO THE LOCAL PARAMEDICS, FIRST RESPONDER GROUPS, AND FIRE DEPARTMENTS. IN ADDITIONA, AREA ORGANIZATIONS RECEIVE CPR TRAINING THROUGHT THE HOSPITAL'S EMS DEPARTMENT. FORM 990 - GENERAL EXPLANATION ATTACHMENT HOSPITAL PARTICIPATES IN THE SECONDARY TRANSITIONAL EXPERIENCE PROGRAM BY PROVIDING EMPLOYMENT OPPORTUNITIES TO HANDICAPPED STUDENTS. PASTORAL CARE AND SOCIAL SERVICE DEPARTMENTS PROVIDE ASSISTANCE FOR PATIENT AND FAMILY NEEDS. PROVIDED LIFELINE VOICE COMMUNICATORS TO ELDERLY PATIENTS WITH SPECIAL NEEDS. EMPLOYEES SERVE AS SPEAKERS AT HEALTH FAIRS, SCHOOLS, AND A VARIETY OF AREA ORGANIZATIONS. ASSIST THE UNTIED WAY CAMPAIGN BY HAVING STAFF MEMBERS ORGANIZE THE HSOPITAL'S ANNUAL FUND DRIVE. PROVIDE A VARIETY OF HEALTH SCREENINGS TO THE PUBLIC IN DIFFERENT LOCATIONS THROUGHOUT THE COMMUNITY. TAX EXEMPT BONDS FORM 990, PART IV, QUESTION 24 St. Mary's Decatur HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990, PART VI, LINES 6 & 7ATHE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL DECATUR (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT.
MEMBER RESERVED POWERSFORM 990, PART VI, LINE 7BResponsibility for the policy and operations of St. Mary's Hospital Decatur (the "Corporation") is vested in its Board of Directors, except with respect to specific powers reserved in the Corporation's Bylaws to the Corporation's Member, Hospital Sisters Health Services, Inc. ("HSSI"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The member of HSSI is Hospital Sisters Health System ("HSHS"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The members of HSHS are the individual sisters who from time to time are the duly elected Provincial Superior and Provincial Councilors, respectively of the American Province of the Hospital Sisters of St. Francis ("American Province"). The American Province is the United States organization of the Congregation of the Hospital Sisters of the Third Order Regular of St. Francis, a religious institute of the Roman Catholic Church. The governance and operations of the Corporation are subject to HSSI's right to exercise these reserved powers with respect to the Corporation and organizations of which the Corporation is either, directly or indirectly, a controlling member or a controlling shareholder ("Affiliates"). HSSI's right to exercise certain of these reserved powers is, in turn, subject to the approval of HSHS and HSHS' members. The reserved powers include all rights granted to HSSI by law and the right to: (a) Adopt, approve amendments to, or amend any statement of philosophy, mission, mission integration or values or any name, logo, or mark of the Corporation or of any Affiliate; (b) Adopt, approve amendments to, or amend the Articles of Incorporation of the Corporation or of any Affiliate; (c) Adopt, approve amendments to, or amend the Bylaws of the Corporation or of any Affiliate; (d) Appoint and remove the Board of Directors, any one or more of the Directors of the Corporation or of any Affiliate, and the Chairperson and President of the Corporation or of any Affiliate; (e) Approve the recommendation of the Board of Directors to appoint or remove the Board of Directors, any one or more Directors of the Corporation or of any Affiliate, or the Chairperson and President of the Corporation or of any Affiliate. (f) With respect to the Corporation or any Affiliate, approve the purchase, sale, alienation, exchange, lease or encumbrance of any real property of the Corporation or of any Affiliate, which property has a value in excess of limits set from time to time by HSSI; (g) Approve the operating and capital budgets of the Corporation or of any Affiliate, and any deviations by the Corporation or of any Affiliate from such budgets in an amount or percentage specified by HSSI from time to time; (h) Approve the strategic plan and goals of the Corporation or of any Affiliate; (i) Approve the sale of substantially all of the assets of the Corporation or of any Affiliate; (j) Approve the merger or dissolution of the Corporation or of any Affiliate; (k) Adopt or amend the plan for ministry education and governance for the Corporation and its Affiliates; (l) Approve the Corporation's Mission Accountability Reports and those of any Affiliate; (m) Approve the financial policies and procedures of the Corporation or of any Affiliate and approve any deviations from such policies and procedures by the Corporation or any Affiliate; and (n) Adopt policies to implement the Reserved Powers of HSSI.
FORM 990 REVIEW PROCESSFORM 990, PART VI, LINE 11aThe hospital employs KPMG to assist in the overall review and electronic submission of its Form 990. KPMG provides guidance in identifying critical errors in the return submission and feedback on quantitative and qualitative responses. Additionally, the hospital CFO performs a thorough review of the return and reviews it with the hospital CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS.
ADDRESS OF OFFICERS WHO CANNOT BE REACHED AT THE HOSPITALFORM 990, PART VI, LINE 11Adam Cumbo 528 Lucas Lane Forsyth, IL 62535
CONFLICT OF INTEREST POLICYFORM 990, PART VI, LINE 12CThe organization is subject to the corporate compliance program and conflict of interest policy ("policy") of Hospital Sisters Health System, an Illinois not for profit corporation exempt from federal taxation under section 501(c)(3) of the internal revenue code. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH the organizaton's CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP OR ACTIVITY CONTEMPLATED, ENTERED INTO OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWERS ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
WHISTLEBLOWER POLICYFORM 990, PART VI, LINE 13Provisions within the Corporate Compliance Program and Conflict of Interest Policy provide protections for whistleblower type activities.
COMPENSATION PROCESSFORM 990, PART VI, LINE 15THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES (IHS), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
DISCLOSURE: DOCUMENTS AVAILABLE TO THE PUBLICFORM 990, PART VI, LINE 19Board-approved financial statements are made available to the public upon request. The governing documents and conflict of interest policy are not made available to the general public at this time.
POOLED INVESTMENT ACCOUNTFORM 990, PART X, LINE 11ST. MARY'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501 (C) (3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. INVESTMENTS FOR THE POOLED ACCOUNTS ARE ALL HELD FOR OTHER THAN TRADING PURPOSES. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS.
LOANS TO INTERESTED PERSONSFORM 990 SCHEDULE L, PART IIJohn J. White was an owner of Surgical Specialists of Central Illinois, S.C. who received a loan from the Hospital. THE $362,509 ISSUED TO SURGICAL SPECIALISTS OF CENTRAL ILLINOIS, S.C. WAS ISSUED AS TWO SEPARATE LOANS. $163,196 OF THE ENDING BALANCE REPRESENTS THE LOAN THAT WAS IN DEFAULT AT THE END OF THE FISCAL YEAR. THIS LOAN WAS SETTLED IN NOVEMBER OF 2010 AFTER THE END OF THE FISCAL YEAR.
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSFORM 990 SCHEDULE L, PART IVBOARD MEMEBER, JON ROBINSON, IS A 50% PARTNER IN THE BOLEN, ROBINSON LAW FIRM. THE FIRM PROVIDES LEGAL SERVICES TO THE ORGANIZATION AND ALL SERVICES WERE CONSIDERED TO BE ARMS-LENGTH TRANSACTIONS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Springfield Health Partners LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14936 Laverna RoadAddressLine1
CityspringfieldCity
StateILState
ZIP Code62707ZIPCode
FieldValueIRS element (for citing)
EIN371364419EIN
Primary ActivitieshealthcarePrimaryActivities
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1hshs mgBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROADSPRINGFIELDIL62707371058692HEALTHCAREIL501(c)(3)11ANA
Hospital Sisters Services Inc
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)(3)11ANA
HOSPITAL SISTERS OF ST FRANCIS FDTN
4936 LAVERNA ROADSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)(3)11ANA
HSHS SELF INSURANCE TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)(3)11ANA
HSHS HEALTH CARE PLAN TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)(9)3NA
Hospital Sisters Healthcare West Inc
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729510157933HEALTHCAREWI501(c)(3)3NA
SACRED HEART HOSPITAL
900 WEST CLAIREMONT AVENUEEAU CLAIREWI54701390807060HEALTHCAREWI501(c)(3)3NA
ST ANTHONY'S HOSPITAL
503 N MAPLE STREETEFFINGHAMIL62401370661233HEALTHCAREIL501(c)(3)3NA
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREETBELLEVILLEIL62220370663567HEALTHCAREIL501(c)(3)3NA
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUESHEBOYGANWI53081390808480HEALTHCAREWI501(c)(3)3NA
ST JOHN'S HOSPITAL
500 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANEBREESEIL62230371208459HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)(3)3NA
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)(3)3NA
ST MARY'S HOSPITAL
111 SPRING STREETSTREATORIL61364362169181HEALTHCAREIL501(c)(3)3NA
ST MARY'S MEDICAL CENTER
1726 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)(3)3NA
ST VINCENT HOSPITAL
835 S VAN BURENGREEN BAYWI54301390817529HEALTHCAREWI501(c)(3)3NA
ST JOSEPH'S HOSPITAL
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)(3)3NA
HSHS MEDICAL GROUP INC
4936 LAVERNA ROADSPRINGFIELDIL62707263956318HEALTHCAREIL501(c)(3)11ANA
HSHS WISCONSIN MEDICAL GROUP INC
8040 Excelsior Dirve STE 200MADISONWI53717264515959HEALTHCAREWI501(c)(3)11ANA
Orangs Cross Ambulance inc
919 Ashland AveSheboyganWI53081391860942HealthcareWI501(c)(3)9St Nicholas
Wisconsin Upper Peninsula Onc Mngmt Svcs
835 S Van BurenGreen BayWI54301391677100HealthcareWI501(c)(3)3St Vincents
Unity Limited Partnership
2366 Oak Ridge CircleDe PereWI54115391750729HealthcareWI501(c)(3)9HSSI

Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Memorial and St Elizabeth's Healthcare
4000 North Illinois StreetSwanseaIL62226371312961HealthCareILSt Elizabeth'sRelatedfalsefalse
Health Ventures Of So Illinois LLC
2810 Frank Scott Pkwy W STE 700BellevilleIL62223371334060HealthCareILSt Elizabeth'sRelatedfalsefalse
Prairie Heart Insutute - Carbondale LLC
800 East Carpenter StreetSpringfieldIL62769371321197HealthCareILSt John'sRelatedfalsefalse
Northeast Wisconsin Radiation Therapy Se
1821 S Webster Avenue STE 300Green BayWI543079047263749065HealthCareWISt Vincent'sRelatedfalsefalse
Pain Center of Wisconsin
4131 W Loomis Road STE 300GreenfieldWI53221263155343HealthCareWISt Vincent'sRelatedfalsefalse
Surgery Center of Sheboygan LLC
3141 Saemann AveSheboyganWI53081260822209HealthCareWISt NicholasRelatedfalsefalse
Prevea Ventures LLC
2710 EXECUTIVE DRGreen BayWI54304203775127HealthCareWIHSSIRelatedfalsefalse
Kiara Clinical Integration Network LLC
4936 Laverna RdSpringfieldIL62707261417684HealthCareILKiara IncRelatedfalsefalse
Carpenter Street Hotel LLC
525 North Sixth StreetspringfieldIL62702364128127hotelILlasante increlatedfalsefalse
Springfield Urgent Care Real Estate LLC
PO Box 19456springfieldIL627949456030413258rent. real estateILlasante increlatedfalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Kiara Inc
4936 Laverna RdSpringfieldIL62707371163401HealthCareILHSHSC Corp
LaSante Wisconsin Inc
4936 Laverna RdSpringfieldIL62707391572196HealthCareILKiara IncC Corp
LaSante Inc
4936 Laverna RdSpringfieldIL62707371163400HealthCareILKiara IncC Corp
Prairie Cardiovascular
619 East Mason STE 4P57SpringfieldIL62701371071858HealthCareILKiara IncC Corp
Prevea Health Services
2710 EXECUTIVE DRGreen BayWI54304391839351HealthCareWIHSSIC Corp
Prevea Clinic Inc
2710 EXECUTIVE DRGreen BayWI54304391839349HealthCareWIHSSIC Corp
Prevea Health Network
2710 EXECUTIVE DRGreen BayWI54304392000537HealthCareWIHSSIC Corp
Prevea Regional Services
2710 EXECUTIVE DRGreen BayWI54304391909993HealthCareWIHSSIC Corp
Renaissance Quality Insurance
980669953InsuranceHSSIc corpPO Box 1159 KY1-1102Grand CaymansCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Prairie CardiovascularBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeqTransactionType
Amount Involved134653AmountInvolved

Affiliate Listing AffiliateListing