HOSPITAL SISTERS HEALTH SYSTEM: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HOSPITAL SISTERS HEALTH SYSTEM (EIN 37-1058692)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201101339349300635
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)
Timestamp2011-05-13T08:26:41-05:00Timestamp
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)
EIN371058692EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL SISTERS HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOSPNameControl
Phone2175234747Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14936 LAVERNA ROADAddressLine1
CitySPRINGFIELDCity
StateILState
ZIP Code62707ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL W COTTRELLName
TitleCFOTitle
Date Signed2011-05-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

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

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEPHANIE MCCUTCHEONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14936 LAVERNA ROADAddressLine1
CitySPRINGFIELDCity
StateILState
ZIP Code62707ZIPCode
FieldValueIRS element (for citing)
Gross Receipts92940219GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees232TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI1500000TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year52993944ProgramServiceRevenuePriorYear
Program Service Revenue CY74356688ProgramServiceRevenueCY
Investment Income Prior Year-4648333InvestmentIncomePriorYear
Investment Income Current Year7519505InvestmentIncomeCurrentYear
Other Revenue Prior Year12390547OtherRevenuePriorYear
Other Revenue Current Year11045386OtherRevenueCurrentYear
Total Revenue Prior Year60736158TotalRevenuePriorYear
Total Revenue Current Year92921579TotalRevenueCurrentYear
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 Year27121012SalariesEtcPriorYear
Salaries Etc Current Year33031518SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year40782087OtherExpensePriorYear
Other Expenses Current Year49435213OtherExpensesCurrentYear
Total Expenses Prior Year67903099TotalExpensesPriorYear
Total Expenses Current Year82466731TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7166941RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10454848RevenuesLessExpensesCY
Total Assets BOY196028780TotalAssetsBOY
Total Assets EOY247386788TotalAssetsEOY
Total Liabilities BOY58332098TotalLiabilitiesBOY
Total Liabilities EOY106684616TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY137696682NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY140702172NetAssetsOrFundBalancesEOY
Mission DescriptionTO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense78495653Expense
Revenue74356688Revenue
DescriptionHOSPITAL SISTERS HEALTH SYSTEM (HSHS) IS THE PARENT CORPORATION WHICH HOLDS THE VARIOUS HOSPITAL AND HEALTH CARE RELATED CORPORATIONS FOR THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS. INTEGRITY OF THE SISTERS' MISSION IS PRESERVED BY THE DESIGNATION OF HSHS AS THE SOLE CORPORATE MEMBER OF EACH OF THE AFFILIATED HEALTH CARE ORGANIZATIONS. THE MISSION OF HSHS IS TO PROVIDE A STRUCTURE AND THE MEANS WHEREBY THE HOSPITAL SISTERS CONTINUE THEIR HEALING MINISTRY. HSHS PROVIDES PROFESSIONAL AND TECHNICAL EXPERTISE IN THE MANAGEMENT OF THE AFFILIATED ORGANIZATIONS.Description
Total Program Service Expense78495653TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
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
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
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 With109672NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees232NumberOfEmployees
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 Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
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 AddressfalseOfficerMailingAddress
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 PersonMICHAEL W COTTRELLNamePerson
Telephone Number2175234747TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14936 LAVERNA ROADAddressLine1
CitySPRINGFIELDCity
StateILState
ZIP Code62707ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
SISTER MARY ANN MINOR OSF
CHAIRPERSON1.0XX000
SISTER MAUREEN OCONNOR OSF
SECRETARY1.0XX000
SISTER MARY MORIN OSF
BOARD MEMBER1.0X000
LEO DONDANVILLE
BOARD MEMBER1.0X000
SISTER MARYANN FALBE OSF
BOARD MEMBER1.0X000
JOHN E STAUDT
BOARD MEMBER1.0XX000
STEPHANIE S MCCUTCHEON
PRESIDENT & CEO40.0XX117480301035997
SISTER MARY MOLLISON CSA
VICE CHAIRPERSON1.0XX000
SISTER BERNICE COREIL DC
BOARD MEMBER1.0X000
STEPHEN J BOCHENEK
BOARD MEMBER1.0X000
JOHN R COMBS
BOARD MEMBER1.0X000
LAWRENCE SCHUMACHER
COO40.0X8887370166493
LEO A LENN
treasurer40.0X4568500204812
ANN CARR
ASST. TREASURER40.0X1534480117382
MICHAEL W COTTRELL
CFO40.0X582921097834
GARY D LEACH
previous cfo40.02987190285215X
CHUCK MOE
PREVIOUS CAO1.01344540234514X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3689932TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation2142247TotalOtherCompensation
Number Individuals GT100 K60NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
DEARBORN ADVISORS LLC
PO BOX 95152PALATINEIL600950152COMPUTER CONSULTING21017484
LEVI RAY and SHOUP INC
2401 WEST MONROESPRINGFIELDIL62704IS CONSULTING2904424
JONES-BLYTHE CONSTRUCTION
1030 WEST REYNOLDSSPRINGFIELDIL62705CONSTRUCTION/REMODEL6200427
MARSH USA INC
PO BOX 96772CHICAGOIL606936772INSURANCE2683548
PPIC
11605 MIRACLE HILLS DRIVEOMAHANE68154INSURANCE4581784
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionAFFILIATE FEESDescription
Business Code561000BusinessCode
Total Revenue Column74356688TotalRevenueColumn
Related Or Exempt Function Income72856688RelatedOrExemptFunctionIncome
Unrelated Business Revenue1500000UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue74356688TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7408839TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities129306Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other18640Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities129306Securities
Other-18640Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column110666TotalRevenueColumn
Exclusion$110,666ExclusionAmount

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 ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER9000991190139$1,190,139
ADMINISTRATION REVENUE5610005855247$5,855,247
OTHER INCOME FROM DEVELOPMENT FUND9000994000000$4,000,000
FieldValueIRS element (for citing)
Total Other Revenue11045386TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column92921579TotalRevenueColumn
Related Or Exempt Function Income72856688RelatedOrExemptFunctionIncome
Unrelated Business Revenue1500000UnrelatedBusinessRevenue
Exclusion$11,156,052ExclusionAmount

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)
Total3245971Total
Program Services2921374ProgramServices
Management And General324597ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22865809Total
Program Services21263752ProgramServices
Management And General1602057ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3403187Total
Program Services3121348ProgramServices
Management And General281839ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1997189Total
Program Services1851774ProgramServices
Management And General145415ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1519362Total
Program Services1436417ProgramServices
Management And General82945ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1779386Total
Program Services1616002ProgramServices
Management And General163384ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total397696Total
Program Services357926ProgramServices
Management And General39770ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total594303Total
Program Services594303ProgramServices

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)
Total13314638Total
Program Services12461266ProgramServices
Management And General853372ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total350231Total
Program Services315208ProgramServices
Management And General35023ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2215871Total
Program Services2177356ProgramServices
Management And General38515ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1340352Total
Program Services1300379ProgramServices
Management And General39973ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total439838Total
Program Services399222ProgramServices
Management And General40616ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total792454Total
Program Services745347ProgramServices
Management And General47107ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1603038Total
Program Services1602905ProgramServices
Management And General133ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10333844Total
Program Services10262067ProgramServices
Management And General71777ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total90159Total
Program Services83634ProgramServices
Management And General6525ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIP. RENTAL AND MAINT.126997541266532534429
SOFTWARE SUBSCRIPTIONS2219260220104718213
RECRUITING60659758148025117
MISCELLANEOUS EXPENSES21901419925419760
DUES & MEMBERSHIP28627825840427874

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total152500Total
Program Services79863ProgramServices
Management And General72637ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total82466731Total
Program Services78495653ProgramServices
Management And General3971078ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1692BOY
EOY3358205EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13228426BOY
EOY13619052EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY4325000BOY
EOY4325000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY40578BOY
EOY40578EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3734791BOY
EOY3434909EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis178859713LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec55948480LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY82277552BOY
EOY122911233EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY91953897BOY
EOY99395067EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY466844BOY
EOY302744EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY196028780BOY
EOY247386788EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY29929301BOY
EOY40570016EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY28402797BOY
EOY66114600EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY58332098BOY
EOY106684616EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY136034342BOY
EOY139703735EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1662340BOY
EOY998437EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY137696682BOY
EOY140702172EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY196028780BOY
EOY247386788EOY
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)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (20 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
HOSPITAL SISTERS OF ST FRANCIS FOUNDATION INC
37118651403truetruetrue$0
HOSPITAL SISTERS SERVICES INC
37116340203truetruetrue$0
HSHS HEALTH CARE PLAN TRUST FUND
3711377240truetruetrue$0
HSHS SELF INSURANCE TRUST FUND
37112062603truetruetrue$0
SACRED HEART HOSPITAL
39080706003truetruetrue$0
ST ANTHONY'S HOSPITAL EFFINGHAM ILLINOIS
37066123303truetruetrue$0
ST ELIZABETH'S HOSPITAL BELLEVILLE ILLINOIS
37066359703truetruetrue$0
ST FRANCIS HOSPITAL LITCHFIELD ILLINOIS
37066123603truetruetrue$0
ST JOHN'S HOSPITAL SPRINGFIELD ILLINOIS
37066123803truetruetrue$0
ST JOSEPH'S HOSPITAL BREESE ILLINOIS
37120845903truetruetrue$0
ST JOSEPH'S HOSPITAL
37066356803truetruetrue$0
ST JOSEPH'S HOSPITAL
39081054503truetruetrue$0
ST MARY'S HOSPITAL
37066124403truetruetrue$0
ST MARY'S HOSPITAL
37216918103truetruetrue$0
ST MARY'S HOSPITAL MEDICAL CENTER
39081868203truetruetrue$0
ST NICHOLAS HOSPITAL
39080848003truetruetrue$0
ST VINCENT HOSPITAL
39081752903truetruetrue$0
HOSPITAL SISTERS HEALTHCARE - WEST INC
51015793303truetruetrue$0
HSHS MEDICAL GROUP INC
26395631803truetruetrue$0
HSHS WISCONSIN MEDICAL GROUP INC
26451595903truetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs20TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts
General Explanationhospital sisters health system ("HSHS") administers the Development Fund, Workers Compensation Fund, Health Care Trust Fund, Self insurance Fund, Flex Plan, and Investment Fund FOR HSHS AND THE RELATED HOSPITALS AND EXEMPT ORGANIZATIONS. HSHS utilizes these funds to provide centralized management and computer services to its 13 affiliated hospitals. The hospitals pay a management fee to HSHS for these services. additionally, HSHS administers the self~insurance programs for professional and general liability, workers' compensation, and employee health, along with a centralized investment program on behalf of all HSHS entities. monetary amounts of support provided are not determinable. The following is a list of management fees paid by each local hospital system: St. Elizabeth's Hospital - Belleville $ 8,581,000; St. Joseph's Hospital - Breese $ 1,694,000; St. Mary's Hospital - Decatur $ 5,186,008; St. Anthony's Hospital - Effingham $ 3,910,000; St. Joseph's Hospital - Highland $ 1,150,000; St. Francis Hospital - Litchfield $ 1,490,000; St. John's Hospital - Springfield $18,670,000; St. Mary's Hospital - Streator $ 2,760,000; St. Joseph's Hospital - Chippewa Falls $ 2,859,000; Sacred Heart Hospital - Eau Claire $ 7,225,000; St. Mary's Hospital - Green Bay $ 4,651,000; St. Vincent Hospital - Green Bay $10,949,000; St. Nicholas Hospital - Sheboygan $ 3,178,000; Total $72,303,008GeneralExplanation

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Amt Of4955 Tax0AmtOf4955Tax
Amt Of4955 Tax On Managers0AmtOf4955TaxOnManagers
Form1120 Pol FiledfalseForm1120PolFiled
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 OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$594,304GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB594304TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierN/AIdentifier

Schedule D IRS990ScheduleD

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Art Public Exhibition AmtsArtPublicExhibitionAmts
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Land Land

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Other Cost Or Other Basis25936OtherCostOrOtherBasis
Book Value25936BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7173812OtherCostOrOtherBasis
Depreciation3281152Depreciation
Book Value3892660BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

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Other Cost Or Other Basis17810775OtherCostOrOtherBasis
Depreciation12126998Depreciation
Book Value5683777BookValue

Other Land Buildings OtherLandBuildings

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Other Cost Or Other Basis153849190OtherCostOrOtherBasis
Depreciation40540330Depreciation
Book Value113308860BookValue
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Total Of Book Value Land Buildings122911233TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

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DescriptionRELATED HOSPITALS IT NOTES PAYABLEDescription
Amount$66,114,600Amount
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Total Of Amounts66114600TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 DISCLOSUREIdentifier
Return ReferenceFORM 990, SCHEDULE D, PART XReturnReference
ExplanationOn July 1, 2007, HSHS adopted ASC Subtopic 740-10, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No. 109. ASC Subtopic 740-10 addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Subtopic 740-10, HSHS must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. ASC Subtopic 740-10 also provides guidance on derecognition, classification, interest and penalties on income taxes, accounting in interim periods and requires increased disclosures. At the date of adoption, and as of June 30, 2010 and 2009, HSHS does not have a liability for unrecognized tax benefits.Explanation

Schedule J IRS990ScheduleJ

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First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
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 PaymentfalseSeverancePayment
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 (7 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
LAWRENCE SCHUMACHER
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LEO A LENN
31647808396305640901976530793206624350035810
GARY D LEACH
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CHUCK MOE
8961300044841022403101111803696030044671
ANN CARR
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STEPHANIE S MCCUTCHEON
77842803245880717870101789501887502211573000
MICHAEL W COTTRELL
39661901322820540200839090145190681349000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
member reserved powersform 990 part vi, line 7bResponsibility for the policy and operations of Hospital Sisters Health System (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 Members. The members of the corporation 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 the members' 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"). The members' reserved powers include all rights granted to them 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 organization 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 organization's CFO performs a thorough review of the return and reviews it with the organization's CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS.
CONFLICT OF INTEREST 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 our 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. The 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.
COMPENSATION ARRANGEMENTFORM 990, PART VII, SECTION AHOSPITAL SISTERS HEALTH SYSTEM EMPLOYS THE MANAGEMENT/OFFICERS OF THE VARIOUS ENTITIES WHICH ARE CENTRALLY SUPPORTED FOR THE BENEFIT OF THE THIRTEEN HOSPITALS IT SPONSORS.
POOLED INVESTMENT ACCOUNTFORM 990, PART X, LINE 11HOSPITAL SISTERS HEALTH SYSTEM 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 SPONSORSED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES that are publicly traded. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTIAN 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 NOT IDENTIFIED TO THE PARTICIPANTS.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990 PART VI, LINES 6 AND 7ATHE SENIOR GOVERNING BODY OF HOSPITAL SISTERS HEALTH SYSTEM ("HSHS") IS THE MEMBERS, WHO 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. PURSUANT TO SECTION 2.3 OF THE HSHS BYLAWS, THE MEMBERS HAVE THE RIGHT TO APPOINT AND REMOVE HSHS BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT.
AFFILIATED HEALTH SYSTEM DISCLOSUREHospital Sisters Health System 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 who earn less than 250% of the federal poverty level. Under these guidelines a family of four without health insurance that has an annual household income of $55,125 or less is eligible for a 100% 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 standardization of quality assurance measures, the sharing of successful patient safety strategies, the addition of clinical research, workforce development and internal benchmarking.
AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED)Enhancing the health status of the community A spirit of collaboration is pervasive for HSHS hospitals in all the communities we serve. Our hospitals work closely with a wide array of public and private organizations that share our commitment to enhancing health and wellness. We know that by working together, we can capitalize on shared resources, reduce duplication of services, and make it easier for residents to get the services and knowledge they need to live healthier lives. St. Joseph's Hospital in Chippewa Falls, WI leads the Chippewa Health Improvement Partnership (CHIP). This collaborative endeavor strives to enhance the quality of life of the residents of Chippewa County, through educational and preventative initiatives promoting wellness and good health. CHIP identifies health needs and establishes priorities from which collaborative activities are created to help improve the health status and quality of life in the community. Recognizing the special and diverse needs of their community, colleagues from St. Nicholas Hospital in Sheboygan, WI serve on the Hmong Health Advisory Committee and the Refugee Task Force. As a partner with the Public Health Department, Safe Harbor and Safe Kids, among others, St. Nicholas provides the Hmong community with access to free preventative health education programs such as stroke awareness, car seat safety, nutrition and foot care and screenings such as blood pressure and blood sugar, bone density and diabetes. "Reaching out and helping our community is what St. Nicholas stands for," explains Program Development Specialist Mary Paluchniak. St. Nicholas also offers alcohol, drug and prescription drug abuse programs in the community, and with the assistance of a grant from the county was able to establish a permanent 24/7 prescription drug drop-off box at the police department to alleviate the misappropriation of prescription drugs and environmental damage caused by disposing of prescriptions drugs in household trash or the public water stream. With more than a quarter of Illinois' population classified as "obese" by the Centers for Disease Control and Prevention, St. John's Hospital in Springfield, IL is working collaboratively to teach children and their parents about healthy lifestyle habits. St. John's is an Anchor Partner of Generation H (H is for Healthy), a newly formed coalition that works to improve children's health and combat the childhood obesity epidemic through programs focused on better nutrition and increased physical activity. On a quarterly basis, St. John's offers Continuing Parent Education Sessions at area schools on topics such as childhood wellness, eating healthy on a budget and summer exercise and safety. In addition, St. John's organizes family health fairs for CATCH Schools providing a variety of free screenings and educational booths, a valuable resource to school nurses and principals. St. John's also organizes the 100 Year Heart school health fairs at which each student spends 10 minutes apiece in seven booths geared toward teaching heart health such as smoking prevention and anaerobic exercise. At St. Mary's Hospital in Streator, IL dieticians offer bi-monthly nutritional programs to educate the public on topics such as diabetes management and salt intake. They also work with children to teach them about healthy eating habits. Skin cancer is the most prevalent type of cancer and annually more than one million cases of skin cancer are diagnosed in the United States. In response, St. Joseph's Hospital in Highland, IL, St. Joseph's Hospital in Breese, IL, and St. Elizabeth's Hospital in Belleville, IL partnered with New Dimensions Cosmetic and Reconstructive Surgery to offer educational programs and free skin cancer screenings at clinics throughout the Metro-east area. By planning major health promotions in partnership with area clinicians, the hospitals are increasing channels for people to access health care as well as capitalizing on shared resources and expertise and reducing duplication of services. Colleagues at St. Mary's Hospital in Decatur, IL noted that many people in the community rely on oxygen. The combination of heavy industry and farming in the area is believed to contribute to poor air quality. To address this concern, a colleague started a monthly COPD support group that consists of six physicians, five nurses, and two respiratory therapists. Together this group is working with the American Lung Association to provide two annual health fairs - one on World COPD Day in November and one for World Health Day in April. As a result of St. Mary's leadership, the word continues to spread about the Breath of Life Club and its membership is growing. St. Mary's is also in the process of placing the COPD Learn More Breathe Better Resource Kit in all their physician offices. In June, The Joint Commission recognized St. Mary's with a disease-specific certification for COPD, an acknowledgment of the work done to address this disease. Because more than 400 babies die annually, mainly through miscarriage in their county, colleagues at St. Nicholas Hospital in Sheboygan, WI recognized the need to provide support for those who had experienced a miscarriage, ectopic, stillbirth or early newborn loss. St. Nicholas' Hope After Loss Organization (HALO) program was created to support parents and their families in the community with resources and counseling regardless of when or where the death occurred. HALO provides bereavement counseling via email, telephone, one-on-one or at monthly HALO support group meetings. In addition, HALO invites parents to participate in memorial services which include a balloon release to honor and remember the babies; siblings, extended family members and friends are welcome. HSHS hospitals recognize that the health of our community depends on a healthy environment. That's why we embrace "green initiatives" and strive to incorporate environmentally friendly design elements as upgrades to our facilities. When the St. Vincent Regional Cancer Center at St. Mary's Hospital Medical Center in Green Bay, WI built a state-of-the-art addition, they included a third floor living roof garden that is the largest green roof in Wisconsin. This expansion was built with the environment in mind as it maximizes use of day light. Ninety percent of rainwater is recycled as irrigation and all storm water passes through a bio-filtration system to purify runoff water. Water-saving technology is used throughout the building and materials are low-PVC or PVC-free with natural finishes of wood and stone. Energy efficient heating and cooling was installed with heat reclamation devices in place. At St. Elizabeth's Hospital in Belleville, IL every hand is working to heal our earth. Annually St. Elizabeth's colleagues recycle 286 tons, almost 1/3 of their waste. The hospital's Environmental Services department initiated single stream recycling of aluminum cans and plastic bottles. Laundry meanwhile sent 1,073 pounds of linens to be made into rags and Pharmacy processes expired medications thus keeping them out of the air and water supplies.
AFFILIATED HEALTH SYSTEM DISCLOSURE (CONTINUED)Supporting medical education and research At HSHS, we work to ensure the advancement of medical knowledge through our support of research and education. In Fiscal Year 2010 we contributed more than $13 million in research and education. Our hospitals support and host scores of Continuing Medical Education courses which are attended by hundreds of physicians each year. St. John's College, Department of Nursing in Springfield, IL is affiliated with St. John's Hospital The College offers an upper division Baccalaureate Nursing Degree Program and Continuing Education Programs to serve nurses and allied health professionals in Central and Southern Illinois. The College is transforming itself from a traditional educational institution to one that offers innovative and leading edge programs designed to prepare candidates to care for individuals throughout life in an integrated healthcare system. Accredited by the National League for Nursing Accreditation Commission, the College offers courses that are expressions of our mission. HSHS' investment in education and training is helping improve clinical quality and patient care. One example of this commitment is training that occurred with the deployment of the Evidence-Based Medicine (EBM) Program and corresponding order sets at our hospitals. Standardizing EBM supports enhanced efficiency and leads to improved outcomes of care by reducing variation in practice and by supporting proven practice approaches in order to meet or exceed community standards of care. Standardizing both content and processes for clinical care decisions also aids in the migration to Computerize Provider Order Entry (CPOE). Another example is our work sharing best practices with other health care providers. Prairie Heart Institute of Illinois (PHII) provides rural hospitals with a Congestive Heart Failure (CHF) Toolkit that includes standardized protocols, patient teaching aids, staff training materials and methods to measure the comparative effectiveness of treatments for CHF. Nationally a few unique programs exist to address the cost and quality of treating the CHF patient. "We've developed a comprehensive approach that involves a multidisciplinary team working together to treat patients with CHF. We want to share our successes with other hospitals because we recognize that we can improve people's lives and simultaneously make our health care system more efficient," explains Frank Mikell, MD, HSHS Chief Physician Executive. The CHF Toolkit was introduced to all 13 hospitals. St. Anthony's Hospital in Effingham, St. Mary's Hospital in Decatur, St. Elizabeth's Hospital in Belleville and St. Francis Hospital in Litchfield are making strides to adopt portions of the CHF Toolkit including the patient teaching aids and the standardized protocols for physicians in the ER. Commitment to Care HSHS is working tirelessly to bring together the various elements of health care services to create better, more efficient care for our patients. Our commitment to high quality, cost-effective care is based on our Franciscan and Catholic values. These values include coverage and access for all and special attention to the sick, poor and vulnerable. The more than 14,000 colleagues in Wisconsin and Illinois who are HSHS remain dedicated to continuing the healing ministry begun by the Hospital Sisters of St. Francis more than 135 years ago.

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 ActivitiesHeathcarePrimaryActivities
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 OF ST FRANCIS FDTN
4936 LAVERNA ROADSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)311ANA
HSHS HEALTHCARE PLAN TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)3NA
HSHS SELF INSURANCE TRUST
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)311ANA
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729510157933HEALTHCAREIL501(c)311ANA
SACRED HEART HOSPITAL
990 WEST CLAIREMONT AVEEAU CLAIREWI54701390807060HEALTHCAREWI501(c)33NA
ST ANTHONY'S HOSPITAL
503 N MAPLE STREETEFFINGHAMIL62401370661233HEALTHCAREIL501(c)33NA
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREETBELLEVILLEIL62220370663567HEALTHCAREIL501(c)33NA
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUESHEBOYGANWI53081390808480HEALTHCAREWI501(c)33NA
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)33NA
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANEBREESEIL62230371208459HEALTHCAREIL501(c)33NA
ST JOSPEH'S HOSPITAL
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)33NA
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVEDECATURIL62521370661244HEALTHCAREIL501(c)33NA
ST MARY'S HOSPITAL
111 SPRING STREETSTREATORIL61364362169181HEALTHCAREIL501(c)33NA
ST MARY'S MEDICAL CENTER
1762 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)33NA
ST VINCENT HOSPITAL
835 S VAN BURENGREEN BAYWI51301390817529HEALTHCAREWI501(c)33NA
ST JOSEPH'S HOSPITAL
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)33NA
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)33NA
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)311ANA
HSHS MEDICAL GROUP INC
4936 LAVERNA ROADSPRINGFIELDIL62707263956318HEALTHCAREIL501(c)311ANA
HSHS WISCONSIN MEDICAL GROUP INC
8040 EXCELSIOR DRIVEMADISONWI53717264515959HEALTHCAREWI501(c)311ANA
orange cross ambulance inc
919 ashland avenuesheboyganWI53081391860942healthcareWI501(c)33st nicholas
wisconsin upper peninsula oncology mgmt
835 s van burengreen bayWI54301391677100healthcareWI501(c)33st vincents
unity limited partnership
2366 oak ridge circlede pereWI54115391750729healthcareWI501(c)311aHSSI

Form990 Schedule R Part III Form990ScheduleRPartIII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
Memorial and St Elizabeth's Healthcare
4000 North Illinois StreetSwanseaIL62226371312961HealthCareILSt Elizabeth'sRELATED00false$0false
Health Ventures Of So Illinois LLC
2810 Frank Scott PKWY W STE 700BellevilleIL62223371334060HealthCareILSt Elizabeth'sRELATED00false$0false
Prairie Heart Insutute - Carbondale LLC
800 East Carpenter StreetSpringfieldIL62769371321197HealthCareILSt John'sRELATED00false$0false
Northeast Wisconsin Radiation Therapy Se
1821 S Webster Ave Ste 300Green BayWI543079047263749065HealthCareWIHSSIRELATED00false$0false
Pain Center of Wisconsin
4131 W Loomis Road Suite 300GreenfieldWI53221263155343HealthCareWIHSSIRELATED00false$0false
Surgery Center of Sheboygan LLC
3141 Saemann AvenueSheboyganWI53081260822209HealthCareWISt NicholasRELATED00false$0false
Prevea Ventures LLC
2710 EXECUTIVE DRiveGreen BayWI54304203775127HealthCareWIHSSIRELATED00false$0false
Kiara Clinical Integration Network LLC
4936 Laverna RoadSpringfieldIL62707261417684HealthCareILKiara IncRELATED7942367091203false$0false
Carpenter Street Hotel LLC
525 North Sixth StreetSpringfieldIL62702364128127hotelILlasante increlated00false$0false
Springfield Urgent Care Real Estate LLC
PO Box 19456SpringfieldIL627949456030413258Rent. Real EstateILlasante increlated00false$0false

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Kiara Inc
4936 Laverna RdSpringfieldIL62707371163401HealthCareILNAC Corp-973978756359221.00000
LaSante Wisconsin Inc
4936 Laverna RdSpringfieldIL62707391572196HealthCareILKiara IncC Corp-47002096267081.00000
LaSante Inc
4936 Laverna RdSpringfieldIL62707371163400HealthCareILKiara IncC Corp-196596070473871.00000
Prairie Cardiovascular
619 East Mason Suite 4P57SpringfieldIL62701371071858HealthCareILKiara IncC Corp-12573580603039631.00000
Prevea Health Services
2710 EXECUTIVE DRGreen BayWI54304391839351HealthCareWIHSSIC Corp00
Prevea Clinic Inc
2710 EXECUTIVE DRGreen BayWI54304391839349HealthCareWIHSSIC Corp00
Prevea Health Network
2710 EXECUTIVE DRGreen BayWI54304392000537HealthCareWIHSSIC Corp00
Prevea Regional Services
2710 EXECUTIVE DRGreen BayWI54304391909993HealthCareWIHSSIC Corp00
Renaissance Quality Insurance Ltd
980669953InsuranceHSSIC Corp00PO Box 1159Grand CaymanCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
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 OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
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 Line1KIARA INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypebTransactionType
Amount Involved12869875AmountInvolved

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