2011-11-11T13:00:33-06:00 2011-03-31 CROWE HORWATH LLP 9600 Brownsboro Road Suite 400 Louisville KY 402411122 990 2010-04-01 205521741 SOUTHERN ILLINOIS MEDICAL SERVICES NFP SOUT 6184575200 1239 EAST MAIN STREET CARBONDALE IL 62901 MIKE KASSER 2011-11-11 true 5023263996 2010 2016-02-24 21:20:13Z REX BUDDE 1239 EAST MAIN STREET CARBONDALE IL 62901 30806669 false X WWW.SIH.NET X 2006 IL SOUTHERN ILLINOIS MEDICAL SERVICES IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES IT SERVES. 7 5 315 6 19876 -3588 0 0 26529563 30743772 -54586 2584 53264 43147 26528241 30789503 0 0 0 0 19314021 12392755 0 0 0 11186123 21999765 30500144 34392520 -3971903 -3603017 11090995 11417438 6351491 6364856 4739504 5052582 X SOUTHERN ILLINOIS MEDICAL SERVICES NFP (SIMS) EMPLOYS PHYSICIANS AND OPERATES PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED, OR AFFLICTED ON A NOT-FOR-PROFIT BASIS. (CONTINUED IN SCHEDULE O) false 12580283 0 12682170 SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES HOSPITAL PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS AT THE THREE HOSPITALS OPERATED BY OUR SOLE MEMBER SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS). THESE HOSPITAL PHYSICIANS PROVIDE TWO DISTINCT SERVICES. ONE GROUP STAFFS THE EMERGENCY ROOMS AT EACH OF THE THREE HOSPITALS AND THE SECOND GROUP PROVIDES CARE DURING A HOSPITAL STAY AT THESE SAME HOSPITALS TO THOSE PATIENTS THAT DO NOT HAVE A PRIMARY CARE PHYSICIAN. BOTH GROUPS OF PHYSICIANS ARE VITAL TO PROVIDING HEALTHCARE TO THE POPULATION OF OUR SERVICE AREAS, AS MANY OF THE RESIDENTS DO NOT HAVE A PRIMARY CARE PHYSICIAN. THE HOSPITAL PHYSICIANS PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THE YEAR ENDED MARCH 31, 2011, THE HOSPITAL PHYSICIANS OF SIMS RECORDED 83,883 ENCOUNTERS IN TREATING THIS POPULATION. OF THESE ENCOUNTERS 61,853 OCCURRED IN THE EMERGENCY ROOMS AND 22,030 WERE ENCOUNTERS WITH HOSPITAL INPATIENTS. (CONTINUED IN SCHEDULE O) 11712764 0 10319488 SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES THE CENTER FOR MEDICAL ARTS IN CARBONDALE, IL. THE CENTER ENCOMPASSES NEARLY 60,000 SQUARE FEET OF SPACE, MAKING IT ONE OF THE AREA'S LARGEST HEALTHCARE FACILITIES. A PROMPT CARE CLINIC IS AVAILABLE WITHIN THE CENTER TO MEET THE IMMEDIATE MEDICAL NEEDS OF PATIENTS ALONG WITH AN IMAGING CENTER AND LABORATORY SERVICES. BOTH PRIMARY CARE AND SPECIALIZED MEDICAL CARE ARE PROVIDED INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, GENERAL SURGERY AND UROLOGY, AMONG OTHERS. THE CENTER FOR MEDICAL ARTS PROVIDES CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS. THE CENTER'S PHYSICIAN PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THIS REPORTING PERIOD, THE CENTER FOR MEDICAL ARTS RECORDED 97,758 ENCOUNTERS IN TREATING THIS POPULATION. (CONTINUED IN SCHEDULE O) 8176535 0 7292958 SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES COMMUNITY PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS. THESE PRACTICES ARE LOCATED IN VARIOUS COMMUNITIES IN OUR CENTRAL SERVICE AREA. BOTH PRIMARY CARE AND SPECIALIZED MEDICAL CARE ARE PROVIDED INCLUDING FAMILY MEDICINE, GENERAL SURGERY, BREAST SURGERY, PULMONOLOGIST, BARIATRIC, ONCOLOGY, AND NEUROLOGY. THESE PRACTICES PROVIDE THE ONLY ACCESS TO SEVERAL OF THESE SPECIALTIES WITHIN OUR SERVICE AREA. THESE COMMUNITY PHYSICIAN PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THE YEAR ENDED MARCH 31, 2011, THE COMMUNITY PHYSICIAN PRACTICES OF SIMS RECORDED 45,638 ENCOUNTERS IN TREATING THIS POPULATION. (CONTINUED IN SCHEDULE O) 0 0 472427 SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES AND LEASES SPACE TO ITS RELATED ORGANIZATIONS. 0 0 472427 32469582 true false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false true false false false false false false false false false true false false false false true 76 0 true 315 true true true false false false false false false false false false X 7 5 false false false false true true true true true false false true true true true true true true true false IL X Mike Kasser 6184575200 1239 East Main Stret Carbondale IL 62901 X JAMES MILLER MD 10 X 0 432110 42140 DAVE HOLLAND 8 X 0 211423 94123 PHILIP SCHAEFER 30 X 0 260629 128583 WILLIAM SHERWOOD 6 X 0 253081 157395 JAMES PAVLOVICH 40 X 466401 0 46480 JEFFREY JONES 40 X 649383 0 51948 ANAD SALEM MD 1 X 33623 0 0 STEVE SABENS 1 X 0 0 0 JEFFREY PARKS MD 1 X 0 0 0 PHIL NORDSTROM 1 X X 0 0 0 KATHLEEN FRALISH 1 X 0 0 0 HAROLD BARDO 1 X 0 0 0 MIKE KASSER 8 X 0 278862 112060 REX BUDDE 4 X X 0 409888 208901 JON W TAVEAU 40 X 644234 0 35986 AISHA WHITE 40 X 468163 0 23963 TANATIP KORTE 40 X 465369 0 39719 2727173 1845993 941298 55 false true false RIVER2 EMERGENCY PHYSICIANS PO BOX 793 TRAVERSE CITY MI 496850793 MEDICAL AND HEALTHCARE PAYMENTS 1354043 MEDICAL MARKETING MANAGEMENT LTD 21415 CIVIC CTR DR 211 SOUTHFIELD MI 48076 MEDICAL AND HEALTHCARE PAYMENTS 951174 WEATHERBY LOCUMS INC PO BOX 7972633 DALLAS TX 753972633 MEDICAL AND HEALTHCARE PAYMENTS 651107 LOCUM MEDICAL GRP 13792 COLLECTIONS CTR CHICAGO IL 60693 MEDICAL AND HEALTHCARE PAYMENTS 372771 MURPHYSBORO INTERNAL MED CINIC 1415 BRADFORD PEAR LANE CARBONDALE IL 62902 MEDICAL AND HEALTHCARE PAYMENTS 363780 24 0 NET PATIENT REVENUE 30464538 30464538 LEASEHOLD REVENUE FROM RELATED ORGANIZATIONS 279234 279234 0 0 0 0 30743772 2584 2584 0 0 0 0 0 0 0 0 0 0 22645 17166 5479 4376 1103 TRANSCRIPTION FEES 561000 7511 7511 RECEPTION SERVICE FEES 561000 11262 11262 MISCELLANEOUS REVENUE 18895 18895 0 0 0 0 37668 30789503 30767043 19876 2584 0 0 0 0 33623 33623 0 8917378 8313621 603757 486161 472786 13375 1863137 1753294 109843 1092456 1048757 43699 0 168925 168925 228406 228406 0 0 0 8791346 8553696 237650 105450 105450 1935141 1899366 35775 22340 20722 1618 0 947099 903031 44068 61925 53284 8641 0 129116 117730 11386 0 0 704446 694865 9581 1994046 1851130 142916 BAD DEBT 6192163 6192163 LOSS ON DISPOSAL OF FIXED ASSETS 4653 4653 EQUIPMENT RENTAL 358616 355616 3000 OTHER EXPENSE 356093 201245 154848 0 0 0 0 34392520 32469582 1922938 0 0 3043 -408842 96427 0 4675511 4724847 6664 16654 18475 12004 620218 776060 7947380 1991705 5490780 5955675 0 0 179877 341040 11090995 11417438 3103402 2965026 3248089 3399830 6351491 6364856 X 4739504 5052582 4739504 5052582 11090995 11417438 X -3603017 3916095 X X false true true X true true X 0 0 0 420225 420225 3179913 573302 2606611 439894 142969 296925 3775157 1275434 2499723 132191 132191 5955675 0 MEDICAL PROFESSIONAL LIABILITY INSURANCE 1343928 EXECUTIVE BENEFITS LIABILITY 36296 DUE TO AFFILIATE - SIHS 1992348 DUE TO AFFILIATE - SIHE 27258 3399830 30789503 34392520 -3603017 0 0 -3603017 31648869 872981 872981 30775888 13615 13615 30789503 35251886 872981 872981 34378905 13615 13615 34392520 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ON APRIL 1, 2007. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE MATTERS SUCH AS THE TAX EXEMPT ENTITY TAKING A TAX POSITION THAT AN ORGANIZATION IS TAX EXEMPT WITHOUT OBSERVING CORRESPONDING PROOF OF TAX EXEMPTION FROM FEDERAL AND STATE TAXING AUTHORITIES AND THERE IS MATERIAL NET INCOME GENERATED BY THE ENTITY OR EGREGIOUS COMPENSATION PAID TO INSIDERS THAT COULD RESULT IN REVOCATION OF EXEMPT STATUS (OUTSIDE THE SCOPE OF INTERMEDIATE SANCTIONS EXCISE TAX PENALTIES). THE TAX POSITION IS TO CONSIDER THAT THESE COMPENSATORY ARRANGEMENTS DO NOT JEOPARDIZE TAX EXEMPTION. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC 740 OR AT MARCH 31, 2011 AND 2010. THE COMPANY DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE COMPANY WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN MISCELLANEOUS EXPENSES. TAX RETURNS FILED BY THE CORPORATION ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE CORPORATION ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED MARCH 31, 2007 AND PRIOR. Other revenues in audited financial statements not in form 990 Schedule D, Part XII, Line 2d DEPARTMENTAL ALLOCATIONS - 855815; COST OF GOODS SOLD - 17166; Other revenues in form 990 not in audited financial statements Schedule D, Part XII, Line 4b REVENUE REPORTED AS REIMBURSEMENT OF EXPENSE - 8962; LOSS ON DISPOSAL OF FIXED ASSETS - 4653; Other expenses in audited financial statements not in form 990 Schedule D, Part XIII, Line 2d DEPARTMENTAL ALLOCATIONS - 855815; COST OF GOODS SOLD - 17166; Other expenses in form 990 not in audited financial statements Schedule D, Part XIII, Line 4b REVENUE REPORTED AS REIMBURSEMENT OF EXPENSE - 8962; LOSS ON DISPOSAL OF FIXED ASSETS - 4653; X X X X false true false false false false false false false JAMES MILLER MD 0 284433 0 680 0 146997 0 7099 0 35041 0 474250 0 37359 DAVE HOLLAND 0 200794 0 816 0 9813 0 75674 0 18449 0 305546 0 0 PHILIP SCHAEFER 0 246329 0 816 0 13484 0 93967 0 34616 0 389212 0 5017 WILLIAM SHERWOOD 0 232790 0 816 0 19475 0 120422 0 36973 0 410476 0 7147 JAMES PAVLOVICH 331951 0 132241 0 2209 0 26758 0 19722 0 512881 0 0 0 JEFFREY JONES 643101 0 748 0 5534 0 27550 0 24398 0 701331 0 0 0 MIKE KASSER 0 248467 0 816 0 29579 0 82134 0 29926 0 390922 0 9004 REX BUDDE 0 396020 0 1173 0 12695 0 158125 0 50776 0 618789 0 0 JON W TAVEAU 641745 0 530 0 1959 0 11800 0 24186 0 680220 0 0 0 AISHA WHITE 466646 0 475 0 1042 0 11929 0 12034 0 492126 0 0 0 TANATIP KORTE 314240 0 149658 0 1471 0 17471 0 22248 0 505088 0 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b COMPENSATION FOR THE ORGANIZATION'S OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. SIHS MADE THE FOLLOWING SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS/CONTRIBUTIONS: REX BUDDE - NO PAYMENT RECEIVED; $152,000 DEFERRED COMPENSATION MIKE KASSER - $9,004 PAYMENT RECEIVED; $72,334 DEFERRED COMPENSATION WILLIAM SHERWOOD - $7,147 PAYMENT RECEIVED; $110,689 DEFERRED COMPENSATION PHIL SCHAEFER - $5,016 PAYMENT RECEIVED; $84,167 DEFERRED COMPENSATION DAVE HOLLAND - NO PAYMENT RECEIVED; $68,646 DEFERRED COMPENSATION JAMES MILLER - $127,175 PAYMENT RECEIVED; NO DEFERRED COMPENSATION JEFFREY JONES - NO PAYMENT RECEIVED; $19,500 DEFERRED COMPENSATION JON W. TAVEAU - NO PAYMENT RECEIVED; $8,125 DEFERRED COMPENSATION AISHA WHITE - NO PAYMENT RECEIVED; $4,750 DEFERRED COMPENSATION JAMES PAVLOVICH - NO PAYMENT RECEIVED; $16,958 DEFERRED COMPENSATION TANATIP KORTE - NO PAYMENT RECEIVED; $8,921 DEFERRED COMPENSATION METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR SCHEDULE J, PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S PRESIDENT IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. SIHS USES THE FOLLOWING METHODS TO DETERMINE THE PRESIDENT'S COMPENSATION: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE JEFFERY JONES EMPLOYED PHYSICIAN X 60000 8327 false true true JON TAVEAU EMPLOYED PHYSICIAN X 40000 8327 false true true 16654 Description of other program services Form 990, Part III, Line 4d SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES AND LEASES SPACE TO ITS RELATED ORGANIZATIONS. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 (CONTINUED FROM PART III) THESE PHYSICIANS AND PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. SIMS CONDUCTS ITS BEHAVIORS BY SHOWING THE ORGANIZATION'S VALUES OF RESPECT, INTEGRITY, COMPASSION, COLLABORATION, STEWARDSHIP, ACCOUNTABILITY AND QUALITY. THE PRIMARY SERVICE AREA OF SIMS IS A VERY RURAL SEVEN-COUNTY REGION WITH A COMBINED POPULATION OF APPROXIMATELY 240,000. THESE COUNTIES ARE CHARACTERIZED BY: - THE RESIDENTS OF EACH OF THESE COUNTIES HAVE MEDIAN HOUSEHOLD INCOMES THAT ARE SUBSTANTIALLY LESS THAN THE STATEWIDE AVERAGE OF $46,590. - MORE OF THE RESIDENTS IN THESE COUNTIES LIVE IN POVERTY THAN THE STATE AVERAGE OF 10.7%. - THE PERCENTAGES OF CHILDREN LIVING IN POVERTY IN THESE COUNTIES ARE SOME OF THE HIGHEST IN THE STATE. SIMS PROVIDES SERVICES THROUGH THE FOLLOWING: CENTER FOR MEDICAL ARTS: THE CENTER FOR MEDICAL ARTS HAS A LONG-STANDING TRADITION OF CARING FOR SOUTHERN ILLINOIS RESIDENTS, WITH A HISTORY DATING BACK TO THE 1930S. ORIGINALLY OPERATED AS THE CARBONDALE CLINIC, THE CENTER FOR MEDICAL ARTS WAS PURCHASED IN 2006. TODAY IT IS A GROWING HEALTH FACILITY THAT INCLUDES A PROMPT CARE CLINIC, AMBULATORY SURGERY CENTER AND A RETAIL PHARMACY. BASIC LAB AND RADIOLOGY SERVICES ARE ALSO PROVIDED ON-SITE. PRACTITIONERS INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, AND SPECIALISTS SUCH AS GASTROENTEROLOGY, GENERAL SURGERY AND UROLOGY. COMMUNITY PHYSICIANS: ANOTHER GROUP OF PHYSICIANS ARE OUR COMMUNITY PHYSICIANS. THESE PHYSICIANS ARE LOCATED AT VARIOUS LOCATIONS WITHIN OUR CENTRAL SERVICE AREA. THESE PRACTITIONERS PROVIDE A VARIETY OF SPECIALTIES, INCLUDING GENERAL SURGERY, BREAST SURGERY, PULMONOLOGIST AND NEUROLOGY. THESE PRACTICES PROVIDE THE ONLY ACCESS TO SEVERAL OF THESE SPECIALTIES WITHIN OUR SERVICE AREA. HOSPITAL PHYSICIANS: ANOTHER GROUP OF PHYSICIANS ARE LOCATED AND WORK WITHIN THE HOSPITALS OPERATED BY OUR SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES. THESE PHYSICIANS STAFF THE EMERGENCY ROOMS AND PROVIDE HOSPITALIST CARE AT THESE HOSPITALS. THESE PHYSICIANS ARE VITAL TO PROVIDING HEALTHCARE TO THE POPULATION OF OUR SERVICE AREA AS MANY OF THE RESIDENTS DO NOT HAVE A PRIMARY CARE PHYSICIAN. SERVICES PROVIDED: DURING THE YEAR ENDED MARCH 31, 2011, SIMS' PHYSICIANS RECORDED 227,279 ENCOUNTERS IN TREATING THE POPULATION AREA. THE CENTER FOR MEDICAL ARTS ACCOUNTED FOR 97,758 OF THESE ENCOUNTERS, COMMUNITY PHYSICIANS ACCOUNTED FOR 45,638 ENCOUNTERS AND HOSPITAL PHYSICIANS PROVIDED THE REMAINING 83,883 ENCOUNTERS. APPROXIMATELY 57.35% OF THESE ENCOUNTERS PROVIDED CARE THAT WAS CLASSIFIED AS EITHER UNCOMPENSATED CHARITY CARE OR UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. AN ADDITIONAL 8.98% OF THE TOTAL CARE PROVIDED IN THESE ENCOUNTERS WAS WRITTEN OFF AS BAD DEBT. COMMUNITY BENEFITS: THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES, HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. THESE PROGRAMS EXTEND TO THE PATIENTS OF SIMS. THE FOLLOWING COMMUNITIES AND POPULATIONS ARE TARGETED THROUGH THESE PROGRAMS: - UNINSURED, UNDERINSURED AND UNDER-SERVED; - POPULATIONS THAT ARE VULNERABLE DUE TO A RANGE OF SOCIO-ECONOMIC BARRIERS SUCH AS POVERTY, EDUCATION LEVELS, EMPLOYMENT STATUS, AND/OR RACIAL DISPARITIES IN HEALTH CARE; - POPULATIONS THAT ARE HARD TO REACH DUE TO LANGUAGE AND CULTURAL CHALLENGES; - POPULATIONS WITH IDENTIFIED NEEDS THAT CAN BE EFFICIENTLY REACHED THROUGH THE LEVERAGING OF COMMUNITY LINKAGES (I.E. FAITH-BASED, SCHOOLS, NEIGHBORHOODS, COMMUNITIES, ETC.); - THE WORKING POOR; AND - POPULATIONS AT RISK OF EXPERIENCING ADVERSE HEALTH CONDITIONS OR OUTCOMES. HOSPITAL PHYSICIAN PRACTICES FORM 990, PART III, LINE 4A (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE HOSPITAL PHYSICIAN PRACTICES OF SIMS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE HOSPITAL PHYSICIAN PRACTICES OF SIMS IS COMPRISED OF 34% MEDICARE, 31% MEDICAID, 10% SELF-PAY/CHARITY AND 25% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE HOSPITAL PHYSICIANS OF SIMS PROVIDED $1,087,724 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE HOSPITAL PHYSICIANS OF SIMS HAVE PROVIDED $2,990,746 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $226,857 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE HOSPITAL PHYSICIAN PRACTICES OF SIMS WROTE OFF $1,932,864 FROM PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. SIMS HAS DETERMINED THAT 20.7% OR $400,103 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. CENTER FOR MEDICAL ARTS FORM 990, PART III, LINE 4B (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE PHYSICIAN PRACTICES OF THE CENTER FOR MEDICAL ARTS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE CENTER FOR MEDICAL ARTS IS COMPRISED OF 18% MEDICARE, 31% MEDICAID, 4% SELF-PAY/CHARITY AND 47% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE CENTER FOR MEDICAL ARTS OF SIMS HAS PROVIDED $1,275,285 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE CENTER FOR MEDICAL ARTS OF SIMS HAS PROVIDED $926,447 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $261,456 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE CENTER FOR MEDICAL ARTS OF SIMS WROTE OFF $677,088 OF PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. THE CENTER FOR MEDICAL ARTS HAS DETERMINED THAT 20.7% OR $140,157 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. COMMUNITY BENEFIT: EACH MONTH, THE CENTER FOR MEDICAL ARTS PROVIDES CLINIC SPACE TO THE DIVISION OF SPECIALIZED CARE FOR CHILDREN AT NO CHARGE. THREE EXAM ROOMS PLUS A DEDICATED WAITING ROOM AREA FOR THIS CLINIC ARE PROVIDED. THIS CLINIC IS SPONSORED BY THE UNIVERSITY OF ILLINOIS TO PROVIDE SPECIALTY CARE TO CHILDREN UNABLE TO AFFORD CARE. SOME OF THE CHILDREN, EVEN THOUGH COVERED BY INSURANCE, ARE SEEN FOR CASE MANAGEMENT OF SPECIALTY SERVICES. A SPECIALIST, USUALLY AN ORTHOPEDIST, EXAMINES CHILDREN WHO MAY OTHERWISE HAVE HAD TO MAKE A TRIP TO AN URBAN AREA FOR SPECIALTY CARE. THE CHILDREN THAT ARE SEEN RANGE IN AGE FROM INFANT TO 19 YEARS. THESE CHILDREN ARE RESIDENTS OF THE SERVICE REGION THAT THE CENTER FOR MEDICAL ARTS IS WITHIN. THE VALUE OF THIS SPACE IS ESTIMATED TO BE $2,200 ANNUALLY. COMMUNITY PHYSICIAN PRACTICES FORM 990, PART III, LINE 4C (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE COMMUNITY PHYSICIAN PRACTICES OF SIMS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE COMMUNITY PHYSICIAN PRACTICES OF SIMS IS COMPRISED OF 40% MEDICARE, 14% MEDICAID, 3% SELF-PAY/CHARITY AND 43% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS HAVE PROVIDED $1,516,442 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS HAVE PROVIDED $703,061 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $143,182 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS WROTE OFF $285,061 FROM PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. SIMS HAS DETERMINED THAT 20.7% OR $59,008 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION'S SOLE MEMBER IS SOUTHERN ILLINOIS HOSPITAL SERVICES, A RELATED TAX-EXEMPT ORGANIZATION. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO THE BOARD OF TRUSTEES AND APPROVE SOME DECISIONS OF THE BOARD. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES, INC., HAS THE EXCLUSIVE RIGHT TO ELECT TRUSTEES TO THE ORGANIZATION'S BOARD OF TRUSTEES. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATIONS BYLAWS. EXCEPT FOR TRANSFERS IDENTIFIED IN THE BUDGET OF THE ORGANIZATION APPROVED BY THE CORPORATE MEMBER, THE ORGANIZATION MAY NOT TRANSFER ASSETS TO ENTITIES OTHER THAN THE CORPORATE MEMBER OR ENTITIES THAT THE CORPORATE MEMBER CONTROLS (THE "CORPORATE MEMBER AFFILIATES"), WITHOUT THE APPROVAL OF THE CORPORATE MEMBER. THE CORPORATE MEMBER HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO TRANSFER ASSETS TO THE EXTENT NECESSARY TO ACCOMPLISH THE CORPORATE MEMBER'S GOALS AND OBJECTIVES. THE CORPORATE MEMBER ALSO HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF THE CORPORATE MEMBER OR A CORPORATE MEMBER AFFILIATE. THE ORGANIZATION CANNOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS IN COMPLYING WITH ANY ASSET TRANSFERS DIRECTED BY THE CORPORATE MEMBER. IN ADDITION, THE FOLLOWING MATTERS MUST BE SUBMITTED TO AND RECEIVE THE APPROVAL OF THE CORPORATE MEMBER: 1. CAPITAL EXPENDITURES IN EXCESS OF $500,000; 2. THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF REAL PROPERTY BELONGING TO THE CORPORATION OR ANY OF ITS SUBSIDIARIES; 3. THE ESTABLISHMENT OR DISCONTINUANCE OF ANY MAJOR SERVICES; INCLUDING SERVICES REQUIRING CERTIFICATES OF NEED; 4. LONG-RANGE STRATEGIC PLANS; 5. MASTER FACILITIES AND SITE PLANS; 6. THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. JOINT VENTURE OR AFFILIATION AGREEMENTS; 8. THE INCURRENCE OF INDEBTEDNESS IN EXCESS OF $500,000; 9. SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE ORGANIZATION'S ARTICLES OF INCORPORATION, OR BY ITS BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 10. DELEGATION OF THE FUNCTIONS, POWERS, DUTIES AND RESPONSIBILITIES OF ANY OFFICER OF THE CORPORATION, AND; 11. ANY OTHER MATTER WHICH MAY BE SPECIFIED FROM TIME TO TIME BY THE CORPORATE MEMBER. IN ADDITION, THE CORPORATE MEMBER RETAINS THE RIGHT TO APPROVE ALL CHANGES TO THE ORGANIZATION'S BYLAWS. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE CEO, CFO AND CERTAIN VICE-PRESIDENTS OF THE CORPORATION FOR THEIR REVIEW AND COMMENTS. THIS DRAFT COPY WAS PRESENTED TO THE FINANCE COMMITTEE BY THE CFO AND THE ORGANIZATION'S TAX ADVISORS FOR REVIEW AND COMMENTS ON NOVEMBER 2, 2011. AFTER THIS REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. Conflict of interest policy Form 990, Part VI, Section B, Line 12c ANNUALLY, THE GENERAL COUNSEL SENDS OUT A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, AND MANAGER TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. DURING EVERY BOARD MEETING, THE GENERAL COUNSEL REMINDS THE TRUSTEES THAT THE BOARD HAS A CONFLICT OF INTEREST POLICY, THAT THE GENERAL COUNSEL HAS REVIEWED THE AGENDA FOR ANY CONFLICTS, BUT THAT THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVER-LOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2010. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF ALL OFFICERS FOR THE FULL BOARD. ONLY THE COMMITTEE WILL HAVE THE AUTHORITY TO APPROVE THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND WILL REPORT ITS ACTIONS TO THE BOARD. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2010. Public Disclosure Form 990, Part VI, Section C, Line 19 THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES FORM 990, PART VII, SECTION A, LINE 1A THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SOUTHERN ILLINOIS HOSPITAL ENTERPRISES, INC., A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): ANAD SALEM - 1 HOUR PER WEEK HAROLD BARDO - 1 HOUR PER WEEK JEFFREY PARKS - 1 HOUR PER WEEK KATHLEEN FRALISH - 1 HOUR PER WEEK MIKE KASSER - 1 HOUR PER WEEK PHIL NORDSTROM - 1 HOUR PER WEEK REX BUDDE - 1 HOUR PER WEEK STEVE SABENS - 1 HOUR PER WEEK WILLIAM SHERWOOD - 1 HOUR PER WEEK THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SOUTHERN ILLINOIS HOSPITAL SERVICES, A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): ANAD SALEM - 2 HOURS PER WEEK DAVE HOLLAND - 32 HOURS PER WEEK HAROLD BARDO - 2 HOURS PER WEEK JAMES MILLER - 30 HOURS PER WEEK JEFFREY PARKS - 2 HOURS PER WEEK KATHLEEN FRALISH - 2 HOURS PER WEEK MIKE KASSER - 31 HOURS PER WEEK PHIL NORDSTROM - 2 HOURS PER WEEK PHIL SCHAEFER - 10 HOURS PER WEEK REX BUDDE - 35 HOURS PER WEEK STEVE SABENS - 2 HOURS PER WEEK WILLIAM SHERWOOD - 33 HOURS PER WEEK WILLIAM THORNE - 36 HOURS PER WEEK THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SIH FOUNDATION, NFP, A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): MIKE KASSER - 1 HOUR PER WEEK REX BUDDE - 1 HOUR PER WEEK WILLIAM SHERWOOD - 1 HOUR PER WEEK Other changes in net assets or fund balances Form 990, Part XI, Line 5 EQUITY TRANSFER FROM SIHS - 3916095; REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133 FORM 990, PART XII, LINE 3 AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2011 SOUTHERN ILLINOIS HEALTHCARE SERVICES AND AFFILIATES RECEIVED AN AUDIT FOR THE 2010 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT. SOUTHERN ILLINOIS MEDICAL SERVICES, NFP IS AN AFFILIATE OF SOUTHERN ILLINOIS HEALTHCARE SERVICES. SOUTHERN ILLINOIS HOSPITAL SERVICES PO BOX 3988 CARBONDALE IL 62902 370618939 HEALTHCARE IL 501(C)(3) 3 SOUTHERN ILLINOIS HOSPITAL ENTERPRISES SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES INC PO BOX 3988 CARBONDALE IL 62902 371136788 LEASING OF MEDICAL SPACE IL 501(C)(3) 11 - Type II NA RIC AND SIHS REHABILITATION SERVICES LLC PO BOX 3988 CARBONDALE IL 629023988 364566925 MEDICAL SERVICES IL NA N/A PHYSICIANS' SURGERY CENTER LLC 2601 WEST MAIN STREET CARBONDALE IL 62901 260425547 MEDICAL SERVICES IL NA N/A SIH CAYMAN SPC GROUP LTD PO BOX 1051 GRAND CAYMAN CJ CJ KY1-1102 980611605 FINANCING CJ SOUTHERN ILLINOIS HOSPITAL SERVICES C CORPORATION false false false false true false false false true true false false true true false true false true