SARAH BUSH LINCOLN HEALTH SYSTEM INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SARAH BUSH LINCOLN HEALTH SYSTEM INC (EIN 37-1136714)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-04-29
IRS object ID
201111199349300906
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)
Timestamp2011-04-29T11:30:03-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1211 N BROADWAY SUITE 600AddressLine1
CityST LOUISCity
StateMOState
ZIP Code631022733ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN371136714EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sarah Bush Lincoln Health SystemBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSARANameControl
Phone2172582513Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 Health Center Dr PO Box 37AddressLine1
CityMattoonCity
StateILState
ZIP Code61938ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCRAIG SHEAGRENName
TitleVICE PRESIDENT FINANCETitle
Phone2172582513Phone
Date Signed2011-04-29DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3142315544Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY BARNETTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11000 HEALTH CENTER DRIVEAddressLine1
CityMATTOONCity
StateILState
ZIP Code61938ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2201761GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.sarahbush.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionSARAH BUSH LINCOLN HEALTH SYSTEM PROVIDES ADMINISTRATIVE SUPPORT TO SARAH BUSH LINCOLN HEALTH CENTER.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year941225ProgramServiceRevenuePriorYear
Program Service Revenue CY908106ProgramServiceRevenueCY
Investment Income Prior Year-70998InvestmentIncomePriorYear
Investment Income Current Year65690InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year870227TotalRevenuePriorYear
Total Revenue Current Year973796TotalRevenueCurrentYear
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 Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1674968OtherExpensePriorYear
Other Expenses Current Year1628829OtherExpensesCurrentYear
Total Expenses Prior Year1674968TotalExpensesPriorYear
Total Expenses Current Year1628829TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-804741RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-655033RevenuesLessExpensesCY
Total Assets BOY3028838TotalAssetsBOY
Total Assets EOY5158527TotalAssetsEOY
Total Liabilities BOY3136957TotalLiabilitiesBOY
Total Liabilities EOY5886597TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-108119NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-728070NetAssetsOrFundBalancesEOY
Mission DescriptionSARAH BUSH LINCOLN HEALTH SYSTEM IS ORGANIZED TO SUPPORT AND ENCOURAGE QUALITY HEALTH CARE SERVICES THROUGH PROVIDING FINANCIAL, MANAGEMENT, AND PLANNING ASSISTANCE TO SARAH BUSH LINCOLN HEALTH CENTER, SARAH BUSH LINCOLN HEALTH FOUNDATION, SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES, AND SARAH'S HOMEMAKERS OF SARAH BUSH LINCOLN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1470555Expense
Revenue908106Revenue
DescriptionSARAH BUSH LINCOLN HEALTH SYSTEM IS ORGANIZED TO SUPPORT AND ENCOURAGE QUALITY HEALTH CARE SERVICES THROUGH PROVIDING FINANCIAL, MANAGEMENT, AND PLANNING ASSISTANCE TO SARAH BUSH LINCOLN HEALTH CENTER, SARAH BUSH LINCOLN HEALTH FOUNDATION, SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES, AND SARAH'S HOMEMAKERS OF SARAH BUSH LINCOLN NFP, INC.Description
Total Program Service Expense1470555TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
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 OfficetrueForeignOffice
Foreign ActivitiestrueForeignActivities
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 EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
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
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
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
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCRAIG SHEAGREN CPANamePerson
Telephone Number2172582513TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 HEALTH CENTER DR PO BOX 372AddressLine1
CityMATTOONCity
StateILState
ZIP Code61938ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationFormerFormer
JOYCE MADIGAN
CHAIRPERSON3.0XX000
JOHN HEDGES
TREASURER1.0XX000
MIKE LANMAN
DIRECTOR1.0X000
JILL NILSEN
VICE CHAIR3.0XX000
LYLA MCGUIRE
DIRECTOR1.0X000
MIKE STANFIELD
DIRECTOR1.0X000
MICHAEL SMITH
DIRECTOR1.0X000
SHERYL ARTMANN
SECRETARY1.0XX043087626708
GARY BARNETT
PRESIDENT & CEO15.0X070325533604
CRAIG SHEAGREN
VICE PRESIDENT FINANCE1.0X024720521626
EDWARD HOPPIN
FORMER OFFICER034240931204X
DENNIS PLUARD
FORMER VP FINANCE039184323783X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2115588TotalReportableCompFrmRltdOrgs
Total Other Compensation136925TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonSARAH BUSH LINCOLN HEALTH CENTERNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 HEALTH CENTER DRIVEAddressLine1
CityMATTOONCity
StateILState
ZIP Code61938ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMANAGEMENT SERVICESDescriptionOfServices
Compensation111222Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
WORK COMP REIMBURSEMENT561000750000750000
MANAGEMENT FEES561000158106158106
FieldValueIRS element (for citing)
Total Program Service Revenue908106TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column29671TotalRevenueColumn
Exclusion$29,671ExclusionAmount

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)
Securities1263984Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1227965Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities36019Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column36019TotalRevenueColumn
Exclusion$36,019ExclusionAmount

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
Unrelated Business Revenue0UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column973796TotalRevenueColumn
Related Or Exempt Function Income908106RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$65,690ExclusionAmount

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total111222Total
Management And General111222ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4400Total
Management And General4400ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5160Total
Management And General5160ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total36024Total
Management And General36024ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
WORK COMPENSATION FEES &CLAIMS14705551470555
DUES13001300
MISCELLANEOUS1681680

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1628829Total
Program Services1470555ProgramServices
Management And General158274ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY56642BOY
EOY146600EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY45412BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1306784BOY
EOY1391927EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1620000BOY
EOY3620000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3028838BOY
EOY5158527EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3136957BOY
EOY5886597EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3136957BOY
EOY5886597EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-108119BOY
EOY-728070EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-108119BOY
EOY-728070EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3028838BOY
EOY5158527EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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

Name Name

FieldValueIRS element (for citing)
Business Name Line1SARAH BUSH LINCOLN HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN237098532EIN
Type Of Organization03TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$1,470,555Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts1470555SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionCAPTIVE INSURANCE INVESTMENTDescription
Book Value3620000BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities3620000TotalOfBookValueSecurities

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 FOOTNOTEIdentifier
Return ReferencePART X, LINE 2ReturnReference
ExplanationMANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Type Of Activities ConductedInvestmentsTypeOfActivitiesConducted

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
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 (5 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
GARY BARNETT
042925402214150525860825002535407368590641532
EDWARD HOPPIN
02269690874330280070825002295403736130477566
DENNIS PLUARD
02323330892890702210825001553304156260313632
SHERYL ARTMANN
03457560448510402690779801891004575840438456
CRAIG SHEAGREN
0198095045811032990798501364102688310267481

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL NONQUALIFIED RETIREMENT PLANIdentifier
Return ReferenceSCHEDULE J, LINE 4BReturnReference
ExplanationSARAH BUSH LINCOLN HEALTH CENTER CURRENTLY MAINTAINS, A NONQUALIFIED, UNFUNDED, DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, ON BEHALF OF CERTAIN DESIGNATED MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE PLAN IS INTENDED TO BE AN UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, AS DESCRIBED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE FOLLOWING PERSONS LISTED IN FORM 990, PART VII ARE PARTICIPANTS IN THE PLAN: SHERYL ARTMANN GARY BARNETT CRAIG SHEAGREN EDWARD HOPPIN DENNIS PLUARD THE FOLLOWING PERSON RECEIVED A DISTRIBUTION FROM THE PLAN DURING THE TAX YEAR: DENNIS PLUARD $ 25,696Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11ATHE SENIOR ACCOUNTING STAFF REVIEWS ALL ELEMENTS OF THE 990 BASED ON PRIOR KNOWLEDGE AND INTERVIEWS WITH OTHER INDIVIDUALS IN THE ORGANIZATION. BOARD MEMBERS SUBMITTED DETAILED QUESTIONNAIRES WITH REGARDS TO THEIR RELATIONSHIPS WITH THE ORGANIZATION PER THE RECOMMENDATION WITH INDEPENDENT CONSULTANTS. THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD AT THEIR MEETING FOR REVIEW AND QUESTIONS.
PART VI, SECTION B, LINES 12A-CMEMBERS OF THE BOARD OF DIRECTORS COMPLETE AN ANNUAL BOARD CERTIFICATION STATEMENT WHICH IDENTIFIES POSSIBLE CONFLICTS OF INTEREST RELATED TO THEIR PROFESSIONAL AND PERSONAL LIVES. DURING DELIBERATIONS AND DECISIONS ON WHICH THERE APPEARS TO BE A CONFLICT OF INTEREST, THE BOARD MEMBER IS EXCUSED FROM THE DISCUSSION AND DELIBERATION, SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON OR BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM IN RESPECT TO THE TRANSACTION OR CONTRACT.
PART VI, SECTION B, LINE 15A AND BALL SALARIES FOR SARAH BUSH LINCOLN HEALTH SYSTEM PERSONNEL ARE PAID BY SARAH BUSH LINCOLN HEALTH CENTER. THE SYSTEM RECORDS COMPENSATION OF ITS PERSONNEL FOR 990 REPORTING AS MANAGEMENT FEES. COMPENSATION IS DETERMINED BY THE SBL HEALTH CENTER ANNUALLY AFTER INTERNAL REVIEW OF MARKET DATA FROM OUTSIDE CONSULTANTS WITH RECOMMENDATIONS PRESENTED TO THE ADMINISTRATION TEAM FOR APPROVAL. THE BOARD APPROVES THE OVERALL COMPENSATION PROGRAM.
PART VI, SECTION C, LINE 19CURRENTLY, SARAH BUSH LINCOLN HEALTH CENTER, THE SYSTEM'S RELATED ORGANIZATION, POSTS THEIR COMMUNITY BENEFIT STATEMENTS ON OUR PUBLIC WEBSITE. NO OTHER GOVERNING DOCUMENTS ARE MADE AVAILABLE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SARAH BUSH LINCOLN HEALTH CENTER
1000 HEALTH CENTER DRIVEMATTOONIL61938237098532HEALTH CAREIL501(c)(3)03NA
SARAH BUSH LINCOLN HEALTH FOUNDATION
1000 HEALTH CENTER DRIVEMATTOONIL61938371136713FUNDRAISINGIL501(c)(3)11-INA
SARAH'S HOMEMAKERS OF SARAH BUSH LINCOLN
1000 HEALTH CENTER DRIVEMATTOONIL61938371395122PATIENT SVCSIL501(c)(3)09NA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
SARAH BUSH LINCOLN HEALTH MANAGEMENT SVC
1000 HEALTH CENTER DRIVEMATTOONIL61938371136614RETAIL RX, DMEILNAC CORP253882355324281.00000
SARAH BUSH LINCOLN CAPTIVE INSURANCE LTD
980566036INSURANCENAC CORP355276999264131.00000PO BOX 69GRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
SARAH BUSH LINCOLN CAPTIVE INSURANCE
b5431252
SARAH BUSH LINCOLN HEALTH CENTER
j5160
SARAH BUSH LINCOLN HEALTH CENTER
o111222
SARAH BUSH LINCOLN HEALTH CENTER
p750000
SARAH BUSH LINCOLN HEALTH CENTER
r158106

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