2011-05-06T09:30:02-05:00 2010-09-30 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2009-10-01 370661230 Passavant Memorial Area Hospital Association PASS 2172459541 1600 West Walnut Jacksonville IL 62650 DAVE BOLEN 3142459541 2011-05-03 true Donna J Larson 3142315544 2009 2016-02-24 21:20:13Z DAVE BOLEN 1600 W WALNUT ST JACKSONVILLE IL 62650 89378851 false X HTTP://WWW.PASSAVANTHOSPITAL.COM X 1906 IL OUR MISSION IS TO PROVIDE EXCELLENT CARE WITH COMPASSION AND COMMITMENT. 16 13 968 225 224369 66081 866456 1318678 78265747 82875256 6155205 504757 1481011 1702660 86768419 86401351 50800 71324 0 0 40777056 46354758 0 0 21267 43975747 37505046 84803603 83931128 1964816 2470223 139492584 143981639 45190922 47503207 94301662 96478432 OUR MISSION IS TO PROVIDE EXCELLENT CARE WITH COMPASSION AND COMMITMENT. false false 67179135 71324 82875256 DELIVERY OF MEDICAL AND HOSPITAL SERVICES WITH APPROXIMATELY 57,661 OUTPATIENT PROCEDURES PERFORMED, 3,390 INPATIENT ADMISSIONS AND 29,329 EMERGENCY DEPARTMENT VISITS. 67179135 true true false true false false false false true true false true false false false false false false false false true true false true false false false false false false true false false false false false false true true false false true 86 0 true 968 true true true false false false false false false false false 16 13 false false false false false true false true true false false true true true true true true true true true true IL X DAVID BOLEN 2172459541 1600 WEST WALNUT STREET JACKSONVILLE IL 62650 ERIC GIEBELHAUSEN MD 2.0 X 0 0 0 AMY JACKSON 2.0 X 0 0 0 LINDA STANDLEY 2.0 X 0 0 0 RICHARD JOHNSON 2.0 X 0 0 0 STEVEN LILLPOP MD 2.0 X 12000 0 0 GREG MAY 2.0 X 0 0 0 KEITH BRADBURY 2.0 X 0 0 0 GINNY FANNING 2.0 X 0 0 0 ROGER HOUSTON 2.0 X 0 0 0 GILBERT JOEHL 2.0 X 0 0 0 PHYLLIS LAPE PHD 2.0 X 0 0 0 ANDY STAFFORD 2.0 X 0 0 0 JAN TERRY 2.0 X 0 0 0 NANCY SPANGENBERG 2.0 X 0 0 0 DONALD HEADEN 2.0 X 0 0 0 MICHAEL MOLYNEAUX MD 40.0 X 102810 0 0 CHESTER WYNN 40.0 X 242237 0 32283 JOANNE CONDI 40.0 X 146270 0 11959 MARC STEINBERG 40.0 X 156246 0 20313 CONSTANCE MUDD 40.0 X 128163 0 18628 DAVID A BOLEN 40.0 X 178910 0 17749 STEPHEN LEE 40.0 X 63500 0 8546 RICHARD MOGLER 40.0 X 92825 0 16508 KAREN DAUM 40.0 X 120121 0 24956 REBECCA GOODMAN 40.0 X 86280 0 16116 RAYMOND HUGHES 40.0 X 352100 0 33378 MICHAEL WHITMORE 40.0 X 326063 0 16365 MARK RUFF 40.0 X 307620 0 32079 BRUCE SANDS 40.0 X 306695 0 0 MARY JONES 40.0 X 294255 0 20374 2916095 0 269254 32 false true false BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 63102 ACCOUNTING & TAX 153731 CENTURION INVESTIGATORS INC 1711 SOUTHWEST JACKSONVILLE IL 62650 SECURITY AGENCY 178470 JOHN C DAILY MD 1572 CONCORD ROAD JACKSONVILLE IL 62650 PHYSICIAN 528806 SPRINGFIELD SERVICE CORP 2960 PROFESSIONAL DRIVE SPRINGFIELD IL 62703 BILLING SERVICE 245158 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PHYSICIAN AGENCY 224047 6 14200 1304478 1318678 PATIENT SERVICE 621110 82875256 82875256 REVENUE 82875256 1778590 26367 1752223 0 0 618531 618531 618531 618531 1692725 10942 2975000 2500 -1282275 8442 -1273833 -1273833 0 0 0 CAFETERIA 722100 554927 554927 LIFE LINE 812900 198002 198002 OTHER 900099 331200 331200 1084129 86401351 82875256 224369 1983048 71324 71324 0 0 0 1394384 1394384 0 33190717 27732424 5458293 1719567 1385543 334024 7729968 6362988 1366980 2320122 1869441 450681 0 172684 172684 131949 131949 0 0 0 2942708 2213200 729508 256359 192807 63552 9895684 7442509 2453175 269801 202916 66885 0 2139933 1609436 530497 79212 59575 19637 0 0 1379020 1037156 341864 0 6043927 4545616 1498311 1055450 793800 261650 BAD DEBT 7226859 7226859 REPAIRS & MAINTENANCE 2493601 1875428 618173 MEDICAID TAXES 1099542 826962 272580 FOOD 945497 711105 234392 INCOME TAX 14308 14308 1358512 1005738 331507 21267 83931128 67179135 16730726 21267 5535 6733 3420310 6050439 11374316 11728463 7230933 10152618 701034 658797 902331 1763504 121984311 69494073 47885453 52490238 50584188 43197779 555899 565144 712573 1072376 16120012 16295548 139492584 143981639 14440922 15191060 30750000 32312147 45190922 47503207 X 78277875 80321684 743055 770105 15280732 15386643 94301662 96478432 139492584 143981639 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 22327 false false false 22327 false 66023041 50000 2714136 9996910 58790267 64700561 423357 899123 66023041 0.72518 0.26172 0.01310 false false 356799 356799 82342220 45049459 37292761 35181816 21816114 13365702 4103476 2628500 1474976 52490238 BENEFICIAL INTERESTS IN TRUSTS 12619760 OTHER ASSETS 703065 FARMLAND 2972723 16295548 USE OF ENDOWMENT FUNDS PART V, LINE 4 CAPITAL PURCHASES, OPERATIONS, SCHOLARSHIPS, INDIGENT CARE. FIN 48 PART X, LINE 2 MANAGEMENT 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. true true true X true X true true true false true true 1871440 1871440 0.02440 11578213 6260105 5318108 0.06930 13449653 6260105 7189548 0.09370 55056 55056 0.00070 4226 4226 0.00010 59282 59282 0.00080 13508935 6260105 7248830 0.09450 157746 157746 0.00200 3180 3180 0.00010 160926 160926 0.00210 true 3129230 21420752 28878845 -7458093 X true true Passavant Memorial area Hospital

1600 West Walnut St Jacksonville IL 62650

X X X X THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $7,226,859 REPORTED ON PART IX, LINE 25, HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ASSOCIATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE ASSOCIATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE ASSOCIATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINGQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT ON LINE 2 WAS DETERMINED BY APPLYING THE OVERALL COST TO CHARGE RATIO TO THE BAD DEBT EXPENSE RECORDED FOR FINANCIAL STATEMENT PURPOSES. THE AMOUNT REPORTED ON LINE 6 WAS OBTAINED FROM THE MEDICARE COST REPORT FILED BY THE ORGANIZATION. ALTHOUGH THE AMOUNT ON LINE 7 HAS NOT BEEN INCLUDED IN PART I, LINE 7, THE AMOUNT SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE IT REPRESENTS CARE TO MEMBERS OF THE COMMUNITY WHICH HAS NOT BEEN REIMBURSED TO THE ORGANIZATION. OUR COLLECTION POLICY STATES "...HOSPITAL MAY PURSUE COLLECTION ACTIVITY ONLY AFTER THE HOSPITAL HAS GIVEN THE PATIENT THE OPPORTUNITY TO ... 2) APPLY FOR FINANCIAL ASSISTANCE..." OUR FINANCIAL ASSISTANCE POLICY STATES "THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR CHARITY CARE DISCOUNTS, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH SHOWS SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH CHARITY CARE ASSISTANCE. IF THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR CHARITY CARE, THE HOSPITAL CAN USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING CHARITY CARE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF THE PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED IS A 100% WRITE OFF OF THE ACCOUNT BALANCE. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1) STATE-FUNDED PRESCRIPTION PROGRAMS; 2) HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3) PARTICIPATION IN WOMEN, INFANTS AND CHILDRENS PROGRAMS (WIC); 4) FOOD STAMP ELIGIBILITY; 5) SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6) ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN); 7) LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND 8) PATIENT IS DECEASED WITH NO KNOWN ESTATE." PASSAVANT AREA HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IN MANY DIFFERENT MANNERS. THE HOSPITAL WORKS WITH THE MORGAN COUNTY HEALTH DEPARTMENT IN DEVELOPING THE MORGAN COUNTY HEALTH PLAN. THE HOSPITAL THEN USES THE RESULTS OF THE HEALTH PLAN TO DETERMINE WHAT PROGRAMS AND SERVICES NEED TO BE OFFERED. ANOTHER SOURCE OF INFORMATION ON HEALTH CARE NEEDS IS THE MEDICAL STAFF. MEMBERS OF THE HOSPITAL'S ADMINISTRATIVE TEAM MEET REGULARLY WITH THE PHYSICIANS TO DETERMINE WHAT NEW SERVICES SHOULD BE IMPLEMENTED. THE SIXTEEN MEMBERS OF THE BOARD OF DIRECTORS, WHO REPRESENT THE DIFFERENT GEOGRAPHIC AREAS SERVED BY THE HOSPITAL, ALSO PROVIDE INPUT ON HEALTH CARE NEEDS, ALONG WITH THE VOLUNTEERS AND THE HOSPITAL'S EMPLOYEES. LASTLY, THE HOSPITAL ASKS THE PUBLIC ABOUT SERVICES THROUGH PATIENT SURVEYS. THERE ARE SIGNS IN THE REGISTRATION AREAS (IN ENGLISH & SPANISH) WHICH INDICATE THE HOSPITAL TREATS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. GUIDELINES FOR PAYMENTS ON PATIENT ACCOUNTS BROCHURES ARE AT EACH REGISTRATION BOOTH FOR PATIENTS AND THE GENERAL PUBLIC. THESE BROCHURES PROVIDE PAYMENT AND FINANCIAL ASSISTANCE INFORMATION (ENGLISH & SPANISH). OUR GENERAL CONSENT FOR TREATMENT HAS A SECTION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM (ENGLISH & SPANISH). THERE IS INFORMATION AVAILABLE ON THE HOSPITAL WEBSITE ABOUT OUR FINANCIAL ASSISTANCE PROGRAM. INFORMATION ABOUT BILLING AND FINANCIAL ASSISTANCE IS AVAILABLE AT BEDSIDE FOR OVERNIGHT AND SURGERY PATIENTS. PATIENT BILLING STATEMENTS ADVISE OF OUR FINANCIAL ASSISTANCE PROGRAMS AND HOW TO CONTACT US TO APPLY. SELF-PAY OVERNIGHT PATIENTS ARE CONTACTED BY SOCIAL SERVICES AND/OR PFS STAFF AND PROVIDED WITH INFORMATION ON FINANCIAL ASSISTANCE PROGRAMS. STAFF RECEIVES EDUCATION TO DIRECT PATIENTS TO SOCIAL SERVICES OR PATIENT FINANCIAL SERVICES IF A PATIENT INDICATES THEY NEED ASSISTANCE WITH A BILL. THE MAIN COUNTIES THAT PAH SERVES ARE CASS, MORGAN, SCOTT, MACOUPIN AND GREENE COUNTIES (PAH HAS AT LEAST 25% OF THE MARKET IN THESE ZIP CODES). THERE IS A SMALLER, SECONDARY MARKET WHERE PAH HAS AT LEAST 5%, BUT LESS THAN 25% OF THE MARKET. THE SECONDARY MARKET INCLUDES ZIP CODES IN BROWN, SCHUYLER, FULTON, PIKE, AND CALHOUN COUNTIES. OVER 90% OF CASES COMES FROM THE PRIMARY MARKET. PAH EXPANDED THE EMERGENCY DEPARTMENT TO SERVE AN INCREASING NUMBER OF PATIENTS. THE HOSPITAL'S PANDEMIC FLU COMMITTEE WORKS WITH THE COMMUNITY PANDEMIC TASK FORCE TO PUT A PLAN IN PLACE TO HANDLE H1N1 FLU. PAH HAS RECEIVED TRACTS OF FARM LAND, THE INCOME FROM WHICH ASSISTS WITH NURSING SCHOLARSHIPS AND WITH PATIENTS WHO CAN'T AFFORD TO PAY. WE FARM THE LAND AS THE DONORS HAVE REQUESTED. PAH IS ASSOCIATED WITH THE MORGAN-SCOTT VOLUNTEER HEALTH CLINIC IN AN EFFORT TO ASSIST THOSE WHO ARE UNINSURED. PAH OFFERS FREE MAMMOGRAM SCREENINGS AS PART OF ITS ASSOCIATION WITH THE MIA WARE FOUNDATION. THIS FOUNDATION ALSO DONATED FUNDS TOWARDS THE PURCHASE OF DIGITAL MAMMOGRAPHY EQUIPMENT AT PASSAVANT. REGARDLESS OF ABILITY TO PAY, NO ONE NEEDING PASSAVANT'S SERVICES IS TURNED AWAY. PAH DONATES OFFICE SPACE, LAB AND IMAGING SERVICES PLUS OTHER SERVICES AND CARE TO ELIGIBLE PERSONS THROUGH THE "FREE CLINIC" (MORGAN-SCOTT VOLUNTEER HEALTH CLINIC). HEALTH EDUCATION PROGRAMS AND FREE SCREENINGS ARE AVAILABLE TO THE COMMUNITIES THE HOSPITAL SERVES (I.E. PROSTRATE SCREENINGS, COLORECTAL SCREENINGS, DIABETES CLASSES, THE KIDNEY MOBILE, "WALKING FOR WELLNESS" PROGRAM, "COMMUNITY HEALTH CHECK", PROGRAMS ON HEART DISEASE, STROKES, BREAST CANCER, ETC.) PAH, THE MIA WARE FOUNDATION AND THE JACKSONVILLE CHAMBER OF COMMERCE SPONSOR A COMMUNITY HEALTH FAIR EACH YEAR CALLED "THE BE AWARE WELLNESS FAIR." THIS FAIR TAKES PLACE AT COMMUNITY PARK AND PROVIDES PREVENTATIVE HEALTH INFORMATION FOR ALL AGES AND ALSO EMPHASIZES BREAST CANCER AWARENESS. IT'S AN EVENT FOR EVERYONE IN THE FAMILY. PAH EMPLOYEES ARE VOLUNTEERS IN NON-PROFIT ORGANIZATIONS, SUCH AS ROTARY CLUB, KIWANIS, CHAMBER OF COMMERCE, HABITAT FOR HUMANITY, ETC. THEY ALSO SUPPORT THE UNITED WAY AND PARTICIPATE IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE. PAH PROVIDES CASH AND IN-KIND DONATIONS TO AREA NON-PROFIT ORGANIZATIONS AND TO AREA SCHOOLS' POST-PROM PARTIES. PAH ALSO PROVIDES DISEASE-RELATED SUPPORT GROUPS, FREE COMMUNITY HEALTH PROGRAMS AND SCREENINGS, USE OF MEETING ROOMS, CHAPLAINCY SERVICES AND LANGUAGE ASSISTANCE SERVICES. WITH THE SUPPORT GROUPS, PAH STAFF FACILITATES SOME OF THOSE GROUPS. PAH PROVIDES FREE MEDICARE CONSULTING SERVICES TO SENIORS. PAH PROMOTES AND SUPPORTS THE JACKSONVILLE AREA SENIOR CENTER, WHICH OFFERS MANY ACTIVITIES FOR SENIORS. PASSAVANT PROVIDES SPEAKERS, SCREENINGS AND HEALTH FAIRS FOR FREE AT THE CENTER. IT ALSO CONDUCTS A "COMMUNITY HEALTH CHECK" AT THE CENTER THE FIRST WEDNESDAY OF EACH MONTH. IN FISCAL YEAR 2010, PAH PROVIDED $11.7 MILLION IN CHARITY CARE AND BAD DEBT CHARGES PLUS $1.2 MILLION OF FREE CHARGES AT THE VOLUNTEER HEALTH CLINIC (TOTALING $13 MILLION) true Illinois Hospital Research and Educational Found 1151 East Warrenville Road Naperville IL 60566 237421930 501(c)(3) 71324 SEE SUPPLEMENT INFO 1 0 PROCEDURE FOR MONITORING THE USE OF GRANTS PART I, LINE 1 GRANTS PAID TO ILLINOIS HOSPITAL RESEARCH AND EDUCATIONAL ASSOCIATION ARE PAID AS PART OF A VOLUNTARY STATE MEDICAID REALLOCATION PROGRAM KNOWN AS THE HOSPITAL MUTUAL ASSISTANCE PROGRAM. NO FORMAL POLICY EXISTS TO MONITOR THE USE OF THESE GRANTS PURPOSE OF GRANTS PART II, LINE 1 TO ADDRESS THE DISPARATE AND NEGATIVE EFFECTS OF THE ILLINOIS MEDICAID PROGRAM EXPERIENCED BY HOSPITALS AND HEALTHCARE SYSTEMS IN ILLINOIS. X X X X false false false false false false false false false CHESTER WYNN 242237 0 0 0 0 0 14534 0 17749 0 274520 0 0 0 JOANNE CONDI 146270 0 0 0 0 0 4262 0 7697 0 158229 0 0 0 MARC STEINBERG 156246 0 0 0 0 0 9375 0 10938 0 176559 0 0 0 DAVID A BOLEN 178910 0 0 0 0 0 0 0 17749 0 196659 0 0 0 RAYMOND HUGHES 352100 0 0 0 0 0 15629 0 17749 0 385478 0 0 0 MICHAEL WHITMORE 326063 0 0 0 0 0 10500 0 5865 0 342428 0 0 0 MARK RUFF 307620 0 0 0 0 0 14330 0 17749 0 339699 0 0 0 BRUCE SANDS 306695 0 0 0 0 0 0 0 0 0 306695 0 0 0 MARY JONES 294255 0 0 0 0 0 14509 0 5865 0 314629 0 0 0 SHERYL ROBERTS BOARD MEMBER'S DAUGHTER 73058 EMPLOYED BY HOSPITAL false MEMBERS AND STOCKHOLDERS PART VI, SECTION A, LINE 7 REPRESENTATIVES OF 139 CHURCHES IN THE PASSAVANT SERVICE AREA MAKE UP THE BOARD OF GOVERNORS. THE BOARD OF DIRECTORS IS ELECTED BY THE BOARD OF GOVERNORS AT THE GOVERNORS' ANNUAL MEETING. BOARD REVIEW OF FORM 990 PART VI, SECTION A, LINE 11 A COPY OF THE FORM 990 IS REVIEWED BY THE CEO AND THE CFO PRIOR TO FILING. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW PRIOR TO FILING. MONITORING AND ENFORCEMENT OF CONFLICT OF INTEREST POLICY PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE CONFLICTS OF INTERESTS BY FILING SIGNED STATEMENTS WITH THE ORGANIZATION. THE BOARD MEMBERS COMPLETE THE CONFLICT OF INTEREST POLICY ON A YEARLY BASIS. THEY ARE REQUIRED TO DISCLOSE ANY CONFLICTS WHEN INFORMATION IS GATHERED TO PREPARE FORM 990. IF THEY HAVE A CONFLICT, THE BOARD MEMBERS EXCUSE THEMSELVES FROM ANY APPLICABLE VOTES. IF THERE IS A QUESTION OF WHETHER OR NOT THEY HAVE A CONFLICT, EITHER THE CEO OR THE CFO WILL INVESTIGATE THE ISSUE AND CONSULT WITH THE BOARD CHAIR, WHO WILL MAKE THE FINAL DETERMINATION. EMPLOYEES SIGN A CODE OF CONDUCT STATEMENT ANNUALLY, WHICH INCLUDES A SECTION ON CONFLICT OF INTEREST. EMPLOYEES ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. IF THEY HAVE A CONFLICT, THEY CANNOT HAVE ANY DECISION-MAKING POWERS REGARDING ANY OF THEIR AREAS OF CONFLICT. REVIEW OF COMPENSATION PART VI, SECTION B, LINE 15A AND 15B THE ORGANIZATION PARTICIPATES IN SEVERAL NATIONAL AND REGIONAL SURVEYS WHERE DATA IS OBTAINED ON VARIOUS POSITIONS SUCH AS CEO, CFO, COO, ETC. THIS INFORMATION IS THEN PROVIDED TO THE BOARD EXECUTIVE COMMITTEE FOR REVIEW AND APPROVAL. FOR OTHER OFFICERS AND KEY EMPLOYEES, A CUSTOMIZED SURVEY CONDUCTED BY INTEGRATED HEALTHCARE STRATEGIES COMPARES THE COMPENSATION DATA PROVIDED BY THE ORGANIZATION TO THE STATISTICAL INFORMATION THEY HAVE. INTEGRATED HEALTHCARE STRATEGIES GENERATES A TRUE MARKET AVERAGE REPORT THAT COMPARES THE ORGANIZATION'S SALARY FOR A POSITION AND ASSOCIATED MINIMUM, 1ST QUARTILE, MIDPOINT, 3RD QUARTILE AND MAXIMUM SALARY POINTS. THE KEY EMPLOYEE DATA IS REVIEWED BY OUR CEO, CFO AND HR DIRECTOR AND MARKET COMPARATIVE SALARY ADJUSTMENTS ARE MADE AS NECESSARY. AVAILABILITY OF DOCUMENTS TO THE PUBLIC PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON INDIVIDUAL REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE POSTED ON THE HOSPITAL'S WEBSITE. PASSAVANT MEMORIAL AREA AUXILIARY 1600 W WALNUT ST JACKSONVILLE IL 62650 370890067 SUPPORTING IL 501(c)(3) 11-III-FI NA JACKSONVILLE JOINT VENTURES 644 N 2ND STREET JACKSONVILLE IL 62702 364180270 MEDICAL EQUIPMENT IL NA RELATED 79868 600708 false 0 false PASSAVANT PHYSICIAN ASSOCIATION 1600 W WALNUT STREET JACKSONVILLE IL 62650 261200566 PHYSICIANS IL NA C CORPORATION 4458315 879113 1.00000 LELAND CAPPS CO US BANK NA 205 S FIFTH STREET SPRINGFIELD IL 62701 376023527 INVESTMENT IL NA TRUST 8890 167570 1.00000 IRMA BARSNES CO FARMERS STATE BANK & TR 205 S FIFTH STREET SPRINGFIELD IL 62701 376026493 INVESTMENT IL NA TRUST 2550 126701 0.80000 BEILSCHMIDT FARM FBO BEREA CHURCH 200 WEST STATE ST PO BOX 1330 JACKSONVILLE IL 626511330 376365758 INVESTMENT IL NA TRUST -367 1538207 1.00000 BEILSCHMIDT FARM FBO PASSAVANT HOSPITAL 200 WEST STATE ST PO BOX 1330 JACKSONVILLE IL 626511330 376365760 INVESTMENT IL NA TRUST 28703 1285593 1.00000 FRANCES CORRINGTON CO US BANK NA 205 S FIFTH STREET SPRINGFIELD IL 62701 376135460 INVESTMENT IL NA TRUST 52854 2144030 1.00000 MILDRED DINWIDDIE CO US BANK NA 205 S FIFTH STREET SPRINGFIELD IL 62701 376227814 INVESTMENT IL NA TRUST 3838 2157834 1.00000 ELIZABETH SHEKELTON CO US BANK NA 205 S FIFTH STREET SPRINGFIELD IL 62701 376124484 INVESTMENT IL NA TRUST 16444 902735 1.00000 THOMAS TISSINGTON FARM 200 WEST STATE ST PO BOX 1330 JACKSONVILLE IL 626511330 376022909 INVESTMENT IL NA TRUST 1436 2489566 1.00000 TISSINGTON CLAUSE XIX 200 WEST STATE ST PO BOX 1330 JACKSONVILLE IL 626511330 376022909 INVESTMENT IL NA TRUST 10 16556 1.00000 FRED VANBEBBER CO FARMERS STATE BANK 200 WEST STATE ST PO BOX 1330 JACKSONVILLE IL 626511330 376118658 INVESTMENT IL NA TRUST 15571 443586 1.00000 JANE H WILSON CO US BANK NA 205 S FIFTH STREET SPRINGFIELD IL 62701 900513371 INVESTMENT IL NA TRUST 9616 417094 1.00000 true false true true false false false false false false false false false false false false false false PASSAVANT PHYSICIAN ASSOCIATION a 82800 PASSAVANT PHYSICIAN ASSOCIATION d 2921685