HILLSBORO AREA HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- HILLSBORO AREA HOSPITAL INC (EIN 37-0661208)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-02-02
- IRS object ID
- 201130339349300423
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-02-02T16:51:06-06:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kerber Eck & Braeckel LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Memorial Drive Ste 950 | AddressLine1 |
| City | St Louis | City |
| State | MO | State |
| ZIP Code | 63102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370661208 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hillsboro Area Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HILL | NameControl |
| Phone | 2175326111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 East Tremont Street | AddressLine1 |
| City | Hillsboro | City |
| State | IL | State |
| ZIP Code | 62049 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Rex Brown | Name |
| Title | President & CEO | Title |
| Phone | 2175326111 | Phone |
| Date Signed | 2011-01-21 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Steve Eckhard CPA | Name |
| Phone | 3142316232 | Phone |
| Date Prepared | 2011-01-21 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Rex Brown | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 East Tremont Street | AddressLine1 |
| City | Hillsboro | City |
| State | IL | State |
| ZIP Code | 62049 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17394061 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | hillsboroareahospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1906 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF HOSPITAL (INPATIENT, Swing bed AND OUTPATIENT) and assisted living facilities. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 240 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 31500 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 39900 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16941785 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16861504 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 265151 | InvestmentIncomePriorYear |
| Investment Income Current Year | 265327 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 216323 | OtherRevenuePriorYear |
| Other Revenue Current Year | 213848 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17454759 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17380579 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7275544 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7383537 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 8427394 | OtherExpensePriorYear |
| Other Expenses Current Year | 8570017 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15702938 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15953554 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1751821 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1427025 | RevenuesLessExpensesCY |
| Total Assets BOY | 27799613 | TotalAssetsBOY |
| Total Assets EOY | 29229565 | TotalAssetsEOY |
| Total Liabilities BOY | 12030435 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11949443 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15769178 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17280122 | NetAssetsOrFundBalancesEOY |
| Mission Description | To positively affect the health and welfare of the communities we serve through the operation of a hospital (inpatient, swing bed and outpatient) and an assisted living facility. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12333273 | Expense |
| Revenue | 16951632 | Revenue |
| Description | OPERATION OF a 25 BED CRITICAL ACCESS HOSPITAL (INPATIENT, swing bed and OUTPATIENT) with assisted living facility. 1,399 Acute days, 1,679 Swing Bed days, AND 17,015 outpatient visits and 13,089 ASSISTED LIVING DAYS PROVIDED IN FY 2010, INCLUDING CHARITY CARE OF $664,159 and total community benefits of $2,985,706. | Description |
| Total Program Service Expense | 12333273 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 240 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terri Carroll CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2175324187 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 East Tremont Street | AddressLine1 |
| City | Hillsboro | City |
| State | IL | State |
| ZIP Code | 62049 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| KURT AUMANN | |||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| BILL BRINK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| REX BROWN | |||||||
| CEO/Director | 40.00 | X | X | 0 | 0 | 0 | |
| BRIAN CADY | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TODD DEAN | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TOM GOODING | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| BARBARA HEWITT | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| DOUG JARMAN | |||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| Don Burton | |||||||
| Vice Chairman | 1.00 | X | X | 0 | 0 | 0 | |
| BARBARA MULCH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PAT POPE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| Patricia Whitworth | |||||||
| direcTOR | 1.00 | X | 0 | 0 | 0 | ||
| Terri Carroll | |||||||
| CFO | 40.00 | X | 0 | 0 | 0 | ||
| CHRISTOPHER WHITTEN | |||||||
| DIR REHAB SV | 40.00 | 109136 | 0 | 4049 | X | ||
| Elvis David Harrison | |||||||
| VP of Patient Care Servi | 40.00 | 104584 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 213720 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 4049 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Brim Healthcare Inc | |||||
| PO Box 930736 | Atlanta | GA | 31193 | Management Services | 579521 |
| Illinois Emergency Physicians | |||||
| po box 793 | Traverse City | MI | 49685 | er Coverage | 513276 |
| Acute Care Inc | |||||
| PO Box 4130 | Des Moines | IA | 50333 | ER Coverage | 446276 |
| Pharmacy Systems Inc | |||||
| PO Box 71-0716 | Columbus | OH | 43271 | Pharmacy Management | 248891 |
| Diagnostic Health Services | |||||
| Liberty Plaza 1 Ste 500 | Addison | TX | 75001 | Nuclear Med | 192000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| All Other Contributions | 39900 | AllOtherContributions |
| Total Contributions | 39900 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Program Service Revenu | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 16861504 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16861504 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16861504 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 278809 | TotalRevenueColumn |
| Exclusion | $278,809 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 80686 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 80686 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 80686 | TotalRevenueColumn |
| Exclusion | $80,686 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 13482 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -13482 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -13482 | TotalRevenueColumn |
| Exclusion | -$13,482 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER INCOME | 900099 | 78587 | 78587 | |
| CAFETERIA | 900099 | 43034 | $43,034 | |
| AMBULANCE REVENUE | 900099 | 6745 | 6745 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4796 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4796 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 133162 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17380579 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16951632 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $389,047 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5679843 | Total |
| Program Services | 5062838 | ProgramServices |
| Management And General | 617005 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118845 | Total |
| Program Services | 105935 | ProgramServices |
| Management And General | 12910 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1156232 | Total |
| Program Services | 1030630 | ProgramServices |
| Management And General | 125602 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 428617 | Total |
| Program Services | 382056 | ProgramServices |
| Management And General | 46561 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27154 | Total |
| Management And General | 27154 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47700 | Total |
| Management And General | 47700 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8480 | Total |
| Management And General | 8480 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1903168 | Total |
| Program Services | 1109684 | ProgramServices |
| Management And General | 793484 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34654 | Total |
| Program Services | 40 | ProgramServices |
| Management And General | 34614 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 123780 | Total |
| Program Services | 48337 | ProgramServices |
| Management And General | 75443 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 433326 | Total |
| Program Services | 402734 | ProgramServices |
| Management And General | 30592 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34042 | Total |
| Program Services | 24198 | ProgramServices |
| Management And General | 9844 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131513 | Total |
| Program Services | 131513 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 708308 | Total |
| Program Services | 538198 | ProgramServices |
| Management And General | 170110 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143806 | Total |
| Program Services | 29352 | ProgramServices |
| Management And General | 114454 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| supplies | 1379078 | 1350294 | 28784 |
| Physician's Fees | 1268727 | 1268727 | |
| Bad Debt | 1241004 | 1241004 | |
| Equipment rental and ma | 440164 | 439468 | 696 |
| Maintenance and Houseke | 376479 | 286062 | 90417 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 268634 | Total |
| Program Services | 123207 | ProgramServices |
| Management And General | 145427 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15953554 | Total |
| Program Services | 12333273 | ProgramServices |
| Management And General | 3620281 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 895938 | BOY |
| EOY | 365283 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15121355 | BOY |
| EOY | 11079388 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1679478 | BOY |
| EOY | 1930619 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 389965 | BOY |
| EOY | 394467 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 247820 | BOY |
| EOY | 303714 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23374190 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9993603 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7838143 | BOY |
| EOY | 13380587 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 964334 | BOY |
| EOY | 1080881 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 662580 | BOY |
| EOY | 694626 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27799613 | BOY |
| EOY | 29229565 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1996775 | BOY |
| EOY | 2023964 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9879176 | BOY |
| EOY | 9786533 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154484 | BOY |
| EOY | 138946 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12030435 | BOY |
| EOY | 11949443 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14682611 | BOY |
| EOY | 16177088 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 801567 | BOY |
| EOY | 818034 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 285000 | BOY |
| EOY | 285000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15769178 | BOY |
| EOY | 17280122 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27799613 | BOY |
| EOY | 29229565 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $8,480 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 8480 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | A portion of the dues Paid to the Illinois Hospital Association and the American Hospital Association are classified as being for lobbying. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 420360 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4842 | InvestmentEarningsOrLosses |
| End Of Year Balance | 425202 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 406863 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 13497 | InvestmentEarningsOrLosses |
| End Of Year Balance | 420360 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.67030 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.32970 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 237676 | OtherCostOrOtherBasis |
| Book Value | 237676 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8575418 | OtherCostOrOtherBasis |
| Depreciation | 5000048 | Depreciation |
| Book Value | 3575370 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 647976 | OtherCostOrOtherBasis |
| Depreciation | 485404 | Depreciation |
| Book Value | 162572 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6363353 | OtherCostOrOtherBasis |
| Depreciation | 4508151 | Depreciation |
| Book Value | 1855202 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7549767 | OtherCostOrOtherBasis |
| Book Value | 7549767 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13380587 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital Lease Obligations | $14,792 |
| Asset Retirement Obligation | $124,154 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 138946 | TotalOfAmounts |
| Total Revenue | 17380579 | TotalRevenue |
| Total Expenses | 15953554 | TotalExpenses |
| Excess Or Deficit For Year | 1427025 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 77912 | NetUnrealizedGLOnInvestments |
| Other | $6,007 | OtherAmount |
| Total Adjustments | 83919 | TotalAdjustments |
| Excess Or Deficit Per FS | 1510944 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 17464498 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 77912 | NetUnrealizedGainsInvestments |
| Other Revenues | 6007 | OtherRevenues |
| Revenue Not Rptd F990 | 83919 | RevenueNotRptdF990 |
| Revenue Subtotal | 17380579 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17380579 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15953554 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15953554 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15953554 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part V, Line 4: | Description of Intended Use of Endowment Funds: | Permanently restricted endowment fund Interest is to be used for the Hospital's building and maintenance. |
| Part XI, Line 8 - Other Adjustments: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION: 6007. | |
| Part XII, Line 2d - Other Adjustments: | Change in interest in net assets of foundation: 6007. | |
| Part X, Line 2: The Hospital has been recognized as exempt from income taxes under section 501 of the internal Revenue code and similar provisions of state law. However, The hospital would be subject to federal income tax on any unrelated business taxable income. Effective July 1, 2009, the hospital adopted the standards for accounting for uncertainty in income taxes. These standards prescribe a comprehensive model for financial statement recognition, measurement, classification and disclosure of uncertain tax positions. The implementation of the standards had no effect on net assets as of July 1, 2009. The hospital continually evaluates the effects of all tax positions taken including expiring statutes of limitations, tax examinations, unrelated business income and new authoritative rulings. The hospital files federal information returns. The statutes of limitations for information returns filed for the years ended June 30, 2007 through 2010 have not expired and therefore are subject to examination. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 0 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 302259 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 302259 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02050 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1761380 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1320901 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 440479 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02990 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2063639 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1320901 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 742738 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46272 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8566 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37706 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1994719 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1521312 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 473407 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03220 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1161913 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1161913 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07900 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3202904 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1529878 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1673026 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11380 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5266543 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2850779 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2415764 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16420 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $564,781 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hillsboro Area Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 East Tremont Street | AddressLine1 |
| City | Hillsboro | City |
| State | IL | State |
| ZIP Code | 62049 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | Part I, Line 7: The Cost to charges ratio was used as derived from worksheet 2, ratio of patient care cost-to-charges. | CostingMethodUsed |
| General Explanation | Part III, Line 3: The Hospital believes that the community benefit obtained from its charity care is understated due to patients that could qualify for charity care but do not apply or provide incomplete information. Some care provided to patients is not classified as charity care due to patients missing documentation that proves they qualify for charity care. The hospital's bad debt does include amounts that could be classified as charity care if the patients would apply or provide the appropriate information to complete the charity care application. | GeneralExplanation |
| General Explanation | Part III, Line 4: Text of Footnote from the financial statementsThe Hospital voluntarily provides free care to patients who are unable to pay for all or part of their health care expenses as determined by the Hospital's criteria for financial assistance.In some cases, the Hospital does not receive the amount billed for patient services even though it did not receive information necessary to determine if the patients met the criteria for financial assistance. Bad debts expense is the estimated amount of patient revenue that the Hospital will not collect.The costing methodology used was the ratio of patient care cost-to-charges. No bad debt amounts were included in community benefit. | GeneralExplanation |
| General Explanation | Part III, Line 9B: All collection efforts will cease immediately on amounts approved for special financial considerations. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: Hillsboro Area Hospital conducts a needs assessment during its Strategic Planning and long range Budgeting process. This process includes obtaining and analyzing various data and market demographics. The data is then supplemented with views and concerns from our community Board Members, other community outreach relationships and other common organizations. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: Uninsured patients and persons who seek and / or obtain services from the Hospital, are informed of the availability of Financial Assistance via signage throughout the patient access areas of the facility, brochures, admission packets, disclosure on the patient bill, in person and telephone assisted customer service, as well as information such as the guidelines and application being predominately posted on the Hospital website. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: The Hospital's primary service area consists of patients in the city of Hillsboro and the surrounding areas. The Hospital is the leading healthcare provider for the Montgomery County Illinois Community. These communities are medically vulnerable and have a large indigent population. | CommunityInformation |
| Other Information | Part VI, Line 6: Designated as a critical Access hospital, the Hospital uses any limited surplus funds to further its exempt purpose by providing programs and access as noted in Form 990, Part III, Line 1 and 4a and continued on Schedule O. The Board of Directors is made up of volunteer community leaders within its primary service area that are approved by the Member organization. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: The Hospital is part of a critical access network that includes Hillsboro Area Health System NFP, its sole corporate member, which provides health and supportive services to the communities they serve.The Hospital also commits significant time and resources to activities and services that meet unmet community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. Such programs include, but are not limited to, health fairs and events, health screenings and assessments, space for daycare programs offered by the local school system, support for vital community services, trauma care, and various community educational services. Hillsboro Area Hospital is pursuing LEED certification for the building addition being completed in July 2010. The environmental benefits of LEED include: reduction of waste sent to landfills, conservation of energy and water, reduction of harmful greenhouse gases, and a healthier and safer place for employees, patients, and the environment. The Hospital is also a member of the Chamber of Commerce and partners with the Montgomery County Economic Development Corporation to obtain grants and expand the services needed in the community. The Hospital provides the use of space at no charge to the Hillsboro Community School District for a Daycare facility. For many years, until May 2010, the Hospital provided classroom space, free of charge, for Lincoln Land Community College to use for nursing instruction. The Hospital also provides Grand Advantage senior exercise classes to the seniors in the area at no charge, and provides the Diamond Club to seniors for assistance with the understanding and organization of medical bills and insurance. Hospital employees also share their expertise through community speaking at local organizations and events. Several monetary donations are made by the Hospital throughout the year to other non-profit organizations. An automatic blood pressure machine is located in the Hospital lobby where the community members can use it free of charge, and the Hospital provides a booth at the local community fair each year where employees take blood pressures and provide health information to the public. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| REX BROWN | |||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Terri Carroll | |||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Information | Identifier |
| Return Reference | Part III | ReturnReference |
| Explanation | Brim Healthcare, Inc. was paid $579,521 for management services. Rex Brown, CEO and Terri Carroll, CFO are employed by Brim Healthcare, Inc. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Hillsboro Montgomery County Illinois | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 376001658 | IssuerEIN |
| Date Issued | 2008-09-30 | DateIssued |
| Issue Price | 7220000 | IssuePrice |
| Description Of Purpose | Capital Improvement Project - Expansion construction | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 7220000 | TotalProceeds |
| Amount Unspent | 1459732 | AmountUnspent |
| Issuance Costs From Proceeds | 83500 | IssuanceCostsFromProceeds |
| Capital Expenditures | 5676768 | CapitalExpenditures |
| Year Of Subst Completion | 2010 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | All transactions are below the reporting threshold of 10000 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section A, line 2 | Tom Gooding and Doug Jarman have a business relationship. |
| Form 990, Part VI, Section A, line 3 | Hillsboro area hospital Delegated control over management to BRim Healthcare, Inc. - CEO & CFO are employed by Brim Healthcare. The CEO & CFO are under the supervision of BRIM Healthcare. |
| Form 990, Part VI, Section A, line 6 | Hillsboro Area Health System NFP, a not for profit corporation is the sole corporate member of Hillsboro Area Hospital, Inc. The Hospital also has individual members. There are two classes of individual members. Annual(Regular) and Life members make up the classes of individual members. |
| Form 990, Part VI, Section A, line 7a | Only the Individual members can elect members to the governing body. The Voting of Directors to the board only occurs in October. In addition, the sole corporate member must approve all board members. |
| Form 990, Part VI, Section A, line 7b | The corporate member, Hillsboro area health system nfp, approves all amendments to the articles of incorporation or to the bylaws of the corporation and approves hospital board members elected. The only voting right of the individual members is the right to elect directors. |
| Form 990, Part VI, Section B, line 11 | The CFO reviews the form 990 and provides a copy of the 990 to each member of the board for review. The Board then votes on the approval of the 990 as it is or contingent upon changes prior to filing. |
| Form 990, Part VI, Section B, line 12c | Employees complete and sign an annual disclosure statement and the board of directors complete and sign a conflict of interest form annually. The board reviews the disclosures and takes appropriate action to resolve any issues. |
| Form 990, Part VI, Section B, line 15 | A performance evaluation is completed and discussed in executive session by the board of directors for executive employees. The process for determining compensation includes reviews of salary ranges for the positions per various databases and/or material available. the deliberation and decision by the board of directors is documented in the executive session board minutes. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are not made available to the public. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Hillsboro Area Health System NFP | |||||||||
| 1200 East Tremont | hillsboro | IL | 62049 | 364539688 | Management and oversight of health care system | IL | 501(C)3 | Line 11c, III-FI | |
| Hillsboro Area Health Foundation | |||||||||
| 1200 East Tremont | Hillsboro | IL | 62049 | 371247796 | Provide support for Hillsboro Area Hospital | IL | 501(C)3 | Line 7 | Hillsboro area health system nfp |
| HIllsboro Area health Services Inc | |||||||||
| 1210 East Tremont | hillsboro | IL | 62049 | 371240643 | Establish and operate facilities for wellbeing of persons in area | IL | 501(C)3 | Line 11c, III-FI | hillsboro area health system nfp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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