2026-05-13T12:36:37-05:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-07-01 370661208 HILLSBORO AREA HOSPITAL INC HILL 2175326111 1200 EAST TREMONT STREET HILLSBORO IL 62049 MICHAEL ALEXANDER PRESIDENT & CEO 2175326111 2026-03-07 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-03-07 2024 2025-03-06 01:10:19Z HILLSBORO HEALTH MICHAEL ALEXANDER 1200 EAST TREMONT STREET HILLSBORO IL 62049 58507601 0 X WWW.HILLSBOROHEALTH.ORG X 1906 IL OPERATION OF HOSPITAL (INPATIENT, SWING BED & OUTPATIENT) AND ASSISTED LIVING FACILITIES. 11 11 354 20 0 0 208540 2923425 39572947 53261571 1846737 2214137 156854 74069 41785078 58473202 7520 0 0 0 15975103 19104413 0 0 0 20364692 28596136 36347315 47700549 5437763 10772653 63095164 74311724 9277633 10546018 53817531 63765706 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. 0 0 39665542 0 53261571 OPERATION OF A 25-BED CRITICAL ACCESS HOSPITAL (INPATIENT, SWING BED AND OUTPATIENT) WITH AN ASSISTED LIVING FACILITY. 900 ACUTE DAYS, 656 SWING BED DAYS, 23,467 OUTPATIENT VISITS AND 13,101 ASSISTED LIVING RESIDENT DAYS PROVIDED IN FY 2025. HILLSBORO AREA HOSPITAL ALSO PROVIDED $115,632 IN CHARITY CARE AND $1,087,642 IN OTHER COMMUNITY BENEFITS AT COST, NOT INCLUDING BAD DEBT. THE HOSPITAL'S PHYSICIAN CLINIC OBTAINED RURAL HEALTH CLINIC DESIGNATION DURING THE CURRENT TAX YEAR. 39665542 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 76 0 354 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X ALEX NAZARIAN 2175324187 1200 EAST TREMONT STREET HILLSBORO IL 62049 EARL FLACK CHAIRMAN 1.00 X X 0 0 0 LISA WHITE VICE CHAIR 1.00 X X 0 0 0 MISTY BORROWMAN TREASURER 1.00 X X 0 0 0 JULIE JENKINS SECRETARY 1.00 0.20 X X 0 0 0 DR JOSEPH BLASER DIRECTOR 1.00 X 0 0 0 DR BEN CADY DIRECTOR 1.00 X 0 0 0 MARY HERSCHELMAN DIRECTOR 1.00 X 0 0 0 JAMES HERTEL DIRECTOR 1.00 X 0 0 0 DAVID HOUGH DIRECTOR 1.00 X 0 0 0 DR NATHAN KIRBY DIRECTOR 1.00 X 0 0 0 JORDAN RUPPERT DIRECTOR 1.00 X 0 0 0 ALEX NAZARIAN CHIEF FINANCIAL OFFICER 40.00 X 142969 0 2155 MIKE ALEXANDER PRESIDENT & CEO 40.00 0.90 X 0 0 0 SUZANNE TATHAM HOUSE SUPERVISOR 40.00 X 173155 0 31108 ASHLEY SMITH VP QUALITY AND SUPPORT SERVICES 40.00 X 141299 0 1954 TOMMI CLINE CNO 40.00 X 147005 0 48301 ABBY BUGG DIRECTOR OF THERAPY SERVICES 40.00 X 137361 0 48815 KATHLEEN DUNCAN VP HUMAN RESOURCES 40.00 X 126781 0 28305 TERRI CARROLL FORMER CFO (FEB '24) 40.00 X 241617 0 19490 1110187 0 180128 18 1 1 0 ILLINOIS EMERGENCY PHYSICIANS P O BOX 677979 DALLAS TX 752677979 PHYSICIAN COVERAGE 2196190 AYA HEALTHCARE INC PO BOX 674907 DALLAS TX 752674907 NURSING PERSONNEL SERVICES 928976 HEALTHTECH MANAGEMENT 2745 N DALLAS PKWY SUITE 100 PLANO TX 75093 MANAGEMENT & CEO SERVICES 853306 CPS SOLUTIONS LLC 5515 PARKCENTER CIRCLE STE 220 DUBLIN OH 43017 PHARMACY SERVIES 409503 EVOLUTIONARY HEALTHCARE PLLC 8530 TERRACOTTA PI OFALLON IL 62269 PAIN MANAGEMENT CLINIC SERVICES 371728 27 2893134 30291 2923425 PATIENT SERVICE REVENUE 621110 53099049 53099049 162522 162522 53261571 2207988 2207988 5651 0 5651 5651 5651 40548 34399 6149 6149 6149 CAFETERIA REVENUE 722514 68418 68418 68418 58473202 53261571 0 2288206 X 341013 341013 13965946 11709855 2256091 323167 263784 59383 3425292 2766855 658437 1048995 842873 206122 901702 901702 48708 578 48130 46200 46200 14370 14370 7673082 6634691 1038391 81347 686 80661 105279 30970 74309 414250 414250 500235 480722 19513 93622 46086 47536 53908 47178 6730 109727 109727 1599260 1248721 350539 440009 82823 357186 BAD DEBT EXPENSE 8744953 8744953 SUPPLIES 3280068 3220103 59965 REPAIRS & MAINTENANCE 914725 813410 101315 MEDICAID TAX ASSESSMENT 618564 618564 2956127 2621527 334600 47700549 39665542 8035007 0 2504765 3197235 21991332 32824176 5121156 7988676 605602 583088 631772 607762 41644790 29188843 11526826 12455947 5245440 7192227 14718089 8347795 750182 1114818 63095164 74311724 4431694 5740010 39607 39607 3070858 2715657 1735474 2050744 9277633 10546018 X 52685699 62253495 1131832 1512211 53817531 63765706 63095164 74311724 X 10772653 811181 -1635659 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 14370 14370 0 PART II-B, LINE 1: HILLSBORO AREA HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS, TO HELP WITH STAFF TRAINING, AND TO ASSIST WITH REIMBURSEMENT. HILLSBORO AREA HOSPITAL ESTIMATED THAT $14,370 OUT OF THE TOTAL DUES PAID TO IHA AND AHA WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS. 442022 15959 457981 435909 6113 442022 433479 2430 435909 430395 3084 433479 426926 3469 430395 0.00000 0.62230 0.37770 0 1 1 272860 272860 20537306 13313937 7223369 19468803 15874906 3593897 1365821 1365821 12455947 CERTIFICATES OF DEPOSITS 8347795 C 8347795 ASSET RETIREMENT OBLIGATION 81638 AMOUNTS PAYBALE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 1960993 DUE TO HILLSBORO AREA HEALTH FOUNDATION 8113 2050744 50518344 811181 811181 49707163 8766039 8766039 58473202 38955596 0 38955596 8744953 8744953 47700549 PART V, LINE 4: THE ENDOWMENTS ARE INTENDED TO BE USED TO SUPPORT THE MAINTENANCE AND EQUIPMENT NEEDS OF THE HOSPITAL. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 8,744,953. INVESTMENT INCOME RECORDED TO RESTRICTED NET ASSET 16,038. CONTRIBUTION FOR PROPERTY AND EQUIPMENT 5,048. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 8,744,953. 1 1 X 1 X 1 X 1 1 0 1 0 38576 38576 0.00100 9340761 8859185 481576 0.01240 9379337 8859185 520152 0.01340 11826 11826 0.00030 6419538 4337933 2081605 0.05340 168412 168412 0.00430 6599776 4337933 2261843 0.05800 15979113 13197118 2781995 0.07140 16396 16396 0.00040 16396 16396 0.00040 0 2917435 1458717 9856660 9871387 -14727 X 1 1 1 1 HILLSBORO AREA HOSPITAL 1200 EAST TREMONT STREET HILLSBORO IL 62049 WWW.HILLSBOROHEALTH.ORG 968 X X X X HILLSBORO AREA HOSPITAL 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X SEE PART V, SECTION C, LINE 7D X 1 23 1 SEE PART V, SECTION C, LINE 7D 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X X 1 X 0 0 HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 5: HILLSBORO HEALTH ELECTED TO DO A ROBUST COMMUNITY SURVEY PROCESS TO COLLECT INPUT AND TO IDENTIFY HEALTH CONCERNS AND NEEDS IN THE DELIVERY OF HEALTHCARE AND HEALTH SERVICES TO IMPROVE WELLNESS AND REDUCE CHRONIC ILLNESS FOR ALL RESIDENTS. THE SURVEY LINK WAS EMAILED TO COUNTY OFFICIALS, INCLUDING MONTGOMERY COUNTY HEALTH DEPARTMENT, MONTGOMERY COUNTY BOARD OFFICIALS, SCHOOL DISTRICT SUPERINTENDENT/EDUCATORS, CITY ELECTED OFFICIALS, HOSPITAL AND SYSTEM BOARD MEMBERS, LOCAL LAW ENFORCEMENT AND COMMUNITY CIVIC ORGANIZATIONS. THE PUBLIC SURVEY LINK WAS POSTED FOR THE COMMUNITY AT LARGE VIA THEIR SOCIAL MEDIA CHANNELS, IN THE LOCAL PAPER AND VIA EMAIL. THE SURVEY WAS OPEN FOR 30 DAYS AND RECEIVED 214 RESPONSES. 29 TOTAL ZIP CODES WERE REPRESENTED IN AND SURROUNDING THE HILLSBORO HEALTH SERVICE AREA. 88.44% OF THE PARTICIPANTS WERE COVERED BY PRIVATE HEALTH INSURANCE, 16.34% MEDICARE AND 10.00% MEDICAID. (SOME PARTICIPANTS MAY HAVE COVERAGE IN MORE THAN ONE AREA. HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTPS://HILLSBOROHEALTH.ORG/SITES/DEFAULT/FILES/2024-08/HILLSBORO%20CHNA%20FINAL%20DOCUMENT%202024%202%20PAGE%20SPREAD.PDFPART V, SECTION B, LINE 10A:HTTPS://HILLSBOROHEALTH.ORG/SITES/DEFAULT/FILES/2024-08/HILLSBORO%20CHNA%20FINAL%20DOCUMENT%202024%202%20PAGE%20SPREAD.PDF HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 11: SEE EXPANDED DISCLOSURE HILLSBORO AREA HOSPITAL PART V, SECTION B, LINE 20E: A MINIMUM OF 2 STATEMENTS AND 1 LETTER ARE SENT PRIOR TO SENDING ACCOUNT TO COLLECTIONS, EACH NOTING HOW TO CONTACT THE HOSPITAL FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 11, PART I: COMMUNITY HEALTH NEEDS IDENTIFIEDAT THE CONCLUSION OF THEIR REVIEW AND DISCUSSION, THE IDENTIFICATION AND PRIORITIZATION GROUP ADVANCED THE FOLLOWING NEEDS AS BEING THE SIGNIFICANT COMMUNITY HEALTH NEEDS FACING THE HILLSBORO HEALTH SERVICE AREA:1. ACCESS TO CARE THE GOAL IS TO INCREASE ACCESS TO COMPREHENSIVE, HIGH-QUALITY HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE SERVICES. 2. WELLNESS THE GOAL IS TO IMPROVE THE PHYSICAL AND MENTAL WELL-BEING OF THE MEMBERS OF THE COMMUNITY. THIS WILL BE DONE THROUGH EDUCATIONAL EFFORTS, INCREASING AWARENESS OF COMMUNITY RESOURCES, AND A CONTINUED FOCUS ON IMPROVING THE SOCIAL WELL-BEING OF COMMUNITY MEMBERS (FOOD ACCESS, EMOTIONAL HEALTH, ETC.). 3. MENTAL HEALTH AND SUBSTANCE ABUSE ALTHOUGH BOTH THE COMMUNITY SURVEY AND SUPPORTING DATA SHOW A NEED FOR ADDITIONAL SUPPORT AND RESOURCES FOR MENTAL HEALTH AND SUBSTANCE ABUSE, THE HILLSBORO HEALTH TEAM DID NOT MOVE THIS PRIORITY TO THE ACTION PLAN PHASE. THE REASONS FOR THIS ARE AS FOLLOWS: LACK OF APPROPRIATE REIMBURSEMENT FOR MENTAL HEALTH SERVICES OVERALL. THE LEADER STATED THEIR FORMER BEHAVIORAL HEALTH SERVICE WAS OPERATING AT SUCH A LARGE LOSS THAT IT PUT THE FINANCIAL STABILITY OF THE ORGANIZATION AT RISK. DUE TO THE UNSUSTAINABLE FINANCIAL NATURE OF THE SERVICE LINE, IT WAS CLOSED THE ORGANIZATION DOES OPERATE A PAIN SERVICE THAT IS AN ALTERNATIVE TO OPIOIDS OR OTHER DRUGS FOR PAIN. THE IMPLEMENTATION STRATEGY WAS DEVELOPED THROUGH A FACILITATED MEETING INVOLVING KEY ADMINISTRATIVE STAFF AT HILLSBORO HEALTH IN MAY 2024. THE GROUP REVIEWED THE NEEDS ASSESSMENT PROCESS COMPLETED TO THAT POINT AND CONSIDERED THE PRIORITIZED SIGNIFICANT NEEDS AND SUPPORTING DOCUMENTS. THEY DISCUSSED STEPS TAKEN TO ADDRESS THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT. THEY ALSO CONSIDERED INTERNAL AND EXTERNAL RESOURCES POTENTIALLY AVAILABLE TO ADDRESS THE CURRENT PRIORITIZED NEEDS. THE GROUP THEN CONSIDERED EACH OF THE PRIORITIZED NEEDS. FOR EACH OF THE THREE PRIORITY AREAS, ACTIONS THE HOSPITAL INTENDS TO TAKE WERE IDENTIFIED ALONG WITH THE ANTICIPATED IMPACT OF THE ACTIONS, THE RESOURCES THE HOSPITAL INTENDS TO COMMIT TO THE ACTIONS, AND THE EXTERNAL COLLABORATORS THE HOSPITAL PLANS TO COOPERATE WITH TO ADDRESS THE NEED. THE PLAN WILL BE EVALUATED BY PERIODIC REVIEW OF MEASURABLE OUTCOME INDICATORS WITH ANNUAL REVIEW AND REPORTING.IMPLEMENTATION STRATEGY:THE GROUP ADDRESSED THE NEEDS WITH THE FOLLOWING STRATEGIES:1. ACCESS TO CARE: THE GOAL IS TO INCREASE ACCESS TO COMPREHENSIVE, HIGH-QUALITY HEALTHCARE SERVICES, INCLUDING PRIMARY AND SPECIALTY CARE SERVICES.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: - EVALUATE FURTHER DEVELOPMENT OF AN ORTHOPEDIC SERVICE IN THE COMMUNITY BY PARTNERING WITH PROVIDERS FROM ADJACENT COMMUNITIES TO DO CLINICS AND PROCEDURES AT HILLSBORO HEALTH. - REVIEW THE CURRENT OR SPACES FOR POTENTIAL RENOVATIONS TO ACCOMMODATE SPECIALTY CARE PROCEDURES. SEEK FUNDING FOR THIS IN LONG TERM PLANNING, GRANTS OPPORTUNITIES, ETC. - SUPPORT THE PHYSICIANS IN THE COMMUNITY WHO PROVIDE OBSTETRICAL SERVICES. WHILE HILLSBORO HEALTH DOES NOT DELIVER BABIES (MOST ARE DONE IN LITCHFIELD), THESE PHYSICIANS PROVIDE PRE AND POSTNATAL CLINICS IN THE COMMUNITY. - SUPPORT A RECENTLY ADDED UROLOGY SERVICE WITH PROMOTION AND RESOURCES AS NEEDS ARE IDENTIFIED. - CONTINUE TO RECRUIT SPECIALTY PROVIDERS TO THE AREA AS SPECIFIC NEEDS ARE IDENTIFIED IN PLANNING AND BY PRIMARY CARE.INDICATORS THAT SUPPORT THIS PRIORITY: - ACCESS TO SPECIALTY CARE SERVICES WAS IN THE TOP FIVE IDENTIFIED PROBLEMS IN THE COMMUNITY RELATING THE HEALTH OR A HEALTHY LIFESTYLE. OBSTETRICS, ORTHOPEDICS AND UROLOGY WERE ALL SPECIFIED NEEDS. - THE OVERALL TEEN BIRTH RATE FOR THE SERVICE AREA (6.79/1000 FEMALES) WAS WITHIN THE NORMAL RANGE AS COMPARED TO THE STATE AND U.S. AVERAGES. HOWEVER, FAYETTE COUNTY, LOCATED IN THE EASTERN SIDE OF THE HILLSBORO HEALTH MARKET AREA, HAD A SIGNIFICANTLY INCREASED TEEN BIRTH RATE AT 88.36/1000 FEMALES. - 20% OF THE OVERALL POPULATION IS AGED 65+ INDICATING A POTENTIALLY INCREASED NEED FOR BOTH ORTHOPEDIC AND UROLOGY SPECIALTIES. OVER 50% OF HOUSEHOLDS HAVE SOMEONE AGED 65+ LIVING IN THEM. - 17.41% OF THE OVERALL POPULATION IS CONSIDERED DISABLED AND APPROXIMATELY 32% OF HOUSEHOLDS HAVE SOMEONE WITH A DISABILITY. (6889 TOTAL HOUSEHOLDS: 2213 HOUSEHOLDS WITH ANY DISABILITY). ANTICIPATED IMPACTS OF THESE ACTIONS: - PATIENTS WILL BE ABLE TO SEE ORTHOPEDIC AND UROLOGY SPECIALISTS IN THE COMMUNITY. - OB PRENATAL AND POSTNATAL CARE WILL BE PROVIDED IN THE COMMUNITY. - PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED CHIEF EXECUTIVE OFFICER SPECIALTY CLINIC PRACTICE MANAGER PRIMARY CARE MEDICAL STAFF MARKETING RESOURCES INCLUDING ADVERTISING AND SOCIAL MEDIA PLATFORMSPLANNED COLLABORATION BETWEEN THE HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: SPRINGFIELD CLINIC SIU PHYSICIANS HSHS INDEPENDENT PROVIDERS SCHEDULE H, PART V, SECTION B, LINE 11, PART II: DURING FISCAL YEAR 2025, THE HOSPITAL RECEIVED RURAL HEALTH DESIGNATION FOR PRIMARY CARE SERVICES TO ALLOW FOR IMPROVED HEALTHCARE ACCESS, AND WE HAVE PURSUED EXPANSION OF WALK-IN HOURS AT PRIMARY CARE TO OFFER MORE AVAILABILITY TO THE COMMUNITY. IN ADDITION, WE ACTIVELY RECRUITED ANOTHER MIDLEVEL PROVIDER IN THE PRIMARY CARE CLINIC AND ADDED A CERTIFIED CHRONIC CARE MANAGEMENT NURSE TO ASSIST THE OLDER POPULATION. IN ADDITION, WE HAVE CONTINUED TO EXPAND PAIN MANAGEMENT CLINIC SERVICES, AND WE CONTINUE TO RECRUIT ADDITIONAL PROVIDERS, INCLUDING INFECTIOUS DISEASE AND UROLOGY, WHICH IS CHALLENGING TO MEET THE NEEDS IN A RURAL COMMUNITY.2. WELLNESS: THE GOAL IS TO IMPROVE THE PHYSICAL AND MENTAL WELL-BEING OF THE MEMBERS OF THE COMMUNITY. THIS WILL BE DONE THROUGH EDUCATIONAL EFFORTS, INCREASING AWARENESS OF COMMUNITY RESOURCES, AND A CONTINUED FOCUS ON IMPROVING THE SOCIAL WELL-BEING OF COMMUNITY MEMBERS (FOOD ACCESS, EMOTIONAL HEALTH, ETC.).ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: - LEVERAGE THE EXISTING HILLSBORO HEALTH FITNESS AND AQUATIC CENTER RESOURCES TO ENCOURAGE COMMUNITY PARTICIPATION. ENSURE SERVICE PRICING IS REASONABLE. - INVESTIGATE WAYS TO PROVIDE FREE OR VERY LOW-COST FITNESS OPPORTUNITIES. - CONTINUE THE SUMMER LUNCH PROGRAM FOR STUDENTS WHO WOULD NORMALLY BE RECEIVING LUNCH AT SCHOOL. - WORK WITH COMMUNITY PARTNERS TO ASSURE EVERYONE IS AWARE OF THE RESOURCES WITHIN HILLSBORO HEALTH AND OTHER COMMUNITY HEALTHCARE PARTNERS TO ADDRESS HEALTH AND SOCIAL SERVICE CONCERNS. THIS WILL BE DONE THROUGH THE ANNUAL HEALTH AND WELLNESS FAIR. - PROVIDE TOOLS AND SCREENINGS THAT SUPPORT EMOTIONAL HEALTH IMPROVEMENT TO THE EMPLOYEE GROUP AND THE COMMUNITY.INDICATORS THAT SUPPORT THIS PRIORITY: - OBESITY: LACK OF ACCESS TO HEALTHY FOODS/POOR NUTRITION WAS ALSO IDENTIFIED AS ONE OF THE TOP FIVE (5) MOST IMPORTANT HEALTH ISSUES IN THE COMMUNITY. - APPROXIMATELY 2% OF THE COMMUNITY SURVEY RESPONDENTS STATE THEY HAVE EITHER ACCESSED OR NEEDED TO ACCESS A FOOD PANTRY. - ALMOST 10% OF THE COMMUNITY SURVEY RESPONDENTS STATED THEY NEEDED HELP WITH THEIR MEDICAL BILLS OR HEALTH INSURANCE. - ALTHOUGH THE SECONDARY DATA SHOWS THAT PATIENTS WHO SELF-REPORT THEMSELVES AS OBESE (BMI >30.0) ARE LOWER THAN THE STATE AND NATIONAL AVERAGES AT 22.2%, STATE AND NATIONAL TRENDS HAVE BEEN INCREASING SINCE 2004. - POOR OR FAIR HEALTH WAS REPORTED BY 17.70% OF ADULTS OVER AGE 18, AS COMPARED TO 15.43% IN ILLINOIS AND 16.10% IN THE U.S. - DIABETES INCIDENTS IN THE MEDICARE POPULATION IS 27.6% AS COMPARED TO 27% IN ILLINOIS AND THE UNITED STATES. SELECTED COUNTIES IN THE SERVICE MARKET AREA ARE AS HIGH AS 29.4% (BOND AND MACOUPIN). - ACROSS THE NATION, THE TOTAL NUMBER OF PATIENTS DIAGNOSED WITH DIABETES HAS RISEN FROM 6.6% IN 2004 TO 8.9% IN 2021. - 50% OF THE STUDENTS IN THE SERVICE MARKET AREA ARE ELIGIBLE FOR FREE OR REDUCED LUNCHES IN SCHOOL. - OVERALL FOOD INSECURITY RATES ARE GREATER THAN THE STATE AND NATIONAL NORMS (11.17%). FOOD INSECURITY IN CHILDREN IS 12.0%, WHICH IS HIGHER THAN THE U.S. NORM. - FOUR (4) ZIP CODES IN THE SOUTHERN SERVICE MARKET AREA ARE CONSIDERED FOOD DESERTS. ANTICIPATED IMPACTS OF THESE ACTIONS: - CITIZENS WILL LEARN ABOUT THE RESOURCES OFFERED BY HILLSBORO HEALTH AND OTHER HEALTH AND SOCIAL SERVICES PROVIDERS. - CITIZENS WILL HAVE ACCESS TO FITNESS PROGRAMMING THAT IS AFFORDABLE. - DIABETES EDUCATION AND SCREENING WILL BE PROVIDED FOR PATIENTS WHO ARE PREDIABETIC OR DIABETIC. THIS WILL INCLUDE MANAGEMENT, MEDICATION MANAGEMENT, EXERCISE, ETC. - STUDENTS WHO NORMALLY ARE FED WITH THE SCHOOL LUNCH PROGRAM WILL HAVE ACCESS TO HEALTHY FOOD DURING THE SUMMER. - PROGRAMS AND RESOURCES THE HOSPITAL PLANS TO COMMIT TO ADDRESS THE HEALTH NEED CHIEF EXECUTIVE OFFICER HILLSBORO HEALTH FITNESS AND AQUATIC CENTER DIETICIANPLANNED COLLABORATION BETWEEN THE HOSPITAL AND OTHER FACILITIES OR ORGANIZATIONS: COMMUNITY HEALTHCARE AND SOCIAL SERVICE PARTNERSDURING THE FISCAL YEAR, WE CONTINUED TO OFFER HEALTH AND WELLNESS FAIR SERVICES AT REDUCED PRICES FOR COMMUNITY MEMBERS. WE HAVE WORKED WITH LOCAL VOLUNTEERS TO FUND A SUMMER LUNCH PROGRAM TO PROVIDE FOOD TO CHILDREN AND FAMILIES IN NEED THROUGHOUT THE COMMUNITY. FOR PHYSICAL WELLNESS, WE CLEARED AND BUILT AN OUTDOOR WALKING TRAIL THAT IS OPEN TO THE PUBLIC.THE 2024 CHNA WAS PRESENTED TO THE HILLSBORO HEALTH BOARD OF DIRECTORS ON JUNE 20, 2024. IT WAS APPROVED AS PRESENTED, AND WORK CONTINUES TO WORK TOWARD IMPROVEMENTS FOR THESE COMMUNITY NEEDS. PART V, SECTION B, LINES 16A-C: HTTPS://WWW.HILLSBOROHEALTH.ORG/PATIENT-TOOLS/FINANCIAL-ASSISTANCE 2 1 - TREMONT RIDGE ASSISTED LIVING 801 E TREMONT STREET HILLSBORO IL 62049 ASSISTED LIVING FACILITY 2 - TEAMWORK REHAB NOKOMIS 207 W STATE STREET NOKOMIS IL 62075 OUTPATIENT PHYSICAL THERAPY PART I, LINE 3C: HILLSBORO AREA HOSPITAL USES THE FEDERAL POVERTY GUIDELINES AS ONE MEANS OF DETERMINING ELIGIBILITY FOR CHARITY CARE. THE FEDERAL POVERTY GUIDELINES ARE UPDATED AND PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. AS A GENERAL RULE, A PATIENT'S INCOME, BASED ON FAMILY SIZE, MUST BE AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES TO BE ELIGIBLE FOR THE CHARITY CARE PROGRAM AND AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES FOR THE UNINSURED/UNDERINSURED CHARITY DISCOUNT. A SLIDING SCALE BASED ON THE PATIENT'S INCOME LEVEL UNDER THE FEDERAL POVERTY GUIDELINES WILL BE USED TO DETERMINE THE PRECISE AMOUNT OF CHARITY CARE FOR WHICH A PATIENT WILL BE ELIGIBLE. SOME PATIENTS' INCOME MAY EXCEED THESE GUIDELINES, BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO ONE TO ACT ON THEIR BEHALF, MEDICAID ELIGIBILITY NOT ON THE DATE OF SERVICE (E.G. SPENDDOWN UNMET) OR NON-COVERED SERVICE, CURRENTLY ENROLLED IN A COMMUNITY PROGRAM REQUIRING POVERTY LEVEL INCOME, INCARCERATION IN A PENAL INSTITUTION WITHOUT OTHER COVERAGE AVAILABLE, SELF-ADMINISTERED DRUGS-MEDICARE/MEDICAID DUAL ELIGIBILITY ONLY, MEDICAID DHS SERVICES ONLY (I.E., MENTAL HEALTH SERVICES ONLY), DRUG AND ALCOHOL REHAB PATIENTS, MEDICAID ELIGIBLE FOR HEALTH WOMEN'S BENEFITS (I.E., COVERAGE FOR PAPS, MAMMOGRAPHY ONLY), AND OUT OF STATE MEDICAID. PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT THE HOSPITAL INCLUDES THE OPERATION OF THE EMERGENCY ROOM. THE EMERGENCY ROOM IS OPERATED 24 HOURS A DAY, 7 DAYS A WEEK, AND IS STAFFED BY A HIGHLY TRAINED GROUP OF NURSING STAFF AND PHYSICIANS WHO DO THEIR BEST TO PROVIDE EXCEPTIONAL CARE TO MEMBERS OF THE COMMUNITY IN NEED OF EMERGENCY CARE. THE EMERGENCY DEPARTMENT HAS A LARGE AMOUNT OF FIXED EXPENSES WHICH ARE NECESSARY TO PROVIDE THE SERVICE ON A 24 HOUR A DAY BASIS, WHICH IS A REQUIREMENT OF OPERATING A CRITICAL ACCESS HOSPITAL. THE HOSPITAL TREATS ALL PATIENTS, REGARDLESS OF ABILITY TO PAY, IN ITS EMERGENCY ROOM AND FOR THESE REASONS IT IS A SUBSIDIZED SERVICE WHICH THE HOSPITAL PROVIDES AND OFFERS TO THE COMMUNITY FOR THOSE IN NEED. PART II, COMMUNITY BUILDING ACTIVITIES: HILLSBORO HEALTH PROMOTES HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE THROUGH ACTIVE ENGAGEMENT AND EDUCATION. WE REGULARLY HOST COMMUNITY SEMINARS AND EVENTS DESIGNED TO EMPOWER INDIVIDUALS WITH KNOWLEDGE AND RESOURCES FOR HEALTHIER LIVING. THESE INCLUDE A YOUTH MENTAL HEALTH SESSION LED BY OUR PRIMARY CARE PROVIDERS, DIABETES EDUCATION CLASSES, MANAGING STRESS IN THE WORK PLACE LUNCH AND LEARN, A UROLOGY HEALTH LUNCH AND LEARN, HEART-HEALTHY COOKING DEMONSTRATIONS, AND CPR CERTIFICATION COURSES. WE HELD AN ANNUAL COMMUNITY HEALTH FAIR OFFERING DISCOUNTED LAB WORK, OPENED A PUBLIC WALKING TRAIL TO ENCOURAGE PHYSICAL ACTIVITY, AND PROVIDED FREE SENIOR EXERCISE CLASSES LED BY PHYSICAL AND OCCUPATIONAL THERAPISTS. OUR LADIES NIGHT EVENT DELIVERED HEALTH EDUCATION TAILORED TO WOMEN, WHILE OUR MEDICARE OPEN ENROLLMENT SEMINAR HELPED PEOPLE MAKE INFORMED COVERAGE DECISIONS. ADDITIONALLY, WE OFFERED SENSORY-FRIENDLY HALLOWEEN ACTIVITIES FOR PEDIATRIC THERAPY PATIENTS, ENSURING INCLUSIVE EXPERIENCES FOR ALL. HILLSBORO HEALTH ALSO PROVIDES FUNDING AND RESOURCES TO A SUMMER LUNCH PROGRAM TO FEED SCHOOL-AGED CHILDREN DURING SUMMER BREAK. OUR TEAM MEMBERS ALSO HOLD REGULAR FOOD DRIVE AND FOOD COLLECTION EVENTS TO DONATE FOOD TO LOCAL FOOD BANKS AND FOOD PANTRIES. HILLSBORO HEALTH IN PARTNERSHIP WITH HILLSBORO HEALTH FITNESS & AQUATICS HOSTED A FREE COMMUNITY EVENT AT THE FITNESS AND AQUATICS CENTER TO PROVIDE FOOD, POOL TIME AND ACCESS TO THE FACILITY SO THEY CAN LEARN ABOUT THE HEALTH BENEFITS OFFERED AT THE FACILITY. PART III, LINE 2: THE COSTING METHODOLOGY USED WAS THE RATIO OF PATIENT CARE COST-TO-CHARGES. 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. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: PATIENT ACCOUNTS RECEIVABLE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE.THE HOSPITAL DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITS EXPENSE BECAUSE PROVIDING MEDICAL CARE AT A SHORTFALL IMPACTS THE HOSPITAL'S OPERATIONS AND GROWTH. THE CARE IS PROVIDED BECAUSE THERE IS A NEED AND A DESIRE TO PROVIDE MEDICAL CARE IN THIS COMMUNITY.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: COLLECTION ACTIONS ARE STOPPED ON PATIENT BALANCES THAT ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: HILLSBORO AREA HOSPITAL CONDUCTS A NEEDS ASSESSMENT WITH ITS STRATEGIC PLANNING AND LONG-RANGE FINANCIAL PLANNING 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 AND MANAGEMENT TEAM DEVELOP A STRATEGIC PLAN. 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'S WEBSITE. PART VI, LINE 4: HILLSBORO AREA HOSPITAL DEFINED ITS PRIMARY SERVICE AREA AND POPULATIONS AS THE GENERAL POPULATION WITHIN THE GEOGRAPHIC AREA IN AND SURROUNDING THE CITY OF HILLSBORO, DEFINED IN DETAIL BELOW. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. THE SERVICE AREA CONSISTS OF THE FOLLOWING RURAL COMMUNITIES. CITIES: HILLSBORO, NOKOMIS, WITTVILLAGES AND UNINCORPORATED COMMUNITIES: FILLMORE, IRVING, COFFEEN, RAYMOND, BUTLER, DONNELLSON, AND TAYLOR SPRINGSACCORDING TO U.S. CENSUS DATA, THE POPULATION IN THE HILLSBORO AREA HOSPITAL SERVICE AREA FELL FROM 18,938 PEOPLE TO 17,488 PEOPLE BETWEEN THE YEARS 2010 AND 2020, A 7.66% DECREASE. ACCORDING TO 2022 DATA, THE POPULATION BY GENDER IN THE SERVICE AREA IS 58% MALE AND 42% FEMALE. THE PRIMARY SERVICE AREA OF HILLSBORO AND TAYLOR SPRINGS HAS 1008 PEOPLE IN THE AGES 0-14, 1008 AGES 15-24, 1376 AGES 25-34, 1218 AGES 35-44, 1095 AGES 45-54, 1054 AGES 55-64, AND 1626 AGES 65 AND OLDER. THE SERVICE AREA IS WHITE (NON-HISPANIC): 83.8%, BLACK OR AFRICAN-AMERICAN: 9.8%, ASIAN: <0.4%, AND HISPANIC OR LATINO: 3.1%. PART VI, LINE 5: DESIGNATED AS 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, LINE 1 AND 4A. THE BOARD OF DIRECTORS IS MADE UP OF VOLUNTEER COMMUNITY LEADERS WITHIN ITS PRIMARY SERVICE AREA THAT ARE APPROVED BY THE MEMBER ORGANIZATION. PART VI, LINE 6: 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.THE HOSPITAL PROVIDES THE USE OF SPACE AT NO CHARGE TO THE HILLSBORO COMMUNITY SCHOOL DISTRICT FOR A DAYCARE FACILITY AND HAS FUNDED STUDER GROUP CONSULTING FEES FOR THE SCHOOL'S COMMITMENT TO A CULTURE OF EXCELLENCE. THE HOSPITAL ALSO PROVIDES GRAND ADVANTAGE SENIOR EXERCISE CLASSES TO THE SENIORS IN THE AREA AT NO CHARGE. 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 HAS PARTICIPATED IN THE LOCAL COMMUNITY FAIR, PROVIDING HEALTH INFORMATION TO THE PUBLIC.THE HOSPITAL PROVIDES THE USE OF SPACE ON OUR CAMPUS FOR THE CERTIFIED NURSING ASSISTANT CLASSES FREE OF CHARGE TO LOCAL HIGH SCHOOLS. THE HOSPITAL ALSO HAS THE HILLSBORO AREA HOSPITAL JUNIOR BOARD WHICH IS COMPRISED OF STUDENT VOLUNTEERS AGES 9-16. THE JUNIOR BOARD MEMBERS LEARN HOW THE ORGANIZATION WORKS, DEVELOP LEADERSHIP SKILLS, AND PLAN AND EXECUTE COMMUNITY IMPROVEMENT ACTIVITIES WITH THE HELP OF THE HOSPITAL STAFF MEMBERS.THE HOSPITAL HAS ALSO PARTICIPATED IN THE STATE COLORECTAL CANCER SCREENING INITIATIVE, HELPED COORDINATE APPOINTMENTS FOR OTHER CANCER SCREENS IN COORDINATION WITH THE MONTGOMERY COUNTY CANCER ASSOCIATION, AND HAS ASSISTED SIU SCHOOL OF MEDICINE WITH RESEARCH PROJECTS IN THE COMMUNITY RELATED TO CHILD DEVELOPMENT, LUNG CANCER SCREENINGS AND YOUTH ASSESSMENTS. FURTHERMORE, THE HOSPITAL HAS HISTORICALLY BEEN RECOGNIZED AS HILLSBORO'S BUSINESS OF THE YEAR FOR ITS POSITIVE ECONOMIC AND CIVIC IMPACT AND ITS OVERWHELMING SUPPORT OF THE COMMUNITY. X 1 1 X X X 1 0 0 0 0 0 0 0 0 TERRI CARROLL FORMER CFO (FEB '24) 32704 0 0 0 208913 0 0 0 19490 0 261107 0 0 0 SUZANNE TATHAM HOUSE SUPERVISOR 168655 0 4500 0 0 0 1151 0 29957 0 204263 0 0 0 TOMMI CLINE CNO 130380 0 16625 0 0 0 2230 0 46071 0 195306 0 0 0 ABBY BUGG DIRECTOR OF THERAPY SERVICES 130343 0 7018 0 0 0 1871 0 46944 0 186176 0 0 0 KATHLEEN DUNCAN VP HUMAN RESOURCES 112955 0 13826 0 0 0 1937 0 26368 0 155086 0 0 0 PART I, LINE 1B ALL FULL-TIME EMPLOYEES HAVE THE OPTION TO BE A MEMBER OF THE HILLSBORO HEALTH FITNESS & AQUATICS CENTER WHICH THE HOSPITAL PAYS DIRECTLY TO HILLSBORO AREA HEALTH SERVICES AS A BENEFIT TO HOSPITAL EMPLOYEES. PART I, LINE 4A TERRI CARROLL, FORMER CFO, RECEIVED SEVERANCE PLAN PAYMENTS IN THE AMOUNT OF $185,440. A CITY OF HILLSBORO MONTGOMERY COUNTY ILLINOIS 376001658 2008-09-30 7220000 CAPITAL IMPROVEMENT PROJECT 0 0 0 A 4910300 7220000 83500 7030981 105519 2010 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 0 SCHEDULE K, PART IV, LINE 2C: THE ORGANIZATION QUALIFIED FOR AN EXCEPTION TO REBATE. THE BOND QUALIFIES FOR THE 2-YEAR SPENDING EXCEPTION. FORM 990, PART VI, SECTION A, LINE 3 HEALTHTECH MANAGEMENT SERVICES, INC. DBA HEALTHTECHS3, PROVIDES MANAGEMENT AND CEO SERVICES. MICHAEL ALEXANDER, PRESIDENT & CEO OF HILLSBORO AREA HOSPITAL, IS EMPLOYED BY HEALTHTECHS3. THE AMOUNT PAID IN TOTAL TO HEALTHTECHS3 IS INCLUDED IN PART VII, SECTION B. THE SPECIFIC AMOUNT PAID FOR CEO SERVICES IN PARTICULAR WITHIN THAT TOTAL WAS $438,230. THIS ALSO INCLUDES SERVICES TO HILLSBORO AREA HOSPITAL AND OTHER RELATED PARTIES LISTED ON SCHEDULE R. 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. IN ADDITION, HILLSBORO AREA HEALTH SYSTEM NFP MUST APPROVE SUCH ITEMS AS BUDGETS, STRATEGIC PLANS, LARGE UNBUDGETED CAPITAL EXPENDITURES, LAND SALES, ETC. FORM 990, PART VI, SECTION B, LINE 11B 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 ANNUALLY, EMPLOYEES COMPLETE AND SIGN A DISCLOSURE STATEMENT AND THE BOARD OF DIRECTORS COMPLETE AND SIGN A CONFLICT OF INTEREST FORM. THE BOARD REVIEWS THE DISCLOSURES AND TAKES APPROPRIATE ACTION TO RESOLVE ANY ISSUES. IF A CONFLICT EXISTS, THE BOARD MEMBER SHALL ABSTAIN FROM VOTING ON THE MATTER. 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. 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. FORM 990, PART IX, LINE 11G EMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,805,454. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,805,454. OTHER PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 909,953. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 909,953. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,919,284. MANAGEMENT AND GENERAL EXPENSES 1,038,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,957,675. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -1,895. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 366,236. TRANSFER TO HILLSBORO AREA HEALTH SYSTEM NFP -2,000,000. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS OF THE ORGANIZATION WORK CLOSELY WITH HILLSBORO AREA HEALTH SYSTEM NFP AND THE OTHER RELATED ENTITIES TO SELECT AND APPOINT THE AUDITOR OF THE FINANCIAL STATEMENTS. HILLSBORO AREA HEALTH SYSTEM NFP 1200 E TREMONT ST HILLSBORO IL 62049 364539688 MANAGEMENT AND OVERSIGHT OF HEALTH CARE SYSTEM IL 501(C)(3) LINE 12C, III-FI 0 HILLSBORO AREA HEALTH FOUNDATION 1200 E TREMONT ST HILLSBORO IL 62049 371247796 PROVIDE SUPPORT FOR HILLSBORO AREA HOSPITAL IL 501(C)(3) LINE 7 HILLSBORO AREA HEALTH SYSTEM NFP 1 HILLSBORO AREA HEALTH SERVICES INC 1210 E TREMONT ST HILLSBORO IL 62049 371240643 ESTABLISH AND OPERATE FACILITIES FOR WELLBEING OF PERSONS IN AREA IL 501(C)(3) LINE 10 HILLSBORO AREA HEALTH SYSTEM NFP 1 0 1 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 1 1