IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME (EIN 37-0673512)
- Tax period
- 2023-10-01 to 2024-09-30
- Filed
- 2026-07-06
- IRS object ID
- 202601879349301060
- Schema version
- 2023v6.0
- 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 G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-07-06T10:32:46-05:00 | ReturnTs |
| Tax Period End | 2024-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 393647910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370673512 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | & RESIDENT HOME | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IROQ | BusinessNameControlTxt |
| Phone | 8154324444 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1Txt |
| City | WATSEKA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60970 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL J TILSTRA | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 8154324444 | PhoneNum |
| Signature | 2026-06-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2026-06-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL J TILSTRA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1Txt |
| City | WATSEKA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60970 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $41,049,499 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://IROQUOISMEMORIAL.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1914 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 409 | TotalEmployeeCnt |
| Total Volunteers | 49 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,739,835 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,564,718 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,280,346 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $38,895,890 | CYProgramServiceRevenueAmt |
| PY Investment Income | $122,834 | PYInvestmentIncomeAmt |
| CY Investment Income | $212,570 | CYInvestmentIncomeAmt |
| PY Other Revenue | $343,587 | PYOtherRevenueAmt |
| CY Other Revenue | $172,833 | CYOtherRevenueAmt |
| PY Total Revenue | $45,486,602 | PYTotalRevenueAmt |
| CY Total Revenue | $40,846,011 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,532,415 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,743,859 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,426,554 | PYOtherExpensesAmt |
| CY Other Expenses | $25,710,304 | CYOtherExpensesAmt |
| PY Total Expenses | $37,958,969 | PYTotalExpensesAmt |
| CY Total Expenses | $45,454,163 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,527,633 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,608,152 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,293,312 | TotalAssetsBOYAmt |
| Total Assets EOY | $22,123,594 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,206,911 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,645,345 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,086,401 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,478,249 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES FOR THE REGION IN A CONVENIENT, CARING ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $35,420,641 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $38,580,749 | RevenueAmt |
| Desc | IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME PROVIDES HIGH QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, SOME CARE IS PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE PREVENTION AND WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND THE MEDICAL UNDERSERVED INCLUDING A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.THE HOSPITAL IS LOCATED IN WATSEKA, ILLINOIS AND SERVES THE SURROUNDING COMMUNITIES IN IROQUOIS COUNTY AND WEST-CENTRAL INDIANA. THERE ARE OUTPATIENT CLINICS MAINTAINED IN GILMAN, MILFORD, ST ANNE, AND WATSEKA, ILLINOIS AS WELL AS KENTLAND, INDIANA. THE HOSPITAL PROVIDES BEDS FOR ACUTE CARE, INTENSIVE CARE, NURSERY, AND LONG-TERM CARE. THE HOSPITAL ALSO PROVIDES AMBULANCE SERVICES TO MOST OF IROQUOIS COUNTY WITH STATIONS IN GILMAN AND WATSEKA. HOME HEALTH AND HOSPICE PROVIDE SERVICES TO WATSEKA AND SURROUNDING COMMUNITIES IN THE HOSPITAL'S SERVICE AREA. THE IROQUOIS REGIONAL HEALTH CENTER HOUSES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. THE HOSPITAL IS CERTIFIED TO PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICE ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECORDS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY.IROQUOIS MEMORIAL HOSPITAL PROVIDES NON-TRADITIONAL HOSPITAL BASED SERVICES SUCH AS AMBULANCE COVERAGE TO WATSEKA AND THE SURROUNDING IROQUOIS COUNTY COMMUNITIES. IN ADDITION TO THE COSTS OF UNCOMPENSATED CARE AND OTHER NON-TRADITIONAL SERVICES, IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME COMMITTED SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND OTHER CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. SOME OF THOSE PROGRAMS THAT FURTHER THE HOSPITAL'S MISSION INCLUDE: - AMBULANCE SUPPORT FOR SPORTING EVENTS AND SURROUNDING VOLUNTEERS- AMBULANCE DEPARTMENTS- BLOOD DRIVES- BREAST CANCER AWARENESS EVENT- BREAST-FEEDING CLASSES FOR EXPECTANT MOTHERS- CAMP 911 SAFETY PROGRAMS FOR AREA SCHOOL CHILDREN- FARM SAFETY EDUCATION- FIRST AID FOR LOCALLY COMMUNITY EVENTS- FREE AND REDUCED FEE HEALTH SCREENINGS- FREE BLOOD PRESSURE SCREENINGS- FREE CPR TRAINING FOR THE PUBLIC- GO RED HEALTHY HEART EVENT- HEALTH-RELATED ARTICLES IN LOCAL PUBLICATIONS- BIRTHING CLASSES- LIFELINE- MEALS ON WHEELS- SPEAKER'S BUREAU- TOURS FOR AREA SCHOOL CHILDREN | Desc |
| Total Program Service Expenses | $35,420,641 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 53 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 409 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBYN MEMENGA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8154325841 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1Txt |
| City | WATSEKA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60970 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RHONDA PENCE | ||||||||
| CHAIR | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KATHY PERKINSON | ||||||||
| VICE CHAIR | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOUG GEIGER | ||||||||
| VICE CHAIR | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SARA MIKUTA | ||||||||
| TREASURER | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAN TINCHER | ||||||||
| SECRETARY | 3.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROGER DITTRICH | ||||||||
| DIRECTOR | 3.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PHILIP ZUMWALT MD | ||||||||
| DIRECTOR | 3.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL TILSTRA | ||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $228,185 | $0 | $13,231 | ||
| SHAWN BRANSKY | ||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $139,836 | $0 | $0 | ||
| THOMAS MCCANN | ||||||||
| VP OF ANCILLARY SERVICES | 40.00 | 1.00 | Yes (X) | $104,603 | $0 | $0 | ||
| MICHELLE FAIRLEY | ||||||||
| CNO | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| SERGE MARINKOVIC | ||||||||
| PHYSICIAN | 40.00 | $284,958 | $0 | $19,136 | Yes (X) | |||
| MHYTHAM BECK | ||||||||
| PHYSICIAN | 40.00 | $330,063 | $0 | $15,427 | Yes (X) | |||
| GONZOLO FLORIDO | ||||||||
| PHYSICIAN | 40.00 | $337,660 | $0 | $9,329 | Yes (X) | |||
| CRISTANTO REYES | ||||||||
| PHYSICIAN | 40.00 | $207,909 | $0 | $10,141 | Yes (X) | |||
| CHELSEA WICHTNER | ||||||||
| NURSE PRACTIONER | 40.00 | $163,970 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,797,184 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $67,264 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STATERA | |||||
| 2250 N ILLINOIS | CARBONDALE | IL | 62901 | EMERGENCY ROOM SERVICES | $1,225,600 |
| ATHENA | |||||
| 311 ARSENAL STREET | WATERTOWN | MA | 02472 | HEALTH CARE SYSTEM | $607,962 |
| TRINITY MEDICAL STAFFING | |||||
| 14217 DAYTON CIR | OMAHA | NE | 68137 | MEDICAL STAFFING | $471,200 |
| AVANT | |||||
| PO BOX 744554 | ATLANTA | GA | 30374 | CONTRACT LABOR | $406,645 |
| CPSITRUBRIDGE | |||||
| 13511 LEW BRIGGS RD | HOUSTON | TX | 77047 | BILLING | $388,687 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $20,528 | FundraisingAmt |
| Government Grants | $712,762 | GovernmentGrantsAmt |
| All Other Contributions | $831,428 | AllOtherContributionsAmt |
| Total Contributions | $1,564,718 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621400 | $36,465,407 | $36,465,407 |
| IDPA PROGRAM | 621400 | $2,033,143 | $2,033,143 |
| 340B PHARMACY REVENUE | 456110 | $27,795 | $27,795 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $369,545 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,131 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $340,414 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $38,895,890 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,915 | TotalRevenueColumnAmt |
| Exclusion | $19,915 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,217 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,217 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,217 | TotalRevenueColumnAmt |
| Exclusion | $63,217 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $389,800 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $197,145 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $192,655 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $192,655 | TotalRevenueColumnAmt |
| Exclusion | $192,655 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $87,265 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $20,528 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $6,343 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,922 | TotalRevenueColumnAmt |
| Exclusion | $80,922 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INCENTIVE PAYMENTS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $25,273 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,273 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,421 | TotalRevenueColumnAmt |
| Exclusion | $3,421 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,694 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,846,011 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,580,749 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $700,544 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $464,556 | TotalAmt |
| Program Services | $359,953 | ProgramServicesAmt |
| Management And General | $104,603 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,863,152 | TotalAmt |
| Program Services | $13,788,203 | ProgramServicesAmt |
| Management And General | $2,074,949 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,282,275 | TotalAmt |
| Program Services | $1,975,604 | ProgramServicesAmt |
| Management And General | $306,671 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,133,876 | TotalAmt |
| Program Services | $982,395 | ProgramServicesAmt |
| Management And General | $151,481 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,514 | TotalAmt |
| Management And General | $6,514 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,521 | TotalAmt |
| Management And General | $9,521 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,924,824 | TotalAmt |
| Program Services | $5,268,971 | ProgramServicesAmt |
| Management And General | $2,655,853 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,439 | TotalAmt |
| Program Services | $73,867 | ProgramServicesAmt |
| Management And General | $37,572 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,306,408 | TotalAmt |
| Program Services | $1,528,793 | ProgramServicesAmt |
| Management And General | $777,615 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $736,566 | TotalAmt |
| Program Services | $488,230 | ProgramServicesAmt |
| Management And General | $248,336 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,066 | TotalAmt |
| Program Services | $12,638 | ProgramServicesAmt |
| Management And General | $6,428 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,509 | TotalAmt |
| Program Services | $135,230 | ProgramServicesAmt |
| Management And General | $28,279 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $712,047 | TotalAmt |
| Program Services | $588,900 | ProgramServicesAmt |
| Management And General | $123,147 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $764,762 | TotalAmt |
| Program Services | $506,919 | ProgramServicesAmt |
| Management And General | $257,843 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $5,028,154 | $3,332,890 | $1,695,264 |
| BAD DEBT EXPENSE | $3,347,582 | $3,347,582 | |
| HAF EXPENSE | $1,731,568 | $1,147,762 | $583,806 |
| REPAIRS & MAINTENANCE | $1,112,543 | $737,444 | $375,099 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,735,801 | TotalAmt |
| Program Services | $1,145,260 | ProgramServicesAmt |
| Management And General | $590,541 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,454,163 | TotalAmt |
| Program Services | $35,420,641 | ProgramServicesAmt |
| Management And General | $10,033,522 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,590,533 | BOYAmt |
| EOY | $2,227,949 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,804 | BOYAmt |
| EOY | $211,683 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,097,364 | BOYAmt |
| EOY | $7,876,906 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,817,812 | BOYAmt |
| EOY | $1,021,127 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,889 | BOYAmt |
| EOY | $181,472 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $43,098,846 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,315,515 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,398,768 | BOYAmt |
| EOY | $5,783,331 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,070,142 | BOYAmt |
| EOY | $4,821,126 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,293,312 | BOYAmt |
| EOY | $22,123,594 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,565,670 | BOYAmt |
| EOY | $8,575,753 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,475,133 | BOYAmt |
| EOY | $1,904,078 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,678,304 | BOYAmt |
| EOY | $890,762 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $487,804 | BOYAmt |
| EOY | $274,752 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,206,911 | BOYAmt |
| EOY | $11,645,345 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,311,234 | BOYAmt |
| EOY | $5,840,818 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,775,167 | BOYAmt |
| EOY | $4,637,431 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,086,401 | BOYAmt |
| EOY | $10,478,249 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,293,312 | BOYAmt |
| EOY | $22,123,594 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,608,152 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $9,521 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,521 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL HEALTHCARE ASSOCIATIONS IS USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,725,167 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,150,584 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,238,320 | OtherExpendituresAmt |
| End Year Balance | $4,637,431 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,510,362 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $610,995 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $396,190 | OtherExpendituresAmt |
| End Year Balance | $6,725,167 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,321,487 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$1,377,033 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $434,092 | OtherExpendituresAmt |
| End Year Balance | $6,510,362 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,196,915 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,124,572 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $8,321,487 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,282,282 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$13,122 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $72,245 | OtherExpendituresAmt |
| End Year Balance | $7,196,915 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00800 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.99200 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $531,825 | OtherCostOrOtherBasisAmt |
| Book Value | $531,825 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,588,580 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,849,264 | DepreciationAmt |
| Book Value | $3,739,316 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,092,177 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,466,251 | DepreciationAmt |
| Book Value | $625,926 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $886,264 | OtherCostOrOtherBasisAmt |
| Book Value | $886,264 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,783,331 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT IN UNCONSOLIDATED AFFILIATE | $45,000 |
| ASSETS LIMITED AS TO USE - DONOR RESTRICTED | $211,682 |
| ASSETS LIMITED AS TO USE - BENEFICIAL INTEREST IN PERPETUAL TRUST | $4,564,444 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,821,126 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATION | Desc |
| Amt | $274,752 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $274,752 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE ONGOING OPERATIONAL AND CAPITAL NEEDS OF THE ORGANIZATION IN MEETING THE COMMUNITY NEEDS AND SERVICES. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | WRITE A CHECK CAMPAIGN | Event1Nm |
| Gross Receipts Event1 | $80,922 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $80,922 | GrossRevenueEvent1Amt |
| Event2 | IMH GOLF OUTING | Event2Nm |
| Gross Receipts Event2 | $26,871 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $20,528 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $6,343 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $6,343 | RentFacilityCostsEvent2Amt |
| Gross Receipts Total | $107,793 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,528 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $87,265 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,343 | RentFcltyCostsTotalEventsAmt |
| Direct Expense Summary Events | $6,343 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $80,922 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $215,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $215,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,586,127 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,097,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,488,269 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10660 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,801,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,097,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,703,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11170 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,801,137 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,097,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,703,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,606,389 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,127,171 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,325,878 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$198,707 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1Txt |
| City | WATSEKA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60970 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://IROQUOISMEMORIAL.COM/ | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| IROQUOIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE DEVELOPMENT OF THE IPLAN COMPRISED OF A MULTITUDE OF REPRESENTATIVES FROM COMMUNITY LEADERS, HEALTH PROFESSIONALS, FAITH LEADERS, BUSINESS LEADERS, LOCAL OFFICIALS, AND THE LOCAL SCHOOLS. |
| IROQUOIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A & 10A:HTTPS://IROQUOISMEMORIAL.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| IROQUOIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: IROQUOIS MEMORIAL HOSPITAL IS ADDRESSING THE KEY NEEDS IDENTIFIED IN ITS RECENT CHNA BY EXPANDING PRIMARY CARE AND SPECIALTY CLINIC SERVICES IN RURAL AREAS, ENHANCING BEHAVORIAL HEALTH, INCREASING ELDER CARE AND HOME HEALTH SERVICES, AND IMPROVING ACCESS THROUGH TRANSPORTATION SUPPORT AND COMMUNITY OUTREACH PROGRAMS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - IROQUOIS REGIONAL HEALTH CENTER | ||||
| 200 LAIRD LANE | WATSEKA | IL | 60970 | REHAB SERVICES, HOME HEALTH, HOSPICE |
| 2 - MULTI-SPECIALTY CLINIC | ||||
| 200 E FAIRMAN AVENUE | WATSEKA | IL | 60970 | PHYSICIAN OFFICE |
| 3 - KENTLAND CLINIC | ||||
| 303 N 7TH STREET | KENTLAND | IL | 47951 | PHYSICIAN OFFICE |
| 4 - GILMAN CLINIC | ||||
| 508 E CRESCENT STREET | GILMAN | IL | 60938 | PHYSICIAN OFFICE |
| 5 - MILFORD CLINIC | ||||
| 34 EAST JONES | MILFORD | IL | 60953 | PHYSICIAN OFFICE |
| 6 - ST ANNE CLINIC | ||||
| 135 WEST STATION STREET | ST ANNE | IL | 60964 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST-TO-CHARGE RATIO AS CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS WAS USED TO DETERMINE THE AMOUNTS ON LINE 7B OF PART I OF SCHEDULE H. ACTUAL COSTS WERE USED TO DETERMINE THE BENEFIT EXPENSES ON LINES 7A, 7E, 7F, 7G, AND7I OF SCHEDULE H, PART I. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,347,582. |
| PART III, LINE 2: | THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINE 2 WAS A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM 990, SCHEDULE H INSTRUCTIONS. |
| PART III, LINE 3: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTS PATIENTS WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS, A PORTION OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ORGANIZATION EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICE. THE ORGANIZATION 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 ORGANIZATION DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. |
| PART III, LINE 8: | HE 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: | QUALIFICATIONS ARE BASED ON POVERTY GUIDELINES PUBLISHED. NO COLLECTION EFFORTS FOR QUALIFYING PATIENTS. |
| PART VI, LINE 2: | PARTNERED WITH ILLINOIS DEPARTMENT OF PUBLIC HEALTH TO ASSESS THE HEATH NEEDS OF THE COMMUNITIES SERVED BY IROQUOIS MEMORIAL HOSPITAL. EXECUTIVE MEMBERS ARE ON THE LOCAL PUBLIC HEALTH BOARD. |
| PART VI, LINE 3: | INFORMATION REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS DISTRIBUTED AT TIME OF THE PATIENT ADMISSION. THE ORGANIZATION ALSO HAS SIGNAGE IN THE ADMISSIONS AREA. STAFF ARE TRAINED TO EDUCATE PATIENTS THAT EXPRESS CONCERNS ABOUT ABILITY TO PAY FOR SERVICES. |
| PART VI, LINE 4: | IROQUOIS MEMORIAL HOSPITAL SERVES A PREDOMINANTLY RURAL POPULATION ACROSS IROQUOIS, FORD, AND KANKAKEE COUNTIES IN ILLINOIS AND BENTON AND NEWTON COUNTIES IN INDIANA, PROVIDING HEALTHCARE TO COMMUNITIES CHARACTERIZED BY AGING DEMOGRAPHICS, DIVERSE SOCIOECONOMIC BACKGROUNDS, AND LIMITED ACCESS TO SPECIALTY SERVICES. THE HOSPITAL'S SERVICE AREA INCLUDES SMALL TOWNS AND AGRICULTURAL COMMUNITIES WHERE MANY RESIDENTS FACE BARRIERS SUCH AS TRANSPORTATION CHALLENGES AND HIGHER RATES OF CHRONIC HEALTH CONDITIONS. |
| PART VI, LINE 5: | IROQUOIS MEMORIAL HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY ACTIVELY ENGAGING IN COMMUNITY HEALTH PROMOTION THROUGH PARTICIPATION IN NUMEROUS HEALTH FAIRS AND LOCAL EVENTS EACH YEAR, PROVIDING EDUCATION ON AGE-APPROPRIATE HEALTH TOPICS FROM CHILDHOOD THROUGH OLDER ADULTHOOD. THE HOSPITAL OFFERS LOW-COST HEALTH SCREENINGS, SUCH AS BLOOD DRAWS AND CARDIAC EVALUATIONS, TO SUPPORT EARLY DETECTION AND INTERVENTION, AND PROVIDES VACCINATIONS AND OTHER PREVENTIVE HEALTH SERVICES DIRECTLY TO LOCAL BUSINESSES AND THEIR EMPLOYEES AT THEIR WORKPLACES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GONZOLO FLORIDO | ||||||||||||||
| PHYSICIAN | $337,660 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,329 | $0 | $346,989 | $0 | $0 | $0 |
| MHYTHAM BECK | ||||||||||||||
| PHYSICIAN | $330,063 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,427 | $0 | $345,490 | $0 | $0 | $0 |
| SERGE MARINKOVIC | ||||||||||||||
| PHYSICIAN | $284,958 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,136 | $0 | $304,094 | $0 | $0 | $0 |
| MICHAEL TILSTRA | ||||||||||||||
| CEO | $228,185 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,231 | $0 | $241,416 | $0 | $0 | $0 |
| CRISTANTO REYES | ||||||||||||||
| PHYSICIAN | $207,909 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,141 | $0 | $218,050 | $0 | $0 | $0 |
| CHELSEA WICHTNER | ||||||||||||||
| NURSE PRACTIONER | $163,970 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $163,970 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | 457(F) PLAN - MICHAEL TILSTRA $20,122.97; CHELSEA WICHTNER $5,216.69; GONZALO FLORIDO $6,865.45; MHYHAM BECK $30,500.00; CRISTANTO REYES $9,400.00; SERGE MARINKOVIC $30,500.00 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE MAYOR, COUNTY BOARD CHAIRPERSON, AND DISTRICT JUDGE EACH APPOINT THREE MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES TO THREE YEAR TERMS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE STAFF MEMBERS THAT PROVIDE THE INFORMATION TO THE OUTSIDE RETURN PREPARER CONDUCT A THOROUGH REVIEW OF A DRAFT OF THE RETURN. PRIOR TO FILING, THE FORM 990 IS DISTRIBUTED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, MANAGERS, MEDICAL STAFF MEMBERS, PHYSICIANS, EXECUTIVE STAFF MEMBERS, DEPARTMENT DIRECTORS, AND COORDINATORS. CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY DIRECTORS, OFFICERS, AND HIGHLY COMPENSATED EMPLOYEES AND ARE REVIEWED BY ADMINISTRATION. INDIVIDUALS WITH CONFLICTS OF INTEREST ARE REQUIRED TO DISCLOSE THEM AND TO REFRAIN FROM PARTICIPATION IN ANY DECISION THAT COULD BENEFIT THEM PERSONALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF TRUSTEES CONDUCTED A COMPENSATION REVIEW. CEO HAS A TWO YEAR CONTRACT. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL DOCUMENTS ARE AVAILABLE UPON REQUEST. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT PUBLIC INFORMATION AT THIS TIME. HOWEVER, IF REQUESTED, THE BOARD WOULD BE NOTIFIED TO DETERMINE RESPONSE. |
| FORM 990, PART IX, LINE 11G | EMERGENCY ROOM FEES: PROGRAM SERVICE EXPENSES 1,560,062. MANAGEMENT AND GENERAL EXPENSES 793,521. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,353,583. OTHER CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 3,263,196. MANAGEMENT AND GENERAL EXPENSES 1,659,814. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,923,010. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 445,713. MANAGEMENT AND GENERAL EXPENSES 202,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 648,231. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1Txt |
| City | WATSEKA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60970 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453834535 | EIN |
| Primary Activities | SUPPORTING ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE TAXPAYER HAS A HISTORY OF MEETING THE TIMELY FILING REQUIREMENTS FOR FORM 990 AND INFORMATION REPORTING ON A TIMELY BASIS. THE LATE FILING OF FORM 990 FOR THE YEAR ENDED SEPTEMBER 30, 2024 WAS DUE TO UNUSUAL CIRCUMSTANCES. THE ORGANIZATION IS REQUIRED TO HAVE THEIR FINANCIAL STATEMENTS AUDITED BY AN INDEPENDENT CPA FIRM PRIOR TO THEN PREPARING AND SUBMITTING THEIR IRS FORM 990. THE AMOUNT OF TIME AND COMPLIANCE THAT GOES INTO THIS IS SIGNIFICANT AND THERE ARE OTHER SIGNIFICANT OPERATION NEEDS TO MEET TO ENSURE THE CARE OF THE COMMUNITY THE HOSPITAL SERVES. THE ORGANIZATION EXPERIENCED UNTIMELY TURNOVER WITHIN THEIR OWN ORGANIZATION AND CONTRACTED ACCOUNTING SERVICES WHICH DELAYED THEIR ABILITY TO PREPARE FOR THE AUDITED FINANCIAL STATEMENTS AND FORM 990. IN ADDITION, THEY EXPERIENCED TURNOVER AT THEIR CPA FIRM TYPICALLY UTILIZED. THE ORGANIZATION OVER THE PAST FEW YEARS HAS STABILIZED THEIR INTERNAL TEAM AND SOUGHT A NEW CPA FIRM AND HAS COMPLETED THEIR AUDITED FINANCIAL STATEMENTS AND IRS FORM 990. THE RELATIONSHIP BUILD DURING THE PROCESS GIVES THE ORGANIZATION CONFIDENCE THAT THERE WILL BE ONGOING TIMELY COMPLIANCE. BASED ON THE HISTORY OF ROUTINE COMPLIANCE AND THE SPECIFIC FACTS AND CIRCUMSTANCES PROVIDED, WE RESPECTFULLY REQUEST THAT ANY PROPOSED INTEREST AND PENALTIES ABATED AND THE IRS RECOGNIZE REASONABLE CAUSE IN DOING SO. ADDITIONALLY, THE PROPOSED LATE FILING PENALTY WOULD HAVE A MATERIAL IMPACT ON THE ORGANIZATIONS ABILITY TO PROVIDE THE NECESSARY HEALTH SERVICES TO THE COMMUNITY THEY SERVE. | ExplanationTxt |