2026-07-06T10:32:46-05:00 2024-09-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 370673512 IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IROQ 8154324444 200 E FAIRMAN AVENUE WATSEKA IL 60970 MICHAEL J TILSTRA PRESIDENT & CEO 8154324444 2026-06-30 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-06-30 2023 2025-03-06 01:10:19Z MICHAEL J TILSTRA 200 E FAIRMAN AVENUE WATSEKA IL 60970 41049499 0 X HTTPS://IROQUOISMEMORIAL.COM/ X 1914 IL IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES. 7 7 409 49 0 0 2739835 1564718 42280346 38895890 122834 212570 343587 172833 45486602 40846011 0 0 0 0 18532415 19743859 0 0 0 19426554 25710304 37958969 45454163 7527633 -4608152 27293312 22123594 12206911 11645345 15086401 10478249 X IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES FOR THE REGION IN A CONVENIENT, CARING ENVIRONMENT. 0 0 35420641 0 38580749 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 35420641 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 53 0 409 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 7 7 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X ROBYN MEMENGA 8154325841 200 E FAIRMAN AVENUE WATSEKA IL 60970 RHONDA PENCE CHAIR 3.00 1.00 X X 0 0 0 KATHY PERKINSON VICE CHAIR 3.00 1.00 X X 0 0 0 DOUG GEIGER VICE CHAIR 3.00 1.00 X X 0 0 0 SARA MIKUTA TREASURER 3.00 1.00 X X 0 0 0 DAN TINCHER SECRETARY 3.00 1.00 X X 0 0 0 ROGER DITTRICH DIRECTOR 3.00 1.00 X 0 0 0 PHILIP ZUMWALT MD DIRECTOR 3.00 1.00 X 0 0 0 MICHAEL TILSTRA CEO 40.00 1.00 X 228185 0 13231 SHAWN BRANSKY CFO 40.00 1.00 X 139836 0 0 THOMAS MCCANN VP OF ANCILLARY SERVICES 40.00 1.00 X 104603 0 0 MICHELLE FAIRLEY CNO 40.00 X 0 0 0 SERGE MARINKOVIC PHYSICIAN 40.00 X 284958 0 19136 MHYTHAM BECK PHYSICIAN 40.00 X 330063 0 15427 GONZOLO FLORIDO PHYSICIAN 40.00 X 337660 0 9329 CRISTANTO REYES PHYSICIAN 40.00 X 207909 0 10141 CHELSEA WICHTNER NURSE PRACTIONER 40.00 X 163970 0 0 1797184 0 67264 17 0 1 0 STATERA 2250 N ILLINOIS CARBONDALE IL 62901 EMERGENCY ROOM SERVICES 1225600 ATHENA 311 ARSENAL STREET WATERTOWN MA 02472 HEALTH CARE SYSTEM 607962 TRINITY MEDICAL STAFFING 14217 DAYTON CIR OMAHA NE 68137 MEDICAL STAFFING 471200 AVANT PO BOX 744554 ATLANTA GA 30374 CONTRACT LABOR 406645 CPSITRUBRIDGE 13511 LEW BRIGGS RD HOUSTON TX 77047 BILLING 388687 28 20528 712762 831428 1564718 NET PATIENT REVENUE 621400 36465407 36465407 IDPA PROGRAM 621400 2033143 2033143 340B PHARMACY REVENUE 456110 27795 27795 369545 29131 340414 38895890 19915 19915 63217 0 63217 63217 63217 389800 197145 192655 192655 192655 87265 20528 6343 80922 80922 INCENTIVE PAYMENTS 900099 25273 25273 3421 3421 28694 40846011 38580749 0 700544 X 464556 359953 104603 15863152 13788203 2074949 2282275 1975604 306671 1133876 982395 151481 6514 6514 9521 9521 7924824 5268971 2655853 111439 73867 37572 2306408 1528793 777615 736566 488230 248336 19066 12638 6428 163509 135230 28279 712047 588900 123147 764762 506919 257843 MEDICAL SUPPLIES 5028154 3332890 1695264 BAD DEBT EXPENSE 3347582 3347582 HAF EXPENSE 1731568 1147762 583806 REPAIRS & MAINTENANCE 1112543 737444 375099 1735801 1145260 590541 45454163 35420641 10033522 0 3590533 2227949 188804 211683 8097364 7876906 1817812 1021127 129889 181472 43098846 37315515 6398768 5783331 7070142 4821126 27293312 22123594 5565670 8575753 2475133 1904078 3678304 890762 487804 274752 12206911 11645345 X 8311234 5840818 6775167 4637431 15086401 10478249 27293312 22123594 -4608152 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9521 9521 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES TO PROFESSIONAL HEALTHCARE ASSOCIATIONS IS USED FOR LOBBYING ACTIVITIES. 6725167 1150584 3238320 4637431 6510362 610995 396190 6725167 8321487 -1377033 434092 6510362 7196915 1124572 8321487 7282282 -13122 72245 7196915 0.00800 0.99200 0.00000 1 0 531825 531825 24588580 20849264 3739316 17092177 16466251 625926 886264 886264 5783331 INVESTMENT IN UNCONSOLIDATED AFFILIATE 45000 ASSETS LIMITED AS TO USE - DONOR RESTRICTED 211682 ASSETS LIMITED AS TO USE - BENEFICIAL INTEREST IN PERPETUAL TRUST 4564444 4821126 ASSET RETIREMENT OBLIGATION 274752 274752 PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE ONGOING OPERATIONAL AND CAPITAL NEEDS OF THE ORGANIZATION IN MEETING THE COMMUNITY NEEDS AND SERVICES. WRITE A CHECK CAMPAIGN 80922 80922 IMH GOLF OUTING 26871 20528 6343 6343 107793 20528 87265 6343 6343 80922 1 1 1 X 125.000000000000 1 X 1 1 0 0 215010 215010 0.00510 7586127 3097858 4488269 0.10660 7801137 3097858 4703279 0.11170 7801137 3097858 4703279 0.11170 1 1606389 0 10127171 10325878 -198707 X 1 1 1 1 IROQUOIS MEMORIAL HOSPITAL 200 E FAIRMAN AVENUE WATSEKA IL 60970 HTTPS://IROQUOISMEMORIAL.COM/ X X X X IROQUOIS MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 21 1 0 0 1 X SEE SUPPLEMENTAL INFORMATION X 1 21 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 125.000000000000 300.000000000000 1 1 X X X X 1 X HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE X HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE X HTTPS://IROQUOISMEMORIAL.COM/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X X X X 1 X 0 0 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. 6 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 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. X X 0 1 0 0 0 0 0 0 0 GONZOLO FLORIDO PHYSICIAN 337660 0 0 0 0 0 0 0 9329 0 346989 0 0 0 MHYTHAM BECK PHYSICIAN 330063 0 0 0 0 0 0 0 15427 0 345490 0 0 0 SERGE MARINKOVIC PHYSICIAN 284958 0 0 0 0 0 0 0 19136 0 304094 0 0 0 MICHAEL TILSTRA CEO 228185 0 0 0 0 0 0 0 13231 0 241416 0 0 0 CRISTANTO REYES PHYSICIAN 207909 0 0 0 0 0 0 0 10141 0 218050 0 0 0 CHELSEA WICHTNER NURSE PRACTIONER 163970 0 0 0 0 0 0 0 0 0 163970 0 0 0 PART I, LINE 4B 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 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. IROQUOIS MEMORIAL HOSPITAL FOUNDATION INC 200 E FAIRMAN AVENUE WATSEKA IL 60970 453834535 SUPPORTING ORGANIZATION IL 501(C)(3) LINE 12A, I IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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.