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CARLINVILLE AREA HOSPITAL ASSOCATION: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
CARLINVILLE AREA HOSPITAL ASSOCATION (EIN 37-0645239)
Tax period
2022-08-01 to 2023-07-31
Filed
2024-04-04
IRS object ID
202440959349301414
Schema version
2022v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2024-04-04T14:17:05-05:00ReturnTs
Tax Period End2023-07-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-08-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370645239EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Carlinville Area Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCARLBusinessNameControlTxt
Phone2178543141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1Txt
CityCarlinvilleCityNm
State AbbreviationILStateAbbreviationCd
ZIP62626ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPaul CourtneyPersonNm
Person TitleCFOPersonTitleTxt
Phone2178543141PhoneNum
Signature2024-03-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstPaulPersonFirstNm
Person LastCourtneyPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2024-03-26PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBrian BurnsidePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1Txt
CityCarlinvilleCityNm
State AbbreviationILStateAbbreviationCd
ZIP62626ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$45,768,893GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.cahcare.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1947FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionProvide quality acute and preventative health care benefitsActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee387TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI-$18,450TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,125,265PYContributionsGrantsAmt
CY Contributions Grants$153,490CYContributionsGrantsAmt
PY Program Service Revenue$37,117,090PYProgramServiceRevenueAmt
CY Program Service Revenue$44,953,661CYProgramServiceRevenueAmt
PY Investment Income$169,049PYInvestmentIncomeAmt
CY Investment Income$392,486CYInvestmentIncomeAmt
PY Other Revenue-$90,370PYOtherRevenueAmt
CY Other Revenue-$103,633CYOtherRevenueAmt
PY Total Revenue$39,321,034PYTotalRevenueAmt
CY Total Revenue$45,396,004CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$21,302,283PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,678,529CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,498,325PYOtherExpensesAmt
CY Other Expenses$19,977,187CYOtherExpensesAmt
PY Total Expenses$40,800,608PYTotalExpensesAmt
CY Total Expenses$43,655,716CYTotalExpensesAmt
PY Revenues Less Expenses-$1,479,574PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,740,288CYRevenuesLessExpensesAmt
Total Assets BOY$38,337,789TotalAssetsBOYAmt
Total Assets EOY$39,338,322TotalAssetsEOYAmt
Total Liabilities BOY$17,086,743TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,282,387TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$21,251,046NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,055,935NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTo maintain a professional medical community, a primary care hospital and other health care services, in order to provide quality acute and preventative health care for the benefit of those persons living in the service area.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$34,340,140ExpenseAmt
Revenue$44,953,661RevenueAmt
DescCarlinville Area Hospital Association is a 25-bed acute care hospital located in Carlinville, Illinois. The Hospital provides inpatient, outpatient and emergency care services for residents of central Illinois.During fiscal year 2023, we carried out our exempt purpose in the following ways: 1) Provided quality short term acute care medical services to 395 inpatients, of which 71.9% were eligible for Medicare. Without our services these elderly patients would have had to travel over 20 miles to receive similar services. (Continued on Schedule O) 2) Provided quality short term skilled care to 137 patients in our swing bed unit, with an average length of stay of 10.7 days. 3) Provided 24 hour a day emergency room services. Our emergency room treated 7,037 patients during fiscal year 2023. We treat everyone who presents themselves to our emergency room regardless of their medical condition or ability to pay. We provided 24-hour physician service so people residing in the Carlinville area do not have to travel long distances for emergency medical care. 4) In addition to the inpatient and emergency services we provide, we also had 33,719 visits in our outpatient departments. These services range from preventative care items such as mammograms and lab tests to rehabilitative services such as Physical and Occupational therapy. 5) The hospital also had 9,718 visits to their specialty clinics. These clinics bring specialists from metropolitan areas to Carlinville on a rotating basis. This provides access to specialty services not otherwise offered in the area.6) The hospital also had 17,175 visits in our Rural Health Clinics. These clinics allow for patients to stay closer to home and get in to see a medical provider.The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. The estimated costs of providing these services was $46,000 for the year ended July 31, 2023, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients.Desc
Total Program Service Expenses$34,340,140TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee387EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Paul CourtneyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2178543857PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1Txt
CityCarlinvilleCityNm
State AbbreviationILStateAbbreviationCd
ZIP62626ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Dennis Pickrel
Chair1.000.60Yes (X)Yes (X)$0$0$0
Richard Walden
Vice Chair1.000.60Yes (X)Yes (X)$0$0$0
Ralph March
Secretary1.000.60Yes (X)Yes (X)$0$0$0
Heather DeNeve
Treasurer1.000.60Yes (X)Yes (X)$0$0$0
Tom Denby
Director1.000.00Yes (X)$0$0$0
Katie Goodman-Thomas
Director1.000.30Yes (X)$0$0$0
James Salske
Director1.000.00Yes (X)$0$0$0
Kate Wilkens MD
Director/Medical Staff President41.000.00Yes (X)$278,634$0$11,009
Brian Burnside
CEO40.001.30Yes (X)$0$0$0
Paul Courtney
CFO40.001.30Yes (X)$0$0$0
Thomas Hatley MD
Internal Medicine40.000.00$188,557$0$7,262Yes (X)
Connee Sloman
CRNA40.000.00$314,525$0$35,912Yes (X)
Stacy Smith
Pharmacist40.000.00$163,215$0$4,300Yes (X)
Harald Lausen MD
Internal Medicine40.000.00$485,212$0$19,952Yes (X)
Lourdes Cruz MD
Pediatrician40.000.00$190,425$0$16,111Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,620,568TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$94,546TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K34IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HealthTechS3
PO Box 636426CincinnatiOH425636426Management Services$1,024,929
Macoupin Physician Services
PO Box 677979DallasTX752677979Hospitalist Physicians$1,018,672
Sanburg Emergency Group
PO Box 677979DallasTX752677979Emergency Room Physicians$992,789
CPSI
PO Box 11407BirminghamAL352463448EMR services$557,857
Aramark
26792 Network PlaceChicagoIL60673Laundry Service$468,415
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K22CntrctRcvdGreaterThan100KCnt
Related Organizations$75,000RelatedOrganizationsAmt
Government Grants$36,713GovernmentGrantsAmt
All Other Contributions$41,777AllOtherContributionsAmt
Total Contributions$153,490TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient service revenue621110$44,562,800$44,562,800
Pharmacy revenue456110$90,501$90,501

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$300,360TotalRevenueColumnAmt
Related Or Exempt Func Income$300,360RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$44,953,661TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$341,492TotalRevenueColumnAmt
Exclusion$341,492ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$226,546RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$330,179RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$103,633RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$103,633TotalRevenueColumnAmt
Unrelated Business Revenue-$18,450UnrelatedBusinessRevenueAmt
Exclusion-$85,183ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$92,710SecuritiesAmt
Other$994OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$42,710SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$50,000SecuritiesAmt
Other$994OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,994TotalRevenueColumnAmt
Exclusion$50,994ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,396,004TotalRevenueColumnAmt
Related Or Exempt Func Income$44,953,661RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$18,450UnrelatedBusinessRevenueAmt
Exclusion$307,303ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$228,104TotalAmt
Program Services$228,104ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,544,560TotalAmt
Program Services$15,581,159ProgramServicesAmt
Management And General$2,963,401ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$457,401TotalAmt
Program Services$383,061ProgramServicesAmt
Management And General$74,340ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,079,608TotalAmt
Program Services$2,593,128ProgramServicesAmt
Management And General$486,480ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,368,856TotalAmt
Program Services$1,152,620ProgramServicesAmt
Management And General$216,236ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,131,867TotalAmt
Management And General$1,131,867ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$85,372TotalAmt
Management And General$85,372ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$256,460TotalAmt
Management And General$256,460ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,983,638TotalAmt
Program Services$5,061,793ProgramServicesAmt
Management And General$921,845ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$261,160TotalAmt
Management And General$261,160ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,435,231TotalAmt
Program Services$2,970,363ProgramServicesAmt
Management And General$1,464,868ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$66,074TotalAmt
Management And General$66,074ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$339,839TotalAmt
Program Services$339,839ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$56,510TotalAmt
Program Services$31,994ProgramServicesAmt
Management And General$24,516ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$203,577TotalAmt
Program Services$15,346ProgramServicesAmt
Management And General$188,231ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$541,504TotalAmt
Program Services$425,138ProgramServicesAmt
Management And General$116,366ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,312,464TotalAmt
Program Services$1,796,265ProgramServicesAmt
Management And General$516,199ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$500,681TotalAmt
Program Services$114,802ProgramServicesAmt
Management And General$385,879ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$3,204,236$3,204,236
Food$348,846$348,846
Repairs and maintenance$69,827$56,683$13,144

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$179,901TotalAmt
Program Services$36,763ProgramServicesAmt
Management And General$143,138ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$43,655,716TotalAmt
Program Services$34,340,140ProgramServicesAmt
Management And General$9,315,576ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$11,323,199BOYAmt
EOY$7,118,624EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,872,927BOYAmt
EOY$5,279,575EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$318,966BOYAmt
EOY$341,665EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$315,041BOYAmt
EOY$379,840EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$42,012,548LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$27,749,159LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,370,829BOYAmt
EOY$14,263,389EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,318,278BOYAmt
EOY$11,002,182EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$125,000BOYAmt
EOY$125,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$693,549BOYAmt
EOY$828,047EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,337,789BOYAmt
EOY$39,338,322EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,083,363BOYAmt
EOY$3,056,583EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$568,234BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,058,340BOYAmt
EOY$12,247,273EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$376,806BOYAmt
EOY$978,531EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,086,743BOYAmt
EOY$16,282,387EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,650,597BOYAmt
EOY$22,427,555EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$600,449BOYAmt
EOY$628,380EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,251,046BOYAmt
EOY$23,055,935EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,337,789BOYAmt
EOY$39,338,322EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,740,288ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$36,670NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$27,931OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$645,780OtherCostOrOtherBasisAmt
Book Value$645,780BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,052,437OtherCostOrOtherBasisAmt
Depreciation$25,410,602DepreciationAmt
Book Value$1,641,835BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,790,271OtherCostOrOtherBasisAmt
Depreciation$784,810DepreciationAmt
Book Value$11,005,461BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,524,060OtherCostOrOtherBasisAmt
Depreciation$1,553,747DepreciationAmt
Book Value$970,313BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,263,389TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Employee health claims$258,906
Estimated third-party payor settlements$440,093
Operating lease liability$279,532
FieldValueIRS element (for citing)
Total Liability$978,531TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$45,762,853TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$36,670NetUnrealizedGainsInvstAmt
Revenue Not Reported$36,670RevenueNotReportedAmt
Revenue Subtotal$45,726,183RevenueSubtotalAmt
Other Revenues Not Included-$330,179OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$330,179RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$45,396,004TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$43,985,895TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$330,179OtherExpensesIncludedAmt
Expenses Not Reported$330,179ExpensesNotReportedAmt
Expenses Subtotal$43,655,716ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$43,655,716TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 4b - Other Adjustments:Rental expenses recorded in revenue for Form 990 -330,179.
Part XII, Line 2d - Other Adjustments:Rental expenses recorded in revenue for Form 990 330,179.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other125.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$46,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$46,000NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$46,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$46,000NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,439,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,566,673DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,872,345NetCommunityBenefitExpnsAmt
Total Expense0.13450TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,439,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,566,673DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,872,345NetCommunityBenefitExpnsAmt
Total Expense0.13450TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,485,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,566,673DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,918,345NetCommunityBenefitExpnsAmt
Total Expense0.13560TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$630,614BadDebtExpenseAmt
Bad Debt Expense Attributable$162,068BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,324,249ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,367,306CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$43,057MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Carlinville Area Hospital AssociationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line120733 North Broad StreetAddressLine1Txt
CityCarlinvilleCityNm
State AbbreviationILStateAbbreviationCd
ZIP62626ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.cahcare.comWebsiteAddressTxt
State License0005686StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other2 provider based RHCs and 1 provider based clinicOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Carlinville Area Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Supplemental InformationOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Supplemental InformationStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care125.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.cahcare.com/financial-information/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.cahcare.com/financial-information/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.cahcare.com/financial-information/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Carlinville Area Hospital AssociationPart V, Section B, Line 5: Focus groups were formed for input. Medical professionals and partners and key community leaders were the groups. After the groups met, a prioritization process identified several potential health needs that were chosen for the needs assessment.
Carlinville Area Hospital AssociationPart V, Section B, Line 6a: HSHS St. Francis Hospital, Hillsboro Area Hospital
Carlinville Area Hospital AssociationPart V, Section B, Line 11: Carlinville Area Hospital completed a Community Health Needs Assessment in fiscal year 2022. The following are the needs identified and the accomplishments for fiscal year 2023:1. Access to Mental Health and Behavioral Health Services2. Workforce Development3. Food Insecurity1. The Hospital's Behavioral Health Team offers education and is involved at area Senior Centers.2. The Hospital's Therapy Departments offer job shadowing to students interested in fields of healthcare. Two of the Hospital's Executive Team members serve as mentors of the county-wide CEO (Creating Entrepreneurial Opportunities) classes.3. Provide food to Project Third Day (which provided food for children in need in the community)There were no needs identified that will not be addessed.
Carlinville Area Hospital AssociationPart V, Section B, Line 16j: Financial assistance contact information is provided on each bill. A notice about the availability of charity care is posted in the admitting areas, including the ER. The Hospital also employs a full-time financial counselor to discuss the availability of various government services and charity care with patients.
Carlinville Area Hospital AssociationPart V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures.
Form 990, Schedule H, Part V, Line 7 and Line 10:CHNA and Implementation Strategy:https://www.cahcare.com/community-outreach/community-health-needs-assessment

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part III, Line 2:The amount on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients.
Part III, Line 3:The estimated amount of the Organization's implicit price concessions attributable to patients eligible under the Organization's charity care policy is calculated based on the percentage of individuals living below the poverty level in 2023. 25.7% can reasonably be considered a community benefit as it would have been written off to charity care.
Part III, Line 4:The footnote to the Organization's financial statements can be found on page 13 and 14 of the attached audited financial statements.
Part III, Line 8:Carlinville Area Hospital Association is a critical access hospital with a Medicare shortfall. The shortfall should be considered a community benefit because providing services to Medicare patients is essential to the patients and the community and increases their access to healthcare services.Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.Hospital services reimbursed on a fee schedule are not included in the Medicare calculation per the 990 instructions. Had this been reported the total loss from Medicare services would have been $178,589.Medicare fee schedule revenue $ 259,771Medicare estimated costs of care relating to payments (438,360)Net (Shortage) $ (178,589)
Part III, Line 9b:Carlinville Area Hospital Association will give the charity care applicant at least 120 days from the date of the first bill to apply for financial assistance without any collection efforts. If the applicant has applied for health care coverage under Medicaid, Kidcare, or other government sponsored health care programs, Carlinville Area Hospital will await the approval or denial of the application without additional collection efforts.Carlinville Area Hospital Association will not refer a bill to collection without first offering the patient the opportunity to request a reasonable payment plan for the amount personally owed by the patient.
Part VI, Line 2:The Hospital works with physicians, the health department, nursing homes and other health care providers in the community to determine the health care needs of the community. The Hospital completed a fourth CHNA in FY 2022 and posted to the Hospital's website.
Part VI, Line 3:Financial assistance contact information is provided on each bill. A notice about the availability of charity care is posted in the admitting areas, including the ER. The Hospital also employs a full-time financial counselor to discuss the availability of various government services and charity care with patients.
Part VI, Line 4:Carlinville Area Hospital Association is a 25-bed acute care hospital located in Carlinville, Illinois. The Hospital serves the residents of Macoupin County. Carlinville Area Hospital is the only hospital within a 14-mile radius of Carlinville Illinois, a small rural community in central Illinois. Illinois Route 4 passes through Carlinville. Interstate 55 is also within 12 miles of the city. The community is mostly agricultural.Other hospitals and medical centers near Carlinville are St. Francis Hospital, a Critical Access Hospital in Litchfield, IL, approximately 14 miles away, Community Memorial Hospital, a Critical Access Hospital in Staunton, IL, approximately 20 miles away and Hillsboro Area Hospital, a Critical Access Hospital in Hillsboro, IL, approximately 24 miles away.Carlinville had a population of 5,576 in 2022. Unemployment was 3.8% compared to 4.8% in the state of Illinois in 2022. The median household income in Carlinville is $53,583. The poverty level in Carlinville was 25.7%.
Part VI, Line 5:Carlinville Area Hospital Association's core purpose is "Excellent healthcare close to home." This is very important to our board as all of our members live in our service area and use our facility. The Hospital extends medical staff privileges to all qualified physicians in the community. Carlinville Area Hospital invests in improvements in the community and continues to minimize long-term debt. The Hospital also provides the following services that would not otherwise be available within the Hospital's service area: Twenty-four hour a day emergency room that treats all patients regardless of ability to pay. Specialty Clinic - The Hospital has an arrangement with a physician group out of Springfield, IL that brings specialists to the Carlinville Area that would not otherwise be available.Throughout the year, Carlinville Area Hospital offered CPR training to the community for a special rate of $30 per participant.The Hospital provided free blood pressure checks in Carlinville and Palmyra on a monthly basis.Carlinville Area Hospital's Imaging Department hosted a free community presentation in observance of National Breast Cancer Awareness Month in October. Early detection, benefits of digital mammography, and how the advanced technology aids in early detection were discussed.Carlinville Area Hospital provides a number of services to the community such as the Safe Sitter Class and the very popular High School to Healthcare Program where high school students get to explore healthcare professions. The Hospital also operates a Weekend Walk-In Clinic to provide a need for the community who might need medical care on the weekend, but do not want to go to the Hospital Emergency Room.Carlinville Area Hospital participated in the Illinois Cooperative Work Study Program. The program offered opportunities for college students to gain hands-on experience in their field of study. The Hospital also served as a clinical site for students in Radiology from Southwestern Illinois College and Pharmacy from St. Louis College of Pharmacy.Other community activities:1. RHC Providers did Free Community Presentations 2. Teamed up with the U of I Extension Office to participate in Health Jam 3. Lunch Bunch Summer Food Program4. Project Third Day - Provide food for kids during long weekends5. Parkinson's Support Group - free classes6. Fall and Balance Class for Seniors - free classes7. Teamed up with Blackburn to offer the Rural Immersion Program. Blackburn college students spend theirspring break learning and exploring careers in health care.8. Human Resources hosted a Blackburn college student for an internship.
Part VI, Line 7, Reports Filed With StatesIL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Harald Lausen MD
Internal Medicine$423,812$0$61,400$0$0$0$0$0$20,829$0$506,041$0$0$0
Connee Sloman
CRNA$254,525$0$60,000$0$0$0$11,462$0$25,867$0$351,854$0$0$0
Kate Wilkens MD
Director/Medical Staff President$241,134$0$37,500$0$0$0$11,009$0$204$0$289,847$0$0$0
Lourdes Cruz MD
Pediatrician$190,425$0$0$0$0$0$7,908$0$8,203$0$206,536$0$0$0
Thomas Hatley MD
Internal Medicine$187,157$0$1,400$0$0$0$7,262$0$1,417$0$197,236$0$0$0
Stacy Smith
Pharmacist$163,215$0$0$0$0$0$0$0$4,769$0$167,984$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationCarlinville Area Hospital Association does not pay compensation to the CEO directly. The CEO is compensated by an unrelated management company, HealthTech S3. The Hospital Board of Directors use the processes described in Part I, Question 3 to determine appropriate compensation for the CEO. The Board of Directors also approves the Organization's contract with the Management Company.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1aThe Executive Committee is composed of the elected officers of the Board and includes the Chairman, Vice Chairman, Secretary, and Treasurer of the Association. The Executive Committee has the power and authority to manage and control the business and affairs of the Association as the Board of Directors; however, the Executive Committee is not allowed to exercise those powers prohibited by Illinois law which include: amending the Articles or Bylaws; sell, transfer, or otherwise dispose of substantially all of the Association's assets; or adopt Articles of Merger or Consolidation.
Form 990, Part VI, Section A, line 2James Salske, board member, and Richard Walden, Vice Chair have a business relationship.
Form 990, Part VI, Section A, line 3Management Company Compensation (CY 2022): Brian Burnside, CEO Compensation: $308,038 Paul Courtney, CFO Compensation: $265,980 The officers are common law employees of HealthTech S3, an unrelated management company, and are compensated for services to Carlinville Area Hospital Association. The CEO has the responsibility of supervising the management, administration and operation of the Organization. The CFO has the responsibility for managing the Organization's finances.
Form 990, Part VI, Section A, line 6The Organization's sole member is Middle Macoupin Health Care Systems.
Form 990, Part VI, Section A, line 7aThe Member has the exclusive right and power to designate three of its Directors to serve as members of the Board of Directors, and by resolution has authority to appoint and remove all Directors from the Board.
Form 990, Part VI, Section A, line 7bThe Member has the exclusive right and power to approve or reject the following actions prior to the Board of Directors taking any action: 1. the annual operating budget, capital budget, long-range plan and any action which will result in a substantial change in the expenditures or revenue forecast; 2. the undertaking of or substantive amendments to a contractual obligation in excess of $50,000, or the guaranteeing of any obligation in excess of $50,000; 3. the purchase, lease, transfer, mortgage or sale of any asset or property with a value in excess of $50,000, except with respect to transactions specified and previously approved within the capital budget; 4. any plan of construction or remodeling involving an expenditure in excess of $50,000, except with respect to transactions specified and previously approved within the capital budget; 5. any borrowing; 6. any application for a government grant; 7. any general plan for the solicitation of charitable contributions or the solicitation or acceptance as a gift of any real property or any interest; 8. any proposal to adopt Articles of Dissolution, Merger, or Consolidation; 9. any selection, removal or change in the compensation or other terms of employment of the operating officers; 10. any substantial change in employee fringe benefits or personnel policies; and 11. any other matters as may be required by law to be submitted to the Member or as to which the Member determines, by resolution, that submission is advisable.
Form 990, Part VI, Section B, line 11bThe Form 990 is distributed to the governing body before it is filed. The CEO and CFO review the Form 990.
Form 990, Part VI, Section B, line 12cAny duality of interest or possible conflict of interest on the part of any Board member should be disclosed to the other members of the Board and made a matter of record through an annual procedure and also when the interest becomes a matter of Board action. Any Board member having a duality of interest or possible conflict of interest on any matter should not vote or use his or her personal influence on the matter. The minutes of the meeting must reflect the disclosure, the abstention from voting, and the quorum situation. Any new member of the Board will be advised of this policy upon entering on the duties of office. The governing Board, CEO, and CFO complete and sign the conflict of interest form yearly. The forms are reviewed by the CEO of the Organization and if a potential conflict is identified the CEO follows up.
Form 990, Part VI, Section B, line 15The CEO and CFO are compensated through HealthTechS3, an unrelated management company. They are considered common law employees of the management company. HealthTechS3 gives the Board of Directors a recommended salary range for the CEO and CFO and the Board sets the compensation within this range after review of performance evaluations and comparability data. The process is documented and is completed on an annual basis.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990.
Form 990, Part IX, line 11gPurchased services and contract labor: Program service expenses 1,121,221. Management and general expenses 295,537. Fundraising expenses 0. Total expenses 1,416,758. Professional fees: Program service expenses 3,940,572. Management and general expenses 626,308. Fundraising expenses 0. Total expenses 4,566,880.
Form 990, Part XI, line 9:Change in beneficial interest in perpetual trust 27,931.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Carlinville Area Hospital Foundation
20733 North Broad StreetCarlinvilleIL62626371193348Support Carlinville Area Hospital AssociationIL501(c)(3)Line 7Middle Macoupin Healthcare Systems0
Middle Macoupin Healthcare Systems
20733 North Broad StreetCarlinvilleIL62626371193396Provide support and benefit Carlinville Area Hospital AssociationIL501(c)(3)Line 12c, III-FI0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd