CARLINVILLE AREA HOSPITAL ASSOCATION: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CARLINVILLE AREA HOSPITAL ASSOCATION (EIN 37-0645239)
- Tax period
- 2023-08-01 to 2024-07-31
- Filed
- 2025-04-14
- IRS object ID
- 202541049349300439
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-04-14T14:35:13-05:00 | ReturnTs |
| Tax Period End | 2024-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370645239 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carlinville Area Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CARL | BusinessNameControlTxt |
| Phone | 2178543141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20733 North Broad Street | AddressLine1Txt |
| City | Carlinville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62626 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brian Burnside | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2178543141 | PhoneNum |
| Signature | 2025-04-14 | 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 | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2025-04-14 | 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 | Brian Burnside | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20733 North Broad Street | AddressLine1Txt |
| City | Carlinville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62626 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,242,266 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cahcare.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1947 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Provide quality acute and preventative health care benefits | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 408 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | -$7,277 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $153,490 | PYContributionsGrantsAmt |
| CY Contributions Grants | $35,261 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $44,953,661 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $51,711,436 | CYProgramServiceRevenueAmt |
| PY Investment Income | $392,486 | PYInvestmentIncomeAmt |
| CY Investment Income | $658,715 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$103,633 | PYOtherRevenueAmt |
| CY Other Revenue | -$54,526 | CYOtherRevenueAmt |
| PY Total Revenue | $45,396,004 | PYTotalRevenueAmt |
| CY Total Revenue | $52,350,886 | 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 | $23,678,529 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,448,414 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,977,187 | PYOtherExpensesAmt |
| CY Other Expenses | $22,279,066 | CYOtherExpensesAmt |
| PY Total Expenses | $43,655,716 | PYTotalExpensesAmt |
| CY Total Expenses | $52,727,480 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,740,288 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$376,594 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,338,322 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,073,743 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,282,387 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,984,037 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,055,935 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,089,706 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To 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 Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $41,292,879 | ExpenseAmt |
| Revenue | $51,711,436 | RevenueAmt |
| Desc | Carlinville 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 2024, we carried out our exempt purpose in the following ways: 1) Provided quality short term acute care medical services to 412 inpatients, of which 66.2% 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 161 patients in our swing bed unit, with an average length of stay of 11.1 days. 3) Provided 24 hour a day emergency room services. Our emergency room treated 7,155 patients during fiscal year 2024. 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 37,559 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 10,714 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 21,625 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 $68,000 for the year ended July 31, 2024, 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 | $41,292,879 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 408 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jay Hodges | PersonNm |
| Phone | 2178543857 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20733 North Broad Street | AddressLine1Txt |
| City | Carlinville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62626 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| Harald Lausen MD | ||||||||
| Director/Medical Staff President | 41.00 | 0.00 | Yes (X) | $537,453 | $0 | $23,147 | ||
| Connee Sloman | ||||||||
| CRNA | 40.00 | 0.00 | $326,282 | $0 | $37,733 | Yes (X) | ||
| Kate Wilkens MD | ||||||||
| Internal Medicine | 40.00 | 0.00 | $317,704 | $0 | $13,073 | Yes (X) | ||
| Mary Damery | ||||||||
| CRNA | 40.00 | 0.00 | $255,947 | $0 | $39,864 | Yes (X) | ||
| Ruth Holley ARPN | ||||||||
| Family Medicine | 40.00 | 0.00 | $170,517 | $0 | $19,959 | Yes (X) | ||
| Thomas Hatley MD | ||||||||
| Internal Medicine | 30.00 | 0.00 | $168,671 | $0 | $19,653 | Yes (X) | ||
| Dennis Pickrel | ||||||||
| Chair | 1.00 | 0.60 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Ralph March | ||||||||
| Secretary | 1.00 | 0.60 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Heather DeNeve | ||||||||
| Treasurer | 1.00 | 0.60 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Tom Denby | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Katie Goodman-Thomas | ||||||||
| Director | 1.00 | 0.30 | Yes (X) | $0 | $0 | $0 | ||
| James Salske | ||||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Walden | ||||||||
| Director | 1.00 | 0.60 | Yes (X) | $0 | $0 | $0 | ||
| Brian Burnside | ||||||||
| CEO | 40.00 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Paul Courtney | ||||||||
| CFO | 40.00 | 1.30 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,776,574 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,429 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 63 | 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 |
|---|---|---|---|---|---|
| HealthTech Management Service Inc | |||||
| 5110 Maryland Way Ste 200 | Brentwood | TN | 37027 | Management Services | $1,131,071 |
| Macoupin Physician Services | |||||
| PO Box 677979 | Dallas | TX | 752677979 | Hospitalist Physicians | $1,065,651 |
| Sanburg Emergency Group | |||||
| PO Box 677979 | Dallas | TX | 752677979 | Emergency Room Physicians | $992,789 |
| Consociate | |||||
| PO Box 1068 | Decatur | IL | 62525 | Health Insurance Admin | $487,817 |
| Trubridge | |||||
| Dept 6448 | Birmingham | AL | 352463448 | EMR/Computer Software | $466,042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 29 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,553 | GovernmentGrantsAmt |
| All Other Contributions | $28,708 | AllOtherContributionsAmt |
| Total Contributions | $35,261 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 621110 | $51,202,028 | $51,202,028 |
| Pharmacy Revenue | 456110 | $2,535 | $2,535 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $506,873 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $506,873 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $51,711,436 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $586,736 | TotalRevenueColumnAmt |
| Exclusion | $586,736 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $222,705 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $277,231 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$54,526 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$54,526 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$7,277 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$47,249 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,686,128 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,614,149 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $71,979 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,979 | TotalRevenueColumnAmt |
| Exclusion | $71,979 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,350,886 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $51,711,436 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$7,277 | UnrelatedBusinessRevenueAmt |
| Exclusion | $611,466 | 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 | $546,697 | TotalAmt |
| Program Services | $546,697 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,295,085 | TotalAmt |
| Program Services | $19,278,794 | ProgramServicesAmt |
| Management And General | $4,016,291 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,513 | TotalAmt |
| Program Services | $478,469 | ProgramServicesAmt |
| Management And General | $97,044 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,387,396 | TotalAmt |
| Program Services | $3,643,612 | ProgramServicesAmt |
| Management And General | $743,784 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,643,723 | TotalAmt |
| Program Services | $1,366,554 | ProgramServicesAmt |
| Management And General | $277,169 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,251,402 | TotalAmt |
| Management And General | $1,251,402 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,938 | TotalAmt |
| Management And General | $72,938 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,018 | TotalAmt |
| Management And General | $211,018 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,461,383 | TotalAmt |
| Program Services | $5,474,740 | ProgramServicesAmt |
| Management And General | $986,643 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,367 | TotalAmt |
| Management And General | $279,367 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,821,807 | TotalAmt |
| Program Services | $3,106,132 | ProgramServicesAmt |
| Management And General | $1,715,675 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,472 | TotalAmt |
| Management And General | $134,472 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,725 | TotalAmt |
| Program Services | $321,725 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,475 | TotalAmt |
| Program Services | $41,231 | ProgramServicesAmt |
| Management And General | $57,244 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,386 | TotalAmt |
| Program Services | $82,692 | ProgramServicesAmt |
| Management And General | $176,694 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $554,886 | TotalAmt |
| Program Services | $435,645 | ProgramServicesAmt |
| Management And General | $119,241 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,463,910 | TotalAmt |
| Program Services | $1,915,078 | ProgramServicesAmt |
| Management And General | $548,832 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $786,260 | TotalAmt |
| Program Services | $164,271 | ProgramServicesAmt |
| Management And General | $621,989 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $3,884,316 | $3,884,316 | |
| Food | $397,082 | $397,082 | |
| Repairs and maintenance | $146,924 | $109,624 | $37,300 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,715 | TotalAmt |
| Program Services | $46,217 | ProgramServicesAmt |
| Management And General | $87,498 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,727,480 | TotalAmt |
| Program Services | $41,292,879 | ProgramServicesAmt |
| Management And General | $11,434,601 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,118,624 | BOYAmt |
| EOY | $5,362,077 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,279,575 | BOYAmt |
| EOY | $6,877,869 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,665 | BOYAmt |
| EOY | $332,317 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $379,840 | BOYAmt |
| EOY | $680,715 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $43,013,429 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,260,406 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,263,389 | BOYAmt |
| EOY | $12,753,023 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,002,182 | BOYAmt |
| EOY | $12,612,558 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,000 | BOYAmt |
| EOY | $125,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $828,047 | BOYAmt |
| EOY | $1,330,184 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,338,322 | BOYAmt |
| EOY | $40,073,743 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,056,583 | BOYAmt |
| EOY | $4,609,847 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,247,273 | BOYAmt |
| EOY | $11,382,117 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $978,531 | BOYAmt |
| EOY | $992,073 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,282,387 | BOYAmt |
| EOY | $16,984,037 | 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 | $22,427,555 | BOYAmt |
| EOY | $22,433,117 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $628,380 | BOYAmt |
| EOY | $656,589 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,055,935 | BOYAmt |
| EOY | $23,089,706 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,338,322 | BOYAmt |
| EOY | $40,073,743 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$376,594 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $382,156 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $28,209 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $645,780 | OtherCostOrOtherBasisAmt |
| Book Value | $645,780 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,052,437 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,739,735 | DepreciationAmt |
| Book Value | -$687,298 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,740,151 | OtherCostOrOtherBasisAmt |
| Depreciation | $818,070 | DepreciationAmt |
| Book Value | $11,922,081 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,575,061 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,702,601 | DepreciationAmt |
| Book Value | $872,460 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,753,023 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Employee Health Claims | $366,748 |
| Operating Lease Liability | $264,373 |
| Due from Affiliates | $360,952 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $992,073 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $53,010,273 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $382,156 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $382,156 | RevenueNotReportedAmt |
| Revenue Subtotal | $52,628,117 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$277,231 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$277,231 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $52,350,886 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $53,004,711 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $277,231 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $277,231 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,727,480 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $52,727,480 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 -277,231. |
| Part XII, Line 2d - Other Adjustments: | Rental expenses recorded in revenue for Form 990 277,231. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| 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 | $68,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $68,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $68,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,451,324 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,580,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,871,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14930 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,451,324 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,580,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,871,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,519,324 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,580,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,939,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,592,932 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $409,384 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,915,607 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,959,439 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$43,832 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Carlinville Area Hospital Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20733 North Broad Street | AddressLine1Txt |
| City | Carlinville | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62626 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cahcare.com | WebsiteAddressTxt |
| State License | 0005686 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 4 provider based RHCs and 1 provider based clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Carlinville Area Hospital Association | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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 Part V, Page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 8 | 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 |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | www.cahcare.com/financial-assistance-process | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.cahcare.com/financial-assistance-process | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.cahcare.com/financial-assistance-process | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Carlinville Area Hospital Association | Part 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 Association | Part V, Section B, Line 6a: HSHS St. Francis Hospital, Hillsboro Area Hospital |
| Carlinville Area Hospital Association | Part 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 2024. 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 addressed. |
| Carlinville Area Hospital Association | Part 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 Association | Part 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 11 and 12 of the attached audited financial statements. |
| Part III, Line 8: | Carlinville Area Hospital Association is a critical access hospital with a Medicare shortfall. This is 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 increased by $185,269.Medicare fee schedule revenue $ 301,151Medicare estimated costs of care relating to payments (486,420)Net (Shortage) $ (185,269) |
| 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 States | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Harald Lausen MD | ||||||||||||||
| Director/Medical Staff President | $357,253 | $0 | $180,200 | $0 | $0 | $0 | $0 | $0 | $23,543 | $0 | $560,996 | $0 | $0 | $0 |
| Connee Sloman | ||||||||||||||
| CRNA | $248,782 | $0 | $77,500 | $0 | $0 | $0 | $12,428 | $0 | $25,562 | $0 | $364,272 | $0 | $0 | $0 |
| Kate Wilkens MD | ||||||||||||||
| Internal Medicine | $242,704 | $0 | $75,000 | $0 | $0 | $0 | $13,073 | $0 | $396 | $0 | $331,173 | $0 | $0 | $0 |
| Mary Damery | ||||||||||||||
| CRNA | $203,372 | $0 | $52,575 | $0 | $0 | $0 | $0 | $0 | $40,260 | $0 | $296,207 | $0 | $0 | $0 |
| Ruth Holley ARPN | ||||||||||||||
| Family Medicine | $151,517 | $0 | $19,000 | $0 | $0 | $0 | $7,100 | $0 | $13,255 | $0 | $190,872 | $0 | $0 | $0 |
| Thomas Hatley MD | ||||||||||||||
| Internal Medicine | $168,671 | $0 | $0 | $0 | $0 | $0 | $7,394 | $0 | $12,517 | $0 | $188,582 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Carlinville Area Hospital Association does not pay compensation to the CEO directly. The CEO is compensated by an unrelated management company, HealthTech Management. The Hospital Board of Directors uses 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 (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | A new Mobile Medical Clinic opended in Virden, IL. The clinic provides care on a walk-in basis. On June 27, 2024, Carlinville Area Hospital broke ground on a new permanent clinic in Virden. Virden Family Health Care is scheduled to open to patients on March 31, 2025. |
| Form 990, Part VI, Section A, line 1a | The 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 2 | James Salske, board member, and Richard Walden, Vice Chair have a business relationship. |
| Form 990, Part VI, Section A, line 3 | Management Company Compensation (CY 2023): Brian Burnside, CEO Compensation: $303,865 Paul Courtney, CFO Compensation: $232,498 The officers are common law employees of HealthTech Management Service, Inc., 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 6 | The Organization's sole member is Middle Macoupin Health Care Systems. |
| Form 990, Part VI, Section A, line 7a | The 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 7b | The 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 11b | The 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 12c | Any 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 15 | The 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 19 | The 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 11g | Professional Fees: Program service expenses 4,926,067. Management and general expenses 764,027. Fundraising expenses 0. Total expenses 5,690,094. Purchased services and contract labor: Program service expenses 548,673. Management and general expenses 222,616. Fundraising expenses 0. Total expenses 771,289. |
| Form 990, Part XI, line 9: | Change in beneficial interest in perpetual trust 28,209. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Carlinville Area Hospital Foundation | |||||||||||
| 20733 North Broad Street | Carlinville | IL | 62626 | 371193348 | Support Carlinville Area Hospital Association | IL | 501(c)(3) | Line 7 | Middle Macoupin Healthcare Systems | 0 | |
| Middle Macoupin Healthcare Systems | |||||||||||
| 20733 North Broad Street | Carlinville | IL | 62626 | 371193396 | Provide support and benefit Carlinville Area Hospital Association | IL | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| Carlinville Area Hospital Foundation | |||||||||||
| 200 E Homer Adams Parkway | Alton | IL | 62002 | 376024648 | Support Carlinville Area Hospital Association | IL | 501(c)(3) | Line 12d, III-O | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |