2024-08-14T14:59:12-05:00 2023-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-10-01 204560540 MIDWEST MEDICAL CENTER MIDW 8157771340 ONE MEDICAL CENTER DRIVE GALENA IL 61036 TRACY BAUER CEO 8157771340 2024-07-25 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2024-07-25 2022 2024-08-08 14:25:15Z TRACY BAUER ONE MEDICAL CENTER DRIVE GALENA IL 61036 37943361 0 X WWW.MIDWESTMEDICALCENTER.ORG X 2006 IL TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF THE CITY OF GALENA, ILLINOIS AND THE SURROUNDING AREA REGARDLESS OF A PATIENT'S ABILITY TO PAY. 12 12 279 12 0 0 1625612 333329 33823189 36868269 287440 519166 140721 170341 35876962 37891105 3723 6588 0 0 16935605 18662799 0 0 0 16698373 17637246 33637701 36306633 2239261 1584472 43422935 49632897 37366304 41991794 6056631 7641103 X MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE. 0 0 20995911 6588 30014938 MIDWEST MEDICAL CENTER OWNS AND OPERATES A 25-BED CRITICAL ACCESS HOSPITAL AND LEADS IN THE DELIVERY OF HEALTHCARE SERVICES TO ITS REGION WITH OVER 260 ASSOCIATES, INCLUDING 35 PHYSICIANS AND TWO MID-LEVEL PRACTITIONERS, WHICH COORDINATE PATIENT CARE AS AN INTEGRATED UNIT. THE HOSPITAL AND ITS ASSOCIATES WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE. THE ACCOMPLISHMENTS WHICH FOLLOW ARE ATTRIBUTABLE TO THE HOSPITAL AND ALL OF ITS DEPARTMENTS AS A WHOLE. THE HOSPITAL IS A NON-PROFIT CORPORATION PROVIDING HEALTHCARE AND RESIDENTIAL SERVICES IN GALENA, ILLINOIS, AND NEIGHBORING COMMUNITIES. ALL OF THESE SERVICES ARE OFFERED UNDER THE MISSION OF THE ORGANIZATION, WHICH STATES THAT "MIDWEST MEDICAL CENTER, INCLUDING THE GALENA-STAUSS SENIOR CARE COMMUNITY, WILL PROVIDE TO THE MEMBERS OF THE COMMUNITY CARING, COMPETENT, AND COST EFFECTIVE HEALTHCARE." IN FISCAL YEAR 2023, THE HOSPITAL PROVIDED 786 ACUTE INPATIENT DAYS, 1,588 SWING BED DAYS, 4,758 EMERGENCY ROOM VISITS, 8,795 RADIOLOGY SERVICES, 116,354 LABORATORY TESTS, 46,266 PHYSICAL THERAPY TREATMENTS, AND 678 SURGICAL PROCEDURES AMONG MANY OF THE PATIENT SERVICES PROVIDED DURING THE YEAR.OR SERVICES INCREASED AGAIN IN 2023 WHICH INCREASED PATIENT AND REVENUE GROWTH. IN AUGUST 2022 WE HIRED A FULL TIME PODIATRIST AND IN FISCAL YEAR 2023 HE HAD 1,605 CLINIC VISITS AND 84 SURGERIES. 4926806 0 4338234 MIDWEST MEDICAL CENTER ALSO OPERATES TWO PHYSICIAN CLINICS KNOWN AS MIDWEST HEALTH CLINIC, ONE LOCATED IN GALENA, IL AND ONE LOCATED IN ELIZABETH, IL. THE CARE PROVIDED IN THE MIDWEST HEALTH CLINICS ARE COORDINATED WITH THE CARE OF MIDWEST MEDICAL CENTER'S HOSPITAL IN AN EFFORT TO CONTINUE TO PROVIDE LOW COST AND HIGH QUALITY PATIENT CARE FOR THE RESIDENTS OF GALENA, ILLINOIS, ELIZABETH, IL AND THE SURROUNDING AREAS. THE HEALTH CLINICS OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC TO MIDWEST MEDICAL CENTER'S HOSPITAL AND THE PRACTICE IS MADE UP OF FOUR FAMILY PRACTICE PHYSICIANS, AN INTERNAL MEDICINE PHYSICIAN, AND TWO MID-LEVEL PRACTITIONERS. ADDITIONAL SERVICES ARE ALSO PROVIDED IN THE CLINIC BY OUTREACH DOCTORS THAT PROVIDE SERVICES ON A LIMITED BASIS IN THE AREAS OF ORTHOPEDIC SURGERY, GENERAL SURGERY, PODIATRY, GASTROENTEROLOGY AND OPHTHALMOLOGY. THE CLINIC PROVIDERS ALSO ENGAGE IN MANY ACTIVITIES WHICH PROMOTE THE WELL-BEING OF THE COMMUNITY AND PROVIDE HEALTH EDUCATION TO THE COMMUNITY. AN EXAMPLE OF THESE SERVICES IS DR. WELLS, DR. HARMSTON, DR. MATT GULLONE, DR. RICHARD FARRELL, AND DANIELLE SEEGMILLER PROVIDE EDUCATIONAL EXPERIENCES AND TRAINING TO MEDICAL STUDENTS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS AT MIDWEST HEALTH CLINIC FOR THOSE STUDENTS INTERESTED IN LEARNING ABOUT RURAL MEDICINE. ANOTHER EXAMPLE IS DR. MATT GULLONE, WHO SPECIALIZES IN SPORTS MEDICINE AND PROVIDES FREE CARE TO LOCAL ATHLETES DURING SPORTING EVENTS. THE CLINIC HAS ALSO BEEN VERY ACTIVE IN PROMOTING ANNUAL WELLNESS VISITS TO MEDICARE PATIENTS AND PROVIDING CHRONIC AND WOUND CARE MANAGEMENT. MIDWEST MEDICAL CENTER PARTICIPATES IN THE ILLINOIS RURAL COMMUNITY CARE ORGANIZATION (IRCCO), WHICH IS AN ACCOUNTABLE CARE ORGANIZATION (ACO). IRCCO IS A GROUP OF PHYSICIANS, HOSPITALS, AND CLINICS WHO VOLUNTARILY WORK TOGETHER WITH MEDICARE TO PROVIDE HIGH-QUALITY SERVICES AND COORDINATED CARE TO OUR MEDICARE PATIENTS THROUGH THE MEDICARE SHARED SAVINGS PROGRAM (MSSP). THE IRCCO MISSION IS TO: 1. IMPROVE THE HEALTH OF THE INDIVIDUAL SEEKING CARE AND SERVICES2. IMPROVE THE OVERALL HEALTH OF THE RURAL POPULATION SERVED 4511037 0 2338854 MIDWEST MEDICAL CENTER RECOGNIZES THAT THE AGING AND DISABLED POPULATION OF PATIENTS ARE OFTEN AN UNDERSERVED DEMOGRAPHIC OF THE POPULATION AND TO MEET THE HEALTHCARE NEEDS OF THESE PATIENTS THE HOSPITAL OPERATES THE GALENA-STAUSS SENIOR CARE COMMUNITY. THIS SENIOR CARE CAMPUS PROVIDES SENIOR CARE SERVICES THROUGH ITS 57-BED LONG-TERM CARE FACILITY AND AN ASSISTED LIVING FACILITY. THE SENIOR CARE CAMPUS PROVIDED 15,685 DAYS OF SKILLED NURSING AND INTERMEDIATE NURSING HOME CARE DAYS IN ADDITION TO THE ASSISTED LIVING. THE SENIOR CARE CAMPUS OFFERS SKILLED NURSING TO THE RESIDENTS AND PATIENTS IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY, WOUND CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED. THE SENIOR CARE CAMPUS OPERATES IN CONJUNCTION WITH THE MIDWEST MEDICAL CENTER HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN MIDWEST MEDICAL CENTER'S CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW-COST CARE TO THE COMMUNITY. 30433754 1 1 0 1 0 0 0 0 1 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 55 0 279 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X KELLI JACKSON 8157771340 ONE MEDICAL CENTER DRIVE GALENA IL 61036 DR BARB SLOAN CHAIR 2.00 0.15 X X 0 0 0 CARTER NEWTON VICE CHAIR 2.00 0.15 X X 0 0 0 JOEL HOLLAND TREASURER 2.00 0.15 X X 0 0 0 DONNA FERRY SECRETARY 2.00 0.15 X X 0 0 0 MATTHEW CAROLL BOARD MEMBER 2.00 0.15 X 0 0 0 CHRIS CURRAN BOARD MEMBER 2.00 0.15 X 0 0 0 HELEN KILGORE BOARD MEMBER 2.00 0.15 X 0 0 0 JOHN LORENZEN BOARD MEMBER 2.00 0.15 X 0 0 0 PASTOR MIKE NESBIT BOARD MEMBER 2.00 0.15 X 0 0 0 DOUG RAHDEN BOARD MEMBER 2.00 0.15 X 0 0 0 TIM VINCENT BOARD MEMBER 2.00 0.15 X 0 0 0 LYNN ZEHNDER BOARD MEMBER 2.00 0.15 X 0 0 0 TRACY BAUER CEO 50.00 0.15 X 357893 0 14430 KELLI JACKSON CFO 50.00 X 140599 0 28540 RICHARD FARRELL MD PHYSICIAN 40.00 X 334322 0 28311 GREG HARMSTON MD PHYSICIAN 40.00 X 312534 0 34956 MATTHEW GULLONE MD PHYSICIAN 40.00 X 296297 0 19824 KENNETH SCHIFFMAN MD ORTHOPEDIC SURGEON 40.00 X 448977 0 42030 ELIZABETH GULLONE MD FAMILY PRACTICE PROVIDER/PHYSICIAN 40.00 X 204004 0 22924 2094626 0 191015 19 0 1 0 RIVER VALLEY ARCHITECTS INC 3300 BIRCH STREET STE 1A EAU CLAIRE WI 54703 ARCHITECT SERVICES 798991 MERCY RADIOLOGIES OF DUBUQUE PO BOX 3160 DUBUQUE IA 52004 RADIOLOGISTS 545234 CERNER CORPORATION 2800 ROCK CREEK PKWY NORTH KANSAS CITY MO 64117 EMR SERVICES 493551 CBJ ORTHOPEDICS MD SC 11901 BRAMLETT ORLAND PARK IL 60467 ORTHOPEDIC SURGEON 478861 CT HORIZONS 845 N KINGSBURY ST UNIT 715 CHICAGO IL 60610 ER PHYSICIAN 462828 22 40828 162167 130334 333329 HOSPITAL PATIENT REVENUE 621990 30014938 30014938 SENIOR CARE REVENUE 623000 4338234 4338234 CLINIC REVENUE 621110 2338854 2338854 FITNESS CENTER REVENUE 621990 176243 176243 36868269 524692 524692 18440 27399 -8959 -8959 -8959 5526 -5526 -5526 -5526 9120 40828 19331 -10211 -10211 CAFETERIA REVENUE 722514 189511 189511 189511 37891105 36692026 0 865750 X 6588 6588 548924 548924 14377996 12957349 1420647 413200 371531 41669 2323341 2008363 314978 999338 854577 144761 38751 38751 46950 46950 30090 30090 5997274 4951099 1046175 88478 88478 58643 53341 5302 406962 406962 535685 535685 54341 41989 12352 1270792 1038708 232084 2132995 1743447 389548 444102 444102 SUPPLIES & OTHER 2640837 2356599 284238 MEDICAL SUPPLIES 2590739 2589770 969 BED ASSESSMENT 736861 365260 371601 PROVISION FOR BAD DEBT 498141 498141 65605 61307 4298 36306633 30433754 5872879 0 800 800 3204618 2632521 4819449 5087633 195263 203533 474073 481747 289969 345903 61294692 37656355 19987298 23638337 14426465 17217423 25000 25000 43422935 49632897 2241331 2492481 17614 18671 108715 106568 34748644 39124074 250000 250000 37366304 41991794 X 4457209 5991560 1599422 1649543 6056631 7641103 43422935 49632897 1584472 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30090 30090 0 PART II-B, LINE 1: MIDWEST REGIONAL MEDICAL CENTER PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION (IHA) AND THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE ORGANIZATIONS RECOGNIZE THAT A PORTION OF THE ACTIVITIES CONDUCTED BY BOTH IHA AND ICAHN ARE FUNDED IN CONJUNCTION WITH THE TOTAL ANNUAL DUES PAID. MIDWEST REGIONAL MEDICAL CENTER ESTIMATED THAT $30,090 OR 39% OUT OF THE TOTAL DUES PAID TO IHA AND ICAHN WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT IN ILLINOIS. 0 1 X 347359 12771 360130 341429 5930 347359 335451 5978 341429 331333 4118 335451 325642 5691 331333 0.00000 0.55160 0.44840 0 0 448597 448597 43094328 28279947 14814381 12519541 9376408 3143133 5232226 5232226 23638337 BOARD DESIGNATED INVESTMENTS FOR CAPITAL IMPROVEMENTS 6449595 C DONOR RESTRICTED-MEDICAL SCHOLARSHIPS 1446670 C UNDER BOND INDENTURE AGREEMENTS 9321158 C 17217423 AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 250000 250000 PART IV, LINE 2B: THE ORGANIZATION HOLDS, IN TRUST, SECURITY DEPOSITS FROM THE RESIDENTS OF THE ASSISTED LIVING FACILITY. SECURITY DEPOSITS ARE REFUNDABLE UPON VACANCY. PART V, LINE 4: THE ENDOWMENTS CONSIST OF TWO DONOR-RESTRICTED FUNDS, WHICH WERE ESTABLISHED TO PROVIDE INVESTMENT INCOME FOR MEDICAL EDUCATION SCHOLARSHIPS. GOLF OUTING 49948 40828 9120 1040 2604 7417 5952 2318 49948 40828 9120 1040 2604 7417 5952 2318 19331 -10211 1 1 X 1 X 125.000000000000 1 X 1 1 1 0 1 0 136958 136958 0.00380 6235791 5692948 542843 0.01520 6372749 5692948 679801 0.01900 4669428 4274493 394935 0.01100 3542 3542 0.00010 4672970 4274493 398477 0.01110 11045719 9967441 1078278 0.03010 0 303985 151993 10494338 10615435 -121097 X 1 1 1 1 MIDWEST MEDICAL CENTER ONE MEDICAL CENTER DRIVE GALENA IL 61036 WWW.MIDWESTMEDICALCENTER.ORG 0005488 X X X X PROVIDER BASED RURAL HEALTH CLINIC MIDWEST MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, SECTION C, LINE 7D X 1 21 1 SEE PART V, SECTION C, LINE 7D 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.MIDWESTMEDICALCENTER.ORG/PATIENTS-VISITORS/INSURANCE-PAYMENT X HTTPS://WWW.MIDWESTMEDICALCENTER.ORG/PATIENTS-VISITORS/INSURANCE-PAYMENT X HTTPS://WWW.MIDWESTMEDICALCENTER.ORG/PATIENTS-VISITORS/INSURANCE-PAYMENT X X X X X X X 1 X 0 X X X X X 1 X 0 0 MIDWEST MEDICAL CENTER PART V, SECTION B, LINE 5: MIDWEST MEDICAL CENTER FORMED FOCUS GROUPS REPRESENTING HEALTHCARE PROVIDERS, COMMUNITY LEADERS, COMMUNITY SERVICES PROVIDERS, SCHOOLS, A COMMUNITY COLLEGE, FAITH-BASED ORGANIZATIONS, LOCAL ELECTED OFFICIALS, PUBLIC HEALTH, AND OTHERS. MIDWEST MEDICAL CENTER PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A & 10A:HTTPS://WWW.MIDWESTMEDICALCENTER.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2022 MIDWEST MEDICAL CENTER PART V, SECTION B, LINE 11: THERE WERE MANY TOPICS IDENTIFIED THROUGH THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT BY MIDWEST MEDICAL CENTER. THESE TOPICS WERE PRIORITIZED WITH THE FOCUS GROUPS AND THE FOLLOWING CORE HEALTH RELATED TOPICS WERE DISCUSSED AS BEING THE HIGHEST LEVEL OF CONCERN FOR COMMUNITY MEMBERS AND LEADERS: IMPROVE ACCESS TO MENTAL HEALTHCARE, IMPROVE ACCESS TO PHYSICAL HEALTHCARE, AND IMPROVE ACCESS TO TRANSPORTATION, INCREASE INFORMATION TO COMMUNITY ABOUT HEALTH AND WELLNESS SERVICES, AND INCREASE RESOURCES FOR SENIORS. MIDWEST MEDICAL CENTER REVIEWED THE ACTIVITIES AND DETERMINED THE FOLLOWING TOPICS NEEDED FURTHER REVIEW BY THE ORGANIZATION AND TOOK THE FOLLOWING ACTION STEPS THROUGH ITS IMPLEMENTATION PLAN AS WELL AS ONGOING MISSION AND OPERATIONS OF THE ORGANIZATION. - MMC WILL COMPLETE AND MAINTAIN A WEB-BASED LOCAL RESOURCE GUIDE FOR MENTAL HEALTH SERVICES AND OTHER MEDICAL RESOURCES. - MMC WILL CONSTRUCT A NEW OUTPATIENT WING THAT WILL INCLUDE ROOM FOR EXPANDING BEHAVIORAL HEALTH SERVICES. - MMC WILL EXPLORE AND EVALUATE THE POSSIBILITY OF ADDING INPATIENT MENTAL HEALTH SERVICES. - MMC WILL CONTINUE TO EVALUATE ESTABLISHING A PAIN CLINIC.- MMC WILL CREATE SPACE FOR AN INFUSION CENTER AND EXPLORE AND EVALUATE ADDING ONCOLOGY SERVICES AT THAT LOCATION.- MMC WILL CONTINUE TO EVALUATE THE NEED FOR LOCAL DIALYSIS SERVICES.- MMC WILL EXPLORE EXPANSION OF CARDIAC SERVICES- MMC WILL EXPLORE COLLABORATION WITH SURROUNDING HOSPITALS AND PROVIDERS TO FACILITATE OFFERING IDENTIFIED SERVICES LOCALLY- MMC WILL EXPLORE AND EVALUATE A THIRD-PARTY MARKETING CONSULTANT TO ASSIST WITH IDENTIFYING AND EXECUTING A MORE ROBUST PLAN FOR MARKETING MMC, ITS SERVICES AND ITS PARTNERS- MMC WILL EXPAND ITS DIRECT MARKETING CAMPAIGN- REGARDING EDUCATION, MMC WILL CONTINUE TO EXPLORE PARTNERSHIPS WITH LOCAL GROUPS AND AGENCIES FOR OPPORTUNITIES TO EXPAND EDUCATION ABOUT LOCAL RESOURCES FOR INSURANCE AND ASSISTANCE NAVIGATING MEDICARE AND MEDICAID- REGARDING HEALTH SCREENINGS, MMC WILL CONTINUE TO EXPLORE PARTNERSHIPS WITH LOCAL GROUPS AND AGENCIES FOR WAYS TO EXPAND ACCESS TO HEALTH SCREENINGS, ESPECIALLY FOR SENIORS AND UNDERSERVED AND UNSERVED COMMUNITY MEMBERS- REGARDING HOUSING OPPORTUNITIES FOR SENIORS, ALTHOUGH THESE ISSUES ARE BEYOND THE SCOPE OR CAPABILITY OF MMC TO RESOLVE, MMC WILL SUPPORT ANY ORGANIZED LOCAL GOVERNMENT OR COMMUNITY-BASED EFFORT TO ADDRESS THESE NEEDS TO THE EXTENT IT IS REASONABLE AND APPROPRIATEFISCAL YEAR 2023 ACTIONS TAKEN TO ADDRESS SIGNIFICANT NEEDS:- MMC COMPLETED AND MAINTAINS A WEB-BASED LOCAL RESOURCE GUIDE FOR BEHAVIORAL HEALTH SERVICES AND OTHER MEDICAL RESOURCES.- MMC IS THE IN THE PROCESS OF CONSTRUCTING A NEW OUTPATIENT WING STRICTLY FOR BEHAVIORAL HEALTH. THIS WILL BE COMPLETED APRIL 2025.- MMC HAS NOT EXPLORED OR EVALUATED INPATIENT MENTAL SERVICES AT THIS TIME DUE TO THE EXPANSION FOR ITS OTHER OUTPATIENT SERVICES WHICH IS SET TO BE COMPLETED APRIL 2025.- MMC IS IN THE PROCESS OF RECRUITING AN ANESTHESIOLOGIST WHO WOULD ALSO OPEN A PAIN CLINIC AT MMC.- MMC IS IN THE PROCESS OF CONSTRUCTING AN INFUSION CENTER AS PART OF THE EXPANSION PROJECT. THE GOAL IS TO ADD ONCOLOGY SERVICES STRICTLY FOR INFUSION WHEN THE EXPANSION IS COMPLETE IN APRIL 2025.- MMC IS CONTINUING TO EVALUATE DIALYSIS SERVICES AS WELL AS CARDIAC SERVICES, BUT IS NOT ADDING ANYTHING MORE AT THIS TIME.- MMC IS IN THE PROCESS OF COLLABORATING WITH MEDICAL ASSOCIATES WHERE THEIR SURGEONS WOULD HAVE OR TIME TO PERFORM SURGERIES ON THEIR PATIENTS AT MMC.- MMC HIRED JANELLE KEEFER AS OUR NEW FOUNDATION AND MARKETING DIRECTOR IN JULY 2023. JANELLE IS WORKING ON MANY DIFFERENT MARKETING OPPORTUNITIES PROMOTING MMC.- MMC HAS NOT PROVIDED EDUCATION TO THE PUBLIC REGARDING MEDICARE AND MEDICAID.- THE HEALTH DEPARTMENT HAS INCREASED THEIR CAPACITY FOR HEALTH AND OTHER LAB SCREENINGS, SO MMC HAS LET THEM TAKE OVER THAT ROLE THAT THEY ONCE DID IN THE PAST. MMC CONTINUES TO EDUCATE AND PROMOTE ANNUAL WELLNESS VISIT FOR MEDICARE PATIENTS. - MMC HAS NOT BEEN INVOLVED WITH HOUSING OPPORTUNITIES FOR SENIORS, BUT WILL SUPPORT EFFORTS WHERE THEY ARE DISPLAYED. MIDWEST MEDICAL CENTER PART V, SECTION B, LINE 16J: THE POLICY IS OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARD TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE. MIDWEST MEDICAL CENTER PART V, SECTION B, LINE 20E: PATIENTS ARE GIVEN THE OPPORTUNITY TO APPLY FOR CHARITY CARE PRIOR TO ANY COLLECTION PRACTICES NOTED EARLIER UNDER POLICIES OF MIDWEST MEDICAL CENTER. THE POLICY AND APPLICATION ARE OFFERED IF A PATIENT STATES ANY PROBLEM IN REGARD TO PAYING THEIR BILL. THERE IS ALSO A REFERENCE ON ALL PATIENT STATEMENTS THAT STATES FINANCIAL ASSISTANCE IS AVAILABLE. 2 1 - GALENA-STAUSS SENIOR CARE CAMPUS 215 SUMMIT STREET GALENA IL 61036 SKILLED NURSING FACILITY, ASSISTED LIVING 2 - MIDWEST HEALTH CLINIC - ELIZABETH 117 N MAIN STREET ELIZABETH IL 61028 PHYSICIAN CLINIC PART I, LINE 3C: MIDWEST MEDICAL CENTER PRIMARILY USES FEDERAL POVERTY GUIDELINES TO ESTABLISH CHARITY OR DISCOUNTED CARE TO THOSE IN NEED OF CARE IN THE COMMUNITY, HOWEVER THERE ARE OTHER CONSIDERATIONS GIVEN TO PATIENTS TO AVOID HAVING PATIENTS BE IN FINANCIAL DISTRESS DUE TO CONCERNS OVER THEIR MEDICAL BILLS. BELOW ARE THE GENERAL GUIDELINES AS DEFINED IN MIDWEST MEDICAL CENTER'S CHARITY CARE POLICY WHICH ARE FOLLOWED BY THE ORGANIZATION: PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME AT OR BELOW 125% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD WILL BE ELIGIBLE FOR 100% CHARITY CARE. PATIENT ACCOUNT GUARANTORS WITH AN ADJUSTED GROSS INCOME GREATER THAN 125%, BUT EQUAL TO OR LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES FOR THE NUMBER OF DEPENDENTS IN THE DEBTOR'S HOUSEHOLD, WILL BE ELIGIBLE FOR PARTIAL FINANCIAL ASSISTANCE. PATIENT ACCOUNT GUARANTORS WITH INSUFFICIENT ASSETS TO PAY THE AMOUNT DUE, AND WHO DO NOT QUALIFY FOR CHARITY CARE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES, WILL BE ELIGIBLE FOR A CATASTROPHIC CHARITY ADJUSTMENT WHEN THE TOTAL AMOUNT DUE TO MIDWEST MEDICAL CENTER EQUALS AT LEAST 20% OF THE DEBTOR'S ADJUSTED GROSS INCOME. CATASTROPHIC CHARITY IS AN EIGHTY PERCENT (80%) ADJUSTMENT OFF BILLED CHARGES FOR MEDICALLY NECESSARY SERVICES. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES (EXCLUDING THE PROVISION FOR BAD DEBTS) DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. (THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE HOSPITAL.) PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT MIDWEST MEDICAL CENTER INCLUDES THE OPERATION OF SEVERAL DEPARTMENTS. THE INPATIENT UNIT ALSO PROVIDES CARE TO OVERNIGHT OBSERVATION PATIENTS WHICH ARE KEPT FOR OBSERVATION IN FOLLOW UP CARE FROM THE EMERGENCY ROOM AS WELL AS PROVIDING A SIGNIFICANT NUMBER OF SWING BED SERVICES. IT IS THE GOAL OF MIDWEST MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 498,141. PART II, COMMUNITY BUILDING ACTIVITIES: MIDWEST MEDICAL CENTER PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. MIDWEST MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. PART III, LINE 2: THE ORGANIZATION USES THE COST TO CHARGE RATIO TO ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF PATIENT AND RESIDENT RECEIVABLES, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS OR RESIDENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS OR RESIDENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS AND RESIDENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS HOSPITAL INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES, RADIOLOGY PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT MIDWEST MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2023, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES IN A LOCAL SETTING, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, MIDWEST MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S BUSINESS OFFICE OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. PART VI, LINE 2: MIDWEST MEDICAL CENTER ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH MIDWEST MEDICAL CENTER'S MISSION IN THE COMMUNITY. MIDWEST MEDICAL CENTER ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND ITS PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. DURING FISCAL YEAR 2022, MIDWEST MEDICAL CENTER COMPLETED A FORMALIZED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY AND CONTINUES TO ACTIVELY RECRUIT PROVIDERS TO FULFILL THE PATIENT'S NEEDS. PART VI, LINE 3: UNINSURED AND UNDER-INSURED PATIENTS ARE ASKED TO MEET WITH THE ORGANIZATION'S REGISTRATION REPRESENTATIVE AT THE TIME SERVICE IS PROVIDED AND WHEN THE PATIENT'S BILL IS GENERATED. A REGISTRATION REPRESENTATIVE WILL EXPLAIN THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND PROVIDE THE FINANCIAL ASSISTANCE APPLICATION. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE ILLINOIS PUBLIC AID PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. INFORMATION ABOUT THE AVAILABILITY OF SUCH PROGRAMS IS ALSO AVAILABLE AT MIDWESTMEDICALCENTER.ORG. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR MIDWEST MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 30 TO 60 MILE RADIUS OF THE HOSPITAL. A TOTAL OF 21,588 PEOPLE LIVE IN THE 600 SQUARE MILE SERVICE AREA. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 36 PERSONS PER SQUARE MILE, IS LESS THAN THE NATIONAL AVERAGE POPULATION DENSITY OF 92 PERSONS PER SQUARE MILE. THE SERVICE AREA INCLUDES SEASONAL AND PART-TIME HOUSING RELATED TO RECREATION AND TOURISM IN THE GALENA TERRITORY AND APPLE CANYON LAKE. THE AVERAGE HOUSEHOLD SIZE IN THE AREA, AT 2.2, IS LOWER THAN BOTH ILLINOIS (3.0) AND THE U.S. (2.5) OVERALL AVERAGE. MEDIAN AGE IS 50.3 YEARS, WHICH IS HIGHER THAN ILLINOIS (38.6) AND THE U.S. (38) BENCHMARK. THE LARGEST LEVEL OF EDUCATION IS HIGH SCHOOL GRADUATE, FOLLOWED BY SOME COLLEGE. THE AREA'S UNEMPLOYMENT RATE OF 1.5%. MEDIAN FAMILY HOUSEHOLD INCOME IN THE SERVICE AREA IS $63,113, WHICH IS LOWER THAN THE STATEWIDE AVERAGE ($65,886) AND SLIGHTLY HIGHER THAN THE U.S. ($62,843). WITHIN THE SERVICE AREA, 9.56% OR 2,031 INDIVIDUALS FOR WHOM POVERTY STATUS IS DETERMINED ARE LIVING IN HOUSEHOLDS WITH INCOME BELOW THE FEDERAL POVERTY LEVEL (FPL). PART VI, LINE 5: MIDWEST MEDICAL CENTER IS AN INDEPENDENT COMMUNITY HOSPITAL GOVERNED BY A 12-MEMBER BOARD OF DIRECTORS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. MMC MANAGES A DIABETIC PROGRAM THAT ADDRESSES INDIVIDUALS DIAGNOSED WITH DIABETES. OUR PHARMACIST, DIETICIAN AND CARE COORDINATOR WORK WITH THE PATIENTS TO GET THEIR LEVELS UNDER CONTROL AND ALSO UTILIZE THE 340B PROGRAM TO HELP THOSE PATIENTS THAT CANNOT AFFORD THEIR MEDICATION. 340B IS FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED. MMC ALSO RECENTLY IMPLEMENTED A DIABETIC PREVENTION PROGRAM (DPP) FOR INDIVIDUALS THAT ARE CLOSE TO BEING DIAGNOSED WITH DIABETES, BUT NOT QUITE THERE YET. THIS PROGRAM IS DESIGNED TO IMPLEMENT A LIFESTYLE CHANGE FOR PATIENTS THAT ARE CLOSE TO DEVELOPING DIABETES OR OTHER HEALTH CONDITIONS. FOR A VERY LOW COST, THESE PATIENTS HAVE ACCESS TO A CARE COORDINATOR, FITNESS STAFF AND DIETICIAN FOR A PERIOD OF 6 MONTHS. OUR PHYSICIANS HAVE STARTED DOING FREE OUTREACH DISCUSSIONS AGAIN WITH LOCAL INDEPENDENT LIVING GROUPS AND BUSINESSES ON THE AREA OF PRACTICE THEY COVER. MMC SHARES A COLLABORATIVE SPACE WITH REHABILITATION AND FITNESS AND IF FITNESS MEMBERS HAVE ANY AREAS OF CONCERN, A PHYSICAL THERAPIST WILL DO A FREE QUICK ASSESSMENT OF INJURIES AND OFFER A RECOMMENDATION OF ANY FOLLOW UP THE MEMBER MAY NEED. OUR FITNESS CENTER HOSTS A 5K WALK/RUN EACH FALL THAT BENEFITS THE LOCAL FOOD PANTRY. MMC OFFERS DISCOUNTED LAB SCREENS 3 TIMES PER YEAR THROUGHOUT THE COUNTY AND ALSO DOES FREE BLOOD PRESSURE CHECKS. WE HOST BLOOD DRIVES A FEW TIMES A YEAR TO SUPPORT THE LOCAL BLOOD BANKS. CURRENTLY WE CONDUCT SPORTS PHYSICALS AT TWO AREA SCHOOLS AND ALL PROCEEDS FROM THOSE PHYSICALS ARE DONATED BACK TO THE SCHOOLS. 1 NOTES RECEIVABLE FOR SCHOLARSHIPS FORGIVEN 3 6588 CURRENT NOTE RECEIVABLE BALANCE FORGIVENESS OF NOTES RECEIVABLE IS GOVERNED BY THE HOSPITAL'S MEDICAL EDUCATION SCHOLARSHIP PROGRAM AND FORGIVENESS IS GRANTED IF INDIVIDUALS FULFILL FUTURE SERVICE REQUIREMENTS WITH MIDWEST MEDICAL CENTER IN HEALTH PROFESSIONAL RELATED FIELDS. THE HOSPITAL TRACKS THIS INFORMATION ANNUALLY AND AWARDS THE FORGIVENESS BASED ON THE COMPLETION OF THE REQUIRED CRITERIA OF THE PROGRAM. PART I, LINE 2: MIDWEST MEDICAL CENTER TRACKS THE GRANTS PROVIDED THROUGH THE USE OF NOTES RECEIVABLE AS THE SCHOLARSHIP PROGRAMS ARE INTENDED TO SUPPLEMENT AND BE A FORM OF STUDENT LOANS FOR MEMBERS OF THE COMMUNITY PURSUING ADDITIONAL EDUCATION IN HEALTH RELATED FIELDS. PRIOR TO APPROVING A NOTE TO A PERSPECTIVE STUDENT, AN APPLICATION IS REVIEWED FOR APPROVAL BY THE HOSPITAL'S CONTROLLER TO ENSURE THAT ALL BACKGROUND INFORMATION ON THE CANDIDATE WAS PROVIDED. AFTER REVIEW BY THE CONTROLLER, THIS INFORMATION IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. EACH STUDENT MUST SIGN A PROMISSORY NOTE WITH MIDWEST MEDICAL CENTER THAT THEY COMMIT TO COMPLETE THE EDUCATIONAL PROGRAM AND THAT UPON GRADUATION THEY WILL PERFORM SERVICES FOR MIDWEST MEDICAL CENTER (PENDING AN AVAILABLE POSITION IN THE HOSPITAL AT THE TIME) OR THEY WILL REPAY THE NOTE WITH INTEREST. (THE REPAYMENT TERMS ENSURE THAT THE ENDOWED AND DONATED FUNDS ARE AVAILABLE IN FUTURE YEARS TO OTHER MEMBERS OF THE COMMUNITY OR THAT SERVICES ARE RETURNED TO THE COMMUNITY THROUGH SERVICE TO THE MEDICAL CENTER.) SERVICES PERFORMED AT MIDWEST MEDICAL CENTER RESULT IN FORGIVENESS OF NOTE RECEIVABLE AMOUNTS BASED ON HOURS WORKED. X X X 0 0 0 0 0 0 0 0 0 KENNETH SCHIFFMAN MD ORTHOPEDIC SURGEON 411585 0 1350 0 36042 0 26959 0 15071 0 491007 0 0 0 TRACY BAUER CEO 293371 0 27451 0 37071 0 14430 0 0 0 372323 0 0 0 RICHARD FARRELL MD PHYSICIAN 296890 0 1350 0 36082 0 13762 0 14549 0 362633 0 0 0 GREG HARMSTON MD PHYSICIAN 271069 0 1350 0 40115 0 12675 0 22281 0 347490 0 0 0 MATTHEW GULLONE MD PHYSICIAN 212050 0 49702 0 34545 0 11884 0 7940 0 316121 0 0 0 ELIZABETH GULLONE MD FAMILY PRACTICE PROVIDER/PHYSICIAN 171065 0 2039 0 30900 0 8250 0 14674 0 226928 0 0 0 KELLI JACKSON CFO 116761 0 12451 0 11387 0 6259 0 22281 0 169139 0 0 0 PAMELA SMITH FAMILY MEMBER OF TRACY BAUER, CEO 61697 EMPLOYMENT COMPENSATION 0 JASON FRANK FAMILY MEMBER OF KELLI JACKSON, CFO 61735 EMPLOYMENT COMPENSATION 0 PATRICIA BAUER FAMILY MEMBER OF TRACY BAUER, CEO 30397 EMPLOYMENT COMPENSATION 0 KAMERON KILEY FAMILY MEMBER OF TRACY BAUER, CEO 18339 EMPLOYMENT COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF MIDWEST MEDICAL CENTER IS MIDWEST MEDICAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF MIDWEST MEDICAL FOUNDATION HAVE THE RIGHT TO APPOINT MEMBERS OF THE BOARD OF DIRECTORS OR REMOVAL OF BOARD MEMBERS OF MIDWEST MEDICAL CENTER. THE MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER WILL ALSO BE BOARD MEMBERS OF MIDWEST MEDICAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF MIDWEST MEDICAL CENTER PREVIOUSLY ISSUED TAX-EXEMPT BONDS THROUGH THE ILLINOIS FINANCE AUTHORITY TO FINANCE THE CONSTRUCTION OF A REPLACEMENT HOSPITAL. UNDER THE TERMS OF THE BOND AGREEMENTS, THE ORGANIZATION IS LIMITED AS TO ISSUING NEW DEBT, PURCHASING SIGNIFICANT CAPITAL ASSETS, DISPOSING OF SIGNIFICANT ASSETS, AND/OR SETTING UP NEW CORPORATIONS OR SUBSTANTIALLY RESTRUCTURING THE CURRENT ORGANIZATION WITHOUT FIRST OBTAINING APPROVAL OF THE BOND TRUSTEES. IN TAX YEAR 2018 THE ORGANIZATION DID HAVE A CHANGE IN THEIR PARENT AND PAID OFF THE TAX-EXEMPT BONDS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS RECEIVED A COPY OF THE FINAL 990 FOR REVIEW AND APPROVAL THROUGH POSTING TO AN ELECTRONIC SECURE WEBSITE BY MANAGEMENT OF MIDWEST MEDICAL CENTER PRIOR TO ITS SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C SINCE MIDWEST MEDICAL CENTER IS PART OF A SMALL COMMUNITY, CONFLICTS OF INTEREST ARE GENERALLY KNOWN. THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUAL DISCLOSURE STATEMENTS. THESE ARE KEPT ON FILE AT THE HOSPITAL AND ALL MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING MANAGEMENT WHICH ATTEND MEETINGS, ARE TOLD OF THE CONFLICTS. ANY MEMBERS WITH KNOWN CONFLICTS ABSTAIN FROM VOTING ON THESE CONFLICTS DURING MEETINGS AND ENGAGE IN ONLY LIMITED DISCUSSIONS ON THESE TOPICS. THE BOARD AND MANAGEMENT HOLD EACH OTHER ACCOUNTABLE THROUGH OBSERVATION AND ENFORCEMENT OF THE POLICY DURING MEETINGS AND AT ORGANIZATION FUNCTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS EVALUATIONS FOR THESE INDIVIDUALS, COMPARES DATA TO COMPETITIVE MARKET DATA OBTAINED FROM SALARY SURVEYS, AND CONSULTS WITH OUTSIDE ORGANIZATIONS AS NEEDED IN REVIEWING CONTRACTS. LEGAL AND OUTSIDE VALUATION SERVICES ARE OBTAINED IN ENSURING THE KEY EMPLOYEES, EXECUTIVES, AND PHYSICIANS' SALARIES ARE IN LINE WITH REASONABLE AND PRUDENT BUYER CONCEPTS AS WELL. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G EMERGENCY SERVICES: PROGRAM SERVICE EXPENSES 1,891,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,891,870. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 1,073,926. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,073,926. CLINIC SERVICES: PROGRAM SERVICE EXPENSES 874,442. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 874,442. MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 210,332. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 210,332. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 900,529. MANAGEMENT AND GENERAL EXPENSES 1,046,175. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,946,704. MIDWEST MEDICAL FOUNDATION ONE MEDICAL CENTER DRIVE GALENA IL 61036 204560639 FUNDRAISING IL 501(C)3 LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0