STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HOSPITAL ASSOCIATION (EIN 37-0684691)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-08-09
IRS object ID
202442229349301809
Schema version
2023v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-08-09T16:56:59-05:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370684691EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Memorial Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone2173573131PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 160AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTeresa SmithPersonNm
Person TitleCFOPersonTitleTxt
Phone2173573131PhoneNum
Signature2024-08-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2024-08-09PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAda BairPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 160AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$51,841,297GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.mhtlc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1947FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionMemorial Hospital provides clinical care, diagnostic, treatment, and wellness servicesActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee413TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,381,302PYContributionsGrantsAmt
CY Contributions Grants$2,121,827CYContributionsGrantsAmt
PY Program Service Revenue$43,717,775PYProgramServiceRevenueAmt
CY Program Service Revenue$47,943,394CYProgramServiceRevenueAmt
PY Investment Income$185,879PYInvestmentIncomeAmt
CY Investment Income$419,212CYInvestmentIncomeAmt
PY Other Revenue$60,203PYOtherRevenueAmt
CY Other Revenue-$12,872CYOtherRevenueAmt
PY Total Revenue$46,345,159PYTotalRevenueAmt
CY Total Revenue$50,471,561CYTotalRevenueAmt
PY Grants And Similar Paid$275,600PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$562,333CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,425,306PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$27,180,067CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$214,558CYTotalFundraisingExpenseAmt
PY Other Expenses$19,321,566PYOtherExpensesAmt
CY Other Expenses$20,356,740CYOtherExpensesAmt
PY Total Expenses$44,022,472PYTotalExpensesAmt
CY Total Expenses$48,099,140CYTotalExpensesAmt
PY Revenues Less Expenses$2,322,687PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,372,421CYRevenuesLessExpensesAmt
Total Assets BOY$47,754,183TotalAssetsBOYAmt
Total Assets EOY$50,796,946TotalAssetsEOYAmt
Total Liabilities BOY$22,088,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$22,404,212TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,666,137NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,392,734NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMemorial Hospital is committed to improving health by providing education and wellness programs and innovative services at all the stages of life.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$40,211,983ExpenseAmt
Grant$562,333GrantAmt
Revenue$47,943,394RevenueAmt
DescMemorial Hospital is dedicated to maintaining and improving the health of all people in the Hancock County area. Governed by a Board of Directors, we serve as a vital safety net, serving our communities with access to quality healthcare services. Memorial Hospital provides many types of community benefit care. Community benefit care includes charity care, community health fairs, lectures, and free health screenings, demonstrating our commitment to improving the overall health of the residents of the Hancock County area.In 2023 the Hospital had 2,377 patient days with 532 admissions and 530 discharges. (Continued on Schedule O)There were 6,105 emergency room visits, 1,344 provider-based physician clinic visits, 7,803 independent physician visits and 44,118 rural health physician clinic visits.We are always committed to providing compassionate care to every member of our community regardless of their ability to pay.To fulfill its mission of community service, the Organization provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Revenue from services to these patients and residents is recorded in the accounting system at the established rates, but the Organization does not pursue collection of the amounts. The resulting adjustments are recorded as adjustments to patient and resident service revenue, depending on the timing of the charity determination.The Illinois legislature passed a bill titled the "Hospital Uninsured Patient Discount Act." Effective April 1, 2009, this Act requires hospitals to provide certain mandated discounts from charges to the uninsured in Illinois. Charges are to be discounted at 135% of cost. Furthermore, a hospital may not collect more than 25% of an uninsured family's gross income in any one year.The Organization provides health care services to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Organization does not pursue collection of these amounts, they are not reported as patient and resident service revenue. The estimated cost of providing these services was $393,000 for the year ended December 31, 2023, calculated by multiplying the ratio of cost to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients and residents.In addition, the Organization provides services to other medically indigent patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Organization also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable.Desc
Total Program Service Expenses$40,211,983TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document64IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee413EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kim ByersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2173576571PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 160AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Dan Asbury
President3.001.00Yes (X)Yes (X)$0$0$0
LuAnn Haas
Vice President3.001.00Yes (X)Yes (X)$0$0$0
Dennis Rankin
Secretary/Treasurer3.001.00Yes (X)Yes (X)$0$0$0
Robert Barlow
Director3.001.00Yes (X)$0$0$0
Charles Gilbert
Director3.001.00Yes (X)$0$0$0
Doug Groth DVM
Director3.001.00Yes (X)$0$0$0
Larry McClintock
Director3.001.00Yes (X)$0$0$0
Tanya Mero MD
Director (Until Sept 23)3.001.00Yes (X)$0$0$0
Katie Pearson
Director3.001.00Yes (X)$0$0$0
Angela Pollock
Director (Until Sept 23)3.001.00Yes (X)$0$0$0
Terry Pope
Director3.001.00Yes (X)$0$0$0
Victoria Kalivoda-Popela DO
Director40.001.00Yes (X)$489,905$0$14,731
Debbie Simon
Director3.001.00Yes (X)$0$0$0
Brenda Young
Director3.001.00Yes (X)$0$0$0
Joe Zumwalt
Director (Until Sept 23)3.001.00Yes (X)$0$0$0
Dr Jean Alexandre
Director (as of Sept 23)3.001.00Yes (X)$0$0$0
Noah Dearwester
Director (as of Sept 23)3.001.00Yes (X)$0$0$0
Jami Hocker
Director (as of Sept 23)3.001.00Yes (X)$0$0$0
Ada Bair
CEO40.003.00Yes (X)$281,075$0$18,301
Teresa Smith
CFO40.003.00Yes (X)$198,379$0$28,451
Peter Perll MD
Surgeon40.000.00$554,301$0$41,835Yes (X)
Drake White MD
Surgeon40.000.00$495,066$0$31,671Yes (X)
Christopher Jones MD
OB/GYN40.000.00$410,420$0$27,654Yes (X)
Gina Bell MD
OB/GYN40.000.00$408,029$0$27,654Yes (X)
Nileshwa Senthe MD
Pediatrician40.000.00$378,934$0$34,954Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,216,109TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$225,251TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Nes Illinois Inc
39 Main StTiburonCA94920ER Physician Services$2,363,027
Sullivan Construction
305 W Depot StColchesterIL62326Construction Company$988,258
Quincy Medical Group
1017 Hampshire StQuincyIL62301Temporary Staffing Personnel$718,978
Psychiatric Medical Care LLC
PO Box 734606DallasTX753734606Geriatric Behavioral Health$543,197
Aya Healthcare Inc
5930 Cornerstone CT W Ste 300San DiegoCA92121Temporary Staffing Personnel$504,255
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Government Grants$2,017,119GovernmentGrantsAmt
All Other Contributions$104,708AllOtherContributionsAmt
Total Contributions$2,121,827TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient & resident service revenu621110$46,823,738$46,823,738
Pharmacy revenue900099$622,318$622,318
Equity in Advance Phys Therapy900099-$6,661-$6,661

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$503,999TotalRevenueColumnAmt
Related Or Exempt Func Income$503,999RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$47,943,394TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$335,859TotalRevenueColumnAmt
Exclusion$335,859ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$63,107RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$75,979RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$12,872RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$12,872TotalRevenueColumnAmt
Exclusion-$12,872ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,377,110SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,258,779SecuritiesAmt
Other$34,978OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$118,331SecuritiesAmt
Other-$34,978OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,353TotalRevenueColumnAmt
Exclusion$83,353ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,471,561TotalRevenueColumnAmt
Related Or Exempt Func Income$47,943,394RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$406,340ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$562,333TotalAmt
Program Services$562,333ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,041,247TotalAmt
Program Services$509,010ProgramServicesAmt
Management And General$532,237ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$114,963TotalAmt
Program Services$114,963ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$21,128,042TotalAmt
Program Services$18,290,757ProgramServicesAmt
Management And General$2,666,898ManagementAndGeneralAmt
Fundraising$170,387FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$243,142TotalAmt
Program Services$213,029ProgramServicesAmt
Management And General$30,113ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,223,789TotalAmt
Program Services$2,918,540ProgramServicesAmt
Management And General$305,249ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,428,884TotalAmt
Program Services$1,264,388ProgramServicesAmt
Management And General$164,496ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$113,883TotalAmt
Management And General$113,883ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$76,460TotalAmt
Management And General$76,460ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$9,724TotalAmt
Program Services$9,724ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,479,152TotalAmt
Program Services$6,839,408ProgramServicesAmt
Management And General$1,632,535ManagementAndGeneralAmt
Fundraising$7,209FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$288,175TotalAmt
Program Services$73,524ProgramServicesAmt
Management And General$199,047ManagementAndGeneralAmt
Fundraising$15,604FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,226,330TotalAmt
Program Services$937,520ProgramServicesAmt
Management And General$274,944ManagementAndGeneralAmt
Fundraising$13,866FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$718,780TotalAmt
Program Services$680,265ProgramServicesAmt
Management And General$38,515ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$165,647TotalAmt
Program Services$93,076ProgramServicesAmt
Management And General$68,324ManagementAndGeneralAmt
Fundraising$4,247FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$132,596TotalAmt
Program Services$103,042ProgramServicesAmt
Management And General$26,799ManagementAndGeneralAmt
Fundraising$2,755FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$625,963TotalAmt
Program Services$422,037ProgramServicesAmt
Management And General$203,926ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,385,008TotalAmt
Program Services$1,608,020ProgramServicesAmt
Management And General$776,988ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$488,926TotalAmt
Program Services$279,879ProgramServicesAmt
Management And General$209,047ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$3,930,532$3,930,532
Provider Tax$805,846$805,846
Repairs and maintenance$466,701$465,623$1,078
Dues, Fees, Subscriptio$393,786$78,007$315,779

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$49,231TotalAmt
Program Services$12,460ProgramServicesAmt
Management And General$36,281ManagementAndGeneralAmt
Fundraising$490FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$48,099,140TotalAmt
Program Services$40,211,983ProgramServicesAmt
Management And General$7,672,599ManagementAndGeneralAmt
Fundraising$214,558FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$13,664,237BOYAmt
EOY$14,574,022EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,627,279BOYAmt
EOY$7,196,541EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$12,645BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$593,841BOYAmt
EOY$510,994EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$503,258BOYAmt
EOY$707,430EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$44,834,592LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$27,847,064LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,978,553BOYAmt
EOY$16,987,528EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,960,872BOYAmt
EOY$7,035,079EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$104,183BOYAmt
EOY$66,300EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$166,371BOYAmt
EOY$278,126EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,142,944BOYAmt
EOY$3,440,926EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$47,754,183BOYAmt
EOY$50,796,946EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,134,262BOYAmt
EOY$3,243,305EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$8,980BOYAmt
EOY$17,850EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,091,227BOYAmt
EOY$13,302,963EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,053,577BOYAmt
EOY$3,371,350EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$800,000BOYAmt
EOY$2,468,744EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,088,046BOYAmt
EOY$22,404,212EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,005,904BOYAmt
EOY$27,626,181EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$660,233BOYAmt
EOY$766,553EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,666,137BOYAmt
EOY$28,392,734EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$47,754,183BOYAmt
EOY$50,796,946EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,372,421ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$293,888NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$60,288OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$9,724OtherActivitiesAmt
Total Lobbying Expenditures$9,724TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationMemorial Hospital is a member of the Illinois Health & Hospital Association (IHA) and 37% of their dues are used for lobbying expenses which totaled $9,724 in 2023.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,136,202BeginningYearBalanceAmt
Investment Earnings Or Losses$387,925InvestmentEarningsOrLossesAmt
Other Expenditures$191,674OtherExpendituresAmt
End Year Balance$4,332,453EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,958,105BeginningYearBalanceAmt
Investment Earnings Or Losses-$509,244InvestmentEarningsOrLossesAmt
Other Expenditures$312,659OtherExpendituresAmt
End Year Balance$4,136,202EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,590,361BeginningYearBalanceAmt
Investment Earnings Or Losses$692,053InvestmentEarningsOrLossesAmt
Other Expenditures$324,309OtherExpendituresAmt
End Year Balance$4,958,105EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,257,525BeginningYearBalanceAmt
Investment Earnings Or Losses$291,901InvestmentEarningsOrLossesAmt
Other Expenditures-$40,935OtherExpendituresAmt
End Year Balance$4,590,361EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,951,916BeginningYearBalanceAmt
Investment Earnings Or Losses$592,682InvestmentEarningsOrLossesAmt
Other Expenditures$287,073OtherExpendituresAmt
End Year Balance$4,257,525EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.99460BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00540PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$514,957OtherCostOrOtherBasisAmt
Book Value$514,957BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,620,298OtherCostOrOtherBasisAmt
Depreciation$17,691,983DepreciationAmt
Book Value$11,928,315BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,098OtherCostOrOtherBasisAmt
Depreciation$23,098DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,984,146OtherCostOrOtherBasisAmt
Depreciation$9,219,164DepreciationAmt
Book Value$3,764,982BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,692,093OtherCostOrOtherBasisAmt
Depreciation$912,819DepreciationAmt
Book Value$779,274BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,987,528TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Other Receivables$967,978
Interest in net assets of Memorial Hospital Foundation$691,349
Right-of-use asset - Operating$152,286
Employee retention tax credit$1,629,313
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,440,926TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Estimated Health Claims$650,000
Estimated Third-Party Payor Settlements$1,408,000
Construction Payable$254,260
Notes and advances from affiliates$2,912
Operating lease liabilities$153,572
FieldValueIRS element (for citing)
Total Liability$2,468,744TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$50,279,095TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$293,888NetUnrealizedGainsInvstAmt
Other Revenue-$562,333OtherRevenueAmt
Revenue Not Reported-$268,445RevenueNotReportedAmt
Revenue Subtotal$50,547,540RevenueSubtotalAmt
Other Revenues Not Included-$75,979OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$75,979RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$50,471,561TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$47,612,786TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$75,979OtherExpensesIncludedAmt
Expenses Not Reported$75,979ExpensesNotReportedAmt
Expenses Subtotal$47,536,807ExpensesSubtotalAmt
Other Expenses Not Included$562,333OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$562,333ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$48,099,140TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:An endowment fund with the income to be used for the benefit of Memorial Hospital Association. Permanently restricted funds are required to be retained permanently, either by explicit donor stipulation or by UPMIFA. Board designated funds are to be used for facility and equipment upgrades.
Part X, Line 2:The Hospital believes they have 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 consolidated 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 2d - Other Adjustments:Transfer between affiliates -562,333.
Part XI, Line 4b - Other Adjustments:Rent expenses included in revenue for Form 990 -75,979.
Part XII, Line 2d - Other Adjustments:Rent expenses included in revenue for Form 990 75,979.
Part XII, Line 4b - Other Adjustments:Transfer between affiliates 562,333.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$393,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$393,000NetCommunityBenefitExpnsAmt
Total Expense0.00820TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,729,403TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,623,499DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,105,904NetCommunityBenefitExpnsAmt
Total Expense0.02300TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,122,403TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,623,499DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,498,904NetCommunityBenefitExpnsAmt
Total Expense0.03120TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,771,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,474,273DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,297,494NetCommunityBenefitExpnsAmt
Total Expense0.17250TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,771,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,474,273DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,297,494NetCommunityBenefitExpnsAmt
Total Expense0.17250TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,894,170TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,097,772DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,796,398NetCommunityBenefitExpnsAmt
Total Expense0.20370TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,465,531BadDebtExpenseAmt
Bad Debt Expense Attributable$303,260BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,847,567ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,872,665CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$25,098MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Memorial Hospital AssociationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11454 North County Road 2050AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.mhtlc.orgWebsiteAddressTxt
State License0005611StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other6 Rural Health ClinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Memorial Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part VOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.mhtlc.org/about-us/community-reports/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.mhtlc.org/patients-visitors/financial-assistance/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.mhtlc.org/patients-visitors/financial-assistance/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.mhtlc.org/patients-visitors/financial-assistance/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Memorial Hospital AssociationPart V, Section B, Line 5: Data collection came from multiple sources for analysis. Some of the sources identified were the IPLAN data system, CDC, Behavioral Risk Factor Surveys, local mental health agency, local hospital as well as Comp Data which is an Illinois repository for hospital discharge data and demographics. As the process progressed, data from local law enforcement as well as a Hancock County Economic Development Survey was included in the analysis by this group.
Memorial Hospital AssociationPart V, Section B, Line 6b: Hancock County Health Department
Memorial Hospital AssociationPart V, Section B, Line 11: The Community Health Needs Assessment (CHNA) was completed in 2021 and 3 needs were identified to prioritize and focus on over the next 3 years. Poor Physical Health Maintenance - Goals for poor physical health maintenance1. To improve weight management and quality of life for Hancock County residents through encouragement of regular physical activity.2. To reduce food insecurity and poor nutrition in Hancock County through educational campaigns and increased awareness of current resources.3. To improve the self-management of chronic diseases for Hancock County Residents. 2. Mental Health - Goals for mental health1. To improve general mental wellness through community education on effective stress management and resiliency.2. Increase access to mental health and substance abuse services for adult and child residents of Hancock County.3. Cancer - Goals for cancer1. To reduce the burden of cancer on Hancock County residents through early detection and supportive services.2. To reduce the burden of cancer by creating awareness of cancer risk factors in Hancock County through wellness campaigns and cancer risk education. Current year actions:- Analyzed, goal setting, and approval of survey completed in 2020. Rolled out new goals and action plan.- Goals set in the areas of Cancer screening improvement, better physical health, and mental health (specifically stress management/post COVID)- Performed several health screening events throughout the county. Free A1-C testing, blood pressure checks and skin cancer checks were performed. We also added a lipid analyzer in 2023 for our health screenings.- Worked with our local Mental Health Services and more counselors were added into the school systems to help our children with mental health issues.- Hospital Dietitian visited schools within the county for healthy food options education for our children.- Hospital represented at the local Farmer's Market monthly. Provides information regarding healthy choices.- Social Media posts completed monthly for all areas of the CHNA goals - Hospital wide fund raising for Hancock County Fights Cancer- We have been able to raise our Mammography screening by 5% from our last CHNA. We are also offering Low Dose CT Lung Cancer screenings. - Hospital formed and now participates in a community-based group to improve health to individuals who live in Hancock County. KEY- Keep Encouraging Yourself- to good health. The Key group provided signage for milage for walking trails, hosted swim events at all pools in the county and attended health fairs and hosted 2 glow walks around the county.
Memorial Hospital AssociationPart V, Section B, Line 13h: PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines, but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor.
Memorial Hospital AssociationPart V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures.
Part V, Section B, Line 7a:Website for Hospital's CHNA:https://www.mhtlc.org/about-us/community-reports/
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Advance Physical Therapy
1452 N County Road 2050 ECarthageIL62321Physical therapy rehabilitation
2 - Memorial Medical Clinic Hamilton
1471 Keokuk StreetHamiltonIL62341Physician clinic
3 - Memorial Medical Clinic Locust Street
610 Locust StreetCarthageIL62321Dermatology

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor.
Part I, Line 6a:The community benefit report information is shared in Memorial Hospital's annual report and available on their website www.mhtlc.org.
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. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part I, Line 7g:A physician clinic included as a subsidized service on the 990. Direct and indirect costs were $3,757,244.
Part III, Line 2:The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients.
Part III, Line 3:The estimated amount of the Organization's bad debt expense is calculated based on the percentage of residents with income below the poverty level. In 2023 the percentage was 12.3%.
Part III, Line 4:The footnote to the organization's financial statements that describes implicit price concessions is located in Footnote 1 on pages 15-16 of the attached financial statements.
Part III, Line 8:Memorial Hospital Association is a critical access hospital showing a Medicare shortfall. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare is the gross reimbursement plus settlement. Both 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. These amounts do not include fee schedule amounts. If costs related to amounts reimbursed on a fee schedule were included there would have been a greater Medicare Shortage. Total revenue received from Medicare based on a fee schedule 1,021,311Medicare estimated costs of care relating to payments (445,129)Net Shortage (1,021,311)
Part III, Line 9b:Memorial Hospital does not pursue collection activities for patients that qualify for charity care or patients that have set up payment arrangements for their accounts. Memorial Hospital does not charge interest on patients with payment arrangements. Also, collection activities are not pursued for patients that are in the process of applying for charity care and patients waiting for approval or denial from public aid. Any personal portion due after financial assistance is established would follow normal collection procedures.
Part VI, Line 2:Memorial Hospital, based on its mission, wants to ensure that the health care needs of the community it serves are met. The Hospital has medical clinics located throughout Hancock County to improve access to health care services to our patients. The Board also has four committees; Finance, Planning, Quality and Community Health, and Marketing Committees that have community representation to ensure that input is obtained from the community when considering the health care needs of those we serve. Community input on desired services is obtained through patient satisfaction surveys that are initiated by the inpatient unit, emergency department, and medical clinics that provide a line of communication to identify additional health care services that community desires. The third Community Health Needs Assessment is completed and posted to our website at www.mhtlc.com.
Part VI, Line 3:Memorial Hospital strives to provide a rewarding and healing process to our patients, plus an affordable, comfortable process to meet their financial obligations. Memorial Hospital informs their patients individually upon admission about the eligibility for assistance under federal, state or local government programs, and provides the patient with information regarding the Organization's charity care policy.Our Collection and Financial Assistance Policies and applications are on our website. We also provide financial counseling to any patient. We post our Charity Care Policy and information regarding federal, state, and local programs at all our registration areas. Brochures are distributed regarding financial assistance with all admission packages.Billing statements have financial assistance support telephone numbers at the bottom of each statement. Our third party billing service provides counseling to our patients regarding available financial assistance if there is a need.
Part VI, Line 4:Memorial Hospital Association is an 18-bed critical access hospital located in Carthage, IL. Carthage is a city in Hancock County, Illinois. It is located in western Illinois along the Mississippi River. The nearest city with a population > 50,000 is Peoria, IL. Its primary service area from its most recently completed community health needs assessment is defined as Hancock County, with Colchester, Lomax, Keokuk, Tennessee and Blandinsville as the secondary service area. The 2023 population is approximately 28,947.The 2023 median household income is approximately $61,026, significantly lower than the state of Illinois. The unemployment rate was 3.3% which is lower than the rate for the state of Illinois of 4.7%.The most common industries are manufacturing, agriculture, construction, and health care. The nearest hospital is McDonough District Hospital in Macomb, IL about 28 miles east of Carthage, IL.
Part VI, Line 5:Memorial Hospital is dedicated to improving health by providing education and wellness programs and innovative services at all the stages of life for residents of Hancock County. The Hospital is governed by a 15-member, volunteer Board of Directors that represent key areas within Hancock County as well as the medical staff. As a critical access hospital, Memorial Hospital is an 18-bed facility that provides general medical, surgical services along with obstetrics and an array of outpatient services for the community. Specialty clinics are also provided locally in the areas of behavioral health, cardiology, dermatology, oncology, neurology, ophthalmology, podiatry, orthopedic, pulmonology, urology, ENT, rheumatology, and sleep apnea so that our patients don't have to travel far to receive needed health care services. These specialty physicians are members of the Hospital's medical staff along with other providers that desire to serve members of our service area. The Hospital extends medical staff privileges to all qualified physicians in the community. Memorial Hospital provides up-to-date, diagnostic equipment and services with a capital budget also presented and approved on an annual basis to ensure that needed equipment is obtained to meet the expectations of our patients. Memorial Hospital operates an emergency room available to all regardless of ability to pay.The Hospital also participates in several health care events throughout the year providing free services as well as a listing of services that are offered through the Hospital, clinics, and specialty clinics. This includes, but is not limited to, health fairs, blood pressure screenings, and diabetic education. Memorial Hospital sponsors the bloodmobile and provides language assistance services.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Hancock County Senior and Childcare Services AssociationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 160AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd
FieldValueIRS element (for citing)
Recipient EIN370902248RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$562,333CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantDaycare operationsPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe Board of Directors determines and votes on specific expenditures. The amount given to Hancock County Senior Services, related organization, was to provide funds for their daycare operations and other operating expenses. The daycare is intergenerational as Hancock County Senior and Childcare Services Association has the children interact with the elderly.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Peter Perll MD
Surgeon$537,113$0$16,000$0$1,188$0$0$0$41,895$0$596,196$0$0$0
Drake White MD
Surgeon$493,878$0$0$0$1,188$0$0$0$31,731$0$526,797$0$0$0
Victoria Kalivoda-Popela DO
Director$487,619$0$0$0$2,286$0$0$0$14,791$0$504,696$0$0$0
Christopher Jones MD
OB/GYN$409,646$0$0$0$774$0$0$0$27,714$0$438,134$0$0$0
Gina Bell MD
OB/GYN$406,755$0$500$0$774$0$0$0$27,714$0$435,743$0$0$0
Nileshwa Senthe MD
Pediatrician$377,746$0$0$0$1,188$0$0$0$35,014$0$413,948$0$0$0
Ada Bair
CEO$254,332$0$25,507$0$1,236$0$0$0$18,361$0$299,436$0$0$0
Teresa Smith
CFO$187,605$0$10,000$0$774$0$0$0$28,511$0$226,890$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Western Illinois Economic Development AuthorityBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN352256539BondIssuerEIN
CUSIP958362BL8CUSIPNum
Bond Issued2016-07-21BondIssuedDt
Issue Price$18,659,314IssuePriceAmt
PurposeRefund Revenue Bond Series 2016 issued 9/16/2008PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$5,264,314RetiredAmt
Total Proceeds$18,659,314TotalProceedsAmt
Issuance Costs From Proceeds$344,284IssuanceCostsFromProceedsAmt
Other Spent Proceeds$18,315,030OtherSpentProceedsAmt
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable BondsYes (1)RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDate Rebate Computation PerformedFormAndLineReferenceDesc
ExplanationIssuer Name: Western Illinois Economic Development Authority Date the Rebate Computation was Performed: 07/16/2021ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Shelley Smith
Family member to Teresa Smith, Officer$51,170Employee compensation0
Katlyn Pollock
Family member to Angela Pollock, Director$63,793Employee compensation0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, line 2The Memorial Hospital Association added the Memorial Institute of Health and Healing in April 2023. Along with conventional medicine Memorial Institute of Health and Healing provides holistic care by combining the benefts of functional medicine, integrative medicine, and an opportunity to use food as medicine.
Form 990, Part VI, Section A, line 1aThe Executive Committee consists of the President, Vice President, Secretary-Treasurer, additional members as the Board appoints, the Chief Executive Officer and any other leadership team members deemed appropriate by the officers of the Board. The Chief Executive Officer and any Leadership Team members do not have the right to vote upon any action being taken. The Executive Committee meets only in the event that the Board is unable to take necessary action, has an agenda for each meeting, keeps minutes of its meetings, and mails a copy of the minutes of each meeting to each member of the Board of Directors within twenty-four (24) hours of the adjournment of the meeting. The primary purpose of the Executive Committee is to carry out critical tasks for effective Board functioning, including, but not limited to, Chief Executive Officer Management performance, management company performance, if applicable, and providing assistance to the Board in situations requiring action when it is impossible or impractical to convene a full Board meeting.
Form 990, Part VI, Section B, line 11bThe Form 990 is reviewed by the Finance Committee and then by the Board of Directors before it is filed. The final return is reviewed and signed by the CFO.
Form 990, Part VI, Section B, line 12cOfficers, Board members, and key employees are required to sign a conflict of interest statement upon hiring or becoming a Board member. The disclosure is updated at the annual meeting. Any possible conflict of interest is disclosed to the other Board members and made a matter of record through an annual procedure and also when the interest becomes a matter of Board action. Disclosures are reviewed by the Board of Directors and any Member for whom conflicts have been identified leaves and abstains from voting. Appropriate documentation of the handling of the conflict is kept to protect the interested party and Memorial Hospital Association. Additionally, the Compliance Officer meets with the Compliance Committee of the board. Any issues identified are logged and followed up by the Compliance Officer.
Form 990, Part VI, Section B, line 15aSalary surveys are reviewed annually to ensure all positions individually are within the market rate. The Executive Committee determines the salary for the CEO. Each Board member does an independent performance review of the CEO, which is compiled and used by the Executive Committee. The Executive Committee uses the Illinois Hospital Association salary survey as a guide for compensation using the high, middle, and low ranges for similar size organizations. Measures such as revenue, performance of the CEO, and budgetary constraints are all factors that are considered when reviewing the CEO's salary. The salary for the CFO is determined by the CEO using the CAH Compensation Survey sponsored by Integrated Healthcare Strategies as a guide for similar organizations. The most recent review of salary occurred in 2019.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. The financial statements are also required to be attached to the Form 990.
Form 990, Part IX, line 11gPurchased services: Program service expenses 6,425,558. Management and general expenses 1,423,834. Fundraising expenses 0. Total expenses 7,849,392. Professional fees: Program service expenses 413,850. Management and general expenses 208,701. Fundraising expenses 0. Total expenses 622,551. Other fees: Program service expenses 0. Management and general expenses 0. Fundraising expenses 7,209. Total expenses 7,209.
Form 990, Part XI, line 9:Change in interest in net assets of Memorial Hospital Foundation Other Changes in net assets-990 60,288.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Hancock County Senior and Childcare Services AssociationBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 160AddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd
FieldValueIRS element (for citing)
EIN370902248EIN
Primary ActivitiesCaring for the elderlyPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 10PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Memorial Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
Advance Physical Therapy of Hancock County
620 Wabash StreetCarthageIL62321113655886Physical therapy rehabilitationILMemorial Hospital AssociationRelated-$5,698$14,8710Yes (1)0.50000
Hancock County SLF LLP
403 S AdamsCarthageIL62321204445121Assisted living facilityIL00N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HGV Foundation IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 S Adams StAddressLine1Txt
CityCarthageCityNm
State AbbreviationILStateAbbreviationCd
ZIP62321ZIPCd
FieldValueIRS element (for citing)
EIN450609346EIN
Primary ActivitiesSupporting livingPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Hancock County Senior and Childcare Services Association
P$167,231General Ledger
Hancock County Senior and Childcare Services Association
B$562,333General Ledger